5 ways to break your training plateau and add weight to your lifts

We’ve all been there. You have been on the same training cycle for the second time and you’re  getting close to the end of your scheduled six weeks. Despite that, you still haven’t seen your lifts go up more than a hair. It’s frustrating, and it’s a grind. There’s gotta be a way to get a little more progress, right?

 

Right. 

 

I’m going to give some specific examples throughout the article to keep it easy, but the concepts apply to nearly every lift. Here are 5 of my favorite ways to break you out of your training plateau and get you some gains. 


ECCENTRIC LOADING

What is it : Eccentric loading, sometimes known as negatives, is the load that occurs on a muscle as it is stretched. Most muscular contractions that we think of are the ones that take place concentrically, where the muscle is shortened. The easiest way to explain it is to use a bicep curl as an example. When the weight is sitting at the shoulder and the elbow is bent, the bicep has very little load on it. As the weight comes down and the elbow straightens out, the bicep is loaded and stretched out at the same time. This is eccentric loading of the bicep. Then as the weight is pulled back up to the shoulder and the elbow is bent again, the bicep is loaded and shortening. This is concentric contraction.

Why do it : The heart of every training program is progressive overload — take your body just a little further than before, let it respond, repeat. Eccentric training of a muscle increases the amount of tension that you can place on a musculotendinous complex. This increases stress, especially on tendons which causes a physiological response from the body. The connective tissues and tendons of the body are sometimes a limiting factor in how much load your muscles can take. Over the course of a careful training program, you can strengthen the tendons and connective tissue around your muscles.

How to apply it : You have two options here, Overload and Tempo change. 

Overload — this method is HIGHLY recommended with a training partner / spotter. Load up with 10-20% more than what you can comfortably lift. It should be a weight that is just beyond what you can move on your own. Have your partner help you lift off from the starting position and then use a slow tempo and control the weight to the end of the movement. Once you reach the end of the movement, have your partner help you back to the top of the lift and repeat. When doing overloads, I recommend keeping the rep range below 8 in order to avoid possible injury. 

Tempo / Pause - This method is much easier than the overloads to do on your own, but still requires safety guards in order to make it work. Keeping your weight about 10% lighter than what you can normally lift for a full set, lower the weight very slowly, (for example a 6 second descent) and then return it back to starting position at normal speed. I recommend a set up that you can drop easily so you can bail out when you inevitably reach failure. I would also recommend a similar rep range as the overload method, 8 or less. 

 

ALTERNATIVE EXERCISE METHOD

What is it: Here we are working the same muscle group but changing the method you use to apply a load. For example; if you have been doing a straight bar bench press, try doing a dumbbell bench press for one or two cycles instead. Taking it a step further, you can switch up the load by changing grips, tempo, single sided or symmetrical, etc. The goal to keep in mind with this one is to keep your alternatives close to your original movement. You shouldn’t start adding in lightweight shoulder moves if you are working to increase a heavy chest press. 

Why do it : Humans are innately lazy beings when it comes to spending energy. Physiologically, we do everything in our power to become more efficient with time and experience. As you get more experienced at a particular lift, there comes a point when you actually use less muscle fiber to get the same work done. This sounds great, and from a standpoint of being able to functionally use the muscle you build, it is great. It is not great however, if you are trying to build muscle. You want to find a way to load the muscle fibers so the body is not able to maximize the efficiency. Additionally, by altering the loading method on a muscle, you are able to potentially work different muscle fibers or more muscle fibers than you were previously. We always want to hit as many muscle fibers as possible to get the tiny breakdowns that lead to healing and growth.

How to apply it : Pay attention to the movement pattern for any given exercise and break it down to its most basic form. The bench press, for example is a forward chest press. Now think about a different way to load the muscle group the same way that ISN’T your normal exercise. Swapping out the straight bar bench for dumbbell alternating single hand presses; using a fat grip on the dumbbell; altering the tempo of your chest press to be a 5 count up and down; superset the dumbbell chest press with explosive pushups… The possibilities for movement are nearly endless. Keep the weight relatively heavy and the repetition range close to what you are already working on.

 

VOLUME FLUCTUATION

What is it : Volume is usually thrown around somewhat casually to mean how many sets or how many reps per set you are working on. Truthfully though, volume includes your weight as well as the sets and reps. We usually calculate volume as a whole number, so sets x reps x weight = volume. For a person doing a squat workout of 5 sets of 5 with 225 lbs, the calculation looks like this: 5 (sets) x 5 (reps) x 225 lbs (weight) = 5,625 lbs (volume). In order to use this to increase your ability to lift more weight, you either add more sets or more reps without changing the weight. This will inevitably increase the overall volume of your training cycle. More volume lifted = more stress on the muscle = more strength gained when the muscle recovers. 

Why do it : Change the volume when you want to increase the strength of a particular lift without adding different exercises or alternatives. It creates a bit of a shock to your system and the new stimulus can be enough to kick start you over the plateau you are stuck on. Additionally, increasing the volume of a training program will inevitably increase the amount of strain placed on the connective tissue around the muscles and joints. This can be extremely helpful when you allow sufficient recovery time, as stronger connective tissue allows you to push your muscles harder. 

How to apply it : Take a look at your current training cycle and use the calculation to figure out the total volume per workout or per week for a particular exercise ( reps x sets x weight). Once you have that number, a good starting point is to increase it by 10%. It’s up to you how to get that 10% increase in volume per week, whether you change sets or reps. Rinse and repeat throughout a 4-6 week cycle and watch your gain train come in to the station.

 

RESTRICTED RANGE OF MOTION TRAINING

What is it : Restricted ROM training uses a shortened range of motion, usually the strongest portion of the range, where you can increase the load. Restricting the range of motion refers to not allowing the weight to go beyond mid-range, keeping the load in the most advantageous position. For example, it means not coming more than halfway down to your chest on the bench press before pushing it back to lock-out. 

Why do it : Every movement has end ranges (read : most extended and most contracted position) and a mid-range. Most movements have limitations to strength at the end ranges where the muscles are at a disadvantage. This is either from the muscle being completely stretched out or completely contracted already. When you stay in the mid-range and keep your load heavy, you have the opportunity to further stress your muscle fibers because you can finish the sets and reps that you might otherwise fail if going through full range of motion. 

How to apply it : First, to be clear, this is only used to get over a plateau. Half reps don’t count in competition, so training half reps for any other purpose doesn’t make any sense. 
When you set up for your lift, set up guards or blocks that are higher than what you would normally use. You should only be able to come down just barely halfway through your rep before the weight is resting on the guards. Perform your sets and reps (volume!) like normal, going through the shortened range of motion. Try not to let the weight rest on the guards too long so you don’t end up stuck. 
Side note: This works well with the major lifts, but is a lot harder to do with accessory lifts. Sorry guys, this one isn’t going to be real helpful for building massive bicep curls.

 

REST

This last point seems like it may be self explanatory, but it is often overlooked. If you aren’t seeing progress from your program, it may be your body’s way of trying to tell you to take a break. This is especially true if you have already tried some of these tweaks before with no results. Training is meant to increase your body’s ability to respond to stress. When you layer on the stress but don’t give your body a chance to improve it’s recovery capacity by resting sufficiently, then you can’t perform at your best. 

Two methods I recommend are: increasing your rest volume during the workout, and increasing your rest volume between workouts.
Increasing the rest volume in the workout is simple : start a timer for how long you rest between sets or exercises. Increase the time between sets until you reach a rest period that is long enough to give you a small second wind between sets. This becomes more prevalent when working on your higher percentage sets, like your heavy doubles and triples. I wouldn’t recommend letting the rest period go beyond about 5-7 minutes, you don’t want to start cooling down from the workout. 
Increasing the rest between workouts is just that — if you normally take a day in between working the same body part (even with a heavy/light contrast cycle), then take an extra day or two before hitting it again. This might mean that your workout schedule no longer cleanly fits into the week with back squats happening every Friday. If you can get the gains you are looking for though, who cares? Just keep track of your training order and keep an eye on your rest periods.



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

Plyometrics : Part 1 : What are Plyos and how do they work

Plyometrics. 

 

This term and type of exercise has been extremely trendy, and is constantly something you see on social media outlets and at gyms across the nation. But what is this whole craze actually about, and why should you be considering plyometrics for your training cycles?

First things first - Plyometrics is most often the term used for jump training, though in truth it is a bit more complicated than that. Plyometrics (or plyos) utilize a large amount of power (strength and speed together) in a short amount of time, and often can be used to utilize maximal amounts of power relatively safely. 

 

How does it work?

Through the manipulation of elastic energy and the stretching properties of muscle and tendons. Using the classic example of a person jumping, when the person lands from their first jump they naturally bend their knees slightly to cushion the landing. This motion of bending the knees also serves to load the muscles that are supporting the body and absorbing that shock, putting a stretch on the tendons of the muscle. Physiologically, every muscle has a reflex contraction cycle which works like this : a tendon gets stretched somehow —> the muscle tendon’s nerves send a message to the spinal cord —> a message comes from the spinal cord to the muscle and causes a strong, sudden contraction. This is how reflex hammers work at the doctor’s office, by the way — the sharp tap on the tendon is enough to stretch it and cause the reflex to take place. 

 

Why does this matter in our discussion of jump training?

Because true plyometrics involve exploiting that reflex contraction cycle. 

When the person lands and stretches the tendons of their muscles, there is an extremely short window of opportunity in which they can contract those muscles again with extra strength above and beyond their normal controllable strength. This is the spirit of plyometrics, being able to overload the muscles in order to cause gains in power by utilizing a physiological reaction.

 

So are jump training and plyometrics the same thing?

Not all plyometrics is jump training, as you can truthfully perform plyometric exercise for nearly any muscle group if you can figure out how to load and unload it suddenly and safely. Also, not all jump training is plyometrics. Jumps are a great example of this, as you don’t have to stretch the muscle to jump from a straight leg or sitting position. Countermovement jumps are absolutely plyometric though, due to the stretch that occurs as you sit down into your hips to achieve a higher jump.

Some jump training programs focus on the explosive power and form associated with a jump regardless of the pre-stretching that goes along with plyometric training. An example of this would be doing jumps from a kneeling or sitting position. 

 

Why do plyos?

Plyometrics are a great way to create progress in your training, especially if you are a power athlete or are working on your overall athleticism. Plyometrics help improve your agility and ability to move quickly, change direction, stop quickly, and generate large bursts of power. Sound familiar? There are very few reasons not to do plyometrics, however if you are going to do them, you should make sure you are ready to do them safely and effectively. 





Stay tuned for the next installment on plyometrics and power generation methods, where we cover how to program and use plyometrics in your training right now.



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

Holiday Diet Survival Guide: 10 ways to not crash between Thanksgiving and New Years

It’s the holidays, and that usually means that your dietary goals get sidelined in favor of Aunt Judi’s chocolate pie (trust me though, it’s really good pie). However, this year can be a little different. Coming into the holidays with a game plan can make a world of difference on your waistline, and keep you on track for your goals. Below I break down some strategies you can use to help fully enjoy the holidays, without being that one family member who avoids the pie at all costs. 


1 Let the holiday be one day long 

A lot of people run into trouble with this one. A holiday by itself is not enough to wreck your goals - but when you let Thanksgiving turn into the whole month of November, it adds up. Compound that with the whole month of December for Christmas, and you have some serious work ahead of you to get out of the hole you dug. 

The Strategy : Celebrate and have fun — but don’t eat a full meal of turkey, stuffing, sweet potato casserole, and three types of pie every day for a week. Keep the special meal limited to just that — one special meal. 

 

2 Pre-Game

When you are really hungry going into a meal, people tend to eat faster and more recklessly than they normally would. Instead of going in feeling like you are starving and ready to eat the whole turkey, do some pre-gaming ahead of time so you can come into the holiday with your normal control intact. 

The Strategy : Before heading out, eat a snack that includes fiber and preferably some greens or fruit. This might mean a small salad, an apple with a little bit of peanut butter, or some fresh raw vegetables. Even if all you can do is an apple while you wait as the family finishes cooking the big meal, it will help. 

 

3 Prioritize your plate loading order

If you prioritize how you load your plate, you can still get a serving of all the tasty goodies, without overdoing it.

The Strategy : Start with your meat first, then vegetables or greens, saving the carbohydrates and fats for last. By the time you get to the mashed potatoes, you will have to keep your serving size reasonable to fit it next to your green beans and turkey. 

 

4 Drink water with each serving

Drinking water throughout the day with each plate or serving will help keep you feeling full, not to mention hydrated. Staying hydrated not only helps curb the hunger signals your brain is receiving, but also helps your body digest your food more efficiently. 

The Strategy : Drink a glass of water as you eat your plate. If you want something else to drink, take a few minutes between plates to drink your specialty beverage and let your body catch up to what you just ate.

 

5 Add in some activity

Many holiday parties, especially with family, turn into a big meal and a nap. Sitting around after eating until its time for second dinner is a sure way to end up in trouble. 

The Strategy : Be the fun person who brings out the stuff to do. A jumbo game of Jenga, passing the football around, or taking a walk to look at the decorations in the neighborhood are all examples of good ways to get moving after that meal, and still enjoy the company your friends and family. 

 

6 Keep a log of your food - Even over the holidays

Keeping track of your food intake is one of the simplest ways to stay on top of what you are taking in. Now there are a smorgasbord of apps that are available to help you do it quickly and easily, and most of the best ones have a free version. The top three that I have used in the past are My Fitness Pal, Lifesum, and Eatly.

The Strategy : Keep logging every day, and be honest - even on the days when you know that you are going to go way over your calorie goals. If you are starting to derail, you will be able to see it quickly with the summaries given by these apps. 

 

 7 Keep working out over the holidays

The holidays (really the whole stretch from November to January) are a tough time to try and stick to a workout schedule for most people. Family is in town, end of year parties, friends, events - it all adds up in a very short amount of time. But if you can manage to keep your body moving and your metabolism burning, it will help you feel better every day and keep you from getting totally sidelined by the end of December. 

The Strategy : Even if you can only find 10 minutes a day to get sweaty, do it. Take a short run, or a quick bike ride. If you feel really brave, try the Burpee Challenge. Start a 6 minute timer and see how many burpees you can do in intervals of 40 seconds on, 20 seconds off. Then try to beat your score the next time.

 

8 Don’t hover by the food

Especially at a holiday party with a large, buffet style spread (work party, anyone?) it can be far too easy to hang out by the food tables and slowly graze. Between the mindless, social nature of the eating and the constant sight, smell, and allure of the food right next to you, it’s not long before you have eaten more than you intended to.

The Strategy : Work the room. Visualize ahead of time what you intend to eat (and how you intend to feel when you leave), then make your plate and walk away from the food tables. Make your way around the entire room and try to focus more on the socialization and the people than on the snacks and goodies.


Some people are better planners, and have a little more discipline when it comes to their diet. For those people, the last recommendations will be easier. For everyone else, these can still be helpful, but if you aren’t already the type who can handle meal prepping or planning out your meals, you may struggle with these tips. 

 

9 Cycle your carbohydrates

Cycling down your carbohydrates for the week leading up to the holiday is a good way to prepare your body for the crazy cheat meal you and your uncle are planning. This has to be done carefully and intentionally, because starting too soon will slow your metabolism down too much by the time you get to the big meal. Starting too late will leave you throwing back large amounts of carbohydrates before your body has depleted it’s glycogen stores in the muscles.

The Strategy : Start cycling your carbs down 6-7 days before the big meal. I would recommend 0.5 grams of carbohydrates per pound of body weight for approximately 3 days, and then 0.25 grams of carbohydrates per pound of body weight for the next 3-4 days. For a 200 lb male, this would mean 100 grams of carbohydrates for the first three days, then 50 grams for the next 3-4. Be sure to drink plenty of water while doing this to help keep yourself hydrated.

 

10 Intermittent Fast

Let’s say you find out one or two days ahead of time that there is a party or cheat meal coming that you didn’t have time to prepare for. Intermittent fasting is one way that you can help mitigate the calorie load for the day and keep your body on track. Starting the day before or even the day of, you can control how many calories you end up taking in before it’s enough to throw you off. I don’t recommend this method for everyone. Only those who know they have the discipline to handle this type of fasting for a day or two should give this a shot. 

The Strategy : On the day of or the day before, only ingest water, black coffee, and non-caloric drinks such as unsweetened tea. Some caffeine is your friend here, and will help stave off hunger cravings throughout the day and keep you sated until meal time. I would recommend at least a 12 hour fast on these days. Once it is time to break the fast and begin feeding, start with something like a leafy green salad and then wait 15-30 minutes before continuing with the rest of the food. 

 

I hope these tips help you get through the holiday season while still sticking to your goals. Nobody wants to have to start over on their health and fitness when January rolls around. By choosing a few strategies and using them, your new year’s resolution can be about adding on to you goals, not getting back to them. 


Happy Holidays!



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

Carpal Tunnel : Conservative Care Research

Let’s talk Carpal Tunnel

Carpal Tunnel is a disease that impairs the function of the nerves of the hand through compression in the wrist. Specifically, a location called the carpal tunnel, where a lot of stuff happens to travel through. This condition affects between 5 and 10% of the population, particularly more in those who work with their hands and do a lot of small repetitive motions (think : keyboard typing all day).

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Conservative care is similar in outcome effectiveness to surgery.

One of the accepted standards for treating this in the past has been a surgical procedure called a Carpal Tunnel Release. Classically, this is done by cutting some of the ligamentous tissue that creates the roof of the tunnel, thereby creating more space for the nerves and blood vessels underneath. However, surgery for this is not the only option. The newest research shows that when it comes to treatment, conservative (non-surgical) care is similar in outcome effectiveness (including pain relief, function, sensation, and strength) to surgery at 3 and 12 month follow up.

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So what is conservative care for carpal tunnel? It includes carefully introducing movement, mobilization of the joints of the wrist and hand , nerve flossing for the wrist and arm, and kinesiology taping of the wrist and hand to help with pain and pressure reduction. All of these treatments have been shown in the current research to improve the condition, and others previously have shown effectiveness with strengthening and stretching exercises for the forearm and wrist (though those studies are not referenced in this article).

 

Overall, this research suggests that as part of a comprehensive care plan and conservative approach for Carpal Tunnel, movement (and rehab), nerve flossing, and taping (like Rocktape) may be able to get you the same results and relief as surgery.


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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 


Original Article and research compiled by Dr. Tim Bertelsman with ChiroUp here.

Sources:
Qiyun S. Et al. Comparison of the short-term and Long-term effects of surgery and non surgical intervention in treating carpal tunnel syndrome: a systematic review and meta analysis. Hand. 2018 Jul.
Bueno-Garcia, Elena et al. Dimensional changes of the carpal tunnel and median nerve during manual mobilization of the carpal bones - anatomical study. Clinical biomechanics, volume 59, 56-61.
Wolny T et al. Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial. Clin Rehabil. 2018 Oct.
Akturk S et al. Comparison of splinting and Kinesio taping in the treatment of carpal tunnel syndrome: a prospective randomized study. Clin Rheumatol. 2018 Jun 15

Low back pain with lifting - 4 ways to stay in the gym

Lower back pain can really slow you down and take you away from your gains and your goals. Here are 4 strategies that can help you keep exercising with lower back pain, especially when used in combination with each other.

Get your head right.

1. Get your head right - First and foremost, I want to stress that the human body is not fragile. We are capable of enormous feats, and the capacity for those feats is inherent in every single person. Accordingly, here are some facts to help ease your mind when you think “I’m going to blow my back out if I work out” :

  1. There are 17 muscles in the lower back and associated core at that level. Mind you, that’s 17 named muscle GROUPS, not just individual muscles. In addition to that, there are a lot of muscles and major ligaments that contribute to strength and stability for the lower back that are not directly involved, such as the gluteals and the hip flexors.

  2. Even when you DO hurt your lower back, a LOT of lower back pain is known as “self resolving” - I.E. it will heal all on it’s own if you just let it do it’s thing. The statistics are wildly variable in the literature, but it paints a picture that there may be recurring instances of pain or discomfort that aren’t serious. 

  3. Your fear of getting hurt by doing things may actually be hurting you. It’s called the Fear-Avoidance model, and one aspect of it means that when you are afraid of causing pain, you may in fact avoid things that would actually be beneficial and help get you out of pain.

  4. Movement and motion (as long as they are not painful) can actually help override pain sensations. One major theory in the world of pain science is the Gate Control theory, which (in short) states that non-painful input from the body can override and deactivate painful input.

All of these points together should stay in the front of your mind, so you know that you can still get in the gym and get it done without fear and anxiety. 

Change your load.

2. Change your loading style - Maybe if your lower back is feeling a little “tweaky”, it’s time to consider altering your lift choices until either things get stronger, you recover more, etc. That means that instead of conventional straight bar deadlift, you consider doing Sumo pulls, or Hex bar deadlift instead. Below is a list of some of my favorite modifications and variations for lower back pain with exercise.

For pain when you Deadlift: Try Banded Romanian Deadlifts, Hip Thrusts, Hex Bar Deadlifts, Sumo Deadlifts, or Kettlebell Deadlifts instead.
For pain when you Back Squat: Try Front Squat, Belt Squat / Pit Shark Squat, Goblet Squat, Split Stance Squat (Stationary lunges), or Leg Press instead.
For pain with Kettlebell Swings: Try Rows, Battle Ropes, Banded Romanian Deadlifts, Single Leg Hip Extensions or Kickbacks instead.
For pain with Crunches/Ab Exercises: Try Front Planks (ONLY IF DONE PROPERLY), Side plank, Glute bridges, Anti-Rotation exercises, Renegade Rows, Ab Wheel Rollouts, Strap Support Plank and March, or Dead Bugs (weighted or banded as able).

Look outside the gym.

3. Examine your “out of gym experience” - Most training in the gym is done to improve your ability to do things - lift heavier stuff, run further, move faster, etc. A good training program should also include recovering well in order to be better prepared to handle the stress you intend to put on your body again. 
Take a look at :
- Sleep schedule. Are you resting enough? Here’s a good question for you to ask yourself in order to find that answer : Are you always tired? Fatigue can be a lack of rest and sleep in your schedule, not getting enough calories in the day to actually fuel the work that you are doing, or you may be sick and need to let your body recover. The bottom line is this : If you are tired, then you aren’t going to perform (and recover) as well as you would like to. 
- Your diet. A really, really hard and honest look for some of us. Are you eating foods that are intended to fuel your body and help you feel better, or just things that taste good or are convenient? What are your goals, and how much are you willing to balance psychological food desires with physical caloric needs?
- Stress levels. If you have a great gym program but are so stressed at work or home that your body is running your cortisol levels through the roof on overtime, you won’t be recovering and healing well. Sometimes the best thing you can do to help with recovering is to take a mental rest and find some peace. Mental health is still a part of your overall health and definitely ties in to your physical health. 
- Daily habits. If you work out 7 times a week for 2 hours a day, thats still only 12% of your time throughout the week spent being active and working on your body. What else are you doing with the other 88% of your waking time? Are those activities the ones that are contributing to your back pain? What can you do to address that problem?

Get objective.

4. Find an objective viewpoint - No matter who you are, nobody is great at seeing themselves without some bias. You may not be able to see what you are doing wrong, whether that’s your training program, your form on an exercise, your diet, or anything else. Sometimes the best thing you can do is get an outside observer to help you be responsible. That may mean a coach or a trainer who can be present with you when you workout. It could be a workout buddy who also needs to check in on you and make sure you are doing your meal prep at home and not ordering pizza every night. It could be a healthcare professional who can take a look at the whole situation and help you break down what’s going on. Whatever the case, finding an objective viewpoint can be incredibly useful for figuring out how to solve your lower back pain and keep you on track to your goals.

 


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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

American Chiropractic Association's Input on America's Opioid Epidemic

An excerpt from the ACA’s article on Chiropractic and the Opioid Epidemic

“Conservative Care First: A Common Sense Approach


The American Chiropractic Association (ACA) encourages patients and health care providers to first exhaust conservative forms of pain management, when appropriate, before moving on to riskier, potentially addictive treatments such as opioids. To this end, ACA delegates met in Washington, D.C., in 2016 and adopted a policy statement proposing a solution to the dual public health concerns of inadequate pain management and opioid abuse.”

Click Here to read the full article on the ACA’s website.

The Definition of Insanity and your "Old Injury"

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"The Definition of insanity is doing the same thing over and over again while expecting different results" 

Except - That's not the definition of insanity.

I'm sure you've heard that as many times as I have (which is a lot), but it's not true. That is actually a paraphrasing of the definition of perseveration. That being said, this saying and it's sibling "If you always do what you've always done, you will always get what you've always gotten" have a lot of truth to them in some instances. They are particularly true in practice when working with clients who come in and have an "old injury" that never really heals, or that hasn't seemed to change regardless of previous treatment. 

Is it possible that there is something sinister going on inside your body? Maybe - but it's a lot more likely that you never actually addressed the problem that was causing your injury in the first place. 

Habits, Repetitions, and Rabbit Holes

A lot of the problems I see in practice have to do with either A) someone's daily habits that they haven't (or can't) modify, B) someone's repetitions of an exercise plan, or C) an improper (or incomplete) previous diagnosis. All of these have a common thread - they aren't addressing the root of your pain or problem. You may have a short term fix, a "band-aid" that helps for a little while (orthotics for plantar fasciitis, for example) but eventually you end up with "another round of that same old injury". Let's dig a little deeper. 

A) Someone's daily habits. There are a lot of issues that can arise inadvertently from what people do every day without realizing that it may be causing them problems. One example I have seen recently was a female who had knee pain that had been present for months, had gotten an MRI and had no answers to the cause of her pain. One of the culprits we discovered was her footwear choice at work - wearing heels for extended periods of time after switching to a new job caused her to lose a lot of ankle mobility without her realizing it. No more ankle mobility meant awkward stress on the knee (along with some weakness in the hips and poor movement patterns to begin with). Here's the point - this was an easy fix to change her footwear choices and immediately get feedback from her body that this nagging knee pain was due to something that was happening every day without her realizing it. 

B) Someone's repetitions of an exercise plan. I'll put it simply and bluntly. Just because someone programmed a workout, does not make it a good workout or good programming. Compounding that, if an individual isn't currently physically capable of the demands of a movement or workout, it is only detrimental for them to continue to attempt that exercise without modifying it. Repetitive stresses on muscles and joints should be moderated and controlled intelligently. When this aspect of the programming of your workouts is out of whack, whether due to the exercise choices/volume of repetitions/lack of rest cycles, it increases your chances of having problems. This is especially true if you already have a history of issues with a body part or exercise, then pile the reps on top of that. 

C) Improper (or incomplete) previous diagnosis. This is perhaps the least common of the three, but sometimes the most frustrating. Healthcare professionals are people just like their patients and clients - sometimes they miss something, or get stuck in a rut, etc. Unfortunately, that means that sometimes they don't see the whole picture of what is going on with a person. This can be even more frustrating when multiple providers have treated a person, but none of them have communicated about the case. I see clients who have "an old issue" that is actually still the same issue from 10 years ago that was never fully diagnosed and addressed - even after multiple treatments.

It's time the cycle of "old injuries" stopped. If your having pain that has been present for an extended period of time, or keeps coming back - don't give up. Seek out a healthcare professional who will help you get to the root of the problem instead of continuing to just bandage it up. 



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

The FMS - What and Why?

The FMS - What is it?

The Functional Movement Screen (FMS) was first created by Gray Cook and the team at Functional Movement Systems in the mid-90's. Now, it is used all over the world by healthcare and fitness professionals. 

Great, but what is it?

The Functional Movement Screen is a series of 7 basic movements (straight leg raise, rotary stability, overhead squat, in-line lunge, hurdle step, and push-up) that will test your overall ability to move. Each test is scored on a 0-3 scale, and every test is designed to utilize multiple body areas at once. Based on the results of the screening we can quickly assess what areas need work and attention.

The Functional Movement Screen and Sports Medicine

The FMS has a fantastic place in a sports medicine practice, because in all honesty, good athletes make for good cheaters. Most athletes are able to compensate for poor areas of movement or strength in their bodies and "find a work around" in order to accomplish the tasks we ask them to do. This means that at first glance, someone may look like they can move fairly well while performing their particular sport. However, when we isolate a body part during testing, the athlete's form falls apart and their weaknesses show up. This lets us find dysfunctional areas that may be causing them problems that they don't realize - like limited ankle movement causing them knee pain or hip pain during their heavy squat days for example. 

What I look for when doing the FMS with a client

The biggest thing I look for as a sports medicine practitioner is pain first. If someone is able to clear the screening without pain, the next biggest thing I look for is inability to complete the movements. After that, scoring the "top tier movers" means getting picky about form or small differences or dysfunctions that might be indicators of a future problem. By screening people in this order particularly, we can find out if their problem is one that necessitates medical intervention, or if the problem is one that necessitates changes to their training program or exercise form. 

Why do the FMS in a clinical setting?

Being able to assess a person's overall movement quality means that as a clinician, I may be able to better pinpoint where the source of their pain or problem is coming from. From an athletic performance standpoint, if there are movements that are difficult to perform then an athlete will avoid them. When we fix their movement mechanics, they can train more effectively for whatever their sport or activity may be. Having an FMS score as a baseline also can give us an opportunity to assess what is happening with an athlete when they are going through a heavy training cycle and feeling tight, or they are beginning to complain of pain that wasn't present before. When we re-assess, we may find that a portion of their test results have gotten worse and subsequently they are feeling the effects of it. 

 

Interested in finding out what your baseline is, or finding out if your pain may be linked to your quality of movement? Find a provider near you who can run you through an FMS test and talk over the results with you. 



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

Fix Your Shoulder Pain

So, your shoulder hurts. Welcome to the club!

Let's talk about something I've been seeing a lot of lately - shoulders. Starting with a VERY broad overview, shoulder pain falls into two categories : Traumatic (You know what you did and why it hurts) and Non-Traumatic (You really can't recall anything that should have made it hurt). For the purposes of our discussion today, we will be sticking to the Non-Traumatic category. I have to emphasize that if you know which movement made your shoulders hurt and there is even a chance that you may have caused damage, you should get a professional opinion before attempting to fix it yourself. That being said...

Non-Traumatic Shoulder Pain - "This sucks and I don't know why!"

Let's break this down a little further before we start getting into the "fix it" portion of this discussion : if you are the TL;DR type, keep scrolling till you hit the photos. Shoulder pain falls into two more broad categories after we rule out trauma and injuries like SLAP tears and rotator cuff tears. 

 

Category 1 : The "Tight as a drum/stiff as a board" shoulder
If your shoulder is so tight that you can barely even get your hands behind your upper or lower back, guess what: you're gonna have a bad time. A lack of basic shoulder mobility means that every time you load that upper limb with weight or try to do something athletically that you aren't limber enough to do, it's going to be akin to a minor strain of something in your shoulder. You may not even be able to find a comfortable position to sleep in because every position that you attempt puts excessive strain on the joint in some way. 

If this sounds like you, then you need to figure out how to loosen that thing up! Shoulder mobility drills, stretching, yoga, thoracic spine mobility, foam rolling, massage, ROMWOD, take your pick; All these things should help. Even better would be a combination of these and figuring out why your shoulder is tight in the first place.
Is it a repetitive motion you do that tightens your muscles up over time without balance? Looking at you, Mr. "Every day is chest day". Is it poor posture all day long that makes you feel stiff and sore, then you try to exercise anyway without addressing it?


Whatever it is that gets you to this point, try to break the cycle and add some mobility to your shoulders. Find a professional who can help you regain the mobility you don't have, or find tutorials you trust. No matter how you do it though, fixing your shoulders shouldn't make them hurt MORE - if that happens, seek out a professional.

 

Category 2 : The "Mel Gibson in Lethal Weapon / Floating in space" shoulder
If your shoulder has been previously damaged and torn, or is just naturally so loose that you can actually feel it moving in and out of place in it's socket - that's not good either. For these shoulders, REHAB and EXERCISE are important staples of daily life. You have to have STRONG, STABLE shoulders to be pain free. 

Let me put that another way : If your shoulders hurt because the joint is too loose, then your best friend is going to be stability exercise. 

This is not the time to try and "stretch it out" or "add some mobility" to your shoulders - the whole point here is that they are already too loose. If you have already made sure that there is not  extensive damage to the joint itself, then you've gotta get on the grind and add some muscle mass. 


A great place to start is rotator cuff exercises, usually internal and external rotation. Think Karate Kid "Wax On/Wax Off", circle in and circle out type motions. Depending on how poor your shoulder stability is, you may have to start at Square 1 with the exercises. With building basic stability though, following the KISS concept is usually best (Keep It Simple, Stupid).
Finding a trainer/physical therapist/clinician or at least catching some good educational instruction videos online is a place to start. Once you find someone you trust, Get After It! Same as with the tight shoulder though, if the pain is increasing instead of improving - get a professional to take a look. 

"Wait, didn't I read the term "extensive damage" a moment ago? Does he mean like... tears in the shoulder joint, or something?"

You sure did. There's a reason for that - Studies conducted on shoulder pain show that even with minor (i.e. not complete) tears of the rotator cuff and associated structures, REHAB and EXERCISE can have the same (or better!) outcomes than surgical repair when it comes to reducing pain and restoring functionality (study links at the end). So even if your shoulder does have a minor tear in it - try some exercises first. The worst that can happen is it doesn't work and you end up getting it fixed like you were planning on in the first place. Best case scenario is you avoid the cost and the hassle of going through shoulder repair surgery, which is usually on the "Do Not Recommend" section of most people's life reviews. 

 


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TL;DR
If you don't have a damaged shoulder joint, then you probably fall into one of these categories and you should do something about it. No matter what category you fall into, if what your doing still causes pain when you try to fix your shoulders, get some professional help. 


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TL:DR
If your shoulders hurt because they are too tight and your mobility is poor - fix it! Stretch, mobilize, loosen up.


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TL;DR
If your shoulders hurt because they are too loose, then stretching and mobility won't help. Strengthen and stabilize your shoulder.



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Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist. 

Studies :
Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-year clinical results.   
https://www.ncbi.nlm.nih.gov/pubmed/24395315



EXERCISE REHABILITATION IN THE NON-OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS: A REVIEW OF THE LITERATURE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827371/


Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review.
https://www.ncbi.nlm.nih.gov/pubmed/17264144


Natural history of nonoperatively treated symptomatic rotator cuff tears in patients 60 years old or younger.
https://www.ncbi.nlm.nih.gov/pubmed/21310940

Outcome of nonoperative treatment of symptomatic rotator cuff tears monitored by magnetic resonance imaging.
https://www.ncbi.nlm.nih.gov/pubmed/19651947

Surgical and nonsurgical management of rotator cuff tears
https://www.sciencedirect.com/science/article/pii/S074980630278910X