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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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Kettlebell workout that may cause low back pain

Kettlebell workout are great for your back. KB workouts can strenghten your back and should not cause any low back pain. This post from this Greg Brookes is a great read on this subject.

Just like many exercises you may experience muscle soreness after your workout but it is important to differentiate between pain and soreness. Muscles soreness should reduce workout after each workout whereas pain will increase.

Read more

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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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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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How To Improve Thoracic Mobility

Here is a good way to use foam roller

Here is a good progression to improve thoracic extension with a foam roll

  1. Foam rolling
    Start by lying on your back with a foam roll under your back.
    Place your hands on your stomach and then slowly roll forward and back across your back using your legs. If you find an area that is more tender or tight, progress to step 2 below and do 1 set of 10 and progress as tolerated
  2. Arching over a foam roll
  3. Head supported
    1. Arms overhead
    2. Holding a weight
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How To Do A Pull-up

Performing a solid pull-up is not easy, but all of us can master this exercise. Its like a badge of honor in the gym when you can show off your pull-ups, right?

If you you want to strenghten and develop your lats, the lat pulldown machine will be just as effective. Read this blog post to learn about the best exercises for your lats

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How to Train Your Hamstrings

Recent recent shows that Hip-extension exercise selectively activates the biceps femoris long head, and the knee-flexion exercises, like Nordic Curl exercise, preferentially recruits the semitendinosus.
So when you want to train the entire hamstring you need to pick exercises from both groups.

When you want to be specific with your exercises because of certain condition, you can do that.

  • For example for people after an ACL reconstruction with a hamstring graft, typically semitendinosus, you might want to go easy of knee flexion exercises early one to avoid a flare-up and then gradually add more exercises like the nordic curl.
  • Sprinters who pull their hammie, usually have biceps femoris issues. So start early on avoid to many hip extension exercises for the biceps and later on you want to really focus on that type of exercises

Good Extension based hamstring exercises

  • Stiff leg Deadlift
  • Hip extension kicks

Good Flexion based hamstring exercises

  • Nordic curl
  • Prone or seated leg curl

Research

Bourne MN, Williams MD, Opar DA, et alImpact of exercise selection on hamstring muscle activationBritish Journal of Sports Medicine 2017;51:1021-1028.

More Hamstring Articles

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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.

Benefits

💪It’s a unilateral exercise, so we can reduce differences between left and right
💪We can work on anterior hip mobility
💪Also develops lower quadrant stability at same time. You engage lower body and your core for a functional workout.

Muscles Worked

✔Quads
✔Glutes
✔Adductors
Calves and core are involved for stability, which make this a good exercise for patients with back, hip,knee and ankle problems.

How to perform a split squat

There are three key parts to the Bulgarian split squat:
You balance on one foot, with your rear foot on a bench or box.
Your back stays more or less straight throughout the whole movement.
You usually hold dumbbells to add weight, instead of using a barbell.

Single leg squat versus the Bulgarian Split Squat

The Bulgarian split squat has a greater range of motion than the single-leg squat, but it’s also harder to maintain your balance with heavy weights. And because balancing is easier with the single-leg squat, that means it’s also easier to use a barbell instead of dumbbells.

Bulgarian Split Squat versus. Lunges

Functionally speaking, the main differences between the lunge and the Bulgarian split squat are the lunge engages the rear leg more, and uses a shorter range of motion.

The lunge also requires even more balance than the Bulgarian split squat, making it less newbie friendly. Even advanced lifters generally can’t use as much weight on lunges, either.

All in all, though, lunges and Bulgarian split squats are very comparable. Use whichever one feels more comfortable to you.

Videos

Bulgarian Split Squat:
Barbell Split Squat
Lunges
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How to Bent Over Row

Rowing Is One Of My Favorite Exercises

Rowing for back, neck and shoulder problems

Rowing exercises might be the exercise Inused the most in the clinic
I use it for patients with back pain to stabilize the torso. I use it for shoulder patients to stabilize the scapula and I use it for neck patients to improve posture

Many of my patients need to improve engagement of the posterior chain and the bent over row does just that. Perfectly! It’s a compound exercise that involves many muscles, multiple joints and is functional.

Key for any rowing variation is to first “set the back” engage your core and back muscles and pull your shoulder blades back and down. Now you have a stable base to pull from.

If you do a single DB row, make sure to pull back and up. Not straight up.

Barbell rowing can be done with palms up or down. With palms up you get more help from your biceps.

Landmine rowing can be done with both arms, or as a single variation and can be fine tuned to work different parts of your back, depending on where you place your feet.

rowing is a must exercise for most of my patients and should be part of all your back and pulling days.

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