Author name: Elevate PT & Fitness

“Jack Nicklaus had it right when he said, ‘Professional golfers condition to play golf; amateur golfers play golf to condition.’ That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they’re out of shape, have poor swing mechanics, or don’t adequately warm up.”  -Dr. James Andrews Like in many sports, golf requires complex, multi-dimensional movement, particularly during its golf swing. During the golf swing, the body acts as a kinetic chain and needs its parts to work in tandem. If any part of the chain is lacking, other parts of the body will start to compensate. This can lead to bad habits developing and possible injury in the future. Common swing faults manifest as poor form during backswing, downswing, or follow through. Some common problems can include deficits in balance and posture, and decreased mobility of the hips, mid-back, shoulder blades, or neck. Joint restrictions, muscle tightness, or poor body mechanics can also contribute to compensatory movements during execution of the golf swing. Here are FIVE TIPS to help you to improve your golf game and decrease risk of injury: Warm up – perform a golf-specific warm up that includes trunk rotation and static and dynamic stretching of the major golf muscles, including the shoulders, low back, hamstrings, chest, and wrists. One research article showed that the group that performed this warm up routine demonstrated improvements in club head speed compared to the control group1 Strength train the right muscles – research is showing that training the leg-hip, trunk power, and grip strength are especially relevant for golf performance improvement2 Take breaks – a systematic review found that the higher the frequency of swing repetitions, the greater the cumulative load on the low back. Maintain your back health by gradually building up your golf swing volume3 Double Strap – if you are carrying your own golf clubs, make sure to invest in a bag that has two straps like a backpack. A single strap golf bag places more stress on the shoulder it is placed on Get evaluated – get your golf swing checked out by a professional to make sure you are not developing bad swing habits that will predispose you to future injury A licensed physical therapist can provide a golf-specific program and guide you through exercises specifically designed to: Improve the flexibility of your shoulder and hip musculature. Limited flexibility can affect your backswing and follow through position. Improve mobility of your joints, including the hip, low back, mid back, shoulder, and neck. Limited joint mobility can affect your swing mechanics due to compensations Improve glute and core strength for efficient power development and transfer of energy from your hips, up through your trunk and arms, and into the golf club Improve dynamic balance through hip and abdominal control to maintain proper body mechanics throughout the golf swing At Elevate Physical Therapy & Fitness, our Doctors of Physical Therapy can help you recover from any golf-related injuries, as well as improve your golf game performance. We will assess your biomechanics and ensure proper range-of-motion and strength to achieve optimal golf swing mechanics. We can also create a treatment or fitness plan to address any deficits that are impacting your golf game to help you play at your best! Whether you play golf for a living or just a few times a year, physical therapy can help to prevent golf-related injuries and promote optimal fitness to improve your golf performance. Through the months of January & February we will be posting weekly practical tips and tests on Instagram to help with your golf swing. Check us out @elevateptfit! Stay healthy. Stay well. Stay active.    References Fradkin A. Improving golf performance with a warm up conditioning programme. Br J Sports Med. 2004;38(6):762-765. doi:10.1136/bjsm.2003.009399 Torres-Ronda L, Sanchez-Medina L, Gonzalez-Badillo J. Muscle Strength and Golf Performance: A Critical Review. J Sports Sci Med. 2011;10(1):9-18. M. Lindsay D, A. Vandervoort A. Golf-Related Low Back Pain: A Review of Causative Factors and Prevention Strategies. Asian J Sports Med. 2014;5(4). doi:10.5812/asjsm.24289

HOW TO STILL ENJOY THE HOLIDAYS  WITHOUT RUINING YOUR NUTRITION Casey Thomas R.D. | caseythomasrd@gmail.com Today, I’m going to provide you several strategies that will allow you to still enjoy your holiday food without having it set you behind on your goals.  Even a bodybuilder with the strictest of diets can tolerate an indulgent meal 1x/month.  For people like us, we can do it 1-2x/week while dieting and still be fine, as long as we  are mindful about what we choose.  Here’s what I want you to do:  Strategy #1 – Don’t Skip  I know many people who skip their earlier meals before a holiday feast in an attempt to  offset the calories they plan on eating. However, all this does is make you hungrier.  Then you binge, and eat even MORE calories than if you hadn’t skipped your earlier  meals.   My recommendation? Eat a hearty snack before – something like vegetables and  hummus, an apple with nut butter, or a turkey roll-up.   Strategy #2 – Out of Sight, Out of Mind  Don’t post up next to the treat table or hang out in the kitchen! You know you’ll end up  snacking.  Strategy #3 – No Liquid Calories  I know there’s going to be all sorts of liquid calories – juices, eggnogs, sodas, etc. (see  next section for alcohol strategies) – and they are the most dangerous items. They  provide zero nutrients, zero satiety, and the most calories. I’d rather you save the  calories for your favorite dessert than chug a few sodas. At least the dessert will have  some nutrients (however small). More importantly, solid desserts will also give you  some satiety cues.   What’s so special about drinks anyway? You can get a Coke anytime, but you only get  that signature dessert once a year! Strategy #4 – Don’t Binge Drink  Binge drinking is not conducive for a long and healthful life. If you’re still doing it  regularly, you need to grow up. Alcohol provides a whopping 7 kcal/g and is frequently  paired with sugar. You’re basically ingesting a fluid that gets converted directly into fat  (not to mention the other downsides, like suppressing your inhibitions and increasing  your appetite).  The rule of thumb for drinking is this: if you felt it the next morning, you drank too much.  For those of you who need to be serious about your diet – don’t have more than two (for  men) or one (for women) drinks on those occasions.  Pro Tips:   Avoid mixed drinks and go for spirits. They have the fewest calories.   Eat less fat if you plan on drinking. Alcohol suppresses fat metabolism, meaning  the fat you eat becomes fat.  Don’t train and drink alcohol on the same day – you will ruin your effort. You  need quality nutrients post-training. Far better to train hungover than to drink  after a tough session.   Strategy #5 – Make the Core of Your Meal Be Boiled/Steamed Vegetables and  Lean Protein  Note: This strategy is for those of you who need to be really strict with your diet.  Be careful with your sauces and carbs if you decide to include them. Carbs are the  toughest to gauge and have the most ‘sneaky’ calories added in.   Strategy #6 – Take a Break Before Seconds  I know the food was delicious. I know you want more.   Pace yourself.   Satiety cues can lag behind, especially when eating the hyper-palatable (i.e., very tasty)  foods common to the holiday season.   My recommendation? Take 10-20 minutes after your first plate to give your body some  time to realize it’s full. And if you still want seconds after that, go for it.  Strategy #7 – Don’t Be Afraid to Leave Food on the Plate  Listen to your body and don’t eat if you’re no longer hungry. Important note: ‘No longer  hungry’ is very different from ‘food coma’!  And don’t worry about missing out – save leftovers.  Strategy #8 – Have a Good Support Network  People who diet without support from their loved ones fail. People who turn anti-social  when they diet also fail.  You owe your support network honesty. Explain to them what you’re doing with your  nutrition, and also tell them why you are doing it. Explain to them the importance of your  goal.   But please keep in mind that relationships go both ways. While they should be  supportive of you, you still need to be supportive of them. Ask them what they need  from you to maintain a healthy relationship.   And please, please, please – don’t look down on them if they decide not to also follow  your diet! YOU are the one who chose to go on this nutrition journey. Don’t act entitled.   The main goal when dieting should be to have the smallest negative impact on your  friends and family.   Strategy #9: Food is Only One Part of Your Life  Nutritionists like to think nutrition is all there is to life. They push the ‘all-or-none’  mentality.   I disagree.   I believe it’s about being happy and being as healthy as you can be to do all the things  you want to do in life.  Can I find any nutritional redemption in my Mom’s fresh baked cookies? Not really, but  that doesn’t mean I’m going to turn one down when I’m visiting my family for a holiday.  I’m trading a bit of food quality for some happiness. I know it, and I don’t feel guilty  about it.  You know what junk foods are. I don’t need to give you a list. You need to weigh your  danger foods against what you want out of life, and if your danger foods are stopping you from getting what you want, then you definitely need to change something  about them. The main point I want to get across here is that you need to be intentional with your  food. It should always serve a purpose. Is this meal chosen to be healthy for you?  Great. Does it contain some junk items but was chosen for happiness? Still great.  Doesn’t matter,

Have you ever wanted to improve your flexibility because you feel stiff? Have you ever stretched and stretched without feeling like your flexibility improved? Do you not have the time to stretch after working out? Well, we have some good news for you! Research is showing that strength training is just as good as stretching for flexibility. Strength has also been shown throughout literature to have many benefits, including improving balance, decreasing risk of falls, and improving sports performance.1,2 You can’t go wrong with getting stronger. However, you can also target flexibility at the same time through strength training. In this blog post, we will compile what the research says and then provide practical tips for you to start getting those improvements in flexibility while getting stronger at the same time!  If you’re not a fan of reading through research, you can skip to the bottom for a summary. Without further ado, let’s dive into the research: In one study that compared full range resistance training versus static stretching, there was no difference found in the flexibility of multiple joints after just 5 weeks of strength training.3  In another study, individuals with tight hamstrings (you might be able to relate) were split into three groups: a control, stretching, and strength training group. Both the stretching and strengthening group demonstrated improved hamstring flexibility, but only the strengthening group improved in strength.4  In terms of number of sets that should be performed to maximize flexibility, a study found that there was no significant difference between performing one set, three sets, or five sets of an exercise.5 That means less work to still get results! “How often do I have to work out?”, you might ask. Researchers looked at the effect of resistance training performed at different weekly frequencies on the flexibility in older women. Both the group that exercised twice a week and the group that exercised three times a week demonstrated improved flexibility. In general, there may be greater benefit to increasing the training volume for a given muscle.6  Based on all these studies, here are some principles of strength training to improve flexibility: Length of time – you should be able to see results in as little as 5 weeks!3  Range of motion – exercises need to be performed through the full range of motion in order to be effective.3  Repetitions – typically 8-12 RM (your muscle should be pretty tired after finishing your 10th rep) or 60-80% of your 1 rep max.4  Sets – just one set is enough to create change, as long as the intensity is high enough!5 Frequency – the more frequent, the better. At least twice a week will be effective, but three times a week would result in greater improvements.6  Age – the research was performed on college-aged students all the way to older women in their 60’s. However, strength training is safe for kids as young as 8 years old according to the Mayo Clinic. Similarly, strength training is also appropriate, and often much needed in seniors, as long as the strengthening is progressed gradually. If you have any concerns, please reach out to a healthcare professional for guidance! You might still have questions about breathing techniques, how to progress the weights, and which exercises you should do. If you want 1 on 1 guidance through a personalized strength training program, please visit us at Elevate Physical Therapy & Fitness for us to take your strength and flexibility to the next level! Stay healthy. Stay well. Stay active.  References Lee, I. and Park, S., 2013. Balance Improvement by Strength Training for the Elderly. Journal of Physical Therapy Science, 25(12), pp.1591-1593. McGuigan, M., Wright, G. and Fleck, S., 2012. Strength Training for Athletes: Does It Really Help Sports Performance?. International Journal of Sports Physiology and Performance, 7(1), pp.2-5. Morton, S., Whitehead, J., Brinkert, R. and Caine, D., 2011. Resistance Training vs. Static Stretching: Effects on Flexibility and Strength. Journal of Strength and Conditioning Research, 25(12), pp.3391-3398. Aquino, C., Fonseca, S., Gonçalves, G., Silva, P., Ocarino, J. and Mancini, M., 2010. Stretching versus strength training in lengthened position in subjects with tight hamstring muscles: A randomized controlled trial. Manual Therapy, 15(1), pp.26-31. Leite, T., Júnior, R., and Reis, V., 2011. Influence of the Number of Sets at a Strength Training in the Flexibility Gains. Journal of Human Kinetics, 29A(Special-Issue). Ribeiro, A., Carneiro, N., Nascimento, M., Gobbo, L., Schoenfeld, B., Achour Júnior, A., Gobbi, S., Oliveira, A. and Cyrino, E., 2015. Effects of different resistance training frequencies on flexibility in older women. Clinical Interventions in Aging, p.531. Simão, R., Lemos, A., Salles, B., Leite, T., Oliveira, É., Rhea, M. and Reis, V., 2011. The Influence of Strength, Flexibility, and Simultaneous Training on Flexibility and Strength Gains. Journal of Strength and Conditioning Research, 25(5), pp.1333-1338.

We’re committed to always ELEVATING our game and offering the most cutting edge therapies at Elevate PT & Fitness, and, to that end… We’re THRILLED to announce that we now offer Personalized Blood Flow Restriction (PBFR) training for rehab, fitness & sport performance by Owens Recovery Science, the gold standard in the industry, featuring the Delfi Tourniquet System! Employed by college and pro teams including the NFL, MLB, NBA, NHL, and the US Army, and featured in Sports Illustrated, 60 Minutes, Time magazine, Outside.com, ESPN and the Discovery Channel, this technology is a game-changing performance training and injury rehab therapy that’s producing dramatically positive results for us every day.   Here’s a short video of an upper body series with a Yale lacrosse athlete who is using PBFR training for sport performance on a lift recovery day. Elevate PTs are certified in PBFR.  What can PBFR do for you?? Increase strength and muscle hypertrophy with only 30% of an individual’s one repetition max Diminish atrophy and loss of strength from disuse and non-weight bearing after injuries. Improve muscle endurance in 1/3 the time Improve muscle protein synthesis in the elderly Improve strength and hypertrophy after surgery Improve muscle activation Increase growth hormone responses Safe to use among youth clients as young as 12 Can help reduce muscle soreness and optimize performance immediately and 24 hours after treatment TRAIN AND REHAB SMARTER @ELEVATEPTFIT concierge@elevateptfit.com  or call 424.322.8585

Dynamic Warmup for Surfers Research is clear that a dynamic warm-up (vs. static stretching) is best to prepare for sport ️ and to prevent injuries. A sport-specific warm-up is specially designed to move the body through the necessary range of motion and activate the neuromuscular system in ways that simulate the sport. ‍Surfing is a high demand sport with significant injury risk. Up to ⅓ of surfers sustain an injury each year requiring medical attention, missed work, or time off from surfing,  and 91% of surfers have sustained an injury surfing in their lifetime. We see lots of injured surfers at Elevate. Most often we hear that they don’t warm-up at all,🤭 and don’t have an exercise regimen to get their bodies strong for the great demands of surfing. A surf-specific dynamic warm-up will go a long way to help mitigate the risks and prevent injury (especially when combined with our surf-specific strength exercises coming next week). We know the waves are like a Siron song calling you the minute you feel the sand in your toes, but put earplugs in for just 5 minutes and prepare your body for the awesome intensity of surfing!   What a surf-specific dynamic warm-up can do for YOU: Increase core temperature Increase blood flow to muscles Increase stimulation to mechanoreceptors in joints Increase stimulation to the central nervous system Increase musculoskeletal control Increase confidence for performance Increase movement through the range of motion demands for the upcoming activities Improve exercise / sport performance Reduce risk for injury Scap Strength for Surfers Surfers, swimmers, water polo players and other water sport athletes who present with shoulder pain often have weakness in / poor control of posterior chain shoulder girdle musculature including the infraspinatus of the rotator cuff and the trapezius scapular muscles.  . Elevate Founder Dr. Meredith Soelberg PT, DPT, MBA demonstrates a few simple  exercises to address the common deficits. All you need is a Theraband to help get these specific muscles doing their job better for top SPORT PERFORMANCE and to PREVENT INJURY.  Shoulder external rotation with Theraband – this is a TWO STEP exercise, to emphasize the scapula stabilizers and the infraspinatus cuff muscle. Squeeze shoulder blades together and down to stabilize. 2. With elbows at 90 degrees and at your sides, AND shoulder blades squeezed together and down, PULL the band apart.  Hold 3 seconds. Slowly release. Repeat 10x. 3 sets… Cheerleader Series’ Ts and diagonals with Theraband – stand tall, shoulders away from ears. T – will emphasize the middle trapezius fibers.  Elbows straight, shoulders at 90 degrees, pull band apart to make a T shape.  Give a squeeze to your shoulder blades at opening of the T. Then slowly release back to start position. Alternating Diagonals – will emphasize numerous important scapular muscles reciprocally.  Start in the same start position as the T exercise. Pull band apart with one arm pulling up, the other pulling down. Palms face forward, the band is in a diagonal, elbows straight. Give a squeeze to your shoulder blades  Meet back in the start position. Then do the opposite diagonal. . . What’s great about the diagonals is the reciprocal movement pattern it trains – very functional for the movement in these sports!. 1 T + 1 diagonal each direction = 1 rep.  Repeat 10x. 3 sets. ❗️KEEP ELBOWS STRAIGHT. ❗️ . If you’re having shoulder pain, come in and our Doctors of Physical Therapy can evaluate it, get you out of pain, and started on an injury and sport specific program. Need a Theraband?  We’ve got all colors!   Strengthen your Serratus Anterior for Surfing The Serratus Anterior does so much for the surfer! It wears a lot of hats as a protractor / abductor, posterior tilter, upward rotator and stabilizer of the shoulder blade!  It’s particularly important in the intricate biomechanics of reaching overhead in the paddle, and for a strong pop-up. … Lack of control, strength, or activation of this important muscle is believed to be associated with painful shoulder conditions found in surfers and other water sport and “overhead” athletes.  Here’s a progression of “scapula pushups” with a Theraband for added resistance to isolate that serratus anterior, and at the same time, work your core muscles that are also critical for surfers and water sport athletes!  Try 3 sets of 15 of level 1.  When that gets easy, try the next level!.

When we experience pain or are going through a period of rehabilitation often this is accompanied by an increase in psychological stress. This stress may be due to financial burden, inability to exercise or perform usual activities, and being in physical pain. Stress can cause physiological changes such as elevated cortisol levels, increased heart rate, increased blood pressure and a dysregulated immune system.  Meditation has been shown to decrease blood pressure,  regulate the immune system, improve respiratory rate and sleep (van der Zwan 2015) As we work to improve our physical health it is also important to take care of our mental health. Meditation is a great way to enhance the overall effects of the rehabilitation process.   Here is Part 2: of our meditation series: “The HOW”- Intro to basic meditation and ways to incorporate it into daily life.   Meditation Tips and Techniques: Timing: Meditating at first can be a challenging and frustrating task, therefore timing is very important. It is crucial that you choose a time of day where you are not too tired or overwhelmed by the things happening around you. I have the most success meditating in the morning before anyone else in the house is up and the world around me is quiet.   Position: Seated or lying in a comfortable position. Make sure that you have everything you need in place so that you do not fidget or become focused on your discomfort as you will be in this position for at least 10 minutes. Feeling uncomfortable is a really easy way to lose focus.   Surroundings: What room or space gives you the most joy or feelings of relaxation? Living room? Kitchen? Office space? Bedroom? Favorite chair under a window? If any of these things I listed sparked immediate anxiety then this is NOT the place you want to glide into that peaceful state of mindfulness and relaxation.   Breath and Sequence: Sitting in one place for 10 minutes is the “easy” part. Calming and quieting your mind for 10 minutes without judgement is a completely different beast. By using your breath and a body scan sequence we can help to calm our mind and sink deeper into that meditative state. Start at your feet and take note without judgement of each segment of your body while sending a breath of love, appreciation and gratitude to that area.    10 day challenge:  We challenges you to meditate for 10 minutes a day, over the course of 10 days! The best way to create new habits is consistency and practice! Just like we exercise and strengthen muscles skeletal muscles we must also strengthen our mindfulness muscle! See how you feel after the 10 days and maybe reflect on ways that you were successful and not as successful. What worked best and what was challenging?  Tell us how you did!   Meditation Part 3: What tech can help you meditate?  Top apps and gadgets to help guide us in our journey of mindfulness. Insight Timer  Pros: This app allows you the freedom to pick and choose depending on how long you have to practice, what style you’d like (e.g. body scan, loving kindness, anxiety/stress reducing, etc.), or just set a timer and sit without guidance,” Cost: Free! .   YogaGlo Pros: There area large variety of guided meditations to choose from with such well-respected teachers. Plus, you can customize your workout by choosing the length, teacher, and/or level you want, as well as a variety of topics and focal points that can help you zero in on specific meditation goals Cost: Free 7-day trial/ $22.99 per month after trial.   Headspace Pros: One of the best known meditation apps. They offer hundreds of guided meditations, mini-meditations, sleep sounds, SOS meditations for emergencies, meditations for kids and animations to help you better understand meditation Cost: $7.99 to $12.99 per month after trial.   Ensō  Pros: For those well-versed in meditation, I love the Ensō app which has a simple timer that you can set with bells at different intervals to keep you alert and set a soothing endpoint to your practice. Cost: Free, in app purchase.   Calm Pros: Contains topics ranging from calming anxiety to gratitude to mindfulness at work—as well as sleep sounds, nature sounds, and breathing exercises—you can really choose your focus. “There are new meditations every day, progress trackers, and seven-day and 21-day programs for beginners Cost: Free, in app purchase. 10% Happier: Meditation For Fidgety Skeptics. 10 Percent Happier For Fidgety Skeptics. Pros: This app has meditations aimed to help users with anxiety and sleep, and there is new content each week. More than 500 videos and additional content added each week. Cost: Free and premium version.