The New York Times just published an obituary for Dr. John Sarno, a doctor at New York University who wrote controversial and best-selling books on the psychological origins of chronic pain.

As a chronic pain sufferer myself, I find it interesting that physicians, nurses, other medical professionals, and people in general often dismiss the idea that there can be a psychological component to pain. Dr. Sarno championed the idea that stress can not only make pain worse, but that stress itself can cause pain.

The obituary notes that many people (both doctors and non-doctors) dismissed Dr. Sarno as a quack. Having only skimmed through his most famous book, Healing Back Pain: The Mind-Body Connection, a few years ago, I can’t defend every idea in it. Maybe there were some elements of questionable science, some leaps of logic, or some plain old quackery.

But the basic idea that emotional or mental stress can cause pain shouldn’t be controversial any more. There are SO many scientifically plausible ways that this can work.

Dr. Sarno apparently argued that stress might contribute to “mild oxygen deprivation caused by reduced blood flow to muscles and nerves throughout the body.” That’s just one idea.

Another is that stress can activate your sympathetic nervous system (your so-called “fight-or-flight” system), and turn down your parasympathetic nervous system (your “rest and digest” system). When this happens, the body will not be able to heal as well, since your body is diverting resources to deal with immediate threats (even if those threats are just imagined). Your body doesn’t want to invest in long-term repair when there’s a fire to deal with!

Other research on placebos and “nocebos” (things that make you perceive more pain, even if they are harmless), has repeatedly demonstrated that the mind has an extremely powerful influence on the perception of pain:

The nocebo effect might even be powerful enough to kill. In one case study, researchers noted an individual who attempted to commit suicide by swallowing 26 pills. Although they were merely placebo tablets without a biological mechanism to harm the patient even at such a high dose, he experienced dangerously low blood pressure and required injections of fluids to be stabilized, based solely on the belief that the overdose of tablets would be deadly. After it was revealed that they were sugar pills, the symptoms went away quickly.

At IFAST, we often get athletes and clients of all ages who are dealing with some form of pain, whether it’s chronic back pain or an acute ankle sprain. We address those pains using all the tools at our disposal, including biomechanics, nutrition, and most of all, an understanding that the brain plays a huge role in pain.
If you’ve ever dealt with chronic pain, you might check out Dr. Sarno’s book (it’s less than $5 on Amazon!), or come try out what IFAST has to offer. We might just be the holistic approach you’ve been looking for.

If you’re a volleyball player (or your daughter plays volleyball), this might sound familiar…

“My back hurts.”

“My shoulder hurts.”

The fact of the matter is, volleyball players are rarely equipped to take on the physical demands of their sport.

Hours a week in the gym jumping, landing, cutting, serving, and swinging takes a toll on a body, when the physical foundation necessary to withstand that level of work isn’t there.

When this situation plays out, we get symptoms, and sometimes those symptoms become injuries.

Why does my back hurt?

Breaking this down in simple terms, think about the abs and the back as opposing pieces of a see saw.

If the back is hyperextended then they become dominant (the down side of the see saw) and the abs are left helpless and weak (the side of the see saw stuck in the air).

Now if you walk around in that position (like all volleyball players do), and you play in that position (like all volleyball players do), then we get back pain.

When the spine is hyperextended, the vertebrae opens up in the front and pinch down in the back. This pinching down occurs on the disc resting between vertebrae.

On top of that, when the back is stuck in hyperextension, the muscles in the back are ON 24 hours a day and the abs are OFF…or at least not in an optimal position to be strong.

Try flexing your bicep for a minute straight. If that wasn’t enough, try flexing it for 5 minutes.

Now, imagine a muscle not being able to relax all day or night. This muscle becomes upset and irritated.

Now we have a stiff and sore back on top of potential disc issues in the spine.

How do I fix my back pain?
Or keep it from happening altogether?

Pain is never a simple answer but from a training perspective, restoring balance back to the abs and back muscles will reduce back tension and allow the abs to be in a strong position to help support our hips and trunk and shoulders.

The spine rotates best when in a neutral position, and low back hyperextension is not a neutral position.

Hyperextension robs the body’s ability to rotate, so we end up forcing it and/or extending even more.

To help fix this, here are a couple ab exercises that help reduce low back hyperextension, restore balance back to the abs and back, reduce tension in the back and strengthen the abs ability to provide trunk rotation when swinging.

Why does my shoulder hurt?

Shoulders can be as tricky, and pinpointing exactly why it hurts can be risky because there are a lot of factors involved.

At the core of those factors though, is the core (pun intended!).

As we mentioned above, hyperextension of the spine robs the body of rotation, and the shoulder is not immune to this.

Spine position determines rib position, rib position impacts shoulder position and shoulder blade position impacts shoulder position.

When a shoulder is in a less than optimal position, and hundreds or thousands of swings are performed, we get shoulder pain.

Less rotation is available in the joint so we end up bumping into the joint when finishing our swing, or straining a muscle or tendon because this less than optimal position of the shoulder joint puts too much stress on it.

How do I fix my shoulder pain?
Or keep it from happening?

The answer is similar to the back pain solution.

If the hyperextension of the spine is the beginning point for putting the shoulder in a bad position, then we must start by addressing the position of the spine and get it back to neutral.

This also puts our abs in position to be stronger just like in the back pain example.

Now, my abs can control the spine hyperextension which puts the rib cage in a good position, which puts the shoulder blade in a good position, which puts the shoulder in a good position.

Here is an example of how we might make a back pain ab exercise into a shoulder ab exercise…

Conclusion

It all comes back to the abs.

But, training abs without taking into account body position will get a volleyball player nowhere, except maybe the training room to get treatment!

Get the back and hips in the right position, train the abs there, and then add some shoulder work on top.

If you follow this simple approach, you’ll not only reduce shoulder and back pain, but you’re training to improve performance at the same time!

P.S. – If you’re in the Fishers/Indianapolis/Carmel area and want to improve your vertical jump, please check out our Vertical Jump camp here at IFAST in July!

At IFAST, we host an annual powerlifting meet. I have been a part of 2 of them. One as an intern, loading plates and spotting. One as a coach and lifter. I know I am biased, but these meets are one my favorite things that we put together as a gym. The atmosphere of a powerlifting meet is like no other. The lifters and coaches are anxious. There is usually very loud music playing and its usually something like Pantera. Once the meet gets going the room fills with encouragement, cheers, and the sounds of plates banging. I absolutely love it! The sport of powerlifting is people pushing themselves to their limit and I love what that brings out in our IFAST family in our meet.

I love what these meets bring so much that I want to start a powerlifting team here at IFAST. The team would be welcome to any current member that wants to sign up. We would still have our awesome annual meet, which is July 29th, by the way, but we would also travel to meets that the team is interested in competing in. This a great chance to meet new lifters and show off how well the IFAST family can bench, squat and deadlift! I understand the difficulty of getting everyone to train together, but I am thinking we could meet up and train as a team a few times a month. Let’s go, folks! Come be a part of the IFAST powerlifting team. Come experience a supportive and encouraging environment while we all get a little stronger everyday in the process! I will be at the front desk or available by phone or email to answer any questions you may have.

 

 

 

I will be posting signs up at the gym with more information and if you have any questions, please ask me at the front desk.

I hope to hear from you soon!

If you haven’t read part 1 of this series, please go here first: Fixing knee pain… When there’s “nothing wrong” with your knee, part 1

Joint position and lost adaptability influence how your knee feels. It then stands to reason that regaining the lost adaptability should impact how your knee works and may impact that painful achy knee.

Here are a couple strategies you can start to work on to restore lost adaptability.

This recommendation is based on what is considered the most common human postures and movement patterns we all experience at one time or another (Zink, Lawson, 1979; Dunnington, 1964). This human pattern favors more of a right turn of your pelvis than to the left. This, in turn, alters your hip joint position and may restrict how your hip moves. Just like that song (the hip bone’s connected to the thigh bone, the thigh bone’s connected to the knee bone) changing the position of one part of your body changes other parts.

In this case, it may affect your knee position and movement.  Try this simple activity to start to restore normal adaptability to your pelvis, hips, and knees.

Seated hip shift

Sit with your hips and knees in about 90 degrees bend. Relax your back into the back of the chair.

Keeping your feet evenly placed on the floor, shift your right knee forward and your left knee back as far as comfortable.

Hold this position for 20-30 seconds while you breathe in through your nose and out through your mouth.

In part 3, we’ll look at some more complex and challenging activities to further impact your knee’s adaptability.

Until then, consider coming in to take advantage of our free IFAST Physical Therapy Injury Consult. We’ll answer all your questions and show you how quickly we can improve your knee pain. You are not under any obligation, and again, it is free of charge.

Call IFAST Physical Therapy today

on the northeast side of Indianapolis today for

your free injury consultation.

317-578-0998

 

I recently went on vacation to San Francisco with my wife and our five-month-old baby. It was our first time traveling on a plane with our son, which turned out not to be as horrifying as I had feared. I played solo daddy for four days while my wife went to a conference, and then we had a few glorious days of California sunshine, overeating, and spending time with friends.

Jason, our other morning coach and gym admin extraordinaire, wrote me a travel workout program. It consisted of things I could do without any equipment (push-ups, lunges) and was supposed to be no longer than 15-20 minutes long.

Unfortunately, I somehow managed to get through our entire vacation without once doing a workout. I had some fantastic excuses that I won’t bore you with (but if you must ask, I walked over four hours almost daily; our son slept poorly and kept us up all night; and having eaten way too much seafood the night before, I didn’t feel it was safe to disturb my digestion by moving around too much).

Anyway, after returning to Indianapolis, I felt like I was starting over from zero. This is very demotivating, and so of course I chose to wallow in my self-pity rather than actually start over.

Finally, after wasting another (few) weeks on feeble excuses, I decided that enough was enough and started exercising again. And you know what? After I started, it really wasn’t so bad.

There’s no trick. You just have to get started, and the resistance eventually melts away. It’s like procrastinating on anything — writing a term paper, filing your taxes, proposing to your girlfriend (I wouldn’t know anything about that one). Once you get started, it’s much easier to keep going. It’s just getting started that’s the hard part.

Okay, there is ONE trick. The trick is to make it as easy as possible. As low-resistance as possible. I’ve talked previously about how flossing just one tooth, as silly as it sounds, can eventually get you to get in the habit of flossing your teeth.

So when I did my first workout after my extended vacation, it was super easy. In fact, it was too easy.

Instead of warming up for 20 minutes, I skipped the warmup. (To avoid injury, I kept the weights light.) That way, I couldn’t tell myself, “I don’t have time to get a good warmup, so I’ll just skip this workout.”

Instead of doing three or four sets of squats, I did two.

Don’t tell anyone, but I even skipped my conditioning at the end.

I was done with my “workout” in 15 minutes.

What’s important is not that first workout. It’s the second, and the third, and all the workouts that follow.

So while I probably could have made myself work harder in that first workout, I was setting myself up for success over the next week and the next month.

We all get sick, take vacations, or find some other way to fall off the wagon. The next time that happens to you, try making it ridiculously easy for yourself (floss one tooth!) to get back in the habit, and let me know how it goes.

At IFAST we put a huge emphasis on position. By position, I mean how you are stacking yourself in an exercise or how you line up. When someone gets a program early on in their IFAST career it will include positional exercises. When I say positional exercises, I mean exercises that ask you to hold a position for a few seconds or a few breaths. So why do we take position so seriously?

The positions we may ask you to hold are laying a foundation for you to move around with more control in later programs. If we were to ask you to build a home on ground that wasn’t so stable, you can assume the house will not be as sturdy as it could be. If he we haven’t assured that you can get into a position and then own that position, we could be doing the same thing. We could be setting you up for failure. If you see exercises that seem very similar back to back in your program we are likely emphasizing the pattern that the two exercises support. We may ask you to hold a position for a few breaths and then complete a similar exercise where you are more dynamic or less stable.

This is something you might see in our Athletika classes. In large group settings, it can be difficult to coach everyone on every single rep. This is where position comes in. Tony and I may ask you to hold a position so that we have more time to coach you as an individual, have more time to see what everyone in class is doing, or make the work out more brutal. This is a very effective way to ensure you are laying a good movement foundation and keeping everyone safe in large group setting.

Examples of positions that will transfer over to larger movements that we use commonly at IFAST would be plank or squat variations that carry over to push-ups and squats. A plank from the hands will have more of an emphasis on improving a push-up while an exercise like a squat w/ PVC or a plate squat will likely be putting more of an emphasis on improving a squat.  When you see half kneeling or split stance exercises we are often going after patterning for a lunge or another exercise that may require a ton of control of one foot or hip at a time.

These examples may not be as exciting as a 500 deadlift but often learning ow to control a position can be what adds plates to the bar on down the road or being stable and owning a position is what is going to keep you lifting and able to complete that exercise later on in life. Next time you see and exercise on your program and you’re not sure why we are asking you do it, please ask. We love getting questions about our programming. Often times understanding why you’re being asked to do something will allow you to give the task more focus and will give you more context for the exercise and the progressions that come later in you programming.

We put a huge emphasis on position because controlling position is the key to lifting heavy, lifting fast, and lifting for a long, long time.

Question:  My knee has been hurting for a couple of months. My X-rays and MRI show no damage to my knee. My direct knee exam didn’t show anything either, but my knee still hurts. Any ideas?

Answer:  Many people suffering from knee pain seek help from health professionals only to be told that there’s nothing wrong with their knee.

That doesn’t mean there is no cause. After all, the knee does hurt.

In such case, it may simply be a loss of adaptability of the knee.

Knees obviously bend forward and back, but they also have a normal ability to twist inward and outward to a small degree. This allows the knee to adapt to uneven surfaces that you may not be able to see such as when walking across an unfamiliar grassy area.

If the twisting movement of the knee becomes limited by repetitive activities or a lack of physical activity, this may result in prolonged or increased pressure on areas of the knee. Over time, this may result in knee pain.

The photos below show what that presentation may look like. As you can see, this patient’s right thigh turns inward and the lower leg turns outward. In this case, if her knee is unable to twist normally, it could result in patellar tendonitis, patellofemoral pain (pain behind the kneecap), or create a general aching over the front or inside of the knee.

  

This type of presentation is not uncommon for any knee, painful or not. It’s only when the normal twist isn’t enough to adapt to your activities, or it’s even possible that it may twist too much (Heiderscheit, 2002). This can be identified during an exam.

In my next blog, I’ll be providing some strategies to help address this type of knee pain issue. Until then, consider coming in to take advantage of our free IFAST Physical Therapy Injury Consult. We’ll answer all your questions and show you how quickly we can improve your knee pain. You are not under any obligation, and again, it is free of charge.

Call IFAST Physical Therapy today

on the northeast side of Indianapolis today for

your free injury consultation.

317-578-0998

 

 

 

 

In this video, I discuss setting yourself up for success when pursuing a goal with a deadline. What are some of the components of successful goal setting and what may be holding you back? Click the video above and reach out to indyfast@gmail.com with any questions or comments you have about setting yourself up for success.

If you’ve been in the gym lately, you might have seen some signs floating around asking if you’d like to win $500 or get a nutrition plan that is made for you. These signs are not just flare for my lovely desk. They are promoting our upcoming challenge, Fit by the Fourth! I had a client recently ask “Why do we have these 30 challenges? I thought this was a marathon, not a sprint.” This was great question. Yes, more than likely any fitness goal you have will be best seen with the the long game in mind, but a challenge can absolutely help support long term goals. Here are ways that I see a challenge being beneficial to your long-term goals and how you could benefit!

Dialing In

A challenge is a great tool for dialing whatever may be your weakest link. If your weakest link is consistency in your workouts, meal planning, or tracking your progress a challenge could be a tremendous tool for getting things sighted in to go after that long-term goal. They can be a great way to get the ball rolling and lay a foundation of good habits that support what your long-term goal may be.

 

Easier to Digest

Another benefit to a month-long challenge is that they are much more palatable than someone throwing down a 12-month calendar of training and nutrition and telling you to follow it. I’m not saying a 30-day challenge is easy, but it is much easier to take into account the things you may face in 30 days rather than 6 months or a year. You can look at your calendar for the month and have a strategy for all of the events that may try and slip you up. Life is never predictable but 30 days are certainly more predictable than 180 days.

 

How can it benefit everyone’s fitness journey?

In my opinion, individuals at both ends of the spectrum could benefit from what a challenge has to offer. Maybe you have a higher body fat, struggle with nutrition, and need guidance.  A 30-day challenge could be a great way get you started in your fitness journey. The challenge would you give structure and support. This will be a good time to develop habits of planning, prepping, and discipline. After your 30 days of intense focus you will witness changes and hopefully those changes are what can motivate and propel you further along your fitness journey.

At the other end of the spectrum, maybe we have a client that is so close to a body fat percentage goal they can almost see the muscles or striations they want. 30 days of intense focus might just be what you need to blow everyone away at your 4th of July party.

We use challenges to build community, create healthy competition, and help people reign in focus to reach their goals. Sign up by May 26th to be a part of our Fit by the Fourth Challenge. For more information ask your coach for details or talk to me at the front desk! Have a great rest of your week!