Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews: health
Showing posts with label health. Show all posts
Showing posts with label health. Show all posts


5 Reasons to Consider Nutrition and Behavior Change in Rehab
  1. Nutrition, that being the foods we eat and science behind its digestion, provides energy for our bodies, for our patients’/clients’ bodies. However, proper nutrition does more than fuel day to day activities.
  2. In a rehabilitation setting nutrition can affect functional mobility and recovery. First off, for our patients/clients to participate in therapy sessions, they need to be fueled to do so. But in addition to that, proper nutrition will facilitate more efficient healing, building, and strengthening of tissue, which will ultimately affect functional outcomes. 
  3. Nutrition also plays a role in the development of chronic disease. With proper nutrition, your patients/clients will not only function better, but reduce their risk of developing conditions such as heart disease, diabetes, and obesity. And for the older population, adequate nutrition can prevent malnutrition and the devastating associated effects. 
  4. With the previous three reason in consideration, nutrition will ultimately affect your patient/client’s quality of life. Are they able to thrive in the environment in which they live? And are they able to do so without the burden of disease?
  5. As a healthcare provider, know that you can help facilitate behavior changes if needed. Including changes that can help your patients/clients achieve the benefits of proper nutrition. Though remember, much more goes into merely providing education. Among many factors, medical history and scopes of practices must be taken into account.

via - Dr. Patrick Berner, PT, DPT, RDN - Fuel Physio

If you're looking to add a nutritional screen to your practice, check out Dr. Patrick Berner's awesome resource, now updated with 4 easy to digest (pun intended) sections. The newest section is on patient behavioral modification strategies, definitely important for nutrition and health/wellness.


Keeping it Eclectic...




This weekend is the NSCA Training for Combat Sports conference in Las Vegas. Day 1 featured tons of super relevant and interesting content, including a talk about fight camp nutrition with Dan Garner. Dan is a strength coach and nutrition specialist that works with many UFC fighters. This is a topic I’ve talked about before on this blog and something I’m deeply interested in – how do we make weight while maximizing performance?
Dan’s talk was packed with information, but I do want to share some important concepts. Remember that nutrition is highly individual and while these are great guidelines, you should contact a professional for a personalized program.
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Dan reviewed 6 elements for a strong fight camp nutrition framework:
  1. Psychology
  2. Energy Balance
  3. Carbohydrate Intake
  4. Peri-Workout Nutrition
  5. Immune Function
  6. Vitamin & Mineral Status
Dan’s ideal timeframe for fight camp is 10 weeks with a goal of cutting 1-2 pounds per week in order to minimize extremes as you approach weigh-in. As you train hard through fight camp (or in the weeks leading up to your competition), your focus should be on performance and NOT making weight. This comes with precise, strategic planning.
Although there are tons of weight cutting and diet strategies, the bottom line is that everything is dependent on energy balance or imbalance. Meaningful strategies to determine calories in versus out allows a fighter to plan their weight loss over the duration of a fight camp. This sets up the final weight cut to start from a lower number in order to reduce extreme methods and unpredictability at the 11th hour.

The most common weight cutting strategy I hear around the gym is some kind of carbohydrate sparing or ketogenic diet. However, the importance of carbs for for fighters is critical. To get some buy in, Dan referenced studies by Noakes et al and Hall et al that found no difference in weight changes across subjects who sustained a low or high carbohydrate diet given the same decrease in overall calories. In addition, another study showed that subjects who included bread in their diets actually lost more weight than those who did not – highlighting the importance of a diet that is sustainable, rather than the mystery weight loss qualities of bread.

Proteins, carbohydrates, water, and electrolytes should all be consumed before, during, and following a training session. The main one most fighters don’t get enough of is actually WATER. Can you imagine water being the difference between winning and tapping out? Actually, performance and endurance levels start to decline with as little as a .5% loss in body water! This only worsens at greater levels of dehydration with strength and coordination deficits, cramping, heat exhaustion, and even altered mental capacity when you exceed a 4% water loss. This can mean a slower reaction time to get your underhook or maybe even forgetting your game plan.

Immune function depends on 2 major factors: diet and sleep. We’ve touched upon energy balance, but I’d like to quickly discuss sleep. Sleep is an essential component of recovery and regeneration without which our bodies could never see gains. While it’s important to achieve an adequate training level to spark adaptation, it’s equally important to sleep in order to maintain these gains and minimize the risk of getting sick during your fight camp. There are tons of methods to improve sleep hygiene including decreasing screen time before bed, breathwork, and meditation, but I think the biggest takeaway from Dan’s talk is that even a 15 minute increase in sleep has been demonstrated to improve immune system function.

Your supplement needs depend on your personal vitamin and mineral status, so it’s really important to work with a professional. But I will share 2 of Dan’s examples of how supplementation can influence training if appropriate.

  • ZINC: Your body needs zinc to create thyroid hormones; thus, depending on your baseline, zinc levels can significantly affect your metabolism. Dan referenced someone who added zinc supplementation and increased their metabolism by 992 calories per day. This not only impacts the possibility for weight loss, but also could be used as an additional 900+ calories towards fuel for performance and recovery.
  • IRON: Iron is critical for strength development and muscle function. Dan referenced a study where a volleyball team was split into a control group and a group receiving an iron supplement. During the season, all members of the team had the same training and competition program, but those who were repleting iron experienced 2x increases in strength. This could be critical for maintaining strength levels in sports with constant competition, such as BJJ.
Below I’ve added a few takeaways from Dan’s lecture that I found most interesting regarding each of these elements:
1. Psychology
2. Energy Balance
3. Carbohydrate Intake
So not only is it supported by the literature that percentage of carbs doesn’t affect weight loss, but carbs are essential for performance and recovery. Carbs fuel anaerobic performance – this means kicking, punching, jumping, and many other integral movements for martial arts. In addition, carbs are truly the master fuel. This means that when you’re training, the body uses carbs as the primary fuel source. In a carbohydrate depleted state, there is an increase in stress hormones that actually breakdown muscle tissue and decrease muscle mass and immune function. The body needs a readily available fuel source in order to spare muscle tissue.
Peri-Workout Nutrition
You can see that it is essential to achieve proper hydration to maximize performance. Dan suggests a minimum threshold of .5oz per pound body weight daily, that increases with training intensity. Strategies that I use to ensure that scaled amounts above threshold are appropriate for training include re-hydrating based on weight change during a training session, as well as urine analysis.
Immune Function
Vitamin and Mineral Status
A big thank you to Dan Garner for sharing what was obviously just a tiny peek into his vast knowledge about training nutrition. Remember that your nutrition needs may not be the same as your teammate’s. It’s important to reach out to a professional to develop the best program for you. Finally, always listen to your body, it will give you more insight than you can imagine. I am looking forward to rewatching this lecture on the online stream to pick up even more information!
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Find out more about Dan Garner at www.coachgarner.com.
Read more from Laurey at @Combat_Physio or combatphysio.com

Some patients have recurrent sports injuries, others have persistent pain or conditions that flat out don’t respond. Whether it’s sports medicine research or research on nutrition or wellness, there are 5 things most people can do to overall be healthier. These are back to basic essentials, except they are all modifiable ways to improve health and wellness.

1) Get better sleep
  • Poor sleep patterns/habits seems to be a pattern for
  • Athletes with recurrent injuries
  • Athletes who are underperforming
  • Individuals with headaches, chronic lumbar pain, or general persistent pain states
Actionable/Objective steps
  • No blue light exposure 2 hours before bed
  • Try to get 7-8 hours of sleep (+/- 1-2 hours depending on the individual) 
  • This can easily be tracked with a Fitbit or similar smart fitness tracker or smart watch, log it daily in your calendar
  • Use white noise, avoid alcohol and caffeine after 6 pm
  • If you have to, time block your sleep time to be consistent every night - no smartphone, games, tablet after this
2) Move more often
  • One of my favorite nutrition websites, nutritionfacts.org recently stated your blood literally starts to have a semi stasis after only 1 hour of sitting
  • Even studies showing people who have 1 moderate-heavy workout but are overall sedentary the rest of the day are at higher risk for CV diseases than people who move regularly throughout the day 
  • A simple solution one study found for chronic LBP was to take 2 walks/day
Actionable/Objective steps - use a fitness tracker, phone, or smartwatch
  • Move hourly - go for at least 250 steps/hour - my Fitbit notifies me to move and tell me how many steps I have
  • Try to go for the vaunted 10,000 steps/day - I was shocked after running a 5k I only got a little over 3000 steps!
3) Strength Train
  • General exercise, and particularly strength training has been shown to reduce injury rates in many sports
  • Even individuals with persistent pain states who are centrally sensitized obviously benefit, but they first have to accept they may have some degree of pain or discomfort for the rest of their life
  • You also have to be careful not to flare them up, and grade the training
Actionable/Objective steps
  • Get programming from a personal trainer or online
  • Time block in your calendar 3-4 days a week to strength train, time blocking makes it something you have to check off before you day is done and makes you more accountable
  • use Google calendar, which now integrates with both apple health and Google Fit - to find times in your calendar and block them off - then track using Fit/Health
  • Much better than saying, “I’m going to work out a few days this week.”
4) Mindfulness
  • Mindfulness has been proven to help anything from chronic pain states to addiction
  • Even if you do not have any pressing health/pain states, mindfulness can help your personal life and business mindset
Actionable/Objective steps
  • Download or join on desktop the app Headspace - it takes you through guided mindfulness 10 minutes a day
  • Time block it daily
5) Adopt a plant based diet
  • Another nutritionfacts.org citation stated that as little as one hour after eating animal based proteins (dairy or meat - yes even lean meat), there is a low level inflammation in your blood stream
  • Not EVERY one needs to go plant based, but it does improve overall health (reduces risk of CV disease, reverses it as well, also reduces the risk of some cancers)
  • even taking tumeric daily has been shown to reduce inflammation - does inflammation cause pain? No, but it sensitizes peripheral structures
Actionable/Objective steps
  • Used Dr. Michael Greger’s app, The Daily Dozen - available on iOS and android
  • Try for a score of 50 for 1 week, then 60 on week 2, 70 on week 3, and maintain 80 or higher for 4 weeks and on
An important part of going through a program like this is that it has to be accountable and objective. Patients also have to realize that it takes time for these changes to occur and they may not immediately feel better. Chronic pain patients may still have pain for example, but they may have more energy and endurance, while simultaneously prolonging their life. Who wouldn't want that?

When I get a chance (in all my free time), I’ll make this a calendar or excel based checklist you can give your difficult cases. I just gave this advice recently to a young DPT I have been doing online consults with. This was after most traditional treatments had failed to help his chronic low back and leg pain. The mindfulness and plant based diet was what he needed to get him over the hurdle and start graded exposure back to working out and running.


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. Live cases, webinars, lectures, Q&A, hundreds of techniques and more! Check out Modern Manual Therapy!

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The next Modern Manual Therapy Webinar is scheduled for Sept 30th, 8:30 pm EST! Mike Eisenhart of pro-activity.com will be presenting on Nutrition Basics and Metabolic Syndrome.

Not only will this be a great refresher on nutrition, but there are great business opportunities to learn how to add wellness to your practice! 

You will learn
  • Metabolic related conditions and the impact and opportunity they bring
  • Discuss the PT's role in nutrition and an understand how nutrition related services can be incorporated into traditional PT practice
  • Assess metabolic screening data and understand coaching strategies that can produce clinically relevant results
These webinars fill up fast and replays are only available to participants and to subscribers of Modern Manual Therapy Premium!

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...






image from slideshare.net

The ecosystem, or overall health of your patients is probably something you do not have to take into account in most of your cases.