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Fitness is Not Sports Performance

One of the biggest challenges plaguing sports performance is the prevalence of general fitness programs masked as "sports performance" programs.

Sadly the concept of sports performance has become so polluted that most parents and young athletes buy into programs that ultimately are just heavily fitness-focused with very little or poor instruction in regards to true development as it relates to sport.

True sports performance addresses much more than how fit you are or how hard you are willing to work. It's much more than cleans, sled drags, sprints, and conditioning circuits. You can use all these methods and more to sell someone on the "look" of sports performance. But if you truly analyzed most "sports performance" programs they boil down to general fitness and that's it.

Some will say, "Well fitness is important in sports. You got to work hard. You got to be in shape. You got to learn how to push through." Fact is anyone can workout tired. Anyone can workout sore. If they want it bad enough. The problem is none of that matter when it comes to performance. The reality is once an athlete has to go up against another human being, only one thing matters - is their ability greater than their opponent?

It doesn't matter how fit you are and how hard you train if you show up on competition day and fail to be at your best. Sport performance is multi-faceted and should never be treated in the context of fitness-focused training. There are general fitness attributes that are important in sport, but true sport performance must move beyond fitness in order to allow athletes to truly realize athletic potential by focusing on specific adaptions relevant to their sport.

It's important to do your homework and look beyond what may seem like sports performance. Despite what you may see on Instagram or hear from a friend, what you sign up for may not be exactly what you were looking for.

For more related reading:
https://gallagherperformance.com/4-things-you-need-to-know-about-sports-performance/

 
https://gallagherperformance.com/physical-preparation-vs-fitness/

 
https://gallagherperformance.com/learn-how-to-spot-the-fitness-frauds/

 
https://gallagherperformance.com/training-maximize-athletic-potential/

 
https://gallagherperformance.com/athleticism-requires-more-than-just-strength-speed/

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

Pain Indicates A Health Problem, Not A Fitness Problem




As Gray Cook says, pain indicates a health problem not a fitness problem. In rehab, we deal with pain and dysfunction. In exercise and training, we deal with dysfunction. Pain and health problems should be managed by a licensed professional with appropriate training.

Exercising in pain is not the solution and you should seek proper guidance on how to get out of pain and correct dysfunctions before resuming your regular exercise or training program. Otherwise you may just get stuck in the perpetual pain cycle. The plan is to reduce pain, improve the tolerance to exercise through graded exposure, dose exercise and train to correct dysfunctions.
The management of pain should not be left to unqualified individuals in the exercise/fitness industry. With the rise of continuing education programs and certifications intended to help fitness professionals identify, through screening, an individual's level of training readiness.

Movement screens are generally performed to assess for mechanical sensitivity (aka pain with movement) and/or abnormal motor control (aka movement dysfunction). The screens are usually graded on a scale to reflect a score indicative of that individual's current performance.

A sample scoring system would look something like this:

0 = pain

1 = can't perform movement or has loss of greater than 50% range of motion

2 = performs movement with compensation

3 = performs movement without compensation

Screening provides valuable information and obviously it is ideal to work one towards a higher movement score.

The issue I have taken up with screening is the tendency for some fitness professionals to act as a pseudo-therapist when a client is experiencing pain. In my opinion, unless you have a professional license to work with the human body (i.e. chiropractor, physical therapist, massage therapist, medical doctor, etc.) you have no business providing 'rehab' or 'advice' to a client. The best advice you can provide is to have them seek a professional medical opinion from a trusted source.

Again pain is a health problem, not a fitness problem. Most people within the fitness industry simply have a personal training certification. Managing a client's pain is not within your scope. Pain is a referral to a medical professional. Once pain is managed properly, then exercise is reintroduced.


Got pain?

Give our office a call and let us help you get out of pain by providing you the tools to understand your pain, how to prevent it, and how to improve the way your body functions. The model at Gallagher Performance was developed to bring excellence in both pain management and exercise/fitness education.

 
For more related reading:

 
https://gallagherperformance.com/solution-long-term-improvement-back-pain/

https://gallagherperformance.com/receiving-value-treatment-training/

https://gallagherperformance.com/a-movement-screen-will-never-show-movement-habits/



12 Week Distance Training Client Results

This training client sought out our services for three primary reasons:

1) Rehabilitate a chronic recurrent low back condition that has prevented him from training with any type of intensity or frequency for over two years AND get back to training while staying healthy in the process

2) Get stronger while packing on some quality size, and

3) Regain the feeling of athleticism from when he played college football.

We recently concluded 12 weeks and during that time he had three BOD POD evaluations. Debate on the accuracy of the BOD POD aside, impressive changes were made in only 8 weeks. These evaluations occurred on 11/21/17, 12/19/17, and 01/16/18.

Some of the BOD POD highlights include:

  • Fat Weight lose of 3.786lbs
  • Body Fat % decrease from 12.6 to 10.3
  • Fate Free Weight gain of 6.745lbs
  • Body Weight increase from 182.9 to 185.9

 

Images 1-3. BOD POD results from 1/16/18. This was the third, and most recent, analysis during an 8-week period.

Included below are photos of a few of his training weeks to give you a glimpse of how his training was structured. Along with the changes seen in his body composition, his strength continues to progress and he is training with weights and a frequency that he has not seen in over two years while maintaining a healthy feeling body.

Continue reading

3 Exercises for Athletic & Mobile Hips

Please watch: https://www.youtube.com/watch?v=RRZL6Y6gtZI

In this video, we discuss exercises aimed at training proper hip dissociation - an often overlooked and undertrained function of the hips. Poor hip dissociation is commonly a reason for pain and poor performance.

Some key points discussed in this video:

  • What hip dissociation means. Hip dissociation is the ability to independently move the hips without compensations from the rest of the body.
  • Why poor hip dissociation and compensations are often a reason for low back pain, hip pain, and even pain within the knees and feet/ankles.
  • How poor hip dissociation is related to increased risk of injury.
  • Why the inability to move properly though the hips limits athletic potential and will negatively impact your performance.
  • And most importantly - what to do to improve your ability to move your hips independently with simple exercises that you can perform at home, at the gym, or basically anywhere with just a few simple tools.

Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://www.gallagherperformance.com/blog/advanced-training-for-elite-athletes

https://www.gallagherperformance.com/blog/2-exercises-for-groin-and-knee-pain

https://www.gallagherperformance.com/blog/the-solution-to-long-term-improvement-of-back-pain

https://www.gallagherperformance.com/blog/pistol-squat-or-skater-squat-which-is-better

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

https://www.gallagherperformance.com/blog/a-powerful-innovative-approach-to-improving-how-the-body-functions

 

When Should I See A Chiropractor?

[embed]https://www.youtube.com/watch?v=1aaE3CIouTU[/embed]

In this video we discuss some important points to consider when to see chiropractor or why to see a chiropractor, especially one that has a sports injury and rehab specialization and practices in a functional movement model.

Some points to consider:

  • How important is your health to you? Health is an investment and requires a proactive approach rather than be reactive.
  • Do you want to get out in front of rather muscle tightness and joint range of motion/mobility restrictions before they get more serious or painful?
  • Most people are unsure of who to see for back pain and joint pain, even muscle tightness. They may see their PCP, but not receive the answers or solutions they were hoping for. They are looking for a provider they can trust.
  • Those that have a positive experience with a chiropractor or have one they trust, turn to them when they start to "feel off" or they feel their body is moving as it normally does or they start to feel pain.
  • Ideally, chiropractors who have a specialization in functional rehab, sports injury, and movement are the experts you should see for the most musculoskeletal conditions that we commonly deal with.
  • When, or if, you see a chiropractor is ultimately your choice and one that can prove to be beneficial and a worth while investment.
 
More related reading:

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

https://gallagherperformance.com/low_back_pain_treatments_that_just_wont_help/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

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

https://gallagherperformance.com/effective-treatment-shoulder-pain/

https://gallagherperformance.com/solving-movement-problems-entertainment-vs-effective/

Pistol Squat or Skater Squat - Which is Better?

[embed]https://www.youtube.com/watch?v=5m32gpo5AG4[/embed]

In this short video we discuss a commonly performed exercise in some group exercise or fitness classes as well as sport performance training programs - the pistol squat.

The pistol squat is a challenging exercise. For some it is a competitive exercise and one that they must train and improve.

However, what if you aren't training to compete in an event that includes pistol squats? What if you are training for general fitness or sport performance and want a better alternative? An alternative that will build great single-leg strength and control, and have better transfer to improving athleticism, speed, all while keeping the joints healthier?

Enter the skater squat.

You see for many people, the pistol squat can contribute to unnecessary compressive forces on the spine and hips that can lead to pain and movement intolerances. This is an unwanted result of training or exercise. Who wants to spend weeks working out only to takes weeks off due to pain or injury?

And these reasons are exactly why the skater squat becomes a better alternative to the pistol squat. You get a uniquely challenging single-leg exercise that builds strength, is more friendly to the spine and hips, and more closely mimics the dynamics of running, sprinting and skating.

As always, Gallagher Performance is here to answer your questions when it comes to exercise, rehabilitation, chiropractic, and sport performance. Watch the video to learn more.

More related reading:

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

https://gallagherperformance.com/the-best-exercise/

https://gallagherperformance.com/solution-long-term-improvement-back-pain/

https://gallagherperformance.com/advanced-training-for-elite-athletes/

How Do You Build An Athlete?

[embed]https://www.youtube.com/watch?v=1qdKlvKwwPM&t=11s[/embed]

In this video we discuss the necessary steps it takes to optimize athletic development and "build an athlete".

Key points discussed are:

  • The importance of practicing your sport skills and practicing with intent
  • Taking the necessary steps to stay healthy in a strength & conditioning program
  • Understanding the process of long-term adaptations in athletics
  • The application of the speed-strength continuum, it's importance in programming and identifying where athletes fall within the continuum
This presentation is geared towards power-speed athletes who thrive on the development of speed and strength qualities. Power-speed athletes participate in sports such as football, hockey, baseball, basketball, track & field (throwers and sprinters), lacrosse and weightlifters just to mention some of the more common sports.

These considerations are important for enhancing sports performance, identifying the true needs of the athlete and taking the steps to keep them healthy in the process.

Take a listen and learn more!

More related reading:

https://gallagherperformance.com/why-specificity-in-your-training-plan-matters/

https://gallagherperformance.com/the-value-of-in-season-training-for-athletes/

https://gallagherperformance.com/athletes-do-not-need-balance-to-be-successful/

https://gallagherperformance.com/gallagher-performance-training-how-we-are-different/

 

2 Exercises for Groin and Knee Pain

Please watch: https://www.youtube.com/embed/xBOWKP4CO4Y

Above is a short video addressing common reasons why ground and/or knee pain develops and two exercises to get to the root of the problem. Addressing muscular dysfunction through therapeutic exercise continues to prove to be the most effective and evidence-based intervention for common musculoskeletal conditions such as tendinitis, bursitis, sprain/strains, joint pain and muscle tightness.

These exercises involve minimal equipment and are easy to perform at home, in a hotel room, or at the gym. All you need is:

  • Chair/bench or some form on a firm elevated surface
  • Your own bodyweight

Exercises covered in this video:

  1. The Adductor (Groin) Side Plank
  2. The Rear-foot Elevated Split Squat (Bulgarian Split Squat)

Also covered in the video are common reasons why groin and/or knee pain may develop and why these exercises can be very effective once a patient is out of pain.

 
More related reading:

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

https://www.gallagherperformance.com/blog/the-solution-to-long-term-improvement-of-back-pain

https://www.gallagherperformance.com/blog/advanced-training-for-elite-athletes

Chiropractic, Rehab & DNS Treatment

https://www.youtube.com/watch?v=ceIcoreYu8o&t=4s

This video illustrates how we integrate chiropractic, rehabilitation and dynamic neuromuscular stabilization (DNS) into patient treatment. For the purposes of this video, these techniques were used to speed up post-workout recovery, ensure structural balance and improve how the body functions. Similar to fine-tuning a race car, the human body can benefit tremendously from fine-tuning to keep body prepared for high performance.

Key take home points:

  • Treatment is directed at patient-specific goals and outcomes. There are different levels of care that may need, ranging from symptomatic (i.e. painful conditions) to more performance-based therapy or fine-tuning.
  • Chiropractic manipulative therapy (i.e. adjusting) was not filmed but utilized for the spine and hips.
  • Soft-tissue work was done manually and instrument-assisted to mobilize muscle and connective tissue to improve recovery.
  • Dynamic neuromuscular stabilization (DNS) was used to fine-tune motor patterns and muscular activation. Proper muscular activation and stabilization function of muscles helps to ensure proper muscular coordination while minimizing stress on the joints.
  • This all adds up to optimizing performance while keeping the body as healthy as possible.
More related reading:

https://gallagherperformance.com/fascia_muscular-adhesions_how_they_relate-_to_pain_and_overuse_injuries/

https://gallagherperformance.com/dynamic-neuromuscular-stabilization-advancing-therapy-performance/

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

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

Four Years at Gallagher Performance

April 2017 marks four years since Gallagher Performance opened and with another anniversary passing, I thought it was time to start reflecting back on our fourth year in business.

All our services from chiropractic to massage to personal training to sports performance training continue to experience steady, consistent growth since we first opened. Growth that led us into our own facility in December 2016. The move has been a very positive and necessary one for our continual business development.

On January 2, 2017, Gallagher Performance opened in our new location. After long hours and lots of work we ended up looking like this:



The new facility has enabled us to widen our reach, both within the community and online. Being a community resource is tremendously important to us. We are now able to hold classes, lectures and have been asked to speak to area sports teams and organizations. We are also now able to provide more educational videos on our social media and YouTube channels.

Even with the transition to a new facility, we remain loyal to providing quality of service over quantity. Gallagher Performance is about individualized attention in all our services. This is why our chiropractic and rehab patients are with their doctor every minute of every office visit. This is why Gallagher Performance isn't a gym; it's a training facility. We don't offer an open gym membership, but rather different levels of training services to meet the needs of our clients and athletes. The reason why we set it up this way is because we want people to experience how supervised training by qualified professionals yields amazing results. And our clients are achieving remarkable results in private and semi-private settings that enable individual considerations to be made appropriately.

In regards to our services, it has been another great year. GP’s chiropractic and rehab therapy was recognized as one of the best in the Pittsburgh area for a third consecutive year. The results we achieve through our chiropractic, manual therapy and functional rehabilitation have helped people get out of pain and return to the activities they enjoy. There have been literally dozens of patients who have come to us after a doctor has told them they needed surgery, but we’ve helped them avoid these procedures. We've helped them understand the importance of not only getting out of pain, but why changing the function of their body is the key to a successful outcome and long-term recovery.

Our personal and performance training services continue to generate tremendous results for our clients and athletes. The results keep our clients loyal and the referrals coming in. We have truly cared about delivering quality in all services since we opened. It’s a great feeling to see how much our clients appreciate the attention, know-how, and confidence they receive while working with us. When you focus on quality of service and improving the consumer experience, only good things can happen.

During our four years, we have seen tremendous growth in our distance/online training services as we have gone international. Now while we are growing and our reach may not be that impressive by some industry standards, it is humbling to see how our distance services are being sought after by people beyond the state of Pennsylvania. We have seen the reach grow to 12 states (AZ, CT, GA, IA, IL, MT, NJ, NY, NC, OH, TX, WI), into Canada (Alberta, Ontario), and into Portugal, Italy, and Japan.



The reason for our growth isn't a big marketing budget. Rather, we work hard to set up everyone we work with for success in any way possible –  trusting that those efforts will lead to referrals and retention. At Gallagher Performance, we don’t try to just “factory line” our clients/athletes through the same program with a "cookie cutter" approach.  This is because we understand training and rehabilitation is a very individual experience and everyone we work with needs very individual considerations made for them. That's what it takes to produce lasting, meaningful results.

Our sports performance training services continue to be utilized by a variety of athletes from a growing list of amateur/club organizations, high schools, and colleges. In addition, GP continues to direct the Strength & Conditioning program for the Franklin Regional Hockey Club as we move into our fourth year.

During the past year, we've seen new names join of list of athletes who have reached the collegiate level. This is tremendous accomplishment on their behalf and we are privileged to work with such determined and hard working athletes. Here's the list we have worked with, from sports performance to chiropractic and rehabilitation, and where they are coming from:

 Collegiate Athletes

  • Wes Ashley, University of Wisconsin - Stevens Point (NCAA DIII) - Hockey
  • Andrew Brncic, Alderson Broaddus University (NCAA DII) - Football
  • Colin Childs, California University of Pennsylvania (NCAA DII) - Football
  • Ben Dipko, Slippery Rock University (NCAA DII) - Football
  • Noah Dipko, Indiana University of Pennsylvania (NCAA DII) - Football
  • Justin Gismondi, Robert Morris University (ACHA DI) - Hockey
  • Ryan Grieco, Seton Hill University (NCAA DII) - Baseball
  • Carter Henderson, Duquesne University (NCAA DI) - Football
  • Evan James, Penn State University Greater Allegheny (NCAA III) - Baseball
  • Colin Jonov, Bucknell University (NCAA DI) - Football
  • Katie Kimmich, Seton Hill University (NCAA DII) - Soccer
  • Dante Luther, Washington & Jefferson University (NCAA DII) - Football
  • Jake Roberge, Northwestern University (NCAA DI) - Soccer
  • Mike Roberge, Northwestern University (NCAA DI) - Soccer
  • Charan Singh, University of Massachusetts (NCAA DI) – Football
  • Todd Summers, Villinova University (NCAA DI) - Football
  • Ryan Watson, Lake Erie College (NCAA DII) - Soccer
  • Christian Wilson, Mount St. Mary’s (NCAA DI) - Track & Field
We could continue on about each of these individual athletes and the people we have had the pleasure of working with during our short time in business, but suffice it to say that we are very proud of each of each person we work with and what they’ve accomplished.

The same goes for our general fitness and weight loss clients. The fat loss and strength gains they experience are awesome and measurable. They consistently prove to be hard working and determined, month after month.  But beyond that, we love knowing that they’re training pain-free and will be able to reap the benefits of regular exercise for a long time.

Another Year in the Books
In wrapping up, we acknowledge that Gallagher Performance would not be what it is without the consistent support we receive. A sincere thank you goes out to all you – clients/athletes, parents, family, friends, and professional colleagues – for your continual support over the past four years. Special thanks to our marketing firm, 4C Technologies, for their continual support and expertise. Without you all, Gallagher Performance would not be what it is today, and we look forward to many more years to come.

Resetting the Body's Function Post-Injury

"After an injury tissues heal, but muscles learn. They readily develop habits of guarding that outlast the injury" - Janet Travell, MD
Guarding after an injury is normal and it is to be expected. However, when left unidentified and untreated, guarding or protective patterns can become common reasons for chronicity and why someone "hasn't got better". This is why we must go beyond structural injury and think function in treatment rehabilitation.

From the functional viewpoint, we must evaluate for these guarding patterns that patients readily default to due to injury/pain.  Identifying and treating these guarding patterns appropriately will often times enable patients to feel better almost immediately.

While yes it is important to evaluate for structural injury (fracture, dislocation, ligament sprains, tendinopathies, disc herniations, etc.) and manage them accordingly, the reality is these tissues will heal in time. However, after these injuries heal, there can be presentations within the body that create complications in achieving full recovery or become reasons for relapse.

Often times patients will complain about tight calves and hamstrings after spraining an ankle or tightness in their low back and hips after a disc rupture. Or they may have developed pain and/or sensitivities in other areas of their body seemingly unrelated to their initial site of injury.

The ankle ligaments will heal. The disc will heal. But the body will guard and protect and this becomes programmed within the nervous system. This is exactly what we need to treat for patients to get better and this new reality becomes very liberating for patients.

When patients come to understand that their injury has healed, but it's their brain and muscles that must re-learn how to work as they did before the injury, they become less fearful and more confident in a positive outcome. Essentially, they come to understand that we must reset their body so their neuromuscular function returns to pre-injury status.

To reset the right things in the body, we must assess and analyze the problem then utilize corrective measures in treatment and/or training. This system helps us develop efficiency in treatment and enables us to expect results.

What type of corrective measures? The gold standard becomes manual therapy and therapeutic exercise. When combined, these serve to get patients out of pain and improve the function in their body.

Yes these results can often times be rather immediate, however in some cases recovery can test a patient's patience as the process may be slower than they aniticipated.

When progress is slow, it is important to remember the following:
  1. Therapeutic exercise is the most evidence-based treatment.
  2. Passive treatments (tape, modalities,etc.) may offer temporary relief but are not helpful in medium and long term recovery.
  3. Injections and surgery have been not shown any greater effectiveness in outcomes than exercise.
  4. Seek advice and treatment from a licensed professional who specializes in functional movement. Ideally this would be a rehabilitation chiropractor or physical therapist with movement specializations are the gold standard here. These practitioners focus on the functional paradigm of manual/physical medicine. And no, your "functional trainer" at the gym doesn't count.
  5. Self-management is key. Reduce activities that provoke pain, apply gradual exposure to activities to build confidence and tissue capacity through exercise. Exercise must be tailored to you to reduce pain and improve strength and function throughout your entire body.
  6. Progress load and exposure gradually. The key is to be consistent with your exercise therapy. Forget about how much you were doing before the injury and what others are able to do. Everyone responds differently. Focus on your recovery and what works to get you back on track.
  7. Getting back on track can take a long time. In some cases, upwards of 3 to 12 months depending on a number of factors including duration of symptoms, functional deficits and patient compliance during their exercise program. Keep in mind, other treatments can offer faster recovery but nothing has demonstrated better long-term results than progressive exercise.
When patients understand that guarding is normal, that we must reset and improve their body's function and they understand the process, they in turn are very likely to experience a positive outcome.

More related reading:

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

Improved Approach to Chronic Pain Management

Pain is incredibly complex, making the treatment and management of chronic or persistent pain a unique challenge. After reading this article, the hope is that you have a better understanding of the complexities of pain and how treatment must be directed if one is truly to overcome chronic pain.

Pain has a nasty habit of getting in the way of activities that we not only enjoy, but also the mundane tasks of everyday living. It becomes of paramount importance that treatment not only decreases pain, but also that the individual is able to resume activities that are important to them with improved function and mechanics.

To begin with, let's start with an understanding of pain and the reality behind why we perceive pain.

1) Pain is in the Brain
Pain is a message from our brain that is meant to protect us.  Even though pain is meant to protect us, pain is not a reliable source of indicating the extent of an injury or even where the injury is located. The classic example here is phantom limb pain. Amputees regularly will experience this phenomenon. One may experience left leg pain, yet they do not have a left leg. If pain is purely related to damage or injury, how would one experience pain in a limb that doesn’t exist?

The reality of pain perception can be a difficult education point as this is typically a new concept for the majority of patients and one they may need some time to understand. But it’s critical as their beliefs about pain can complicate the recovery process. It’s extremely beneficial for patients to learn about pain and address fear-avoidance behaviors and other factors that will interfere with reactivation into normal movement and activities of daily living.

2) Hurt Doesn't Equal Harm
Another key component of the education process is that “hurt doesn’t equal harm”. Just because a movement or activity may “hurt” this doesn’t mean that you are doing harm to the body or damaging tissues. In fact, there is a growing body of research supporting poor correlation between pain and structural changes seen on advanced medical imaging. Just because one has degenerative joint disease, a disc bulge, or rotator cuff tear doesn’t mean they will have pain as these imaging findings are routinely found in asymptomatic individuals.

It’s important patients understand this concept because when it comes to exposure to movement through exercise, you don’t want the fear of structural damage to interfere with the ability to become more active. While not all movement will be pain free, movement isn’t causing harm. And that’s extremely powerful for patients to understand.

3) Movement is Medicine
Movement has the ability to be healing by reducing the pain response in our brain. Thus this is why movement is like medicine and why movement eventually has to take center stage in the management of chronic pain. Similar to manual therapy, graded exposure to movement through exercise will essentially teach your nervous system to “wind down” and not be as sensitive to pain. In doing so, you become more confident and reassured that you can do more without pain or the fear of a relapse in your condition.

4) The Work is Just Beginning 
Unfortunately, the pain fix isn’t an overnight solution. For chronic pain patients, often times the rehabilitation process can take months of consistent work and repeated inputs to the nervous system to make a substantial change on pain and function. Repeated inputs come in the form of manual therapy and home exercise/self management strategies. Thus patient’s must understand the importance of compliance within their home exercise program as this makes a significant difference in their outcomes.

It’s important they understand the nervous system is easily tricked. It's easy to yield immediate change, but these changes should not be confused with lasting results. This concept is illustrated with any number of assessments commonly used in chiropractic and physical therapy offices – from leg length analysis to functional screens - as well as therapeutic interventions – from manual therapy to manipulation. By performing pre and post checks, it's possible to see immediate changes within one treatment. It can be easy to impact pain and create changes in range of motion or body function that have patients leaving your office feeling great.

But no single input can create lasting change. It requires multiple inputs over a period a time to create lasting change within the nervous system. This is why exercise and training is so important. If patients are not provided with the right exercises to compliment therapy, this is why they have pain relapses. Patients must exercise and must train to make a lasting change within their body. Otherwise they will get frustrated with chronic recurrences of leaving a provider's office feeling great only to experience a return of pain symptoms. And this becomes the pain cycle many become stuck in unless a change is made.

Break the Pain Cycle
If you are dealing with chronic or persistent pain or stuck in the pain cycle, the hope is that this article gets you thinking differently about how pain should be managed for successful outcomes. It’s why the management of painful conditions, especially chronic pain, must focus on pain education, the appropriate use of manual therapy (ex: joint mobilizations/manipulation, relaxation techniques such as PIR, soft-tissue and neurodynamic mobilizations) and graded movement exposure through exercise.

More related reading:

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

 

Ultimate Runner's Guide to Injury Prevention

Running season is fast approaching. Spring and summer have a host of events from marathons, to half marathons, to triathlons, to various course races. Many have likely already started their training. And then of course we can’t forget those who will simply take up running in hopes of shedding unwanted body weight for the summer.

Whether you are taking up running to become healthier and lose weight, to qualify for Boston, or if you have your eyes set on crossing a race off your bucket list, your routine training will either build you toward your goal or you will be bogged down with nagging injury after nagging injury.

When you consider that 65-80% of runners will sustain an injury during the running season, clearly there is something that needs addressed to help runners cut down their chances of being sidelined or having recurrent issues during their training.

If there is one thing that most people know about me is that I’m not a distance runner. I’ll make that disclaimer up front. Never been a distance or endurance athlete and never will be. I live in the power-speed world of athletics. However, as a former hockey player and strength athlete, one of favorite past times and off-season training methods was (and still is) sprints.

Between my background as a chiropractic rehabilitation specialist as well as personal and professional experience in speed development, I’ve learned a thing or two about what it takes to build a body that is resilient to the demands of running/sprinting rather than breaking down. And at Gallagher Performance we have developed a reputation for not only building speed demons, but keeping their body healthy and ready in the process.

So what gives? Why is someone like me writing an article about running?

The name of the game in athletics is physical preparation and the same can be said of distance running. Unfortunately there seems to be a misunderstanding in that one only needs to run to be successful at running. While this may be true for some, there are numerous others who simply cannot solely rely on running in order to be prepared to run. Simply just running to be ready to run is an oversimplification of arguably the most complex human movement.

If that sounds ridiculous or confusing, let me explain my logic.

Most runners will eventually encounter their fair share of aches, pains, strains and overuse injuries. Plantar fasciitis, shin splints, tendonitis, stress fractures, runner’s knee, IT band syndrome and joint pain are common to the running community. Once training demands exceed what is one physically prepared for, this is where things start to go south.
These conditions may be present for a number of reasons, including any of the following:

  • Sharp increases in training volume
  • Foot wear
  • Gait mechanics
  • Strength deficits
  • Joint dysfunction or fixations
  • Improper motor control of lower extremities and/or torso
  • Overtraining
  • Inadequate physical preparation
This article is not intended to address training theory or programming as it relates to preparation for an endurance event, foot wear or gait mechanics. What I want to address is the reality that one must be physically prepared for a specific event and this requires that a runner must possess the necessary prerequisites in movement as it relates to running.
And no, being physically prepared doesn’t mean being fit or having a certain level of fitness. Being physically prepared for a distance running event goes far beyond one’s aerobic fitness.

To get my point across, allow me to use the analogy of intelligence. One can be intelligent yet being prepared for an exam in Civil War History is another issue. Now one may take that exam and it could go very well or horribly bad, but it doesn’t change the fact that the individual is still intelligent. What it means is they were either prepared or unprepared for that specific exam.

So while one may be “fit”, it does not mean they are physically prepared for a specific physical event. Even if one lifts weights, bikes, and jogs on a regular basis it doesn’t mean they are ready for a marathon. And most understand this, as they will specifically prepare for a marathon by training for it over a number of weeks.

But what is one to do to make sure their body is ready for the demands of running other than simply running? I mean that’s all one needs to do right? Just get out there and put in the miles right?

Yes, you will have to put your time in on the road or track. That’s a given. But there are also other considerations to make beyond the traditional means of endurance training (see this article here - 2 Common Misconceptions in Endurance Training).

The reality is running is tremendously demanding on the body and it’s even more so from a distance standpoint because of the need for far greater precision in running form, mechanics and motor control of the feet, ankles, hips and torso.

The need for strength and precision in movement control for the distance runner should make training strength and precision in movement control a high priority. This skill of awareness or proprioceptive ability can be trained through exercise. And this brings us to the heart of the article – ensuring you are physically prepared for running. Ensuring that your feet/ankles, hips and torso are more resilient against the cumulative physical demands of running.

Understand that I realize, like any competitive athlete, the cumulative trauma of the competitive season adds up and it is a challenge to stay 100% healthy. There are a number of variables that go into keeping one healthy. The hope is that through this article you gain an understanding of how training and maintaining certain physical abilities through specific exercises will not only help to offset what your body endures on the road, but make it more resilient as well.

The following exercises will serve to build the physical foundation that will help one stay healthier during training and the competitive running season, thus making sure your physical preparation meets or exceeds training demands.

1. Respiration with Trunk Stabilization
[embed]https://www.youtube.com/watch?v=UxONX_8ZGkI[/embed]

2. McGill Side Bridge
[embed]https://www.youtube.com/watch?v=NJhqDATf5_k[/embed]

3. Low Oblique Bridge with Hip Differentiation
[embed]https://www.youtube.com/watch?v=IXc7wr3oBkY[/embed]

4. Single Leg Balance & Swaps
[embed]https://www.youtube.com/watch?v=Exz8f-ngKPM[/embed]

5. Pallof Press
[embed]https://www.youtube.com/watch?v=i-0HIVP5ZQA[/embed]

6. Plank Progressions
[embed]https://www.youtube.com/watch?v=aKWc4XJ9xKI[/embed]

7. Box Squat
[embed]https://www.youtube.com/watch?v=WJh3xyMWj7g[/embed]

8. Romanian Deadlift
[embed]https://www.youtube.com/watch?v=l4Mk6OEE2RQ[/embed]

9. Lunge Matrix
[embed]https://www.youtube.com/watch?v=UGdmImUcQFw[/embed]

10. Power-Speed Drills
[embed]https://www.youtube.com/watch?v=Ti5-hTsOC-8[/embed]

That's a Wrap
While this list is far from comprehensive, it will serve as a general template to help runners to address basic physical prerequisites needed to stay healthy and train with minimal risk of setbacks. This is general template for physical preparation of a runner. Remember, like any athlete, physical preparation serves as your foundation as a runner. Take time to develop your physical preparation. Take time to develop your strength and movement control as it will allow you to get more out of training and keep your body healthy in the process.

Solving Movement Problems: Entertainment vs Effective

The value of movement is undeniable. But the industry of movement has become a bit of a circus.

I have seen some doctors, therapists, and trainers using the label of “movement provider” lately and while I’m not quite sure what that means, I can speculate as to what they are trying to communicate. Yes there are many universal truths when it comes to human movement, health and performance, but the true pioneers of movement are few. Social media has created a tool for spreading quality information and education. I understand leveraging social media can become incredibly valuable to a business. However, when it comes to movement, exercise, and fitness, social media has become more entertainment than substance.

It’s become a sea one can easily become lost in, caught up in the wow factor of challenging movement drills and variations while others are less likely to engage with more of a simplistic focus. Movement providers from licensed healthcare professionals to run-of-the-mill trainers pop up all over the worldwide web and social media sending messages that may seem conflicting. There’s more information than ever yet many people searching for solutions are more confused than ever. The industry seems to thrive on confusion more than any other. Confusion creates dependence and the industry loves confusion because someone has to have the answers. They want to build an audience.

But are you building an audience based on your information being entertaining or effective?

Sadly it seems that he who yells the loudest, gets the most followers and gets the most attention must have the answers right? I mean they do have 62,000 followers, they must know their stuff? Not necessarily. Entertaining may score you points on social media, but effective scores you points with patients and clients. Yes there are extremely effective movement experts with massive followings, but I doubt they exist in the real world in the masses like they do on social media. If you’re chasing entertainment yet don’t know how to effectively get someone from point A to point B, it’s all smoke and mirrors.

While overhead lateral rotational lunges with hanging bands may score thousands of views on Instagram, does it have any significant relevance? From a clinical perspective, those who treat patients regularly know the majority of what entertains on social media has little transfer to patient care. The reality is that the majority of patients with musculoskeletal issues have lost the ability to perform basic human movement. There is a reason why the lumbar disc patient is a disc patient. Most of them are deconditioned and lack adequate strength, motor control, mechanics and proprioceptive awareness not only in their low back, but likely in their feet and hips as well. They need the basics. The fundamentals. Problem is the basics aren’t sexy and don’t get you likes or follows on social media. Advanced progressions of basic human movements make up 90% of what’s on social media, yet in the office 90% of our patients only need the basics. The same can be said for the population that works with a personal trainer or strength & conditioning professional. They often need the basics and just building off them.

The majority of patients and clients need to master the basics without the need of external resistance. For most, simply working against the resistance of their own bodyweight is sufficient. Problem is, if you take away the bands, the barbells, the kettlebells, the dumbells, the cables and sliders from some doctors, therapists, and trainers, they will struggle to think of exercise progressions/regressions to yield better movement by simply using one’s own body. The really good movement providers can achieve improvement without the need of equipment. This may be incredibly simplistic and not score big points on Instagram or Facebook, but you’d be surprised at how challenging the basics and their variations will be. So if you are using social media as your reference library on how to rehab your own injury, rehab a patient, or create a workout for your next training client, I would be incredibly cautious.

Sure the squat may be basic, but how many are actually capable of a proper bodyweight squat? The answer may surprise you. Yet how many are capable of a proper squat before heavier and heavier loads are introduced or they try an overhead, band-resisted, anti-rotational squat? I’m gonna bet not many. If you’re capable of performing an overhead, band-resisted, anti-rotational squat with ideal form, great. You’re part of less than 1% of the population that is capable. The other 99% need more of the basics and arguably may never need to do that advanced of an exercise. Most won’t even have the desire as they won’t see the relevance.

The basics may be boring, but they are incredibly effective. We all need them. The basics serve as the foundation. What kind of basics are we talking about? If I was to build a short list of basics to ask yourself, it would look something like this:

  • Are you able to breathe without excessive chest or shoulder movement?
  • Are you able to balance on one-leg for at least 60 seconds?
  • Are you able to balance on one-leg (eyes closed) for at least 30 seconds?
  • Are you able to hold a plank for at least 60 seconds?
  • Are you able to hold a side plank for at least 30 seconds on each side?
  • Are you able to perform a lunge with ideal form and control?
  • Are you able to perform a squat with ideal form and control?
  • Are you able to raise your arms overhead with ideal form and control?
  • Are any of these movements painful?
  • Are any of these movements difficult to perform due to tightness or restricted range of motion?
If you have answered, “Yes”, to one or more of these questions, you are lacking the basics. Lacking of these basics has been correlated with increased incidence of back pain, neck pain, hip pain, knee pain, foot/ankle pain as well as reduced athletic ability. And believe it or not, no equipment is needed to help someone achieve these basic standards. All you need is your body and the ground. This is what the really good movement providers understand and it’s all they need to work with.

Why are the basics so important?

People want to exercise to get in shape and improve their health yet most of us aren’t in shape to exercise. When we loose the basics – the fundamentals to human movement – more complex or more demanding activities will take a toll on our body. If the basics are challenging yet you wonder why you have knee pain after running or why your back kills after leg day, you now have some possible answers. Our body will eventually pay a price when higher and higher demands are placed on an inadequate foundation. Make a point to master the basics and never loose them. Your movement provider should be capable of helping you achieve the basics. In doing so you’ll realize a quality of health and physical ability that may have previously seemed impossible to achieve.

More related reading:

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

The Most Effective Treatment for Shoulder Pain

Our approach to working with shoulder pain or injuries is very unique in that we really don’t work around shoulder injuries when properly indicated. The majority of the time, we don’t force someone to rest for several days while inflammation quiets down. Yes, it can be necessary in rare circumstances. However, rest and traditional methods of ice and anti-inflammatory meds are often over utilized when properly prescribed movement (i.e. exercise) is probably the better bet for improved recovery. At Gallagher Performance, we have a nasty habit of getting our athletes, clients and patients to work through pain and injuries by strategically incorporating exercise with specialized approaches tailored to find “the hardest thing they do well”. We want to find what they can be successful with while not posing any undue risk. And the best part? The system works.

When it comes to the shoulder, pain and injury is most commonly associated with poor shoulder function and faulty mechanics. And when I say most commonly, it’s not a stretch to say over 50% of shoulder injuries are due to these underlying problems. If muscles are unable to fire properly to provide ideal amounts of support (stability) and motion (mobility), then injury will occur regardless of how strong or flexible one is.
I have written extensively on the subject of the “hidden cause of injury” since the root cause of the overwhelming major of musculoskeletal injury is dysfunctional movement. Most doctors and trainers do not have the training or eye to look for dysfunctional movement and no amount of rest, ice, and Advil will ever provide the solution. No amount of passive modalities, taping, cupping, mobility drills, or stretching will correct dysfunctional movement. When it comes to shoulders, the solution to reducing shoulder pain and preventing injury is all about restoring proper rhythm and mechanics of the shoulder joint. This includes all it’s associated articulations – the glenohumeral and scapulothoracic. Basically we have to improve how both the “ball and socket” joint or “shoulder joint” (as most of us know it) and “shoulder blade” function together.

When it comes to improving the function of the shoulder, we’ll take an athlete or patient and have them perform variations of rows, pulls, presses, and ground-based movements with adequate loads to reinforce ideal body mechanics and correct dysfunctional movement or stability patterns. This is done through a combination of exercises, tempos, external stimuli, and progressions to essentially re-educate the nervous system. This is why it’s called neuromuscular re-education. We must teach the nervous system to do things better and break bad habits. Yes bad habits can be very challenging to break. Most people would rather pop a pill or rest until their pain disappears rather than break bad habits because breaking bad habits sounds like hard work. Popping pills and rest are great because they are easy and effective. But those who deal with chronic recurrences may want to think about a different strategy once their patience wears thin.
For example, some lifters have such poor thoracic spine posture and scapular dyskinesis that they may need 6 months+ of rehab and corrective work. But they have no interest in that. They have no interest in stepping back a little and refocusing their training for long-term development. They prefer to band-aid symptoms while they push their training and perpetuate the pain cycle.

The funny thing is breaking bad habits isn't as hard as most people think. If you work with the right person you’d be surprised what proper coaching, cueing, and exercise can do in a relatively short period of time. The reality is most people are highly resistant to breaking bad habits because of either ego or the unwillingness to take a step backward. Typically after a number of training or therapy sessions, the individual is able to perform any and all movements without pain and with improved shoulder mechanics. For those dealing with shoulder pain, improving their mechanics through sensory-motor training enables their nervous system to be re-educated. This re-education process is the most effective form of therapy and healing available. It cannot be understated that a critical component of this process is proper coaching and cueing. This is the responsibility of the coach or therapist. As much as proper coaching and cueing can be beneficial, improper coaching and cueing can prove to be very damaging. It is my opinion that many injuries occur because the athlete or patient had previously received very poor coaching or instruction.

This is exactly why performing exercise with proper technique is proving to be the single most effective form of therapy as it promotes almost immediate healing. If someone is having pain during a movement, they are doing something wrong. Correct them into the proper movement and watch their pain disappear. The key is re-educating the nervous system so movement becomes both therapeutic and performance-enhancing to one’s body rather than promoting pain and destroying joints.  This is truth when it comes to the shoulder joint as well as any joint within the human body.

Tired of pain? Want to reach your full potential? Visit gallagherperf.wpengine.com
EXPERIENCE THE DIFFERENCE.

More related reading:

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

WHAT ARE MY OPTIONS IF YOU DON’T TAKE MY INSURANCE?

The insurance industry has become increasingly difficult to work with as many large carriers have limited or completely closed off providers from joining their network.

In such cases, we operate as a fee-for-service facility and offer affordable plans that truly increase the value of our patient’s experience. But rather than take my word for it, let's do the comparison between traditional chiropractic and the difference at Gallagher Performance.

TRADITIONAL CHIROPRACTIC
Most traditional chiropractors spend 5-15 minutes per patient and often attempt to have them come 2-3 times per week for an extended period of time. Most patients only experience passive modalities and adjustments with a predictable routine of stim-heat-adjust-out the door. And if there is rehab, often it is supervised by unlicensed aides who instruct patients in exercises. Most traditional chiropractors will see a patient 18-24 times in order to resolve their problem. Depending on co-pay or co-insurance, the out-of-pocket expense can add up quickly. For someone who has a $25 copay, that means they will have $450-$600 of out-of-pocket expense.
THE GALLAGHER PERFORMANCE DIFFERENCE
At Gallagher Performance, you spend 30-60 minutes with your chiropractor, enabling faster recovery in fewer visits. Most of our patients recover in less than 8 visits, spend 100% of their time 1-on-1 with a board-certified rehabilitation chiropractor, and are provided with essential knowledge and tools needed to ensure pain doesn’t come back. Our approach will actually save you money while providing you with a higher quality of treatment. That’s value you can’t compare!

 

The Best Exercise

Often I am asked, "What is the best exercise?" or "What is the best type of exercise?"

To answer that question, let's set the stage of what exercise really is - movement.

Teaching patients not only about chiropractic but how to move better all comes back to function and understanding how all the intricate parts of our body make up a highly complex movement system. But here are some key points to understand:

1) Function determines movement. Chiropractic and rehabilitation seek to restore proper movement function. Functional examinations determine WHY movement is painful or problematic. Utilizing the functional model of movement helps to determine who is at risk for injury, which movement patterns or body regions are dysfunctional, and what treatment or exercise strategy is needed to address those issues in combination with chiropractic/manual therapy methods.

2) Function is critical to movement and movement is critical to our health. Our bodies are designed to move. The growing list of chronic diseases and immense burden on the healthcare system associated with an overly sedentary society clearly demonstrates one conclusion – we need to move more.

3) Movement is exercise and exercise is medicine. The medicinal benefits of exercise are numerous. There is a reason why exercise and proper nutrition is being labeled as "lifestyle medicine".

For those who wish to start an exercise program, the public is told to “see your doctor” before starting an exercise program. Most patients are cleared to exercise after history and vitals are considered “normal”. Sure your organ system may be healthy enough for exercise, but nothing is mentioned about seeing a doctor to determine how well you move or how well your muscles and joints are functioning. Why wouldn’t this be considered? Why wouldn’t seeing a “movement specialist” before considering an exercise program be equally advocated?

So, in typical fashion, most of us embark on an exercise program believing we will be healthier for it. We are told to exercise and practice sound nutritional habits, but what do most of us do for exercise?  How about go to the gym, sit on a machine and pull or push weights while hunched over with lousy posture.  Or, after sitting for 40-60 hours per week, let’s go out and put staggering amounts of stress on our bodies through recreational activities like weekend skiing, Thursday night softball league, rec league hockey, golf, or basketball.

There's nothing wrong with those activity choices, yet what happens when pain or injury come into the picture? Most of blame the exercise or blame the activity when, in most cases, we should be blaming our own body.

When it comes to pain and injury, the reality is what our body is capable of performing cannot meet the demands we are placing upon it. The overall function of our body must be ready to handle a specific task or movement otherwise problems will eventually arise. Problems that may range from mild (muscular tightness/stiffness, joint aches) to more severe (pain and/or injury).

The beauty of the functional model is that those regions that have mechanical sensitivity (pain) and/or abnormal motor control can be identified and solutions are discovered. Exposing these compensations and correcting them plays a huge role in not only getting patients out of pain, but improving how their body functions.

Why is changing how our body functions so important?
While pain is why most people seek care, the reality is if we only change pain and fail to change how a patient’s body functions, we have our reason why so many patients relapse. But if we get them out of pain and improve how their body functions then we are doing what we need to do to keep the pain from returning.

Whether we need mobility (improved range of motion) or stability (motor control), that can be addressed with a proper functional examination through movement. After a functional examination, it just makes sense to reinforce functional movement patterns with specialized exercise to build a foundation of proper movement coordination, strength and skill.  Now we are beginning to get somewhere to build form, function and fitness. Now we are getting people to move better through better exercise!

Correct movement is the best exercise
Once people learn better movement, how to project their joints and what exercises they should be performing, their bodies are much healthier for it. There is less risk of injury and most will ultimately start feeling better instantly. Rather than beating their bodies up due to poor movement, movement becomes healing. Correct exercise is the answer. Correct movement is what we need to get out of pain, feel capable and feel healthy.

That’s the essence of the functional model. It’s about promoting health and healing through therapy, movement, and patient-centered education. That’s what we pride ourselves on at Gallagher Performance as our model is truly unique in the services we provide and the results we achieve.

More related reading:

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

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

https://gallagherperformance.com/do-you-really-need-more-mobility/

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

Post-Surgical Rehab Success is All About Team

Recently, Shannon Perrine of WTAE Channel 4 News in Pittsburgh featured a story on a patient of ours, Karla White. The focus of the story being Karla's same-day hip replacement surgery. It was a short, yet informative piece on the work of her surgeon and the rehabilitative process with special attention to the factors that played a role in a very successful outcome. If you have not seen the story, head to our Facebook page and check it out. All of our social media links are here on the website. You'll find them at the top of the page.

After the story aired yesterday, I had a number of thoughts that came to mind. Primarily these thoughts centered around how many medical professionals and the general public have a misunderstanding of the training and qualifications of chiropractors and strength & conditioning specialists. Especially as they relate to rehab, be it from injury or surgery. Many may find it unconventional and, at times, silly that one seeks out the professional help of a chiropractor or strength coach for the oversight of their rehabilitation.

Traditionally, once a patient is ready to begin post-surgical rehab, this process is guided by a physical therapist. It’s conventional thought and accepted practice.  You have surgery, then you go to physical therapy.

That said, there are post-surgical patients who will seek out a chiropractic rehabilitation specialist to manage their rehabilitation. And, depending upon the setting and patient, strength & conditioning specialists may be involved as well.

Now there may be a few thoughts running through your mind right now. Maybe thoughts such as:

“Wait….chiropractors aren’t qualified to do post-surgical rehab!”
“Why would you use a strength & conditioning specialist for a rehab patient? Those are only for athletes!”
This news story has opened up the opportunity to help educate, so let’s address these questions or concerns.

Are chiropractors qualified for post-surgical rehab?
The reality is, when patients seek a provider for their post-surgical rehab, they may choose to seek a professional who is not a physical therapist. Some may not have the flexibility to make their own decision, but for those patients are looking for the best person for the job and they will exercise their right to make that decision. Regardless of title (PT or DC), patients must be in the hands of a provider who has the professional training and expertise to handle their rehabilitation appropriately. Providers must be competent and efficient for the sake of minimizing post-surgical complications and improving outcomes.

I’ve highlighted this before in previous writings, but my residency truly provided professional training very few chiropractors ever receive. During my 3+ year residency, I managed or co-managed numerous spinal, shoulder, hand/wrist, hip, knee, and foot/ankle post-surgical rehabilitation programs. Our department at Palmer College of Chiropractic worked with local orthopedic and neuro surgeons to co-manage routine as well as highly complicated surgical cases within the Quad City area. Meaning, we saw everything from athletic injuries to total joint replacements.

I don’t stress this to simply pump my own tires, but to convey to our audience that I’m not new to post-surgical rehabilitation and there are chiropractors out there that have similar training and expertise as well. We don’t exist on the level of physical therapists nor are we claiming to be physical therapists. Physical therapists have their own unique training and skill set. The ones I know do outstanding work for their patients.

The point I’m trying to make is that it is possible for chiropractors to have a background in functional and post-surgical rehabilitation. These chiropractic rehabilitation specialists are qualified and are capable of successful post-surgical rehab outcomes.

What is the value of Strength & Conditioning during post-surgical rehab?
For all those that want to be evidence-based, exercise and strength training literally helps more musculoskeletal conditions that all other treatments. The same can be said of post-surgical rehab as it is all about regaining range of motion, strength, and functional capacity. If you have the privilege of having a knowledgeable and qualified strength & conditioning specialist in your corner, they will provide enormous value to the post-surgical recovery process.

Yes, the involvement of strength coaches may be more commonly used in the athletic world, within the collegiate, professional and international ranks. But, when available in the private sector, they add an immense advantage as the rehabilitative process is very time sensitive and it’s critically important no time is wasted. The more quickly a post-surgical patient can regain adequate strength and movement quality through gradual exposure to the functional demands of strength training, the more quickly they are able to return to their activities of daily living, job, or sport with confidence and minimal complication.

Strength coaches are experts in what almost all musculoskeletal conditions will benefit from: exercise and strength training. Keep in mind, they must have the appropriate qualifications. Not all strength coaches are created equal and those that are capable of being involved with a post-surgical patient are rare. I can't stress that enough. These professionals understand their role and the best results are seen when they work together with the rehabilitation specialist to ensure ideal outcomes for the patient.

Post-Surgical Rehab Success is All About Team
The success of the post-surgical rehab program is not solely dependent upon any one specific individual involved in the process. Successful post-surgical outcomes take on a team dynamic. In this case, the surgeon, rehabilitation specialist, strength & conditioning specialist, and patient all had critical roles.

The Surgeon
For Karla, she had a tremendous orthopedic surgeon in Dr. Julius Huebner. Due to a congenital condition and progressively worsening degenerative joint changes to the left hip, Karla underwent direct anterior approach total hip replacement in late May 2016. This surgical approach is essentially a “surgical strike” as described by Dr. Huebner in the video. His surgical procedure resulted in no damage to adjacent tissues and structures. The procedure was a precise as you can get, enabling same-day hip replacement surgery and a faster recovery.

The Rehabilitation and Strength & Conditioning Specialists
In preparation for her surgery, she worked with the team at Gallagher Performance during the months prior to her surgery to improve her post-surgical rehab outcomes. Her pre-surgery rehab program enabled Karla to remain as functional as possible during that time. Pre-surgical rehab programs are never easy and quite challenging. However, Karla is a tremendous patient who demonstrated nothing but commitment and patience, knowing that the work she did prior to surgery meant having that much less to do post-surgery.

Likewise, during the course of her post-surgical rehab program, Karla worked one-on-one with either myself or Ryan. I managed the early phases of her rehabilitation recovery, implementing manual therapy and exercise. This continued as she progressed to more strength training focus in her rehab. That's when Head Performance Coach, Ryan Gallagher, designed and implemented her strength & conditioning program.  The collaborative focus was on developing ideal movement patterns to spare her joints, thus improving the health and relative function of her legs, hips and spine. Exercise selection and progressions were based on post-surgical guidelines, tolerances, and functional capacity all while ensuring adequate strength and movement control were demonstrated.

The Patient
As for Karla, she was the ideal patient.  She was compliant and motivated throughout the entire process. Karla loves to be active and workout, which only added to her motivation. A motivated patient is so refreshing to work with for countless reasons. The rehabilitative process can be frustrating at times, with obstacles and ups-and-down marking the road. As challenging as rehab can be physically, rehab can be even more challenging mentally. To her credit, Karla was always willing to work, even when she was frustrated or progress was slow. She always worked hard and focused on the little details. It’s because of her attitude that she demonstrated and her drive to regain the quality of life she desired that she is where she is today.

Summing Up
The combined team effort was the key to the success of this post-surgical rehab story. This theme must be present to ensure a patient has the outcomes they desire. It’s a privilege to be involved, providing our services to complement the team effort required during the post-surgical process as we recognize our role in the rehabilitative process. We thank Dr. Huebner for his medical expertise, Karla for being outstanding to work with, and WTAE’s Shannon Perrine for her excellent coverage of the story.

At Gallagher Performance, our focus is on developing the resilience of our clients and patients. We are committed to utilizing cutting-edge, patient-focused progressions to help every individual we work with not only achieve but also exceed their goals. With our extensive training and knowledge in chiropractic, manual therapy, sports injuries, rehabilitation, and performance-based training, we work with all individuals who are interested in living healthy, active, and pain-free lives.

More related reading:

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

Gallagher Performance Receives 2016 Best of Pittsburgh Award

Pittsburgh Award Program Honors the Achievement
Gallagher Performance has been selected for the 2016 Best of Pittsburgh Award in the Chiropractors category by the Pittsburgh Award Program and is among a very small group of businesses that have won the Best of Pittsburgh Award for three consecutive years.

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 2016 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

Solving Pain: The Influence of Czech Rehabilitation Techniques

As physical medicine becomes increasingly specialized, chiropractors and therapists must remain educated and capable of offering the highest quality in their professional services, knowledge, and examination abilities. Regardless of whether you are entrusted with the care of an athlete, chronic pain syndrome patient, or post-surgical rehabilitation, we have the job of reaching successful outcomes for each individual we encounter.

We must find their real source of pain, their true sources of dysfunction. Even if it means identifying sources others do not know exist.

We should be able to perform orthopedic, neurological, and also functional assessment to not only diagnosis problems, but also determine how to prevent any future problems.

One such country that has encouraged this level of thinking among it’s doctors and therapists is the Czech Republic.

The emergence of Czech ideas within the United States has grown over the last 15-20 years. My mentor and residency director, Dave Juehring, DC, DACRB, CSCS and director of the Sports Injury & Rehabilitation Department at Palmer College of Chiropractic in Davenport, IA has one of the most extensive backgrounds in Czech approaches to manual medicine and rehabilitation within the United States. In my opinion, there is no brighter mind in the chiropractic rehabilitation world. He may not be well known by industry standards, but those that know him know his knowledge and skill set is second to none.

The knowledge and expertise he is able to share with his residents, rehabilitation interns, and students has a profound impact on our professional development.

Among many lessons, he really has helped us understand the approach taken within the Czech School of Manual Medicine as well as the Prague Rehabilitation School. The intent of this article is to share some of this knowledge and highlight how these Czech methods can improve rehabilitation outcomes and athletic performance.

Alternative Thinking
The Czech School of Manual Medicine truly has revolutionized the management of musculoskeletal pain. Early in the 1950s, neurologists by the names Vladimir Janda, Karel Lewit, and Vaclav Vojta took a special interest in the rehabilitation of the motor (aka movement) system. As western medicine became progressively more technologically driven, Janda and Lewit focused on the value of manual approaches such as chiropractic, joint mobilizations, and neuromuscular rehab techniques, such as PIR (post isometric relaxation) as critical pieces of the rehabilitation plan. Janda was instrumental in the assessment of muscle imbalances, Lewit’s in joint dysfunctional. Vojta was instrumental in the discovery of global reflex locomotion patterns.

Collectively, their research focused on joint dysfunction, muscle imbalance, and the assessment of faulty movement patterns.

These concepts became components of identifying “Functional Pathology of the Motor System”. In other words, identifying why someone has developed pain or a movement related problem. In contrast to traditional medicine, which had a growing emphasis on medical imaging (X-rays, CT scans, MRIs) to identify structural pathology as the cause of pain.

Developing Ideas and Techniques
The work of Janda, Lewit, and Vojta influenced the work of Pavel Kolar and his work now represents a very innovative and powerful approach to how the central nervous system not only controls but expresses movement. This approach is known as Dynamic Neuromuscular Stabilization (DNS). The application of DNS has value from the neurologically impaired child to adults dealing with musculoskeletal pain to elite athletes. Kolar’s knowledge and skill set has landed him jobs with the Czech national teams in soccer, hockey, and tennis.

DNS has become highly effective in speeding recovery from injury, rehabilitate the body’s function as a unit, and enhance performance. Even the Czech President relies on his unique skill set. Kolar has worked with some of the world's best athletes, such as Jaromir Jagr, Roger Federer, and Novak Djokovic to name a few.

Thanks to the influence of these Czech clinicians, we are now able to look for predictable patterns of dysfunction within the human body and correlate them with pain or injury. It is in the Czech model we are able to piece together the clinical relevance of local, segmental joint treatments (mobilizations, manipulation), muscular imbalances, and central nervous system coordination of movement to optimize how the body functions and performs.

Read more on DNS here:

Dynamic Neuromuscular Stabilization: Advancing Therapy & Performance
The Hidden Causes of Sports Injury
https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

https://gallagherperformance.com/sports-chiropractic-rehabilitation-massage-therapy/