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Denver’s most credentialed Active Release Provider & only Denver Active Release instructor, Dr. Glenn Hyman.

It’s hard to believe, but in August, 2000 – 11 years ago – I got my first ART certification. In November, 2000, I went to Toronto to get my second. I remember getting heckled by Canadians over the Bush-Gore election mess.

Now it’s 11 years later, I’m proud that I’m the only Active Release Instructor in Denver (I was invited by Dr. Mike Leahy, the ART founder, to become an instructor in 2002). Tomorrow – August 5 – I’ll be completing the newest Active Release course, Active Palpation Technique. I presently have every credential offered by Active Release except this brand new course. And I’m proud of that.

The truth is that others take a few ART classes, and then loudly advertise that they are ART providers. But that doesn’t mean that they base their practices on Active Release like I do, or like my associate Dr. Jeff Stripling does, or like my friend, colleague and competitor Dr. Michelle Clark does.

Sure, at Denver Chiropractic Center we also use chiropractic adjustments and physical therapy, but it all starts with ART. In fact, today I saw a new patient who was upset with her experience with another Active Release provider in Denver. This person advertises ART, and she went to see him for ART. But when she went, he did X-rays and adjusted her. When she asked for ART, he curtly told her that she didn’t need Active Release.

We don’t do that at our clinic. At Denver Chiropractic Center, we are an Active Release practice, and every patient gets Active Release, every time. If you’re looking for the most credentialed ART doc in Denver, and the only instructor in town, at a clinic that puts Active Release first, give us a call at 303.300.0424.

Why I started doing triathlons and how this fuels my drive to help you…

This one’s a little embarrassing and personal, but if you bear with me you’ll see I have a point to make.

In late 2006 I started having anxiety attacks. Let’s just say burning the candle at both ends caught up with me (being a new parent, running a business, lifting very heavy weights way too often, and over-using stimulants to get it all done). I also – at the same time – managed to get acute gastritis, lose my appetite and drop 15 pounds in 3 weeks.

Since I had a cancer history, the rapid weight loss set off all sorts of medical fire alarms, and another round of MRI’s and CT scans started. After a brief bout of medical treatment, I started looking for natural ways to fix myself up.

My favorite little section of Outside Magazine has always been the book reviews. In the middle of all of this was a review of a book called Spark, by Jon Ratey, MD. In this book, Ratey (a psychiatrist) reviews all of the evidence that indicates endurance training is better for treating mild cases of anxiety and depression (and other related problems, including ADD and learning problems) than pills are.

That sounded like a good treatment program to me. As I mentioned before, I had long been a gym rat. Heavy weights were all I thought I needed, so this endurance thing was new to me. I decided to do the triathlon that I had sponsored for years, Xterra Buffalo Creek.

I still recall making this decision on my 39th birthday, after battling the anxiety for 3 or 4 months. I had no idea how to train for a tri. I had a 1994 Trek 930 P.O.S. mountain bike in my crawl space. It didn’t shift. I owned no running shoes. I had never swam 100 meters in my life.

I bought a training plan from triathlongeek.com ($17.95) and started.

Workout #1 called for swimming 250 meters, 10 lengths of the pool. My heart rate shot so high after about 75 meters, I thought I actually might have a heart explosion. This was not good for the anxiety.

My running wasn’t any better. I had to run-walk my way through a 2 mile run. I turned in a 15:00 pace (per mile, not good).  I was tooling around on the beat up mountain bike, not able to shit gears. I had no clue.

But a funny thing happened: I started feeling the anxiety going away. Training for a tri actually was curing my anxiety. Training for a race healed me. (Yes I finished, near last. But not dead last.)

And so now, 3 tri seasons later, this is what drives me to keep going. And this is what drives me to help you. Runners run for a reason. Cyclists ride for a reason. Triathletes train for a reason. Cross-Fitters do ball slams for a reason. And so on.

These things we do keep us sane. They are the things that make us happy. They define us. For some of us it’s just about training and finishing. For others, it’s about winning. But to all of us, these sports are sacred.

So when a triathlete who’s training for her first sprint distance race comes to see me because her knee hurts and she can’t train, I know there’s more than just a race at stake. When a marathoner comes to see me because his foot hurts, I understand why he’s going to keep training anyway. When a mom comes to see me because she hurt her shoulder in Pump class, I understand why it’s crucial that I fix her so she can get back to class.

I understand why you do these things that you do. And that’s why at my clinic we try so hard to fix you up when you’re hurt. We don’t want you to miss out on your training. We don’t want you to stop. When we’re treating you, we almost never tell you to stop. Maybe back off a little, but don’t stop.

And so this is why I do what I do, and this is why that I’m honored that you call me when you’re hurt. As I’ve done for the last 13 years, I will do my best to keep you in the game. I’m presently training for my 4th season of Xterra triathlons. I am not fast and I don’t care.

I’ve got my own reasons behind my tri habit, just like you have your reasons for doing what you do. Some people don’t’ get. They think we’re crazy for doing all this sports stuff. And as you know, we don’t care what they think. Don’t stop.

So here’s wishing all of you a great summer of training, racing & living. Enjoy!

Barefoot Running: The Dirty Secret

Last year, I treated a pro runner who would train barefoot in a park. She would come in with the most horrendously dirty feet you’ve ever seen. The dirt and grass stains were literally ground into her skin. She told me that no matter how much she scrubbed them she couldn’t get them clean. Awful. But that’s not the dirty little secret we’re here to discuss today (though it is true).

The dirty secret behind barefoot running is that a lot of people get hurt. The theory, made stylish by popular books like Born To Run, can be summarized like this: Our feet evolved to function without shoes. We have lots and lots of little muscles that should provide natural support for our feet. By wearing highly supportive and cushioned shoes, we are cheating our feet of the the work required to make them strong.

“Throw away your shoes and thrive!” seems to be the underlying message. It makes sense, and I’m a proponent. But must of us aren’t ready for it.

Running barefoot, or running in minimalist shoes as most of us prefer (Nike Free, Vibram 5-fingers, Terra Plano Evos, etc) requires a little remedial work. For some people, those small muscles in their feet aren’t ready for it. Ditto the calf muscles and Achilles Tendons. As a result, I’m seeing quite a bit of plantar fasciitis, Achilles tendonitis, and shin splints in barefoot runners.

If you’re thinking about taking the Barefoot plunge, or maybe have already been dipping your minimally clad toes into the proverbial pool, your best bet is to ease into it. If you’re used to putting in 10 miles or more on a Sunday, don’t put on your brand new Nike Frees and run 10. Walk for a mile and then run slow mile. Repeat that for a week or two before slowly upping the miles.

But before you even get that far, do a few barefoot drills in the safety and comfort of your house. Of course, if you have underlying conditions that would be aggravated by these, don’t do them (herniated discs, pre-existing foot or ankle problems, etc).

1. Hops. Simply stand with your feet together and do some 2-legged hops. Just jump a few inches off of the ground. Land on the balls of your feet, and as soon as your heels touch, hop back up. This will start to get your Achilles Tendons ready for the recoil required when running barefoot.

2. Side to side hops. Hop from your left foot to your right foot, moving side-to-side. Again, land on the ball of each foot, and as soon as your heel touches, hop onto the other foot. This will strengthen your calves and ankles.

3. Foot switchers. Stand with one foot in front of the other. Hop up and switch positions. This gets the smaller muscles of your feet ready to push off.

left foot forward

right foot forward

If you want, you can progress to barefoot indoor skipping. When doing these exercises, start with a set or two that lasts for 10 seconds. Slowly work up to a minute, but be mindful of any soreness. Give your feet, ankles and calves a chance to get stronger before heading out to get the dirt and grass stains embedded in your own feet.

By the way, we treat plantar fasciitis, ankle sprains, Achilles tendonitis, shin splints, and calf injuries at Denver Chiropractic Center. Our approach combines and Active Release Technique with rehabilitative exercises. We can help you get rid of the pain.

How to get stronger outside: The Swing Set Workout

Keeping an eye on 3 kids shouldn’t mean that Meredith and I need to skip workouts. Of course the kettlebells travel nicely from the basement to the backyard, but few of you actually have kettlebells. So here is a G-R-E-A-T bodyweight swingset workout that you can do anywhere.

Get out of the sweaty musty gym, head to the nearest park (or if you have a big ol’ swing set in your backyard, head there) and get ready to have some strength-building, muscle-working fun in the sun.

We’re going to cycle between 3-5 rounds of the following exercises:

·      Decline Pushups

·      Pull-ups / Australian Pull-ups

·      Hanging leg raises

Decline Pushups. Decline pushups are a little tougher than flat pushups, so if you have trouble with regular pushups, just stick with those. But the decline pushup is great for working the chest, shoulders and core.

Place your hands about shoulder width apart (who remembers the Zone of the Dog shoulder articles?) and your feet on a swing. Make sure you don’t let your body sag – use your core to keep it tight.

Decline pushup 1

Decline pushup 2

Anyway, strive for sets of 20 pushups, moving down slowly and back up a little bit faster. Once you get to 3 sets of 20, instead of adding more reps, try doing your reps at a slower and slower pace.

Pull-ups

Next, we move on to pull-ups. We’re going to shoot for 10. If you can’t do sets of 10 pull-ups, do smaller sets to get to 10. For example, 5 sets of 2. Or 2 sets of 3 reps followed by a set of 2 reps and then 2 sets of 1 rep. As long as you get to 10. I prefer the monkey bars with my palms facing each other, but any hand position you prefer is fine.

pull-up small 1

pull-up pic 2

Pull-ups can be hard on the elbows, so generally, the wider you can position your hands, the less the elbow strain. If you can’t do pull-ups, bring a buddy who can help you!

Hanging leg raises

After the pull-ups, shake out your arms and get ready to hang. I still think that hanging leg raises are among the best ab exercises out there.

While hanging, brace your abdominals as of you’re about to take a punch. Then curl your knees up to waist level. Hold for a second or two, and SLOWLY lower back down. Shoot for 10 reps with good form. If you can do only 3 or 4, that’s ok. Don’t combine smaller sets to get to 10. Over time, you’ll get stronger and the rep count will get higher.

abs

So there you have it. A great upper body / core workout with just 3 exercises and a swing set. If you want to up the ante and have a couple of kettlebells lying around, the kettlebell complexes that I show on the last post are great!

New late night hours start today (and a wedding pic)

I just wanted to let you know that as of today, I’ll be in the office seeing patients until 7 PM on Tuesdays and Thursdays. For those of you who have been scrambling to get here by 5, things should get easier.

To summarize, our office hours are now:

Monday: 9-5

Tuesday: 9-7

Wednesday: 9-5

Thursday 9-7

Friday 9-3

The catch here is that I, Dr. Glenn Hyman, won’t be in on Fridays during the summer, but I WILL be here Monday through Thursday (until 7 Tuesdays and Thursdays). But don’t worry, we’ll still be open on Fridays, Dr. Jeff Stripling will be here on Fridays (and the other days, too).

Congratulations to Meaghan and Cody!

Yesterday our good friends Meaghan (the legendary Mega-Nanny) and her fiance Cody Chavez were married at the beautiful Arrowhead Golf Club in Roxborough Park. Here’s a pic:

Meaghan and Cody
Meaghan and Cody exchangin I-do’s

And Meredith and I got all cleaned up, too:

Meredith and Me at the wedding
Meredith and Me at the wedding

Once again, congratulations Meaghan and Cody!

Back from teaching for Active Release Techniques & NEW summer hours.

I just got back from sunny San Diego last weekend, where I was teaching for Active Release Techniques. It’s hard to believe that I’ve been an ART provider for 11 years, and an instructor for 9 years. I’m still the only ART instructor in Denver.

Anyway, the weather was beautiful (I flew out in rain and snow here) and the hotel was right on the bay. Here I am in front of some sort of famous racing sail boat that seemed to be a big deal to boat-savvy people (I get seasick so I’m no boat guy).

Me in SD
As always, working hard in tough places

The sunny, breezy weather got me thinking about summer time, and summer hours. So, starting May 31 (the day after Memorial Day) our office hours will be as follows:

Monday: 9-5

Tuesday: 9-7

Wednesday: 9-5

Thursday 9-7

Friday 9-3

The catch here is that I, Dr. Glenn Hyman, won’t be in on Fridays during the summer, but I WILL be here Monday through Thursday (until 7 Tuesdays and Thursdays). A lot of you have been asking for later hours with me for years, and I’m happy to oblige.

As many of you know, I have 3 little sons, ages 5,3 & 1, and I just want to spend a little more time with them this summer. So that’s why I’m going to take some Fridays off. But don’t worry, we’ll still be open on Fridays, Dr. Stripling will be here on Fridays (and the other days, too.).


Why we suggest maintenance care…

Spine (Phila Pa 1976). 2011 Jan 17. [Epub ahead of print]

Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome?

Senna MK, Machaly SA.

Source

Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University.

Abstract

ABSTRACT:: Study Design. A prospective single blinded placebo controlled study was conducted.Objective. to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic non-specific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low-back conditions after an initial phase of treatments.Summary of background. SMT is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP but the efficacy of maintenance SMT in chronic non-specific LBP has not been studied.Subjects and Methods. 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized to receive either (1) 12 treatments of sham SMT over a one-month period, (2) 12 treatments, consisting of SMT over a one-month period, but no treatments for the subsequent nine months, or (3) 12 treatments over a one-month period, along with “maintenance spinal manipulation” every two weeks for the following nine months. To determine any difference among therapies, we measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline and at 1-month, 4-month, 7-month and 10-month intervals.Results: Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029 respectively). However, only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the non maintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.Conclusion. SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy.

Why you should be doing deadlifts (start today, we’ll show you how).

Many of you have been asking about Meredith’s knee after reading about her recent surgery in the last DCC newsletter. We certainly appreciate all of the interest you’ve shown.

Meredith is on the road to recovery. She’s doing all of her normal everyday activities, and her rehab continues.

While a big part of her recovery is having me do Active Release to normalize her muscles (quads, calves, shin muscles, etc), as well as working on her IT band, lateral meniscus and Lateral Collateral Ligament, doing her rehab is just as important.

The deadlift is at the center of her rehab program.  That’s right, good old-fashioned deadlifts (with a little twist).

The deadlift is a classic weightlifting exercise that can fit into anyone’s training program. You certainly don’t need to use a barbell to do it. In fact, Meredith and I got rid of all the barbells in the basement (to make room for the kiddos) years ago and have NEVER missed them.

This exercise activates and strengthens just about everything in your legs, including the glutes, hamstrings, adductors, and spinal extensors. You want all of these muscles working together, and the deadlift teaches them to do that. It’s great for preventing injuries in runners, triathletes, hikers, climbers, and even relatively sedentary people. Of course, clear this with your doctor first, as you could get hurt if you do it wrong.

We’ll demonstrate here with a pair of kettlebells, and they allow for the most optimal mechanics.

1.     Stand with your feet about hips’ distance apart. Have the kettlebells between your feet.

Deadlift 1

2.     Looking forward, arch your back slightly and start moving your hips backwards. Maintaining that arch is important, as the muscular tension directs forces away from the discs and ligaments in the back.

deadlift 2

3.     Start bending your knees as you reach for the bells.

Deadlift 3

4.     Grasp the bells, brace your abs, and use your legs (NOT your back) to lift the weights. Think about pushing your heels into the floor. Come to a full upright position.

deadlift 4

5.     To lower, start the motion with your hips moving backwards and lower the weights all the way to the ground. Let them come to rest on the ground before setting yourself up for the next rep. This allows you to correct your form for each rep.

deadlift 5

Start with 3 sets of 5 reps with moderate weights 2-3 times per week. Over time, you can work your way up to 5 sets of 10-20 reps. Just make sure you progress slowly. Remember, the goal is to get stronger safely.

If you’re having hip pain, back pain, hamstring problems or (like Meredith) knee problems, your best bet is to get the problem checked out by us. Call 303.300.0424 today to schedule your next appointment.

Using the ASLR to prevent back pain, hip pain, knee pain and more

I spent a recent December weekend hanging out once again with some very smart physical therapists in Brighton. We were becoming certified practitioners of the Functional Movement Screen. (Many of you may recall that this past August I went to Brighton to learn about the Selective Functional Movement Assessment. Despite their seemingly similar names, the two are different. End digression.)

I’ve been using the Functional Movement Screen for years, but decided to get officially certified because it’s becoming a key part of my practice- finding the underlying dysfunctions that end up producing pain. It’s about fixing the problem, not just getting rid of the symptoms.

The Functional Movement Screen (FMS) is a system of 7 movements that are scored on a 3-point scale. 3 is good, 1 stinks, and 2 is somewhere in between. A total of 21 is perfection. Research shows that athletes (of any level) who score 14 or less are three times more likely to get injured than athletes who score a 15 or more.

The idea is that you identify your worst functional movement and then work to correct it, thus improving your score. You then do follow up screens to determine what you need to work on next.

So I’m going to have you check yourself on the movement test considered most important – the Active Straight Leg Raise.

At first glance, this may seem like a test of hamstring flexibility. It is, and more. It also assesses your active hip flexion, and your ability to maintain hip extension on the other side. These are three very important fundamental ranges of motion.

Your hamstrings start at the knee, run up to the “Sit Bone” and then send fibers into the SI joint. This joint is continuous with the spinal muscles.

Poor performance on this test means you’re more likely to experience one or more of The Big Five- back pain, hip pain, sciatica, IT band problems, and knee pain. So scoring your Active Straight Leg Raise (ASLR) is a good place to start if you want to prevent or improve any or all of these.

The ASLR requires a stick, an optional tape measure, and a buddy. For purposes of the description here, you are the one who’s evaluating the test and your buddy is the one performing the test.

Have your buddy lie down on his back. You need to identify two points on your buddy, the kneecap and the ASIS, or point of the hip. (Start on the left side.) The hip point is that bony thing at the waistline right above where the hip flexes. Measure the distance between the two points to find the middle of the thigh. The middle of the thigh is the reference point for this test.

x

Once you’ve found the middle of the thigh. Stand the stick up to mark the spot.

x

Your buddy is still on his back. (If you are a woman and your buddy is a guy, he’s probably making smart-ass remarks at this point because he knows he’s about to do a really bad job on this thing. Try to take pity on him.) Your buddy’s head must stay on the ground, his arms at his sides, and his palms UP, to avoid cheating.

So, your stick is at mid thigh on the outside of the left leg. Have your buddy raise the left leg – with the knee straight – as high as he can. The right leg MUST stay flat on the ground. If your buddy can get his left ankle (the bumpy bone on the outside of the ankle) above the stick, he gets a 3. If he can get his ankle between the stick and the left kneecap, he gets a 2. If he can’t raise the ankle past the level of the left kneecap, that’s 1.  (3 pics)

x

Erin gets a 3 for this effort, her heel is above her mid-thigh

x

With her heel between the stick and her right knee, Erin gets a 2.

x

Erin couldn’t raise her foot past her right knee, so she gets a 1. Boo.

Now test the other side. When scoring, a 3 on each side is ideal. 2 on each side is OK. 1 on each side is bad. Different scores on each side is considered an asymmetry, and that’s bad.

If you’re interested in getting a baseline score for how your body is functioning, call up and make an appointment. We don’t charge any extra fees in conjunction with a treatment. The idea is to figure out which Functional Movement you score lowest on and take steps to improve it. We’ve developed rehab protocols to improve each pattern and improve your overall score. This reduces your likelihood of getting injured.

Update on my triathlon training

I’ve been taking some time away from swimming and biking, but still doing some running. Mostly, I’ve been hitting the kettlbell pretty hard.

I bought a DVD about improving your VO2 max with the kettlebell snatch & this weekend I finally watched. Very interesting.

In a nutshell: You set a 2-second cadence with the kettlebell snatch, so one rep every two seconds. This amounts to essentially non-stop snatching.  You do 15 seconds of this with 15 seconds of rest. For 25 minutes.

Absolutely brutal. A Danish study showed that this was more effective than intense running or biking for increasing VO2 max. How will this affect my triathlon training? Well, hopefully it will increase my VO2 max. Stay tuned…

Interested in learning more? Well, kettlebell class just might be returning soon.