Injury Post-Rehabilitation: When Physical Therapy is Not Enough

It is pretty commonly understood after a major injury it is appropriate to see a physical therapist for follow-up.  The physical therapist's job is to get you back to doing "normal activity."  "Normal activity" is basically walking, maybe some light jogging, house work and a little yard work.  If you are going to be doing activity beyond those things I highly recommend Post Rehabilitation.

What is Post Rehabilitation?  Post Rahab is getting you back to normal activity for you!  That might include running, sprinting, sports, or other activities considered moderate to intense.  Generally physical therapy is going to focus primarily on the injury site, while post-rehab is going to focus on the whole body.  For example, if a person suffers an Anterior Cruciate Ligament Tear the Physical Therapist is going to work primarily on range of motion activities, hamstring and Quad specific activities and some balance activity, almost exclusively for the affected leg.  The PT mostly wants to get that person moving normally again.

Post Rehab takes it to the next level.  When I administer a post rehab program for an ACL injury I generally do the following:

• Stability exercises for the ankle, knee and hip to address joint alignment on both legs.
• A hamstring exercise to continue to protect the ACL.
• An exercise to work on Glute (butt) and hamstring recruitment during squatting motions.  One of the things that can contribute to ACL injuries is high quadriceps dominance over the hamstring and glute.  The more even in strength the three muscle groups are, the less likely there will be a serious knee injury.
• One or two core strength exercises.
• A pushing or chest exercise to start to regain upper body strength.
• A pulling exercise, maybe two depending on upper body balance.
• And a whole body exercise to get everything working together again and firing in proper sequences.

The client who is serious about post-rehabilitation is less likely to re-injure, less likely to get an additional injury due to over use or overcompensation and more likely to be overall stronger and more stable.  For more information on post-rehabilitation programs visit www.canyonptandf.com or contact tom@canyonptandf.com 

What You Should Expect From a Personal Trainer: Before Your First Workout

You have just signed up to start working with a personal trainer.  You bought some new workout clothes because you deserve them, and although you are a little nervous, you are ready to blow your fitness goal out of the water.  You are not sure exactly what to expect, you are pretty sure you are going to be cursing someone the next day because you are too sore to use a toilet by yourself.  But in all reality, if your trainer is doing his job, you will pretty much know what to expect when you walk in and you probably will not as sore as you might think the next day!

Probably the most important, and often most neglected, thing a personal trainer does is the initial client consultation.  In my experience, most trainers gloss over this part.  I do not know if they do this because they do not think it is important, or it is not very sexy, or they are just lazy, but a thorough assessment is what a trainer should use to build a relationship with the client, learn about the client's medical history, understand the client's goals, past successes, failures, likes and dislikes and observe the body in motion to discover any previously unknown injuries, muscle imbalances or postural deviations.  In short, it is the process by which the first workout is built!  If all a trainer does is go over medical history and get a few starting measurements they are operating blindly and likely giving the client a cookie-cutter workout.

Here are the basic steps you should expect every client to take when starting with a new client:

1. Medical History:  A trainer should go over medical history in depth with the client to make sure there are no medical issues which need to be addressed prior to working out.  The medical history should also reveal any injuries past or current the client might have that need to be accounted for.

2. Goals, Past Experience, Likes and Dislikes: A trainer needs to understand the clients goals.  Too often a trainer will pre-judge a client and decide right away what his or her goals should be.  A trainer should be focused the clients goals, not his goals for the client.  A trainer needs to know what the client has done in the past.  Did it work, did they enjoy it, why are they not still doing it?  The client should have input in to the process.  Reaching fitness goals has to be a collaboration between client and trainer or it will never work.

3. Measurements: Almost every trainer takes starting measurements.  Most of them make a huge deal out of Weight, circumference, bodyfat, and any other measurement they can take.  Trainers are playing the odds.  They figure if they take enough of them one will improve and they can use it to demonstrate success.  I take the bare minimum of measurements.  What do I need so I can keep an eye on the client's progress.  But guess what?   A client knows if progress is being made.  Clothing starts fitting better, they feel better, they have more energy, they are better at their sport and all the other things that go with success.

4. Photos: A trainer should always take photos of clients performing simple movements such as squats.  There are two reasons.  First, even a veteran trainer has a hard time catching every postural deviation or muscle imbalance in real time.  Photos help the trainer see where the work needs to be done.  Photos are also great to show to the client so they can see an internally rotated knee or lateral hip transition or there potential area for injury.

5. The final thing a trainer needs to do is take time to talk to a client and get to know them.  What kind of lifestyle does this person lead?  Are there outside factors keeping them from being successful, are there mental barriers, who are the people in their lives who are good or bad influence.  This information can be critical in constructing a road map for success.

Hopefully your trainer did all these things before you started your workouts.  If he did not, you might want to ask why, and ask to do some of these things.  Next week we will talk about what a first workout should really feel like, and what you might expect to get out of it.  For more information of trainer best practices or how you can get started with a personal trainer email tom@canyonptandf.com or visit www.canyonptandf.com.

Are We Killing Our Kids With Sports? Part 3 of 3

Today I want to look at how a three sports, two sport or one sport athlete can maximize his or her athletic potential in the safest way possible and still carve out a path to playing at the varsity or even collegiate level.  Before we look at specific examples remember these things: If you are good enough, they will find you.  Very few people ever make a living playing sports; focusing on academics can often be worth as much in scholarship money as athletics and has more long term potential.  Regardless of how talented the athlete, they cannot play if they are injured.

Let's start with an easy example, the one sport athletes.  By the time they get to high school many kids have discovered they really only enjoy playing one sport and they are good at it!  I will use boys soccer as an example.  A boy interested only in playing soccer has an opportunity to play high-school varsity and club.  In many instances the clubs can be a better path to playing NCAA ball than high school.  The varsity season usually runs from late July to October and there is usually then a break until the club season starts up in February or March.  Most club seasons then run up to the beginning of the varsity season.  The key here, is the break.  For the two to three months of break the kid can rest his body a little, start a strength and conditioning program, spend time with friends and generally check out from soccer for several weeks while still working on being a better athlete.

A two sport athlete gets a little more complicated depending on the sports.  Let's use the common example of football and baseball.  Football runs from late July through October or November and is really only played in high school.  Baseball is a different story entirely.  It can literally run year around between club and varsity programs.  My recommendation is this.  Use the time between when football ends and high-school baseball begins as the off-season and get him into a good strength and conditioning program.  He should not spend any time on sport specific activities until about two weeks before baseball season begins.  At that time he can go to the batting cage and work on fielding and throwing.  Find a club baseball program that will let him participate only during the time between the end of high-school baseball and the beginning of football.  During the summer continue to do two days, about 30 minutes a day of strength and conditioning activities.  The strength gains will be minimal but it will help with maintenance and injury prevention.  About 2 weeks before the football season starts he can start focusing on sport specific activities again.  During the football season it makes some sense to take a 1/2 hour 1 - 2 days a week to get in the batting cage or throw a few balls.  The same could be true with throwing or catching footballs during the baseball seasons.

And now for the three sport athlete, or often the 7 season athlete.  I will use girls softball, basketball and soccer as an example if for no other reason I am familiar with them.  Because this player is going to be in-season 9 to 10 months out of the year for varsity sports, by default the summer has to be her off-season.  Have her focus on the sport that is in season.  During the fall when softball is being played (in Colorado, anyway), take about a 1/2 hour a day, three days a week and work on shooting, dribbling, juggling and ball handling.  I would recommend doing one sport each day and alternate so one week two basketball and one soccer, then two soccer and one basketball the next week and so on.  In the winter focus on basketball and do the same thing a 1/2 hour per day with softball and soccer, and then in the spring focus on soccer.   As a coach I would love to have this kid on my team, any team, at any level!  During the summer she should be doing a strength and conditioning program.  Many club teams are in search of guest players during the summer.  Pick one or two tournaments for each sport and contact club teams to find guest spots.  Although it is not an ideal off-season it is still better than playing full-on club ball year around, allows her to focus on building strength, speed and agiliy, and still gets her in front of college coaches.  Even if seasons are going back to back, I would insist she take a week between sports to decompress.

There are many, many different combinations of sports out there, and these are just common examples.  The key is focus on one sport at a time. Perhaps the high school sport is not as competitive  as a club sport but at least the kid gets to play with his or her friends and playing on a poor team can often be as valuable an experience as playing on a great one.  Anyone looking for more information on how to manage multi-sport athletes please e mail me at tom@canyonptandf.com

Are We Killing our Kids with Sports? Part 2 of 3

Last week I explored some of the disturbing trends I am seeing in youth sports.  I am seeing burnout at an early age, many use injuries to shoulders, backs, knees and ankles and kids stressed out about doing something that is supposed to be fun and build a love for competition and teamwork.  The question then, is what can be done?  How does a kid who dreams of playing at the college and wants to play multiple sports do it without tearing up their minds and bodies?

1. Insist on one day off every week and an off-season every year.  Think about this.  In 2014 LeBron James earned $72.3 Million (Forbes) in salary and endorsements.  The NBA season starts in October and ends in June.  It is an incredibly long season.  But it is still not year around.  One of the best athletes of our time being paid tens of millions of dollars still gets an off-season to rest his body, spend time with his family and hit the weight room.  And yet so many 15 and 16 year-old kids are expected to play 7 days a week, 365 days a year.  Give the athletes time to recover, time to get stronger and time to be kids.

2. Never, ever, make it about money.  Ever.  I have many times heard: "I have to play in this tournament because my parents paid a lot for me to be in it."  or "If I don't get an athletic scholarship I won't be able to afford college."  What a load of garbage.  These kids are already competitive kids.  Their playing time is dependant on their performance on the field.  It is not okay to link their current or financial future to their sports performance at 15 years old.  There are an increasing number of adults who cannot handle the pressure of a high intensity, high performance job and you want to put that on a teenager?  Instead of dropping thousands of dollars on softball tournaments try investing that money in a college fund.  Two problems are solved.  And believe it or not there are infinite ways to get better at sports for little or no financial investment at all.

3. Restrict the athletes to one sport at a time but encourage them to play multiple sports.  The quickest way to burn a kid out is having them play two sports at a time.  Again, lets look at an adult example.  Let's say you have one full-time job (Going to school) and two part-time jobs.  You work 8 hours a day Monday - Friday at your full-time job and sometime have to work from home evenings and weekends.  You then work another 2 - 4 hours a day Monday - Thursday at your 1st part-time job and then another 2 - 4 hours 2 - 3 days a week and all day Sunday.  Would you ever know if you were coming or going, what you were supposed to do, or where you were supposed to be?  And what about those days when you are scheduled at the same time for two and sometimes all three of those jobs?  How do you decide which one you focus on?

Do, however, encourage kids to play more than one sport.  It is not out of the question a kid finds one sport they love and wants to play as much as possible.  This is where club sports can play a roll. A soccer player could play a high school season in the fall and a club season in the spring or summer still having a solid off-season.  But if the kid is an overall athlete and excels at and enjoys playing more than one sport, encourage it.  Most high-schools offer affordable and competitive programs at a relatively low price.  The programs are also heavily regulated by state athletic associations requiring days off, restricting playing time to a safe level and assuring coaching qualifications.   Multiple sports give the athlete a chance to switch gears to avoid burnout, teach new skills and make them better over-all athletes.

4. Stop being their agent and start being their parent.  I cannot stress the importance of this.  We are talking about children.  They have to check in every time they leave the house.  They cannot even drive themselves around and yet, I hear, "She is so driven and just wants to play all the time.  I cannot stop her."  More garbage.  Be the parent.  Parents need to help kids make responsible choices for their benefit and well-being not so parents can save a buck or live vicariously through their kids.  This is not every parent.  But it is more than anyone wishes to admit.  Parents need to put limits on the time kids play sports just like they do with television, video games or anything else.

Next week I will outline specific gameplans for specific scenarios to help kids start enjoying sports again and still have opportunities to to play multiple sports, play at the next level and be extremely competitive while still following the four rules I outlined.  If you have any specific scenarios you would like addressed e mail me at tom@canyonptandf.com.

Are We Killing Our Kids with Sports? Part 1 of 3

I have been working with young athletes for over 15 years now.  I enjoy it in part because there is seemingly no limit to their energy, ability to improve and drive to do so.  But more and more I am seeing a disturbing trend.  Kids are getting injured, burning out and coming to resent sports as early as 15 or 16 years old.  By the time many of them get to play at the college level they are so broken or resentful of the process they are either going through the motions because it is all they know, or done with sports.

Now do not get me wrong.  Not every student-athlete is washing out of athletics.  But I do see it more now than I did even 10 years ago.  I am sure there are many scientific papers out there about this but this is more about my observations.  I invite you to add any comments of your own or study references.  Here is what I am seeing:

Most athletes who have a chance to play in college are probably good at more than one sport.  They are just good athletes.  Even though they may be best at or enjoy one sport the most, they love competing with their friends and teammates in several different sports.  When they enter high school they are already 3 or 4 sport athletes and want to continue because they really enjoy it. Over the years athletic participation has become very competitive.  There are more student-athletes than ever competing for a limited number of sports scholarships.  Club programs offer an opportunity to play a sport year around during the high-school sports' off-seasons to get better and be more competitive.  The club programs often market themselves as the best way to get noticed or recruited by college coaches.  So you take a 3-sport athletes, give them the opportunity to play in a high level club to get recruited and suddenly you go from a 3-sport to a 5 or now even 6-sport athlete!  These athletes are also under pressure to perform in the classroom.  College athletic programs are taking grades more seriously than ever so academics count.

I more and more often see student-athletes playing a high school varsity sport and club sport in the fall, varsity sport in the winter, varsity and club in the spring, and 1 or 2 club sports in the summer.  Technically this becomes a 6 or 7 sport athlete.  Every spare moment they have is spent catching up on school work or practicing a sport on their own. Sleep is a secondary thought at best with many of these kids getting 4 - 5 hours a night regularly.  The seasons blend together and there is no time for recovery, rest, or strength training.

The 4 - 7 sport athletes I see have chronic over-use injuries.  Their shoulders are fatigued, sore and tight, their backs are sore and often spasm, they have weak hips, knees and ankles which often lead to strains and sprains.  By the time they are 16 or 17 their bodies are so worn down the student athletes are "band-aiding" themselves together long enough to get through a season or even a tournament.  Mentally they never get a break.

I will make an analogy:  Let's assume you love your job.  You cannot believe you get paid to do what you do and really enjoy going to work every day.  Now lets assume you have to be there 15 hours a day, 7 days a week.  Let's also assume someone runs a chair into your knee every day hard enough for you to feel it but it is not really painful.  And let's say they run this chair in to you 100 times a day.  Every day.  You have 6 or 7 different bosses all telling you to do your job better and all of them telling you how to do it and all of them having different ways they want it done.  How long do you think you would last?  I would probably make it 2 or 3 months and then just be done!  And we expect these kids to do it for years and years.  Think about it!

Next week I will explore some solutions.  I will talk about ways to build better athletes and start making sports fun again and less of a grind.  I will also talk about the reality of what it takes to play sports at the college level.  I welcome your comments and suggestions.  You can post here or e mail me at tom@canyonptandf.com.  And for more information on injury prevention visit www.canyonptandf.com.

The Biggest Reason to Stay in Shape May Surprise You!

The emphasis for most fitness articles, blogs, professionals, and television spokes-people with bad hairstyles is getting in shape.  They are forever showing pictures of normally attractive, but overweight men, women and children in the most unflattering clothing, poses and situations next to photos of, in theory, the same people ripped out of their minds standing next to supermodels on private yachts.  It is as if these people lost 20 pounds and were immediate showered with cash and became the most popular people at the Sports Illustrated Swimsuit Edition photo shoot.

But very rarely does anyone talk about the importance of staying in shape.  

Let's be clear.  Staying in shape is important for your heart health, cholesterol levels and all of those critical things.  But the other thing staying in shape does is help prevent injury!  And I am talking about really fun injuries like ruptured ligaments, sprained ankles and pulled muscles.  These are all things that can take you out of work, out of sports and out of day to day life for a very long time and are also quite expensive!

What does staying in shape have to do with this?  I will tell you!  When a person is out of shape and overweight, their body gets used to moving a certain way.  Over the years the body has learned its limitations and moves appropriately.  As a person starts to get in better shape, the body starts to move more efficiently.  It can run faster, move more quickly, lift more weight and do things it never used to do.  These abilities start to happen gradually as progress is made.

When a person stops working out, eating correctly, running or otherwise, gets out of shape, it can happen very quickly.  In two to three weeks of inactivity a person can lose virtually all the work they did.  However, the memo does not get to the body right away.  It will still try to move as if the person were still in shape.  So when a person tries to round second base and accelerate toward third, they can pull a hamstring, or when cutting to get to a soccer ball can rupture an ACL or sprain an ankle stepping off a curb.

So do yourself a favor.  Get your butt in shape, and stay there!  Give your body a fighting chance to stay in-tact and help you do the things you want to do.  For more information on getting and STAYING in shape contact tom@canyonptandf.com or duebersports.com.

The Trick to a Stronger Chest, Work on Your Back

I feel like I can hardly walk 5 feet without running across someone talking about how much they can bench, some "newest secret the experts don't want you to know" to make your chest stronger, or some reference to your pecs.  If you were visiting from a distant planet you would think being able to bench 225 is critically important to our survival, seconds only to breathing, consuming all meals in under 5 minutes and rock hard abs.

First, let's clear something up about experts.  We WANT you to know our "tricks."  We go out of our way to demonstrate our ticks in such a way as to show we ARE EXPERTS!  If all we did was run around announcing we are experts and then scurry under rocks you would be much less likely to believe us or pay us large wads of money!

Okay, as for your chest, and its strength.  I would like to mention, by the way, your chest is probably strong enough as it is.  If you can push the door open, or push yourself up off the ground you are probably all set in the chest strength department.  That is, of course, unless you are a professional athlete, or your job requires you to regularly push rocks up hills.  Then you need to constantly increase your chest strength.  So yes, to get a stronger chest you need to move heavy weight in the form of dumbbells, your body, large rocks, etc, but that is only part of the equation.  The other part is your back.  Let me explain.

Your body generally works best when you have balance between opposing muscle groups.  The closer in strength your quads are to your hamstrings the greater overall leg strength you have.  The same holds true for your upper body.  If all you do is chest exercise your chest tends to get tighter.  You might notice your shoulders are starting to wrap around forward a little and your palms are facing the front of your legs.  They should be facing the sides of your legs.  Your chest is now in a constant state of flexion.  And, because of this, can create less force.  Think of it as only being able to partially cock the hammer on a gun.  When the trigger is pulled it can not travel as far and cannot create as much force when striking the round.

If you have been neglecting your back and start to spend a little time on it you will likely notice two things: 1. Your back is nowhere near as strong as your chest.  Can you row as much as you can press?  Probably not.  Second, your chest is tight enough it is not allowing your shoulders to travel back as you pull an object back.  Start doing a ratio of 2:1 back exercise to chest exercise and stretch that chest!  Focus on squeezing your shoulder blades and keeping your shoulders low. Your chest will start to loosen up and your shoulder will start going back to where they belong.  Now you can fully cock that hammer and BAM!

For more on strength and muscle balance e mail Tom at tom@canyonptandf.com or visit canyonptandf.com.  Oh and for those of you following the story of my research assistant, she is two weeks post op, and doing very well.  With a little luck, today we lose the Cone of I Don't Know Why You Hate Me But I am Sorry for Whatever I Did and if You Take it Off I Will Stop Doing It And Love You Forever.