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Painful Back? You May Be Hurting It By Stretching

What you need to know:

  • Many healthcare providers and trainers poorly understand how movement of the nervous system relates to several common pain syndromes and musculoskeletal conditions.
  • Dealing with neural tension is not as simple as just stretching. While stretching may feel good, it very easily may aggravate symptoms.
  • Once appropriate treatment of neural tension begins, patients often normalize their movement very quickly and experience pain relief. Often this pain relief is instantaneous.
What is Neural Tension?
Neural tension is rather unheard of yet it often plays a significant role in many pain syndromes and musculoskeletal conditions. We all understand for movement to occur in the body, joints must move and your muscles must contract. But did you know that your nervous system tissue must also move freely and unimpeded during movement?

Neural tension is commonly mistaken for muscle tension. Your nerves were not designed to stretch, but rather to glide and give during movement.
If some form of obstruction (soft tissue or bony) impedes your neural tissue then pain or restriction of normal nerve movement is a common result. This normal nerve movement may only be a matter of millimeters, but nerve tissue is highly sensitive and does not like to stretch. Thus if too much stretch is placed on a nerve, the result is adverse neural tension and that can create pain, limited range of motion, as well as other classical symptoms associated with nerve tissue (numbness, burning, shooting pain, etc.)

Neural Tension Treatment
The movement of your nerves, or neurodynamics, can be assessed by a licensed chiropractor or therapist trained in the process of detecting and treating neural tension. Screens or tests commonly used to identify neural tension help identify not only which nerve(s) have adverse neural tension but also where the nerve is being obstructed during its movement.  Identify where the nerve is being obstructed is critically important because treatment is tailored to the site of obstruction.

Again, this highlights the importance of an accurate assessment as treatment can be more accurately applied to the structure(s) creating adverse neural tension. Once treatment begins, patients often normalize their movement very quickly and experience pain relief. Often this nerve pain relief is instantaneous.

What Conditions Commonly Involve Adverse Neural Tension?
Some common conditions that adverse neural tension often plays a role in or is a complicating factor that must be treated include:
  • Neck Pain
  • Shoulder Pain
  • Tennis Elbow
  • Carpal Tunnel Syndrome
  • Low Back Pain
  • Hip Pain
  • Sciatica
  • Plantar Fasciitis
Stretching vs Nerve Mobilizations
A common misconception in the treatment of back pain and associated muscle tightness is the idea that one must stretch to get relief. Stretching may bring temporary relief, only for one to experience the tightness come back once again or, worse yet, an increase in their pain.

Interestingly, when neural tension is identified as the underlying reason for muscle tightness, the treatment of neural tension doesn't actually involve stretching. Excessive stretching can actually irritate your nerves and increase pain. Excessive stretching may potentially damage your nerves as well.

This should make the message pretty clear - stretching may not be the best thing for your back when it's giving you all the signs that it isn't responding favorably.

Rather than stretching, restricted nerves and the surrounding muscles require a different approach known as nerve mobilizations or nerve sliders. Qualified chiropractors and physical therapists will utilize nerve mobilizations to help entraped nerves slide better during movement. They will also treat the surrounding muscles or tissues that is obstructing your normal nerve movement. After treatment, they will retest your neurodynamics and repeat the process until your full neural movement is restored. This process may take a few treatments to clear up, or take several, depending on severity.

Research Supports Neurodynamics
The concept of neurodynamics or neuromobilization is originally based on the research of Michael Shacklock and David Butler. Over the past several years, further research has added to the scientific support of the concept that your nerve tissue requires full freedom of movement to remain pain-free.

The following excerpts are from Michael Shacklock’s book Clinical Neurodynamics: a new system of musculoskeletal treatment:
"Neurodynamics is an innovative management tool involving conservative decompression of nerves, various neural mobilising techniques and patient education techniques. Neurodynamics offers a fresh understanding and management strategies for common syndromes such as plantar fasciitis, tennis elbow, nerve root disorders, carpal tunnel syndromes and spinal pain."

"Essentially the entire nervous system is a continuous structure and it moves and slides in the body as we move and the movement is related to critical physiological processes such as blood flow to neurones. This movement is quite dramatic and it is not hard to imagine that fluid such as blood in the nerve bed, a constricting scar, inflammation around the nerve or a nerve having to contend with arthritic changes or proximity to an unstable joint could have damaging effects, some of which could lead to pain."
Final Words
Neural tension can be present with many common musculoskeletal conditions, such as back pain. Very often neural tension is easily mistaken for muscle tension, leading many to want to stretch in order to find relief. Stretching can be counterproductive and may aggravate pain symptoms. In order to treat neural tension, it must be examined accordingly. At GP, we are trained in detecting and treating adverse neural tension and why it is present.

If your pain is not resolving with other interventions, consider your pain may be associated with neural tension and you may benefit from the most appropriate course of treatment and client education.

More related reading:

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

 

Learn How to Spot the Fitness Frauds

Health and fitness is a service-based industry and, like all service-based industries, the Internet has dramatically changed how people are reached with marketing and sales strategies. Among many factors, a huge player is the rise in popularity of social media and the entertainment it provides. From Facebook to Twitter to YouTube to Instagram, one has the opportunity to reach people with greater ease than ever before.

Certainly, there are many positives that can result from this; however, there is the other side. The side where the opportunists, the con-artists, and the shameless self-promoters thrive. They have more interest in deception than education. Sure they can entertain and fascinate, but are they providing something of substance? Social media has opened the door to anyone who wants to push health and fitness information before anyone can scrutinize the quality, making sure it holds up to the science of human and exercise physiology.

So how do you identify the frauds? The con-artists? The over-night sensations who compete in one event (show, competition, race) and are now parading themselves online as some go-to fitness expert before anyone has realized they are only serving one giant cup of nonsense, likely peddling other's work and intellectual property as their own?

My brother and I ponder this subject quiet often. We discuss it with close friends and colleagues in the health and fitness industry. So here is a short list of items that should make you question both what you are reading and the person associated with it.

1) Lack of qualifications for what they claim to do.
Honest members of the industry will come straight out and tell you what they’re trained to do and more importantly, what they are not trained to do. In the fitness industry, some jobs don’t require much of a formal education, while other jobs require quite the opposite. A run-of-the-mill personal trainer only requires a basic certification before gaining hands-on experience. Those who work in high-performance settings, with specialized clients, or integrate therapeutic or corrective measures into their programs will require considerably more education as they are held to higher standards of competency. Naturally, the higher you climb, the greater your earning potential. The problem arises when trainers mislead and misrepresent themselves, acting as if they are qualified in areas they are not, all in the name of earning the almighty buck. They are usually the ones who are also trying to convince you that education is not importance and "only experience matters". This is just wrong. Stop it. This is a classic con-man scheme.

2) They Suffer from Selfie-Hashtag-Buzzword Syndrome.
Social media has created a monster known as the selfie. Those trying their best to break into the fitness industry want to make as much noise as possible. What better avenue than selfies, right? They use their endless stream of selfies as if they are pushing a business card in your face. As if somehow we should buy into what they are doing and come along for the ride. Then to top it all off, they bombard us with hashtags, buzzwords, and trendy phrases intended to connect, motivate, and inspire. Ultimately, they want you to buy into them. They want your attention and your business. Most in the fitness industry are guilty of this, and I must admit we play the game as well. But if you sift through all the selfies and hashtags and find only more selfies and hashtags with nothing of real substance, red flags should go up. There is a point at which those that you follow online must stop existing in the virtual world and provide a physical form of interaction. Who have they worked with? What results have they produced? If their body of work is mostly selfies and hashtags, they're a fraud.

3) What they say doesn’t line up with how they look.
This builds off my earlier point. Sure there are plenty of trainers and coaches and fitness experts who look great and seem to have the body of your desires (attention ladies). The are usually the one posting selfies, using their body as their business card. They want you to know how great they look on a constant basis. There are thousands in the health and fitness industry that look great. So what?  Does that necessarily mean they know what they are doing or that they possess the knowledge on how to help you reach your goals. I agree that people in the health and fitness industry should “look the part”. They should exemplify health and fitness because it's their passion, not because they are trying to sell you on themselves or their products. Looking the part is important, but if you are going to base who you decide to work with solely on how they look, you could be in for a rude surprise. Talk to them. Ask them questions. They should be knowledgeable. They should be educated on the subjects of anatomy, physiology, nutrition, human movement, and how these topics relate to your goals.  People get into these industries all the time because it looks easy on paper. It’s not easy.  If they are clueless, they are in the wrong business.

4) They always have something to say, always trying to sell.
If someone is really good – meaning they know what they’re talking about and consistently get quality results – you never hear from them. Rather you hear about them – from their clients, colleagues, and their competition. But, you never hear from them directly.

What about the imitators? They are all about making noise. All about getting as much attention as possible. They will not only hustle to get your attention. No, hustling is not enough. They are going to overwhelm you, wave after wave after wave of their propaganda.

Trust your gut the next time some health or fitness “expert” pops up on your social media and your reaction is, “Not them again.” Your gut instinct is usually an honest one.

Final Words
There are plenty of honest individuals and organizations in the health and fitness industry that operate themselves with integrity. Seek them out. They desire to properly educate and help others achieve their goals, doing so with tremendous success. These are the trainers and coaches you need to find and receive guidance from when you are unsure of how to pursue your goals. But with all the noise and distractions, they can be hard to find because they aren't out there shamelessly promoting themselves. Unfortunately, there are far too many frauds and con-artists who end up getting more business than they should because of the noise they generate. Noise does not equal results. Hopefully this article allows you to best identify who you should be trusting with your health and fitness pursuits. And hopefully it helps you to ignore the noise.

More related reading:

https://gallagherperformance.com/the-truth-about-functional-exercise/

https://gallagherperformance.com/training-tip/

https://gallagherperformance.com/how-to-develop-physical-fitness/

Gallagher Performance Receives 2015 Best of Pittsburgh Award

Pittsburgh Award Program Honors the Achievement
Gallagher Performance has been selected for the 2015 Best of Pittsburgh Award in the Chiropractors category by the Pittsburgh Award Program.

Each year, the Pittsburgh Award Program identifies companies that we believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and our community. These exceptional companies help make the Pittsburgh area a great place to live, work and play.

Various sources of information were gathered and analyzed to choose the winners in each category. The 2015 Pittsburgh Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the Pittsburgh Award Program and data provided by third parties.

About Pittsburgh Award Program
The Pittsburgh Award Program is an annual awards program honoring the achievements and accomplishments of local businesses throughout the Pittsburgh area. Recognition is given to those companies that have shown the ability to use their best practices and implemented programs to generate competitive advantages and long-term value.

The Pittsburgh Award Program was established to recognize the best of local businesses in our community. Our organization works exclusively with local business owners, trade groups, professional associations and other business advertising and marketing groups. Our mission is to recognize the small business community's contributions to the U.S. economy.

SOURCE: Pittsburgh Award Program

Are You Promoting Independence?

As a chiropractor, I often treat people who have already exhausted all of their insurance money from seeing other chiropractors and/or physical therapists. They come to me out-of-pocket and immediately expect me to do significantly more in one or two visits than the previous professional(s) did after the 12-20 visits that drained their insurance benefits.

I’ve routinely accepted the challenge and many times I’ve closed their case in 2-4 visits by having them listen to advice, advice that addresses underlying issues previously missed or ignored by other providers. Yes, I am a chiropractor and I will adjust and perform manual therapy as needed. But the difference maker time and time again has been the time focused on education directed at independence. Promoting independence on the patient’s behalf is a game changer. This is why I feel so strongly that empowering a patient should be the focus behind therapy and prescribed home programs. As patients discover how they are able to better themselves, their compliance becomes a non-issue and outcomes drastically improve.

The opportunity to educate others is a responsibility that should never be taken lightly. As a provider, the methods utilized to accurately assess a patient’s condition and direct treatment must also serve to improve provider-patient education and accountability.

Gray Cook places this perspective into words very well:

“Our current medical and physical cultures are wasting a lot of time and not creating independence in our clients or our patients. Do we want them to be well and go tell others about their experience or do we want them to keep returning as continual consumers? At what point does wasting time conflict with an oath to do no harm?”
Are you wasting your patient’s time?
One of the fundamental challenges within healthcare is that the human body is a complex adaptive system composed of several interacting parts that are continually changing in response to the stimulus from the environment. This complexity makes understanding the human body a difficult task. Unfortunately, some healthcare providers find reality too complex and would rather repeat the same routine evaluations and treatment over and over again to fit their own skill set rather than truly diagnosing a patient’s condition before administering treatment. This is where providers should question their principles. Are you doing the same thing over and over? Are you so ritualized that your care lacks individualized attention? Are you wasting your patient’s time because you keep missing their problem?

The very essence of what we do is problem solving. Before you can solve a problem, you first must identify what is relevant. On most patients, you can find any number of problems, but it is the relevant problems that are the key. To find relevant problems, you must have a reliable method. The foundation for any method is knowledge and experience. Knowledge and experience that is rooted in understanding how basic science (anatomy, physiology, biochemistry, etc.), pathology, assessment (orthopedics, technique, imaging, etc.), and treatment all integrate.

I’m continually shocked and disappointed when speaking with a new patient who has been told by previous providers that their symptoms “Don’t make sense.” When it comes to musculoskeletal (MS) care, everything makes sense. It may be extremely complex, but it makes sense. If something doesn’t make sense to you, then you don’t understand it well enough. Make changes. Take a more detailed history. Change your perspective. Perform a more detailed assessment. Expand your knowledge base. Do something different.

Never dismiss a patient as not making sense.

As a physical medicine provider, it is your job to have a knowledge base that is large enough to encompass the overwhelming majority of MS problems and conservative interventions. If you don’t, chances are you will suffer along with your patients because your knowledge base is not sufficient enough to diagnose their problems.

Diagnosis must have accuracy and completeness. It must include a pain generator and the relevant problems or dysfunctions. These must be put into context for the patient so they can understand how they came to be the way they are. This is critical as it provides the framework for the education and advice you provide your patient.

Ultimately, that very same framework serves to empower your patients to become more independent. The process is about transitioning them from dependence on you as the provider to an independent patient who truly understands their problem, how to go about fixing it, and the steps needed to prevent recurrent issues in the future.

Final Words
I’m not trying to do anything in my work at Gallagher Performance that is unheard of, but it is still rather uncommon. For my conscience, I would rather create independence than be routine. I also feel that this conscience is growing among healthcare providers and that it is a mindset patients desire to see from their provider.

Promote independence. Your patients will thank you.

More related reading:

https://gallagherperformance.com/stress-overload-and-injury/

https://gallagherperformance.com/relief-care-vs-regular-chiropractic-care/

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

The Hidden Causes of Sports Injury

The purpose of this article is to provide some basic information about the importance of understanding the role posture and function have in pain, injury, and movement dysfunction. The hope is that you will gain an understanding of why your chiropractor or therapist must evaluate and bring into consideration issues that may not seem related to your pain.
Patients come to us with symptoms and we want to get to the source of their symptoms. In addition to providing relief through manipulative therapy and treating muscular adhesions, it can prove to be incredibly valuable to identify the source of their symptoms. In my experience, the source of a client or patient’s symptoms is often found in painless dysfunction of the motor system.

All too common, providers become reductionist in their evaluation and treatment of the motor (aka musculoskeletal) system. In order to provide long-term solutions and minimize reoccurrences, a holistic or global approach to evaluating functional capacity is needed to identify what is driving pathology in the motor system. This concept is of critical importance when you understand that the majority of motor system pathologies exist because the demands of activity exceed the individual’s capacity. If the demands upon the motor system are at a high level, then capacity must be even higher. Even if demands are relatively low, capacity still must exceed the level of the demand. If there is a capacity “shortage”, the result is a higher injury risk. In musculoskeletal care, one of the greatest challenges is identifying functional capacity “shortages” and how to address them during the course of conservative treatment to provide both immediate and sustainable results.

Professor Vladimir Janda and Dr. Karel Lewit pioneered the process of identifying functional pathology within the motor system. The model is in contrast to the traditional North American orthopedic model, which focuses on structural pathology (ex: disc herniations, rotator cuff injury, labral tears, etc.) as the reason for pain and impairment. But simply focusing on structural pathology can take your eyes away from identifying key reasons as to why they developed in the first place.

Outside of structural pathologies, the functional approach to managing motor system pathologies includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. Faulty movement patterns are protective movements that form in response to pain or the anticipation of pain. These are often the hidden causes of injury, the reasons why many structural pathologies occur. Czech physician Vladimir Janda likened musculoskeletal pain and dysfunction as a chain reaction, thus stressing the importance of looking beyond the site of pain for the source of pain. Janda observed that due to the interactions of the skeletal system, muscular system, and central nervous system (CNS), dysfunction at any one joint or muscle is reflected in the quality and function of joints/muscles throughout the entire body. This opens the door to the possibility that the source of pain may be distant from the site of pain.

Janda also recognized that muscle and connective tissue are common to several joint segments; therefore, movement and pain are never isolated to a single joint. He often spoke of “muscular slings” or groups of functionally interrelated muscles. Muscles must disperse load among joints and provide stabilization for movement, making no movement truly isolated. This ultimately is the reason why many providers within physical medicine are catching onto the saying, “Stop chasing pain.” Chasing pain and other symptoms (ex: tightness, stiffness, restricted movement) may provide short-term relief, but are you providing long-term results?

A common intervention in the rehabilitation of motor system pathology is therapeutic exercise and resistance training. These exercises are used to help restore any number of neuromuscular qualities, such as endurance, strength, and motor control. But often, even in a rehab setting, exercises fail to progress a patient in the recovery process. Sometimes, the application of exercise can make a patient's condition worse. Similarly, many people with the intention of being healthy and wanting to help their body “feel better” will use resistance training in their exercise regimen. Working out, exercising, strength training should improve our state of muscle balance, right? Sure they get the cardiovascular, endocrine, and psychological benefits of exercise, but they start to wonder why all their exercising is only making certain areas of their body feel worse. This is why it’s important to learn that unless exercising occurs in a thoughtful manner, based on a functional evaluation of movement and capacity, the benefits of reducing injury risk, improving posture, enhancing motor control, and restoring muscular balance will be difficult to achieve.

For example, what Janda discovered is the tendency for certain muscles within the body to become tight and overactive, while others have the tendency to become weak and underactive. So if someone is performing general exercises, the brain will select the muscles that are already tight to perform the majority of the work. This is a phenomenon knows as “compensation” or “substitution”. Muscles that are already chronically overused will continue to be overused, leading to greater risk of an overload injury. The muscles that are “weak” have developed a sensory-motor amnesia that will not correct itself unless the exercise is carefully selected and tailored to activate these dormant muscles. Such exercises emphasis the quality of the movement pattern over any prescribed number of sets or reps. The eye of the provider can’t be focused on isolated impairments, but on finding the motor control error. Finding the hidden causes of injury or motor system dysfunction.

Remember, what enhances performance also reduces injury. Finding the solutions to enhancing performance will often address hidden motor system dysfunctions. If you are training for athletic performance, you must build functionally specific or sport-specific capacity. If you are recovering from injury, you must build function rather than solely focusing on palliative measures and treating the site of symptoms. In either scenario, you are building a better athlete and fast tracking the rehabilitation process by taking a functional approach to motor system dysfunction.

More related reading:

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/the-importance-of-functional-evaluation/

Interview with Ben Gallagher DPT, FMSC

GP recently interviewed Ben Gallagher DPT, FMSC. If you happened to figure out that Dr. Ben is related to us, you are correct. Ben is a physical therapist at Somerset (PA) Hospital Rehabilitation and Wellness Center. As brothers, we share some very similar concepts in the treatment of patients. But, we also share contrasting viewpoints, which makes it fun to learn from each other and gain a better understanding of the professional roles we serve in providing improved quality of patient care.

Now, let's get to the questions.

GP: Please introduce yourself and give our readers some information on your professional, educational, and athletic background (as well as what you have had to overcome since birth in order to participate in athletics).
BG: My name is Ben Gallagher, brother to Sean and Ryan. I live in Somerset, PA with my wife and daughter. I am a physical therapist and have been working at Somerset Hospital Rehabilitation and Wellness Center for over two years. I graduated from Indiana University of Pennsylvania (IUP) with a degree in Exercise Science in 2008. Then went on to Saint Francis (PA) University to get my Doctorate in Physical Therapy, graduating in 2012. Since graduating I have become FMS (Functional Movement Screen) certified, focusing my continuing education on movement analysis and manual therapies thus far.

Athletically, I grew up playing most sports, mainly focusing on basketball until the 8th grade when I got into ice-hockey as a goaltender, then that became my passion. I played through high school and into college at IUP. As for what I had to "overcome," that would be referencing my heart condition. I was born with Tetrology of Fallot, a congenital disorder that required surgery as a young child and again in 2008, and another in about 15-20 years. The condition restricted me from some sports and it is not advised I lift max weights, placing a limitation of how I could physically train for sport. However, prior to my 2008 surgery, in which my heart was over 3x normal size, I had no issues or symptoms. The doctors attributed my training to why I could function so well with such a crappy heart. Training was a mainstay, and still is.

GP: The thought process in your evaluation and management of patients is not widely instructed in physical therapy programs. What were the biggest influences in your professional development in not only the care that you provide, but also why you sought out additional resources beyond what you learned in school?
BG: The purpose of physical therapy school is to: 1) make sure you pass the licensure exam, and 2) make sure you don't seriously hurt anyone. As for producing quality clinicians? No. School just teaches you the basics, and most practicing therapists provide you just that, the basics, which is what you could find on a Google search. So, as for what helped my professional development, honestly the biggest thing was I just thought differently. I saw things differently and I attribute that to my athletic background and training history. For example, as a PT student I would tell my class-mates, "I'm gonna have my grandmas deadlifting." My classmates would gasp, as if that was the most absurd thing they ever heard. But my thinking was, "If someone needs to build strength, why am I gonna have them lie down and lift their leg? When I want to build strength, I train the squat and deadlift, so how couldn't the same application benefit my patients?" Now let me clarify, not all movements are appropriate for all people, at all times. That's why programs need to be individualized, not cookie-cutter.

So for me, I thought, why do I want to further inundate myself with PT knowledge that is elementary and narrow-minded. I sought out other means to fill that thirst for a fuller, better understanding of how the body functions. FMS, which is for any health or fitness professional, is just one of many means to that end that I am pursuing.

Plus, I have to add this: In reference to the grandmas deadlifting story, there was a research article published shortly after in regards to the most effective exercises to strengthen the hips. The study basically ridiculed all traditional PT exercises and found the most effective was a single-leg deadlift. How 'bout them apples?

GP: You are extremely involved with your patient’s care, preferring to perform a lot of manual therapy and oversee the exercise process. This is not common of the majority of physical therapists. Can you speak to why you find this so valuable in the outcomes your patients are able to achieve?
BG: I don't even know where to begin with this issue. I get fired up about the lack of quality care there is in this field.  Most therapists treat with a shot-gun approach, meaning they're not sure what is really going on or how to treat so they will throw a ton of stuff at you hoping something sticks and works. But the best in rehab are like snipers. They isolate what the exact issue is and address it appropriately. And how can you do that if you are not present and in the mix with your patient's rehab process?

GP: As a physical therapist, you see tremendous value in what chiropractic care has to offer. Could you please give your thoughts on what makes chiropractic and physical therapy so complementary?
BG: Following off the above question, when you are involved with your patient's care, you may find that some issue(s) may be out of your scope and there may be better, more skilled hands that are able to provide effective care. How can one means of healthcare be the most effective? What is most effective is what the patient needs. How can chiropractic care be so bad, which is the view of many therapists, when chiropractors help so many? And how can therapists think we are the kings of rehab and exercise when many therapists stick you on a machine and walk away? I have referred patients to chiropractors and massage therapists. But, I do so instructing them on what they need to share with those professionals, because just going blindly to another professional does not always mean you will get quality care. Chiropractor, massage therapist, physical therapist, strength coach….I don't care what your title is; if you're good, you're good.

GP: Posture, stability, and mobility are intensely debated topics at conferences and continuing education seminars. Could you expand on your philosophy when it comes to the dynamic role between posture, stability, and mobility, what athletes and coaches should understand about these topics, and what should be left to physical medicine providers such as physical therapists and chiropractors?
BG: The first thing that athletes and coaches should understand about posture, stability and mobility is that you likely don't fully understand these concepts. Most lay people honestly don't understand how posture impacts how their body feels and the role it has in movement. Someone with good posture likely can't explain why they have good posture or how they achieved it. But, that is why we, as professionals, are here.

The stability-mobility debate is like a left-wing versus right-wing debate. My philosophy is it's a spectrum. No one physical issue is 100% in either direction, but I do believe stability is the issue the majority of the time. And if mobility is an issue, and is addressed, such as stretching or mobilizing, it should complimented by stabilization training to ensure you have control of the new motion you have just obtained.

GP: You have developed a reputation in your area as a “go-to-therapist” for athletes being referred from orthopedic surgeons because of your eye for assessing movement and your ability to successfully return athletes to competition. Besides the FMS, what other assessments do you find valuable in dealing with athletes and their competition needs?
BG: For those who don't know, the FMS is a tool used to assess a person's quality of movement using seven standardized movements. If you move poorly, you are then going to compensate, compensation leads to altered or poor biomechanics, which leads to injury. So the whole purpose of the FMS is to make sure you move well. The job of the clinician is to not only identify poor movement, but to also figure out why you are not moving well. Therefore, what other assessments do I find valuable for athletes? I want to see them go through their athletic movements: swing a golf club or hockey stick, throw a ball, jump, land, cut, sprint, run, etc.

To be able to do this effectively you must first be able to analyze the movement correctly. Is the movement efficient? If it is not, then you must be able to figure out why it is not and be able to address the problem effectively. All this said, what is really needed is knowledge of athletic movement, a good clinical eye, and the knowledge of how to fix whatever issues are present.

That’s a Wrap
Ben, thank you for taking the time to answer our questions. Your knowledge and insight is truly appreciated. We hope this was informative for our readers as well. For those in the Somerset, PA area, be sure to check out Ben at the Somerset Hospital Rehabilitation and Wellness Center for tremendous results when it comes to returning from injury or understanding how to move better for your exercise or sport-related goals.

More related reading:

https://gallagherperformance.com/posture-and-movement-linking-training-and-therapy/

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

What's the Deal with the Tape?

Similar to the current trend of marketing driving training (discussed in this article), marketing appears to have a similar and undeniable impact on services provided in the world of physical medicine. From the latest and greatest in modalities such as laser therapy and electrical muscle stimulation to musculoskeletal injury interventions such as kinesio tape (KT), the colorful tape that gained popularity from the Olympics.

Earlier this week, a GP client was speaking of someone they know who recently got “taped” because they were having knee pain while running. This client went on to explain that a few days after getting taped, the very same person went out for a run and felt a “tearing and pop” in the same knee that had been taped and is now in worse pain than before.

Our client wanted to know, “What's the deal with the tape? Is it effective or is it a cheap trick?”

Kinesio Tape: Legit or Hype?
What seems to be at the center of any benefit from the application of KT is something known as novel sensory input. Basically, this means when you tape someone, they feel it. Sensory input changes “output” – in this case – motor control and perception of pain.

In the case of the painful knee (or any joint/muscle), stick some tape on it and odds are in your favor that the patient will feel slightly better for a brief period of time.
But is this really “therapy”, getting at the root of the problem, or simply masking pain symptoms?

First, we must start with an understanding of pain. Pain is your body’s way a telling you something is wrong. Pain with movement indicates a movement problem and no amount of tape will ever solve a movement/biomechanical problem. However, taping is very effective at altering proprioceptive/sensory feedback. Sensory input will dampen pain perception, thus making it easier for your brain to ignore pain signals and you are now feeling “less pain”. This is known as “sensory gating”.

You feel less pain and you are happy, so what’s the problem?

You have disrupted the injured tissue’s ability to tell the truth, now you are more likely to continually overload a compromised structure and worsen the condition. To illustrate this phenomenon, one only needs to recall Manteo Mitchell, the sprinter who sustained a fracture of his fibula – wearing KT – while running the 400m in 2012 Olympics. The applied KT allowed the athlete to distribute more load on a painful and compromised ankle. The tape did its job. It blocked pain and allowed the athlete to feel capable of competing, but unfortunately the result was a worse condition than before the tape was applied. Keep in mind, this isn’t always the outcome of taping but it certainly is a risk one must understand.

Not only are companies claiming the pain relieving benefits of KT, now some are stating how their tape prevents injury or enhances performance. Just go to their websites and read for yourself. Spider Tech’s website has the tag line: “Recovery, Performance, Prevention” and Rock Tape (on their About Us page) has this to say:

“I discovered that the tape can be used to ENHANCE PERFORMANCE. I found that taping in advance of exercise promotes increased blood flow to the muscles, thereby reducing fatigue.”
Marketing with fancy words and convenient KT placement on some elite athletes does wonders for a product’s popularity. But are the claims substantiated?

There are few high-quality studies on taping, but a recent systematic review of the research literature revealed that KT had insufficient evidence to support its use for musculoskeletal injury. Studies have shown that benefits from KT are generally minor, brief and inconsistent in nature. The value of taping is unclear, with several experts dismissing the effectiveness of taping as placebo only. The systematic review conclude that KT did provide short-term pain relief and even range of motion (ROM) improvement, but failed to offer any long-term results to patients.

In Closing
For the most part, taping is a lot of marketing hype. At best, taping is mostly a minor and imprecise method of pain control. The amount of tape being used by athletes lately is silly and, in my opinion, its popularity has more to do with marketing than results. Sure taping may make someone feel better and in a “results now” society this can go a long way to keep patients satisfied. However, there is no long-term solution to be found with any amount of tape.

Where does one turn for a long-term solution?

At GP, we consider ourselves part of a growing body of providers who strive to identify the repetitive movements and postural abnormalities that cause pain and discomfort by performing thorough and detailed examinations. Assessments and individualized treatment plans aim to identify the underlying cause of your condition rather than merely alleviating symptoms.

The more accurate the assessment, the more accurately treatment will target a patient's pain generators. At GP, we stress a collective and active approach on the part of each of our patients through education. By clearly educating each patient on their condition and why they are performing prescribed exercises, the focus becomes about patient empowerment and providing them with a sense of what they can do for themselves. This typically results in great patient compliance and shorter treatment plans, with the average patient realizing fully recovery in 4-8 treatments. Many patients quickly improve in as little as 2-3 treatments.

Reference:
Mostafavifar M, Wertz J, Borchers J. A systematic review of the effectiveness of kinesio taping for musculoskeletal injury. Phys Sportsmed. 2012 Nov;40(4):33-40. 

 
More related reading:

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/technique_and_performance/

https://gallagherperformance.com/why-therapists-should-understand-strength/

Stress Overload and Injury

In the world of athletics and pursuit of elite level performance, injuries are a given. However, the prevention of sports injuries is never as simple as identifying movements or exercises that should be avoided. It would be nice if it was that simple and if we could solve all the injury problems for athletes across the globe by eliminating one particular movement. Unfortunately, the human body is too complex to be solved by one solution that can be applied to everyone.

Rather than debate the role of specific exercises in a training or rehabilitation program, loading parameters and progressions, or whether certain exercises pose greater risk than reward, the purpose of this article is to discuss a much deeper concept that is at the heart of injury prevention and management, the balance between stress and adaptation.

Hello, My Name is Stress
Stress is something each and every one of us is all too familiar with. Whether it’s related to financial struggles, work-related problems, academic pressures, athletic expectations, family or relationship issues, stress is a common theme of the human existence. Now while these forms of mental stress are responsible for many reactions within the human body, for the purposes of this article this is not the kind of stress I am talking about. Rather, we will be discussing what is known as biological stress and how it relates to injury.

What is Biological Stress?

Biological stress accounts for all the physical demands (stress) placed on our bodies, both mechanical stress and metabolic stress.

Mechanical stress is a measure of the force produced and absorbed by the entire neuromusculoskeletal (NMS) system, including components such as nerves, muscle fibers, tendons, ligaments, fascia, and bone.

Metabolic stress is a measure of the demand placed on all the systems responsible for energy production/recovery and involves every major organ system in the body, such as the cardiovascular, nervous, muscular, endocrine, and immune systems.

As you can tell, both mechanical and metabolic stress are highly interrelated. The greater the degree of mechanical stress, the greater the degree of metabolic stress.

Balancing Stress & Adaptation
Training is best defined as, the targeted application of stress designed to disrupt homeostasis and put the body’s defense mechanisms at work; remodeling, strengthening and improving the efficiency of many different systems throughout the body.”
Factors that Influence Biological Stress:

  • Training Volume
  • Training Intensity
  • Training Frequency
  • Exercise Selection
These simple variables are what define individual training sessions and the training block/phase. They will dictate the amount of biological (mechanical and metabolic) stress, its application to the human body, and how much stress is applied. The training goal becomes to apply the correct type of stress in the appropriate dose/amount while targeted to the appropriate areas necessary to improve performance.

Training and biological stress is one side of the coin. The other side takes into consideration factors that influence adaptation. What makes the training process enormously more complex than it appears is what happens in between sessions as our body responds to the stress of the training session or adapts. The complexity stems from how many variables are involved in how we adapt to the stress imposed by training.

Factors that Influence Adaptation:
  • Genetics
  • Training History
  • Nutritional Habits
  • Sleep Quality
  • Mental Stress
Our genetics, nutritional habits, level of mental stress, training history, and sleep play a critical role in how quickly our body’s systems and tissues are able to rebuild and adapt from the stress of the training process. Get enough sleep, eat well, have better genetics and a long history of training, you will adapt much faster and respond quicker to the same level of training/stress than someone who is experiencing higher levels of mental stress, has poor sleeping habits, a poor diet, and lesser genetics. Even minor differences in any one of these factors can have a major impact on the ability to adapt to your current training.

Out of Balance, Out with Injury
By now, it should be clear that looking at sports injuries solely from the standpoint of the use or misuse of particular exercises or protocols doesn’t paint a very complete picture of why they happen. Even when discussions of injuries extend into the realm of assessing various movement patterns and joint function while trying to predict or minimize risk of injuries purely through improving quality of movement, often times these discussions fail to consider the fundamental concepts of the stress-adaptation balance.

The truth that is rarely discussed is that every athlete and individual is truly different and no two people will ever respond to a given training program or level of stress in the same manner. Recently, the days of individualized training have been replaced with current fitness trends of bootcamps, CrossFit, P90x and other such programs that irrationally encourage anyone and everyone to do the same thing.

Not only do such approaches always fail to consider a person’s individual ability to adapt to stress, they often preach that results are a direct result of nothing more than lots of effort with lots of intensity. The classic American attitude of “more is always better” approach has spilled over into training, training with high intensities at increasingly higher volumes. Now combine that with no individualized considerations and what you have is a recipe for injury. Current fitness trends seem to place a greater importance on the business model rather than having an appreciation and understanding of the complex function of the human body as it relates to developing a quality training program for the individual.

When you consider the stress-adaptation balance, it's not surprising why the injury rates are continually rising in youth sports. Young athletes today are under incredible pressures to specialize in one sport, be it from coaches or parents, and this is why it’s become sadly common to see athletes as young as 12-14 suffering from chronic stress injuries like tendinitis, or the more correct diagnosis of tendinosis. The ‘multi-sport’ athlete has been replaced with the ‘single-sport, all year long’ athlete. A year round competitive schedule, lack of properly constructed sport practice, and lack of time dedicated to physical preparation and athletic development is largely to blame for the huge increase in youth sports injuries in recent years.

I just happened to catch a recent interview with Tommy John on Dan Patrick’s radio show. For those of you who may be familiar with his name, Tommy John is a former MLB pitcher and the “Tommy John” surgery is named after him since he was the first individual to have the medical procedure of ulnar collateral ligament reconstruction. When asked about his thoughts as to why the surgery is so common now, Tommy John has this to say,
“I really believe….that sports, high school sports, little league sports, have become year round. And they force these kids at a very young age to pick a sport and that’s the only sport that they play, they train at. And you have these….pitching academies and your kid comes in and pays $2000-$3000 and you go in every Saturday and work on pitching. And I tell parents this, “If the best pitchers in the world don’t pitch year round, then why should your kid pitch year round?”….You have to get all these great surgeons that do Tommy John surgery, or did Tommy John surgery, they cringe when you say ‘year round pitching’ because you must let the arm rest.”
Without knowing exactly why, Tommy John nailed the central issue when it comes to several sports injuries, the lack of appropriate rest to allow the body the chance to recover and adapt to the stress placed upon it. Despite his example of baseball and pitching, the truth is each sport has it own unique injury rates. It truly all comes back to stress and the inability of most coaches and trainers to respect the stress and adaptation process. While some athletes are capable of adapting to stress far more efficiently than others, no one is immune from the effects of a poorly designed training or sport preparation program. Such programs are run by coaches or trainers that chronically stress athletes with little understanding of how to facilitate recovery and adaption, ultimately leading to injury.

Final Words
Regardless of whether you are a doctor, therapist, coach, athlete or simply just train to be healthy and stay in shape, this article was to present you with a more complete view of the role stress and adaptation play in the injury process. There is certainly value in assessing the degree of stress specific exercises may place on particular joints/tissues and whether or not they are appropriate for an individual given their needs or limitations. Failure to consider the role of stress tends to lead to an approach to injury prevention based purely on exercise selection/avoidance rather than one than also places consideration on biological stress and adaptation management.

More related reading:

https://gallagherperformance.com/ultimate-runners-guide-to-injury-prevention/

https://gallagherperformance.com/3-simple-steps-to-reduce-your-risk-of-sports-injuries/

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

https://gallagherperformance.com/magnesium-for-better-health-athletic-performance/

The Benefits of Performance Therapy


For those of you that are familiar with Gallagher Performance, you understand the importance we place on the integration of our sports training, chiropractic, massage, and manual therapy services. We feel this model allows for optimizing sport-based outcomes while keeping our athletes healthy and ready-to-train. The model is not completely unique, as chiropractors, therapists, physical medicine providers, and strength/physical preparation coaches are collaborating in similar models to better serve their clients and athletes.

With that in mind, one frequently asked question we receive is,
"How are these services different from sports medicine care I can receive from a physical therapist or other specialist?"
The concept of what is commonly referred to as ‘Performance Therapy’ can be seen as a unique and completely separate approach from traditional sports medicine or physical therapy. To illustrate this, here's a quick look at a comparison of the mindset behind sports medicine and performance therapy.

Traditional Sports Medicine
  • Reactive approach to sports injuries
  • Therapy and rehabilitation focused
  • Emphasis placed on passive modalities, manual therapies, manipulation, therapeutic exercise
  • Tissue-specific
  • Patient-centered
  • Occasional focus placed on "injury prevention" strategies
  • Primary goal is the return to training or sport abilities prior to injury
Performance Therapy
  • Proactive approach between coach, athlete, and doctor/therapist
  • Focus is on mechanical efficiency for skill acquisition and motor learning
  • Continual "tweaking" to optimize performance
  • Manipulation and manual therapies used for facilitation, to enhance the process of building mechanical efficiency
  • Skill-specific
  • Athlete-centered
  • “Injury prevention” is a by-product of the process
  • Primary goal is to enhance sport performance
We are very fortunate to have a skilled and knowledgable team of therapists and coaches working at GP. The dynamic created between therapist and coach allows us to not only screen each client and athlete prior to all training programs, but to also carefully watch their movement during each training session. The goal is identify specific movement qualities that could potentially have a negative impact on sport-specific movements, the acquisition of new skills, or injury prevention methods. This approach continues throughout the duration of the training program and allows movement dysfunctions to be addressed before they lead to greater issues.

Performance therapy becomes not just about normalizing function or "returning to sport", but optimizing the function of the athlete and "enhancing performance". Therapeutic intervention (or "treatment") occurs as needed during training sessions. This can include the use of a variety of exercises to improve stability/mobility or techniques that activate the nervous system to improve movement coordination. Regardless of the intervention, the goal is for athlete to adapt and improve more quickly than if training and treatment were approached separately.

The transition between training and treatment must be seamless. When it comes to performance therapy, we have noticed the following goals are achieved:
  1. Greater Body Awareness. By integrating the appropriate intervention into the training plan, there is an effect on motor control that generates greater permanence on a neurological level. Basically meaning the athlete masters new movement skills faster. The instant feedback from treatment allows the athlete to provide the coach or therapist with an understanding as to how they feel/move during training. Coaching the athlete thus becomes more specific, allowing them to learn and improve quickly.
  2. Optimization of the Training Session.  Performance therapy integrated with training typically involves a lot of “tweaking” in order to meet the demands of the athlete. It provides the framework to keep athletes performing at their best more consistently. Several athletes receive some type of treatment or practice regeneration/recovery methods prior to competition. So why would they not receive similar interventions during an important training phase?  Both serve the same purpose to optimize performance.
  3. Improved Monitoring of the Athlete. Performance therapy provides additional information on the readiness of the athlete to train. Both the therapist and the coach use this information to make educated decisions regarding the details of each training session, allowing for true customization of your training plan. It’s important that athletes are monitored for how well they have recovered between training sessions so you know how hard to push them. Also, athletes tend to have the ability to 'hide' things very well. Being able to identify slight differences in muscle tightness or movement abnormalities not only will allow us to make better decisions about the training session, but also help prevent more serious matters such as injury or overtraining.
Keep in mind that performance therapy is not intended to create athletes who are dependent on this model, but rather athletes who are held more accountable in the pursuit of their own goals. The coach or therapist is provided with the information needed to recommend the most appropriate "homework" for the athlete, such as foam rolling specific muscles, mobility or stability drills, and the use of recovery methods. Furthermore, performance therapy is not intended to serve as a replacement for other forms of therapy. It is not simply moving the treatment room to the training room. Even though the goal of performance therapy is to reduce the amount of time spent on treatment and return to sport measures, there is a time and place for other medical and/or alternative interventions that should be understood and respected.

Closing Words
Both sports medicine and performance therapy are necessary components in the health and performance of athletes. Failure to integrate therapy in a complementary manner can be a mistake. Without performance therapy there tends to be an increase in reliance on other forms of therapy that stress rehabilitation and recovery.

In sports, the term "game changer" is often used to describe an athlete or action that results in a successful outcome that changes the course of a game. The same can be said about performance therapy because of its ability to play an invaluable role in an athlete's development. If you've been experiencing lack of results or just can't seem to stay healthy, performance therapy may just be the "game changer" you have been looking for to improve your abilities as an athlete and GP is where you can find it.

Dietary Fat Is Not the Bad Guy

Despite what you may have been told, fat isn’t always the bad guy in the "Battle against the Bulge". Healthy fats such as monounsaturated fats, omega-3s fatty acids, and saturated fats - yes, you read that correctly - all can play a huge role in improving your health, memory, mood, and body composition. Let's take a look.

#1 - Better Health
The human body is about 97% saturated and monounsaturated fat, leaving the remaining 3 % to polyunsaturated fats. Half of that three percent is omega-3 fats, and that balance needs to be maintained. Vegetable oils contain very high levels of polyunsaturated fats, and these oils have replaced many of the saturated fats in our diets since the 1950s.

The body is in a constant state of rebuilding cells and producing hormones, two processes in which fats have a very important role. Regardless of what we consume through our diets, our bodies use the building blocks we give it. When we give it a high concentration of polyunsaturated fats instead of the ratios it needs, it has no choice but to incorporate these fats into our cells during cell repair and creation.

The problem is that polyunsaturated fats are highly unstable and oxidize easily in the body. In fact, they oxidize and become unstable during food processing and even light exposure while sitting in the grocery store. The oxidation of fat creates inflammation and mutation in cells. Inflammation has widespread affects on health and immune function. Inflammation is associated with conditions such as arthritis, asthma, and allergies and is now being identified as a key component in chronic diseases ranging from cardiovascular disease to diabetes to cancer.

Saturated fat is not the enemy. As a matter of fact, saturated fat is essential to optimal health and taking it out of your diet is a disaster waiting to happen.

#2 - Improve Memory, Enhance Mood
If you think fat only affects how you look, you’re in for a surprise. Studies are now demonstrating that staying mentally sharp and maintaing a balanced mood may be largely related to the type of fat you eat. Over the past decade, research continues to link omega-3 fatty acids to benefits ranging from better blood flow to improved mood and memory function.

The brain is 60% fat and thrives on smooth signaling between nerve cells — and the body refreshes these connections with a new supply of fatty acids. In a study published in Neurology, researchers found that those who ate fish regularly scored higher on a battery of tests for memory, psychomotor speed, cognitive flexibility and overall cognition. Furthermore, the researchers claimed that consuming EPA and DHA, fatty acids found in fish and fish oil, specifically contributed to the boost in brainpower. DHA has also been linked to decreasing the risk of Alzheimer's disease as well as overall cognitive decline.

When it comes to mood, studies show omega-3s can improve your mood. Research shows omega-3 fatty acids help nerve cells communicate better. This means feel-good brain chemicals like serotonin and dopamine can get in and out of cells more easily, translating into a better mood. Researchers from the National Institutes of Health report that omega-3 fatty acids are as effective at treating major depressive illness as commonly prescribed antidepressant drugs.

#3 - Less Body Fat, Leaner Physique
Consuming "good" fats can improve body composition and make you leaner. This comes as a surprise to many people because fat contains a lot of calories and is more calorie dense than carbohydrates and proteins. But not all fats have the same effect on the body.

Studies show that the body processes specific types of fat very differently. Essential fatty acids (EFAs), such as omega-3s, are not stored in the body. They are used to rebuild cells and make hormones, resulting in an energy expenditure increase in the body. This means that your body will burn more calories. This effect isn't limit to just EFAs either. When consumed in appropriate amounts, monounsaturated fats such as avocado and nuts do not appear to elevate body fat levels and help support hormone production. Saturated fat sources that are rich in medium-chain triglycerides (MCTs), such as virgin coconut oil and grass-fed butter, don't get stored as fat either and promote optimal body composition.

If you would like more detailed information on how fats can help you achieve your health or fitness goals, please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it..

 

Stay Hydrated: How Much Water Do You Need?

What you need to know:

  • Adequate water intake or hydration is determined by many factors.
  • Common advice such as "Drink 8 cups of water a day" or "Drink half your body weight in ounces" are far too simplistic and may not provide you with the water you need.
Why Water is Essential to Health and Performance
"Dehydration of as little as 2% loss of body weight results in impaired physiological and performance responses."
As your body's principal chemical component, water makes up roughly 60 percent of your total body weight. Every system and cell in your body depends on water. Water is essential to normal human function.

Lack of water leads to dehydration, a state that occurs when you don't have enough water to allow your body to perform normal functions. A review published in the Journal of the American Dietetics Association states that "Dehydration of as little as 2% loss of body weight results in impaired physiological and performance responses."

To put that into perspective, this would equate to losing almost 3lbs of water for an individual who weighs 150lbs. That may seem like a lot of water to lose, assuming that one must exercise a lot or resort to extreme measures to lose that much water. But let's take a closer look and see just how easy it is to lose water without exercising.

According to the Guyton Textbook of Medical Physiology, the same 150lb individual will lose about 2.3L of water daily from urine, feces, sweat, and insensible water loss through the skin and breathing. 2.3L equals almost 5lbs of water loss per day from normal body function. This estimation does not factor in a warmer climate. Naturally, sweat rates increase in warmer weather, so this same individual could lose up to 3.3L of water a day.

It should be clear that becoming dehydrated is not a difficult task. There is a common misconception that dehydration only occurs in people that sweat a lot due to exercise or warmer weather. This couldn't be further from the truth. Normal bodily functions can lead to dehydration if water intake is not addressed appropriately.

The importance of adequate water intake has important health considerations as well. There are studies that have demonstrated individuals who stay well hydrated are less likely to experience:
  • Cancers of the breast, colon, and urinary tract
  • Urinary stone disease
  • Mitral valve prolapse
  • Childhood and adolescent obesity
Meeting Your Basic Daily Needs
In sedentary individuals, it appears that men require about 12 cups of water per day and women require about 9 cups of water per day. Whole foods are estimated to provide 4 cups of that daily water total. Another 1 cup of that daily water recommendation comes from 'metabolic water' or water that your body makes from metabolic processes, thus making this water you don't have to worry about consuming.

So for the sedentary individual, they will require about 7 cups of water/fluid per day since the remaining 5 cups of water will come from food and normal metabolic function. This is assuming that one is eating enough to meet their calorie needs.

It's important that any fluid you count toward your daily total is non-caffeinated or non-alcoholic. Caffeine and alcohol raise water needs in the body. If you consume either of these, you will need more water.

Water Needs in Response to Physical Activity
As for athletes, there is strong evidence in the research showing that dehydration will have major impacts on endurance, strength, intensity, and mood. When it comes to athletes, little research has been done to determine exactly how much water intake is needed to prevent dehydration. This likely explains the wide variety of answers one can potentially be given when attempting to figure out how much water they need to rehydrate. The honest answer is, "It depends." The reality is, there are a number of factors that play into understanding how much fluid intake an athletes needs to appropriately rehydrate.

Athletes or active individuals will generally require greater amounts of water due to increased muscle mass, metabolic activity, and sweat rates. So how much water will an athlete require? For starters, we can make a safe assumption that athletes eat more food during the day than the average person and that they have a higher metabolic rate. With this in mind, they will be getting more water from food sources and metabolic function. Depending on the climate an athlete exercises in, daily water intake may need to increase to an additional 2-4L (8-16 cups) on training days. Water intake must be based on factors such as activity level, body mass, sweat rates, and climate.

Bottom Line
A safe, general guideline for athletes and water intake would be to consume 1/2 gallon of additional water on non-training days. When it comes to training days, an athlete may require a gallon or more of water per day to maintain adequate hydration levels.

Source:

Kleiner, S., Water: An essential but overlooked nutrient. Journal of the American Dietetics Association. Volume 99, Number 2, 200-206, 1999.
 
 

History Matters

Seen by doctor after doctor with no relief of your joint pain?
Dealing with a previous injury that still holds you back in your daily activities or sports? Frustrated with lack of results in your training or dieting?

Be it joint pain or just stubborn body fat, it seems all too common that people deal with frustration when they are seeking results and it seems there are no answers as to why they are not getting better or improving. Unfortunately, some people are eventually told to "Live with it" or "Take this pill". While others decided for themselves, "Maybe this is the way I'll always be".

Just like a good real estate agents say, "Location, location, location'. A good doctor/therapist says, "History, history, history'. The history holds the clues, often more than patients expect.

At GP, we understand the importance of taking a detailed history and utilizing comprehensive assessments to provide our patients/clients with quality information and service. Experience the difference GP has to offer and let us help you get the results you want.