Month: July 2022

The one question your healthcare provider should be asking you

The One Question Your Provider Should Be Asking You EP|73

Live LOUD Life Podcast
Lafayette Colorado

Episode 73

The One Question Your Provider Should Be Asking You

With Dr. Antonio Gurule


Sometimes we’re unable to do the things we want because of pain, being out of shape, or simply lacking energy. Therefore, we need help from a professional. With many chiropractors and physiotherapists to choose from, sifting through to find the right one can be difficult.

In this episode, I uncover one way to tell if a chiropractor, physiotherapist, and healthcare provider truly cares about your interest and will get you the results you’re looking for.

Episode Highlights

01:13 – Alarming musculoskeletal pain stats in the US
02:03 – The pain management crisis
06:10 – What’s your motivation for dealing with pain? What do you want to be able to do?
07:44 – My problem with functional improvements and assessments
10:23 – The question your provider must ask
13:00 – One size doesn’t fit all when it comes to achieving your pain treatment goals
14:50 – Trustworthy coaches, personal trainers, physiotherapists, and chiropractors are an investment, not an expense.


About Dr. Antonio Gurule

Nutrition Building Blocks Broken Down

Background:

  • Father
  • Doctor of Chiropractic
  • Owner of Live LOUD
  • Personal Trainer & Health Coach

Antonio 00:00
What’s up guys. Welcome back to another episode of The Live Loud Life podcast. My name is Dr Antonio, your host of The Live Loud Life podcast. happy that you’re here. I’m happy that you’re listening and you’re jiving with our content and our message here.
00:25
What we’re about. If you’re new here, our role is to help guide you to the adventures that you’re made for. Obviously being chiropractors and coaches, we do that through a multitude of different approaches, but we try to meet you where you are. And that’s a little bit of foreshadowing into what we’re talking about today.
00:45
What we have found is families deserve more from their healthcare providers, and we hope that we can fill in the gaps of the message and the questions that you are not getting answers to through the knowledge and expertise that we have. And we do this in a subset of different niches and specialties of which is, primarily prenatal, postnatal, and pediatric care, which is what my wife Dr. Nichelle does. But then outside of that is just musculoskeletal pain. And I heard a stat the other day. This was kind of a reflection off of COVID 2020 and 2021. This is not what we’re referring to, but it started with the mental status of the United States adult. This was just the adult population, not to mention what was happening on with adolescents, teens and, kids is that 40% of them were at an elevated stress level, compared to what they were previously. It just added so much more stress on that.
01:46
But on top of that in, and stress having part a play in that, is at any given point in time, it’s estimated that 35% of us are dealing with some form of musculoskeletal pain. That’s a lot. When you look at the total population of the United States, we’re just talking about United States stats, 35%, a third of you, one out of three, is dealing with some form of musculoskeletal pain.
02:11
Now we know that a lot of this is being mismanaged. i.e., there’s an opioid in pain medication crisis. That’s been what’s going on with fentanyl from just a drug perspective of what’s being prevalent on the streets as well, is there is a crisis around how to manage pain. And most of this is dealt with a numb suppressing sort of approach. In reality, when we have a better understanding of what pain actually is and what’s happening, we can take grasp and form some form of autonomy around our pain.
02:50
Now, there are a subset of cases. I always say this because someone’s like, oh, what about this? What about this? There is obviously a subset of pain that needs a multifactorial approach that might include some form of medication. But as seen this week in particular with three hot low back cases. When we say hot low back cases, this is your typical, I bent over and my back went out situation. I can’t walk. I’m about to go to the hospital to get medication, but I don’t want to.
03:20
It was all dealt with a movement approach, of which we were able to retrieve 50% reduction in pain mitigation with a few basic exercises, explained in a certain context and form to help these individuals get control of their pain in this immediate set so that they can start gaining some momentum in a positive direction rather than going through a negative feedback loop. So what we’re seeing is this approach of not understanding how to actually manage musculoskeletal pain.
03:55
Now, when you’re in this world, as obviously most of the listeners are not, is you see this constant battle of- and this is true in any industry, to be honest, of like how to best approach these. You know, you have one side that thinks this, you have another side that thinks this. Look at just how our nation’s run of just a two-party system, and then the complete opposing views of those and realistically not getting a lot of stuff done in that, but this is not a political show is.
04:25
But that’s what we see. We can’t find a middle ground of understanding that you have to have a patient-centered approach. And that’s what today’s show is. If you feel that you have been, or your case or your musculoskeletal pain or your injuries have been mismanaged, because you got one person saying this, you got another person saying this, you want conservative methods, but you don’t want to take medication, but yet at the same time, they’re not getting you anywhere because you’re self-reliant on not only medication, but maybe physical therapy or chiropractic adjustments. If you feel that your case has been mismanaged, this is the show for you. This is how to manage musculoskeletal pain. And this is through one question and one question alone.
05:07
Now this is a ‘who’ not ‘how’ question. Meaning, this doesn’t necessarily tell you the how; this just indicates the appropriate question to determine if you have the right provider who will provide you, who will be the ‘who’ for you providing the how, the means, so on and so forth.
05:29
And this is a question that we’ve heard in multiple different areas from multiple different people in one way or another. Some have obviously coined the term to be theirs, but it’s something that’s been around coaching and marketing and advertising. Realistically, this comes down to the trust factor and the trust factor is whether you as the client, patient, or member trust the individual.
05:56
And if the individual is asking this question and they’ve gained your trust, then you know you’re on the right path. But the question sheds light to the underground or the underlying truth message or goals that you’re trying to accomplish. So it’s really more about you as the client and patient as a self-reflection, but it’s hard to know that if you’re not being asked the question.
06:30
A thought process is important because when you’re dealing with musculoskeletal pain, if asked incorrectly, the answer is, well, I just want my pain down. Well, why is that important? This has been asked, like the five whys. You just keep asking why, you keep asking why until they finally break down and cry because they know the real answer.
06:58
I’m just kidding. They don’t always break down and cry. They know the answer because you’ve dove in far enough to determine their true motivation. Now, when we’re dealing, obviously, with musculoskeletal pain, it’s less about immediate pain. It’s more about, well, I can’t do X, Y, and Z, which are important to me. And I would like to do that.
07:22
And to name off a few of these most recent back cases is I love gardening. It’s summertime in Colorado. I want to be able to garden. I want to be able to enjoy my yard. I want to be able to enjoy the outdoors. And I can’t do that right now because of my pain. Or I lead an active lifestyle. I want to be able to go paddle boarding. I want to be able to go hiking. I want to be able to do those things. I want to be able to get down on the floor with my grandkids or my children to enjoy time with them, but I don’t feel comfortable about that. I want to be able to sit in a meeting and not feel like death when I get up.
07:55
And this is more of a motivating factor for vocational improvement, whatever that might be. And in reality, what it looks like is it’s very draining mentally and you want your energy back.
08:09
And so we now start to see a different criteria on what goal outcomes we should be looking for. Many a times, providers, such as myself are looking for “functional improvements”. And this is dictated by the insurance model. Meaning they want you to go through a checks and balance list to determine if there is functional improvement to understand if your treatment is showing improvement.
08:42
Now, there is validity to that. Meaning a lot of times these functional assessments are based on, well, getting dressed in the morning is easier. I’m able to do more activities, but from a functional improvement, what others are looking for is just like, I’m able to measure your stability or quantify your stability or quantify your range of motion.
09:08
And that has improved. Thus you must be improving. And I think there’s a time and place where that could be important, but for me, I hate that. I don’t think it’s valuable. I don’t think there’s a lot of great carryover to the conversation to you as a client, member, or patient of really understanding what that even means.
09:28
Now I could say, yeah, you look like you have about 30 degrees range of motion, and I can ballpark that and describe it, but it has to be put into the total narrative of what we’re actually trying to do, i.e., your goals of getting back to X, Y, and Z.
09:42
So I always ask, what are the things that you want to be able to return back to? That gives me a clear, defined movement pattern or criteria of which we’re trying to achieve. And then we mold and blend our treatment approach to be able to do that. So if you want to be able to do gardening, oftentimes you have to pick up a bag of mulch or some compost or something like that that could weigh anywhere between 30, 50, or maybe more well. Here’s a kettlebell. I’m going to teach you how to pick up an odd object or a box or something like that that weighs a certain amount. And that way, you gain a specific parameter idea and feeling and more context – again, context, context, context – around how to move, navigate, and manage the pain that you currently have, but then also in the future to reduce it.
10:32
Now, coming back to the question. So the question that we ask on every single new patient that comes in the door that we’ve been treating and, or if there was a new issue or a new problem that we’re trying to solve is, Hey, if we’re sitting down here now, depending on obviously the length of what we’re talking about. Sometimes this length will change, whether it’s three, six, a year, or three years. We’re just going to pick three to six months to just start the narrative.
11:05
I’m just going to read you here to make sure I kind of get it right. Obviously this speaks off differently depending on the person. But if we’re sitting down here having the same conversation three months from now, and you’re looking back over the past few months, what has to happen for you to actually feel confident or happy about the progress that you’ve made in your recovery to make that this was a successful investment in your time, energy and money.
11:43
This is an open-ended question to allow you describe what’s important in your life. What are the things that you can reflect upon that you really want and that are really important. And oftentimes this is described in a way that is not forced upon, but someone will ask you like, well, do you want to be able to do this? Yeah that would be nice. That’s not motivating enough for you. And it’s not that motivation is the key to this, but if I’m able to tap into and understand realistically what things you want to be able to do, I can better approach that.
12:26
Now this is the question, again, that every single healthcare provider should be asking whether you’re coming in for cardiac support from your cardiologists, maybe your rheumatologist, so on and so forth, so that they can navigate not only the management of that, but then address it appropriately with maybe medication, but also with an appropriate referral, not just the standard cookie cutter.
12:51
Well, you need physical therapy. You need to get your heart stronger. You need to get your joints stronger. More times than not, musculoskeletal conditions should be managed on, we’ll say a progressive subset of physical therapy in chiropractors and rehab professionals, but personal trainers and strength conditioning coaches, with the caveat of understanding about pain management. I think there’s obviously a subset of personal trainers and strength conditioning coaches who are just kind of the same run of a mill. Hey, we’re going to put you in a group, bootcamp, doing this and make you stronger. Things need to be tailored.
13:29
That’s the approach that we’re trying to get to is when you’re dealing with musculoskeletal pain, unfortunately, and I do apologize that this is the way it oftentimes goes, is unfortunately this changes the narrative and context about how things should be approached. And some get more musculoskeletal complaints than others. And that’s just the nature of it.
13:55
But I always try to emphasize the gift of injury. Be blessed that you’re able to actually move and navigate through a lot a lot of these situations. Many people are actually not able to do that. But be blessed in understanding that your body’s trying to tell you that, Hey, what we’ve been doing in the past is not working. And if you want to live a long, loud, active life, something has to change, and this is your body’s way of telling you, just like I wish I was able to have a certain thought process that I see others are able to accomplish. It’s just not the way that my brain thinks. And I have to go through sometimes along the route in order to achieve a certain goal, results, or just even a mindset and thought process that I’m trying to go through where others it just seems to click.
14:44
It’s just how it is. And unfortunately that takes more time, energy investment. Based on my knowledge, I don’t have to invest as much time, energy, and money in coaching from a health perspective as far as like nutrition and personal training, so on and so forth. But for me, I have to invest more time and energy on someone who can help me navigate my thoughts and mentor and coach from that perspective.
15:15
It’s based on our strengths. The question again, helps you navigate well, what are the important things? This same question is asked in a different context professionally and personally. Well, what has to happen if I was to go with a coach? What has to happen in my life?
15:33
For me, reflecting back, that would say this was a successful investment of time, energy, and money, both professionally and personally, over the next three, six months, year or three years. I would answer with, well, I want to be able to be here. I want to be able to do X, Y, and Z. I want X amount of revenue. I want to diversify into maybe other investments or something like that.
15:57
So you just have to understand that the friction that you have in your life, whether it’s mentally, whether it’s musculoskeletally, whether it’s, a form of health cardiac– but basically just your lifestyle, your health. We all have some friction at different points of life. And your investment is an investment. Your payment is not a cost, it’s an investment, but the due diligence of making sure investment is properly allocated should be navigated through questions such as this.
16:40
If someone’s just going through this, you know, checking on the box and saying, yeah, we can help you. This is pretty standard. Here’s our protocol. So on and so forth. That’s not what you’re looking for, right? You’re investing a lot in this and your provider should be diving in and trying to understand what your goals and motivations are in, in relation to musculoskeletal pain and why that’s preventing you from being able to do that so that they can bridge and connect the gaps to get you back to that quickly.
17:09
Obviously it’s very motivating, but more importantly is getting you back to that with the utmost confidence in whatever you were dealing with before. So for instance, in that case before of gardening and lower back pain, my patient Michelle, that was dealing with, it was not about getting her back to gardening.
17:27
It was getting her back to a point where she felt confident in any sort of gardening task that she would come past: picking up a bag of mulch again, picking up a bag of compost, picking up a large rock that needed to be moved from A to B and having the knowhow of how to pick up odd objects, but also how to leverage her body to be able to do it, but also have the strength and capacity to be able to accomplish it so that she didn’t fear having a recurrence or something like that.
17:57
So, once again, the question that I want you to consider, not obviously asking, but if someone’s not asking you, this is like, Hey, this might not be the person to team up with you. This might not be your who for your how, is if we were sitting down having the same conversation three months ago, and you’re looking three to six months ago, and you’re looking back over the last few months, what has to happen for you to feel confident or happy about the progress you’ve made and the investment of your time, energy and money and your care. And then you share it.
18:39
So if you’re not getting these questions as described previously here, it’s a thought-provoking question. It’s intentionally framed in a way to have you reframe and reference what is actually your goals outside of just pain reduction and management, when we’re talking about musculoskeletal pain and finding the right person and provider.
19:11
Oftentimes while, as we know, manual therapy is very beneficial, oftentimes it’s just having someone work through these questions with you to help you get the right answers and the right direction. In this same example, obviously Michelle, who saw me with some lower back pain for gardening. She was nearby and she was able to come see me and the power of manual therapy and adjustments provided a catalyst to the system.
19:42
But we have worked with other individuals from San Diego all the way out to New York that are going through the exact same thing. And we simply frame the same question and did an evaluation virtually to help guide them. Hey, this is what I’m seeing. This is where you are. This is how your pain’s being described. Based on that history and examination of what I’ve asked you to do, I have a strong feeling it’s this. And if you want to get back to X, Y, and Z, gardening, snowboarding, hiking, riding your horse, whatever that is, here’s the best approach that we can do, that we’re going to build mobility around these joints because it’s really important for you to have mobility here and here to reduce added load onto your lower back, as an example.
20:24
It’s really important for us to go through stability exercises, oftentimes seen as core exercises when we’re talking about the lower back, but here’s how I want you to approach it. So more times than not, this is a conversation of navigation, not essentially implementation. And then finding other obviously resources if manual therapy or adjustments or something like that might be needed.
20:45
So, we always say the foundation of recovery is that narrative in that conversation of understanding that, and there are obviously proper diagnostics of knowing the context of the situation. And then the manual therapy is simply a catalyst. It does help you get there faster if someone knows what they’re doing and they do it well, but it’s not always needed.
21:07
So I implore you to dig deep. You are vetting me as a provider. Obviously, if they’re a referral, they come trusted from obviously who referred you, but it’s still, in my opinion, your responsibility to vet your providers. I encourage anyone coming in to ask questions about what we do so that I can get them to get to this, so I can have a conversation and be able to ask these types of questions, so that I can know if they do trust me. Because if there’s no trust in that relationship, it’s not going to be a successful relationship. You’re not going to see the amount of success that you could see if you’re working with someone that you actually trust.
21:52
So, if you don’t trust your provider, I encourage you to find a new provider. There are plenty of providers out there. Now, those trusted providers sometimes come at a premium, and that premium should not be again as a cost. This is an investment, and oftentimes it saves you actually time, effort, and money in the long run because you’re able to get the results that you want based on that question a lot sooner than if you were to go with your standard run in the mill situation.
22:21
So if you are digging this, please share it with someone else who’s been frustrated of going through the system. We appreciate if you’re digging this to give us a comment, to like, to subscribe, to share this so that we can get this message out that there are providers out there that want the best for you, and that are not just trying to push you through the system and push you through the wheel.
22:44
And if you have any questions specifically about certain topics, we’d love to be able to address those. So please shoot us a comment and you can shoot us an email at hello@liveloudlife.com. Our social media is @live.loud.life on Instagram. And then we have you can check this out on YouTube. We have a number of different pieces of content and videos on YouTube, helping you deal with musculoskeletal pain from a number of different issues, prenatal, postnatal, pediatric care, so on and so forth.
23:17
So thanks again for tuning in, guys. Live loud. I hope you have a wonderful week, and we’ll see you next time.


Progressive Play, Developmental Milestones & Pediatric Physical Therapy EP|72 W/ Nicole Schremp PT

Live LOUD Life Podcast
Lafayette Colorado

Episode 72

Progressive Play, Developmental Milestones & Pediatric Physical Therapy With Nicole Schremp PT, DPT, PCS

With Dr. Antonio Gurule


How do you know if your infant or child is progressing appropriately?

You want the best for your kids and while some would argue not hitting certain milestones are not an issues, addressing these issues earlier than later will help the gain strength and confidence to interact with other children as they grow in any situation

Episode Highlights 

What are developmental milestones?

What are some of the ways a pediatric physical therapist can help?

How is pediatric physical therapy different from what is considered “standard” physical therapy?

Why is “play” considered to be so important?


Nicole Crippen Schremp, PT, DPT, PCS

Background:

  • Mother
  • Doctor of Physical Therapy
  • Pediatric Pediatric Specialist

 

00:09

Alright guys, welcome back to another episode of the Live LOUD Life podcast, I am with Nicole Schremp. She is a pediatric physical therapist, we just wanted to have a conversation and chat around what really what, you know, pediatric PT could look like some of the common things to look for, that might indicate or warrant, you know, consults or a conversation with a pediatric physical therapist. She’s, she’s at Children’s Hospital here in Denver today, for those of you who are local, and want to have a conversation, but I’ll let you introduce yourself, talk a little bit about you know, your history, what you what drew you to Pediatric Physical Therapy, so on and so forth. Awesome.

 

00:55

Well, thank you so much for having me, it’s an honor. Um, so as we talked about, I am pediatric physical therapist. So I completed my doctorate physical therapy at the University of Colorado. And while I was there, I actually had my first clinical in pediatrics and really had no idea what this field was I came into school thinking I was going to go into sports. And during the first clinical, I literally fell in love with the population. I have always had this motherly instinct and loved like babysitting and being with kids. And then I went, I found out PT and I get to be with play with kids all day, I just, it was wonderful. I continued to explore different avenues throughout school. However, kind of circled back to my last clinical, I went down to Texas Children’s and was inpatient there. And it really just solidified that I wanted to work with pediatrics. Knowing that I also knew how much more there was to learn, I was like, we only got so much when we were in school. So I applied and was able to complete my pediatric residency after I graduated, so that just gave me so much more exposure and experience in all different settings. It was a 13 month program that just finished last July. So I feel so fortunate to have continued my learning and every day, I just have more more questions. And love, literally love what I do.

 

02:35

That’s amazing. So when now, at least for me, and I think for most people, when they hear physical therapists, they usually think about, well, a something hurts and or post surgical. Right. So like I had surgery. And so let’s go to a physical therapist. So how would this? How would this conversation differ? And obviously kids do get injured and unfortunately have to go through surgery and things where that would be applicable. But my understanding is your role is separate from those Correct?

 

03:06

Yeah, that is correct. So I do a lot more with the developmental side and children. As a pediatric physical therapist, just broadly, we work with children and families, we want to assist the child in reaching their maximum potential in whatever capacity is the goal is that they can be active participants like in their home, in their school and in their community. So we want to make those everyday activities easier for kids. This can range from a child who might not be hitting their milestones. As the CDC puts them out there, we know that all kids have different trajectories in development. But sometimes, some kids need a little bit more help to start rolling or walking along those lines. And that’s more of that early intervention through the hospital. Now I am in a more developmental role. So children that have longer term care in the hospital, they can’t leave for one reason or another. I am helping them with those opportunities, giving them more opportunities to work on their city and and they’re rolling and all of those foundational moments and movements that we need later in life.

 

04:25

So obviously, in a similar field and understanding this but for for listeners. And we had on I had a conversation via messenger with a pediatrician at one point when the CDC took out crawling as a necessary developmental milestone. We’re not gonna get into the details of what the conversation was. But why is why are rolling, crawling and these types of things foundational Are these importance for the listeners or parents, you know, people just like, Oh, it’s okay, they didn’t crawl, they’ll be okay.

 

05:06

Well, in a broad sense, we want kids to have opportunities, we want them to move and explore their environment. So whether it’s them developing strength or improving their range of motion, or crawling really helps develop those fine motor and all of those arches of the hands and helps open up our hands in preparation for different activities. So all of those different areas, I really want a child to develop that symmetrical strength and range of motion. And we also need to be able to weight shift our body when we’re little, which we don’t think about to move forward and back or side to side and be able to catch herself, which helps us start with that balance. It’s going to help develop core strength as we’re moving in and out of, you know, our bases support. So where do we feel really stable? But are we able to go out and go get something and then come back without falling? All of those different pieces are going to be really important to start developing for children. So that they can, when they’re older, be able to do what they want and move around? Well,

 

06:13

yeah, no, I think that’s such a good explanation of it. Because I mean, when you look at, and I’ve heard multiple people say this in a number of different ways, but but rehab, rehab, training, whatever that might be, is really just a an extension of training in general, because when you’re talking about adults, it’s really no different. The more exposure you have to certain things makes you well rounded and better able to handle situations.

 

06:39

Yeah, that’s it. That’s exactly it. It’s key after PTS that we play, we do so much play with children, we just are trying to give them opportunities to explore their environment that they might not be either getting because they have an injury or, or we have to teach families to help them really learn how they are involved in their child and how we can make these activities. Functional, and really fun. But parents are really the driving force behind who we collaborate with.

 

07:14

Oh, yeah, for sure. I mean, kids aren’t going to do it on their own right. So when, when you’re having let’s say, for instance, you’re you’re at a barbecue at a you’re at, you know, whatever else having a conversation with somebody, what are some of the things that you encourage people to to look out for that might indicate outside of a pediatrician saying, hey, it looks like we’re behind on certain things. Because with a lot of things, there’s silent or subtle markers or indications that something might be going on where obviously the better to intervene before it starts to develop into a obviously a poor pattern.

 

07:57

So that’s, you know, it’s a broad question, but also not so I think some different things, especially for thinking about a child and their development. So what does that zero to 12 months kind of look like when we’re supposed to be able to roll and be in our belly and lift your head and set all of those as kind of progressive to help us walk it and move. So some things that, you know, we’re looking for, we want a child to be when they’re on their back, like kicking their arms and legs against gravity, and like kicking them in a symmetrical pattern. So we have both arms and both legs are be able to move, they’re able to bend and straighten and bend and straighten. That’s not only showing, there’s the good range of motion, but it’s also showing they have some strength, they’re actually moving their body against gravity, which for them is a little bit heavier than it is, you know, for us. We’re also you know, thinking about if a child is standing, that they’re able to stand and kind of move their body side to side versus are they only standing on their left leg? Like, maybe they’re not strong enough to move back and forth? So some other pretty common ones that we’re hearing more about our children just do they only turn their head to one side? Is there a flatter spot on one side of their head? So that’s where you know, there’s some different indications of torticollis or plagiocephaly? Or, you know, those those more? I guess like, is a child just only looking one way? Or are we able to have full range of motion in our neck to look both ways? So I think those are some of the big things that we’re looking for. And some children just aren’t as motivated to move with others. So is that a child and if it is like that might be their personality, but how can we keep encouraging them to move and want to explore by giving them fun activities, or something that they really want to get to is a cause and effect toy really appropriate for them? So They hit something that lights up and they’re like, oh my gosh, I want to do that again.

 

10:04

Yeah, no, I mean, and that’s what’s so interesting too. I mean, part of a lot of this is just obviously general observation, right? Because a kid is not going to be able to dictate and tell you if something’s wrong, or if they feel unbalanced or pain outside of crying. But yet, I think just overall perception and awareness for our own bodies is something that a lot of us lack. So I think just paying attention is such a big important thing, not only to your own body, but also to the kids to see what, what seem what seems off, outside of, you know, more serious things. Why do some of these things occurred like, like a strengthen bounced, outside of like a, you know, a significant neural disorder, which would be obviously more prevalent, or I guess, more, more prominent? First, I want to see, how do these strength imbalances occur in kids, when you would think there’s like, well, they’re just a kid, shouldn’t they just be naturally doing these things?

 

11:05

Yeah, it can be a hard question. It can be some, you know, sometimes, kids, our families need them to maybe be in a carrier more, or they’re in their mercy more, or they’re not exploring as much, or sometimes they might just, we might always hand them something on their left side, not even thinking about it. But there were only handed on their left side, or sometimes, however, we lay them down, everything might always be on the right. So they might only be rolling to the right. So their strength in the, you know, some core muscles and our arms and neck muscles only in one direction. So sometimes it just might be things that we’re not even thinking about. But when it would, kind of back to what you were talking about, in terms of observation, so much of what I do my first session is just watching a child move. So the power of observation of seeing how, what are their movement patterns? How are they moving? Do they have a variety of movements, or some things that we run into in the hospital, we only walk in on one side of the room. So if a child’s head is always to one way, they might only be strengthening moving as they roll to the you know, left, because that’s where everyone is, that’s where action is. Which could be true at home with changing tables or crib, they might just environmentally get exposure more on one side than the other.

 

12:32

That’s a good point. Because as I’ve had this exact same conversation with individuals that have multiple monitors, that you know, it’s I have two monitors, but ones over here and they gotta catch in their neck because they’re doing they only look right, they never look left and or we just live in this world. We don’t look out and around to create more exposure. Do you? Now obviously, being a pediatric physical therapist, do you see any adults do you intervene with adults? And my my curiosity with that is and I’m not sure if you’ve heard I’m sure you have though, is DNS dynamic neuromuscular stabilization. A lot of that’s based on developmental patterns, where they use these principles to intervene even with adults and getting people back into developmental patterns to fix issues. Do you find benefit in what you’re doing with adults as well as exploring these developmental patterns?

 

13:26

That’s a great point. So I don’t I ever since graduation, I’ve really been focused on now are named pediatric. Yeah, I have heard of it. But I don’t feel like I can really speak to it right now. Because that’s not where gotcha I’d be shocked if I wouldn’t see. I wouldn’t find it valuable for them just because knowing what I know about kids. So that’s something that I yeah, I do really have my niche right now. Most of the time, sometimes there are more adults with congenital or more pediatric diagnosis that I see right throughout the hospital, but most of the time, I’m working with children more on that developmental side. So working on those, those early motor skills.

 

14:17

What’s the obviously there could be put with plagiocephaly separately in Georgia call us like a fairly early intervention. What’s kind of like the the, I guess, average range of kids ages that that you do see or is it is very broad and wide.

 

14:35

It’s very broad and wide. I think I most I guess if I had to pinpoint it would be like zero to probably five right now is most of what I’m seeing at the hospital. During my residency, I was I spent time outpatient and did do some sports, pediatrics. I also was in the school district at Cherry Creek, so I worked with first and second graders. I’m so I have had that early experience. So from that zero to three year old all the way up to you at 1920. Knowing that right now I’m back to the younger age group.

 

15:14

Now, for adults, when, interestingly enough, sometimes when we’re dealing with like a weakness issue, their body weight, as you had indicated for peds, which is different, obviously based based on the age, but their body weight is too much for them, is there a time where you’re, you’re using resistance training outside of their own bodyweight, ie, different modalities or bands or something like that?

 

15:42

When I was in the sports, kind of doing more ortho for one day a week, for those nine months, when I was in the residency, we definitely were using a lot of bands using different probably very similar modalities that you would use on the chiropractic front. But definitely ankle sprains or low back pain or rehab from a sports injury, all those things that I think when you think about physical therapy, and kind of where your mind tends to go

 

16:11

outside of that in your specialty of zero to five, it’s pretty much just exploration, crawling groundwork, so on and so forth.

 

16:18

Yeah, it’s a lot of like giving these children opportunities and making it fun and exciting. And like, it’s a lot of play, we want them to want to do the movements, like it’s, I will do some facilitation to help them get into certain positions. But we’ve found more and more research of just like that cause and effect of them doing it and we get really excited or like they roll up, we’re like, oh my gosh, that’s amazing. Or they roll and they get some reward on the other side, whether they see a book they see mom, or you know what that looks like. So a lot of it is just using the child and letting them explore their environment and that reward of clapping or you know, some of those things, so they get really excited. Do you

 

17:03

is there any? I’m sure there is benefits? I don’t know if it’s the questions asked correctly. But if you do intervene with it, but is there advantages to doing soft tissue work in any situation to help facilitate a you know, some massage or vibration to activate something

 

17:21

100% And I was just in a continuing education course over the weekend, looking at how breath really impacts the body’s movement and core and thinking about some of the children I work with have tricks and bent. So they’re the top of their breathing, you know, is impacted because they have that open hole. So what is what can you do for read mobilization or some soft tissue massage on the ribs to really help expand and improve breathing, which is also going to help in so many different ways?

 

17:56

That’s interesting. Yeah, that’s a really good point. What are what are a few things just, I mean, obviously, in our industry, there’s certain there’s certain things that we want people to, I guess Miss tuberous, if you will, but not even Mr. Buzz, just like what are a few things that you think you would you’re trying to get out that people that people should know, about Pediatric Physical Therapy?

 

18:24

Yeah, that’s a great question. I think the big thing that I want people to know is encourage your child to explore like, it’s okay to let them play on their own and be able to move around in their own environment. And it’s also okay, if you have some questions on things that might not seem right for your child to ask your pediatrician and really use them as partnership. If they’re, you know, think everything’s fine, and you just still have your like parent instinct that something’s going on, reach out to a PT or look into early intervention. If it’s if you’re zero to three years old, it’s something that would be a it’s really great service for children with any sort of delay to receive services in their home. So I would just, I would just say, if something doesn’t feel right at all, whether it’s, you know, your chiropractor or another PT or your pediatrician, and if you don’t get an answer, just continue to ask.

 

19:33

How might I mean, this is? This is such a funny question, I think, because we kind of get the same. For adults, it’s harder because creativity, especially in that type of setting is is harder to intentionally elicit. But But if play bass is so important, what things do you tell your parents Now granted, you’re seeing them in an intervention status, if you will? But what things do you encourage people to do? If clay base is so important? How do you encourage parents to help their kids play more at home?

 

20:09

Yeah, I so one thing is really just talking to parents, what is your routine at home? What is your day look like? And then how can we put little pieces into their day that you don’t really think about as therapy, but therapy, so say diaper changes is, is something that we’re really working on some for strings. So we want parents who After every diaper change to help the child bring their hands to their toes. So something you know, you’re already bringing your self, the child on their back. So we’re really working on touching our knees or our toes in that position, or did the child love bubbles, like, let’s play bubbles down the hall and see if we can encourage them to crawl to the bubbles or to stand up to pop the bubbles. Putting little squiggles on Windows to have them stay in there and just pull off the little swigs. It’s really a ton of core strength and balance and reaching. So there’s a lot of different play based activities that we can get really creative with, and really seen the big pieces like how does it fit into their life and their routine? I don’t want to give parents a laundry list of homework, I want to give them some things that they are like, oh, yeah, we basically do that. But I can tweak it this way. And that’s actually going to help their child their individualized program of whatever that child needs to get stronger, or more whatever, like developing those skills.

 

21:41

And I think that’s I think that’s such an important way of getting at it because we say something very similar, right is it’s like, oftentimes, what we’re doing is no different than what you’re already doing. But the intention of how you’re doing it just changes slightly. And that makes the world a difference.

 

22:00

Portal. That’s the I love that how you set that the intention? Yeah, that’s exactly it. We’re making it fun and enjoyable, but they’re just a little, there might be a little different tweak, to really help us get that result that we’re looking for, or the child is going to start doing something just a little bit different. And parents are like, Oh, my gosh, this is wonderful.

 

22:21

Yeah, yeah, that’s awesome. I think that I think, I think that’s all I think that’s amazing like to it, because obviously, there’s there’s extenuating circumstances of more serious conditions that require a lot more obviously, one on one, but for the general type of public of having these things, most kids are doing fine with it, because they have this natural exploration, but making it fun in in seeing the games can also highlight certain things. I mean, I know for our kids, we talk a lot about like, they naturally go, I’m gonna pretend like I’m a dog, and you’re seeing how they crawl or do all these other things. And you really start to see discrepancy, so on and so forth. So that’s, that’s a lot of great information. I honestly, I learned so much. I don’t have a lot of other follow up questions. I think this has been wonderful for me to share to give people an idea, especially not to, because I think there’s a number of great pediatricians out there. But I think a lot of times these in our world, these movement based things of what we find to be super important, sometimes just get swept under the rug, they’ll grow, they’ll grow out of it as what we commonly hear, right. But we, you know, my thought is, well, maybe, but we might as well optimize them so that they can be interactive with their peers at school at home.

 

23:46

Yeah, I think that’s the big piece, we just want the child to participate with their family, friends in school environments. And you’re right, they might grow out of, but they might not and why not get evaluated by, you know, whatever setting that is, if it’s, if it’s a PT like to have a PT just do an evaluation, see where they are some other ones that we hear a lot that they might grow out of is to walking. So definitely that’s one that I did bring up before but something to be on the lookout for. So anything a child does all the time that they their only way of moving W sitting into another one. So it’s okay if we’re you know, going in and out of it or using that to transition but if we can’t move outside of sitting, you know in a W position or we’re only looking into our head to one direction or only walking on those toes, it’s kind of when we get siloed that that might you know, something that we definitely want to look at it. We want just kids to move. We want that variety. We want them to just do different things in different ways.

 

24:55

That’s such a good that’s that’s a good point too, because I think I think it’s kind of hard to say They sometimes like, well, what’s normal is like, well, when you walk when you look at anybody walking, we all pretty much walk the same way. And when you see something else like, well, we kind of use general general common sense. Like that doesn’t seem natural to how everyone else moves or walks. Same with crawling or scooting. Yeah, they’re like, well, they get around fine. Well, yeah, cuz they can, like we’re the other example that we commonly use is like humans are very task oriented, goal driven, as you said, I want to do this because I get a reward. We’re no different. If the task is to run a mile, you’re going to figure out how to do it, regardless of its efficient or not,

 

25:42

right? Yep. And that’s it. Some kids, there’s so many different ways of crawling, if you like, look on the internet or research, there’s like, I mean, so many different ways, we would ideally like a child to hands and knees crawl, because they’re getting cemetry, they’re getting reciprocal movements, they’re strengthening both sides. Some of these other ways of crawling, the child is efficient, they’re getting around, but might only be strengthening one side, or they might be putting one side of their body in a less optimal position. So we want the reason they’re doing that as they figured out how to move and get that reward. But we want them to let them keep going. But we also want to strengthen and you know, work on whatever other piece there is to that?

 

26:25

Yeah. Well, I appreciate the time this has been this has been extremely helpful for me as well. And obviously good to always see like, what are what are certain things that are coming up that are like, hey, it’s always that’s a hard conversation to sometimes like, this doesn’t look normal. But it’s just it’s, it’s worth asking a few questions and knowing who to talk to. Is there. Is there anything else that you would like to leave people with that has come to mind that maybe I didn’t ask a question about,

 

26:55

you think that it, I really, just to circle back, let your child explore, be able to have fun and play inside outside all of those different areas. And just trust your instinct. If you feel like you want to ask them questions, please do?

 

27:12

How can how can people reach out to you? If they want to work with you or or anything like that?

 

27:19

Yeah, I would love to hear from you with questions or anything. So I have an email address that I’ll pass along that we’ll be putting this in the show notes. Nicole dot c that Trump dpt@gmail.com. It’s a little bit of a handful. So we’ll just put it in the show notes. Have it be there?

 

27:38

Well, perfect. I really want to appreciate you taking the time out of busy day and chatting with us and sharing your knowledge.

 

27:46

Awesome. Thank you so much. One last piece that I want to put in the show notes too. If you’re if you have questions on milestones, work, and the CDC has different avenues for milestone trackers and milestones. And then

 

28:02

for early intervention, because this does come up every now and then where would one reach out to or who should they who should they be researching or looking out to for those early intervention resources.

 

28:12

So early intervention is a federally mandated program. So it’s like support for an education for children, you know, developmental delays and their families. So it’s anyone from the zero to three, you can go on. And I think if you just type in early intervention, there’s different community center board. So you want to reach out to your community center board or ask your pediatrician for a referral.

 

28:39

That’s probably Yeah, so it’d be a pediatrician be a good resource early intervention. Yeah. That’ll come up. Yeah. Well, thank you so much. I really appreciate the time and chatting.

 

28:50

Thank you so much for having me.


How to Choose Weight Lifting or Training. EP|71 Live Loud Life Podcas

Live LOUD Life Podcast
Lafayette Colorado

Episode 71

How to Choose Weight Lifting or Training.

With Dr. Antonio Gurule


Want to increase the weight you lift?

Or the number of reps you do?

Whatever your goals are, Dr. Antonio has guidance for you.

Episode Highlights

3:00 – “How do I know what weights to use? / How many reps to do?”

5:00 – Tough at 10 method

=7:30 – Goblet squat sample of building up weight or reps

15:00 – Discouraging from doing the same exact workout day after day


About Dr. Antonio Gurule

Nutrition Building Blocks Broken Down

Background:

  • Father
  • Doctor of Chiropractic
  • Owner of Live LOUD
  • Personal Trainer & Health Coach

Anthony Gurule  00:00

Hey what’s up guys, welcome back to another episode of the Live LOUD Life podcast. My name is Dr. Antonio, I’m your host of the Live LOUD Life podcast. My wife and I, we co-own Live LOUD Chiropractic and Coaching here in Lafayette, Colorado. We are just outside of Boulder, Colorado in Boulder County. And our mission is to help families. We want to help make families stronger, so that we can build a stronger community. We want to help guide you to the adventurous life that you and your family were meant for. And we do this through chiropractic and coaching. chiropractic, obviously being more of a hands on approach, more of a clinical conversation, clinical diagnostics, but the coaching aspect is really what we believe is, you know, the foundation of what our system methodology, whatever you want to call it is, because a lot of this comes around through just coaching suggestions and recommendations. also, you know, obviously within that comes into clinical prescriptions of certain things to eat or supplements, so on and so forth. But it’s coaching a lifestyle, it’s coaching, it’s coaching a philosophy and a foundation about how to live an active healthy life as an individual, and setting an example of a healthy active life for your family, for your immediate family, for your friends, and more importantly for your community. So stronger families to make a stronger community as a whole would be a win win, right? And that’s what we want to be able to do. we want to be able to help fill in the gaps in the holes that you’re maybe not getting from, from other roles and conditions.

 

Anthony Gurule  01:43

And today that’s in particular where we’re going to talk about. it’s going to be a little bit more of a shorter episode because this is more of a quote unquote, you know, just discussion around how to lay out a framework and a better understanding of how to work out or what exercises are safe or maybe not safe during pregnancy. This is a very, very common question that we get.

 

Anthony Gurule  02:12

My wife Nichelle has created a mini course that has some workout ideas, recommendations, and prescriptions than laid out into a workout. She guides and  educates other clinicians on how to broach this topic as a chiropractor, how to better serve prenatal patients through chiropractic care, but also exercise recommendations and prescriptions, having recommendations with other personal trainers within the community whether that’s CrossFit whether that’s Orange Theory, chatting with coaches and owners and saying hey, if you have prenatal patients and they’re having these types of symptoms, or this has happened, here’s some better recommendations, not modifications. We call them lateralizations–you’re just you know, you’re doing something something different or something else we you know, we borrow that term from Charlie Weingroff, who’s a physical therapist and strength conditioning coach. But it also and also doulas, right, doulas and midwives and OBs who are directly involved with the prenatal process from nearly conception all the way through, having this conversation. we know that exercise is important during pregnancy,

 

Anthony Gurule  03:19

There are so many different studies that talk about the benefits of exercising during pregnancy, not only for the mom, but also for baby, which is quite interesting. They’re seeing increased cognitive-what’s the word I’m looking for? Excuse me, their cognitive output as a as an as a child through as they age is actually better from moms that actually worked out during pregnancy.

 

Anthony Gurule  03:50

Now this is tough, right? How do you define working out or exercise? it’s different for everybody. But we want to, and we encourage that, and yet we’re sympathetic to the different stages of life, aches and pains, so on and so forth, which obviously would limit what you can do from an exercise perspective. So you know, it’s a bit of a gray area on determining what is working out? what is exercise? What are the physical guidelines or recommendations for pregnancy? And without getting into the like, nitty gritty detail of every single thing. And obviously, every potential situation, if you had this versus this, what could happen? we’re not gonna be able to do that. What we just want to lay out is what is what are we trying to accomplish here, and we want to encourage you to stay as physically active as possible.

 

Anthony Gurule  04:41

And one of the things that constantly comes up is, well, should you add something in that you have not already been doing? Let’s say for instance, someone just through the stages of life with work and kids or whatever that is, they were not able to work out as much before they got pregnant, but now that they’re pregnant, whether they have more time or they understand the importance of exercises during pregnancy, well, would we say, “Well, you haven’t been exercising, so you shouldn’t do too much.” No, that doesn’t, that doesn’t really make sense. Now, we would encourage not to do too much, there’s obviously, you know, a too far swinging the pendulum of the other way. But we wouldn’t say “no, don’t exercise because you weren’t doing something before,” we just have to find those first few stepping stones to help them start to gain some momentum. and help hold their hand, if you will, So that their technique and they feel confident about lifting, or how far they’re walking or whatever that is. And that’s an important topic, because a lot of times people want to add things in, but they weren’t quite ready or weren’t doing them before. And they then assume that they’re not able to do them at all. So you do have to take that in consideration, there is a ton that you can do, and that you can still add, even though you weren’t doing them prior to pregnancy.

 

Anthony Gurule  05:54

Now on the big questions is, is it safe? you know, outside to contact sports, or different things like that the majority of what you’re going to do is safe for pregnancy, right? Rock climbing, we have pregnant patients that have been rock climbing before, obviously, there’s a certain inherent risk with certain sports or activities. You know, you could fall off riding your bike, you could fall over running, right, so we’re not encouraging any of these by any means. We’re just kind of, you know, setting some suggestions, if you will. And you have to take into consideration.

 

Anthony Gurule  06:31

Now, there are certain things to consider when you’re talking about like weightlifting, and how heavy and the intensity that you’re doing. And if you’re doing Valsalva movements, which is essentially holding your breath to maintain a more rigid or stiff torso, as you’re seeing changes in blood volume and blood pressure, you know, you do have to take that in consideration. And that is again, of course a conversation with your provider that is managing your, your pregnancy, but we recommend Mama’s weight lift, or do resistance training. During pregnancy, again, we talked about about load management and the intensity and things like that, but you can still lift and do fairly intense things. And it’s a fairly as a you know, as a scale and a wide range during pregnancy and see a ton of benefit from that. Now, are we trying to hit one rep maxes and PRs during pregnancy, I mean, some would argue yes, but I would argue, why, that’s not really an accurate representation of what your strength is anyways. So you know, you do have to to kind of keep manipulating the numbers and the weights and the intensity and the sets and reps in order to do it. But weightlifting and resistance training is safe, and it is effective. Now, outside of that, there’s not a lot of unsafe things to do, again, outside of contact sports, or things that would elicit, you know, potential trauma to you or baby based on impact we’ve had, again, not our recommendations, but some have tried very just easy scheme, because they’re in the winter months, and they wanted to and they felt very confident about not falling. So you know, you have those types of things.

 

Anthony Gurule  08:16

Overall, again, we’re talking about movement. You need to move, and it’s good to get your heart rate up. And it’s good to breathe hard. So that doesn’t mean just because you’re pregnant, you can’t do HIIT training or circuit training or CrossFit or Orange Theory. But you do have to listen to your body and understand certain signs that would indicate that things might be too much, right? Now those are going to be different for everyone, but a lot of this comes down to you know, lightheadedness, you know, breathing too hard. Certain aches and pains within lower extremity, chest, abdomen, so on and so forth would be obviously like your more extreme ones. If you’re becoming pale or anything like that, I mean, again, these are the same criteria, though, that would be if someone else was working out or training too hard. So it’s realistically the same thing. It’s just that your threshold level for all those most likely have gone down. And depending on what type of an athlete you were before, you’re going to be maybe a little frustrated that you’re not able to do the things you were able to do previously, which makes sense. But if you’re someone who wasn’t exercising before, you’re probably going to be a little bit more hyper aware of that, of just feeling that shortness of breath or that uneasiness. So again, we’re not saying you have to push through that because we’re not trying to set yourself up for a strength and conditioning program to increase your metabolic capacity to increase your strength and conditioning during pregnancy. We’re trying to help you maintain a healthy active pregnancy.

 

Anthony Gurule  09:54

Now, walking. walking is great. but in general, we encourage you to do something above and beyond walking. Obviously, again, certain things would dictate that you would not be able to do so. And this is again, any exercise. Any exercise that you do during pregnancy needs to be consulted with and work through and have a conversation with the primary physician who is managing your pregnancy, whether that’s your nurse practitioner, your midwife or your OB or obstetrician, right. But we would encourage more than just walking. walking is fantastic, but that’s kind of like your baseline minimum, right? Just like our activities, or recommendation activity guidelines. We want a few days a week of where we’re kind of just doing this steady state getting our steps in, you know, kind of pushing ourselves, we’re huffing and puffing, but still just kind of at that conversational level, but you’re not really getting a lot of benefits outside of that.

 

Anthony Gurule  10:55

So if you’re just walking, high five. kudos. can you do something more? Can you do some bodyweight squats? Can you do some bodyweight, you know, good mornings? can you do some walking lunges? do you have a suspension training, we’re able to do some bodyweight rows? Do you have some bands that you can do some rows with? You know, there’s a lot that you can do that allows you to get a little bit more out of that. Now, again, this all comes back down to preferences of exercises that you like to do, because that’s gonna allow you to maintain the most consistency, but then also the intensity that you like to do. And we do encourage having an open mind and at least being willing to try some high intensity things that allow you to still get your heart rate up a little bit. And it’s okay to lift more than five or 10 pounds. And not saying that that is a bad thing. There’s programs out there where it’s all directed around that where it’s lighter weight, high rep, but I just don’t want individuals and mamas to feel like they’re not able to do more and or being ashamed because other people are just saying they should back off because they’re pregnant. “why would you need a lift that much?” It fits within your strength, and your comfort, and your wheelhouse, that is totally fine.

 

Anthony Gurule  12:05

Again, you if you’ve been doing that enough, you understand the risk reward ratio and having a conversation with your practitioner has driven us to kind of help navigate and guide as you start to get further through pregnancies, what things maybe we need to change or manipulate. But that’s totally fine. Now outside of that, the question around safe also comes up around core exercises. diastasis recti, pelvic floor strength, so on and so forth, we want to enhance the capability of understanding how to control tension within your abdominal wall and your pelvic floor through pregnancy, because the pressure is increasing due to baby taking up more space. But we’re not we’re not necessarily we’re not gaining more strength, right.

 

Anthony Gurule  12:45

And so what a lot of people assume it’s when we’ve seen this, is “I don’t want diastasis. So I’m doing more core work to prevent diastasis from happening.” diastasis recti will happen in 100% of moms, it’s estimated at the week 35 Everyone will have some form of it. Now it is technically not a quote unquote diagnosis, though, until 12 weeks postpartum, because it is a normal thing that everyone will get. So you can’t diagnose someone with something that everyone will get–doesn’t make sense, right? So after that, though, if you still have weakness or spacing issues, then we can have a you know, a stronger conversation about putting a diagnosis on that.

 

Anthony Gurule  13:26

But what we’re trying to enhance and help is what exercises are quote unquote, not safe versus unsafe, but adding too much pressure or tension into the abdominal wall or the pelvic floor and creating more laxity. again, as that pressure for as baby’s growing starts to put more pressure on the pelvic floor and the abdominal wall. If you’re doing more things that increases the pressure within the within the abdominal cavity that’s going to push on that separation even more and/or push on that pelvic floor even more, creating potential incontinence or prolapse issues and/or more bulging and doming within the abdominal wall stretching out that separation or that gap even further, potentially making the recovery process more challenging or slightly longer. I’m not saying that it will but potentially, so we do have to take that in consideration. So we go through activation exercise of the pelvic floor, of the abdominal wall so that you better understand how to control those pressure increases while you’re lifting or exercising so that you simply can stay at a management level.

 

Anthony Gurule  14:28

And that in turn, helps you get through pregnancy of understanding how to lift up your older kiddo, having to lift up dog food or anything like that. It’s just managing and controlling pressure. So there’s really not anything that I would say that safe or unsafe. Now, things that we would advise against for core exercises is sit ups or crunches. You know a lot of those things that create like hanging knee raises and different things like that during pregnancy. A lot of those things that create a lot of intra abdominal pressure and tension. and especially during a flex position, that tends to put a lot more pressure on the abdominal wall, the separation where diastasis will occur as well as the pelvic floor.

 

Anthony Gurule  15:09

So, you know, while we never say never, there’s definitely a category of things that we definitely urge against because the risk/reward benefit and again, risk not being “injured,” But risk of potentially putting more pressure and making the recovery process  on the other side harder, is not is not something that we find to be as advantageous. But you can still get the benefits of quote unquote, core exercises through full body movements such as goblet squats, such as deadlifts, you know, depending on the phase that you’re in, push ups, which are, you know, a dynamic plank. or being able to do a TRX row, which is a reverse plank as you’re just lifting yourself up. three point rows where you’re on, you know, two hands or doing like a row on a bench, where you’re in a tabletop position that’s adding anti rotation exercises. So there’s a ton that you can do that still highlights and isolates, the core isolates, sorry. that highlights and will emphasize core activation, but through a full body compound movement. And what’s great about that is during pregnancy, depending on your energy levels, it’s hard to do all the little isolated accessory and all these separate exercises as it is. So it’s kind of nice being able to combine everything, so you get more bang for your buck, especially if you’re a parent and you’re on and you’re on baby number two or three, right?

 

Anthony Gurule  16:31

So what exercises are safe for pregnant women to do? All are. reduce or eliminate for sure contact activities, different things like that. the increased risk activities of you know, trauma and things like that. Outside of that you’re managing pressure, I would definitely encourage reducing anything that’s heavy lifting, that’s, that’s requiring you to do Valsalva moves, you’re having to hold your breath for an extended period of time. that changes blood pressure, so on and so forth. But outside of that, Pregnancy is a completely safe time to do all exercises. we definitely as we highlighted, urge and encourage, you know, certain things over other ones just for you know, added bang for your buck or full body movements, so on and so forth. And that, but outside of that you are free to do what you want.

 

Anthony Gurule  17:19

If you want guidance, though, you know, there are there are trainers out there that work specifically with prenatal patients. we would love to be able to have that conversation with you if that’s something you want to bounce back or navigate. Because we do want to encourage as much as we can. A very, very active pregnancy through exercise working out or however you want to describe that. So if you found this beneficial, please like share, subscribe. if you’re pregnant, I hope you can utilize this and take some of the information for you and yourself. If you have anyone else you know… a relative a family member, a friend who is pregnant and they’re unsure they’ve been you know asking this question what things I don’t know what things I can do. I don’t know if it’s safe for baby share this video with them. We’d love to be able to provide a better frame of reference and or context to be able to ask better questions so that they can find the workout program  or the movements that work best for them during their pregnancy. Until next time guys live loud .if you’re currently pregnant, Congratulations, and we look forward to helping and serving in the future.


5 Easy Tips to Improve Your Deadlifts (video included)

Today, we will be going over five of the top tips that we give to help our patients and our clients, who visit our Lafayette Chiropractic Clinic,  with deadlifting. 

Watch the video 

 

This is an associated video with a podcast episode that we did. It's the same information that we did in the Podcast. We just wanted to demonstrate what those tips are so that you can see it in live-action to give you a little bit more of a frame of reference.

Now, how can you apply this information?  

Well, digest it. 

Practice it. 

Film yourself. 

Get a coach. 

If you don't have a coach looking at you and you're trying to go through a self-developmental process, you're just trying to understand your body a little bit more. That is a fantastic way to understand what's going on. 

But sometimes, you need that expertise and coach's eye to give you what you need.

 

So let's dive in:

1) Keep the bar close 

 

The first tip is keeping the bar, or the weight closer to you and not letting it get too far in front of you.

From a side view I need my shins right up against the bar, so you can see how close that weight is to me. This helps me keep that bar path nice and straight and close to my body as I go up and down, hinging to do the movement. 

Now, if I did this exact same thing, but I'm standing out here, you can see how much further that bar gets away from me and I can feel how much more load and stress is being put on my back as a result of that. 

Now the same also goes true. If we're just talking about like a kettlebell. We prescribe sumo deadlifts or kettlebell deadlifts all the time. 

But what we instruct is for people to straddle, or stand directly over the kettlebell, okay, now, why is because it keeps that weight nice and close to you. And it allows you to sit back into your heels to make sure we're loading that posterior chain. 

But same thing, if I'm forward here, where that kettlebells in front of my toes, I'm going to be putting potentially a lot more strain on that lower back, because I've increased the distance from the kettlebell to the actual lever, moment arm, which should be essentially my hips, right.

So as I'm reaching forward, that's going to put more strain on here, now, you can still maintain a neutral spine, a long spine or a straight back, but just simply the act of having an out in front of you, even though my backstraight, this is having to work that much harder. 

So we want to make sure we're keeping the weight, the box, whatever that is closer to us, okay. 

 

2) Watch your speed 

Now, the second point that we want to make is pulling too fast. 

You can see in the video that I'm pulling the bar too fast. 

So what that means is, my shoulders are connected my arms, my hands connect to the barbell, the work is basically being done from here to pull my upper body up, which is effectively going to pull my arms up.

So what can happen is if I just start yanking too fast, I'm rising too fast. I'm trying to jerk that bar up to be explosive, because you want to move the weight all finding good, but what can happen with all of the speed is we lose tension and end up rounding the back. 

 

We're effectively not keeping all that pre tension that you've built up. And what happens is you want to yank really fast in the spine will end up rounding your back sometimes, because your body's trying to move too fast and you're not maintaining the tension.

We want to be able to make sure that when we're rising up the whole unit, and the whole system is rising up together at the same speed, and  we're not rising with a really fast, jerky motion.

 

 

3) Control your hips

The next fix that you want to think about is not letting your hips rise too fast as well.

I gave an analogy on the podcast, which I'm going to describe here.

Imagine my elbow is my hips. My forearm is my torso, and my fist is my shoulder.

So in this setup, which is a hinge, it's perfectly fine for your torso to be horizontal to the ground.

So what will happen sometimes is we'll set up and then we'll start to lift and the hips will come up, because you trying to pretension the hamstrings and the posterior chain.

When the hips start to rise too fast then the upper body is trailing which has to follow to lift the weight but they are not moving together. We want collectively for everything to be moving together.

As an example, let’s say we have a good setup. But based on maybe being a little bit too squatty or low, what's going to happen is once I want to start lifting, you're going to see the hips rise to increase tension in the hamstrings or posterior chaing.

You see this one step, two step jerky motion. It could be subtle and you might be maintaining a neutral spine still, but I'm shifting hips first, and then the rest is coming.

Again, the reason why most people are doing that is because we did not tend to pretension that posterior chain, the hamstrings and the glutes enough. And so your body's trying to find that tension, before you lift. Your body is trying to store up elastic energy to help you initiate the movement before the concentric motion of the muscles takes place.

Ideally, what you'd want to try to do is find that hip position that makes you feel like you're under that initial tension. And when referring to barbell deadlifts you're going to hear a little click as the barbell pulls into the ring of the plate. 

 

It is fine to start a little low, and then raise the hips a little bit. But that is the pre-tension, and then you should move as one unit. 

 

4) Activate your core and get your torso ready 

Next tip is activating your core and getting your torso ready! We hear brace, tighten abs, and a number of different cues that people will give when lifting to clients or coaching.
We are going to go back to our forearm analogy.  In order for the shoulders to effectively rise as the hips come through and forward. The forearm (torso or core) cannot be soft, right?

Notice, obviously, my, my forearm is one piece/bone. But that's essentially what I'm trying to do, I'm trying to turn my torso into one stiffened piece, so that the forced transfer that my legs are doing, as my hips are driving forward, will adequately raise my chest, raise my shoulders, raise my arms and raise the weight.

If we're soft, and we have a soft system, then as you come up, you're going to be dispersing energy all over the place and not being as effective and efficient. And this could could potentially lead to some back pain or an injury, right? So we want to make sure that that that mid system is stiffened. So that you can transfer all that force that you're generating to your shoulders, arms, weight, so on and so forth.

So what do we need to do? We need to stiffen the torso.

The torso is essentially the area from my shoulders, ball socket joints to ball and socket joints at the hips.

As I'm hinging, my torso stays together as a unit.  The curvatures you have in your spine as your stand with normal posture will be preserve and maintained when you hinge, it is simply your torso is in a different angle in space.

We're trying to maintain that and as the load increases, you have to stiffen the abdominal wall all the way around to ensure that you're keeping that together. We can do that by increasing your intra-abdominal pressure.

One of the main cues people understand will be to take a big breath of air in, increase the air and then hold it, that'll help stiffen your torso/abdominal wall.

One of the most important things to understand is knowing how much tension you need to generate. If you're over bracing it will not be useful for you and expending more energy than necessary. But as the task gets heavier, you're going to need to brace and stiff more, because low load is going to really challenge your positioning on that torso.

Another cue  is to stick your fingers into the space/midsection between your ribs and your pelvis. Next, pretend like you're blowing out a candle forcefully.  You should see and feel that part of your torso expand, right?

While I'm not pushing my belly out, that little cue of blowing hard stiffens the torso automatically and you get a little bit of an expansion of the abdominal wall. You should also feel this in the back. The next cue is the same but with a Wonder Woman or Superman pose.  With your hands on your waist and in between your ribs and pelvis your thumbs will be pointed and right in the side/back muscles near your spine.  When you blow the candle out you should feel a little pulse against your thumbs.

This is an amazing tool for someone who's recovering an injury who's feeling vulnerable in certain hinging or squatting positions.  We can enhance the bracing and stiffening because it's going to provide more stability, and more comfort, that allows us to keep moving and keep loading you and keep progressing while feeling more and more confident.

 

5) break down pre-tensioning and wedging  

 

The last tip is going to break down pre tensioning and wedging.

Pre tension or wedging is essentially one trying to pull themselves down into the hole or pull themselves into the bar, which is basically like compressing the spring. So when you are ready, you begin to release the stored up energy to help you initiate the movement, and then all the muscles involved in this movement are going to go through its concentric phase to actually lift me up.

When talking about pre tension or perhaps better understood as activation, we are trying to load and prime the posterior chain which would be the backside of the body.  And for deadlifts we are looking at the hamstrings, glutes, and back primarily.

We can facilitate the pre tension by wedging and pulling down into the bar, but we can also increase this tension by torquing into the floor.

When we tell people anchor your feet,  they are going to be screwing into the ground, without actually moving your feet.  This creates a coil of tension up the legs.

Now we also have to pre tension our connection to the bar, kettlebell, or dumbbell so that we have a strong linkage to the task.  If we have a weak connection or weak grip that is going to make it harder to move the weight.

So imagine a dowel, the bar, or a handle.  Your hands are right next to each other and you are trying to snap it in half like breaking a stick.

This is exactly like screwing our feet into the ground, only now your shoulder having coiled up tension that also connects all the way down to your lower back and hips through the lats.

So if effectively doing all of these things together, you're going to be in a stronger state to start the movement through better pre tension and wedging.

 

Effective & efficient deadlifts 

Each one of these tips coincide and overlap with each other, to effectively make the movement done more effective and efficiently. 

 

Now, when we talk about effectiveness and efficiency, that's good, because that allows you to lift more, and if done well, you can lift more and if done well, you also reduce the chances of overloading some of the more vulnerable places within a deadlift, which would usually be areas like your lower back.

 

Many of you may only be picking and choosing one or two of these tips to implement. Many of you know this ins and outs of deadlifting, but if you are new or hesitant because of a previous injury these tips will be very helpful for you.

If you're doing deadlifts, hopefully this helps you. If you're not doing deadlifts, I encourage you to do deadlifts. It can be barbells, it can be kettlebells, it doesn't matter. 

 

I just want you to pick up some stuff off the ground, make that posterior chain stronger, make those postural muscles stronger, make your hips stronger, reduce load and share load between the Jones joints to make your back pain better to help heal back pain.

 

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