The Present Leg of The Journey - Opportunities, Experiences, & General Questions/Reflections:
My how time seems to get away from me on occasion! It's been a while since I've written or posted anything to this blog, a realization that hit me full on today. The last couple of months have been educational, inspiring, and generally thought provoking. This one's more on a personal note, and a bit of where my head is at:
Travel Abroad - Off to the Abu Dhabi Grand Slam with USA Judo
October ended with a trip overseas to Abu Dhabi, UAE with USA Judo for the Abu Dhabi Grand Slam. Traveling for an international competition was a great experience, and hopefully there will be more to come in the future. Very proud of our athletes, and this is an exciting time for all of our Olympic-hopefuls.
Sports Medicine & the Military
I have recently begun working with a population that can only be described as professional sports for the military. I can say that even in this short amount of time, this is probably the most rewarding opportunity I have experienced in my career to this point. It has shortened my schedule in clinic, but it definitely fits with my ideal population, and my 'Why.'
Every day I learn something new and have to think of a way to address a new or unique problem that I wouldn't come across anywhere else. It definitely forces me to think outside the box, blends all of the arenas I have been studying - athletic training, physical therapy, strength & conditioning - and allows for some great interaction with other professionals on our team.
These individuals play in a game where the stakes are far greater than any Super Bowl or World Series, and it's rewarding on some many levels. The most profound thought for me has been the realization that the return is almost exponential: every one of them we help to perform, will result in them being able to help numerous others during their course of time in their career field. At the end of the day, your politics, beliefs, and opinions really don't hold any water. We owe an incredible debt of gratitude to these individuals whether we are willing to acknowledge it or not. I suppose the other side of this all is that when you are surrounded by individuals who strive to constantly be the best and do their best, the need & desire to raise your game becomes infectious. It's fantastic to know that regardless of the circumstances each day may bring, you love your work and you know it's what you have answered a calling. (Not 'THE' calling, as I don't believe we have just one.)
Older & Wiser
Some may know that I tore my MCL a few months back grappling. While there was initial frustration at getting injured and having to put grappling on hold for a while, I have come to realize it was necessary and I see the positive side. It made me get into the driver's seat as a patient, it made me apply and experience the process of going from injury, to rehab, to transitioning back into strength & conditioning. My goals currently are to get back to skiing this winter, and to get back on the mat and continue learning grappling & judo.
It also got me thinking, and I'm not sure if there are any answers to the questions, but I began to wonder:
While I am still not willing to play the 'Age Card' that so many seem willing to throw for me, I do recognize that as I creep toward 40 I definitely require a different approach to training & recovery than I did at 20. Does that mean it isn't doable or that you can't train hard? Of course not. But it does reinforce the concept of 'Train Smarter, not just Harder.' I don't care much about my weight or what the scale says. I do care what my absolute power and conditioning are, however. Rest & Recovery have proven to be way more important than we like to admit.
And so continues to journey. The quest to get stronger, endure longer, and continue learning and growing both professionally and personally. Food for thought as we head into the Holidays and start thinking about and plotting our goals for the New Year!
Rocktaping for Hands: Preventing Hand Rips During Sport
Many athletes have experienced these nasty buggers. Weightlifting, gymnastics, CrossFit, rock climbing, tactical ropes. There are numerous scenarios where the right combination of tight grip, friction, and a hard surface produces a shearing force that is greater than the capacity for the skin to withstand, and we get one of these annoying and sometimes painful rips.
There's nothing worse than having this occur early in a CrossFit event where you have numerous rounds to complete. The combination of sweat, chalk, and metal leaves a lot to be desired! While some athletes use gloves in sports that allow it, many find them to be cumbersome or just simply don't like using them. Luckily, there is a very simply and effective way to apply Rocktape to save your hands. It may sound cliche, but "an ounce of prevention is worth a pound of cure." The best way to manage one of these wounds is simply to avoid them altogether.
The following video walks you through the steps of cutting and applying the tape. I have taught this exact taping technique to two different athletes last week, so I though perhaps it wasn't as 'common knowledge' as I had assumed.
Check out the video, and feel free to share with any of your fellow athletes who would benefit. Also, check out the "Downloads" tab on the homepage of the Athletes Physiotherapy website where you can download and print the exact step-by-step instructions for performing this taping application.
Filling In the Gaps -- How we can help you improve your game!
When talking with athletes or new clients, I often get a series of questions surrounding what exactly it is I do, and why do I feel that a Sports Physical Therapist is an integral part of training for an athlete?
Sure, I have my biases. But titles and professional affiliations aside, here are a few thoughts on the subject:
1. As the title suggests, we work to identify and then fill in 'The Gaps.' These 'gaps' can be things missing in your current strength & conditioning routine, deficits in mobility or stability which may be effect mechanics, impede your ability to get your body into proper position for an exercise or your particular sport, or decrease your ability to maximally generate force.
There may be residual issues from old injury that still limits the system, but are not deemed as 'problems' by the athlete because they are not painful or have not stopped them from training and competing.
'Gaps' can also exist in training loads & intensities, training cycles, nutrition, & recovery -- particularly in our younger athletes who are trying to do it on their own.
2. As a Physical Therapist & Athletic Trainer I have the skills to effectively evaluate from both a medical and performance perspectives, and have the license to couple manual therapies and exercise to maximize your training time and improve recovery. Soft tissue quality, joint mobility, neuromuscular control, and how the various joints of the body impact one another are all important to address and maintain in order to maximize training, prevent injury, and recover quickly if an injury does occur. Recovery between training sessions or following competition is also important, and can be facilitated with proper planning and intervention.
3. 'It Takes a Village', as they say. Many athletes that start with us have been training on their own. In some cases coaches run their athletes through their version of what training is -- mostly running and sprint style conditioning. Often patients come to us after trying to self-manage their injury, or after a course of treatment that did not make much change. At some point there is a realization that something is missing, and another set of eyes is needed to get the outcome desired.
A team approach is generally most effective. One of our current goals is to work more with coaches, whether it is a Crossfit coach, a Boxing coach, a Jiujitsu or Wrestling coach, a Triathlon, Football, Tennis, or Gymnastics coach. The ability to give feedback and dialogue on what each person is seeing is extremely helpful on both sides. A coach often sees what skills are deficient, where the athlete is slow or not generating enough power, where their heavy on their feet or cheating their technique, etc. As a Physical Therapist, I am not your skills coach. I am not your technique coach. I am not going to change your golf swing, change your fight stance, or address your front crawl stroke. What I am going to do is put you through a evaluation & assessment process to find out where are the restrictions in mobility, where is stability lacking, and identify the energy leaks. Then, we are going to intervene to correct them. The physical therapist can also assist the coach with scaling load and giving parameters for return after injury that allows the coach to best tailor their practice sessions to get the most out of their time and efforts.
If you are an athlete or coach curious about how Athletes Physiotherapy can help you get out of pain, get over an injury, maximize your training, and improve your performance, then get in touch by calling 702-930-8155, email to firstname.lastname@example.org, or schedule your initial visit here: BOOK MY SESSION
Athletes Physiotherapy - Las Vegas,NV
Sports Physical Therapy, Performance Enhancement, and Athlete Development for Las Vegas & Henderson, Nevada
Building & Rebuilding Better Athletes - Sports Physical Therapy & Performance Enhancement In Las Vegas, NV
Part 2: Needs Assessment - Not Always As Obvious As It Seems
What is a 'Needs Assessment?'
Simply defined, a Needs Assessment is:
"A systematic process for determining and addressing needs, or "gaps" between current conditions and desired conditions or "wants. The discrepancy between current condition and wanted condition must be measured to appropriately identify the need."
As you probably would have assumed from the name, this is an assessment of what one needs relative to a particular set of circumstances. Okay so what's the immediate take away from the above definition?
1. The process is systematic -- it is a planned assessment or evaluation that has a thought out process, and an idea of What you are going to measure, and How you are going to measure it.
2. Measurement is necessary and vital - you have to know what you have and how it functions to know what you don't have or still need, right? To say an athlete is fast or strong gives little meaningful information if we don't know what the context is. Fast or strong compared to who or in what circumstances?
3. Re-testing is also required - how do you know you've improved, met your goals, or still have work to do if you don't re-test?
The Needs Assessment is a multifaceted en-devour. It involves the athlete and coach communicating what their expectations and wants are, what they are looking to accomplish, and what their athletes need to be able to do on a regular basis. It also involves an evaluation of logistics - how often does the athlete have to train during the week, how much will be in-house and how much will be the athlete following the program off-site? What access does the athlete have to certain equipment, etc? What is the time line for the event we are programming and preparing for?
Then there is the Athlete Evaluation part of this Needs Assessment. When we embark on programming and training for our athletes, it is important to have an evaluation process in place that is Comprehensive, Relevant, and Repeatable.
A. Comprehensive: The Athlete Evaluation should look to cover all bases and expose all holes. Depending on your background and scope of practice, this process may require multiple disciplines doing a part. To start, it should give us a picture of the health status of the athlete. Information on health history and injury history should be obtained. Appropriate systems screening should be performed. A more thorough orthopedic assessment should be performed if recent injury or surgery has been reported. Movement Screening can then be utilized to assess proficiency with baseline fundamental movements and identify provocation of pain or deficiencies that require addressing before loading the system. Lastly comes Performance Testing - the more 'sport specific' and 'fitness specific' testing.
B. Relevant: The tests and measures used in the Athlete Evaluation should be relevant in that they measure variables that are meaningful. They also must measure in a way that is meaningful. Tests & measures do not necessarily all have to be a direct reflection of sport movements, but there should be an industry standard applied to make the information comparable and meaningful. For example, if you train football players and the commonly reported and utilized test of speed is a 40 yard sprint, then it would make sense to measure your athlete's time in a 40 yard sprint, as opposed to measuring them at a 35 or 50 yard sprint. Will they need to sprint 35 or 50 yards in their sport, sure probably, just not during a Combine -- when it counts! Relevance can also apply to the tests chosen based on sport and position.
C. Repeatable: Procedures and individual tests & measures must be repeatable. It should go without saying, but testing once at the start of a program is not enough. We must continually assess and reassess the athlete in order to identify effectiveness of our programming. Simply adding weight to a lift or adding time onto a run is not an equivalent of success. If your football player is an offensive lineman who increases weight in his bench press, squat, and dead lift but can't move his feet quick enough to block the guy across the ball from him, your program was ineffective. If your fighter can go hard for 5 rounds of 5 minute high intensity intervals, but gasses out during his actual fight due to lack of aerobic conditioning, your programming was ineffective. Wouldn't it be nice to know that before it's "Go-Time?"
If you re-test and you are finding holes still exist which make you start to question the program's effectiveness, we then have to look for the Why? Is something missing? Is the athlete no following the program as you meant it to be followed? Has the coach made changes and instructed the athlete but neglected to inform you?
Is what you deem important not given as much value by the athlete or coach? This can be a big one. Sometimes the athlete does not see the same value or relevance to a particular variable because they don't fully understand its application to performance. It is our job to effectively communicate that what we are asking the athlete to do will increase their performance and is applicable to their sport or event.
In many cases, when dealing with young athletes or athletes who have not had access to resources like a performance coach, the athlete simply is not aware because they have never had the guidance or direction and thus do not have the depth of knowledge in programming or training. Often times the just go into the gym and do whatever workout they were shown by their last coach or teammate. This is often a source of untapped potential, but will require a fair amount of educating on the front side.
If you are an athlete looking for help with your training or with overcoming an injury, schedule your initial appointment HERE.
If you are a coach looking for solutions to getting your athlete or team ready for competition, contact Athletes Physiotherapy at (702)-930-8155 or by email: Kbosch@athletespt.com for information on how we can improve your performance!
Athletes Physiotherapy - Las Vegas, NV
Building & Rebuilding Better Athletes - Sports Physical Therapy & Performance Enhancement In Las Vegas, NV!
Part 1: A Collaborative Approach To Athlete Management: The Merging of Science & Experience
Athletes Physiotherapy is committed to providing a high performance solution to improve the health, well being, and longevity of the athletes and dancers we work with.
While the circumstances behind each athlete encounter varies, the application of a few specific principles and key philosophies allows us to provide each athlete with an individualized solution to their specific needs.
How Can We Help?
The needs of the athlete, which cause then to seek out our services in the first place, often include:
Key Philosophies & Principles of Athlete Management:
There are a number of principles and key philosophies and help our athletes meet their rehabilitation and performance goals. For this overview, I will avoid discussing specifics of interventions and skill sets, and will instead hit on the main philosophies applied to athlete management in no particular order:
1. Athlete Needs Assessment
Needs Assessment can be broken down into 2 major components: the Initial Interview and the Comprehensive Evaluation.
a. Initial Interview: This is where we dialogue with the athlete about why they are seeking our help and what they see as their biggest needs. We get an idea, in their own words, of what has & has not worked for them up until this point, and what are their goals both in athletics and is they relate to their time with us in clinic. We also discuss the athletes history as it relates to their past & present health, training, injuries, etc.
b. Comprehensive Evaluation: The Comprehensive Evaluation is made up of multiple components which give us information about the overall status of the athlete. We have chosen a number of base variables to look at with each and every athlete, and then have another layer of performance testing which is done to match their particular sport or athletic needs.
2. Individualized Programming
Once we have all of the pertinent information from the Initial Interview and Comprehensive Evaluation, we can then write programming tailored to the athlete to meet the needs that have been established.
Programming is at all times:
a. Science-based to get the greatest results in the shortest amount of time
b. Tailored to the individual athlete with attention to the power, endurance, speed, and agility
requirements of their sport or position
c. Progressive & maintains the safety of the athlete at all times
3. Team Approach
We subscribe to the idea that communication is key. Our function is that of a Performance Coach, as the ultimate goal is to maximize the performance of the athlete for their given sport or event. We are fortunate that we are able to wear multiple hats in the field of Physical Therapy, Athletic Training, and Strength & Conditioning in order to get our athletes the results they are looking for. However, it is important to note that we also know our limitations. We are not your skills coach. We are not your technique coach. If you already have a Strength Coach, we will work with them to fill in the gaps. Communication between Athlete & Therapist is just as crucial as communication between Therapist and Coaches. In the ideal situation, we work as part of the athlete's team and are able to regularly dialogue with the athlete and coaches to maximize the athlete's training schedule and be sure that we are all helping to achieve the goals that have been established without overloading the athlete.
Let's Work Together to Achieve Your Goals!
If you are an athlete looking to overcome an injury, improve your performance, or get ready for an event, be sure to contact us or schedule your initial visit online HERE. If you are a coach and would like to partner up and allow us to help your athletes reach their maximum potential, contact us HERE to discuss how we can start working together!
Athletes Physiotherapy - Las Vegas, NV
Movement Screening & Athlete Management: Athletes Physiotherapy & Van Hook Sports Performance -- A Team Approach to Physical Therapy & Performance Training in Las Vegas, NV.
Movement Screening & Athlete Management
There is a lot of talk and controversy surrounding the use of Movement Screening. While there are a number of ways that you can screen movement, I think the more commonly utilized & discussed are the Functional Movement Screen (FMS) & Selective Functional Movement Assessment (SFMA). For detailed information on these two programs, see the folks over at functionalmovement.com as there is a plethora of information! Here's my disclosure -- I don't have any financial incentive to refer you to their site, it simply is the easiest way to shorten this post provide you with resources to answer questions you may generate.
That being said, these two systems are separate but interrelated. The FMS is often looked at as the Fitness Screen, ie it can be used by anyone who deals with movement in absence of pain. This includes personal trainer, yoga & Pilates teachers, martial arts instructors, physical therapists & chiropractors, etc. The SFMA is looked at as the Medical Counterpart to the FMS. There are a number of ways to use the FMS in practice:
As an example, let's say "Joey MMA Figher" comes in to train in preparation for their next fight. He is put through the Functional Movement Screen and is found to have hip pain during a few of the tests. If it is the Strength Coach performing the screening, he then punts to the Physical Therapist and says 'Hey, "Joey Fighter" has Left hip pain during the Overhead Deep Squat, Left Hurdle Step, and Left In-line Lunge.' This should trigger 3 things to happen:
For information on Screening and Athlete Management, check out the Athletes Physiotherapy Website or contact us by phone at 702-907-5107 or email to email@example.com
Treatment & Training Packages are available, and for the month of January 2015 Athletes Physiotherapy is offering FREE FUNCTIONAL MOVEMENT SCREENING. Contact us today to schedule your Screening Session!
Athletes Physiotherapy is a physical therapy clinic located in Henderson, NV in the southeast portion of Las Vegas. Our focus is on High Performance Physical Therapy with an emphasis on sports, dance, and orthopedics. We provide one-on-one, individualized care for rehabilitation and performance enhancement.
This may be one of my shortest blog posts, as the video speaks volumes for why bionics and the future of prosthetics is one of hope, potential, and empowerment. I am impressed with the attitudes and view expressed by Hugh Herr, as it is an angle that is not often heard or shared.
Too often we see the select few people who have a remarkable story that happens to get picked up by the media. The individual who loses a limb or has some catastrophic event, they go through their acute medical care, surgery, physical therapy/rehabilitation and end up beating the odds. The typical view thinks "wow, how incredible that he/she had the resolve to keep going and not let their circumstances stop them." The idea that the human being can never be truly broken, that it is technology which is inadequate or broken is a real game changer.
Sure, the event is still traumatic. There is healing that needs to occur on a physical, psychological, and emotional level -- for the individual as well as their family members, friends, etc. But think about how much brighter the outlook can be if technologies like this are available. I would venture to say that for individuals going through these events, currently and/or in recent past, the outlook has not been as bright because of the limited access to advanced bionics. Let's be honest -- with insurance limitations, inflated costs, and the constant hassle that comes with negotiating our current medical system, we see able bodied individuals not receiving the care or equipment they need. I assume it is only that much worse given the greater cost associate with these new systems.
But think of the potential. The ability for people to not only get back to high level activities like dancing, running, or sports, but to just have the ability to get back to work, to play with their kids. Take away the barriers and the productivity of the individual sky rockets.
I am sure there are a lot of issues yet to deal with, and a lot of questions being asked and thought up, but I do hope to see this type of technology readily accessible to the masses in my life time.
Athletes Physiotherapy - Las Vegas, NV
It's a word that is interpreted a number of ways. Some envision 'Recovery' as what you do after surgery or an illness.
For some there is a notion that recovery is overrated and is suggested by those who are 'too conservative.'
I've heard the notion that overtraining is a myth, and recovery happens on its own and without the need to scale down training intensity or utilize other approaches like manual therapy, massage, somatics like Feldenkrais, Yoga, or Pilates. In many circles, the word Recovery is never even addressed.
So, what's the deal? Is there a real need or benefit to recovery periods built into your training? What is a recovery period or recovery session anyway? For sake of not turning this blog post into a dissertation, we will stick to the basics. It should be mentioned that at this time, within many high level Professional & Olympic level sports, recovery is often included within a good strength and conditioning program, and this is often fostered by the 'team approach' that often exists in these settings where you have a multidisciplinary approach to athlete management.
Recovery is basically the period of adaptation and training effect that results from exposure to a workload in training or competition. What is important to keep in mind is that it's not simply just training that is necessary to improve physical capacities like power, endurance, speed, etc. It is also necessary to maximize the post-training/post-competition time period where the body is remodeling, repairing, and replenishing itself. What is done after the athlete trains or competes is just as important as the training itself, as the goal is to replenish what the body depleted during training and minimize fatigue. Athletes who do not use recovery strategies and stack training sessions closely together so that they are training on top of residual fatigue from the previous sessions are the ones who tend to develop injuries or maladaptation.
So what can be done? First, it starts with education. Educating athletes and coaches on the importance of recovery and what it is and is not is the first step. Recovery does not imply that the athlete has to have down time where they do nothing. What it does mean is that strategies are employed in the training program to vary the loading of the body and utilize variations in intensity, cross training, and disciplines like physical therapy. Post-training activities and movement sessions which get the body moving can be performed as an 'active recovery.' Emphasis on hydration, nutrition, and sleep are all important in maximizing the training effect and speeding the rate of recovery so that more workload can be tolerated by the athlete.
Training at a high level often results in musculoskeletal and neuromuscular stress which, if minimized and dealt with early on and on a regular basis, will allow for continued training at a consistent high level. Manual therapy and Dry Needling are two techniques that are utilized in my practice with great success.
The nuances of Manual therapy, Dry Needling, and the process of Monitoring Training Effect and the readiness of the athlete for the planned workload are beyond this blog post, as they are large topics in and of themselves, but will be addressed in my next few posts, so stay tuned!
Have questions or comments? I'd love to hear them!
Athletes Physiotherapy - Las Vegas, NV
Thank you for stopping by the Athletes Physiotherapy Blog! Kristopher Bosch founded Athletes Physiotherapy in Las Vegas, NV. He is a Father, physical therapist, athletic trainer, pilates teacher, & perpetual student!
EDGE Mobility System
John Rusin - StrengthDoc
Sue Falsone - S&F
Systemic Dry Needling