Monday, June 30, 2014

It's Fancy Feet, not Fancy Shoes...


If you have seen a round of televised golf or perused your local golf shop lately, then you have probably witnessed how many different options for golf shoes there are now (like Keegan's Air Jordan's here).  Why so many choices?  Well, golf's popularity is skyrocketing and money is a huge driver for all the major sports wear companies to get into golf shoes, but more importantly the golf community is trying to reconnect us with the ground. What do I mean by that?  Well, we know that golf is a game that consists of taking ground reaction forces and transferring those into rotational forces that ultimately produce a solid swing and ball strike.  As golf grows in popularity and more 300+ drivers and super-human iron players hit the tour, the need to find an edge wherever possible is on the minds of players, coaches and sports companies alike. Dumping more technology into shoes does have some benefits as far as comfort and force transfer are concerned, but what if...dare I say it...the shoes don't matter at all?  I know it's crazy, but what if you could improve your game by making the things attached to your legs (called feet) more functional rather than buying a beastly pair of $300 shoes and shoving your currently dysfunctional hairy Hobbit tootsies into them?   Just how important are foot mechanics for a golfer, or any athlete for that matter? Well let's start with the fact that each foot contains 26 bones, 33 joints and more than 100 muscles, tendons and ligaments, not to mention the 7000+ free nerve endings!  Now all of these components are controlled by the central and peripheral nervous system, as well as some other balance coordination centers.  You might say the foot plays a 'small' role in your athletic ventures.  What happens when we roll an ankle repeatedly, one or two of those 33 joints doesn't move quite right, maybe we lack the motor control to orchestrate foot movement properly or maybe we have just been stuck in rigid shoes for 40 years of our life?  Sound like a plausible scenario for they typical golfer, how about just the typical human?  All of these maladies cause dysfunctional movement patterns and compensations that begin from the ground up, and these can have a tremendous affect on your golf swing, as well as everyday life. The foot is immensely complex and its biomechanics are still not fully understood, even with all of the current research that is dealing with gait and foot biomechanics.  One thing that is certain, when the foot lacks mobility, stability or intrinsic control, then the rest of the body is at a deficit when it comes to optimum athletic performance.   So how do we find out what our foot functionality situation is?  Get assessed, plain and simple. This is not meant to a be a completely shameless ploy to get patients in my office, but seriously getting a trained pair of eyes and HANDS to assess movement is crucial.  It doesn't really matter if it is FMS, TPI, SFMA, etc...the whole point is to find out where your biomechanical kinks lie and then wipe them off the radar.   I have personally taken FMS, SFMA and I am currently TPI certified, and it is my passion to constantly learn everything I possibly can about human movement.  So if you are out there hacking at range balls every week, please take one range hour and exchange it for a proper analysis and rehab plan.  It will be worth it. If something as small as fixing faulty foot mechanics can improve your golf game, imagine what tackling an entire body of dysfunction could do for your game or for that matter, your life.   Until next time... "You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose. You're on your own, and you know what you know. And you are the guy who'll decide where to go." - Dr. Seuss

Dr. Beau Beard, DC, MS, CCSP, TPI

 


Monday, June 23, 2014

"Tapping Superhuman"

This blog will serve as the introduction to a book that is in the works, "Tapping Superhuman", it will not be coming to print for some time, but none the less it's a fun topic to ponder and discuss.

If you haven't seen the Bo Jackson ESPN 30 for 30, leave this page now and go watch it!  Here is just one of many clips.


The whole documentary did an amazing job at really portraying Jackson as something more than human.  Which, maybe in a way he was...is?

Have you ever been in awe of the physical prowess of an athlete or seen something that you could not believe?  I feel like my life has been filled with moments such as these, and it has led me to gather thoughts from around the world on the topic of what it means to be 'superhuman'.

People like Bo Jackson and the feasts he accomplished are exactly what this article and my future book will cover; what is it that makes certain individuals a cut above the rest?  Whether it is conquering the Ultraman, riding a 60 foot wave or snapping a pine bat like a twig, what is the "IT" factor that is so frequently talked about?

In my book I will be releasing interviews with famous and some not-so-famous athletes, exploring research on the mind, body and ways to overcome both, as well as giving some anecdotal and experiential insights.

I really wanted to write today, to see what all of you out there think makes it possible for some people to accomplish unimaginable feats.  Is it just mind over matter?  Is it genetics?  Is it other worldly?  Can it be taught or trained?  

Having devoted my life to the learning and understanding of the human body, I am constantly amazed at how as humans we are able to bend the limits of the world around us by simply 'putting our mind to something'.  This past week two of our athlete ambassadors, Zachary Andrews and Vanessa Stroud, ran the Bryce Canyon 100.  First of all congrats to both of those crazies!  Second, think back to Pheidippides of Ancient Greece, who reportedly ran from Marathon to Athens in under 36 hours, only to breathe his last breath after delivering his message, and now a mother of two and an easy going Alabama boy are tromping out 100 milers like it ain't no thing!  Longer distances, free climbs, wing suits, free diving, etc... could it be that humans are capable of just about anything, so long as they can imagine it is possible?

A lot of current science is geared toward advancing the physical limitations of humans, whether that means performance, age related longevity or cognitive function.  It is a very exciting time to be alive, knowledge and information are multiplied at an alarming rate these days, which means more discoveries and breakthroughs are made on what seems like an almost daily basis.  The only thing that is certain as it pertains to superhuman feats is that before we can become superhuman, we must first fully understand what it is to be 'human'.

Please leave some feedback on this post...do you know a 'superhuman'?  What does it take?  Can anyone become one?

Until next time...


"With our thoughts, we make our world"

- Buddha

Dr. Beau Beard, DC, MS, CCSP

Monday, June 9, 2014

The Orthotics Debate

I had the pleasure of listening to a lower extremity seminar presented by Dr. Mitch Mally, who is a world renowned speaker and extremities expert, guy is lighting quick too.  Check out a seminar if you get a chance, Mally Seminars.  Dr. Mally discussed how he does not fit a patient for orthotics until he feels that he has corrected the function of the foot, and every patient in his clinic is getting an orthotic.  This is a great way to look at where orthotics fit into the treatment model, but in my opinion not EVERY patient needs an orthotic, probably not even 80% NEED an orthotic.  At least Dr. Mally's approach is a bit more forward thinking than some patients I see that are prescribed an orthotic that is being used as a constant propioceptive reminder to the foot of why it is malpositioned or dysfunctional, without any actual rehabilitative cue.

In our clinic orthotics are the rarity, and it usually comes down to those patients that have been through the entire treatment and rehabilitation gamut, and finally we need to give them some sort of corrective orthotic to maintain longer lasting results, the key word here being, CORRECTIVE.  What do I mean by corrective?  Dr. Mally's theory is that he is improving the structure and function of the foot through treatment, and when the foot has reached an optimum functioning level, he will then fit an orthotic to 'hold the foot' in this newly improved form.  Again, I think there is merit to this approach, but I think longer lasting results, and in the sports world, higher performance results, are gleaned by instead fully rehabbing the foot/issue to the fullest potential of that patient/situation.

Once we put someone in a rigid orthotic, we offload the intrinsic and sometimes extrinsic muscles that correlate to appropriate function of the feet.  By doing so we dampen the propioceptive abilities of almost 7000 nerve endings that are present in each foot.  The elite athlete relies on every propioceptive and mechanoreceptive fiber they have access to, so by stripping the foot's natural mechanics out of the equation I believe we are not doing what is in the best interest of the athlete/patient.  Again, there are instances that will require an orthotic, large leg length deficiencies, collagen laxity disorders or morphologic/traumatic structural changes, but this is not the norm.

With all the recent hub-ub about the Vibram Five-Fingers case, I guess I'll take a second to discuss the other side of the spectrum.  If a rigid orthotic is detrimental, shouldn't a minimalist shoe be the answer?  Well not exactly, the medium upon which we stride has changed significantly from that of our caveman brethren.  As a species we have moved from dirt and grass to concrete and hardwood, these changes have forced us into the modern footwear we know today.  While Vibram had/has a great idea, the American mantra of 'a little is alright, but more is always better' is what spelled their ultimate demise.  Inactive, overweight and out-of-shape people were looking to the Vibram to cure their foot pain, knee pain and maybe even make them a middle-American ultra runner.  The truth is that we have to protect our Westernized feet to a certain degree, and running a couch to 5K is in a sock of a shoe is probably not ideal for the vast majority of people.  All of that being said, training barefoot (or close to it) is CRUCIAL to improving balance and overall athletic prowess.  Although, care should be taken to provide the right setting and activity for athletes/patients to do so.



So the next time you or one of your patients is fitted for orthotics, ask yourself if everything has been done to get the foot (and the rest of the body) to the highest level of function without adding a supportive treatment to the equation.  I think outcomes can be improved, injury will be prevented and performance is definitely enhanced.

"The foot feels the foot when it feels the ground."

- Buddha

Dr. Beau Beard, DC, MS, CCSP

Thursday, May 22, 2014

"My breath was lightning"

"The muscular system lies at a 'functional crossroad' since it is influenced by both the PNS and CNS"
   - Vladimir Janda

This quote should be one of many foundational thoughts for any clinician, trainer, athlete, etc...  This is also of utmost importance for understanding one of the keys to a powerful, accurate and repeatable golf swing.  There are three interconnected parts to general balance, consisting of 'propioceptive' balance, muscle balance and neurological balance.  Within each of these areas of balance lie subcategories that allow us (practitioners, coaches, trainers) to fully understand and have impact on changing/improving athlete mechanics.

The emphasis in this article will be on neurological balance, and how to train or improve that balance in order to better the golf swing.  This is directed towards golf, but it applies to all sports as well as every day life.  Neurological balance is the push and pull between the parasympathetic and sympathetic nervous system, I'm leaving out the enteric system for this discussion.  The parasympathetic nervous system is thought of as the "rest-and-digest" portion of the autonomic nervous system (ANS).  This means the parasympathetics control most of what happens when eating/digesting, sleeping and sexual arousal, sounds like my college roommate!  The sympathetics are thought of as our "fight-or-fight" system, they control up and down regulation of vital hormones, as well as protective triggers such as the hair standing up on the back of your neck.

Now that we have a very brief description of the two, it also crucial to understand that a large majority of the general public today live in a state of 'sympatheticotonia' or a constant state of heightened activity of the sympathetic nervous system.  This is due to our sleep deprived, mal-nourished (nutrient not so much calories) and over-stressed lifestyles.  This body state lends itself to increased resting tone of the musculature, which means that we lack the ability to completely relax our muscles.  Many golfers out there may have experienced an increased sympathetic state while standing on the first tee or hovering over that 3-footer.

All great golfers share many qualities that have pushed them to the top of their field, and one of those qualities is the ability to go through a cycle of 'relax-contract-relax'.  Sounds simple, but the ability to control the pattern in which our body completely relaxes and contracts our muscles is crucial.  As we move through a golf swing starting with take away and moving into the back swing, joint centration and the ability to relax all muscles except those crucial to moving into the top of the swing.  As we move into the down swing the hips, then thorax, then arms, etc... are firing but still not at 100%, in this manner we still deliver the club in a free flowing, whip-like manner.  Impact is a violent event and it is all hands on deck in terms of muscle recruitment, but immediately after impact almost everything should relax again to allow for an easy and full turn and follow through.




Tiger's 'relax-contract-relax'

How do we tie the autonomic nervous system and this 'relax-contract-relax' idea together?  Well, in a sense it is sports meditation, learning to harness the power of diaphragmatic breathing in order to restore some balance to the ANS.  I will admit this is only a part of neurologic balance; chiropractic adjusting, sports psychology, nutrition, rest and many other elements play an integral part, but for our discussion we will focus on breathing.

When we breathe using our thoracic diaphragm, belly breathing, versus an apical or chest/neck dominant pattern we activate a few of the cranial nerves as well as the S2, S3 and S4 nerve root levels, which are all parasympathetic nerve fibers.  This in turn releases certain neurotransmitters that decrease heart rate, constrict airways to inhibit hyperventilation and also reduce the resting tone or tightness of the musculature.  Sounds like a deadly combo for a hand trembling, heart pounding amateur with a cutoff swing!

Another huge aspect to this parasympathetic activation is that it allows you to fully relax and contract the musculature as previously discussed.  Just as a bullwhip builds a tremendous amount of energy from simple flick of the wrist, the goal of the golf swing is to take a supple musculoskeletal system, wind it up like a spring and let it explode, all in very controlled manner.  Of course neuromuscular coordination and hand-eye coordination do play a vital role in the golf swing, or any other sport.

So how do you tap in to this parasympathetic power, the first step is learning to breathe like a baby.  As an infant most all of our breathing, except the occasional blood-curdling cry, is performed from the belly.  So take a look at the video below in order to start learning how to become a breathing ninja.  I personally think that learning how to breathe properly, especially in an athletic and pressurized setting is paramount for optimum sports performance.  The parasympathetic activation through diaphragmatic breathing is just one piece to the breathing paradigm.


Again, this is just one small piece of the puzzle as it equates to athletic performance and general wellness.

Until next time...

"And when I breathed, my breath was lightning"


- Black Elk (famous Sioux medicine man)

Dr. Beau Beard, DC, MS




Sources

 2011 Jul;17(7):623-8. doi: 10.1089/acm.2010.0666. Epub 2011 Jun 20.
Diaphragmatic breathing reduces postprandial oxidative stress.
Martarelli D1Cocchioni MScuri SPompei P.

Tuesday, March 11, 2014

Regression for Progression

Today's blog is going to focus on the need to take some athletes back to the basics in order to fully alleviate an injury, or to fully realize their optimum performance.

There are two different scenarios that I deal with on a daily basis in my clinic. The athlete or patient that comes in with an acute or chronic injury that is not allowing them to perform to the best of their ability or sometimes at all. Or, the patient/athlete is seeking an assessment, correctives, therapy or combination of all or any of these in order to push them to the next level. Should I treat these two scenarios the same, in terms of rehabilitation, training and athletic development?

I think that the answer is an unequivocal, YES. 

I believe this is true for a multitude of reasons.  Just because someone is not truly injured, does not mean that they do not have a mechanical inefficiency.  If I have someone come to me to expound upon their current athletic prowess, and I just take it as a given that I can start building on the current foundation...well, I have already failed.

Assessing and reassessing is what allows us as practitioners, trainers, etc... to be truly great at what we do. A keen eye, solid knowledge base and critical thinking will never fall out of favor for the great practitioner.  

So now I can finally get to the point, why do we regress an athlete before we progress them. The simple answer is because we all think we are stronger, faster and bigger than we really are, well, at least in the athletic realm we do. This is why a fine tuned assessment is so important, in that it allows a practitioner to hone in on the true problem or problems and dial everything back.  

Let's use an athlete with moderate patellar tendonitis as an example. The athlete is a football player and has had the complaint for back-to-back seasons. Now most adept practitioners can alleviate the symptoms of patellar tendonitis in about two weeks time, no problem.  But without a great assessment, we may miss things like improper core sequencing, hip and foot pathomechanics, increased resting tone in prime movers or stabilizers, poor breathing patterns,  or a whole plethora of other very important contributing factors. If we treated the local symptoms, and started this athlete on an eccentric single-leg squat routine, we may be setting him/her up for a long term repetitive injury pattern.

Athletes do not always appreciate being brought back to the basics, but to truly realize athletic potential the foundational blocks of performance must be laid.  These foundational premise are based upon mobility, stability and probably the most important of all, neuromuscular control.  Of course there are other factors, such as freakish genetics that never hurt to throw into the equation.  

So what does regression for progression mean.  It means that an athlete has to earn the right to such things as training upright, at full speed and with heavy weights.  Emphasis must be placed upon proper mobility and stability at every joint, proper breathing techniques and any energy leaks
 must be remedied.  Without shoring up inefficiencies in these areas, an athlete can compensate to the best of their abilities, but true potential will be stymied by injury or sub-obpitmal output.

I know this is a somewhat vague blog, and does not go into details, but it is so important that health and fitness professionals dial an athlete back.  As with everything else in life, timing is everything, so be cognoscente of an athlete's focus on and off season.

"A successful man is one who can lay a firm foundation with the bricks others have thrown at him."
- David Brinkley

Dr. Beau Beard, DC, MS - Stay light, stay fast.

Friday, January 31, 2014

The Chiropractic Myth

"Oh I BELIEVE in chiropractic"

"Yeah, I need to get REALIGNED sometime soon"

"My hips become UNLEVELED about once a month"

These are statements that as a chiropractor I hear everyday, and I'm sure my colleagues do as well.  Now I'm not one to argue these points every time I hear them, but at some point we all need to release some steam.  So hear goes.

First of all, chiropractic is not a religion therefore it requires no belief.  I don't think I have ever heard someone say, "oh I believe in orthopedic surgery", they just take it to be the truth.  So what is the difference?  What has caused this faith based relationship with a non-allopathic treatment for musculoskeletal injuries?  Well, it is our own fault, the chiropractor's fault.  We are our own worst enemy.  Our dogmatic and sometimes blind chiropractic ideals that we bind ourselves to tend cripple us in the publics' eye.  When part of our profession disregards current research, or continues to pitch an adjustment as the cure for cancer we will continue to be viewed as a cultist movement rather than the predominant and viable choice for musculoskeletal injuries.  Now I know some people out there are saying, "well the psychosocial aspect of the treatment is known to be just as important or more important than the treatment itself", you are exactly right.  That is not a belief issue; instead that is a perception issue.  OUR reality does not exist in belief it lives in perception.

Second, believe it or not we are not realigning your spine, nor are we moving bones back into place or un-pinching a nerve.  I know this may be blasphemous to some chiropractors, but the truth is that we are actually inducing movement into the joint or joint complex that may be inhibited by osseous, muscular, tendonous, ligamentous structures or any combination of the aforementioned.  Through the induction of movement in this inhibited joint, a neurological resetting and muscular relaxation occurs due to the fast twitch muscle reflex being activated.  Certain pain inhibiting chemicals are also released in accordance with this adjustment.  Other effects of the chiropractic adjustment have been researched, such as the increased or decreased parasympathetic/sympathetic function and improved immune response, but most of these have not been studied in depth enough to result in viable data.

My last point goes hand in hand with the previous statement of "moving bones", I constantly hear patients stating that their MD, PT or other practitioner told them that their "hips are unlevel" and that they should possibly get adjusted.  First of all, I truly do appreciate the referral, but this is like me sending someone to his or her primary care doctor for an ibuprofen deficiency because they have plantar fasciitis.  The NSAIDS may mask some of the pain, and may in fact give enough relief to aid in healing, but that isn't really their problem.  

I'll let you in on a secret, EVERYONE'S HIPS ARE UNLEVEL!!!  Humans are not symmetrical, so in essence we are never level and we don't really need to be.  Of course a huge difference in leg length, scoliosis or some other deformity can cause unleveling or rotation, but it really boils down to how you move.  If your "hips" measure differently but you can move through all planes of motion and you are pain free then WHO CARES!  Yes sometimes orthotics, heel lifts or other aids are needed to help true anatomical variances, but those are not things that will ever be remedied by a chiropractic adjustment alone.

All of this being said, I am and always will be a chiropractor first, but we need to start being smart and stop being lazy.  We are not moving C7 back into place, or leveling a patients hips, and if you think you are...well, you're wrong.  Start educating yourself but more importantly your patients and the public.  Chiropractors do have a profound impact, but that impact needs to be completely understood in order to be PERCEIVED appropriately.  


"There is no truth.  There is only perception."
    - Gustave Flaubert

Until next time...
Stay light, stay fast.


Dr. Beau Beard, DC, MS

Monday, December 23, 2013

Scoring Touchdowns Makes Sense, Scoring Movement Does Not

Let me preface this entry by saying that Gray Cook is an incredibly intelligent guy and he has been at the forefront of the "movement to movement", so for that I have to thank him.  He has definitely influenced my education in only positive ways.

That being said, I'm going to roll up my sleeves and get right into this.  The Functional Movement Screen system is a great tool for certain sectors of health and fitness, but it does not belong at the elite level of athletics.   FMS has positively started to shift the focus of performance training to that of proper movement patterns rather than trying to pile strength and power on top of a weak foundation.  In the injury rehabilitation world, tools like FMS and SFMA have helped practitioners look at injuries as a result of inefficient or poor movement throughout the body, instead of focusing solely on pain or the area of chief complaint.  For these reasons it has been a blessing to many of us.

A few years back Gray Cook, who is a physical therapist by education, wrote a book called "Movement" that introduced the FMS/SFMA screens.  The Functional Movement Screens are a group of movements that can be scored, and based upon standardized scores are deemed acceptable or not.  The Selective Functional Movement Assessments are tailored more towards movement screening for those people who already have an injury.  These screening protocols, and many that have sprung up just like it, have spread like wildfire through the fitness and healthcare industries.  The popularity is due in part to the fact that they really do help practitioners/trainers recognize true causes of injuries, and the fact that they can be taught and implemented in a weekend seminar.  Being a recent graduate of chiropractic school, I know just how "dangerous" a weekend seminar can be.  All of the sudden every patient presentation needs exactly what you just learned the past weekend, WHAT A COINCIDENCE!!!

Well, with out making too many enemies I believe that the FMS screening protocol is horrible...at the elite level of athletic or for those who are educated beyond an online certification.  Now let me explain.  Most everyone has heard of the NFL combine, a series of tests that are scored and then analyzed by scouts in order to take raw talent and make it somewhat measurable.  Some of the more popular tests in the draft are the 40-yard dash, the 225 bench press test and the vertical jump.  All of these tests can be boiled down to hard, fast numbers; numbers that can be improved upon by proper training and hard work.  Now compare this to the scoring done in an FMS screen, some of the more popular screens in this protocol are the overhead squat and the step-over inline lunge.  Now quantify these movements, provide them to a psychological fragile athlete (which we know all elite athletes are), and then try to get them to improve on something that may not be able to change.  There are some developmental issues, sports specific training and many other reasons why a certain movement pattern may not be achievable by all athletes.  So when you tell an athlete that they have failed a test, but they do not possess the ability to truly improve upon this area, you are setting them up for a shot to the ego that is not easily remedied.

Now I know some of you are saying, why does an athlete care if they fail a screen or not?  Well they do.  Elite athletes are notorious perfectionists, and when we place so much emphasis on something that may not be able to be changed, or more importantly that may not NEED to be changed.  Well, that is where the rubber meets the road.  So what do I propose?

While working with the Sports Performance department at Bradley University, one of the first things brought to my attention was, "we are using FMS, but what do we do when we get the scores?".  Now this is a perfect example of what I'm trying to convey here.  The Bradley Sports Performance staff is at the top of the collegiate training world, but even at that level they were a little lost as what to do with these "scores".  My job while at Bradley came to be one of integration between the athletic training staff and the sports performance coaches.  A marriage between injury prevention, proper injury treatment and cutting edge sports injury rehabilitation.  One day while performing a set of "screens" that I have developed on an athlete I was questioned by the athletic training staff as to where I "learned" this screening protocol.  My simple response was that these assessments were a culmination of 4 years of chiropractic education, 3 years of a masters in sports science and rehabilitation, and hundreds of hours of working with the top practitioners in the field of sports manual medicine.  I know it sounds like I'm bragging, but what I'm trying to say is that cookie cutter screening protocols, lead to cookie cutter diagnosis and treatment.

The most powerful tool in the toolbox of any practitioner or trainer is his or her education and experience.  The FMS is literally a step backward for most of the people that end up implementing it.  Then why is the popularity soaring?  For one, Gray Cook has the education and the experience needed to be a great practitioner, and he is a motivational and charismatic speaker.  That paired with the ease of implementation have led to an FMS take over.

Stop quantifying movement, and start qualifying it.  No two people are the same and in fact the left and right side of one person are never the same either.  So what does that mean?  It means that you have to be a student of human movement, an anatomy superstar and most importantly you must trust your knowledge and be supremely confident when dealing with athletes.  You have to treat each individual as an INDIVIDUAL.  Evidence based treatment will never fall out of favor, nor will there ever be a replacement for those professionals who go beyond the normal curriculum and beyond the norms of the their field.  Break the mold, if you have a hunch and can back it with sufficient data go with it.  That is how progress is made.

Until next time...

"All change is not growth, as all movement is not forward"
- Ellen Glasgow

Dr. Beau Beard, DC