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An Ounce of Prevention is Worth a pound of Cure – Part 2: Stages of Recovery

In my previous blog An Ounce of Prevention is Worth a Pound of Cure – Part 1, I discussed my journey with my injury and how I struggled with leaving the sport I loved.

In Part 2, I am going to discuss the stages I believe we go through when we get injured and the science behind the injury and the healing process.

STAGE 1. DENIAL: I told myself it’s not that bad and even though the health care professionals told me it would take 6-8 weeks, in my mind, it would only take two. They don’t know how strong and skilled I am, I thought.

 

The Science

Acute phase (Inflammatory):

  • Lasts approximately 7-10 days after the initial injury.
  • The tissue is swollen, red, warm and/or all of the above.
  • At this stage, the body needs to heal.
  • Rest, gentle range of motion and/or protection of the injured area is important.

 

When the first two weeks passed and my knee was still very sore and I couldn’t bend it let alone run on it, I started to wonder what went wrong. “I should be healing faster than this; I should be back to at least straight line sprints,” I thought.

STAGE 2. TESTING IT: So I tested it – and before I knew it I was trying to convince myself that the sharp pain with every step is normal and it probably did that before.

STAGE 3. IMPATIENCE: I felt I was losing muscle strength and my skills were fading away while everyone else around me was progressing in their skills. So then I started to wonder what the therapist wasn’t doing to boost my healing process. How will I ever catch up?

STAGE 4. RESEARCH: I started researching all the options including consulting Dr. Google. Maybe they misdiagnosed it? Maybe they aren’t even providing the right treatment? I approached my Physiotherapist with my “research” and the therapist reminded me that it has only been three weeks since my injury.  

(Three weeks can feel like an eternity when you’re 19 and itching to get back at the sport you love.) I started to feel myself get lazy. However, remember in stage two when I tested my knee? Well, this caused more damage. BAM! my first setback placing my recovery back to week one.  

 

The Science

Subacute Phase (Repair and Healing):

  • This phase lasts approximately 1- 6 weeks depending on the tissue that is healing and if there is good blood supply to those tissues.
  • During this phase, you want to promote healing, oxygen and blood flow to the injured tissues. It is important to maintain mobility, strength and endurance through guided progressive exercises with your friendly healthcare practitioner.

Note: Stages1-4 can continue until you realize that everything has a process and that you need to trust that process.  It isn’t until you realize that things take time, that you start to heal.

 

STAGE 5. ACCEPTANCE: It isn’t until this stage that you actually start to make gains by leaps and bounds – maybe because the required healing time has elapsed or maybe it’s because you are mentally ready to recover and go through the process.  Whatever the case may be, you’re finally listening to the advice provided to you and you’re listening to what your body is telling you. You start celebrating and focusing on the little improvements and you build on them. Then over time you look back and think “wow” I’ve come a long way.  

You then realize that you can modify your workouts and your training to fit what you can do and you stop focusing on what you can’t, plus you know that at https://healthyusa.co/shred-fx-review-best-performance-enhancing-formula/ you will always find the best supplements to fulfill your workouts. Having an injury is frustrating and can throw a wrench in your plans — whether it’s leaving the sport you love, changing positions or careers, or how you play with your kids. But the process can never go fast enough.

The Science

Remodeling Phase (Maturation):

  • It lasts two months to one year depending on the tissues involved and the damage.
  • This phase encompasses a long period starting when the subacute phase is complete and continuing into a progressive return to sport/ function/life. In the beginning of this phase, around the 6-8 week mark, scar tissue is still forming and can still be remodelled up to 10 weeks.

 

The Equation for Recovery Time

Those stages are very familiar to me, both as a physiotherapist and as a patient. After having three knee surgeries and countless other injuries, I place a lot of importance on proper and careful recovery.

There really is no equation to determine the length of time it will take someone to recover (although I wish there were). It is a question I am asked all the time and even a question I ask when I’m the one lying on the physio table.

As a physiotherapist, I hope I can help others go through this only once or perhaps, with prevention, never really have to consider any of those stages. It is easy to look back and say, I wish I could have prevented that injury. But it shapes you, makes you stronger and teaches you patience. You learn more about your body and you learn the amazing things you can endure — physically and mentally.

We are humans, not robots, and there are many variables to consider when determining our recovery period. Including nutrition, sleep, stress (physical or emotional), and environment.

Each injury has been a different experience. Sometimes I recover quickly and sometimes it can nag me for years. But like I said in my last blog post, recovery from an injury is a lifelong journey, as is maintaining and improving our health, performance and longevity.

Only when you know the question, will you know what the answer means

42.

The answer to life, the universe, and everything.

I’ve used this joke a lot, but I’m about to be a Dad, so get used to me re-using jokes.  I think that’s part of becoming a Dad.  That, and I can rarely think of a better way to exemplify what I’m trying to say when I come across broad, over-arching answers.

This topic tends to come up with me one of two ways:

  • I’m making fun of something that is being touted as the new answer to everything (or is being advertised that way to do one thing… get you to buy and consume whatever it is).
    • My call for this year is tea.  No one particular tea, but ones with cool names in general, not the “normal” teas we’re used to seeing (like orange pekoe, earl grey or english breakfast), but the exotic sounding ones, like matcha, yerba maté, and other crazy stuff that might not even be tea but is being sold that way because we don’t know how else to conceptualize it otherwise.
  • I’m trying to explain the “Wellness and Lifestyle” model of healthcare.  Which, if we’re watching the slow decline of society into chronic illness, and chronic illness management, we desperately need.

Todays post is the latter of those two options.  Reading through research lately has been fun/tedious, but every once in a while you come across something seriously awesome.  I’m embarrassed I haven’t come across this sooner, to be honest.  but here it is:

Is it possible to have TOO much Nrf2? Stay Tuned... (U.S. Marine Corps photo by Staff Sgt. Steve Cushman/Released)

Is it possible to have TOO much Nrf2? Stay Tuned… (U.S. Marine Corps photo by Staff Sgt. Steve Cushman/Released)

Nrf2, a master regulator of detoxification and also antioxidant, antiinflammatory and other cytoprotective mechanisms, is raised by health promoting factors

This article is simply awesome.  Here is laypersons summary of their abstract:

  • Nrf2 is short for nuclear factor erythroid-2-related factor 2 (yeah… Nerf 2 is a little easier to say/reference)
  • It’s a “transcription factor”, meaning it leads cells to “read” certain parts of our DNA and causes certain physiological cascades afterwards.
    • And this one activates the transcription of over 500 genes!
  • Things that it does:
    • detoxifies the body of molecules that can be toxic when accumulated to unhealthy levels as well as toxic metals
    • Anti-oxidant activities (reduces “bad” oxidation of molecules that can lead to mutations, aging, or unnecessary waste)
    • Produces anti-inflammatory changes (think, Advil, or fish oil)
    • Stimulates the creation of new mitochondria, and improves the function of already existing mitochondria (think, more energy, easier)
    • Stimulates autophagy – a cleaner for your cells, that gets rid of “trash” that can be problematic if not kept under control
  • Things that increase our amount of Nrf2:
    • Phenolic antioxidants, like plants, herbs and (wait for it…) tea
    • gamma and delta-tocopherols, tocotrienols.  Vitamin E – healthy fats, olive oil, avocado, etc.
    • Long chain Omega 3 fats EPA and DHA – from fish, krill, squid, grass-fed meats, etc.
    • Carotenoids like lycopene (in tomatoes and grapes)
    • isothiacynates from cruciferous vegetables (kale, spinach, broccoli, etc.)
    • Sulphur compounds from allium vegetables (garlic, onions, shallots, etc.)
    • Terpenoids (herbs like cinnamon and ginger)
    • Low level oxidative stress (low intensity exercise, like walking)
    • More intense exercise
    • Fasting/Caloric restriction
  • Chronic Inflammatory Diseases that are prevented/treated by increasing Nrf2?
    • cardiovascular diseases
    • kidney diseases
    • lung diseases
    • Diseases of toxic liver damage
    • Cancer [prevention]
    • Diabetes/Metabolic Syndrome/Obesity
    • Sepsis
    • Autoimmune diseases
    • Inflammatory Bowel Disease
    • HIV/AIDS
    • Epilepsy
    • lesser evidence also points to the improvement of 16 other diseases

Sounds pretty impressive eh?  I like part of the conclusion, “Nrf2 is argued to be both lifespan and health span extending.” [emphasis mine]  FINALLY a focus on not just increasing the length of our lives, but also the quality of those years.

Get out for a hike for some low intensity restorative exercise!

Get out for a hike for some low intensity restorative exercise!

The authors also speak to the potential of having TOO much Nrf2 (which is smart to hopefully nip the “if some is good, let’s crank the knob up to 11!” bud), as it can cause a type of acne in certain cases, and more life-threatening risks in very extreme situations (in mice with a gene removed from their body that would regulate Nrf2, so it just continues to accumulate).  So it DOES NOT follow a, “if some is good, more is better” model either.  Very interesting… Almost like all those things that improve it should be employed, but not to excess.

News Flash – Being reasonable is healthy.

So if we want to improve our bodies detoxification pathways (which are a real thing, that your liver and kidneys help with), tidy up our cells, improve our mitochondrial health and generally improve our lives doing the things that help improve this particular transcription factor is not a bad idea.  What are those things?

  • Eat a diet rich in vegetables, fruit (of various colours and textures) and quality meats and fats
  • Use some herbs and spices to make your food a bit more interesting
  • Consider long term side effects of steroids supplementing a modest amount of Omega 3 fats from high quality sources
  • Move your body at a low, steady pace, most of the time.  Then at a hard pace every once in a while.
  • Avoid overeating, and maybe consider fasting or taking on the mindset from Okinawa of “Hara Hachi Bu” – meaning to eat only until you’re 80% full

Stay Healthy Friends!

Dr. Adam Ball

What You Need to Know to Get and Stay Healthy

Hey Folks!

It’s been a LONG time since I’ve posted!  Apologies for that.  So I’ve been thinking about what sets Chiropractic apart from other professions, and why we’re crucial when we DO share so much of our scope and skills with many other professionals (physics, massage therapists, osteos, athletic therapists, etc.) and it ultimately comes down to our philosophy.

But I’ve spoken about that numerous times before like what do proteins do for the body

.  So while I may hint at it throughout the rest of my life (and this post), I’ll attempt to tackle a different topic today.

Today I’d like to speak about how the truth isn’t sexy.  The true, and ultimate answers with regards to health (and fitness, really) isn’t particularly sexy.  I’ve mentioned that there are no shortcuts before, but that truth continues to shine through time after time throughout the years. There is exceptions like if you smoke and switch over to vaping and try out box mods then you can see the difference quickly. A great brand is the trademark of glass blunts by smoke cartel on this market.

Chiro’s are different because we’re the only profession that is based on the idea that there’s nothing wrong with you.  Intrinsically, you likely have the genetic blueprint to live a long, healthy, happy life.  Some folks (a small percentage… though it seems to be growing) have gene-based alterations in their set point, but, luckily for us, the overarching treatment plan is largely the same.  Assuming you’re physiology is good, and providing the necessary ingredients to provide health to your body isn’t nearly as sexy as rushing you into an Operating Room to cut you open and pull out your ruptured appendix, preventing the immediate risk to your life.

Medical doctors do AMAZING things.  They literally SAVE peoples lives and prevent deaths that would be imminent without them.  We should be grateful for it (and in those situations, people typically are).  The problem, is that nowadays lifestyle illnesses are responsible for most deaths.  So while Emergency interventions with Medicine can save your life (in the right situation, unfortunately not everyone lives) in the event of a heart attack or stroke, the cause of those issues didn’t happen suddenly. One thing I highlight here is to take care of your teeth as early as possible, many people don’t have money when things get out of control, check out must read for clean teeth and stay healthy.

I’m totally borrowing this analogy from James Chestnut, but you can think of the Medical Community as the “fire department”.  In this analogy your body is your house.  When your house is on FIRE, you call the fire department.  Given good timing and adequate staffing, the fire department saves your house from burning to the ground, but there is likely damage that will need to be repaired to make it “new” again.  When that time comes, does it make sense to call the fire department to come fix your house up?  Would the fire department become frustrated with your calls to them to help fix your house?  Absolutely.

This is where we are right now.  The medical community is overwhelmed and frustrated with the number of people who are “pre-diabetic”, “at risk” for heart attack and stroke or cancer, but don’t actually HAVE those problems.  Makes sense, right?  You have the tool that helps when that situation arises, but it isn’t quite there yet, and you can tell that by the way the person is headed, that they’ll likely get there over time.  If only there was a way to help turn those people around.

Well there is.  The PROBLEM, is that it isn’t very sexy – so it doesn’t appear like it could be the answer.

And thennnnn…

You want to get fit.  You want to pack on some muscle, but you enjoy being able to go for a run, play volleyball on the beach and you don’t want to put on any fat while you get stronger.  Welcome to the goal of everyone.  Some people get past this issue and reorient their goals.  That’s what leads to elite performances in sport.  Strongmen, Throwers and Powerlifters don’t CARE how fast they can run 800m, unless it makes them better at their sport/tasks at hand, which it doesn’t.  Sprinters don’t care if their shoulders lack range of motion and that gymnastics would help make their shoulders stronger and healthier… because it doesn’t help them sprint faster.  One goal – be the best in the world at ONE thing.  For most of us, this isn’t the goal.  And to be honest, it isn’t particularly healthy – but when the stakes are olympic gold, or high salary contracts, I can understand when it’d be worth it.

To prepare for true fitness, you’ll get a million different opinions.  it is likely impossible to be the best at absolutely everything.  Who knows, maybe that will be proven wrong one day, but until then it seems like it’d be true.  So to improve your level of fitness, you need to lift heavy things, move your body in progressively more complex ways, sprint every so often and otherwise move about with a good amount of frequency.  You need to eat well, too, but we’ll cover that next.  There’s no “This ONE move you AREN’T doing and your trainer WON’T tell you about!”  It doesn’t exist.  There’s hard work at intelligent tasks and that’s it.  Work the short time domain and the long one.  Work the heavy stuff, the fast stuff AND the slow stuff.  Use gymnastics, kettlebells, medicine balls, barbells, rings,  and as many other implements as you can.  Give EVERYTHING you have sometimes.  Other times focus on quality and perfection in movement (though that should be the goal for ALL movement).  Work on moving hard and fast when you’re moving, and resting when you need to.  THAT, creates fitness.  No BS, no secrets.

And thennnn…

You want to know what to eat.  We were told fat was bad, and then that maybe it isn’t.  But what about vegetable oils, omega 3 oils, saturated fat and so on?  We are CONSTANTLY barraged with recommendations for supplements to take.  Whether it’s a commercial, a multi-level addiction marketing agency, we never know what to take seriously and what not to.  There is SO much information and contradictory claims out there with regard to nutrition that it has been the topic of hundreds of books.  And it will continue to be.

BUT, this is where that Chirpractic view of HEALTH comes in.  This is where we develop our BS filter.

Most Chiropractors are of the opinion that we don’t need more people trying to put out fires on their own with a garden hose and store-bought fire extinguisher (still speaking in metaphor here… those are actually good things to have around in the event of a real fire).  We don’t want to be responsible for putting out uncomplicated low back pain fires.  We want to increase your health.

Improve movement, mobility and stability in the spine and extremities, and you get healthier people.  Fine tune peoples nutrition to help them provide their body with what it NEEDS, and you get healthier people.  Teach people about the value of friendship, family values, being grateful, and positive thinking and you get healthier people.  THAT is what chiropractors like myself specialize in.  Your back/neck/shoulder/hip/knee/whatever pain will “magically” go away when you cover all these bases most of the time. Just search and read, the delfogo review. You can get some tips and advice there.

Devote yourself to getting HEALTHY, not just avoiding disease.  Be the healthiest, happiest person you know.

Stay Healthy friends,

Dr. Adam Ball

Addressing Lifestyle & Making you “Healthy”

Hi Folks!

I have experienced a small handful of patients coming to see me who brought up in passing that “oh yeah, I’ve been feeling numbness over here” or, “oh yeah, and I hit my head really hard and have a wicked headache right now”… Both (and others) which were followed up with – “Can you help with that?”

Yes.  I can.

While my main concern is for the function and structure of your spine and its joints, I can address your extremities (feet, ankles, knees, hips, shoulders, elbows, wrists and hands… anywhere you have a joint, really), I can address numbness and I can address headaches.  Pretty much any part of your health – I want to know about.  While I don’t want your symptoms to be your focus, knowing that they were present, and that now they are not is a nice metric of you getting healthier and your body finding its balance.  So please, let me know if there is something new, or something in particular that you’d like me to concentrate on.

I am concerned with improving your experience of how you look, how you feel and how you perform (thanks to Robb Wolf for articulating these concise metrics of health).  When you look, feel and perform well – you’re usually pretty darn healthy.  Healthy Folks don’t have numbness, headaches or debilitating back pain/IBS attacks.  Healthy Folks do eat an impeccable diet, exercise intelligently and regularly lower their stress levels.

You have the time.  You just need to schedule it in and be efficient.  Pencil in “20 minute workout”, or “prepare lunch and dinner for tomorrow” instead of “watch Greys”.  Set an alarm on your blackberry/iphone to remind you to work out, say “I love you” to someone or simply smile and take a deep breath.

Make living healthy a habit.  It isn’t difficult.  Living in a wheel chair is difficult.  Not playing with your children because you’re in too much pain is difficult.  The initial change might be uncomfortable at first, but once you’ve gotten used to making healthy decisions, you’ll notice it gets easier and easier.

If you have any questions, let me know – I am well studied in the areas of nutrition/diet, biomechanics, exercise, and most other areas that have an effect on health.

In health,

Dr. Adam Ball

Your DNA doesn’t care about who you are…

As a wellness and prevention practitioner, I face the occasional challenge in regards to patient compliance to a genetically congruent lifestyle far more frequently than I face those patients who have been provided with bad information.  My experiences with patients have taught me something that I’ve heard before, but which really resonated with me today.

Your DNA does not care one bit about WHO you are, how important you may be, or how much money you make.  Not even a little.  THAT is powerful information, and it can be an important reminder to be meticulous with how you spend your time, and what you allow to enter your body (in terms of food, thoughts and movement).

100 times out of 100 your DNA and its’ genes will respond to the stimulus they are provided.  You will only express genes and their corresponding proteins in response to the environmental demand you place on them.  This can mean the expression of vibrant health, or the expression of unfavourable physiological states (often referred to as pathology).

So, this is where the truth comes in, and in some cases where it can sting a little.  If you’re working your butt off, putting in 80 hour weeks, forgetting meals (which doesn’t necessarily have to be a bad thing, depending on what foods you’re eating), neglecting friends and family (your positive social relationships with actual people), and reducing the amount of time you spend sleeping (or avoid it all together) – And all this makes you a billion dollars… well, I hope you have children to pass the money on to, because you aren’t going to be around long enough to enjoy it.

If you don’t make your health a priority now – you will have to at some point (if you’re lucky enough to live).  I know what this is like.  I had 40+ hours a week of classes, supplemented with 40+ hours a week of studying – all leading to something that was going to be my future career, i.e. if I didn’t pass those classes, then I just invested a tonne of cash in an education I wouldn’t be able to use.  That’s a fair amount of pressure and it’s a fair amount of stress – and my body responded with crappy sleep, lots of food cravings and a less than desirable body composition.  When I started out in my first year I would avoid going to the gym, going out with friends and a lot of other stuff I loved doing because I felt like I needed that time to study.  What I found out later on (when I knew I could get good grades without killing myself with the books for hours), was that when I spent that time in the gym or with my friends, that I was more focused when it came to study and I was far more efficient with my time.  My grades improved with less studying.  I retained the knowledge better.  I was healthier and in better shape.  And I grew my relationships with my friends.

What’s the moral of the story?  Your DNA wants you to succeed.  When you provide it what it needs, you will do better in every aspect of your life.  How concentrated are you at work during those 80 hours if you have back pain, blood sugar swings and some mild depression?  Does it make sense to you that you might feel better and concentrate more knowing you are experiencing the best health of your life?

It does to me.  And I’ll spend the rest of my life trying to help it make sense to you too.

 

Cheers Folks!

Dr. Adam Ball

Sudbury… ROCKS!!!

Hey Folks!

So I probably should have written a blog post about a month ago, but life got busy.  Sorry.

For those of you that don’t know, I (Dr. Ball) moved up to Sudbury to take over an awesome chiropractic practice and to bring the message of wellness to the masses up in Northern Ontario.  For those of you that may be new to my site, Wellness is the ability of your body to express and maintain ever increasing levels of health – you just need to provide the right input stimulus.  But what is the right stimulus?

The right stimulus means having access to an appropriate range of motion (having your spine checked out by a good quality Chiropractor, Physio, Massage therapist and whoever else you feel you should consult with), moving your body in intelligent ways (intelligently programmed CrossFit, MovNat, and the occasional other well programmed Strength and Conditioning facility).  Why does this matter?  Because movement charges your brains battery.  I like this great example I heard from Dr. James Chestnut; If you spend your day sitting around eating food and watching TV – are you energized?  Or are you tired?  Conversely, if you get up off the couch and go for a walk outside or do a little exercise, expending energy, do you feel more tired?  Or do you feel energized?  How does that make sense?  It makes sense because the movement of your body activates nerves, moves blood and as many great Chiropractors like to say, “turns the lights on”.  Movement isn’t the whole story though…

Another very important ingredient to the environment you provide your body is your diet.  You need to provide your body with highly nutritious foods (meats, vegetables, fruits, and good quality fats), and avoid those foods that are setting you back.  I’m sorry to say it, but there are foods that are less good for you, and foods that are more good for you, it’s as simple as that.  And unfortunately the USDA and most nutrition and diet “experts” don’t know this yet either, which makes me sad AND makes for conflicting nutrition advice that makes a reader like yourself want to say, “oh shut up, none of you know what you’re talking about – everything in moderation”.  I’ll resort to another great quote to counter the “moderation” dogma, “everything in moderation works so long as you only want a moderate level of health”.  And finally, the MOST important input to your success as a student of health (which we all are)…

Your mental health is the most important part of your internal environment.  De-stressing or finding practices that help you relieve your stress levels (breathing techniques, yoga, tai chi, etc.) are great ways to manage your internal environment.  If you don’t believe in yourself, it will help if someone else does, but ultimately YOU will decide your outcome.  Finding happiness and contentment is a daily practice and everyone has good days and bad.  Setting goals, spending time doing things you love, moving your body and eating well (those sound familiar) will all support a positive internal environment.

So for those of you that don’t know me – that’s what I’m about.  For those of you that do, it’s a nice reminder.  Set goals, set the micro-goals that lead to those goals.  How important are those goals to you?  If they’re important they’ll dictate how strictly you adhere to the guidelines that you know will lead to the achievement of your goal.  Slow progress is sometimes “easier” than quick progress.  Set the path and follow it closely.

Cheers Folks!  And to my Element and CFM friends, Miss you guys!

Dr. Adam Ball

The Shoulder Position – It won’t just strain your rotator cuff

So I had planned on stopping the “shoulders saga” after the previous two posts but then thought about this on the way to work today – there are a lot of ways to work on the shoulders that essentially do nothing for you, therapeutically.  I confess, in my past I have worked on shoulders for my benefit versus the benefit of my patient – but I was just a young buck, and didn’t know any better!  Dear therapists, repeat after me, “I will not punish my patients with painful soft tissue work for my own pleasure”.  Now then, what the hell am I talking about?

As you’ve read about before, the shoulder is an intricate and interesting structure with some pretty amazing functions that, when faced with a poor position to work from, will present with some problems.  I trust you’ve been doing some pre-hab, to correct your poor positioning and prevent future problems.

No doubt, at some point in your shoulder pain/discomfort/tightness past you’ve asked someone to give you a massage/shoulder rub/thumb-destroying good time.  No doubt, it hurt quite a bit, and if you were the victim of experienced hands, you may have had to use your safety word (which may or may not have been “popcorn”).  There is a decent chance you walked away and felt “better”, at least for a little bit.  Was it “better” in comparison to the excruciating pain you were just recently feeling?  Or did your shoulder pain go away only to come back in a day or two?  If you “felt a bit better” for a day or two, that’s good news, but the treatment was ultimately no different than popping a couple advil.

“Heresy!  Those patients’ muscles were sore and I stripped the hell out of their muscles and then they weren’t sore anymore!  What happened to “treating the cause???” – I fixed the problem!”

Did you?  Invariably, the rhomboids, levator scapulae, traps, rotator cuff muscles and maybe even the lats are going to be tender on a patient with an active shoulder complaint.  Taking this a step further, using trigger point therapy (or really just ischemic compression as there probably isn’t any true pain referral happening here), ART, stripping massage, or any of the other dozens of different soft tissue techniques on sore muscles is going to result in, “yeah that really hurts, but it hurts in a good way, you can press harder if you need to”.  Which means the patient believes the therapist is doing the right thing, and so does the therapist.  But WHY are the muscles tender and WHY did they develop this shoulder problem?  (The answer to this second question is not, “because they bailed awkwardly on a ring dip”)

Poor positioning and movement patterns.  This probably just sounds repetitive at this point but unless you work to correct your shoulder positioning, you are going to continue having problems.  Spend some time stretching out your “business” as Kelly Starrett would say.  Instead of being “bad” at certain movements, make sure you aren’t trying to execute those movements from a weak position and take the steps to improve your position.

Now, before I get attacked for “putting down” soft tissue work, which I’m not doing, let’s go back to how you should be approaching the solution to this problem.  You start with some poor scapulae positioning and then you do overhead work, pullups, oly lifting, etc. and experience some pain and your “bad shoulder” starts “acting up”.  By all means, see a therapist if you want to experience some serious pain, and naturally improve your pain status (after treatment) with regards to this acute situation.  Now that you’re past that, move forward and prevent future problems – ask your therapist what steps you should take (where to stretch, where to strengthen) to prevent future painful episodes.  Many times the tender muscles in an acute episode are not the muscles you should be working on to correct shoulder positioning.  For examples, the rhomboids are going to be sore in this acute situation, but they are more than likely weak and stretched away from their optimal position.  Pressing on them does nothing to improve shoulder positioning and may even make the situation worse.  Working on pec minor in an acute situation, isn’t going to do a whole lot to help with the patients pain, but would be the right step to take in improving shoulder positioning.

Now then, since you’re now seeing an awesome athletic therapist, massage therapist, physiotherapist or chiropractor that knows they’ve addressed your true problem and sent you on the path to wellness – Promise referrals, your first born, whatever, but make sure you thank your therapist for caring about you having some solid shoulders versus you coming back next time you do a work out with ring dips in it.

What’s that saying?  An ounce of prevention…?

Cheers Folks!

 

Dr. Adam Ball

The Shoulder Position or 10 minutes to a new you!

Hey Folks!

So it has taken me a little longer to get to this than I had planned, but here it is; What to do in the case of some poor shoulder positioning.  This is going to help you improve your function, meaning better pendlay rows, better overhead squats and better just about everything involving your arms, as I mentioned earlier.  It’s going to make your posture better, which is going to make you sexier and may even improve your confidence.  The world looks better when you’re standing upright with good posture.  For serious.

As a disclaimer:  I am only really speaking about the typical abducted and rolled forward shoulders that we see in the dreaded D-bag/Bridal shoulder position.  This is also known as “upper cross syndrome” but that makes it sound like you’re stuck with it.  We’re going to unstick you.  Keep in mind, there are plenty of other poor shoulder positions, but most of them just aren’t as common, especially among Crossfitters.  Now then… Let’s get started!

So first things first, have someone look at you (ideally shirtless, or with some tight clothes on) from behind and assess where your scapulae are hanging out while you stand comfortably.  If they look like the ones in this photo… then YOU are a victim of the D-bag/Bridal shoulder.  Oh the horror.  Here is what you need to do.

 

Notice the position of the “shoulder blades”

Do the following every time you’re in the gym (and if you aren’t in the gym regularly, you need to be doing this at LEAST 3x a week, and ideally 5x a week if you care about making progress):

Step 1 – roll your pecs out with a lacrosse ball (about a minute per side) – you can do this by leaning into a wall with the lacrosse ball placed just below your clavicle

Find some sore spots in your pecs with the Lacrosse ball

Step 2 – Stretch out your upper traps and suboccipitals for a minute per side – Sit on your hand and tilt your head away from the side of the hand your sitting on, search around by keeping your head tilted and looking down at your left shoulder, or trying to touch your ear to your shoulder (without cheating and shrugging your shoulder up to your ear).

Step 3 – Use either the two lacrosse balls taped together, or if you’re feeling ambitious, the foam roller – place them at the apex of your mid back (thoracic spine) curve (this is usually between the shoulder blades and with the Lacrosse balls, they’ll be straddling your spine) between you and the ground.  Place your hands on an empty barbell above your head in what would be your snatch or overhead squat position.  You can reposition the foam roller/lacrosse balls higher or lower depending on how you feel.  Spend a minute or two (depending on what you can tolerate) in this position.

Awesome.  So the goal of these stretches is to break up some adhesions and help create some “slack” in your pecs, and traps/suboccipitals.  This will also help open you up by adding thoracic extension and a stretch for your pecs.  The next step is going to involve strengthening the elements of these movements that are stretched and weakened.  Please remember… This is not Crossfit. This isn’t trying to move a large load a long distance quickly.  This is trying to hold a mild to moderate load still for a long time – so I guess it’s kind of the opposite?

Why would I want you to train these muscles differently than your glutes?  The main function of these muscles is to stabilize the scapulae, not to forcefully retract them – so we want to improve your muscular endurance, not your contractile power.  Once you’ve achieved better positioning, it WILL make developing more contractile power easier though.

You are going to ADD these exercises to your pec and trap stretches and you are essentially going to be doing them indefinitely.  Or at least until you have achieved better shoulder positioning, and the overhead squat is your new favourite lift.

Step 1 – Lie on a bench/chiro table/bed on your stomach with your head hanging off the edge.  Lift your head up as high as possible while also keeping your face parallel to the rest of your body.  You are still looking at the floor – NOT at the wall in front of you.  Hold this for 30 seconds to a minute and then relax.  Repeat once or twice more, depending on your tolerance.

Step 2 – If you’re really ambitious, you can combine this with step 1.  While you’re lying there on your stomach, point your thumbs towards the floor with your arms out at your sides and lift them up off the bed/table/bench.  You should feel the contraction between your shoulder blades.  Hold this for 30 seconds to a minute and then relax.  Repeat once or twice more, depending on your tolerance.

Chin tucked, head back, scapulae squeezed together. Hold.

Dig it!  There is all sorts of cool stuff you can do in addition to these stretches/exercises, but for now I would stick to this program.  It’s simple, it’s relatively easy and it only takes about 10 minutes.  You can spare 10 minutes to save your shoulders.  Future you will appreciate it.  Future you will also be crushing bodyweight snatches and smiling while she does it.

Cheers Folks!

 

Dr. Adam Ball

The Shoulder Position and Why Your Traps Aren’t Actually That Huge

Hey Folks!

We’re back with an exciting blog post about some proper shoulder positioning – where your shoulder should be, what that helps you to accomplish functionally, and the effects its’ position has on your appearance.  This information will change your life… or maybe just your press, and snatch, and overhead squat, and bench/push ups, and just about everything else that involves your arms… oh, and also the way people look at you (in a good way).

 

Anatomical position AKA where god/evolution/whoever/whatever decided your shoulders SHOULD be.

Due to our forward and front facing world, many of us succumb to what PT all-star Kelly Starrett would call the “D-bag” shoulder position, also known as “bridal” shoulder.  This is bad news for form and function because of the numerous movements and muscles involved with the scapula (what you would call your “shoulder blade”).  The scapula is a weird looking bone that allows our shoulders to have an impressive range of motion.  So what’s the deal with anatomical position, and why should you strive for better shoulder position?  If your scapulae are abducted and protracted (rolled forwards), some muscles in the area are chronically shortened while others are chronically stretched/lengthened.  Imagine having to walk with one flat on and one stiletto on – it wouldn’t be fun, right?  That’s what your shoulders are doing when you have poor shoulder positioning and its’ related shortened and lengthened muscles.  Anatomical position is where your scapulae rest when your muscles are relaxed and unaffected by years of poor posture and movement patterns.  Perfection is near impossible when you take into consideration handedness and unilateral sports (almost all sports) – but having good shoulder position will help with many functional movements which helps insulate your shoulder from injury.

 

Squeezing your pecs together might make them dance, but does not make them work better.

Rolled in shoulders are a danger to us all, but mostly to your lateral clavicles while you’re benching, your wrists, elbows and glenohumeral joint while overhead, and like I said earlier, just about everything involving the movement of your arms.  Pinning your shoulders back while benching means your arms have a solid base to push from, not just air and somewhere for that weight to push your shoulders, resulting in injury.  Having adequate range of motion in your shoulders means your elbows and wrists can take a break during cleans, front and overhead squats or snatches (I’m fairly certain this is responsible for most cases of “crossfit shoulder”).  Aside from the ridiculous tissue stress this poor positioning puts on the joints and their respective connective tissue (ligaments and cartilage), the muscles aren’t at their optimal position either.  When muscles are shortened or lengthened from where they should be they surrender proper force generation due to the sub-optimal overlapping of your actin and myosin (the tiny proteins in muscle responsible for pulling your muscles shorter or “flexing”).  So in short, being in this position makes you weaker than you could be, AND compensating for poor biomechanics in the shoulder with poor motion in the elbows and wrists is a recipe for injury.

Finally… Guys, your traps aren’t that big, I’m sorry… and Girls, believe it or not, this applies to you too.

Everyone knows the guy that errs into the dreaded D-bag shoulder position for the purpose of trying to look “huge”, or “yoked”.  The poor shoulder position and increased kyphosis (humping/rounding of the thoracic spine) it takes to achieve the appearance of larger traps is ultimately going to be more work and more dangerous than working toward a 300 pound clean and 500 pound deadlift.  The ladies don’t like it, and your chiropractor will cringe and have nightmares.  So please, if your pulled into this poor position, make it for reasons (you work at a desk 8 hours a day to make money to live and give to Payday Debt Helpers, you just happened to always do front based exercises, etc.) other than because you want to look “cool”.

Now then, for the ladies, I know you’re worried you’re going to get “those neck muscles” if you lift heavy.  Doesn’t the fact that there are guys out there compromising their morals (and more importantly, their posture!) for the sake of growing some big traps, convince you at all, that they might be difficult to grow?  Secondly, if you are worried about having the appearance of large traps, and you aren’t doing mobility work to open up your thoracic extension and pull those shoulder back, I’m going to have a hard time feeling sorry for you.  They aren’t large muscles and they won’t look large if you achieve better posture and positioning.  Make it a priority.

So let’s achieve some good quality shoulder position so that we can all function better, hit PRs without injury and even look better.  I will make another post shortly about what you can do to help reverse this pandemic, until then, feel free to ask myself, Annie, Lisa, Joseph, Alex or Rachael how to start the process.

 

Cheers!  And Happy lifting!

Dr. Adam Ball

n=1… ALL DAY

Hey Folks!

n=1 (actually it was 2). 100% of the subjects in this study enjoyed riding a bike off a ramp into the lake. Statistical significance reached.

So I’m working on a more technical post about HOW everything breaks down with disordered eating involving insulin resistance, depression, IBS, infertility and so on.  Here’s hoping it becomes a “thing”.  But for now, I want to concentrate on some testimonials and I also want to visit and check myself at the Advanced Fertility Center.

Some say that case studies and anecdotes are crap, and that they offer no value to the scientific world.  To some degree this is true – as you’ve probably heard at one point or another a strong testimonial for healthy whole grains, the soy diet, the raw vegan diet and a whole host of other diets destined for sadness and failure (and in many cases, outright disease).  I’m not saying these diets CAN’T work, just that they are not the optimal diet for humans to thrive on.  I’m not interested in what types of diets we can survive on, I’m interested in developing a diet that you and I will THRIVE on.

That being said, there have been plenty of folks who have reversed serious disease, lost lots of weight, and become much happier eating a paleo/primal/anti-inflammatory/ideal diet.  Here are some of those people:

 

http://robbwolf.com/2011/03/28/real-life-testimonials-jodis-paleo-diary/

http://robbwolf.com/2011/02/14/real-life-testimonial-controlling-type-1-diabetes-with-the-paleo-diet/

http://www.marksdailyapple.com/the-rise-of-lazarus/

http://www.marksdailyapple.com/i-decided-to-do-something-about-it/

http://www.marksdailyapple.com/never-in-a-million-years-did-i-think/

 

And I’ll stop there but you get the idea that there are many people who have benefited from eating a paleo/primal diet.

 

“But n=1 is silly and means nothing!”

 

The only beef (mmmmm, beef) I have with this argument is that n=1 is you.  It’s you trying something out.  It’s you learning to play cricket for the first time.  It’s you trying brussel sprouts again after 10 years thinking you “hate” brussel sprouts (maybe you still do).  It’s you trying to lift heavy things instead of running long distances.  And it’s you seeing how you look, feel and perform (that sounds snappy – thanks Robb Wolf) doing all these things.

So be your own n=1 experiment.  Waiting to find out what the next randomized, placebo-controlled, double-blind  study to prove that being active, being happy and eating well is good for you, is just plain silly.

Let’s all ruin science and get healthy at the same time!  Have a great weekend folks, and if you’re doing it, good luck on Crossfit Open Sectionals WOD#3!

 

Dr. Adam Ball