Personal Fitness, More Than Exercise

Personal Fitness, More Than Exercise

-Dan Allen, DPT

Resolutions are made leading up to every January 1st, but unfortunately, 80% of New Year’s resolutions fail by February. If your goal involved becoming a healthier you, maybe you joined a gym, or started a calorie deficient diet, or even opted for a “Dry January.” Honestly, you should be commended for your effort. The decision to improve your health is a good one. The problem is that health is complex and requires a plan with a great deal of patience and persistence to achieve.

The Plan of Attack is Crucial

From personal experience I remember the moments when I would walk into the gym and feel overwhelmed by the numerous choices of what could be done for the workout. Usually, I would simply step onto the treadmill or elliptical and try to sweat for awhile before hopping off without second-guessing my choice to workout that way. Surely, this is not bad. On the contrary those minutes were helpful for my heart health and kept my caloric burn above zero. However, I now see those moments were wasted opportunities that could have been remedied with a clear goal in mind.

The key to success is setting the right kind of goals and developing a plan to achieve them. Your plan needs enough detail to drive successful completion with enough freedom to modify when changes need to be made. The right plan of action involves a team to hold you accountable to ensure that you don’t drop your resolution by February.

The Right Kind of Goals

When I take on a client in personal training I help that person come up with clearly defined goals, so that we can mutually work to develop a plan for success. The plan should be focused beyond the most common goal of losing “x” amount of pounds.

When considering human motivation we know that pain can be a uniquely powerful tool to help us perform a behavior in hopes of feeling less pain. Sales people and marketers use these tools to encourage buyers to choose their product, whether or not they truly need or want it.

Salespeople have the skill of displaying their product in a way that gives soothing relief to one of our pain points. We can use this technique in ourselves to help instigate lasting change. So, is the point of losing weight just a matter of having less mass on the scale or is it more psychologically complex? Thus, your goals need to go beyond a number. The goal needs to correspond to something that really matters to you. What hurts you so much right now that you can’t do, but you would do anything to be able to?

Personal training should also focus on more factors of your health beyond your weight or body mass index. Training should focus on other health variables. For example, at the end of 2017 I had a client come to me for training who had an A1C, a measure of blood sugar levels, of 12.0, which would put her in the range of being very dangerous blood sugar and potentially deadly. By setting goals, increasing physical activity, and being held accountable, she lowered her A1C to a much healthier 6.5. That type of change is not one that will show up on the scale, but it is the kind of change that will keep you alive and functioning.

How to Stay Consistent

A lifestyle change is not a single moment in time, it is every moment in time. Patience and persistence is truly the key. The goal of all fitness intervention by a professional should be to educate, guide, and prepare someone to manage their own health.

If you would like to schedule a consultation to talk about what we offer for personal fitness training, please reach out via email dan@AGADAPT.com or phone (952)303-4550.

Treating Your Pain with Evidence

When it comes to musculoskeletal (think back, neck, shoulder, hip, knee etc.) pain there are just about as many treatment options as there are colors in the rainbow. That can be a good thing as it allows people to seek out potentially helpful options. However, in a country where hundreds of billions of dollars are spent each year on managing these conditions it is important to have some current facts to support how we manage musculoskeletal pain. That is why we look to the research.

In 2017 a research article was published that summarized 146 other research studies on the best treatments for musculoskeletal pain. The article gave us insight into what areas we can focus on to help people feel better when they are hurt. This was a valuable paper because it got to the heart of a complex problem and was supported by solid evidence, not the most recent fad treatment option that are shared by friends on Facebook or that you find on Buzzfeed.

Exercise, The Key To Pain Treatment

The pyramid below is a basic representation of what actually works based on current research.

The research article found that for musculoskeletal pain, exercise was the best treatment option available. The amazing thing about exercise as a treatment is that when someone is compliant with the exercise it has lasting effects. The trouble with more passive modalities such as acupuncture, TENS, ultrasound or manual therapy (hands on) techniques, is that when we follow individuals long-term the benefits decrease unless they are combined with exercise based interventions. It is amazing! A relatively low-cost treatment has a powerful effect to change pain for the long-term.

The Importance of Psychological Interventions

I do think that it is important to mention how important psychological treatments such as cognitive behavioral therapy and instruction on coping behaviors can be. It is important to always remember that none of us are just a bag of muscles and bones. We all have thoughts, emotions, feeling and perceptions, and all of those things can influence the pain that we feel. Because of that, it is important to dedicate time to making sure that our thoughts, emotions, feelings and perceptions are not interfering with our health and healing.

Pharmaceuticals and Surgery

Lastly, there are many cases where musculoskeletal conditions should be managed with surgery or pharmaceuticals such as NSAIDs or cortisone injections. However, those should be looked at as first line treatment options only in more rare circumstances. While also being costly, treatment of pain using pharmaceuticals and surgery comes at a greater risk of side-effects or complications. In most cases I highly recommend that an individual try more conservative options before moving towards injections or surgery to decrease the possibility of adverse effects as a result of these treatments.  As a former patient of mine once said, “No one ever dies of back pain, but some people have died from the treatment of back pain.”

So, next time your back pain flares up, or you try to throw someone out in your rec league softball and hurt your shoulder, consider trying conservative care before seeking out more involved treatment options. A physical therapist can be a great starting point that can help you determine whether or not you would benefit from conservative management with exercise or if you need to move further up the pyramid.

Babatunde, O. O., Jordan, J. L., Van der Windt, D. A., Hill, J. C., Foster, N. E., & Protheroe, J. (2017). Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS one, 12(6), e0178621.

Dry Needling in Physical Therapy

Poking into a structure that has been hurting may not make intuitive sense for pain relief. However, there appears to be value in having small filament needles inserted into an irritated structure.

The History of Needling for Medicine

Needling has been going on for millennia as more of an Eastern medicinal practice. Acupuncture as a practice may date back almost 8,000 years, though more certainly there is evidence of the practice appearing around 2,300 years ago. It was in those ancient texts that we can find information about meridians and the flow of Qi (chi), as well as how ancient Chinese people used acupuncture to resolve a variety of medical concerns.

Dry needling originated from studies based upon the principle of injecting very irritable muscles in the body with a small needle and some form of pain relieving substance. Then, it evolved as practitioners realized that they were seeing positive outcomes from the needle pokes alone without any injected substance. Thus, here we are currently with a more Western Medicine practice of using a small filament needle to address a muscle or fascia tissue that has become tender and painful (sometimes referred to as a trigger point).

The most frequently asked question that remains is: what is the difference between dry needling and acupuncture? The answer to that question is tricky due to the fact that both involve using the same or at least similar needles and the needles are poked into the skin to treat a given pathology. However, acupuncture is a treatment designed to affect the “energy” and Qi while working through meridians, while dry needling is a treatment designed to affect a specific muscle and the surrounding fascia and nerve tissue.

Research to Support Dry Needling

In comparison to other forms of therapies, dry needling itself is a relatively new treatment option. With any new treatment option the research is new and growing. However, at this point we are starting to see more randomized controlled trials and other studies about the effects of dry needling in rehabilitation. We have at this point research for the following conditions and anecdotes for treating a host of others;

• Knee pain

• Hip pain

• Tendinopathy

• Headaches

• Neck pain

• Shoulder pain

• Low back pain and Sciatica

• Plantar Fasciitis

• Tennis Elbow

• Myofascial Pain Syndrome

• Fibromyalgia

Does it Hurt?

Between 60% and 70% of individuals will experience temporary pain during the actual treatment session. It is also not uncommon to experience soreness following the treatment. Not everyone does, but you may feel that for 24-48 hours you have soreness at the site of the needling. Icing and gentle massage to the area can help with the soreness. However, remember that this procedure is done to help reduce pain related to musculoskeletal problems, so any temporary soreness should not interfere with the benefits of having needling performed.

Making the Benefits Last

Dry needling itself should not be the only thing you do to help your painful condition. You should be performing exercises including stretching that have been prescribed by your physical therapist. The needling is intended to help you have less pain and move better.

Call now to schedule! 952-303-4550 Or book online at www.agadapt.com

White, A., & Ernst, E. (2004). A brief history of acupuncture. Rheumatology, 43(5), 662-663.

He, C., & Ma, H. (2017). Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials. Journal of Pain Research, 10, 1933.

Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., & Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews, 19(4), 252-265.

Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(3), 133-149.