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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.

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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.

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Rehabilitation Succeeds Where Technology and Pharmacology Failed: Effective Treatment of Persistent Pain across the Lifespan

From: https://www.mdpi.com/2077-0383/8/12/2042

Chronic pain affects up to 30% of the adult population and 11% to 38% of the childhood and adolescent population. The area of rehabilitation research for patients having persistent pain is on the move with a substantial increase in the scientific understanding of persistent pain over the past decades. This rapid growth in pain science has inspired rehabilitation clinicians and researchers around the globe, leading to breakthrough research and the implementation of contemporary pain science in rehabilitation settings

For chronic low back pain the current, most up to date, research suggests treatment includes a combination of “pain science education, exercises, combined with manual therapy where needed”

For chronic neck pain, the latest research shows most benefit from strenghtening treatment of the neck and upper quadrant.

More information on the latest research of chronic pain can be found in this series

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Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain

Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking.

All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3.

In 3 randomized clinical trials of (681) participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources.

Source:

Juch JNS, Maas ET, Ostelo RWJG, et al. Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials [published correction appears in JAMA. 2017 Sep 26;318(12 ):1188]. JAMA. 2017;318(1):68-81. doi:10.1001/jama.2017.7918

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How can exercise help chronic pain?

Answer:

Although resting for short periods can help with pain, too much rest may actually make it worse and put you at greater risk of injury. Research has shown that regular exercise can ease pain long term by improving muscle tone, strength, and flexibility. Exercise may also cause a release of endorphins, the body’s natural painkillers. Some exercises are easier for certain chronic pain sufferers to do than others. Try swimming, biking, walking, rowing, and yoga.

Finding the right exercise for YOU is most important. Not every person with low back pain responds to one type of exercise. Not every person with rotatorcuff problems needs to do the same exercise. The “right” exercise is very individual. However, it has to be an exercise you enjoy!

For people suffering from pain, their initial response is to avoid activity and seek rest. And yet exercise therapy is often prescribed as a treatment option to manage pain. There are known benefits of exercise and regular physical activity. CDC lists following as the benefits of physical activity: controls weight, reduces risk of cardiovascular disease and metabolic disease, reduces risk of some cancers, strengthens bones and muscles, improves mental health and mood, improves ability to perform daily activities and prevent falls, and increases chances of living longer. Exercises and physical activity not only have benefits in healthy individual but also has proven benefits in people with pain and injuries

Aerobic exercise/endurance training and resistive exercise/strength training are two different types of exercises which can be aquatic or land-based. Pain control is achieved differently with different types of exercises.

Prescribing appropriate intensity and frequency of exercise is important in achieving the desired effects of hypoalgesia and therefore you want to seek out a professional who understands pain and will take the time to evaluate you and who will listen to your concerns and most importantly answers your questions about pain.

Research?

An immediate local mechanical hypoaglesic response has been shown to specific exercises of cervical spine in patients having neck pain for at least 3 months. Specific exercises included (1) cranio-cervical flexion with 10 second contraction for 10 repetitions with 10 second hold in between, and (2) cervical flexion endurance exercise of head lift in supine was performed for 3 sets of 10 reps at 12RM with 30 second rest in between sets (each rep lasted for 3 second with 2 second interval between reps).

A systemic review done by Hayden et al, concluded that supervised exercise therapy which consists of stretching and strengthening, and is individually designed improves pain and function in chronic nonspecific back pain.

Martin et al designed an exercise program which has shown to be an effective management for fibromyalgia in short term. Exercise program included aerobic training, flexibility exercises and strength training.

  • Thorén P, Floras JS, Hoffmann P, Seals DR. Endorphins and exercise: physiological mechanisms and clinical implications. Medicine & science in sports & exercise. 1990 Aug. 22(4): 417-428
  • Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. The Journal of Pain. 2014 Dec 31;15(12):1294-304.
  • O’Leary S, Falla D, Hodges PW, Jull G, Vicenzino B. Specific therapeutic exercise of the neck induces immediate local hypoalgesia. The Journal of Pain. 2007 Nov 30;8(11):832-9.
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Functional Cupping

About ten years ago, Pieter de Smidt was looking to add to his array of manual therapy skills for soft tissue treatment. 

de Smidt, PT, DPT, Cert. MDT, MTC, owner of Reset-Wellness Physical Therapy in Houston, TX, was well-versed in instrument-assisted soft tissue mobilization (IASTM), which still proved painful for some patients. But after seeing the benefits of ‘distracting’ the tissues by using taping, he decided to expand that repertoire. 

“Cupping seemed to be an obvious answer,” recalled de Smidt. “I figured maybe we should try distracting the tissue rather than always shearing the tissue. This was something people could tolerate.”

These days, de Smidt still tends to start with an IASTM-based treatment, but if this proves painful, he can do a simple contrast with IASTM on one side and cupping on another, and asking the patient which feels more comfortable. 

What is Functional Cupping?

While cupping may be somewhat new as a modality of manual therapy in Western medicine, the concept itself has been traced back as far as 1500 B.C., when the ancient Egyptians were said to have utilized the process. A specially-designed cup — don’t just pick up any instrument — is applied to the skin for a few minutes under suction, allowing it to affect the underlying tissue, particularly the fascia.

Functional cupping works by applying the cups in relevant areas followed by initiating dynamic, functional movement and affecting positive change in movement restrictions. The goal is to restore movement while decreasing pain in areas of previous restriction. Simplified, the cup is placed where restriction is felt, allowing the practitioner to move the body to the outer limits of that particular movement. As a result, tissues begin to soften, increasing the range of movement. 

Best of all, the client or patient has a strong degree of control over their own movement with the cups in place, and can dictate and control their own levels of discomfort. Many times, people assume cupping is a painful experience due to the prevalence of dark, purple spots that will appear on a person’s skin in areas where the cups were applied. However, this is simply the result of blood flowing to the affected area due to the suction pressure. Some believe the darkness of these spots has relevance as to how the injury is progressing, though this theory is not commonly held in Western medicine.

Read More:
https://www.elitecme.com/resource-center/rehabilitation-therapy/functional-cupping-manual-therapy-applications-and-uses/

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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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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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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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How To

In this series we review popular exercises and show you the proper form, why you should do these exercises and when you should look for an alternative exercise

How To Perform a Hip Thrust

The Hip Thrust exercises has become a lot more popular and for good good reason. For function and overall lower extremity development, you also need to train the backside of the legs, the posterior chain.

Read More Here

How to do Bulgarian Split Squat

The Bulgarian split squat isn’t an all-around better exercise than the barbell back squat, but if you incorporate it into your plan intelligently, it can help improve your leg development while reducing your risk of injury and muscle imbalances.

Read More Here

How to Improve Thoracic Mobility

The Foam Roller can be used to improve thoracic mobility, esepcially to improve extension which a lot of use due to our forward bend posture.

Read More

How to train your hamstrings

The hamstring is is made of 2 groups, the semis and the biceps femoris. Each responds to different type of exercises.

Read More

How to Squat with knee pain

If you have knee pain, especially pain on the anterior (front) of the knee, give this exercise a try

Read More

How to squat with back pain

If your back is hurting, sometimes you need to alter your leg workout.

Read more

How to Bench Press

Follow these 4 steps to safely perform the bench press. If you have pain with Bench press this post also shows you some alternatives.

Read More

How to do a pull-up

We have videos to show you step-by-step how to master the pull-up

Read More

Coming soon

How to deadlift

How to Squat

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Why more people are paying cash for physical therapy

If you’ve ever had an injury or dealt with chronic pain, you probably followed a pretty traditional course of action to address it. You went to your primary care doctor and they sent you to the lab for x-rays, prescribed medication, or both. You may have gotten a referral to a specialist or even a surgeon. You went to that appointment and were either told that you needed surgery or that you needed to modify your physical activity and avoid certain activities in order to not exacerbate the problem. Basically, you were thrust into the assembly line that has become “modern healthcare”.

But did you know that you could bypass all of this hassle – and get faster results – by going directly to a physical therapist? Physical therapists are trained to diagnose your problem and provide a fully customized treatment option that doesn’t involve prescription medications or procedures. In almost all states (including Texas) you don’t even need a prescription to see a physical therapist.

The problem is that for many people, traditional physical therapy has not produced the results they are looking for. Physical therapy does work. But what often doesn’t work is the model of care.

Because of all the limitations insurance companies have placed on reimbursement over the years, most traditional physical therapy clinics (those that take insurance) have been forced to see more patients than they would like at any one time – just so they can pay the bills and keep the lights on. In most clincs a PT sees 2-3 patients at the same time each hour. But not with Reset-Wellness PT!

Additionally, insurance companies have essentially taken over your care. They decide who you can see, what type of treatment you will get, and how many visits you are allowed to have. These decisions are being made by someone who’s never even spoken to you, met you, or actually looked at you. Because of this, “physical therapy” has gotten a bad reputation and a lot of people find that it’s a waste of time, or that it consists of just a bunch of exercises. It’s not the physical therapist’s fault, it’s the insurance company’s fault.

The good news is that you’ve got options and alternatives when it comes to taking care of your back or knee pain. If you don’t want to be prescribed medication, you don’t want to deal with procedures like injections or surgery, and you don’t want to go to traditional physical therapy and feel like you’re wasting your time because you are ignored or are doing the same exercises over and over – the answer is to go outside of your insurance and pay out of pocket. This is known as going “out of network”. And more and more people are doing it because they are fed up with the traditional models of healthcare and physical therapy that don’t give them the results they are looking for.

But isn’t that expensive? Not at all, and it really depends on what you value. For me, and for most of the folks that we work with, it’s far more costly to live with chronic back pain, have to miss out on activities you love, and end up with a surgery you never even wanted. It’s also far more costly to spend years going to weekly chiropractic and massage therapy appointments just so that you can function and manage your pain. When it comes to musculoskeletal problems, you NEED a physical therapist in your corner and as part of your health care team. But it can’t be the traditional kind where all you get is cookie cutter treatment plans. Physical therapists who don’t contract with insurance companies are able to spend more time with you and create a truly customized plan of care. We focus on getting to know you and your body instead of what paperwork needs to be filled out for your next insurance authorization. Our clients like this model because they get long-term success instead of short-term pain relief. Our therapists like this model because they are free to use their brains and actually do what they were trained to do. Everyone should have their own, personal physical therapist to call and come see anytime you need, just like you would a chiropractor, dentist, doctor, or massage therapist. The only way to do this, is to go outside your insurance.

If you are curious about whether or not this model of physical therapy is right for you just give us a call at 713.331.9453 It’s not for everyone, but more and more people are finding that it is. Most of the folks we meet and work with say: “I wish I had found you first”.

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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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