You are NOT your diagnostics. What hurts isn't always what is on your MRI. Treat the symptom generator not the “abnormal” findings, you will be pain free sooner.
Mechanotherapy is what you are looking for, you just don't know it yet!
You have water in your row boat. What’s the best solution: find the hole and fix it or bail the water out? This is the classic question of treating the symptom versus treating the source of the problem.
What causes pain?
If you have pain, is it chemical or mechanical? Mechanical pain is overwhelmingly more frequent than chemical pain. Something stiff or something weak will cause pain. The chemical reaction or some say “inflammation” is the consequence of the mechanical problem failing. Ultrasound, dry needles, electricity, lasers, are some of the examples of what we might use to treat a mechanical problem with chemical means. There are no double blinded, good studies to show any of those things are any better than a placebo. Clinical experience shows they don’t help.
Mechanical fixes (mechanotherapy) are joint “mobilization” and muscle and tendon “progressive loading.” (both described below) What is unfortunate is the American Physical Therapy Association doesn't even recognize mechanotherapy as a possible treatment option. We as a profession cannot agree on what is best for patients so we end up losing patients to other professions because we don’t address the real problem. Managed care doesn't want LESS things to bill for they want MORE. The equipment used to treat chemical problems cost lots of money. Expensive buckets to remove the water spilling into the boat.
Mechanotransduction (The scientific word for mechanotherapy) is defined by Khan and Scott as “the physiological process where cells sense and respond to mechanical loads.” These mechanical loads induce stress on the tissues to which they are applied, and this stress induces a response in the tissue to create a stronger structure in order to withstand that stress in the future. One of the most common examples of this concept being applied is through Wolff’s Law. Wolff’s Law states that “bone grows and remodels in response to the forces placed on it.” In other words, weight-bearing bones, such as femurs and tibias, are made stronger in loaded, weight-bearing positions--think squatting with a barbell. Not only are you squatting your body weight, but you are also squatting the additional weight of a heavy bar. Your bones thrive on this type of stress and they thank you.
Wolff’s Law is often only associated with loading bones to prevent conditions such as osteoporosis. However, it can be applied to other tissues as well, such as tendon, muscle, and cartilage. Therefore, another way of looking at this concept is that the application of Wolff’s Law to the entire musculoskeletal system is mechanotransduction. By utilizing a great enough stress to drive cells to respond in order to build and develop stronger tissues, we can create a progressive loading program through which the body trains to adapt to increased forces.
Mobilization is a form of stretching that changes the amount of range of motion of the joint as opposed to the flexibility of the soft tissue around the joint. Allowing for flexibility through stretching and not stabilizing the joint causes a temporary change in pain that requires more attention.
Stabilizing the joint through progressive loading then, once the joint is working better, loading the joint with heavy loads is how the hole in the row boat is patched. Low load-high rep exercises will cause the connective tissue to grow. Low rep-high load exercises require sound connective tissue integrity. This will improve the body’s ability to tolerate activities of daily living as well as the ground reaction force of running, lifting, or sports.
Restoring high level activities cannot be performed by chemical means, it must be done using mechanical means like loading. Squatting, deadlifting, and push press are key to a body that can tolerate some force. Here at MVPT, we do not use any modalities to treat your mechanical problem. We do a thorough evaluation, find the stiffnesses or weaknesses and then put a plan together to help you correct the abnormalities in joint position or weakness. Call 702-998-2900 to make an appointment today!
Want to read up?
Khan, K. M., & Scott, A. (2009). Mechanotherapy: How physical therapists’ prescription of exercise promotes tissue repair. British Journal of Sports Medicine, 43(4), 247–252. https://doi.org/10.1136/bjsm.2008.054239
How Wolff's Law Is Used During Fracture Rehab in PT. (2018). Retrieved from https://www.verywellhealth.com/wolffs-law-in-physical-therapy-2696151
What if the person you met during your next health care visit taught you that you didn’t need their services? Wouldn’t it be nice if you booked an appointment with a health care provider and you knew exactly what he or she were going to do? How much it would cost? Wouldn’t it be nice to know there were no huge bills coming down the pipe after the care? What if you knew up front that the goal of the health practitioner was to get you discharged as soon as possible? Are you worried about the health care provider telling you that what you are doing is bad for you? Barbells are bad for you right? Running is hard on your knees, correct? Squats are the enemy, right? NO. After 15 years of experience, reading volumes of research, attending continuing education classes with the brightest and most accomplished practitioners of a wide variety of disciplines, a primary theme surrounding health care is: Quality care is hard to come by. You will not find quality care in the corner health care facility. The average health care provider is inundated with managed care hoops to jump through. If you are an athlete, the “sports doctor or PT” who spends a quarter of their time with Medicare patients is not skilled in sports care. If they spend ¼ of their time on total knees and hips, they don’t have the experience to help you. You need someone who spends 100% of their time with active people.
At MVPT we spend our time with all kinds of active people of all walks of life. Kids in team sports to “elderly” who run or hike(by the way, I would put these “elderly” up against any of our kids - so impressive). Here is a list of athletes (but not limited to) that we at MVPT have had the pleasure of assisting:
• Obstacle Course Racers (OCRs)
• Track runners
• Power lifters
• Rock Climbers
• Team sports-Lacrosse, football, soccer, basketball, baseball, etc
“I am a rock climber. Three and a half years ago, my hand went numb. I have been to countless doctors and physical therapists since then without relief. Ron is the first PT/medical professional to really examine me from head to toe, as opposed to jumping to conclusions based on limited information or judgements on my athletic pursuits (like “You’re a climber? Tendonitis.” or ”Your hand is numb? Carpal tunnel.”). He made connections between what I thought were unrelated aches and pains, and all of the pieces are finally coming together. Ron gives each client a personalized training program, which he constantly tweaks based on your physical response and changing body. Even with multiple patients training simultaneously, Ron always manages to give personal supervision to each of us. Ron is also honest about your progress, and he is not one of those PTs who prescribes ongoing sessions; instead, he evaluates the benefit of continuing therapy on a daily or weekly basis. Because of the training provided by Ron, my strength and endurance are returning, people are noticing my muscles again (woohoo!), and yesterday I had my best rock climbing day in over 2 years!” –JEN
What does MVPT do that other related health care professionals don’t do? We listen and inspire, first of all. We spend time with you. We use 15 years of clinical experience to treat the origin of the problem, not mask the problem. We use active treatments for active problems. Passive treatments feel good, but they do not get the source of the symptoms as fast as progressive loading does. Your sport or activity is very rarely bad for you. The problem is you don’t have the range of motion (ROM), strength, or mechanics to do the job you are trying to do. Rest will not give you the skills to return to activity quickly. If you are here for a running problem then you need your run evaluated. Walking mechanics are not running mechanics; rolling or sit-to-stand mechanics are not running mechanics. You have to run to understand the biomechanical errors you are making during running. After hundreds of hours of continuing education in running and gait training alone, we have the book knowledge/science background in all things running. We back up that knowledge with over 8 years of treating runners daily through rehab, strength training, and coaching. We recognize the difference between “feeling good” and resolving the problem. There are many interventions that feel good. There are a select few that can that get you back to performing at a high level quickly. Most athletes agree, performing your best without pain or injury is what really feels good.
As an Athletic Trainer, it is difficult for me to admit something is an injury, let alone seek out another professional for my own rehabilitation. After a grueling attempt at World’s Toughest Mudder in November of 2015 – and I use the word “attempt” loosely, as I was an official finisher – I was left with nagging tibialis posterior (i.e. the inside of my ankle) pain that just was not resolving. I had heard about Ron through a friend, and figured it couldn’t hurt, especially as I refused to allow my MD to immobilize the ankle in a boot. Admittedly, I was a bit nervous, as I have a particular approach to dealing with injuries, and was afraid he might be another run-of-the-mill, protocol-rooted PT; fortunately, I was wrong, and his knowledge of the anatomy as it related to running (and vice-versa) was impressive to say the least. Within six weeks, not only was I pain-free, but I placed sixth at BattleFrog’s inaugural BFX24, another 24-hour Obstacle Course Race (OCR), with 55 official miles. Not only had Ron gotten me back to 100%, but he completely changed my running mechanics for the better, and, dare I say it, made me stop hating to run!
In September, with less than a month before OCR World Championships, he helped to quickly resolve a groin injury that threatened to end my season early. Whenever a friend or fellow athlete has asked for a recommendation, or mentioned a nagging injury, I never hesitate to recommend Ron – he has a phenomenal understanding of the capabilities of the human body, and will have you leaving better than you were pre-injury. -STEPHANIE, professional OCR
What is progressive loading? Progressive loading is a progressive approach to loading the tissue in trouble and creating an environment in which the structure can learn to handle the stress of the activity. Or simply put: training/treating your body gradually and increasingly. No visit is the same. We use 15 years of clinical experience to identify the tissue in trouble, examine the biomechanics of the activity in question compare it to the movement of the body in trouble, and build an individualized plan to restore the activity as soon as possible. There is no evidence a cookie cutter movement screen or plan will identify an injury or aid in performance. The needs of the individual patient cannot be generalized. Let’s simplify things. Our medical system has so many specialists that the entire body system is rarely taken into consideration. Medical education has no contact with barbells whatsoever. A barbell is not your enemy. All athletes require strength. All humans require strength. There is no situation whatsoever where too much strength is a problem. Crossfitters are not performing a dangerous sport. They are mishandling loads. They are moving the bar too fast, too soon, or with too much weight. We team up with their coaches to ensure the athlete progresses well enough to get back to full activity as soon as possible. Chances are the athlete does not possess enough ROM, strength, or biomechanics. If you have a problem with your over head squat, for example, will a traditional PT have a barbell around so you can show them how you are doing it? If they tell you that is a bad motion for you, they are misinformed.
“When I walked into Max Velocity I had been struggling with pain for over a month that disrupted simple daily activities. Tying my shoes became a near impossible task. On my first visit, Ron was not only able to diagnose the cause of the pain, but he also took the time to explain why it was not an assortment of other issues. His demonstrated knowledge gave me confidence that I would soon be feeling healthy again. I continued to do the exercises he recommended and within days the pain began to subside. It’s just a few weeks later, and I am now pain free and back into my full training (and also hitting some new prs). Thank you Ron!”
- Lauren, Crossfit Regional Qualifier
Wait, you coach too? Yes. Coaching is not our primary objective. We coach out of necessity. We decided that if we are going to be training experts then coaching credentials are necessary to ensure the knowledge base of what it takes to complete certain tasks is obtained. Has your current PT asked you what the distances are for an Olympic triathlon? Do they know what is required of you from a training point of view if you are trying to qualify for Boston in the marathon? If you are 12 weeks from a marathon wouldn’t that load be different than if you are 2 weeks away? Wouldn’t you want your PT to know the difference? A Physical Therapist who has finished a full ironman, 5 half irons, 4 full marathons, 20ish half marathons, and a lifetime of sport participation knows what it’s like to be an athlete. 2 years of Division 1 coaching in cross country and track, while developing friendships with NCAA champions, national championships, and Olympic caliber coaching experience makes us an ideal resource to help you return to full activity. Wouldn’t you want your health professional to program your treatment to help you attain that goal rather than unnecessarily shut you down? HYPERSPEED LV is in place to help the young athletes of the valley cross train intelligently. Remove the one-sport over-specialization that is plaguing our youth. The primary swimmers of the group have decreased times by the minute by removing 2 days a week of swimming and adding progressive loading. If we gripe to parents about how their kids train then we should offer a solution. WE DO NOT INTEND TO POACH athletes. We intend to make the patient the center of the situation and use a team approach to the athletes success. Our goal is to teach you to not need physical therapy. We would rather see you and 2 of your friends for 3-4 visits than 1 person for 12 visits. WE understand athletes, we want to take care of our own. Traditional medicine is set up for treating the sick and NOT to treat the near healthy. Help us create a paradigm shift in health care. Please feel free to interact, ask questions, and get informed. If you are interested in making an appointment please call the clinic 702-998-2900 or go to maxvelocityPT.com to “request an appointment,” and I will call you back.
Generations ago kids played outside. They ran, jumped, climbed trees, and rode bikes. They played baseball in the spring and football in the fall. And they played many other sports in between. Neighborhood kids would gather after school, find a ball and some open area, and they would play a game. The kids these days have incredible technology and dangers that were not around 20 years ago. A pick up game nowadays is an old thought. They simply cannot play without supervision. So what is a parent to do so their kids will exercise? Many turn to organized sports - some to an extreme. Kids are more competitive at younger ages than 5 years ago, 10 years ago, 20 years ago. Club coaches mistakenly educate parents the kid must play year round to be competitive when the scholarships are handed out or big competitions come up. That is simply not true. Athletes, especially young ones need a diversity of physical activities. 81% of D1 college athletes were multisport athletes in high school. The trend in collage recruiting is to PASS on one-sport athletes. They are a risk to the investment the school makes in that athlete due to injury. Single sport athletes typically get injured when they are sophomores or juniors in college. Because kids don’t know any better (and don’t read blog posts), it falls on the parents to seek out the information that will maximize their kid’s chances of success.
They say that life is 90% how you react to the 10% of the things that happen to you. I can say that over my lifetime, that is very true. Today’s blog post is using that metaphor in a business sense. While MVPT is still the community leader in running medicine and the Las Vegas valley’s only running specialty clinic, something interesting happened when MVPT opened its doors in 2014. Kids came. A lot of kids came. The more kids who came, the more their parents talked to other parents. The valley is full of kids who are training for sports. Since the weather of Las Vegas is tolerable for the majority of the year, kids train year round. That could be a problem. Kids over-train the one sport they play. Over specialization is a huge nationwide problem and Las Vegas is no different.
Injury “prevention” is almost an impossible goal. Accidents and injuries happen. “Minimization,” is a better goal. While the spirit of prevention is alive and well, educating an athlete to do this or that to eliminate any chance of injury is simply incorrect. I have been guilty of doing this. Every day, I read research and study, and now I realize that is false hope. Your young athlete will be injured. That is a fact. Can we make it a sprain instead of a fracture? YES. Can we get tenonosis instead of an ACL tear? YES. How? Strength. There is no situation ever where an athlete is ‘TOO STRONG” and therefore a detriment to his or her performance. However, there are limits. If the kid just picks up a barbell and loads it up he may be doing more harm than good. The key is in the details. Originally, the idea for MVPT was formed when a lot of the so called “sports trainers” were hurting kids left and right. Not just asking them to lift, but asking them to lift too much too soon, or choosing inappropriate exercises.
You see, the demands of the sport shouldn’t be replicated in training, it adds to the over use. Understanding the movement patterns of the skills of that sport is the skill of training athletes. Anatomy, physiology, and proper periodization are the key. The skills have to have a progression. The load of weight lifting is a major component health AND performance. Weakness hurts. Since the motor development of kids is hampered by NOT going outside, they are left to figure it out on the field. Then that demand is specific to the sport. The athletes flounder.
Then comes the cross training. The cross training should be movement specific, loaded when it is appropriate, and must compliment the sport. The feather in the cap at MVPT is a physical Therapist who is trained in barbells and human movement. A life-long multi-sport athlete himself, the program can be tailored to athlete specifically. The movement for an individual will depend on many factors. The experience to deal with these factors comes from 15 years of clinical experience. There are no short cuts - no models that can predict with certainty whether or not an injury will or will not occur. There is simply no evidence with any predictive power that short cuts help. They cannot prevent an injury nor do they help with performance. The athlete’s nervous system has to learn and adapt to a new method. Hard work, dedication, adaptation to loads, and movement correction are the keys to sports performance. So the question is at what age can a young athlete begin a strength program? The answer is, as soon as he or she has the movement maturation to tolerate such a load. Some kids are ready at 8 while others need more time. Age is not as important as movement when it comes to making this decision.
We at MVPT pride ourselves in “evidence based” care. Which means the interventions that actually help are the interventions we delegate. We offer a “functional” evaluation to screen a healthy athlete and make recommendations on minimizing trouble. We would love an opportunity to use our vast knowledge and experience to help your child perform better. Discounts apply to teams. Please go to the website at maxvelocity.com for more information or you may call the clinic at 702-998-2900 to make an appointment. Please feel free to share, comment, or like! Help us spread our message!
HYPER SPEED is coming to Las Vegas! MVPT is proud to announce a new youth triathlon team. If you have a young triathlete (boy or girl) between the ages of 7 and 15, they can join Hyper Speed and compete in local and national events! Young athletes of all ability levels from novice to elite status are welcome. Our goals are simple. First and foremost, have FUN. Fun, to us, is training hard, training smart, and falling in love with competing and racing to maximize our potential. For some, that will be competing at the Elite level. For others, we will work toward achieving elite status. We are accepting anyone who wants to have fun competing in swimming, biking, and running.
We will race all of our local races as a team. The Las Vegas Triathlon Club is a valuable asset to our community, and all of our athletes will race in their club races. We will have a presence at Rage, Sand hollow, Las Vegas Triathlon, etc as well as travel to Washington for qualifier races for the youth National Championships. We will conduct ourselves as a team. We will travel together. We will race in matching kits, matching hats, matching shirts, and bags. Hyper Speed will have a sense of community and pride. HYPERSPEED LAS VEGAS is a USAT sanctioned club.
Where do we start? As with all the athletes and patients at MVPT, it all begins with an evaluation. We don’t want anyone getting injured. Each athlete will receive a musculoskeletal evaluation before we train. We will identify any strength or range of motion abnormalities before they start becoming an issue. We will then begin a strengthening program to create a body framework that is ready swim, bike, and run at a high level. Then, we will swim (both open water and pool), bike (both road and trainer), and run (road and track). Each athlete will have custom workouts in a group setting. Everyone will have a race plan built on the individual training they receive at practice.
Our long-term vision at MVPT is to prevent and promote health through movement. We have been very humbled and fortunate that more kids are training at MVPT than we expected. The opportunity to start kids with healthy habits and prevent future biomechanical injuries is a very cool idea. On the other side of the spectrum there are youth within our community who possess world class potential. We want to give those kids a chance to flourish.
We are planning a HYPER SPEED info night Friday, January 29, 2016 at MVPT. With some input from people on social media, phone (702-998-2900) or email firstname.lastname@example.org. If you are remotely interested please do not hesitate to contact Ron.
Since its inaugural event in 2007, CrossVegas has captured the hearts and chamois’ of cyclists throughout the valley, but this year, it also boasts being one of the UCI World CycloCross events. As the competition grows closer, everyone is looking for ‘The Edge’: new wheels, disc brakes, di2 groupo, SRAM or Shimano, bibs and jersey or skin suit…so many variables that impact performance. But what about the key variable? The Engine.
Throughout the off season, stage season, road season, and crit season, you have spent time on the saddle, checked off the miles, chased KOM’s, and “Cat”ed up. For most of you, cycling has been the heart and soul of your training. You have developed a formidable engine with powerhouse thighs that even Sagan might envy. But, now as cross approaches, you are jumping OFF your bike, leaping over barriers, running up hills, and tackling sandpits like a ninja. If your purpose is simply to show up and participate, those powerhouse legs of yours will find a way to get the job done. But if you’re seeking a PR or hoping to admire the view from atop the podium, you need something more. Your engine needs an upgrade!
So what is ‘The Edge’, this holy grail of cross excellence?
Although you developed a powerful engine for cycling, you may be missing a key component to this crossover - the kinetic chain of triple extension through the hip, knee and ankle, critically executed to ensure the injury-free land-based exercises required in CycloCross. The major muscle groups utilized during cycling are your Quadriceps, Hamstrings and Calves. However, the driving force required for running, leaping and jumping activities is your Gluteals – the booty!
To get your edge, you need to be able to engage your glutes for more power, speed, and efficiency in the OFF bike exercises.
Want to get that upgrade?
At Maximum Velocity, by analyzing your running gait and biomechanics, we are able to breakdown the elements of form and rebuild it with improved efficiency and potential. And the best part is that stronger glutes and better movement will reduce the likelihood of injury. My next blog post is a deeper exploration of the common issues cyclists face when crossing over to running (see what I did there, cross is everywhere!).
So as you prepare for the 9th Annual CrossVegas, acquiring your taste buds to the latest brews and ales, growing that ever-so-last-minute beard, prepping your excitement for cash and pizza primes and generally having a smashing jolly good old time on your bike…. Don’t forget to come to see us and find your ‘Edge’.
Lisa is taking evaluations to help you find your edge. Feel free to go to maxvelocityPT.com or call 702-998-2900 to make an appointment.
A question I receive nearly daily both directly and indirectly is what makes Maximum Velocity PT different than any other physical therapy place. The more times I answer that question the better I get at answering it: TIME. Yes it comes down to time. Do you have time to go anywhere 3 times a week you don’t enjoy or get paid for?…NO! What about if you do break away and the person who is attending to your healthcare will only spend 10 min with you? Was that worth your time? Every now and again as a blog post I will post a patient spot light to highlight what we at MVPT are doing to protect your time.
Brooke is a made up name although she did encourage me to post her case. “Brooke” reports to physical therapy for lower back pain. Looking through her paperwork, I guessed this was an average case of lower back pain. I guessed wrong. Turns out she has had this episode of pain has been about 6 months and progressively is getting worse. She has had other episodes of pain. She cannot run due to pain and she hesitated when answering this question. She mentioned the pain has come and gone throughout all three of her pregnancies. Since she brought her pregnancies up it turns out on her 1st pregnancy she had an episiotomy. That is the muscles of her pelvic floor were cut and they cut her pelvic floor after she tore. No intervention for recovering from that trauma whatsoever. Each successive pregnancy the tearing occurred. Further review reveals much more problems a male PT and a female patient typically wouldn’t share. Since I take the time to discuss during the exam and I am thorough we explored further and it turns out the pain comes with running but the urine loss is much more of a problem. Not only is running embarrassing but inconvenient. Running brings on the urine loss but so does laughing, jumping, and sneezing. This is a 30 something year old fit woman who is severely limited by mostly pain but also the urinary issue. She didn’t know they were related. She followed all traditional routes. The primary care sent her to OB/GYN. He examines and says “sorry that’s what happens when you have 3 kids but the machinery looks good. I don’t know what to tell you.” GO TO PT IS THE ANSWER. I would hope an OB/GYN has a women’s health PT in his/her pocket because it is an Incredibly important relationship for both of them to have. So she was left to twist in the wind thinking she is broken and that is part of being a mom. NOT TRUE. I am no women’s health PT and I told Brooke that if my basic treatment doesn’t help that we would find her one. Happy to report we didn’t need that referral.
Brooke learned to control her pelvic floor in easy situations and the tasks became progressively more challenging. Soon stability exercises for her hips, back, and pelvic floor allowed for full pain-free motion. What she interpreted as pain before was weakness or instability of her back. Her lower back, hip, and pelvic floor muscles were not working together. As a result, her laughing, sneezing, jumping, and running are all pain-free, as well as, no urine loss with each position as well. She beams when she talks about how good she feels. All I did was listen and spend time with her. What is the best part? She is fully functional with no pain or trouble in 3 visits. She came once a week for 3 weeks. She did her homework, applied new concepts for moving around in her daily life, and she is fully functional. She reported to PT with “a running problem” and left with confidence and dignity while running with no issues.
So what is different at MVPT? We offer performance improvement through education by taking the time to actually listen to the person who is sitting on the table. Attention to details during a thorough evaluation, follow up visits that progress from visit to visit in order to develop a movement pattern that feels better and therefore will perform better. Feel free to look around my website. Find the button that allows you to “request an appointment.” MaxvelocityPT.com. Please feel free to share this post as word of mouth is the best marketing strategy. Happy Running!
I talk all day about the goal of helping runners reach a level of success or consistency that would allow the entire community to be happy healthy runners over the lifespan. I mean let’s face it, have you ever met a grumpy runner? When they report to PT they are grumpy but when they get back out there, the joy is palpable. Who doesn’t like joy? I always take the time to say:
There are NO STUDIES TO SHOW RUNNING IS BAD FOR US.
In fact, more and more evidence arises every day from the research world on why it is important for our skeletons to be working hard. With that here we go with the 10 reasons (and who knows may be there is a hundred and if you want to add please do!).
#10 Cool clothes. You know you love the tech shirts, the colors, the different cuts, and the different types of shoes out there. Runners tend to be more adventurous (see fun races like the Star Wars half marathon but can someone say expensive? lol) and that tends to show on race or training day. I love how “safe” a runner looks in obnoxious neon colors. Come all y’all, lets be safe out there!
#9 More Health and Injury Prevention. In communities around the country where there are more runners per capita then Vegas there are lots and lots of prevention programs. There is more and more popping up here but the average runner is not prepared. Running is a skill that asks the skeleton to handle to most force possible, THAT’S A GOOD THING. Eating to train, would allow for better immune responses and overall better health. They go hand in hand, much more to come on that topic.
#8 Less Medicine. In America our philosophy is “eh someone will fix me later.” As medicine gets more and more technologically advanced we are also losing how awesome nature is. A scientist in some lab trying to change our body chemistry is risky. One drug leads to needing this drug to stop the side effects of the first drug. As we get more and more dependent on chemicals we lose our body chemistry. Take control of your health. What you eat and how you move are much more effective than any drug around. Not to mention the legal and political ramifications of big business pharmaceuticals (don’t get me started, lol.) Choose nature not chemistry.
#7 Decreased Health Care Cost. We are in an all-time high for health care cost in America and all time low is quality care. Why? There are millions of theories but when it boils down to the patient level, the patient requires so much more help. Patients are not informed. They do not invest in themselves and do what ever anyone in a lab coat says. That goes for any profession. (I am not anti-doctor, I am anti-poorly educating patients.) More preventative lifestyle, means the demand is less and therefore less medical bills. Take control of your health.
#6 Better Joint Health. Running or the pounding of running actually causes our connective tissue to harden. YOU WANT HARD THAT. That includes joint surfaces. There are no studies directly correlating running to poor joint health. In fact the factors that influence heart disease (obesity, smoking, diabetes, etc) are more correlated with total knee replacement than running. Not using your joint surface results in softening your connective tissue or joint surface. “Oh I cant do that, I have bad knees” doesn’t fly. Your knee pain has more to do with movement patterns at your back, pelvis, hip, or foot than it does just predisposed to bad knees. Did you ever consider that just because there is arthritis in your knee that may be that is not even the thing that hurts? The joint problem is a sign something else is going on. Get your movement checked, retrain it, and get back out there.
#5 More trails. Las Vegas is new so things are just getting started but how exciting is it that there are more and more trails every year? WE NEED MORE! More users, more options. Trails through the city, trails away from the city, trails that are hard, trails that are easy, trails that are pretty, and trails that are connecting to other trails. How fun would it be to commute via running? Good mornings, good nights, all around. Biking and running trails together.
#4 Better Restaurants. If all the runners in Vegas took a stand and we all did not eat at these cookie cutter, over processed chain restaurants and supported local talented chefs we could see a huge change in the community. (Local music too but may be too much for this discussion, lol.) Your daily nutrition is the base for your health. You are what you eat. Choose nature and not chemists, get more local people involved in food and give them the confidence they can make it work. The big business owners eat up the people that want you to eat right. Support them. You vote with your money, choose more farm to table places and lets get back to the fundamentals of health. Eat real food, stop the chemistry experiments on my body!
#3 Less Obesity. We are the fattest country in the world and we got there when the food pyramid was really pushed. Over processed food is literally killing us. We are a proud nation that is losing who we are. We used to out work the rest of the world and now we are getting lazier by the day. It starts with daily nutrition, then there is movement. Not everyone can run the Boston Marathon but daily movement is key to our body’s health. Running at faster tempos, changing tempos, is better than the long slow drag for losing weight. Compete with yourself, do something you never thought you would do. Find a running coach, learn to train. We are all runners some have just lost their way.
#2 Sunrises and Sunsets. Have you been to Lake Mead at sunrise? Have you been to red rock at dusk? What about McCullough trail at those times? Valley of fire? Gees, we can go on and on. Sunrise, train, and then eating breakfast is one of my favorite weekend routines. Even better is sunrise, RACE, and then eat breakfast. I love eating breakfast w the other racers and exchanging war stories. When runners are exposed to such natural beauty something lights up their face, may be even the soul is charged up. When runners are taken away from running it is this piece that is removed, they lost the soul. Our soul is best expressed with a challenge. How much more gratified are you when you reach your goals? Set a goal and reach it.
#1 SMILES. Lets get right down to it. Runners smile best. Have you been to the finish line of a race? There are no grumpy people at the finish line, spectator or racer. No one has ever regretted a hard run. One of my most favorite things is watching runners succeed. First 5k? First 5 min mile? Everything in between. Happier bodies mean more pleasant interaction on a daily basis. More plugged into their body with healthier diets over good food and fun stories where nature occurs. That sounds like a much happier world. Something happens to us when we interact with nature. Not look at it from the window but touch it, hear it, EXPERIENCE it. Those are the people I like having around. Bottom line: Get out there and experience the world around you. After all runners know how to explore a new city, new food, new drink, and new trails. Get out there and be happy while you train, your community loves you for it!
Feel free to disagree, comment, or share! Help me spread the word!
Ron Gallagher is owner/Physical Therapist at Maximum Velocity Physical Therapy right here in Henderson, NV. He believes that education and performance are key to prevention, rehabilitation, and success in all physical endeavors. Go to website maxvelocityPT.com to read more or even “request an appointment.”
When we look at the history of Physical Therapy the profession is only about 50 or so years old. We as a profession are in an infant stage of development. The medical profession is hundreds of years old and the amount of learning and discovery is still happening. As you might imagine the growth of Physical Therapy research is growing at an alarming rate. We have to in order to catch up. So every physical therapy school in the country will soon be a Doctor of Physical Therapy. This level of education is the same as a dentist or a lawyer and now requires a thesis-type paper. These programs are heavy research oriented. They have to be, we are catching up. In order to bring the Physical Therapy research to reach the community the students must practice “evidence based.” This means that all of our interventions (exercises, treatments, etc) must be backed up by science and the treatment must be scrutinized. The way it actually plays out is the physical therapy industry has split intentions. If I sit here and provide only evidence based interventions, what will I bill for? How much time will the PT’s spend with the patients? Insurance companies will deny unqualified treatments too, sometimes that’s good and sometimes not so good.
What if a patient walked in and said, “I only want you to scratch my back. Your fingernails on my back will make this neck pain go away.” The role of the PT is to say “Sorry, but this is what has been shown in the literature to be effective for treating the bulging disc in your neck.” There is an art to treating that bulging disc in her neck too. The PT must incorporate the personality type of the person and educate them as a person. The skill of communication is where the art of educating the patient takes place. As a profession we have less time to communicate or listen, our ability to grow the profession is losing. This post is designed to highlight 6 things that patients are very surprised physical therapists can help with.
1. Scoliosis or any “hereditary” spine problem. Our body responds to the force or pressure we put on it. So with attention to details, some hardwork, and proper education PTs can change the way a faulty spine moves. It requires a mechanical or physical change the patient has to be ready for and the PT has to educate what the person should feel and not feel. Ultrasound, electricity, and anything else from the outside in cannot change how the spine actually moves. Movement can improve the function and can help with a lot of the pain and stiffness associated with long term spine problems. If the spine moves the same way then that same spine will adapt to that same motion.
2. Intimate problems even sex associated problems. Womens Health specialty of physical therapy is growing at an alarming rate. Before and after pregnancy for women. Intervaginal techniques help restore normal function of the reproductive system. Inter rectum treated prostate problems in men. IT IS NOT NORMAL FOR WOMEN TO LEAK URINE AFTER THEY GIVE BIRTH. Exercises, manual therapy techniques, and movement retraining can definitely help these people. This can completely change a persons life. (There is very little expertise in this area from MVPT, LOL but I can get you someone who knows)
3. Wound Care. Now-a-days a big role for PTs in the hospital is addressing big ugly wounds. Bloody, pus-y, tunnels, dressings, ointments, stages of healing, wound vacuums, post-surgical, and any other method of helping people heal from these limits in function due to wounds. This education is part of the general knowledge base of every PT.
4. Arthritic conditions or presurgical care especially ACL. Our body craves moving. If there is no movement then the body breaks down. Arthritic problems are more associated with movement errors than “wear and tear.” It is not what you do, its how you do it. There are plenty of previous athletes who do not suffer years later. The ones who do not suffer continue to move and the ones who suffer either move in a way that creates the arthritis or they lose the motion all together. The answer is re-educating movement through strengthening and stretching. There is a lot of evidence to show that appropriate PT can be just as if not more successful than total joint replacement. Also, if you get one replacement the trend is to add hips and the other knees to the mix if you cannot get the movement problems under control. Before surgery have a movement reeducation PT evaluate your mechanics and learn to move better.
There is an extremely high incidence of total knee replacement in knees that have ACL reconstruction. It has nothing to do with the surgery but the mechanics to tear the ACL is the same as the mechanics that offer the arthritis to the knee. Get stronger first, learn what motions put tension on the graft, and what exercises you can do to eliminate the problem. If you move the same way, you will get the same problems. PT for the ACL for athletes should be up to 20 weeks long. Usually the patients get discharged at 12 weeks or so. Learn to cut well, learn to jump well, learn to run with no biomechanical errors. These concepts will save the graft for the long term. Any major surgery will have this same phenomenon. If your not sure what your PT will do about these topics, interview them before you go. Make sure you are getting value for your time and money. Be a good consumer, not all health providers are up on the latest techniques. At MVPT we specialize in ACL reconstructed knees and the rehab after. Running is a pre-cursor to sports. Good mechanics are a pre-cursor to running.
5. Balance problems like dizziness or vertigo. Your balance depends on 3 systems to hold you up: sight, body awareness or position, and vestibular or your inner ear. When these things are on the same page you have balance, when they stop working together you lose it. A PT with experience can treat you in the clinic without the big and fancy gadgets. The gadgets make it fun and cool and help to a certain extent but you still need movement re-education. It is not uncommon for weakness to bring on balance problems and get mistakenly referred to a balance clinic where they work on the vertigo stuff. Let a movement oriented PT teach you a strengthening program you can do on your own and eliminate balance issues in order to prevent falls. Falls are the leading cause of death in folks 65 or older. Falls lead to hospitals, hospitals are where people get sick (perhaps the topic of another blog post, lol).
6. Head Aches. The general health care system has to start realizing there is no one better at treating head aches than a PT. This is the only quick fix in PT. The upper cervical spine is the place that connects your skull to your spine. When your skull is moving incorrectly you can get head aches. They are very often mistaken for migraines. Your posture and your head position can greatly influence head ache pain. Teaching the spine and skull to move, strengthening the muscles that hold up right posture, and stretching if there is lack of ROM can eliminate a head ache in 1 visit.
At MVPT the answer to physical or functional problems will always be movement re-education. There is NOTHING we can do from the outside that is better than what the body can do for itself. We use cutting edge techniques to educate consumers on the best way to treat themselves. Evidence based practice is crucial to improving the functional lives of the patients that we see. Otherwise we might chase our tail and not know what is what. Prevention is the best way to treat injuries. If you or someone you know has a movement problem feel free to call, stop in, or email. I love taking inquiries. If it is something that needs one on one stuff for we handle it. If it does not require that then I will refer you accordingly. The focus is re-education. Feel free to call at 702-998-2900. The website is www.maxvelocityPT.com. Happy training!!
This post could easily be twice or three times longer but I am going to give you the short and sweet version. This post will bounce around from me and my personal life to me as a professional. Each topic will have a personal and professional section kept short for brevity sake.
Childhood and the Wide World of Sports
Personal-When I was a kid sports on TV was new. The broadcast companies didn’t think people would watch hours and hours of sports. So on Saturdays after cartoons they had a show called “The Wide World of Sports.” They showed off the beaten path sports like skiing, track, ping pong, and once a year they spotlighted what we know now as the Ironman world championship in Hawaii. I was enamored by it. I thought/think THOSE athletes are amazing, I could never do what THOSE athletes can do. They do long, I do power, it will never work for me. I wanted to watch more and more of it but we simply did not have the access to it.
Professional-Since I was bigger than any other kids I was educated with I had to play offensive and defensive line, play the outfield and hit homeruns, play forward and specialize in rebounds, and basically any other power athlete job. I was absolutely enamored by mechanics of sports throwing, hitting a baseball, and running etc. I loved the human muscle anatomy of sports. My life as a clinician began with coaching and being coached as an athlete. I had some junior college looks for baseball and was a very good athlete but nothing panned out.
Personal-Like most people college was a fantastic time in my life. I made great friends and tried to figure out who I was. It was during this time that I figured since my “athlete” days are over I was not an athlete. I ate, drank, and trained like my athlete days were over (no training). I met my wife and we decided that since we were happy together we can eat and drink together! We did not exercise and we started our life together.
Professional-I struggled to get into PT school because of my “brain.” I didn’t believe I belonged there and If it wasn’t for some key people to push me and give me some confidence, I may not have made it. I got into PT school and my goal was to become an expert clinician. I did not recognize my diet, exercise, and fitness level affected my learning. I wanted to learn the most advanced manual therapy skill, I surrounded myself with excellent clinicians and took some advanced orthopedic courses to further my clinic skills. After a few years of getting my license I had more continuing education credits than most PTs out for 5 or 6 years out of PT school.
Personal-I was missing something. I wasn’t myself. I was sick all the time. I had ballooned up to about 300 pounds and I was not a happy guy. I had a runner who was a very important to the clinic (VIP) and she said “If you know so much about this why aren’t you doing it?” OUCH. She was right, I was unhappy and it was because I checked out from my body. I was a hypocrite. Walking turned into running, running turned into more running, and then the weight started to come off. I was starting to reconnect with the athlete that I am. However, the weight loss stopped abruptly. 4 ½ marathons, 1 sprint, 2 olympics, and silverman/1/2 Ironman in 2009 and no weight came off despite the healthiest diet possible according to American standards. I was still sick and then I decided to get some help. 3 nutritionists later and I am no lighter and I feel even sicker. That is when I found metabolic efficiency. Metabolic efficiency is a cutting edge daily nutrition strategy that supports endurance training, weight loss, and performance. Metabolic efficiency has the evidence behind to show that it is the wave of future of healthy lifestyle. When I learned how to properly nourish myself I became ultra aware of where our food comes from and how it is prepared and realized that nutrition is the key to a healthy life. It is far more important than any medicine or chemical and I also learned from another perspective our bodies are amazing. Another 50 pounds comes off and my mind, body, and spirit are in a brand new place. My whole life I did not know what it meant to feel good. Feeling better, more confident, I quietly asked myself what I was capable of. I knew that the ironman was a long way away, but could I get there? With more and more experience with training, coaching, and nutrition the plan was to complete the ironman. After 5 ½ Irons, 4 marathons, 25ish ½ marathons, and new body chemistry I was ready. In 2013 I volunteered at Ironman Arizona and was able to sign up for 2014. My A race for 2014 was Ironman Arizona and finished. While I was not as prepared as I could have been and with rough race conditions I did not reach my time goals, but I finished and completed my dream of doing something only “those” athletes could do.
Professional- After 5 years or so of continuing education in spine or pain I decided I would look for a course that specialized in triathlon. I wanted help with my training and thought maybe I would learn something that I could use in the clinic. I found a course in Charlottesville Virginia that would prove huge in my clinical development. Turns out this course attracts the top running health professionals in the country and presents cutting edge research. I would go back the next 3 years in a row. Every year more and more cutting edge research and high level training. This training would drown out the status quo information in mainstream training, physical therapy, and medicine I was learning along the way. This revolutionized my clinical brain. Running is the hardest thing to do on our musculoskeletal system and the orthopedic skills to train people to run requires high level skill. At the same time I fell into the network at UNLV and started coaching with the cross country and track programs. In that time I was able to coach at the 2012 Olympic trials and watch Americas top athletes prepare and recover. At that moment I knew I had something to offer. Our most skilled athletes needed an upgrade in training and I wanted to be at the forefront of change. I want to bring cutting edge information to the ground level of where people who need this training are. Why can’t “regular” everyday athletes benefit from high level training? Elite athletes are no more skilled than age groupers. Wouldn’t it be fun to inspire people to reach goals using cutting edge education and training techniques? As I got better at treating this population of people, using high level orthopedics, run training, and latest running literature it became apparent. Why can’t I work at a place where I can do this all day? Maximum Velocity Physical Therapy is born.
In summary, the personal journeys of chasing my dream of training for and completing an Ironman and the quest to become a master clinician has intertwined themselves and produced Maximum Velocity Physical Therapy. Big business is ruining healthcare, insurance companies are dictating to healthcare to work in a factory kind of way. There is no way to conduct high level of care at a factory pace and when the orthopedic skills to apply to running are high level something had to change. At MVPT, your health and progression are the focus of our day. You can go to the website www.maxvelocityPT.com and request an appointment or call 702-998-2900 for any inquiry.
Lets review. First 2 facts, 80% of runners will be injured during their run career. 100% of these running injuries can be attributed to Loading Rate. Loading rate is physics term used to describe the speed and force our body has to handle during running. Loading rate is a 3 way balance between contact style (part 2), limb alignment (part 3), and limb stiffness. Jay Dichary is the PT running expert who has described this in his book "Runners Anatomy." Great read for health professionals and runners alike.
Limb stiffness is a funny concept to explain. Runners know this feeling and have a hard time explaining it. Remember the first time you ran a mile? 10 miles? 20 miles? That hurt so good feeling is our body adapting to stress. Another way to describe limb stiffness is hardening. Our body must adapt to the force of running and when this adaptation can keep up with the miles we are running, the body does not get injured. If there is too many miles, too fast, or a contact style/limb alignment problem the body cannot adapt fast enough and stress fracture occurs. Literally the bone splinters under the abnormal force. Musculoskeletal health can be defined as our ability to handle stress. Stress tested skeletons are happy skeletons. Limb stiffness pain is GOOD. We need this pain in order to with stand longer length runs. Osteoarthritis is attributed to a unstressed skeleton and not a over worked skeleton. Runners have BETTER arthritis problems when compared to people who have the factors leading to heart disease like obesity, diabetes, smoking, etc.
Maximum Velocity Physical Therapy is only running specialty clinic in southern Nevada. There is not another health professional in souther Nevada that can treat running limitations quite like Ron at MVPT. At MVPT running injuries are puzzles. The pieces are related to loading rate. A gait evaluation has specialized testing and video taped analysis to identify these abnormal forces. The gait analysis can also be used to identify performance limitations too BEFORE they become injuries. We at MVPT want lifelong runners who continue to reach goals. Since we have no limitations, we can be creative in how involved we are in your running progress. 1-3 visits over the course of a few weeks may be all you need to be in control of your running. Feel free to stop in and ask questions we love visitors! Please call 702-998-2900 for an appointment or "request an appointment" at out website. Happy Running!!
First, a quick review of the previous posts. Running injuries are directly related to LOADING RATE or how your body handles the force and speed that the ground inflicts on our body. Jay Dichary is the pioneer of this concept and I encourage you to read his book “Runners Anatomy.” He states:
Running Injuries are directly related loading rate (Part 1). Loading rate is directly related to Contact or how your body adapts to force of running (Part 4).
Contact style from part II is how the body is interacting with the ground. Limb Alignment is the focus of today’s discussion and limb stiffness will be discussed in part 4. Limb alignment has the most variability of the aspects that influence loading rate. Limb alignment is synonymous with running mechanics or even running biomechanics. Running mechanics can be described as the position your body is in when contact with the ground occurs. That position is key. Remember running is a skill. The skill of landing in a way that the big and powerful muscles do the work while minimizing ground reaction force. Running is painful when we are doing it wrong. Joint motion of the spine, hip, knee, ankle, and foot, as well as, stability of the same joints will have a huge impact on how we run. In order to handle landing force we must be able to slow down 3-5 times our body weight and we must be able to propel 1-2 times our body weight. Therefore, strength is the cornerstone for efficient running. Postural muscles hold our body in positions while big strong prime movers handle the work of running. Soft tissue injuries while running like IT Band, patellar tendon, plantar fasciaitis, and shin splints are related to the wrong tissues taking on force while the correct tissues are not working hard enough. With proper identification of the problem, proper cueing during running, and a strength program that supports efficient running, pain-free running can be restored.
At Maximum Velocity Physical Therapy we are the ONLY running specialists in Las Vegas or Henderson, NV. We offer gait analysis, that is, gait evaluation with video analysis, and can help runners return to running with no pain or assist a runner who would like to take their running to a new level. At MVPT we believe that strength training is a runner’s best friend. We offer running performance enhancement strength classes to assist an oft injured runner or help the runner reach new goals. For a limited time, we will allow you come on by and experience a class to see if it is something you can benefit from (I will casually pitch you my program though, just be aware, lol!). Please go to maxvelocityPT.com to read more about us or request an appointment for physical therapy, gait evaluation, or functional evaluation today!