Therapy

Cystic Fibrosis Awareness Month

I recently learned May is Cystic Fibrosis Awareness Month. Cystic Fibrosis (CF) is a genetic disease that affects the lungs and digestive system, specifically the pancreas, with build-up of abnormally thick mucus. Because of this build-up, CF patients are prone to multiple and severe lung infections, as well as the inability to properly digest and absorb nutrients from food.

Well, a close family friend, Jamina “Lil’ J” Winston, has CF and in January, had a terrifying experience while visiting New York City. I received a frantic call from my sister saying she was flying out to NYC and let me know Jamina was in the hospital and it didn’t look good. I am about 2.5 hours away from the city, so I told my bosses that I would likely be disappearing for a few days (I am very lucky to have the supportive network here that I do).

Cystic Fibrosis Foundation Great Strides Walk 2009. My sister is the pink one (fundraiser) with Jamina kneeling just behind her left shoulder.

 

After a few scares and crashes, Jamina was able to communicate via notepad (she was on a ventilator and unable to talk). Even though she had been close to death for a week, down to 65 pounds, and filled with tubes, she was still able to crack jokes and (silently) laugh while I was with her. Amazingly, her sense of sarcasm was still evident in her writing and body language. To illustrate just how amazing of a person she is, Breaking Muscle had an article on Jamina and her battle to continue swimming with CF.

Lil’ J in her full hospital get up, yet still chipper.

Now time for the good news. This past weekend, Jamina received a double lung transplant and within 24 hours, she was off the ventilator, sitting up in her chair, and able to walk. This is an exciting, but expensive, development for Lil’ J, as her main caregiver (her mother) had to leave her job to move closer to the Duke medical facilities (one of the top CF/lung transplant facilities in the country).

I believe we will find an answer for cystic fibrosis in my lifetime, however this will not happen without increased awareness throughout the public. Please take the time to visit the Cystic Fibrosis Foundation website and Jamina’s fundraising site to help cover medical expenses, and help spread the information available. I am not asking for anything more than your time to learn more about this disease. Everyone has a cause they fight for, and this is mine.

If you are able to help support Jamina and her medical expenses, please visit her donation page here. If you would like to donate to the CF Foundation, you can contribute to the 2013 Cystic Fibrosis Foundation’s Great Strides Walk. Please share this post with family, friends, coworkers, and as many people as you feel would be interested in learning about it. I appreciate your time and interest in this matter.

All the best,

Drew Henley, CSCS, USAW, CES
480-241-4112
Drew@HenleySP.com
Twitter.com/DrewBHenley
Facebook.com/HenleySP

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6 Investments for Your Health (That are Worth the Money)

1. Foam Roller

I’ve mentioned on numerous occasions my love for foam rollers, and it still bears repeating – if you don’t have one, get one. For about twenty bucks, you can’t find a better deal to help your body.

2. Tennis Balls

As great as a foam roller is, sometimes it’s better to have something more localized. Tennis balls act as a poor man’s shiatsu massage, hitting on specific trigger points with more pressure than a foam roll can produce. Also great for smaller areas such as feet and the posterior shoulder. If you get a sleeve of three, keep one as a trigger point tool, then tape the remaining two together to form a peanut. The peanut is great for going along the spine and can be used for soft-tissue work or T-spine mobilization.

3. Theracane

Unless you’re lucky enough to have someone on call for massages whenever you please, you can’t do much better than the theracane. There are some areas (like the upper traps) that are hard to work on with the foam roll or tennis ball.

4. Ab Wheel

My favorite tool for training the abs, the ab wheel has stood the test of time and far outperformed any other “six pack abs” device. The abdominal muscles, as well as the lumber spine, were not made for repetitive flexion. The proper function of the rectus abdominis (the main abdominal muscle trained with crunch-related exercises) is to resist spinal extension and hyperextension, which is trained with the ab wheel.

5. Quality Shoes

Many leg and lower back issues caused by exercise can be attributed to improper footwear. My personal preferences are Asics and Brooks, but there are several other good brands (New Balance, Saucony, among others) available, I’ve just learned these fit my feet well. The human body is built from the ground up, a poor base will lead to other problems up the chain.

6. The Right Gym

Depending on what you need or want in a gym (pool, basketball, racquetball, etc.), the cost can go from modest to pretty absurd. Many gyms sound great with the bells and whistles they feature, but how much will you actually use them? The gym I grew up in was subsidized by the city and only cost $100 a year, which will only cover 2-3 months at some of the chains. There were no frills, no extra amenities, and it worked great for me. It might not have been the best fit for others, but for me it was perfect. I recommend looking into private personal training based gyms, most will offer times other than your scheduled training sessions where you are free to use the facility.

This is only a partial list, but it is a good place to start if you’re hoping to move & feel better. As always, if I can ever help out in any way, please don’t hesitate to contact me.

All the best,

Drew Henley, CSCS, USAW, CES
480-241-4112
Drew@HenleySP.com
Twitter.com/DrewBHenley
YouTube.com/DrewBHenley

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Introducing Dr. E and The EDGE

As I have mentioned, there are a lot of exciting changes coming to Henley Sports Performance, and one of the biggest is the partnership with Dr. Erson Religioso III. Dr. E is an Orthopaedic Manual Physical Therapist and the creator of The EDGE tool for assisted soft tissue manipulation. If you have been following the site, you’ve likely seen a few links to articles or videos Dr. E has posted on his website, www.themanualtherapist.com. Today, I would like to officially announce the partnership between Henley Sports Performance and The Manual Therapist. Dr. E has taken the time to answer a few questions for my readers about The EDGE and OMPT in general.

I need to be honest, I’ve been looking forward to this partnership ever since I received my EDGE in the mail. It’s an amazing tool that I use all the time on myself. Can you explain who should be using The EDGE and relate it to the other soft tissue manipulation tools on the market? 

Dr. E: Thanks Drew! This is an exciting opportunity! I designed the EDGE to be used by any health professional who is licensed to perform soft tissue manipulation on a client. The practices acts may vary from state to state, but that includes physical therapists, chiropractors, massage therapists, athletic trainers, occupational therapists, and osteopaths. Some in the Sports Performance world have purchased it for self treatment, which is fine, but I always recommend being evaluated by a health professional, particularly one who specializes in manual therapy for anything more than self treatment of simple tightness or limitations in movement.

There are definitely a lot of tools on the market, including a direct copy of mine. I originally designed it to be a versatile system, an all in one that was easily pocketable, relatively light, but high quality stainless steel. I believe the price is not the only value you get with the EDGE. The main thing I can offer is a willing evolution and open source community. I am always looking for feedback and evolving the shape/design every 1-2 iterations of it. I can also offer something my competitors don’t, which is regular and updated instructions and videos, even by request on my blog, facebook, and twitter pages. I use it daily, on all types of patients, from head to toe. I also teach courses in it locally in Buffalo, NY, or in house if your facility prefers.

I can say I’m very pleased and impressed with mine. So other than The EDGE, what methods do you use with your patients to facilitate recovery?

Dr. E: I have several certifications which lead to my specialization. I am credentialed in Mechanical Diagnosis and Therapy, by the McKenzie Institute USA, and also a Fellow of the American Academy of Orthopaedic Manual Physical Therapists. Much of my caseload is spinal, headaches, followed by general orthopaedic conditions. I try to combine the best of what the literature reports as effective and valid, like MDT for the spine, spinal manipulation, and stabilization with what actually works clinically, like soft tissue manipulation. I use both functional or movement based release, and instrument assisted release for “issues in the tissues.”

Other than hands-on work with clients, you work with several universities and students, correct?

Dr. E: Yes, I teach for 3 doctor of physical therapy programs, D’Youville College (my first alma mater before doctorate), Daemen College, and State University of New York at Buffalo. I also teach and mentor post-graduate physical therapists for the Orthopaedic Manual Therapy Fellowship programs at Daemen College, the McKenzie Institute USA, and Evidence in Motion. In addition, I am working on starting up a certificate in Orthopaedic Manual Physical Therapy at D’Youville College, and also teach continuing education courses in Neurodynamics, Spinal Manipulation, Comprehensive Soft Tissue Manipulation, and Temporomandibular and Craniofacial Pain.

You also run your site and maintain an incredible YouTube channel (which can be found here, it is an amazing resource for anyone who works on the human body and improving movement). Is there anything I am missing?

Dr. E: Well, I have a consultation practice within Rose Physical Therapy, owned by my good friend and former mentee Dr. Terry Rose, DPT, MS, FMS, FAAOMPT. We work very synergistically and have a blast daily! Both of us decided to go out on our own after working in management positions for 10+ years just about 1 year ago. The businesses are both doing well!

It seems as though much of your work is improving tissue quality to correct imbalances, deficits, etc. What can individuals do to maintain healthy tissue quality? 

Dr. E: It is! Although “issues in the tissues” are just one part of the problem. We look for dysfunction in the entire neuromusculoskeletal system. That being said, movement is key. The average person bends forward thousands of times a day. They also spent much more time sitting than standing. Get up and move! Try not to sit for more than 30-45 minutes. Get up and backward bend at your waist 10 times/hour. Sit upright, like everyone says their mother told them too (only she slouched too!) If everyone sat upright and moved more often, there would be a lot less general headache, neck, and lower back pain.

For the athletes, train globally and functionally. Seinfeld actually said it best “Lifting weights only makes you better at lifting weights.” Rest appropriately. Static stretching has pretty much been disproven to decrease injury, and some studies show may possibly decrease performance. However, early evidence shows dynamic stretching may be effective. Get screened by an FMS expert for injury risk assessment. Go to a manual therapist for evaluation at any signs of pain that can’t be helped with movement or form correction. Hydrate often!

More importantly, how do you think manual therapy and sports performance/strength & conditioning work together to reduce overuse injuries and maintain physiological balance? Athletes and people in general perform better when we are free of pain and in a state of homeostasis, what do you notice is lacking from individuals and their exercise programs?

Dr. E: I would say the average consumer or patient ends up on the wrong end or even the top of the bell curve. There is a bell curve in all professions.  What is lacking in both avenues, rehab and performance training is a “no pain no problem” attitude. Dysfunction and poor movement does not always equate to pain until it’s too late. In an ideal world, a physical therapist would screen at least annually, similar to a primary care physician. If we had “well visits” most likely a lot of overuse and postural based muscle imbalances could be prevented.

What is lacking in both professions are really science based programs and 1:1 personal sessions that base the patient’s or athlete’s program on them as individuals. It requires commitment on both ends. Training, and rehab, which are really just aspects of the same thing, but on different ends of the spectrum, require both parties to participate. Goals take work and there are no magic cures.

My colleague said at the FMS course that your average physical therapist doesn’t take the patient far enough. Referrals work both ways and once we get our patient pain free, it is certainly appropriate to send them on for further strength and/or performance training with a qualified trainer if you as a therapist do not have the facility, time, or training to do so. Both professions can learn a lot from one another!
 
I couldn’t agree more. It’s important for therapists and strength & conditioning professionals to have connections that allow the transfer of patients. I have been fortunate to work with excellent physical therapists and athletic trainers with whom I was able to transfer care with ease.  When an athlete I trained gets injured, I send them directly to the medical staff and once they are able to return, the PT/ATC trust me to correct the underlying problem. Without effective communication and transference of patients, there would be a lot more recurring injuries.
 
Thank you again for taking the time to inform my readers on your side of the industry. Keep the great information coming Dr. E!

Please be sure to visit Dr. E’s website at www.themanualtherapist.com and all the resources he provides. You can also see his most recent posts here, in the sidebar to the right. 


In addition to this new partnership, I am proud to announce I have successfully completed my NASM-CES certification and will provide details on the credential and my thoughts of it in the future. As always, if you have any questions, comments, or requests, please feel free to contact me at any time.
All the best,
 
Drew Henley, CSCS, USAW, CES
480-241-4112
Drew@HenleySP.com
Twitter.com/DrewBHenley
YouTube.com/DrewBHenley 
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5 Goals Every Program Needs

Last week, I posted three of my training principles (scroll down to #2) that help dictate the programs I write and how I work with my athletes. These principles help establish my mindset when I am writing workouts and act as starting point in program design. Since we have established some aspects that should be considered prior to beginning a program, today I am going to outline five goals every program should achieve by the end of the training cycle.
#1 Address any Injuries, Imbalances or Deficits – As I have said before (here and here), I believe it’s almost impossible to have a successful training program without a thorough assessment. It is necessary to find any muscular imbalances, range of motion deficits, and learn as much about previous injuries as possible prior to beginning training in order to maximize gains and performance. Athletes will become physically unbalanced over the course of a season, so it is important to restore them to their balanced state. For example, pitchers complete thousands of repetitions of shoulder horizontal adduction, internal rotation, and scapular protraction. To balance this, a program should contain plenty of shoulder horizontal abduction, external rotation, and scapular retraction. Also, a balanced athlete is less likely to be injured, which brings me to my next point…
#2 Minimize Potential for Common Injuries – It’s important to note I didn’t say “Prevent Common Injuries” because that is an impossible promise to fulfill. However, we can train in a manner to reduce the likelihood of an injury by strengthening the tissue that is commonly damaged. Think of a basketball player with weak ankles, instead of consistently wearing ankle braces except that one fateful day, train dynamic balance to strengthen the ligaments, tendons, and muscles of the ankle and foot.  Another example is female basketball and volleyball players and ACL injuries. Women are at a higher risk for non-contact ACL injuries (which, according to the National Academy of Sports Medicine, account for 70-75% of ACL injuries) due to their increased Q angle. A good way of training to limit this is to train more eccentrically to help the athlete learn how to properly stop and change directions safely.
#3 Train Movements, not Muscles – Great lesson I first picked up from Vern Gambetta’s book Athletic Development. The result is to improve how an athlete moves and functions, not just individual muscles. This keeps the focus on the big picture (sport performance) rather than looking good in the mirror or building impressive 1RM numbers. Movements are complex actions involving intricate coordination between several body systems (nervous, muscular, skeletal, etc) and precise firing patterns of muscles across the entire body. By learning to perform sport specific movements efficiently, athletes are able to…
#4 Achieve Automaticity – Don’t ask me to say automaticity because I stammer worse than Nemo trying to tell the class he lives in an anemone (if you don’t know what I’m talking about, you have lived a sad, sad life and need to stop reading this so you can watch Finding Nemo immediately). Thankfully, phonetics isn’t (always) a requirement to training athletes to achieve automaticity. As I mentioned before, Dr. Gabriele Wulf’s research has shown that an athlete is capable of improved reaction skills when handled on a subconscious level. When athletes are able to move without dedicating conscious effort to the specifics, they can act and react faster to their environment.
#5 Improve Sport Performance – This should go without saying, but the primary goal of a training program should be to improve the athlete’s performance in their sport. Training is a means to an end, not an end in itself. If an athlete adds 50 pounds to his squat 1RM, but does so at the cost of his agility, thus resulting in a decline in performance, then the training program failed. Athletes can always improve, it’s just a matter of choosing the proper areas to address. Be sure everything is geared towards improving the performance in the sports arena, not the weight room.
These are just the five universal goals of every good training program, with plenty of room for addition for individual needs. I hope your programs address all of these goals and your athletes are reaping the benefits. If not, I strongly advise you look through your programs and be sure you can say “yes” to everything listed above.
Let me know your thoughts on these five goals or how you work with your athletes to achieve them. If I can ever be of assistance to you or your program, please feel free to contact me.
All the best,
Drew Henley, CSCS, USAW
480-241-4112
HenleySportsPerformance.blogspot.com
Twitter.com/DrewBHenley
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Articles & Videos You Should See 11-14

I hope everyone had an enjoyable weekend for the holiday and showed their support for all those in our armed forces for their sacrifices they have made to allow us to enjoy our way of life. Here are this week’s Articles & Videos You Should See.
Articles
Resistance Training vs Static Stretching – In sports where flexibility is at a premium (swimming, gymnastics, baseball pitchers, etc.), it can be difficult to convince athletes to participate in weight training. They fear that the strength gains somehow come at the cost of their flexibility. This study will give you something tangible to get them into the weight room.
This Christmas Help an American Business – This is NOT a sales pitch of any sort. It is actually a great message and way to give during this holiday season that not only provides a service to your loved ones, but also helps others in your community by supporting local businesses. I will certainly be incorporating this into my holiday shopping this year.
The One Arm Press – I’m a big fan of unilateral training, especially single arm presses (great for hitting the core as well as smoking your shoulders). I’m not saying they should be in every program, but Dan John does a good job describing his method and use of the exercise.
Technique Highlight: SLR with Traction – An…interesting technique for improving hamstring flexibility and ROM of the hips. But Dr. Erson Religioso makes a point of reserving it for clients or athletes you’re sure can handle the technique. I’ve always been intrigued by the use of traction in therapy and this is another reason why.
Thoughts on the FMS Level 1 – Another appearance by Dr. E, this time his thoughts after attending the Functional Movement Systems seminar. I have used some of the aspects of the FMS in assessing athletes, but have not yet had the pleasure of attaining the certification. It is certainly on my list, right after I finish studying for the NASM CES advanced specialization. I liked his recognition that this industry needs the collaboration of all areas – strength & conditioning, physical therapists, ATCs, and doctors – in order to thrive.
The Myth of Symmetrical Programs – Great post by Mike Robertson on program design. To oversimplify it into a single sentence, programs should only be balanced if the athlete is balanced to begin, otherwise the goal is to ATTAIN balance. I highly recommend taking the link regarding row and bench as counterparts, lots of good information in there as well.
Videos
Hands On Neutral Spine – If your athletes are having problems with their deadlift technique, specifically rounding the back, Tony Gentilcore provides a great training tip. Have the athlete slightly bend the knee, then lower their shoulders until they rest with their hands on their knees. From this position, have the athlete lower their hips and shoulders at the same rate.
Volleyball Practice Warm Up and Strength Training – Great video by Joe Bonyai. I especially liked the mobility drills he has throughout the clip and would recommend most sports (not just volleyball) utilize them in their programs.
All the best,

Drew Henley, CSCS, USAW

480-241-4112

HenleySportsPerformance.blogspot.com

Twitter.com/DrewBHenley

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