Performance Place Sports Care Podcast

SHOW NOTES Funny… I reached out to Nate since he has such great Youtube videos for runners but after emailing back and forth for a bit I realized we met 7 years ago at an Ironman 70.3 where I treated his hamstring. What a small world! He has a great story about how he dealt with his hamstring injury and how he came to use those same methods to assist runners have better running experience. Nate Helming founded The Run Experience with the goal of reaching a broader audience of runners and outdoor enthusiasts who want to be able to run and enjoy the outdoors and remain injury-free. He has helped athletes finish their first races, conquer new distances, overcome pre-existing injuries, set new PRs, reach the podium, and qualify for national and world level events. Nate Helming is based in San Francisco and in addition to coaching runners and triathletes of all levels, he trains Olympic level cyclists, professional triathletes, elite mountain bikers, and national-level ultra runners on strength and mobility. Nate

SHOW NOTES In this session we are going into some personal accounts of hamstring strains. In school, clinicians seem to get the textbook presentations… then they get out into the real world of healthcare and see all of the uniqueness of people and situations. People are unique… this is why case studies are great. The patient’s I’m interviewing are not people I have confirmed have a hamstring injury but I did ask my network of people to find a “hamstring strain” for the interviews. Do we need to know if they are truly hamstring strains or not? No, the takeaway from this session will be that this is what people experience when they “feel they have a hamstring strain.” Other possible diagnosis for hamstring region pain are: Lumbar Radiculitis Referred Muscular Pain Sacroiliac joint Dysfunction Inflammatory/metabolic causes Amongst a bunch of other things... Always go see your sports doctor for a proper examination and treatment plan. Book an appt with Dr. Sebastian today! Sebastian’s Youtube Channel for hamst

SHOW NOTES In this podcast I’ll go over my personal experience with a hamstring tear to kick off hamstring month. I was devastated but have completely recovered. I’ll reveal all of my secrets: The story of how the hamstring tore The recovery period of the hamstring tear How I rehab a hamstring tear How to grade a hamstring tear How to return to play from a hamstring tear If you haven't seen yet, I'm doing a Youtube video a day for 2018 just for all of you to get extra information from the podcast. This month is all on hamstrings. Sebastian’s Youtube Channel for hamstring videos. Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here.   Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don’t get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam wit

SHOW NOTES Back pain isn’t the death sentence you think it is. Majority of people can get better with a little understanding and dedication. Dr. Stuart McGill PhD is a spine biomechanist at the University of Waterloo. Over the years, he has conducted numerous lab experiments on the human spine to figure out how much load it can take, what motions cause it to become injured and more. He’s the author of some awesome books, such as Back Mechanic: The Secrets to a Healthy Spine your Doctor isn’t Telling You, which was written specifically for chronic low back patients to better understand and resolve their condition. Dr Stuart McGill’s Bio: Dr. McGill is a professor emeritus, University of Waterloo, where he was a professor for 32 years. His laboratory and experimental research clinic investigated issues related to the causal mechanisms of back pain, how to rehabilitate back-pained people and enhance injury resilience and performance. This produced over 240 peer-reviewed scientific journal papers, many internatio

SHOW NOTES I recently contacted the National Strength and Conditioning Association (NSCA) region director asking for an interview referral for the best person on this topic… her answer was Dr. Seth Myers. I thought it was funny he was the top suggestion because he is also a chiropractor. I thought I was going to be given the contact of someone who only does coaching. Dr. Myers didn’t disappoint. Trained under the ideals of Dr. Stuart McGill PhD, he gave some great pointers on how we can address and prevent lower back pain while squatting, deadlifting, snatching and more. Here’s some topics we hit: - Assessment - Direction of tolerance or increase symptoms and what it means - Disc and type of injuries - Outcome Measures other than pain - Butt Winking (Spinal Flexion) - Intra-abdominal pressure - Core work and why - How to return to lifting - Fear avoidance Dr. Seth Myer’s Bio: “My name is Seth Myers and I am a Sports Chiropractor practicing at JointFit Chiropractic and Sports Medicine Center in Manhattan,  KS.

SHOW NOTES   I know it sounds boring but it won’t be. If you have back pain you must listen to this podcast at least twice. Think of it as a crash course in human anatomy and biomechanics. Why should you want to know about the anatomy when all you want is the pain to go away? Because to gain control of your condition, you need to understand the reason it’s occurring. A strong majority of people develop back pain because of their lifestyle. If we change our habits then we change our back pain. Simple (in most cases). You may be thinking, “I have a disc herniation that’s causing my pain.” That could be true but much of the time the disc herniation was there well before your back pain presented itself… and if you find times throughout the week when you’re pain-free then your back pain can be improved! Don’t blame the disc, blame the pain triggers… empower yourself and fight for a pain-free life. This podcast will give you the necessary tools you’ll need to understand the next two podcast sessions that will be no

SHOW NOTES In this podcast session, I wanted to share my personal story about low back pain. I developed lower back pain when I was playing high school baseball at the age of 15. It was not overuse related… it was traumatic. The reason I say this is because majority of people’s low back pain seems to come out of thin air. Mine was a definite event. The injury put me out of my sport for 8 months, during which I saw a Physical Therapist for 3-4 months, a Massage Therapist, a Chiropractor, an MD, an Orthopedic Surgeon and lastly a Chiropractor specializing in Active Release Technique and Exercise Science. Dr. Ron Higura’s office in Orange, CA was my last stop and my reason for working with people today. In this podcast I go over the follow: My Injury Mindset My Rehab My Treatments My Recovery My Strength Training My Mindset today My recover was a process. It took a lot of hard work. I have been without back pain for the last 20 years. Sebastian’s Youtube Channel Attention Docs and Fitness Professionals: Access

SHOW NOTES   After receiving my copy of the Gift of Injury, the story of Brian Carroll’s return to powerlifting after a horrific back injury, I asked the two authors to be on the podcast. Brian Carroll and Dr. Stuart McGill blend the worlds of science and powerlifting together perfectly… the moral of the story is that if Brian can feel better and win again then many other people/ weekend warriors/ athletes can overcome their back pain. Here’s Brian’s bio: Brian Carroll: Brian is a world class powerlifter with over a decade of elite class lifting under his belt. Coming back from a devastating back injury in 2012 that broke multiple bones that most experts said he would never recover from, he has returned to the pinnacle of world class lifting (while 100% pain and symptom free). He is now dedicated to helping others avoid the same mistakes that he made in the past through private and group coaching Brian flew to Dr. McGill’s lab in Canada for a full assessment and develop a plan of attack. His goal was to be at

SHOW NOTES Have pain you don’t consider an injury but it lingers? Are you strong but constantly experience joint pain? Is your squatting form solid but your back still hurts? This is the podcast for you. Honestly this could be the most ground breaking concept you’ve ever hear as an athlete, lifter, runner or even health care clinician. I met Dr. Richard Ulm DC in Long Beach this year at the Perform Better Summit, where he was speaking about the concept of Functional Capacity, Functional Gap and Compensation Patterns. The concepts he talks about in this podcast are derived from Vladimir Janda’s Lower Cross Syndrome and furthered by the work from Pavel Kolar. Dr. Ulm takes the concepts of both and translates them to high performance movements and the compound movements we use in the gym every day. Squats Deadlifts Jumps Etc Bodybuilding.com article (In the editing process to be published) Correlated Videos: Loading the Foot https://www.youtube.com/watch?v=JIfG9ihWZ3Q Shutting of the ECSS https://www.youtub

SHOW NOTES Why is being strong important? Why do we need “Anaconda Strength?” Why should you put down your morning latte and listen to this at the gym? Dan John, a world renown strength coach and public speaker, goes over these points as my guest today. I first heard Dan speak over 8 years ago at a RKC Kettlebell certification. Simply put, he makes complicated exercise/ movements simple. We spent 2 days learning the Kettlebell Swing, Goblet Squats, the Plank, the Birddog and Turkish Get-up… I was doing them all wrong prior to going. Learning the Birddog was like no other… have you ever done a Birddog that made you sweat? I hadn’t… that’s because I wasn’t creating enough tension. Knowing when to turn tension on and off is important for strength, injury prevention and being able to relax. Dan goes into this concept as well as physical attributes needed to be a healthy, functioning weekend warrior. The Quadrants - For Physical Goal Setting https://www.otpbooks.com/dan-johns-four-quadrants-infographic/ Tension

 SHOW NOTES Did you know there’s no pitch count restrictions in youth softball? Baseball has implemented one to protect our youth, so why not softball?   If our competitive softball players are going to play so much we should take the necessary steps in the off-season to get them healthy again.   Nancy Newell dropped a knowledge bomb on us today. This podcast is a must listen for competitive softball players, softball parents, coaches and strength coaches. She gives a ton of great information on performance and prevention of shoulder pain.   Here are just some of the topics:   Owning the sagittal plane Put the softball down Get better sleep   I wanted her to go more in-depth about an article she wrote about the top 10 offseason priorities for softball players. You can find her article here.   Here’s a few videos we covered:   High Tension Deadbug   Standing 1-arm Cable Row   Push-Up   Half-Kneeling 90/90 ER Holds   DB Goblet Squat   Anterior Humeral Glide   You can reach Nancy through her website. http:/

SHOW NOTES Numbness and tingling of the hand, arm, and forearm is an extremely common “injury” for both athletes and non-athletes. I figured we needed to do a podcast session on the upper extremity exclusively and Dr. Fontaine was my go-to-guy. The causes of numbness to the hand range from a pinched nerve in the neck, to Carpal Tunnel Syndrome, to a peripheral neuropathy and much more… each condition is treated slightly different… it all starts with proper diagnosis.  Dr. Matt Fontaine walks us through some reasons for paresthesia or loss of sensation into the upper extremity and some common questions. Some topics we cover are:   Double Crush Syndrome The meaning of Negative Nerve Conduction Tests How much a nerve should slide Ulnar Nerve  https://www.ncbi.nlm.nih.gov/pubmed/11466640 Radial Nerve https://www.ncbi.nlm.nih.gov/pubmed/16182056 Logic of how to find the location of the trapped nerve Treatment options What’s the longest you should wait for the “wait and see” approach   Dr. Matt is extremely

 SHOW NOTES Tim was featured on Session 37 where he went into some really cool tips for engaging the deep core muscles using a balloon breathing technique. Back by popular demand, I interviewed Tim on the fly again about Pilates.   What is Pilates? How is Pilates different than Yoga? Does Pilates burn a ton of calories? Differences of Pilates floor work vs machines? Why you shouldn’t do selfies, and what is #grind…. enjoy.   This was a fun one… he really started to twist the knife on if I look like Paul Rudd or not. You can find out picture references here.  Reach Tim on his website timfleisher.com or email him at tim.fleisher@gmail.com.  

SHOW NOTES In this session I’ve picked the best questions from the last few weeks and spent 10 minutes or so answering each.   Case 1: Hip Pain with Cycling “Hi Doc, I've been doing insanity 4 days a week for over a year plus road cycling, a bit of running and swimming without any injuries thank God. Now it's been 3 weeks I haven't done any sports.. and I planned to start again on next Monday.. but this kind of hip pain (Rectus Femoris Origin Strain) just came to me today.. I didn't hit anything nor anybody hit me.. it just came to me all of a sudden. What causes this? Many thanks in advanced.. Cheers!”   Case 2: Ankle Impingement “8 months ago i had a bad ankle sprain which lead to persistent ankle anterolateral impingement which results in slight overpronation and slight valgus heel and hence wrong gait also impair any weight bearing activities...The problem is persistent and no improvement with normal physical therapy exercises. I'm about to go for a surgery of ankle arthroscopy but i want to ask you if yo

 SHOW NOTE Sitting will be the death of us. We often times sit for 8-10 hours at work, sit in our car to drive home, and sit to eat dinner. In this day and age, sitting is what most people do throughout their days. In this podcast session, I speak with an ergonomic specialist, Dr. Kevin Christie. He gives some awesome tips on how to sit better and what else we can do to decrease the effects sitting has on our body. Dr. Christie’s podcast “The Modern Desk Jockey” https://itunes.apple.com/us/podcast/the-modern-desk-jockey/id1139780808?mt=2  targets how we can improve our work life through better ergonomics, posture, mini-breaks and more. In this session, I dig deeper into some tips for your work station at your job and at your house... but this information just scratches the surface of what you will learn from his podcast series.  At the very end, he drops some business tips for fellow chiropractors and healthcare providers looking to build their practice. You can reach Dr. Christie at his practice http://www.

SHOW NOTES In this session I have my first live caller! I have known this person for a long time so I was very blunt about the suggestions. Too bad I can’t do this with everyone the first time. He's been suffering from an ankle injury for the past few weeks but can also recall also injuring it in high school (hint possible unaddressed old injury). He also had a past hamstring injury on the same side. The questioning process may seem random in the beginning but this is the history taking process of an exam. Granted I am not looking at him in person but we do get some insight to his corrections through conversation. Highlights: He stretches way too much in comparison to his resistance training, rehab and movement drills Suggestions: Work on trunk stabilization Warm up better Work on acceleration and change of direction drills during the week Add more rehab (local and global stabilization) to his weekly plan Understand the connection between the ankle and the torso/ pelvis more Act like an athlete not a weekend

SHOW NOTES  This is a solo podcast today on a few questions I have been asked my opinion on over the last few weeks. It should be fun!   Why can’t we get grandma to exercise? Age related corrections or suggestions for rehab and exercise. Strength and Conditioning guidelines for youth athletes. How much is too much? The ACSM stance What is an injury vs. pain? How long should a warm up take and what should it entail?   From a Sports Medicine point-of-view, warming up will take as long as it needs to. There is not set time, but a well designed warm up should take around 15-45 minutes. Warming up before lifting should address the following:   Getting the blood moving Preparation of movement Stabilization of the feet, knees, back, and shoulder girdle Mobilization of the ankles, hips, thoracic spine, glenohumeral joints and the neck   Access the show notes.

SHOW NOTES  Dr. Justin Dean was nice enough to take time out of his busy work schedule from many time zones away to educate us about running injuries, specifically a foot condition called Plantar Fasciitis.   It’s important to note that we both used the term “Plantar Fasciitis” loosely in this interview because the term is so loosely used in the the runner world. The term actually means irritation to the structure called the plantar fascia, but most people use it to describe “foot pain.”   Dr. Dean has been working with high level runners in China for about a year now and has more continuing education than most MDs, PTs, DCs and ATCs. Last year he mentioned he traveled to more than 30 continuing education seminars… most of us do 4 at the most in a year.   Listen to this podcast session and learn about a few actionable things you can test and try if you’re experiencing foot pain from running. Sorry about the Skype lag we had on this one… China IPs were tricky.   Dr. Justin Dean's Website: https://drjustindean.

SHOW NOTES Have you ever wondered if you are eating enough protein? How much should you take to lose weight? How about if you are running a marathon? If you are trying to just stay alive? That’s right… if you don’t eat enough protein you will die. But how much is enough?   Andrea Marincovich, a Registered Dietitian, is my guest on the show this week. She will go over all of the numbers and calculations related to having the right about of protein for your lifestyle.   Some calculations: Body weight (lbs) / 2.2 x (grams of protein) = daily grams of protein needed  Correlated Video: https://youtu.be/zENRhO26xCM  For grams of protein: 0.8 = bar minimum 1.7 = distance runner or recovery from significant trauma (breaking the skin) 1.1 - 1.2 = recovery from an “overuse image” 1.1 - 1.3 = Resistance training while improving body image   References: MyFitnessPal App   Andrea contact information: Facebook AMarincovich@gmail.com

SHOW NOTES In this session I go over some question from listener’s emails about their own injuries.   Case #1 Knee pain after going on a cruise ship Article to read   Case #2 Shoulder/ Trap pain with surfing Article to read   Case #3 Neck pain after a Crossfit workout None currently   Case #4 Knee pain after golf and cycling weekly It will be here when it’s live   I go into each of these cases and break down some rehab and treatment ideas they could try next. I also go into the probable cause of their pain and some references they could look at.   You can access the show notes at https://www.p2sportscare.com/podcast/   Dr Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don’t get confused by what your doctor told you in your appointment.