Gallagher Performance Blog

Acute Low Back Pain with Sciatica Treatment


Disc herniations and bulges can heal without surgery. Expert neurosurgeons will tell you the same thing. Yet why most elect for surgery is they never find conservative treatment that solves the problem.

We must identify the underlying reasons WHY the disc herniated or became sensitive. Often these reasons deal with improper movement and postures that overload the disc routinely. We get too focused on the event - the moment the back locked up and pain hit like a ton of bricks - and not enough focus is brought to the process that led to the injury.

With this patient, we had to focus on teaching sparing the spine while winding down sciatica symptoms in the right leg. Focus was also placed on flexion intolerance, reduced lumbar spine extension, and poor transverse plane stability of the lumbar spine and pelvis.

The combination of these interventions and pain education resulted in significant reduction of low back pain and near complete elimination of sciatica in TWO treatments.

The important thing to remember here is that while the total number of in office treatments was low, this patient was provided with the proper home instruction that enable him to make a dramatic impact on his pain and symptoms. Patients need to understand what is driving their pain. They need to understand how their postures, movements, and habits are either helping them or sabotaging their healing process. From here they can make the appropriate modifications and learn to problem solve their pain.

Sometimes you don't have to wait weeks or months for pain relief. Making lasting changes in the body is a different story. This can take a longer period of time with the correct inputs through repetition. And this is exactly why education and home care instruction is vital to patient success. Help them understand their pain and the recovery process.

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If You Don't Have a License, Stay in Your Lane

Personal trainers or strength coaches don't have a license to diagnose, treat, or manage musculoskeletal conditions. Yet some are convinced they can play 'therapist' or 'doctor' on the regular.

While I do agree that it's important for coaches/trainers to understand pain and how to make appropriate modifications to an exercise plan based on a client/athlete's current limitations, it's completely inappropriate to give any level of medical advice. Just because you took a course or use correctives in your exercise plan, it does not put you on the level of a PT, DC, or MD regardless of your opinions of those professions.

For example, saw a patient who, for months, had been dealing with chronic knee pain. Yet her personal trainer convinced her it was no big deal and she needed to "pump blood into her knee" by exercising and that would heal her knee - only to be informed she has a torn meniscus. This kind of situation occurs more than you would believe and it's wrong.

Social media is littered with people such as this who present solutions to pain or specific physical ailments. They generically provide exercises or stretches for some common condition (low back pain, shoulder pain, knee pain). It's often just regurgitated information cause it's easy to copy.

Yet they know NOTHING about YOU, but assume to know you. This is wrong. People listen cause it's free advice and there is perceived authority. Sadly, a large social media following equals perceived authority in today's world.

They are providing 'treatment' in the form of exercises or stretches to relieve the pain they are 'diagnosing' you with. Some even goes as far as to discredit certain medical or rehab professionals. They say, "Don't listen to them." What they are really saying is, "Listen to me." Again, wrong.

No license? Don't listen to them. They aren't qualified.

Coaches and trainers - You want to wear a medical hat, then play by our rules. Go ahead and get yourself a professional degree and pass national or state licensure requirements. Until then, stay in your lane.

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Exercise Is What You Do. Movement Is What You Feel.

Movement gets a lot of hype these days and receives plenty of attention in the fitness industry, strength & conditioning industry, and rehabilitative fields. From movement screens to movement coaches, movement is a buzz word it seems some are simply trying to capitalize on.

Movement screens don't prevent injuries, they just give you information. What you do with that information is what matters. And do we really need all these screens to 'diagnose' what's wrong? Does someone suck at an overhead squat because they have tight ankles, weak glute medius, tight TFL, hip flexors, and lats? Or maybe because they are just simply uncoordinated? Because they don't understand the movement? You'd be surprised at how quickly movement expression can change with proper coaching of postures and technique. Watch what happens. Our brain has the ability to figure things out.

Coaches or therapists may provide an elaborate 'corrective exercise' program or 'activation' warmup, but what's the use when it's executed with poor quality of movement? Now you're just doing stuff that doesn't help. You could do a lot more with basic exercises that have a high quality of execution and movement competency. If all the focus is on "doing exercise" without the focus on the "feel of the movement", you're missing the boat.

Movement competency, injury prevention, and performance-based training are all linked. You can't separate them out. The best injury prevention methods are found in performance based applications. The best physical and athletic development models reduce injury. And both performance and prevention have a focus on movement efficiency or movement competency.

Performance and injury prevention boil down to how well do you express fundamental movement qualities. The best programs coach someone through movement so they feel and understand how to express higher levels of function/performance in exercise and sport.

Training and rehabilitation occur through movement, not simplistic exercises. Sadly that's what most people get. And that's why they don't progress, why they have pain, or why they relapse.

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Posture & Movement Require Brain Education

Our brain controls our posture and our muscles. Therefore posture and muscle tone (i.e. how tight or relaxed a muscle is) is an expression of the brain. We must pay attention to this expression and how it relates to movement.

A frequent cause of disturbance in our movement quality, why muscles get tight, why we display poor posture, and why we may have trigger points or pain is due to insufficient muscular stabilization of our spine.

Insufficiency is our stabilization system is exactly the reason why patients and athletes who have poor body awareness demonstrate poor ability to simply relaxation. Believe it or not, relaxation is easier said than done. If the brain doesn't know how to relax fully certain muscles, the low-grade state of contraction will keep muscles and surrounding joints under constant stress. This constant stress will ultimately lead to trigger points in muscles, dysfunctional movement patterns, and altered posture.

This is why specific exercise progressions that respect the developmental aspects of posture and movement are so critical. Exercise should not only address muscle function, but it must also address brain control to change how our body functions.

"Brain Education" focuses on the efficiency of our postural and movement control to avoid overloading of specific tissues and joints while promoting muscular balance.

Movement and relaxation is a skill. It must be practice daily through purposeful exercise with complete awareness to the feeling of the movement. This is the gateway to change in the body. These changes are valuable to anyone who is simply looking to get out of pain or improve their athletic ability.

However, there are still those that challenge the notion that there is an “ideal” or “good” posture. They will have you believe that there is no such thing as “good” or “bad” posture. The reality is, when it comes down to determining what is “good” or “bad” posture can be simply summed up by saying….”It depends.”

What will dictate “good” or “bad” when it comes to form or posture will depend upon a number of variables specific to the individual. We can find efficient form and ideal posture that someone should respect and when they don’t, the result is excessive wear and tear on their joints and tissues, leading to pain and progression of degenerative changes.

Yes we need to be efficient in movement and have a vast movement capacity. Yes there is no single posture that we should maintain for an extended period of time, no matter how “good” it is.

But those notions go out the window when our body meets increasing external resistance to our movement or we are performing movement at increasing speeds.

What does that mean?

Yes, we should be able to flex our spines and perform a body weight squat with posterior pelvic tilt (aka the dreaded “butt wink”) and resultant lumbar spine flexion. Yes this would be considered normal healthy human motion. But that doesn’t mean that one should perform a loaded barbell squat with the same intent or form. This could be an injury waiting to happen. When increased load or speed of movement comes into the picture (ex. barbell squat), very specific considerations must be made to that individual on the form and posture they express during the squat pattern to maximize their muscular efficiency and minimize stress placed on the joints.

These are the same considerations that must be respected when it comes to rehab and the subsequent development of fitness/physical ability. According to McGill, this breaks down into two stages:
  • Stabilization of the injury and reduction of pain by approaches that follow desensitization and healing.
  • Development of strength and physical ability only begins when the first stage has been achieved.
In order to desensitize the patient, we must promote postures and movement that minimize stress on the joints and injured tissues. Otherwise, as stated by Mosley, most people will “wind up” their nervous system as a way to over-protect because they are aren’t prepared for what they are asking their body to do. Desensitization and reducing perceived threat is critical in the first stage of healing.

Once pain is reduced, the development of specific fitness qualities can take center stage. This is when we address the complexity of the movement system. Panjabi established the importance of the passive, active, and neural systems for trunk/core stability and movement. Jull and Richardson found in voluntary movement, activity of the deep spinal muscles precedes activations of the superficial muscles (aka feed forward mechanism).

The integrated spinal stabilization system (ISSS) serves as the “feed forward stabilization mechanism”. The ISSS consists of the diaphragm, pelvic floor, all parts of the abdominal wall, short intersegmental spinal muscles, deep neck flexors, and serratus anterior.  We know that these muscles essentially form the “deep core” that is so important to train for efficiency of posture and movement.

The ISSS required “Brain Education” to work optimally. There is no way around it. We must focus our attention and efforts to ensuring that no matter the task, we must rely of the ISSS if we are going to realize our movement potential, maintain healthy posture, and minimize joint pain.

Don’t fall into the trap of believing someone who says “good” or “bad” posture doesn’t exist. Again the answer is it all depends. Posture and the considerations we make regarding it are always specific to the individual and task at hand. Posture shouldn’t handled in a general approach. Most rehab, training programs and online instruction is handled in an over-generalized fashion. When people need specific, when they need individualized considerations. And that’s the best approach when it comes to helping one learn how to educate their body in regards to what’s best for their posture and movement.

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Tempo Runs for Speed Development


Charlie Francis defined tempo running as running performed at 65-75% of maximal speed. Tempo runs have long been used in the training of sprint athletes to enhance speed training. Outside of sprint athletes, sprinting ability and speed is arguably the most important skill field-based athletes can possess. Yet many have never been introduced to tempo runs and why they can be invaluable to their speed training.

Tempo runs can serve as tool to increase speed for a number of reasons:

1) Tempo runs are based on volume that is critical in building specific adaptations relative to speed. Similar to building maximal strength, most training programs spend the bulk of the calendar year in the 75-85% 1RM range and athletes still get stronger due to the volume of training perform at those intensities. You don't always have to train at or near your maximal strength to get stronger. Same is true for speed. You need to build volume to lay the foundation for increased maximal speed.

2) Due to the lower intensities, tempo runs aid in recovery from more intense speed training through aerobic metabolism pathways. Tempo runs improve capillary density, thus improving blood flow to our musculature and improving recovery.

3) Tempo runs are great for building aerobic and anaerobic-alactic capacity without interfering with power or speed development athletes require.

4) Including body weight exercises such as push-ups or a variety of abdominal movements during rest periods can heighten the cardiovascular conditioning response.

5) Different types of tempos and formats will depend upon the athlete and their specific needs. There is a plan and purpose behind their structure. In this video we have @makennagrieco performing tempos more specific to her needs as a 100m sprint athlete that is early in her general preparation phase.

As always hit us up with your questions.

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Exercise - Choose Consistency Over Intensity

Exercise or training should not be fatigue seeking. The problem with a lot of training programs or exercise in general is that they are fatigue seeking.

The primary mentality is to work hard, wear you down and make you sore rather than build competency or skill. This is a mistake and, all do respect, it's wrong.

This is especially true for athletes. If your workout or training is taxing you so much and making you so sore that you can't perform or learn new sport skills, it is counterproductive. You physically cannot drain yourself in a workout, day in and day out, and expect to see improvements in sport mastery. Your body doesn't have enough reserves and you'll never reach mastery.

You cannot go "all out" every work. You cannot go maximal effort every day. But most people think this is they way to do it because that's what they've been told or what most of us see in videos of athletes training. This could be any sport athlete, fighter, or strength athlete. No one wants to put out a video of an athlete who is tapering or who is focusing on building training volume rather than going hard. We just see videos and visions of these athletes peaking or when intensity is at its highest. We made the mistake of assuming this is how they train all the time.

If you would watch most athletes train and practice year round, you'd see a totally different story. Your reaction may be more along the line of, "That wasn't so intense. That wasn't that tiring." Great athletes train for the long run, not to burn themselves out.

Why? You want to set yourself up to train the next day rather than feeling like you are so sore and tired that you can't train or have a lousy training session. This mentality and approach correlates with mastery.

You can't red line the body regularly with intensity. Most athletes that practice this mentality are too beat up by the time they get good at their sport.

Yes great athletes train with intensity but they do it periodically and strategically.  This is "Consistency over Intensity". You don't have to be an athlete to learn from these concepts. Apply them get far more out of your workouts and your training in achieving your strength or fitness goals.

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Exercise Hacks Ep. 15 - Fix Tight Hips and Improve Athleticism with Lateral Movement


A common reason for low back pain, hip pain, knee pain is poor functioning hips. What happens to poor functioning hips? They usually get tight. This tightness leads to reduced range of motion and increased likelihood of back, hip, and/or knee pain.

Likewise, a common reason for reduced athletic potential is poor functioning hips.

The hip complex is meant to be trained in multiple planes of motion because the hips are designed to move in multiple planes of motion. Yet most people live in the sagittal plane of movement - essentially only moving  forward or backward - and they gradually lose the ability to move in lateral or rotational planes of motion.

Including lateral movement exercises can prove to be beneficial for reducing muscle tightness and joint pain as well as enhancing athleticism.

Here is just a sample of lateral movement exercises that are scaleable to an individual's capacity. These are great for training lateral strength, motor control, and improving weight transfer that feeds agility and power. They can easily be performed with most gym equipment. Depending on preference, you may need to purchase some furniture sliders or a slide board. You may need to get creative based on what you have access to. Regardless, the principles of movement are still the same.

In this video we feature:
  1. Lateral monster walks (use band or Hip Circle)
  2. Slider lateral lunge
  3. High box Crossover Lunge
  4. Cable Skater Lunge
  5. Lateral plyometric power
There are plenty of other lateral movement exercises that could be included. Keep in mind exercise selection should be given careful consideration based upon the individual.

Give your hips a good lather.  They'll be feeling more greased than a Five Guy's bacon cheeseburger. And that a good thing. Motion is lotion that is vital to the health of your joints. You'll be primed for speed and power. Plus your cranky back and knees will thank you.

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Finding a Solution Requires Not Being Part of the Problem

There are many examples of things we just assume to be true for long periods of time that aren't true at all. The perpetuation of this group think is a real problem.

This is especially true when it comes to the industries of nutrition, health care, and fitness. Here's some examples:

Dietary cholesterol has no impact on blood cholesterol levels. There is no reason to limit cholesterol in the diet. It has no impact on risk of heart disease and there is no evidence to support any link to heart disease. Except in the cases of genetic variations, the same can be said for saturated fat. Most people end up avoiding these nutrients at the expense of their own health and performance.

Sodium has been demonized for decades when its arguably one of the most critically essential nutrients in our diet. Sodium has no impact on blood pressure when you control for variables such as potassium, calcium, Vitamin K, Vitamin D, and thyroid hormone levels. The recommendations for adequate sodium intake can vary greatly based on individualized considerations, but many people are falling short of a healthy range of sodium simply because they believe too much sodium is bad for them.

More and more research is proving the efficacy of chiropractic and massage therapy. Sure there are some bad eggs out there, but the overwhelming majority provide excellent results through treatment that is both evidence-based and safe.

Resistance training has long been considered too harmful or damaging for adolescents. However the reality is, when proper instruction, supervision and programming is accounted for, resistance training is safer than most youth sports.

A huge reason why these misconceptions perpetuate lies in over generalized recommendations. As with most cases, the best answer to finding a solution is, "It depends." We need to move toward more personalized recommendations that take into account an individual's current health status, goals, lifestyle habits, and genetics while taking it consideration the most current guidelines.

You are either part of the problem and perpetuating group think or part of the solution and exposing false claims.

Don't be part of the problem, be part of the solution. What misconceptions do you encounter regularly that people need to hear the true story on?

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Movement That Enhances Performance Reduces Injury

There's a major flaw in the fitness industry - the ignorance of movement quality at the expense of fitness goals.

How far can you run? How fast can you complete this workout? How much can you lift? How many reps can you do? How hard are you willing to push yourself?

What fitness has driven us to believe is that these are the true measures of progress and physical fitness. Yet there is little attention paid to how well we move and how important that is to our health and fitness.

Yes we must progressively challenge the body in order for it to change and adapt. Yes higher intensity exercise is associated with greater improvements in health and fitness markers. Yes if you want to push your body to higher levels of performance you are going to feel it. But at what expense?

Are we willing to prioritize fitness goals over the health of our spine and joints?

There is an old Chinese proverb that says "You are as old as your spine." There is a lot of truth in this statement. There are plenty of people in their 20s and 30s who have stiff and painful backs that make them feel much older than they really are. Likewise, there are those in their senior years who feel great and have less physical limitation than people half their age.

When we focus on movement and the posture associated with movement, our bodies follow suit. Our muscles work more efficiently and our joints are spared. Movement becomes healing and therapeutic rather than damaging.

When we prioritize movement, we can progressively train harder by being smarter. We promote fitness as well as longevity of our spine and joints. When we chase goals and numbers at the expense of movement quality, we find ourselves nursing injuries that interrupt progress. We end up with joints that are beat up, stiff, and painful.

If you don't focus on the details of your movement now, you'll likely be forced to focus on them later. This is the difference between training for performance and rehab. Movement that enhances performance also reduces injury. Don't ignore the importance of movement quality. It may just make or break your fitness goals.

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Chronic Disease is Bankrupting America

Yes it sounds extreme, but it could be our reality. If healthcare spending continues to increase at its current rate, It is estimated that by the year 2040 that 100% of the federal budget will go towards Medicare and Medicaid. That's 100% - meaning no money for anything else.

According to the latest CDC report, 1 in 2 American adults have a chronic disease and 1 in 4 have multiple chronic diseases. Roughly 40% of adults and 20% of adolescents are obese. 30% of children have a chronic disease, up from 13% in 1994. These numbers represent a massive burden to not only to our healthcare system, but our country.

We know that 100 million Americans are prediabetic or have Type 2 diabetes. That's 1/3 of the population. And 88% of people who are prediabetic don't know they are. Now consider the average cost of treating an individual with Type 2 diabetes is $14,000. When you do the math the numbers are staggering beyond belief - and it's only for diabetes!

There is no sustainable way to pay for the rising costs associated with the treatment of chronic disease. It's a major issue that needs to come to forefront of serious conversation with the realization of the personal responsibility we all need to assume in the prevention of these diseases.

Yes they are preventable and no the reason is not just your genetics. 85% of disease risk comes from behavioral and environmental factors while only 15% is related to genetic factors. Meaning the vast majority of chronic disease risk factors are under our control and there needs to be an emphasis on this point.

The solution must have a primary focus on prevention and reversal of disease rather than merely suppressing symptoms. We need to take control of our behaviors as they relate to our lifestyle choices. Choices such as getting adequate physical activity/exercise, nutrition, sleep, and stress management become the real medicine because they have THE biggest impact on our health. And there needs to be more personal responsibility assumed in these areas.

If you won't do it for yourself, do it for America.

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Groin Pain Rehabilitation


Groin pain is a common complaint in athletes and active populations as well as a common source of frustration. What makes it so frustrating is the poor understanding of proper management because of the number complexities related to the true cause of groin pain.

15% of all injuries responsible for competition time lost in hockey players is due to groin pain from common conditions such as groin strain, femoral acetabular impingement (FAI), labral tears, and sports hernia.

Sports hernia is one of the most difficult causes of chronic groin pain to identify and manage. Sports hernia is a weakness and/or injury to the abdominal wall and supporting musculature which can result in groin pain. The difficulty in diagnosis lies the fact that most sports hernias do not produce a palpable hernia and are not seen on advanced medical imaging such as radiograph, ultrasound, MRI, or CT. Surgical exploration is generally the most excepted method in producing a definitive diagnosis of sports hernia after other potential sources of groin pain have been eliminated.

Diagnostic methods in determining the presence of sports hernia may include the identification of five classic signs and symptoms:
  1. Complaint of deep groin/lower abdominal pain,
  2. Exacerbation of pain with participation of sport activities that is relieved by rest,
  3. Tenderness with palpation of the pubic ramus,
  4. Pain with resisted hip adduction,
  5. Pain with resisted sit-up test
Disclaimer: Do not attempt to diagnosis your own condition. Proper evaluation and diagnosis of your pain or problem should be left to licensed medical professionals only.
Surgical intervention has been shown to be an effective method, both in the short-term and long-term, for the management of sports hernia while little is understood about the long-term effects of conservative, non-surgical treatment of this condition.

Here we show a glimpse inside the rehabilitation of post-surgical sports hernia for one of our hockey athletes. Early rehabilitation focus on core control and stability with progressive demands of the extremities.

This model will be vital for proper progression through treatment and functional training prior to return to sport. Rehabilitation must address underlying functional deficits of the core and hips while building a foundation of movement control and awareness necessary for the future development of strength, speed, and power.
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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.
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Exercise Hacks Ep. 14 - Jump Rope & Sprint Mechanics


Going back once again to the podcast with Clinically Pressed, I mentioned the jump rope as a great tool for developing low grade plyometric qualities in the foot and ankle.

Let's take this a step further and demonstrate how these same qualities apply to sprinting. Front side mechanics or tripe flexion is extremely important to running and sprinting ability. Most people focus on the posterior chain and triple extension with little focus on triple flexion.  There is a reason why sprinters spend so much time practicing and rehearsing front side mechanics with marching and skipping drills.

A critical part of triple flexion is dorsiflexion at the ankle. Often you'll see athletes sprint with a lazy foot that isn't brought into dorsiflexion during the gait cycle. This must be addressed and trained accordingly. We want to train an 'active' foot, not a lazy foot. Training an active foot will require cues but the use of external cues such as the jump rope will force an athlete to become more reactive, thus possibly leading to quicker learning of new skills.

The jump rope can be included in skipping drills to develop ideal foot/ankle mechanics as they are necessary for optimal speed and power development. If these qualities aren't trained and mastered then athletic potential will be hard to realize.

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Sleep - The Foundation of Health And Performance

Roughly 1/3 of our life should be spent sleeping yet there is an epidemic of sleep loss and deprivation. If we fully appreciated the benefits of sleep when it comes to health, mental performance, and physical ability, it would reshape the way we view the importance of sleep.

1 out of 2 Americans get less than 8 hours of sleep per night and 1 out of 3 Americans get less than 6 hours of sleep per night. Sleeping less than 7 hours a night results in objective declines in health markers as well as mental and physical performance.

Let's talk health and sleep. The shorter your sleep, the shorter your life. It's a sad truth but it's a reality that less sleep is correlated with a shorter life span. Getting 6 hours of sleep per night or less is associated with increase in risk of chronic diseases such as obesity, diabetes, cardiovascular disease, Alzheimer's, and cancer as the immune system is suppressed on a genetic level.

Let's talk sleep and performance. Sleep is the greatest legal performance enhancing drug available to us. Sleep deprivation of 6 hours or less will decrease physical performance in strength, power, peak running speed, cardiovascular function, and time to exhaustion by around 30%. It is also harder to loss body fat when sleep deprived - so if you are trying to loss weight, you need 7-9 hours of sleep per night as diet and exercise alone won't be enough. Sleep is the foundation for diet and exercise progress.

Getting 7-9 hours a sleep per night is critical in motor skill acquisition and learning. Meaning if you practice and get adequate sleep, you will perform 20-30% better in those same skills the following day. Sleep smooths out motor learning and is critical in skills becoming automatic.

Sleep isn't all about quantity as you want to focus on getting quality sleep as well. To maximize the quality of your sleep it's ideal to sleep in a cooler environment. Try putting down your phone, turning off the TV, and dimming the lights an hour before bed. Avoid alcohol or other sedatives as they block the ability of the body to get into the deep stages of sleep critical to rejuvenating the body. It's advised to avoid stimulants such as caffeine and even exercise in the hours before you plan to go to bed. Start a sleep routine and stick with it.

Sleep - Get some!

Source: Dr. Matthew Walker

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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.

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Athleticism Requires More Than Just Strength & Speed

There's no single blueprint coaches follow when building an athlete. There are no shortcuts. Those cool looking, cookie-cutter programs found online, they often result in failure. In the training world, athletes aren’t built by copying the same program and applying it across the board. At GP, we are in the business of individualized architecture – intelligently designing personalized programs for each athlete. Whether in the weight room or on the field, it should be individual-specific.

We dial in to specificity instead of just saying let’s just go train hard and get bigger, stronger, or faster in the generic sense. Coaches and athletes can be obsessed with bigger, stronger, faster. Yes these are important elements of training but not at the expense of movement skill.

Sometimes athletes need more specific work when it comes to the quality of their movement in regards to stabilization, sequencing, rhythm, relaxation, timing, etc. Developing movement skill is often ignored or disregarded. The problem is there can be a huge disconnect between what an athlete thinks they are doing during a specific movement and what they are actually doing. We must improve their perception and awareness of movement. When combined with proper strength and conditioning, Improving an athlete's body awareness and movement skill will yield far greater results than just focusing solely on strength and speed numbers.

Movement skill acquisition should increase with as strength and speed development increases. This will only enable the athlete to move more efficiently and with less risk of injury.

There are different methodologies, philosophies, systems and styles used in the strength and conditioning industry. Reality is there is no gold standard by which everyone should follow. It’s about finding the right fit for both athlete and coach. Every athlete is slightly different and there won’t be one method that will work for every athlete. That's exactly why individualized decisions should be made for the athlete.

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Exercise Hacks Ep. 13 - Horizontal Pressing Alternatives for Painful Shoulders


Outside of low back pain, shoulder pain is one of the most prevalent musculoskeletal complaints. For avid exercisers and athletes, shoulder pain is something most are familiar with, especially when it comes to horizontal pressing movements.

The most popular of the horizontal pressing movements being the barbell bench press. Bench press often enough, long enough, and heavy enough, you will likely experience some degree of limitation due to shoulder pain or injury.

This can be for a number of reasons that all should be considered. But there is one reason why the barbell bench press becomes unfriendly to the shoulders - the fixed position the scapula (shoulder blades) are placed into.

Creating a tight upper back and stapling the scapula to the bench is critical for a big press as this forms the foundation for pressing.

But let's consider healthy shoulder motion is dependent upon a freely moving scapula. Otherwise too much stress is placed at the glenohumeral joint (shoulder joint). Yes, accessory exercises should be programmed to maintain healthy shoulders but there is only so much that can be done to offset thousands of pounds of bench pressing volume. We absolutely should be proactive in our approach to avoiding shoulder pain and/or injury.

That's why it is important to incorporate horizontal pressing movements that allow the scapula to move more freely. Whether they are used as a primary movement, accessory movement or alternative while the shoulder is on the mend, the exercises seem in this video can offer increased shoulder stability and motor control while giving your joints and connective tissue a break from intense training. See in this video are:

1) Standing Horizontal Cable Press

2) Stability Ball Dumbbell Press

3) Stability Ball Alternating DB Press

4) Stability Ball Single-Arm DB Press

A great benefit to these exercises is the amount of core and hip engagement required which is awesome for teaching force transfer through the body and how to steer strength.

Note: if performing heavy presses on a stability ball be sure to use a properly rated ball.

For more related reading:

The Site of Pain Is Rarely The Source of Pain

A testimonial worth sharing:

When I first visited Gallagher Performance 6 months ago, I went for a nagging discomfort around my shoulder on the right side of my back that had stuck with me for the past 7 years. Not only was this uncomfortable, but it was also a major limiting factor in my physical performance. For years on my own, I tried various types of stretches, mobility exercises, and strengthening exercises, all to no avail. Due to its chronic nature, I continued to research the potential issue, and was convinced it was fascial adhesions in that area causing the discomfort and limited mobility. From there, I went to a number of deep tissue massages from various professionals, but those only resulted in short-term relief, not the long-term fix I was looking for. I continued my journey by going to various physical therapists in the area. I would tell them I thought facial adhesions were causing this issue. They would listen, target that area with facial release methods, give me various stretches and mobility exercises, but still no results.

Finally, I found Gallagher Performance one day as I searched for a fix for my shoulder and decided to give them a shot. Since I was still convinced that fascial adhesions were my issue, I went for a deep tissue massage for my first session with Ryan. Ryan listened attentively as I told him about my symptoms and the fascial adhesions that I believed were causing my discomfort and limited mobility in that area. Once the session started, he went to work on those fascial adhesions that I so strongly believed were the culprit. But this is where Gallagher Performance separated themselves from all of the other practitioners that I visited. Even though Ryan started on the facial adhesions, through his extensive knowledge and expertise, he quickly identified that fascial adhesions were not the issue. In fact, I unknowingly had issues in other areas in my body that were the root causes of my discomfort in that area. From there, through Ryan’s genuine desire to help his clients, he introduced me to Sean in order to work through the multitude of issues that caused this chronic discomfort and limited mobility for the past 7 years. Since that first visit, I’ve continuously worked with Sean and have practically eliminated the issue that had limited me for so many years.

Ryan and Sean were the first professionals to take an honest and objective approach to my issue. Instead of allowing my unprofessional diagnosis of my issue dictate their actions and approach, they independently applied their experience and knowledge to diagnose my issue and set me on the correct path for a long-term fix. Sean’s expertise in his field, specifically his knowledge of DNS (Dynamic Neuromuscular Stabilization), gave me the tools I needed to fix the root causes of my issue. His unique knowledge of DNS was imperative to my early success, but as we continued to work together on my path to maximizing functionality and physical performance, his experience and expertise in every area physical therapy allowed him to effectively diagnosis and treat any issue that would arise. Even though my discomfort has subsided greatly, I continue to work with Sean on correcting other problem areas that are limiting the full functionality of my body that I require to perform at a high level as an ice hockey goaltender. Only when I began my work with Sean was I not only able correct a lingering issue, but was also able to (and continue to) maximize my physical performance and functionality in ways I’ve never experienced before.

In addition to my periodic visits with Sean, I have been working with Ryan on the nutrition and training side for three months now, and as with my work with Sean, experiencing results that I have never experienced in those areas. For years, I have tried various exercise and nutrition programs, but the results that I experienced (if any) were short-term. I was never able to stick to a nutrition plan for very long or have a training program that was designed specifically to my needs. Ryan met those needs by developing a nutrition and training program built on a very simple yet powerful concept – sustainability. No longer was I burning out of my nutrition program because it was to strict and unsustainable, nor was I giving up on my training program because I wasn’t seeing any progress. Through the scope of sustainability, Ryan develops programs that not only brings incredible results, but also have the ability to be adhered to for the long-term. In addition, since Ryan and Sean work closely together, Ryan is able to take the feedback from my work with Sean and adjust my nutrition and training plans accordingly. I never had success in the past using various cookie-cutter nutrition and training programs. But once I started working with Ryan, I began to see great results on a consistent basic through the plans that he developed specifically for me.

My experience with Ryan and Sean has been, and continues to be, exceptional. Not only is their knowledge and expertise high-level, but they are truly tremendous people. They genuinely want their clients to succeed and will do whatever it takes to make that happen. The level of support and professional expertise that I have received from both Sean and Ryan is unparalleled, and I can’t thank them enough for success they helped bring into my life.

I would not hesitate to recommend anyone to see Sean and Ryan. Whether you are an athlete or non-athlete, young or old, I have no doubt in my mind that Ryan and Sean will be able to provide the level of support you are looking for. Gallagher Performance is much more than just a chiropractor, a personal trainer, or a massage therapist – they offer a multitude of services that restore health, functionality, and maximize physical performance. If you are looking for a high level of expertise and support in any of these areas, I urge you to give Gallagher Performance a try. They are hand-down some of the best in the business.

-Zaid Alzaid

For more related reading:

The Essentials of Hamstring Rehab


This video highlights the hamstring rehab with Carter Henderson. Carter was a standout linebacker at Duquesne University, leading the team in tackles the last two seasons. Now he is in preparation for an NFL Pro Day.

Carter came to GP for rehab of a hamstring pull 12 days out from his Pro Day. His initial 5 days focused on manual therapy, eleetromuscular stimulation (EMS), with a primary emphasis on exercise progressions based on his tolerances and weaknesses. Focus was placed on exercise specificity to the stresses the hamstrings encounter during sprinting. We aimed to match joint angles, mechanics, and dynamics as they relate to his sprint form and lateral movement.

Days 6-8 on his rehab focused on tempo runs and flying 40s, keeping intensity below 75% effort. Gradually worked into higher intensities with specificity to pro day drills. Focus still on manual therapy, joint mobilizations and manipulation when indicated.

Effective treatment for a hamstring strain, and for any injury, must address not only the site of pain but ALL possible predisposing factors. There are essentially three ‘reasons’ as to why hamstring injuries occur. Sprinting is not the problem. Focusing on each predisposing factor through progressive treatment and training will best prepare the athlete for return to sport activities.

The act of ‘pulling’ a hamstring usually occurs at high speed running during the terminal swing phase of the gait cycle. As the hip is decelerating the forceful momentum as the leg swings forward, the hamstrings are loaded and lengthening as you are finishing the swing phase before foot strike. There are predisposing factors that ultimately cause the hamstring to be compromised such as:
  1. Poor neuromuscular control of the lumbopelvic region,
  2. Asymmetries in muscle length and/or hip range of motion, and
  3. Sacroiliac joint dysfunction
All of these factors need to be and should be considered when devising a treatment and rehab protocol to ultimately reduce the risk of re-injury and improve rehabilitation outcomes.

The utilization of manipulation, massage, soft tissue techniques, and nutritional considerations to support tissue healing become the foundation of early care and recovery from hamstring injury. Everything used to facilitate healing is based on examination and identification of the presence of any predisposing factor(s).

The transition from rehabilitation to return to sport then becomes dependent upon a process that addresses proper tissue healing and exercise progressions to improve structural balance, lumbopelvic control, strength, and coordination of movement required by sport specific demands in output and movement patterns.

This essentially sums up the process behind Carter's rehabilitation program.

Carter has turned around nicely and tons of credit to him. He wasn't able to walk without pain when we first started his rehab and was able to run a 4.75 sec 40 yard sprint on his pro day at Duquesne University. He did everything right in his rehab. Carter is extremely coachable and great to work with and we wish him all the best.

For more related reading:

A Movement Screen Will Never Show Movement Habits

Movement screens or testing can offer valuable insight into why you have pain or limited function.

However what tends to be more valuable is when someone help you understand your movement habits.

By observing how someone moves and the postures they assume during daily activities - walking, bending, twisting, reaching, pushing, or pulling - we can tell you more about the chronic stresses that may be the major contributors to your current problem.

Without understanding your movement habits, we are missing a big part of the healing process or why you experience plateaus in your training/exercise program.

Once you understand movement habits the focus becomes finding what provokes your pain and discovering your weaknesses. By identifying pain triggers, we can build a plan that enables you to control your pain and improve function while your body heals.

Systems and screens for movement are a useful tool, but they tend to be general in nature. They aren't highly specific to the individual all the time. They might work, but often times you must dig deeper and be more accurate in observation, evaluation, treatment, and self-management to help someone achieve their goals.

For more related reading:
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  • 4484 William Penn Highway

  • Murrysville, PA 15668

Hours of Operation

    Monday-Thursday: 9am-1pm, 3pm-6pm
    Friday: 9am-1pm, 3pm-5pm
    Saturday: by appointment only
    Hours are by appointment only