Wednesday, July 31, 2013

Improved Performance: It's Not Just for Athletes

As specialized performance physical therapists we deal with a wide range of patients, from athletes on the field to athletes in the game of life. If you're a collegiate or professional athlete you already understand the importance of having the right team in your corner to keep you moving in top form. However, most of us are not professionals in sport or movement. We enjoy it for the sake of the activities we perform. Each of us can strive to be the best golfer we can be, the fastest marathon runner or best player on your co-ed flag football team. No matter the sport, if you enjoy doing it, you should highly consider seeing a Physical Therapist to help improve your performance.


So you play a sport or prefer a certain activity but you have pain?
Very often, pain with movement is related to acute injury or repetitive trauma in a movement picture that isn't operating with the best mechanics or structural balance. Movement patterns’ is a phrase that is flying out of the mouths of movement pros everywhere. You will hear strength coaches, personal trainers, athletic trainers and physical therapists use it. What you have to understand is that a physical therapist is the only pro who can watch someone move, understand the pattern and address the deficient pieces.

These patterns are based in neuroscience, primitive reflexes, and some very specific anatomy that no other pro is trained in to this combined detail. A strength and conditioning pro talking about these pieces of the movement puzzle is like a busboy trying to bake the perfect souffle; it might work out in the end but not after a LOT of trial and error. It's best left to the right professional.


Who's in your pit crew?
While the majority of us may not be competing at the highest levels, lots of smart folks are becoming aware that you don't have to be paid to play in order for you to have the team of pros that will keep you moving well and having fun.

In the past, these people might seek the help of their local PT Mill physical therapist. This is a good start. That physical therapist is going to be able to diagnose the cause of pain with great accuracy and then develop a plan to decrease it both acutely (right now) and for good. Problem is that the 'Mill' physical therapist isn't really equipped to take their clients much further than just "good enough". There are lots of reasons for this which we've chronicled in previous posts.
 

What if you want to get better than "good enough"?
Some people turn to their exercise pro. Strength coaches and personal trainers are great resources. Their skills in exercise technique, safety and effectiveness are excellent. Problem here is that they are not trained in any way to handle a client when pain creeps in. Some people think to themselves, “I’m not moving the way I want I move, I’ll just go see my personal trainer and I will become a better mover by becoming more fit.” We in physical therapy have a phrase for that – "adding fitness on top of dysfunction". It's a common problem and the one's who are the most blind to it are the trainers and coaches themselves! The best your strength coach can do is avoid the painful movement and design programming 'around the problem'.

Each of these strategies will help you deal with your pain but neither of them alone is the way to your highest movement efficiency and lowest pain possible. The power of a performance-minded, HYBRID physical therapist AND strength pro is unmatched in this niche of recreational and professional performance. The ability to directly address pain right when it's happening and then design and implement the plan that will knock it out for good is the most powerful skill set around. And now, you can have this high level treatment approach too! There are lots of HYBRID physical therapist/strength coaches out there. Problem is they are too quiet! That and they're too busy! These pros are highly trained, highly sought after and have the most profound impact on people's lives that most just let their work speak for them.
Your right hand man (or woman) should be a hybrid NEW BREED physical therapist. We will most efficiently pick out the areas of poor function, address them and then systematically reinsert them into the overall high level movement pattern they belong to. Even if you're not complaining of acute pain, we can help you work to keep it that way. With this approach, if something does occur, we can pinpoint why and what we should do to correct it immediately.

How are hybrid physical therapists/strength coaches changing the field of physical medicine?

In a perfect PT world, clients would have their hybrid physical therapist at top of mind for all movement related pain and to constantly be looking for ways to make them maximally efficient and powerful movers. Clients see us, similarly to how they see their dentist. You have your check-up set once every couple months. If everything checks out, we schedule another check-up 3-4 months out. But if the client is in pain or during a check-up we find a movement issue we address it with a few treatments and have that client back on their way. It all comes down to the way physical therapists assess MOVEMENT– even people without pain may have room for improvement. When we say, “all the way well”, we mean the solid foundation for an overall improved quality of life.

What’s the danger in throwing some endurance and strength at a faulty system? Further dysfunction. Simple example: If you had 50% strength in one hip, and do a normal back squat, you use one side more than the other and build strength in an asymmetrical manner. This widens the disparity between the sides and leads to greater compensatory movement and imbalance; the type which your trainer will never understand so don't bother trying to explain it to them. Now, if that trainer decided to go and become educated as a physical therapist, they would soon see the error in their approach. It's novice level physical medicine thinking. I'm not going to give my plumber a hard time for giving me incorrect info about an electrical problem I have, so it's not fair to blame a trainer for a physical medicine mistake as they've never been educated about it.
Are you a physical therapist who wants to boost their skills and truly be an asset for your patients, you know, like the actual reason you went to school for all of those years....?
Start sharing posts like this. Write your own. Connect with mentors and like minded physical therapy friends and have these conversations with your colleagues. If you're not incorporating some formal training of performance, physical strength, flexibility, or power movement, progression you aren’t what's best for your field or your clients.


Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. In addition he holds a Master's Degree in Clinical Exercise Physiology. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. The concept of 'all the way well' in his work as a physical therapist and fitness professional is what continues to drive Dr. Berio to be the best movement specialist there is.

Dr. Berio is the founder of SPARK Physiotherapy in Alexandria, Virginia. A clinic and approach designed from the ground up to set the new standard for integrity and patient satisfaction in the PT industry. Carlos remains active in several sports and enjoys agility training, power lifting and adventure races. He is an advocate for his patients, clients and his fellow PT colleagues. He can be reached at cjberio@sparkphysio.com

Tuesday, July 23, 2013

SPARK Physio Radio Show: Invest. Improve. Ignite. The new-breed approach to save physical therapy.

In this episode of the SPARK Physio Radio Show Dr. Carlos Berio talks about the SPARK Physio mantra of: Invest. Improve. Ignite!


Listen to internet radio with SPARK Physiotherapy on BlogTalkRadio

Tuesday, July 16, 2013

SPARK Physio Radio: Athletes: Your Body IS the Game - Play It Well

In this episode of the SPARK Physio Radio Show Dr. Carlos Berio discusses the importance of Physical Therapy for performance improvement and injury prevention in athletes.


Listen to internet radio with SPARK Physiotherapy on BlogTalkRadio

Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. In addition he holds a Master's Degree in Clinical Exercise Physiology. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. The concept of 'all the way well' in his work as a physical therapist and fitness professional is what continues to drive Dr. Berio to be the best movement specialist there is.
Carlos remains active in several sports and is an avid agility training, power lifting and adventure race runner. He is an advocate for his patients, clients and his fellow PT colleagues. He can be reached at cjberio@sparkphysio.com.

Wednesday, July 10, 2013

SPARK Physio Radio Show: Improved Performance = Less Pain

In this epidosode of the SPARK Physio Radio Show Dr. Carlos Berio discusses why improved performance can be good for everyone and how you can improve your performance to get all the way well!


Listen to internet radio with SPARK Physiotherapy on BlogTalkRadio


Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. In addition he holds a Master's Degree in Clinical Exercise Physiology. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. The concept of 'all the way well' in his work as a physical therapist and fitness professional is what continues to drive Dr. Berio to be the best movement specialist there is.

Dr. Berio is the founder of SPARK Physiotherapy in Alexandria, Virginia. A clinic and approach designed from the ground up to set the new standard for integrity and patient satisfaction in the PT industry. Carlos remains active in several sports and enjoys agility training, power lifting and adventure races. He is an advocate for his patients, clients and his fellow PT colleagues. He can be reached at cjberio@sparkphysio.com.

Saturday, July 6, 2013

A First Line Resource for Nutrition: Your Physical Therapist? Boost Healing AND Performance

Nutritionists and dietitians are highly trained members of the medical and lifestyle team who's skills in designing food plans aren't matched by anyone in medicine. That said, did you know that prior to seeking their Doctoral degrees, the vast majority of physical therapists earned Bachelor's level training in a health related field where they too have gained useful skills in nutrition. What many don't realize is that this is the same EXACT training that most nutritionists and dietitians have. Some practicing physical therapists actually have advanced training in nutrition. The biggest difference is that instead of seeking licensure in nutrition, we chose a physical medicine practice. So how does this info help you, the client??
Nutrition plays a large role in the way that people deal with pain and also the way they are going to heal. To be a truly complete NEW BREED PHYSICAL THERAPIST, you must address your clients' nutrition concerns and barriers to ensure that you are having an impact on all the dimensions of getting all-the-way-well.

As I practice physical therapy and strength and conditioning, clients often ask questions about how their nutrition could impact their outcomes. In most cases clients don't need to be specifically walked through a diet plan. It sure is helpful to have this kind of structure and when clients ask for it. When this happens we send them to some of the country's best nutrition pros. However, most people are making such HUGE mistakes with their personal nutrition that very basic biochemistry and physiology recommendations can be made that have a long and lasting effect.
There are a couple insights we offer to almost every client. These are the ways in which most people get their nutrition back on track for healing and performance:

Eat Frequently:
The importance of this cannot be overstated especially in people who are struggling with being overweight. The 'thermic effect' of food can account for up to 15% of your total caloric expense throughout the day.
Think of it like this:
Let's say you are eating 2000 calories per day. If you eat those calories over three meals, you may be losing out on this extra energy expended to "turn on" your digestive system. If you ate SIX smaller meals throughout the day you could effectively increase your overall caloric expenditure to 2300 calories per day (2000 + 15%). That's 300 calories you leave on the table, so to speak, if you eat the 'standard' breakfast, lunch and dinner.

Adequate lean protein:
This is an area that is ambiguous for many and can be frustrating. Protein is an essential building block for repairing tissues. Your body metabolizes proteins for many bodily functions and missing out on enough of it can seriously slow your overall recuperative ability. 
A rule of thumb for "How much protein should I eat?" is to take in 0.8 - 1.5grams of protein per kilogram of body weight. This is a BIG range but it makes sense.
IF you are exercising regularly and at a high intensity, you are going to rapidly break down your body requiring more of the building blocks to repair. This client should be on the higher end of this range.
IF you don't exercise very regularly, you still need protein but you will need less.

I know the metric system is lost on many, me included, so here is the conversion:
1 pound = 0.453592 kilograms
For example if you weigh 160lbs, you are 72.57kg 

High complex carbohydrates and fiber:
CARBOHYDRATES ARE ENERGY! They aren't fat. They don't make you fat. They are essential for fueling your body to produce the effort to do real work that makes people better... AT EVERYTHING! You've got complex carbohydrates and simple carbohydrates.
Complex  carbs = fiber, wheat, bran, oats; foods that are overall less easy to digest and therefore are broken down in such a way as to give you energy over a longer period of time.

Simple carbs are found in highly processed products, anything with added table sugar and in a lot of 'junk' foods. There are also natural foods high in sugars such as many kinds of berries. That said, there are times and situations when simple carbs are OK or advisable. At most other times, complex, high-fiber carbohydrate foods are the way to go.
When choosing the types of carbs to eat, the rule of thumb should be to ask yourself, "Am I going to use this energy NOW?" If the answer is no, you have absolutely NO reason to eat food or drink a drink that is loaded with sugar. This type of food is FUEL! Fuel up with the high octane stuff and watch your performance improve almost IMMEDIATELY!

Hydration:
Most of us don't drink enough water! It's among the most plentiful resources and by most accounts it's still almost free. Yet, we elect to drink so many kinds of fluids that contain sugar, carbonation, caffeine and overall nothing good for you. The gold standard for the amount we should be drinking varies depending upon who you ask or where you read but you'll never go wrong getting eight to ten 8oz glasses of water per day. If you are performing a good bit of high intensity exercise you should drink more. Not rocket science here. You are made up of mostly water. You should do your best to make sure that all of your tissues are properly hydrated to maximize your body's ability to heal and perform.
We don’t specifically offer nutritional guidance as a stand-alone item. That being said, we do include these basic nutritional insights to our clients as all-the-way-well care. All physical therapists have the biochemistry and physiology training to play a larger role in our patients’ nutrition and health. A major barrier to this is that most physical therapists cannot spend adequate time or effort needed to address nutrition- most of them don’t even have the hand’s-on time that they need to do their best work! This is why it's vitally important to take the extra time to find people and form relationships that are guaranteed to help you and/or your clients get all the way well.
Fad diets and the repackaging of standard diet and nutrition information come and go! There is some good to fad dieting – structure! Almost all PTs can give you excellent nutrition advice without overstepping their scope of knowledge. Some of the simple tricks will always apply: fewer "bad" calories, less sugar, more lean proteins, high fiber, etc. Once you get that foundation down you figure out the specifics based on your body and your needs.

 
Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. In addition he holds a Master's Degree in Clinical Exercise Physiology. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. The concept of 'all the way well' in his work as a physical therapist and fitness professional is what continues to drive Dr. Berio to be the best movement specialist there is.

Dr. Berio is the founder of SPARK Physiotherapy in Alexandria, Virginia. A clinic and approach designed from the ground up to set the new standard for integrity and patient satisfaction in the PT industry. Carlos remains active in several sports and enjoys agility training, power lifting and adventure races. He is an advocate for his patients, clients and his fellow PT colleagues. He can be reached at cjberio@sparkphysio.com.
 

Monday, July 1, 2013

SPARK Physio Radio Show: A First Line Resource for Nutrition: Your Physical Therapist? Boost Healing AND Performance

In this episode of the SPARK Physio Radio Show Dr. Carlos Berio discusses what nutrition has to do with Physical Therapy and how it plays a role in getting you all the way well.  


Listen to internet radio with SPARK Physiotherapy on BlogTalkRadio

Dr. Carlos J Berio, PT, DPT, MS, CSCS, CMTPT is a licensed Doctor of Physical Therapy, Certified Strength and Conditioning Specialist and a Certified Myofascial Trigger Point Therapist. In addition he holds a Master's Degree in Clinical Exercise Physiology. He has treated high school, collegiate, recreational, and professional athletes of various sports including baseball, softball, football, hockey, tennis, swimming, golf and the martial arts. His experience as a collegiate and semi-professional athlete as well as a professional baseball coach make him a sought after resource among elite level athletes on the field and in the training room. The concept of 'all the way well' in his work as a physical therapist and fitness professional is what continues to drive Dr. Berio to be the best movement specialist there is. 


Dr. Berio is the founder of SPARK Physiotherapy in Alexandria, Virginia. A clinic and approach designed from the ground up to set the new standard for integrity and patient satisfaction in the PT industry. Carlos remains active in several sports and enjoys agility training, power lifting and adventure races.  He is an advocate for his patients, clients and his fellow PT colleagues. He can be reached at cjberio@sparkphysio.com.