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As I see it, every day you do one of two things: build health or produce disease in yourself.

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Running Injuries - Part 2
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    RunSmart Interview - "The Authors"

    Prior to my book signing at Leeds County Books in Brockville, Canada in August, I was interviewed by Doreen Barnes for BrockNewsTV. They have recently posted the interview online:     Many thanks to Dale…

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    BlogTalkRadio 11/10/09: The Injured Runner

    Join me on BlogTalkRadio on Tuesday November 10, 2009 at 8:00 pm central time for the latest episode of "Consumer's Guide To Health". If you're running a winter or spring marathon, you're probably well into…

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    MDT: A Powerful Tool With Athletes

    I have spent most of my career working with athletes, be they recreational or elite. They have run the gamut from endurance sports to power sports, and all points in between. Over 12 years…

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    A Conspiracy Of Silence - Part III: Health Care Utilization PDF Print E-mail
    Monday, 15 December 2008

    "Get your facts first, then you can distort them as much as you please." (Mark Twain)

     

    If the American public knew what was going on in the undercurrents of their health care, I don't think they'd stand for it much longer. Regardless of whether you have insurance or not, if the average person was a better consumer of their health care, they would demand accountability. They would demand results. And they would do so just as they do with any other free enterprise industry.

     

    First of all, it doesn't matter whether the care is good (outcomes-driven and evidence-based) or not, your insurance carrier is likely going to pay for it. What is currently accepted in our community may not in fact be a part of any accepted clinical guidelines, or, worse yet, it may be totally unsupported in the scientific literature. Though we are finally seeing some examples of “payment for performance” (something I wrote about here in 2007), the third party payment issue produces a potential level of mediocrity, whether we like it or not. Is there any reason to do what is best when you're going to be paid regardless of what you do?

     

    Second of all, this is another issue of trust. For years, we have gone on the assumption that the one person you can trust implicitly in your health care is your primary care provider. Why not? These gatekeepers are the revered ones, and thus we believe that what they do for us is in our best interests. The same is true of specialists like orthopedists. “Of course they will do what is best for us” ...

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    A Conspiracy Of Silence - Part II: Evidence-Based Medicine PDF Print E-mail
    Sunday, 07 December 2008

    We all want to believe that what is being done in our health care world is correct and for the right reasons. It is an issue of trust. For years, there has been a relative reverence for the role of health care providers (physicians in particular) in our community. And we have gone through history believing that health care providers act in our best interests.

     

    If there is one area in which this trust may be betrayed, it is in the health care world.

     

    The conspiracy of silence extends to our health care environment. The “silence” covers a broad scope – from evidence-based practice issues, to self-referral and “referral for profit”, and to over-utilization of services. And yes, these issues exist in virtually all communities in this country.

     

    Let' s start off with the most basic element of health care – that of “evidence-based medicine” (also referred to as “evidence-based practice”). In simple terms, this refers to practice patterns (how patients are actually diagnosed and treated) that are consistent with the scientific literature and/or established clinical guidelines. Why do we care about “evidence”? Because our task as health care providers is quality of care – and science is required to establish what constitutes “effective care”. Clinical practice guidelines don't tell a provider what they can or cannot do - they simply provide the framework for effective clinical practice. We are long past the days of leeches and blood-letting – we now have science to guide us. Without it, long-term health care costs will be higher, and the overall health status of our community will dwindle.

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    A Conspiracy Of Silence - Part I: Training PDF Print E-mail
    Sunday, 30 November 2008

     

    "The inability to challenge our belief systems in the face of good scientific evidence is the primary limiting factor in the advancement of both health care and coaching, as well as human performance and injury prevention" (excerpt taken from "RunSmart" - 2008)

     

    There is a conspiracy of silence in our community. It is evident in our health care, and it is evident in the world of fitness and coaching. It is a powerful undercurrent, a stealthy viral element that attacks us from all sides. Not a day goes by in which I don't witness it's effects. And the first step required to get down to the real issues in health care and fitness on a much broader scale, is to acknowledge and address it.

     

    Much of what we experience in the context of health care and fitness is what I would term "Flat Earth Syndrome". Let me explain. For a great part of world history, civilization thought that the world was flat. It was part of the commonly-held belief system of the ages. It was actually part of the religious beliefs as well.

     

    And then we discovered that - it wasn't. If you sailed a ship, you didn't fall off the edge of the world. You actually just kept on sailing. And suddenly, there was science to prove that the world was, indeed, spherical.

     

    “Shhhhh, don't talk about this. We have empirical evidence – and that's all we have ever needed. We need to be careful with this science stuff, because if it takes hold, we might lose our power and control. So let's just be quiet about it. Maybe if we don't talk about it, it will go away."

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    Stretching The Truth PDF Print E-mail
    Monday, 27 October 2008

    It's finally cooling off in Austin. With cooler weather comes the start of all the marathon training programs in preparation for the Austin Marathon in February. And with cool fall weather and marathon training comes ... yes, the questions about stretching.

     

    Stretching has become a panacea. So let's attempt to put a few things to rest with some good sports sciences evidence - though I suspect much of it may come as a surprise to many.

     

    Let's start with a couple of interesting facts. Research on 5K runners has indicated that the fastest runners are the most inflexible. The increased passive muscle tension effectively gives the runner "free speed" because it's not requiring energy to produce it. Add to that the lack of research supporting the relationship between stretching and ---insert injury here --- [options include plantar fasciitis, achilles tendonitis, IT band syndrome, etc]. So we have to assess stretching by starting with the questions "why am I stretching in the first place?".

     

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    The Reality Of Aero PDF Print E-mail
    Sunday, 12 October 2008

    In the world of triathlon, it's all the rage.

     

    Got aero?

     

    It is a big trend in the triathlon community - the perceived benefits of aero tubing, aero helmets, aero bottle holders - you name it, aero is where it's at these days. Whether it's a more aerodynamic frame, or more aerodynamic bike fit/position, or a more aerodynamic helmet, "aero" is a huge catch phrase in the triathlon world. This focus on aero was once again brought to my attention at the Longhorn 70.3 half Ironman last weekend. As I was there supporting a number of athletes that were competing, I witnessed a lot of aero frames and helmets (or "coneheads" as one of my athletes calls them). In some ways, these struck me as frightening trends in that there is obviously a lot of talk and marketing dollars going into some of the beliefs held by triathletes these days.

     

    And much of it revolves around the supposed benefits of aero on the cycling segment of the race.

     

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    2008 McKenzie Conference Of The Americas - Review PDF Print E-mail
    Monday, 06 October 2008

    At the end of July, I attended the McKenzie Conference of the Americas in Orlando, Florida. Though Orlando doesn't rate very highly on my short list of conference locales, the conference itself was well worth the time in the Land of Mickey. And though it may seem that a report of this is a little bit of "old news", I still think it's important to bring this to the attention of both clinicians and patients alike.

     

    The McKenzie Institute conference has a rotating schedule. In alternate years, it is an International conference which moves throughout the global regions that have branches of the McKenzie Institute. On alternate years, the conference is a regional one - for example, our region being the Americas. I've been able to attend all of the North American/Americas McKenzie conferences since 1994 (8), and about half of the international conferences (3) . After my first McKenzie conference in La Jolla, I came to the realization that the McKenzie Institute are commited to excellence in conference programming. Through the amazing work of Ann Carlton and the U.S. office, we have continually been provided with exemplary conference speakers and workshops.

     

    There are a couple of aspects of the McKenzie conferences that have always struck me as important. The first is that the speakers have been incredible. They are always individuals that are actively involved in either research or clinical involvement, and the information presented is current. Yes, current. That is a novelty in the world of conferences these days. I've been to far too many conferences and course that were out of touch with the issues that truly impact our profession. More often than not, the literature presented is current and relevant to clinical practice - if not truly cutting-edge.

     

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    Usain, Michael, And Lance PDF Print E-mail
    Thursday, 11 September 2008

    Usain Bolt,

    Michael Phelps.

    Lance Armstrong.

    What do they have in common? That should be an easy answer. It's certainly not their chosen sports - track and field, swimming, and cycling. These three fine athletes have shown us a glimpse of the levels of human performance that are possible. They have done things in their sports that many thought weren't possible.

    Usain Bolt was running with arms spread wide for 30m of his 100m final - and still ran 9.69, a new world record. Then he arrives at what he calls "his event", the 200m, and runs 19.30 - then proceeds to mug with the camera and play to the crowd and run around like a little kid, so carefree and playful.

    Having been in Atlanta to witness Michael Johnson's world record in the 200m in 1996, I can only say that I for one thought it would be a very long time before we witnessed another 200m world record. Bolt showed us it could be done.

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    Update: RunSmart Level One PDF Print E-mail
    Wednesday, 20 August 2008

    RunSmart Level One is an introduction to the philosophy and application of "RunSmart: A Comprehensive Approach To Injury-Free Running". Starting in September, RunSmart Level One will be offered in two different formats to more effectively guide the athlete - a four week program, and a half day weekend clinic.

     

    RunSmart Level One consists of both classroom educational sessions and practical gym sessions. Small group sessions promote interaction and more individualized instruction and supervision. Sessions are lead by the author, Allan Besselink, and Marc Frazier, owner of South Congress Athletic Club. Session topics include running mechanics/form, strength training, plyometrics and drills, and Recovery-Centered Training. The RunSmart book is used as the primary resource manual and reference for the program and is included in the program fee.


    RunSmart Level One is offered in three different formats:
    1. Classroom and practical - 2 sessions per week over 4 consecutive weeks (8 sessions total) - cost is $100. These sessions are offered on Tuesdays (practical) and Thursdays (classroom) at 7:00 pm at South Congress Athletic Club, the home of the Smart Life Institute.
    2. Classroom only - 1 session per week for 4 consecutive weeks (4 sessions total) - cost is $60. The classroom sessions are Thursdays at 7:00 pm.

    3. A half day clinic - covers the same content as #2, but in a 4 hour weekend clinic format - cost is $60.

    Registration is online with the next clinic on Sunday September 14, 2008 and the next four week program starting on Tuesday October 7, 2008 (introductory session on Thursday October 2).

     

    A Level Two program will also be offered in the Fall 2008 as an extension of the Level One program. The sessions will be smaller and more attention will be given to individual program development.

     

     
    The "Aha" Moment PDF Print E-mail
    Thursday, 17 July 2008

    Another athlete got caught cheating today. Another cyclist at the Tour de France - make that three for 2008's edition and we're barely through the Pyrennes. Is anyone surprised?

     

    Now before anyone starts the diatribe on how cycling is so full of drug users, let's remember that we've seen any number of athletes in any number of pro and collegiate and amateur sports test positive for a plethora of supposed "performance-enhancing" drugs. And let's also keep in mind that as long as athletes strive for greater performances, and as long as a truckload of money is being thrown at them, there are always going to be those that will try their luck with drugs.

     

    Oddly enough, this isn't the part that upsets me most.

     

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    Noise PDF Print E-mail
    Tuesday, 08 July 2008

    It's a noisy world we live in.

     

    "Noise" is not just of the "sound" variety. We are bombarded with sensory information all day long. It is a 24/7 process. We live in a world of data. Our senses take in so much data about the world around us that we can't even process all of it. You can't get away from information. Some have even gone so far as to call it "information overload".

     

    And I can't agree more.

     

    Why even discuss noise? It was brought to my attention by a client's comments to me yesterday. He remarked that in the time I have known him, I've always been able to "filter out the noise of the situation" to find solutions - as a PT and as a coach.

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