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What is Evidence-Based Practice and Why Is It Important?

What is Evidence Based Practice?

What is Evidence Based Practice (EBP) and why is it important? At Reset-Wellness we believe that our programs should be based on the best research out there. EBP is made up of 3 components that together make for the best outcomes.

  • Research.
    What does clinical evidence teach us? We use the SHA and the FMS to create programs that are grounded in evidence.
  • Clinical Expertise.
    Peter’s background and experience as a Physical Therapist is what sets us apart from most other personal trainers.
  • Client’s values and expectations
    If we don’t make a program that fits your needs, you will never achieve YOUR goals.

We combine the best evidence, and our 28 years of experience to create a programs for you, to reach your goals and satisfy your needs. By working together we will achieve the best outcomes possible. You will have to do the work, you will have to make the lifestyle changes, but we will guide you along the way and together we will #UpgradeYourLife

Source: What is Evidence-Based Practice and Why Is It Important?

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FITNESS TRENDS 2016

Reset Wellness is keeping up with the trends in Health and Fitness:

  • HIIT: part of every workout we do
  • Bodyweight training: we offer TRX
  • Outcomes: using FMS to identify your areas of improvement and then we re-assess to see if we accomplished our goals
  • Outdoor activities: when weather permits we train out door
  • Core Training: We incorporate core in to everything we do. It’s at the core of what we do.
  • #ACSMFitTrends

Source: WORLDWIDE SURVEY OF FITNESS TRENDS FOR 2016: 10th Anniversar… : ACSM’s Health & Fitness Journal

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Detox Waters

Try adding the below 5 naturally detoxifying ingredients to your water and take your detox game to the next level.

To detoxify means to remove toxins. Our bodies do a pretty good job of this already, and is why we have livers, colons and kidneys to filter and help remove our waste, but some people like to help the process along, especially when they’re feeling sick, bloated or low energy.

You can use a variety of sources to Detox. Different teas are a popular; Juicing; Eating only raw fruit and vegetables are other common detox routines. But the most safest and possibly best way to start a Detox is to drink lots of water. Our body is mostly water and staying hydrated can assist our body to cleanse toxins from our system

Lemon, Citrus, Cucumber are great additions to water to help detoxify.  Read more

Reset-Wellness Favorites

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You need more than HIIT

HIIT or low intensity, long duration training?

I have been reading more about HIIT versus Cardiac Output workouts.

This article on LinkedIn really made me think even more about this topic. I’m curious to see what others think on this topic? Here is another Great Article on this topic.

I think that HIIT is not enough. You can improve your recovery in between workouts, but building a solid cardio foundation with long duration, low intensity workouts. Not as sexy, but key to a more balanced approach to working out.

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Check out our Wellness Programs

ctrl_alt_del_life

From Detox to Vacation Bootcamp

Whether you’re looking for weight loss, sport nutrition or healthy aging, we’ll coach you the whole way!  During detox week you spend a week with us at the Bed&Breakfast and we help you to re-boot your wellness.

Read more

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Is the Paleo Diet a Fraudulent Fad or the Healthiest Diet to Hit Mainstream? 

Paleo Diet

Came across this interesting article. The Paleo diet has been around for years. The popularity of Cross Fit brought this diet more into the mainstream. like many other diets there is no real credible research to show that it works.

paleo-burger

What do you think?

Source: Is the Paleo Diet a Fraudulent Fad or the Healthiest Diet to Hit Mainstream? Could It Be Both? | Peter de Smidt, PT, DPT, Cert. MDT,MTC,STC | LinkedIn

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Vacation bootcamp?

Five reasons why bootcamp could help with weight loss

Rather than slogging it out at the gym for months, attending a weight loss bootcamp has a number of benefits and will leave you feeling completely rejuvenated

The idea of focusing on nothing but health and fitness for 24 hours a day may seem a bit intense, but attending a Vacation Bootcamp is a brilliant way to kick-start a new exercise regime.

Rather than embarking on months of post-work gym sessions and morning runs, and getting gradual results, you can fully devote yourself to the cause. It’s like giving your car a full service and a new engine.

Read More

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Shoulder Pain?What can do in the Gym?

Shoulderpain is one of the most common problems that happen to my fitness clients. The #benchpress #shoulderpress and even #bicepscurls often lead to #shoulderimpingement .
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If you have pain, you don’t have to stop lifting. But you may have modify your #exercise #programming .
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Get someone who understands #injurymanagement and #injuryprevention as well as #strengthandconditioning to help you with your #workout .
This information is intended for educational and entertainment purposes only. If your have symptoms, please see a qualified healthcare provider.

Everyone is Different. This an example, your program may vary.
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Knee Pain? Want To Work Out?

If you have #kneepain, weight training can help. However, you may need to modify your workout.
This chart shows you how different exercises compare, as far as strain on the knee.
We are all individuals, so different exercises may affect pain differently .
This information is intended for educational and entertainment purposes only.

Example only. Your program may vary

If you have knee pain you don’t have to stop lifting, but you may have to adjust your program. Find an exercise and a volume that you can safely perform.

Gradually increase your programming. Most of us get in trouble by doing too much too soon

Pieter de Smidt, PT, DPT, Cert. MDT, MTC
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Back pain? Want to lift?

This might vary from person to person

Everyone is different. Your pain is not the same as someone else’s pain. If you have pain, get a qualified Healthcare Provider that understands lifting weights to help you stay active 

If you have back pain you don’t have to stop lifting, but you may have to adjust your program. Find an exercise and a volume that you can safely perform.

Gradually increase your programming. Most of us get in trouble by doing too much too soon

Pieter de Smidt, PT, DPT, Cert. MDT, MTC
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Does blood-flow restriction training work, and who can it help?

Blood-flow restriction training has almost as many applications and names as it has uses.  From: https://www.elitecme.com/resource-center/rehabilitation-therapy/blood-flow-restriction-training-does-it-work/

Some call it occlusion training; others, hypoxic training. Bands, cuffs, and even ACE bandages have been used in attempting to utilize the benefits of the training for a number of desired outcomes.

Yet just about everyone agrees on one point – the practice is gaining popularity due to its effectiveness.

First things first: no matter what name you choose to use, let’s clarify how it works. People, for any number of reasons, may be unable to lift heavier weights or do extensive strength training for a period of time. Whether it’s an injury or another condition, blood-flow restriction training allows the patient to lift lighter weights while receiving benefits similar to people lifting heavier. 

“They can gain strength and hypertrophy without having to work at a particularly high intensity,” explained Pieter de Smidt, PT, DPT, Cert. MDT, MTC, who is the president and owner of Reset-Wellness Physical Therapy in Houston, TX. “That makes it ideal for physical therapy patients.”

De Smidt’s explanation is as follows: the accepted standard is that in order to gain strength or hypertrophy, a person must be able to lift weights that are at least 65 percent of the person’s maximum capacity for that exercise. For example, if you can lift 100 pounds, you must lift at least 65 pounds in order to see tangible benefits in added strength. 

Of course, for people coming off of recent injury or surgery, this is an impossible task. It becomes challenging for the physical therapist to allow these patients to strengthen themselves because of the reduced capacity for exercise and lifting. “I can’t make you work hard enough for the body to adapt,” explained de Smidt.

With blood-flow restriction training (BFRT), however, that same patient who is unable to lift 65 pounds while recovering or while injured can suddenly see benefits while lifting only, say, 20-25 pounds. 

How? Say you want to work your upper body. You wrap a pressure cuff or similar restrictive instrument around the upper portion of that limb, reducing the ability of blood to flow out of the working muscle. When properly performing blood-flow restriction training, blood is able to enter the muscle via arterial flow, but the veins are restricted so that blood is partially prevented from leaving the working muscle. 

“That’s the ideal scenario for repairing the tissues,” de Smidt explained. “But by lifting lighter weights, you’re not providing any mechanical stress or doing mechanical damage to your muscles. Everything you do goes toward growth.

It’s a great way to gain that strength safely, while slowly progressing toward your ability to lift those weights normally. It’s a temporary solution – you don’t need to be doing it forever, just until you’ve safely regained strength and the patient is able to lift heavier items again.”

De Smidt was originally attracted to blood-flow restriction training not only by its ability to create hypertrophy, but by the potential for utilizing the training for prevention in a passive state. “If I restrict your blood flow without anything else,” he explained, “while you’re, say, in a cast, you will not lose your muscle mass or strength if you do this training during immobilization. Otherwise, strength loss and atrophy can occur very quickly.”

Post-injury, post-surgical, post-immobilization – they’re all strong indicators for the potential benefits of blood-flow restriction training. “It works for anyone who has a reason why they’re unable to perform typical, high-intensity exercises can benefit,” said de Smidt. “But it can also be used in your athletic population.”

De Smidt outlined a pair of uses for BFRT in athletes – in-season training, when coaches and trainers are leery of players hitting the weights too hard, or use it as the finishing touch at the end of the workout to maximize the benefit of strength training. “You can reduce the mechanical stress component,” de Smidth said of the first example.

Contraindications

De Smidt cautioned against using the method with post-surgical patients before consulting with the surgeon. It’s also important to account for any cardiovascular restrictions, such as hypertension, before proceeding with blood-flow restriction training. PTs should avoid utilizing BFRT in areas with open wounds or impacted by lymphedema. ANy area with clotting risks or limbs with a dialysis port should also be avoided.

Benefits

Years ago, patients would undergo surgery for vascular necrosis of the hip. These patients were too young for a total hip replacement, so the chosen procedure would require six months non-weight bearing, It’s easy to imagine the atrophy and loss of strength that would take place over that time.

“Initially, we started those patients on a passive protocol, followed by an aerobic protocol, and finally strength training,” de Smidt recalled. “Using BFRT, we saw significant differences in the strength loss as opposed to in the past.

“That’s how I got into this – they were immobilized, they weren’t allowed to do many exercises because of that initial fragility. This allowed us, for a few weeks, to get ahead of the atrophy. Slowly, we made the patients more and more active, and it was nice to see how BFRT helped in that process.”

PTs, OTs, certified athletic trainers, and personal trainers can all benefit by utilizing BFRT similarly with their patient populations. “As long as [the professionals] know how to use it, it can be very effective.”

De Smidt cautioned that each session shouldn’t exceed 10-20 minutes, and that this strategy should not be used as a primary strength-building approach. “If you’re healthy, and able, the research shows you should be lifting heavier weights to gain strength and hypertrophy,” he urged. “Once, twice a week in a healthy person, this can provide a different kind of stimulus because you fatigue much more quickly. You can use it as the finishing touch to a regular workout.”  

BFRT is great for strength training, hypertrophy, aerobic endurance – it can be used to increase a patient’s VO2 max in a short amount of time – and can be performed actively or passively. But by using it at the beginning of a session, de Smidt says you can reduce the patient’s pain, expanding their capacity for exercise throughout the session. After injury, the patient can start day one, while post-surgical patients tend to wait 1-2 weeks before starting through a slow progression. 

Lastly, a few safety precautions: de Smidt says the gold standard is usage of a Doppler to determine lymph occlusion pressure. “Say, at 200, we have no more pulse shown, we work at about 50 percent of that. We don’t want maximum occlusion –the key is doing this safely to maximize its potential.

With several decades of research behind the method, de Smidt says BFRT should likely be used more liberally within the clinical setting, but some practitioners have concerns about safety…

If you would like to learn more from de Smidt himself, sign up for one of his seminars by following this link.

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Training with pain?

We all will have to deal with this at some point. You may have some pain, but still want to workout. Should you? Can you? And if so, how?

  • Reduce the ROM
    By working a shorter range of motion (ROM) you can typically reduce symptoms. If you have pain, regardless of load and volume, in a certain part of the range of motion this works well. If you have pain in the bottom of the squat, try a box squat and see how you feel.
  • Reduce the load
    The key is to bring down the weight to a point JUST BELOW your pain threshold. If you have pain lifting 50#, can can lift 45# without pain: exercise for a few sessions at 45# and if all goes well, try to go back to 50#. Then slowly progress from there. This works well if you have pain during a specific lift
  • Reduce volume: less reps or less sets
    This works well for situations where you do not have pain during working out, but you have pain the next day. For example: if you have been doing 5sets of 5 reps with deadlifts, go back to 3 sets of 5 reps with same weight. If not pain next day, do one more session at 3 sets. Still no pain: got to 4 sets. if no pain after 2 sessions, go back to 5 sets. Keep monitoring how you feel during workout and for 24 hours afterwards
  • Slow down the tempo
    Often times you can develop pain when you go too fast with your lifts. You may not feel what part of the lift gives you discomfort. You may be compensating by going faster, but over time this can lead to injury. If you have any kind of tendonopathy, tempo changes can help your pain. If you have pain with faster reps, this may be an indication of pain generated from a tendon. Slow down your movement, focus on proper form and see how this affects your pain

Its NOT “No Pain, No gain” and its also NOT “Pain, so stop”. Modify your workout and see how your symptoms respond. But keep training, unless pain gets progressively worse

Pieter L. de Smidt, PT, DPT
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Going Back to the Gym?

Train Smart | Train Safe

Be Smart. Be Safe. Don’t Get Hurt

If you haven’t been training for the past 6-8 weeks, please start with a workout you can easily perform.
Even if you been doing some HITT, or body weight exercises, you need to ease back in to heavy lifting.

Plan 1:
2 easy warm up sets and 2 heavier sets

Pick a weight that you can do for 15 reps and have 2-3 reps in reserve. Do 2 sets and see how you feel. Then lift another 2 sets with a heavier weight you can do for 8-12 reps. Let’s see how you feel the next day before you increase volume.
Consider doing some active rest breaks with some mobility work, instead of posting pics😉 focus on your body and monitor how things feel.

Plan 2:
Pyramid training can also be a safe way to resume working out

  • Set 1: 60% 1RM x15 reps
  • Set 2: 70% 1RM x12 reps
  • Set 3: 80% 1RM x6-8 reps
  • Set 4: 70% 1RM x12 reps
  • Set 5: 60% 1RM x15 reps

Plan 3:
User Blood Flow Restriction Training

Work with 30-40% 1RM and do 4 sets: 30/15/15/15 reps. Make sure you inflate the cuff to an appropriate setting specifically for you. Find an experienced Physical Therapist or Trainer to help you with this

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Injured? Want To Work Out?

If you are in pain, or had a recent injury/surgery, and you want to start working out again, but don’t know where to start: reach out to a Physical Therapist. PT’s can help you safely start moving again. They understand your medical history and they understand exercise. However, if you want to start lifting weights again you may want to look for a specialist that also understands strength training. That is where I fit in: “bridging the gap between rehab and fitness”

There is not a one-size-fits-all program for you. Your condition, your goals, your background, your anatomy make you unique. So a succesful program needs to be individualized. Many trainers and coaches can help with that, but they typically do not have the medical knowledge to understand your condition and you may get hurt again.

Here are some sample workouts I have put togetherfor patients over the past few weeks

5×5 approach
Full Body workout

If you need a workout that is specific for your goals, your medical history and your workout history AND you dont want to get injured again: email me

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What Is Blood Flow Restriction

Getting Popular
Not just for patients, also for athletes
Improve strength, gain mucle mass and increase endurance

Blood flow restriction training is getting more and more popular in rehab setting and in the gyms. With good reason, as there is a substantial amount of research coming out that shows the benefit of BFR to improve strength and hypertrophy.

Research on Hypertrophy

With traditional workouts you need to load the muscles at least at 65% of their 1 Rep max. So if you can curl 50# maximally, you need to work with 33# to gain hypertrophy. Research on Blood  Flow Restriction shows that you can get the same results with loads as low as 20-30%, so with 10-15# dumbbells!

How does it work?

  • Blood flow restriction training does not break down the muscle like traditional resistance exercise because the loads are so light: So less Muscle damage!
  • But BFR creates huge amounts of protein synthesis due to the hormonal responses the body has to BFR training: So more Muscle growth!

Where do the cuffs go?

The cuffs should be placed either at the upper arm, or at the upper thigh.
Cuff pressure should be 4-5 on a scale of 10 (maximum pressure you can handle) for the upper body and 6-7 on a scale of 10 for the lower body. Always be on the low side. More pressure does not create better results!
If your Therapist or Trainer uses Doppler, its even safer and more accurate!

What Exercises should I do?

Results has also shown that there is a systemic effect: people that used BFR just for upper body exercises, gained lower body strength too. You can basically use any type of exercises, from bike or treadmill to dumbbell or barbell activities. The 30/15/15/15 protocol is what appears the most in the literature. So you perform 4 sets, the first one with a weight that you can lift for 30 reps and then 3 sets with 15 reps each. Rest only 30 seconds in between. If you can not complete all the reps, reduce the weight next session!

Do you want to try Blood Flow Restriction Training?

If you have never tried it, book a session and let me work with you. We have different cuffs, from different vendors and you can see which one you like the best. Email me with questions

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Weightlifting is not bad for your knees, low back or shoulders

@TheStrengthTherapist

Weightlifting will not hurt you knees, back, shoulders
We need to stop telling people that weightlifting is bad for them.

  • Yes, before anyone start with weightlifting they need the prerequisite mobility and stability and know good form.
  • Yes, not everyone needs to use a barbell to do deadlifts. Actually most people do not, but they can use trap bar, rack pulls, Kettlebells, Dumbbells, or even do a dowel hip hinge
  • Yes, not everyone needs to lift a barbell overhead. They can use a machine, Dumbells or a landmine
  • Yes, not everyone needs to do a barbell squat ATG, but some form of squatting should be done by all of us, as its part of our daily lives

Research has shown over and over again that weight lifting is not bad for and actually can really help us. More strength, more resilience. Stronger bones and muscles won’t hurt anyone

Pieter L. de Smidt, PT, DPT
@TheStrengthTherapist

Knee Research:

@TheStrengthTherapist

Shoulder research

@TheStrengthTherapist

Back research

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