More than just injuries.

Sometimes I've really thought about the name Victory Sports Rehab and if it does me a disservice or not.  While my training is as a chiropractic practitioner and a sports medicine doctor, what we are able to do at Victory is so much more than just waiting till you have pain or an injury.  But why would you come to a rehab facility if you weren't injured?

1. Injury Mitigation

This one is probably the most obvious.  Many times, injuries can be mitigated through prevention programs, exercises, and stretches by going through an appropriate screening.  Obviously there is no way to prevent all injuries, but compounded injuries through bad motions, muscles, joints, etc, can hopefully be at a minimum mitigated to not be as severe (or even subclinical).

The problem we find though is there are so many programs and people claim that they can prevent injuries, so which one is correct? If you've read my blog posts before, then you probably know my answer is about to be vague.

The answer? It depends.

I promise I'm not trying to cop out, but it really is case dependent.  There are a lot of general things that we can do (ACL prevention programs have done a good job of that) due to knowledge of the most common mechanisms of injuries.  I can run a baseball pitcher through an arm care program and probably make them better, but the only way to truly know if what we are doing is helping is by doing a complete assessment that includes active movements, passive range of motion, and coordinated movements.  In fact, coordination is a big factor I see in athletic injuries in children and adolescents.  I love what Eric Cressey has to say on this-

Don't take mechanics solutions to athleticism problems. Before tinkering with mechanics, make sure a pitcher can jog to the mound without tripping.

You have to be an athlete first before you can be a "sports player".  Fundamental athleticism is extremely important to every single athlete, no matter the sport.  In fact, the NFHS and University of Wisconsin conducted a study that showed athletes that played 1 sport were 70% more likely to suffer an injury than an athlete that plays more than 1 sport.  Why is that the case?  Single sport athletes tend to overuse the same joints by playing that sport 8, 9, 10 months out of the year (in some cases all year round), which causes compound damage to joints.  If you are only playing one sport, then injury mitigation and joint health has to be a priority, regardless of "pain".

2. Strength and Conditioning

A proper strength and conditioning program is VITAL to every single athlete, no matter the sport. Once again, it's not a one-size-fits-all approach.  How I would train a football player is different than a baseball player and is different than a soccer player.  Even within that, how I would train a lineman is different than a defensive back, different than a quarterback, etc.  Finding a qualified S&C trainer is one of the two most important off season investments you can make.  While your school or team may have a good coach, taking the time and investment to have someone actually look at your own movements, exercises, and mobility cannot be overstated.

The other important investment is your joint health.  I just talked about injury mitigation, and that goes hand in hand with the S&C.  Reinforcing proper joint motion is crucial to joint health and coordination (the athleticism I mentioned earlier).  The more good input you create in your joints, the better coordinated output you will create (garbage in, garbage out model).  I love how Dewey Nielson, one of the master instructors for Functional Range Conditioning and Kinstretch, describes mobility training.  He basically says that having optimal mobility is like having the cheat codes to movement, and let me tell you, he is spot on!

Personal story- I recently just started rock climbing again after 3 years.  I had a membership in 2015, before I started my own mobility training, and had a hard time figuring out the moves to bouldering.  When I picked it back up this summer, I can tell you that even without climbing for 3 years, it seemed so much easier with having good control over my range of motion.

It is imperative for everyone, but especially for athletes, to make sure your joints are functioning at their highest potential, and one of the best ways I have found is through Functional Range Conditioning. There's no fluff, it is just science and the application of proper stress.  


Honestly, you don't want to wait to see me until you have an injury. As my patients' know, I am gonna make you work, and it's usually easier to work with me when you're healthy than on your injury.  My love is helping athletes who are injured get back to playing, so don't let this post fool you into thinking I don't like injuries, but all of our goals, from the athlete to the coach to the parent to the practitioner, should be to create healthy athletes at all costs.  And I promise, investing into your health is less expensive than treating injuries...

Strong Scaps

Summer baseball has come to an end.  With just a few weeks until school starts, now is a great time to begin some off-season training! While baseball may not be the most intense sport, it does take a toll on the body, especially for pitchers.  So let's discuss some things you can do to help your arm this off-season, in particular taking care of your shoulder blades.

Why an emphasis on the shoulder blades (the technical term is scapulae)?  It is the foundation for proper shoulder movement! Without good scapular movement, overhead athletes cannot perform at their best, not just for baseball, but volleyball, tennis, swimming, etc.  Here is why:

The primary joint of the shoulder is the glenohumeral joint, that is the "ball and socket" that allows the majority of the movement.  The head of the humerus (aka arm bone) sits into the glenoid fossa (aka the socket) and is held in by tendons from the rotator cuff, ligaments, and the labrum.  The glenoid fossa is created by an extension of bone from the scapula, so all of the motion from the gelnohumeral joint is dependent on the scapula being able to create the range of motion.  As we raise our arms up, the scapula has to upwardly rotate to allow the humerus to rotate, otherwise the soft tissue in the front of the shoulder will prevent the shoulder from fully flexing.

Let's do this exercise- I want you to try to keep your scapula down as far as you can, and try not to let it move.  Then, try to raise your arm overhead.  Unless you are hypermobile (which is a different problem in of itself), you probably either feel pain in your shoulder or cannot raise your arm as far as normal.  This is why you need mobile scapulae, especially if you constantly use a shoulder for an activity.

So what are some good scapular exercises?  There are quite a few, and it also depends on your own quality of scapular motion.  But there are some that are great for almost every to perform.  Wall slides are a great simple regression to create good motion, demonstrated here by Lee Boyce from Eric Cressey's blog.  The landmine press is a great resisted exercise to allow proper motion into the scaps, which you can find on our Instagram page today (hint- follow us! @victotyrsportsrehab).  

There is a ton of problems with the scapula we could get into.  If you'd like to learn more, make sure you sign up on the Kinstretch page to receive news when our Victory Mobility Academy is launched! Dr. Blake will be going through step by step how your joints should be moving and what you can do to fix it.

"It's just an ankle sprain..."

If you played football, soccer, volleyball, or basketball (and basically any sport that requires legs), you probably have sprained your ankle at least once in your lifetime.  It's an inherent risk to most sports and one of the most common injuries in athletes, with an estimated 1.016 million reported ankle sprains per year. 

While there is not much evidence to support what we can do to predict an ankle injury, we do know that you are more likely to sprain your ankle again if you have previously had an ankle sprain.  So let's talk about why ankle sprains are so important to rehab properly and not just let it be-

1. Damaged ligaments can lead to long-term laxity.

Ligaments are dense connective tissue that have plasticity (simply means the quality of being easily shaped or molded), and with a serious stress to the ligaments into the ankle, they quickly take on the shape of the stress.  What does that mean? Imagine the plastic wrap around a 6-pack of soda cans.  Now if you stretch that plastic, it stays stretched and does not return back to it's normal shape.  That plastic is your ligaments within the ankle after you sprain them.

That is a very simplistic analogy and not quite accurate, as we do have evidence that ligaments can return back to it's normal shape after some time, but it is not immediate.  How you treat the ligament after the injury plays a big role on future plasticity of that soft tissue.  Without proper stress placed on the ligaments post-injury, the damaged ligaments can stay lengthened over a long period of time and can cause more injuries for the future.

2. It's not a big deal if my ankle doesn't heal correctly, so I don't need to get it treated.

Injured joints have effect more than just the bones and soft tissue.  Joint capsules, muscles, ligaments, etc, play a large role into the neurological system, and your brain and body depend on the feedback from those joints.  In a previous post, I have talked about proprioception, which is the body's ability to sense where it is in space.  If a joint does not have tension within the soft tissue, awareness is decreased, and can either lead to decreased coordination or compensation through other joints in the body.

3. It's not a serious sprain, I can just rest and ice it.

A low grade sprain can still cause a lot of problems, and just resting it (and even going on crutches and bracing it) can cause the tendons to shorten, making the ankle tighter and losing important range of motion.  Most commonly, people lose dorsiflexion in their injured ankle, which is a very important range to have freedom into.  With a loss of dorsiflexion, people have to compensate through other joints, such as getting too much torsion into the knee (think meniscus issues), or becoming quad dominate due to pushing through the toes (think hip impingement or patellar tendonitis).  If you do nothing to take care of preserving your range of motion and keep the healthy soft tissue moving, you can create more problems into other joints of your body.

Don't sleep on a sprained ankle.  Even a simple sprain deserves getting some sort of treatment that helps restore motion back into the ankle and work on preventing another ankle injury.

Is Crossfit a good workout?

I wish I had a dollar for every time someone asks me this question.  It's right up there with "what stretches should I do?"  And my answer is going to be the exact same-

It depends.

Yeah, that means you're going to have to read more into this blog post to get all of my thoughts! But that's because there's not much about health that is just black and white (other than eat well and exercise, but that's just so general...)

First things first, there is nothing inherently wrong or bad about Crossfit.  The idea that you are more likely to be injured because of a Crossfit workout is just not true.  If anything, there are many benefits to the movements and variations in a Crossfit WOD (workout of the day).  You have very complex movements that involve the entire body, demand lots of core strength and stability, and incorporates cardio elements within a strength workout.  Many programs I see at gyms usually focus on strength or cardio (the idea of weight loss vs. toning, which is not really true), but Crossfit does a phenomenal job of hitting both at the same time.

Incorporating lifting weights and high intensity cardio is a great way to create energy consumption confusion within the body, which is why many people see such great weight loss and body mass changes within a relatively short amount of time doing Crossfit.  One day you may have a heavy lifting day, the next is a ton of box jumps or rope climbs or odd object carrying, so you have to be ready for something new, and this keeps your body constantly trying to figure out what is going on.

The community aspect of Crossfit is one of my favorite things about each box.  I have never really seen a group of people supporting one another outside of a sports team like I do within Crossfit.  When you have a group of people that motivate and encourage you on a daily basis, you can really only see good results versus just working out by yourself or in a negative environment.  You also can make incredible friends for life and have a support group outside of just working out.

As I kind of mentioned before, the idea that cardio is for losing weight and weight lifting is for adding muscle mass is not entirely true.  In fact, you can lose a lot of weight doing a weights only program.  I also get asked by a lot of females if doing Crossfit will make them bulky and again, it just depends.  Everyone's body is different, so how our hormones react to exercise can create vastly different results.  If you run a little higher on testosterone, then yes you may have more muscle mass, but that doesn't mean you will "look like a man".  That takes intense training and a strict diet.

Which brings me to the next point and where I do see some problems within Crossfit.  Now before anyone gets upset at me, I am speaking on an individual level, not Crossfit as a whole.  I do see some people who have poor diets and try to do Crossfit but then get upset when they don't see results.  Diet and exercise go hand in hand, you have to have control of both to see true health expression and changes.  Also understanding how your own body responds to certain macronutrients is extremely important.  As for myself, I know I need carbs after a hard workout with my insulin spike.  If I don't ingest carbs within 30-60 minutes after a workout, I crash hard.

I also see people not eating enough calories.  Crossfit burns a lot of calories in a short amount of time, and you should not be reducing calories significantly if you are increasing your exercise routine.  Eating clean does not necessarily mean calorie reduction.  On the contrary, I've recommended patients actually increase their caloric intake by 500-1000 daily and we see MUCH BETTER results.  Again, everyone is different, so it is important to talk food with a healthcare professional or registered dietician.

My biggest beef with people doing Crossfit is not even about Crossfit itself, but the people who participate.  Let me explain- if you are a desk jockey (someone who sits at a desk/chair for 8 hours a day) and haven't been working out, stretching, whatever for years, and then you want to go do full cleans, heavy front squats, and box jump, you are asking for an injury!  Now, the majority of boxes I know make new members go through an on-ramp class to review movements, which is a great start, but rarely can you make true mobility changes within a month from years of joint abuse.

Like I said, that's not a Crossfit problem, that's a people problem and it is true for any type of workout.  You can hurt yourself doing basic cross training at your local gym.  You can hurt yourself doing yoga.  You can hurt yourself playing softball (men over 40, I'm talking to you... warm up and stretch!!).  The only reason we think it happens more in Crossfit is due to the complex movements and use of heavier weights.  Without properly working your joints, those problems were probably going to come out regardless of what type of workout.  Obviously if you can barely flex your arm over your head, then you really have no business doing weighted snatches and presses.  Does that mean you shouldn't do Crossfit?  Of course not, there are tons of modifications that you can do while you work on mobility.  Good boxes with good coaches know what limitations their members have and can always program a modification to the movements that you have restrictions in.

So if I had to some up and give you an answer, Crossfit is a fine workout, if that's the type of workout you want to do.  The important aspects of any exercise outlets is finding something you enjoy doing, make sure you have a solid diet, and if you have the joint mobility to do what you want to do.  If Crossfit is what you want to do, then I highly encourage it!  Is it for everybody? Of course not; but there is nothing inherently wrong with doing Crossfit.