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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

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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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Improve your squat depth

1️⃣Quadruped Rockback – get on all fours with a wide stance, sink back into deep hip flexion, stretching your groin and glute muscles.⁣⁣
2️⃣Ankle Prying – get down into a squat, lean to one side and push the knee forward while keeping the heel down, stretching the lower calf region.⁣⁣
3️⃣Foam Roller T-Spine – get down on the ground in a supine position with a foam roller placed underneath the upper back and your hands behind your head. Use your thoracic extensors to arch the upper back over the foam roller.⁣⁣
4️⃣Ankle Rocking – from a kneeling position in a deep lunge, push the knee forward while keeping the heel down, striving to feel the stretch in the lower calf area.⁣⁣
5️⃣Squat Adductor – get down into the bottom of a squat and use your elbows to push your knees outward, stretching the inner thigh muscles.⁣⁣ ⁣⁣
Do 3 rounds of 6 reps of each of these then proceed to your squat workout.⁣⁣

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Is a Butt Wink Bad?

Is The Butt Wink Bad For Your Back

The Butt Wink can be seen at the bottom of a squat when the low back moves into flexion and starts to round. This can put additional pressure on muscles that stabilize the spine and pelvis, and maybe even the low back disks. It is not really possible to have a full deep squat and not have some lumbar flexion, so it’s normal but should not be excessive or early in the squat.

There are a few possible causes of excessive Butt Wink. 

  • Poor Ankle Mobility
  • Poor Technique
  • Poor Core Stability Control
  • Poor Hip Range of Movement

If you have low back pain with squatting, please find someone who can evaluate your technique and your mobility..

Bottomline: Some Butt Wink is normal, but should be minimal and only in the deepest part of the squat. We all mov differently, so slight movement issues are not important, but excessive deviations might need an evaluation, especially if there is pain.

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Is Squatting bad for you? | Part 2

Is squatting bad for your knees?
Is deep squatting harmful for your knee
If your knees go past you toes when you squat, is that bad?

I get these questions all the time and especially if patients have heard these half-truths from their doctor, its hard to make them understand that “IT DEPENDS”

Many of us have heard this: “do not squat your knees past your toes”, but is it really true?

Yes, you may get more torque (20% increase) in your knee if your knees move past the toes, but if you limit this forward movement torque in the hip & low back may go up as much as 1000%. 20% increase in torque should be well within what a normal knee can handle!

In order to reach FULL depth in the squat the knees almost always have to move forward past the toes. Olympic weightlifters are a great example of this, as they need to train at full depth for their sport, and so often squat with their knees past their toes, and with very high loads too! If you have no knee pain, you can go full depth and with knees past the toes.

We often hear the popular ‘knees over toes’ cue, which actually means don’t let the knees collapse inwards or outwards and keep them in line with the feet. This has nothing to do with knees going past the toes!

What people also tend to forget is that each type of squat is MEANT to have differing amounts of forward knee travel, due to the varying demands placed on the joints of the lower limb due to the different bar positions.
So don’t go expecting someone to have the same amount of forward knee movement in a front squat compared to a low bar back squat.

However, it’s probably not a bad idea to limit ‘excessive’ forward knee travel to prevent undue strain on the patellar tendon and patellofemoral joint. And by excessive I’m talking knees being more than 4-6 inches in front of the toes every rep in people that squat heavy and often.
The main exception is people with anterior knee pain: pain in the front of the knee: try to limit forward movement and focus on a box squat or even a goblet squat to keep the shins more vertical

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Is Squatting bad for you? | Part 1

Is squatting bad for your knees?
Is deep squatting harmful for your knee
If your knees go past you toes when you squat, is that bad?

I get these questions all the time and especially if patients have heard these half-truths from their doctor, its hard to make them understand that “IT DEPENDS”

First Things First: SQUATTING IS NOT BAD FOR YOUR KNEES

Squatting is part of our daily life and squatting exercises can really help for people with knee problems. Squatting can bring out some issues if you do not have sufficient mobility in your ankle or hip; or if you do not have proper stability around the knee. If you do not have any active problems, squatting is fine. If you have active injuries, you might have to modify your squat some. BUT you can still squat!

Deep squatting, basically squatting below parallel or below 90degrees is not always bad. Deeper squats are actually less stressful for your ACL. But with some other conditions, you might need to “proceed with caution”

But what about the meniscus and the patellofemoral joint (joint between your knee cap and your femur)? While compressive forces on the meniscus and PFJ increase as depth increases, if you don’t have any prior injury to these structures there is no evidence that squatting deep will cause injury to these structures. However, if you do have a meniscal tear or PFJ pain, it is a smart idea to limit your depth to pain-free ranges. At least to start off with and then we should be able to progress.

If you have patellar tendon problems, it might also be smart to reduce the depth of your squat by using a box squat, or reverse lunges.

For people with hip impingement you may need to start in a pain free range, but as the injury resolves you should be able to progressively squat deeper as well. A healthy joint can handle a deep squat without pain.

Sometimes your low back can be sore with deep squatting, but this typically happens when you do not have sufficient mobility in you ankle, or hip and your back ends up compensating. A butt wink, some flexion of your low back at the base of the squat is normal; if its excessive, you may have to look at mobility or stability issues, but otherwise do not worry about it.

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Rowing for back, neck and shoulder pain

#UpgradeYourPhysicalTherapy
#rowing variations are my most popular exercises. Rowing is effective for people with a lot of different problems
#backpain
#Neckpain
#shoulderpain

It works for your #posture because this one of the #compoundexercises that involves different joints and muscles

Typically I program twice as much rowing as I do for pressing, but it depends on what your patient/client needs.

Programming options
💪You can program more biceps by using supinated grips.

💪You can focus on scapula stability with narrow grip or on lats with wider grip

💪You can engage the entire posture chain with bent over variations

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What is a SLAP tear?

What is a #SLAP TEAR, also known as Superior Labrum from Anterior to Posterior.
The labrum is a cartilage ring inside the shoulder that provides stability to the joint and. Slap tear is a common tear of your labrum, where your biceps attaches.

From @drnimamehran: SLAP tears (of the shoulder) are most commonly due to repetitive overhead activities, but can also occur due to a fall out on an outstretched arm with a tensed bicep or traction on the arm.

Symptoms include vague, deep shoulder pain, occasionally mechanical symptoms such as popping and clicking. Additionally, patients complain of weakness, easier fatigue and poorer athletic performance.

First line of treatment is always PHYSICAL THERAPY, NSAIDs or possibly injections. PT can help improve any range of motion deficits such as a limited internal rotation. Additionally, PT will help improve scapular strength and stability and rotator cuff strength. Most SLAP tears do not need surgery. In fact, I (@drnimamehran) have managed my own slap tear and many of my friends’ slap tears without surgery.

However, when surgery is indicated, it could involve repairing the SLAP and/or performing a biceps tenodesis, which is placing the biceps into the bone. The idea is that the biceps can be anchored in a different location so it does not put stress on the labrum and removes the pain generating section of the biceps

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Did You Know Series-Shoulder

This series discusses common questions we get from our patients with shoulder pain. We talk about certain conditions and teach you things you can do yourself to reduce your shoulder problems

Do You have Shoulder Problems?

Question: What is a SLAP tear?
A SLAP tear is a tear of your labrum in your shoulder. Read here about what a SLAP tear is.

Question: Do all labrum tears or rotator cuff tears need surgery?
No. Some tears will require surgery, but you should not consider surgery unless you tried a solid conservative Physical Therapy program. Click here to learn more about common shoulder conditions

Question: What are some good exercises when my shoulder hurts?
Everyone needs different exercises for their shoulder, because pain and injuries are very individual. However, some exercises are good pretty much all people with some shoulder pain. Here are some basic exercises, that everyone typically benefits from:

Also look at these posts about weight training with shoulder pain

Question: Where can I learn more about shoulder pain?
We have created a free E-book. You can download it here

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Barbell Myth-6

“Myth 6: The low bar squat is better than the high bar squat”⠀

While the low bar squat is my personal favorite, and the variation I program for most of my general strength athletes, it’s not the end all be all!⠀⠀

I prefer to squat low bar because it feels best to ME. It’s also great for those who are trying to work around current knee pain or for those who have limited ankle mobility.

But here’s the thing…there’s nothing wrong with the high bar squat! It’s actually great for those who:⠀

➡️ Have limited shoulder mobility ⠀

➡️ Are Olympic/Crossfit athletes⠀

➡️ Just “feel” better with this variation in general ⠀

Just like the low bar squat, the high bar squat can be incrementally loaded and is going to produce similar strength and hypertrophy improvements. ⠀

The choice between these two variations, as always, should be determined on a case by case basis. Try both variations and have someone evaluate your movement and screen your mobility to see which one is better for you.

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Peace and Love | Part 3

Phase 2 : After the first days have passed, soft tissues need LOVE

L for Load

An active approach with movement and exercise benefits most patients with musculoskeletal disorders.Mechanical stress should be added early and normal activities resumed as soon as symptoms allow. Optimal loading without exacerbating pain promotes repair, remodeling and building tissue tolerance and capacity of tendons, muscles and ligaments through mechanotransduction.

O for Optimism

The brain plays a key role in rehabilitation interventions. Psychological factors such as catastrophisation, depression and fear can represent barriers to recovery. They are even thought to explain more of the variation in symptoms and limitations following an ankle sprain than the degree of pathophysiology. Pessimistic patient expectations are also associated with suboptimal outcomes and worse prognosis.[19] While staying realistic, practitioners should encourage optimism to enhance the likelihood of an optimal recovery.

V for Vascularisation

Physical activity that includes cardiovascular components represents a cornerstone in the management of musculoskeletal injuries. While research is needed on dosage, pain-free cardiovascular activity should be started a few days after injury to boost motivation and increase blood flow to the injured structures. Early mobilisation and aerobic exercise improve function, work status and reduce the need for pain medications in individuals with musculoskeletal conditions.

E for Exercise

There is a strong level of evidence supporting the use of exercises for treatment of ankle sprains and for reducing the prevalence of recurring injuries. Exercises will help to restore mobility, strength and proprioception early after injury. Pain should be avoided to ensure optimal repair during the subacute phase of recovery, and should be used as a guide for progressing exercises to greater levels of difficulty.

Source:
https://blogs.bmj.com/bjsm/2019/04/26/soft-tissue-injuries-simply-need-peace-love

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