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Marathon Training Academy
March 26, 2015

In this guest post for Marathon Training Academy, you will discover the risk factors for plantar fasciitis and learn how to quickly return to your running routine with these self-treatment techniques!

Posted on Monday, March 23, 2015

10 Tips to Self-Treat Overtraining Syndrome

Overtraining Syndrome (OTS) can affect any athlete in any sport or at any level. I have treated high school athletes to weekend warriors for OTS. Recently I have noticed more cases of OTS among CrossFit enthusiasts and runners of all distances. People are training harder and longer than ever before with wonderful results. At times, even the best of intentions can lead to not so desirable consequences. OTS usually starts with muscle soreness and a feeling of fatigue. Then it quickly progresses into a case of overtraining syndrome or injury. Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from. For my tips and strategies to prevent OTS, please refer to 12 Tips to Prevent Overtraining Syndrome. In this follow up post, I will specifically address how to self-treat OTS.

Overtraining Syndrome will significantly impede your performance and frequently leads to a serious injury. In OTS, your body isn’t able to adequately handle or adapt to the high volume and intensity of exercise that you are performing. If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury. Depending on the duration of symptoms and the severity of the case, OTS is a serious condition which can take a long time to recover from. OTS not only affects the muscular system, but also the circulatory system, the nervous system, and the hormone regulation system. Recognizing the warning signs early and being proactive in prevention will help you to avoid OTS. If you’re already suffering, use the following tips and strategies in your recovery.

10 Tips to Self-Treat Overtraining Syndrome:

Rest. One of the first and primary treatments for OTS is to rest. More rest is required the longer the overtraining has occurred. Therefore, early detection is critical. If the overtraining has only occurred for a short period of time (such as three to four weeks), then a brief three to five days of rest may be sufficient while implementing the following treatment strategies. After the rest days, slowly taper back into training at a lower training volume until recovery is complete. Typically, the intensity of training can be maintained as long as the volume is decreased. I also advise that you start an alternate day recovery cycle. Train for one day, and then take a day off. This will typically last for a few more weeks before resuming your normal training cycle. As you resume full training, it is important that the warning signs of overtraining are identified and corrected. In more severe cases, the training program may have to be interrupted for weeks or months for a full recovery.
Cross train. Opt for an alternate form of exercise to help prevent exercise withdrawal syndrome. If you are heavily participating in CrossFit or running, choose leisurely cycling and yoga as part of your cross training routine. The key is to keep both training volume and intensity low while preserving a baseline of fitness. Most of the medical studies on overtraining are geared toward single sport athletes. For triathletes and other multi-sport athletes, the recovery process may be different depending on the circumstances. If you can identify that the overtraining has occurred in only one discipline, then resting from that discipline (as well as significantly decreasing training in the other sports) may result in a full recovery. Don’t try to substitute more workouts in one sport in order to compensate for rest in another. This will only worsen the symptoms of OTS, which affects both the parasympathetic (PSN) and sympathetic nervous system (SNS). Resting from overtraining on the bicycle by swimming more will help to rest fatigued quadriceps. However, stress is stress to the cardiovascular, nervous, and hormone systems. Cross training is an important component in your recovery. Incorporate it in your typical training cycles as a method to limit your risk of injury. Cross training can make training more enjoyable as it keeps your body stimulated and ready for improvement. As you recover from OTS, the volume and intensity must be significantly reduced to allow for adequate rest and recovery.
Spot train your weak areas. In addition to cross training, use this recovery time to spot train your weak areas. Work on your mobility and balance as a prevention technique for areas that are prone to injury. If you have a history of low back pain or a prior knee injury, utilize this time to single out all those weak areas in an effort to prevent injury in the future. As you rest from your primary training routine while incorporating cross training, perform spot training as well. The Resource Guide includes a specific exercise section with rehabilitation exercises ranging from low back pain to knee pain. These .pdf files include photos and detailed descriptions to help you get started on spot training your weak areas. This is also an excellent time to work on the specific technical skills that your sport requires. It may include learning how to mentally manage your sport better.
Actively manage your aches and pains. Consider seeing a masseuse for regular body work. Another option is to use the foam roller after exercise to speed up recovery times and decrease the risk of muscle soreness or restriction. To learn how to use a foam roller for self-treatment, please refer to Foam Rolling for Rehabilitation.
Acupuncture. Incorporating acupuncture into your recovery process can be very beneficial. Acupuncture can help to address a multitude of conditions which affect the nervous, muscular, and hormonal systems. All three systems should be addressed during the recovery process. Along with many of my clients, I have experienced wonderful results with acupuncture. I highly recommend an acupuncturist who specializes in sports medicine and has experience treating athletes. During acupuncture sessions, you can take time to specifically work on intentional relaxation and meditation which has the added benefit of addressing the nervous and hormonal systems.
Seek help early. If you are experiencing chronic aches or pain or are struggling with an aspect of your training, seek help immediately. A healthy lifestyle is a lifelong pursuit. If you are injured or not enjoying an activity, you will not stay engaged or motivated in the long term. Seeking advice specifically from an experienced coach, physical therapist, or physician can be beneficial.
Decrease the stimulants. It is important to take steps to help both the nervous and hormonal system re-regulate and rejuvenate. Often with OTS, the adrenals become overtaxed and the level of cortisol (a stress hormone) is too high. Intake of stimulants, such as caffeine, tends to worsen the condition. Remember, caffeine can be found in many pre-work out supplements, running gels, soda, coffee, and tea as well as some over the counter (OTC) medications. During your recovery phase, limiting chemicals that promote stimulation to the nervous and hormonal systems (particularly in regard to cortisol and adrenal function) will speed up your recovery. Once you have recovered and are tapering back into full training, I caution you in limiting stimulants as a prevention strategy for future episodes of OTS.
Eat healthy. A healthy diet is critical to avoid injury. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. In the case of OTS, I encourage that you consume a higher fat diet to help your body’s hormonal system re-regulate. Also, adequate protein intake is necessary to support muscle health and development. For more information on protein intake, please refer to How Much Protein Do I Really Need?
Hydrate more frequently. The human body is primarily made of water, which is critical for all body functions. In the case of OTS, I highly encourage you to hydrate more frequently during recovery. Adequate water intake is critical to avoid dehydration which can negatively affect your training. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce. Coconut water is a popular drink that offers vital nutrients. Also, consider a juicing cleanse with a heavy focus on the kidneys and liver to help detoxify the body.
Supplement. My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra. Essentially, it combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation. CapraFlex can be taken long term or intermittently. In the case of OTS, I also recommend a colostrum supplement called CapraColostrum by Mt. Capra. Colostrum is the first milk produced by female mammals after giving birth. It contains a host of immunoglobulins, anti-microbial peptides, and other growth factors. It is especially good at strengthening the intestinal lining which prevents and heals conditions associated with a leaky gut. Colostrum can also help a person more effectively exercise in hotter conditions. Over all, it can boost the immune system, assist with intestinal issues, and help the body to recover faster. Like CapraFlex, Tissue Rejuvenator by Hammer Nutrition contains glucosamine and chondroitin as well as a host of herbs, spices, and enzymes to help support tissues and limit inflammation. I recommend taking either CapraFlex OR Tissue Rejuvenator. You can take CapraColostrum independently or in conjunction with either CapraFlex or Tissue Rejuvenator. I recommend taking these supplements as a recovery strategy. I recommend initially trying a 30 day protocol. If the supplements are aiding your recovery, you may choose to continue taking them for an additional 30 days. I implement this protocol as part of a prevention strategy during times of heavy volume or high intensity training. (Please consult with your pharmacist and/or physician prior to starting any new supplementation protocol. Herbs could interact with some medications particularly if you are taking blood thinners.)

Overtraining Syndrome can be dangerous and severely limit your ability to train. It also significantly increases your risk of injury. A recovery protocol should include a multifaceted approach that incorporates strategies to positively affect the muscular, nervous, and hormonal systems.

Nothing can derail your best laid training plans and goals like an injury or suffering from OTS! If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury and return to a normal training schedule.

AVAILABLE NOW ON AMAZON!

In my book, Preventing and Treating Overtraining Syndrome, I show you how to recognize the risk factors and symptoms of OTS. You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”). This will speed up your results, so that you can train harder and more effectively than ever before! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

Discover how you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

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Posted on Wednesday, March 18, 2015

12 Tips to Prevent Overtraining Syndrome

If you exercise or participate in any sport, then you have likely had some experience with Overtraining Syndrome (OTS). It usually starts with extra muscle soreness and a feeling of fatigue. These symptoms can quickly morph into a serious case of overtraining syndrome. Overtraining can occur when the intensity and/or volume of exercise becomes too much for the body to properly recover from.

Although not well understood yet, research indicates two forms of OTS. One affects the sympathetic nervous system (SNS). The other primarily affects the parasympathetic nervous (PNS). Sympathetic OTS tends to affect sprint or power athletes. The resting heart rate tends to be elevated in the sympathetic form. Parasympathetic OTS tends to affect endurance athletes. In the parasympathetic form, the heart rate is even more decreased than typically found in endurance athletes.

There is no specific test for OTS. The diagnosis is usually determined when a number of factors or symptoms begin to manifest. Warning signs, ranging from mild to severe, include:

Fatigue (mild to severe)
Muscle and body achiness and soreness
A sudden drop in performance
A drop in strength
A drop in cardiovascular endurance
Insomnia or excessive sleepiness
Headache
Illness due to a drop in your immune function
Irritability and moodiness
Decreased appetite or weight loss
An increase in your resting heart rate
A decrease in your heart rate variability
A substantial drop in training capacity and/or intensity
Depression and a loss of enthusiasm for activities (such as training)

Avoid Overtraining Syndrome if you want to effectively train at a high level. It not only impedes your immediate performance, but it also substantially increases your risk of injury. Remember, recovery from a workout is a critical part in avoiding OTS. Your recovery routine should be an intentional and a multifaceted approach.

12 Tips to Prevent Overtraining Syndrome:

Keep a training diary. An exercise or training diary allows you to keep track of how you feel before, during, and after workouts. How did your body respond to training that day? How did you sleep? How was your food intake and nutrition? Also, record your heart rate response during your exercise session. Document as many variables as you can in order to look for patterns. Discover which combinations work well for you and those that have a negative effect on training. Focus on the positive and eliminate variables which cause negative effects. The diary helps you to keep track of it all. There are software programs available to assist in this as well. One such program popular with cyclists and triathletes is Training Peaks.
Monitor heart rate variability. Another potential warning factor for overtraining syndrome is heart rate variability (HRV). It is simply the variation in the time interval between heartbeats. HRV is affected by stress, hormone changes, and changes in the sympathetic or parasympathetic system. A decrease in parasympathetic activity or increased sympathetic activity will result in reduced HRV. A reduced HRV is a sign of OTS. The higher the HRV, the more capable your nervous system is able to adapt to stress. Many different apps can quickly measure HRV. Some apps are more accurate than others. The more accurate and precise the measurement, the more expensive the app. One free app that I use and recommend is Azumio’s Instant Heart Rate.
Monitor for OTS warning signs. Watch for the warning signs (listed above) and decrease your training volume if you are experiencing symptoms. Listen to your body.
Cool down. After performing your exercises, take the extra time to cool down and stretch. Choose exercises and activities that provide range of motion (ROM) to the particular area that you just trained or used. The perfect time to perform static stretching is after exercising. Work on tight and restricted areas. Keep moving throughout the day and avoid sitting for extended periods of time.
Foam rolling. The foam roller is a wonderful tool which allows you to manipulate the body’s soft tissues. This has a potential positive effect on the fascial system, the musculotendinous system, and the circulatory system. It can aid in recovery by improving blood flow and reducing myofascial restrictions. To learn how to use a foam roller for self-treatment, please refer to Foam Rolling for Rehabilitation.
Active recovery. Every day shouldn’t be an intense training day. As part of your training cycles, be sure to include time to participate in other activities to help the body to recover and rejuvenate. Participate in a yoga class, take a leisurely bike ride, or take a walk in the park.
Proper periodization. You cannot and should not train at a super high intensity all year long. Your work volume needs to be properly periodized. Well-balanced gradual increases in training are recommended. Be sure your training plan varies the training load in cycles with built in mandatory rest phases throughout the year. The plan will likely be based on when you need to peak for certain events or races. During the high workload phase, try to alternate between high intensity interval work and low intensity endurance work.
Taper up the training volume appropriately. The 10 Percent Rule is a guideline that many fitness experts use to help athletes (of all levels) avoid injury while improving performance. Many cases of OTS can be attributed to increasing the intensity, time or type of activity too quickly. The 10 Percent Rule sets a weekly limit on training increases. The guideline indicates not to increase your activity more than 10 percent per week. That includes distance, intensity, amount of weight lifted, and/or time of exercise. For example, if you are running 30 miles per week and want to increase the distance, add 3 miles during the next week for a total of 33 miles a week. If you are squatting 200 pounds and want to increase, don’t add more than 20 pounds during the next week. The 10 Percent Rule is only a guideline. In some cases, 10 percent may be too much. Instead, a 5 percent increase per week may be much more realistic.
Rest more. Your body must rest in order to grow and develop. Training every day is not the best way to improve. It can lead to injury and burn out. Take a rest day and have fun. Sleep more. Proper programming includes mini cycles with an off season as well as active rest cycles in between heavy load and heavy volume training cycles. Don’t fear rest, embrace it!
Eat healthy. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development. For more information on protein intake, please refer to How Much Protein Do I Really Need?
Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Adequate water intake is critical to avoid dehydration which can negatively affect your training. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce.
Supplement. I take certain supplements during times of heavy training volume or when I am in a phase of overreaching. I also take them intermittently to help prevent injury or heal from one. My most recommended supplement is CapraFlex by Mt. Capra. Essentially, it combines an organic glucosamine and chondroitin supplement with other natural herbs which are designed to reduce inflammation. CapraFlex can be taken long term or intermittently to help heal from an injury. I also recommend a colostrum supplement called CapraColostrum by Mt. Capra. Colostrum is the first milk produced by female mammals after giving birth. It contains a host of immunoglobulins, anti-microbial peptides, and other growth factors. It is especially good at strengthening the intestinal lining which prevents and heals conditions associated with a leaky gut. Colostrum can also help a person more effectively exercise in hotter conditions. Over all, it can boost the immune system, assist with intestinal issues, and help the body to recover faster. Both of these supplements can be used in heavy volume or intense training phases to help you to recover faster and avoid OTS. (If you are taking blood thinners, please consult with your physician prior to use as the herbs could interact with some medications.)

If you begin to experience any of the warning signs of OTS, be proactive about modifying your training. It is important to objectively measure your training routine and make adjustments before you become sick, overtrained or injured. Incorporate these recommended prevention strategies to help keep your training at a high level. In the follow up post, 10 Tips to Self-Treat Overtraining Syndrome, I specifically address self-treatment strategies.

If you are experiencing chronic aches or pain or are struggling with an aspect of your training, seek help immediately. Seeking advice specifically from an experienced coach, physical therapist, or physician can be beneficial.

AVAILABLE NOW ON AMAZON!

Discover how you can continue to train hard and avoid the associated poor performance, illness, and injury that can result in lost training days and opportunity!

BUY NOW

I am excited about presenting a Low Back Pain Seminar at CrossFit Station.

Date:	Saturday, April 11, 2015
Time:	10 a.m. – 12 p.m.
Location:	1396 E Iron Eagle Dr. Eagle, ID
Registration:	$25 Registration Fee (due by Friday, April 3)
More Info:	Contact Trina or Tony at 208.631.3410 to reserve your spot! Click CrossFit Low Back Pain Seminar for more information.

Event:	Low Back Pain Seminar

Posted on Wednesday, February 11, 2015

Why You Should Walk, Not Run

Although controversial and disappointing for some, running isn’t appropriate for everyone. As a physical therapist and runner, I understand why some people cannot and should not take up running as a form of exercise. Not all bodies are built to run. An existing injury may make it unsafe to run on a regular basis. If you can’t run, don’t worry about it! Many other forms of exercise without repeated impact can help us to keep fit. Walking is a wonderful method of exercise. Out of all the possible movements we can perform, we’re best at walking! Walking daily can reduce stress, improve circulation and hormone regulation as well as benefit your overall well-being.

There are many wonderful methods to stay fit and improve your cardiovascular system, but running may not be the best choice for you if you have any of the following conditions:

Certain Forms of Arthritis – There are 171 different kinds of arthritis. Although causes and presentations vary, the most common form is osteoarthritis (OA). You can still run if you have OA, but you may choose not to if you are symptomatic (experiencing pain). Running would be ill-advised for those with other types of arthritis such as gout or rheumatoid arthritis (RA). The risk of joint injury during repetitive impact based activity (like running) is too high. For more information specifically on RA, please refer to Q & A: Exercises Beneficial in Managing Rheumatoid Arthritis.
Joint Replacement – As America’s population continues to age, total joint replacement has become an increasingly more popular method to treat pain and arthritis in joints. The procedures continue to improve and evolve. Although you may be capable of running after a total joint replacement, I don’t recommend it. Running on a total joint replacement, particularly in the knee or ankle, increases the likelihood that the replacement will wear out and/or fail prematurely. If you have had a total joint replacement, I recommend a less impactful method of cardiovascular exercise.
Morbid Obesity – Running can be an excellent form of exercise and a wonderful method to help one reach his/her desired weight. However, running may not be the safest choice initially if you are morbidly obese. Morbid obesity is defined as a Body Mass Index (BMI) greater than 40 or having more than 100 lbs. of body weight. Running with excessive body weight increases your risk of injury and permanent damage to joints throughout the body. Initially, pursue non-impact activities. As your weight decreases, you may choose to participate in a running program.
Recent Medical Procedures or Injury – The inability to run can be temporary. Often after a medical procedure, physicians will advise not to run or participate in overly strenuous exercise during recovery. The list of possible conditions is long, so refer to your physician and physical therapist regarding when to avoid activity. Once you have sufficiently healed, you can taper back into your prior level of activity or even progress into a new activity. Your physician or physical therapist can offer advice on how to safely resume your activities.
Severe Osteoporosis – Osteoporosis is the weakening of the bones. Running is not contraindicated for all forms of osteoporosis, but it is for severe cases. In mild cases, the repeated impact during running can be beneficial to bone formation if the mileage or time spent on your legs isn’t excessive. In severe cases, running increases your risk of fractures. Initially, the best course of treatment, besides dietary modification, would be weight bearing activities such as weight training and walking.

The key is to rule out possible issues which may make running unsafe. Being well informed initially allows you to tailor an exercise program which can be safe and effective in maximizing your particular goals and needs. For a more thorough discussion on the safety of running, please refer to Is Running Safe? In most cases, running is safe with proper training and a strong focus on technique.

What are the benefits of walking?

Improves circulation and blood flow to the entire body.
Releases stress reducing hormones.
Releases hormones that can control blood sugar levels for up to 24 hours.
Burns calories.
Helps to prevent constipation.
Walking in a fasted state can help your body to learn how to utilize fat more efficiently as an energy source.
We are naturally good at walking. Do it daily!
It is a weight bearing activity that can be beneficial in reducing osteoporosis.
Keeps the spine healthy. The walking motion is vital to nutrient exchange in the spinal discs.

Choose walking as an intentional exercise, and add it to your daily activities as part of a healthy lifestyle. To increase the amount of calories burned during a walk, you may need to make a few changes to your morning or evening stroll. Don’t walk at your preferred speed. The trick is to make your body inefficient by walking slower, faster, uphill, downhill, or at varying speeds. Perform a high intensity workout by walking uphill briskly or using the Fartlek method.

Nordic walking, which utilizes walking poles that can help to stabilize you if your balance is poor, is also very popular. The use of walking poles can reduce stress from your back and lower extremity joints, increase your body strength, and burn more calories than traditional walking!

Do you prefer to walk or run? What might be holding you back from participating in an exercise program? I encourage you to get started now by walking. You may be surprised how quickly you see results! Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Posted on Wednesday, January 21, 2015

How to Self-Treat Shin Splints

If you have ever experienced shin splints (anterior compartment syndrome), you know how excruciatingly painful it can be. You may struggle to run or walk. The pain can linger for weeks and months–taking the fun out of running and exercise. In the previous post, I discussed How to Prevent Shin Splints. Now I will provide simple treatment options to quickly help aid in your recovery. Shin splints can typically be easily self-treated if you don’t have a more serious medical condition, such as a stress fracture, causing the pain.

How to Self-Treat Shin Splints:

Ice. Although shin splints can occur insidiously, they are often associated with a specific event. An active inflammatory process typically occurs. Apply the ice to the anterior tibialis muscle (the muscle right next to the shinbone). The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a cold pack. A bag of frozen peas can be a cheap alternative. Individuals with poor circulation or impaired sensation should take particular care when icing.
Rest. If you are experiencing an episode of shin splints, then you will need to rest. Avoid running (particularly downhill). At the very least, taper your training intensity and avoid exercises that place undue stress on the shins, particularly the anterior tibialis muscle. Utilize this time to incorporate cross training activities, such as yoga, to improve flexibility as shin splints can be linked to poor mobility.
Consider changing your shoes. Your shoes may be worn out and may be the cause of the pain. If you wear a shoe that helps to limit overpronation, remember that the inner cushion and structure of the shoe can wear out before its outer appearance. If this occurs, the shoe can no longer adequately control inappropriate foot and heel movements such as overpronation. This can lead to shin splints as well as IT band syndrome or other hip, knee, or ankle related issues. Shoes only last 350-500 miles. If you are nearing those miles, then it may be time to change.
Add an orthotic. Additional foot control is often needed to normalize gait mechanics. Many running stores sell an over-the-counter orthotic such as Superfeet Blue Premium Insoles. The blue tends to fit most feet, but a variety of options are available for customization. In my experience, these insoles can last 1,000 to 1,500 miles easily. If the over-the-counter options aren’t helping you, please see a physical therapist or podiatrist for custom orthotics. Seek assistance from a professional who is a runner and has experience with treating other runners.
Warm up prior to exercise. I recommend that you increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Consider using a self-massage tool to roll up and down the anterior tibialis as part of your warm up. My favorite self-massage tools for this area include the Thera-Band Standard Roller Massager and The Stick Self Roller Massager. I also recommend using the massager on your calf muscles. Perform calf stretches, but be mindful that prolonged static stretching before exercise may worsen performance.
Cool down. After performing your exercises, take extra time to cool down and stretch. Focus on calf stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up. If you are prone to developing shin splints, I highly recommend regular massage and mobilization of the anterior tibialis muscle, as well as the calves. Tightness in the calves and Achilles tendon are a risk factor for developing shin splints. Be sure to emphasize stretching your calves. Hold each of the following stretches for at least 30 seconds, 3 times on each leg, 2-3 times a day. (These stretches shouldn’t cause more than a mild increase in pain or discomfort.)

Self-mobilize the tissue. Be sure to mobilize the tissue of the anterior tibialis. For this particular area, you may want to use one of the self-massage tools referenced above. You could also use a tennis or lacrosse ball to aggressively work out the tissue along the shin. Remember that mobility issues and myofascial restrictions in the lower legs are highly correlated with the development of shin splints. Use the foam roller to address any lower leg tightness or restrictions. I tend to use the foam roller for the larger parts of the leg including the thigh, back of the leg, calves, and buttock muscles. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation.
Work on the stabilizing muscles of your hips and ankles. As part of a comprehensive rehabilitation protocol, I almost always have clients work on keeping the muscles of the pelvis, hips, and ankles strong. This will help to maintain normal gait mechanics during exercise and running. Not only will this help to prevent shin splints, it will likely help to prevent developing other orthopaedic issues such as plantar fasciitis and hip or knee pain. Please refer to Ankle Resistance Exercises and How to Safely Self-Treat Low Back Pain for my recommended hip and lumbar stabilization strengthening exercises.
Work on your balance. Poor balance is often associated with muscle weakness in the foot and ankle as well as the knee and hip musculature. Weakness and balance deficits can lead to poor foot mechanics, which can lead to excessive strain. I always include balance work as part of my recommended rehabilitation protocol. Please refer to Improving Balance by Using a Water Noodle, How Do I Improve Balance? (Part I), and How Do I Improve Balance? (Part II).
Kinesiological taping. The purpose of the tape is to assist the anterior tibialis muscle with its contraction and to possibly help with swelling and nutrient exchange by assisting the lymphatic system. I have had luck using the KT TAPE and Mummy Tape brands. When treating shin splints, I recommend following these step by step instructions for Kinesiological Taping for Shin Splints. For application and removal tips, please refer to Skin Care with Taping.
Use a compression sleeve or stocking. This condition is often associated with swelling and inflammation in the anterior compartment of the lower leg near the shinbone (tibia). The compression sleeve/socking can help to limit the amount of swelling and promote blood flow back out of the lower leg. This insures better nutrient exchange, waste removal, and can limit the swelling. I particularly recommend wearing a pair while you are in the rehabilitation phase or tapering back into full activity. There are many different styles of compression socks and sleeves, but I prefer Vitalsox Graduated Compression Socks. If you prefer a sock style, then I recommend choosing a pair that is at least knee high.
Start a supplement. Many herbs help to reduce inflammation and pain. One of my favorites is called Phenocane Natural Pain Management. It combines the following: Curcumin, an herb that reduces pain and inflammation; boswellia, a natural COX2 inhibitor that also reduces pain and inflammation; DLPA, an amino acid that helps to increase and uphold serotonin levels in the brain; and nattokinase, an enzyme that assists with blood clotting and reduces pain and inflammation. (If you are taking blood thinners, please consult with your physician prior to use as the herbs could interact with some medications.)
Ask for help. If you’re still experiencing pain after implementing these self-treatment strategies, then it may be time to seek additional help. Your medical physician can help to determine if your pain is associated with a stress fracture. He/she could also prescribe stronger anti-inflammatory medication if necessary. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to seek your physician’s opinion as well).

Have you ever experienced shin splints? If so, which treatment techniques have you found to be the most effective? Please leave your comments below.

Looking for that exercise or book I mentioned in a post? Forgot the name of a product or supplement that you’re interested in? It’s all listed in the new Resource Guide. Check it out today!

Posted on Wednesday, January 14, 2015

How to Prevent Shin Splints

The term shin splints, also known as an anterior compartment syndrome, refers to pain along the shinbone (tibia), the large bone in the front of your lower leg. Shin splints can be excruciatingly painful to the point that you may struggle to walk or run. Worse yet, the pain can linger for weeks to months, but it may not be severe enough to prevent you from exercising. However, it will take the fun out of exercising and running. I will address the common causes for shin splints and share my top tips to prevent shin splints. I provide treatment options in How to Self-Treat Shin Splints.

Shin splints are typically caused by inflammation in the lower leg anterior muscles known as the anterior tibialis muscle. This is the primary muscle needed to lift your foot. Shin splints are often considered an over use injury. Unfortunately, shin splints are relatively common in runners and dancers.

As a physical therapist, I commonly treat acute cases of shin splints that occur when an individual suddenly increases his/her training volume by largely increasing the distance he/she is running. This condition may also occur when an individual isn’t appropriately trained for downhill running. Running downhill causes the anterior tibialis muscle to work very hard in an eccentric manner (meaning that the muscle is lengthening). This can very easily overwork a poorly trained muscle and may cause pain and inflammation.

Common Causes of Shin Splints include:

Flat feet, which cause overpronation while running.
Poorly fitting or worn out shoes.
Tightness in the calf muscle or Achilles tendon.
Weak ankle muscles (particularly the anterior tibialis). Shin splints are also associated with weakness in the other muscles of the ankle and foot.
Weakness in the hip, pelvic, and/or core muscles can lead to faulty gait mechanics, which causes shin splints or possibly other knee and lower extremity injuries.
A change in running surfaces. This is most evident when transitioning from a softer running surface, such as dirt, to a concrete running track.
Stress fractures in the shin (tibial bone). Also, stress fractures in the foot can cause alterations in running form which may lead to shin splints.
Training overload. The muscles of the anterior shin (the anterior tibialis) are performing training intensities and volumes that they are incapable of doing. This causes inflammation, swelling, and pain.

How to Prevent Shin Splints:

Check your shoes. Your shoes may be worn out and may be the cause of the pain. If you wear a shoe that helps to limit overpronation, remember that the inner cushion and structure of the shoe can wear out before its outer appearance. If this occurs, the shoe can no longer adequately control inappropriate foot and heel movements such as overpronation. Shoes typically only last 350-500 miles. If you are nearing those miles, then it may be time to change. If you’re unsure if your shoes are performing correctly, visit your local running shoe store. The trained staff can inspect your shoes for wear and tear. They may ask you to walk or run in order to watch your gait to fit you in the appropriate shoe. Another option to help control overpronation is an over-the-counter orthotic such as Superfeet Blue Premium Insoles. The blue tends to fit most feet, but a variety of options are available for customization. In my experience, these insoles can last 1,000 to 1,500 miles easily. If the over-the-counter options aren’t helping you, please see a physical therapist or podiatrist for custom orthotics.
Progress slowly into a minimalistic shoe. If you are used to a standard built up shoe, progressing into a minimalistic shoe may be more difficult and take more time. Unless you are a child or teenager, expect a safe transition to take at least three months. Don’t transition during a period of intense sports. I highly recommend waiting until the off season as progressing slowly is always a better choice.
If you change running surfaces, progress slowly. If you are used to running on softer surfaces, such as dirt or a running track, progress carefully and slowly when you run on a harder surface like concrete. Over all, softer running surfaces are better for your body.
Have your gait analyzed while running. Gait or running abnormalities can increase your risk of developing shin splints. Over striding tends to occur while running downhill. Check with your local running store or a physical therapy clinic for a monthly gait analysis clinic. If you’re unable to obtain a gait analysis, ask your spouse or a friend to video record you (from behind) while you’re running. Then watch the recording to see if you notice over striding or any abnormalities.
Warm up prior to exercise. I recommend that you increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Consider using a self-massage tool to roll up and down the anterior tibialis as part of your warm up. My favorite self-massage tools for this area include the Thera-Band Standard Roller Massager and The Stick Self Roller Massager.
Cool down. After performing your exercises, take extra time to cool down and stretch. Focus on calf stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up. If you are prone to developing shin splints, I highly recommend regular massage and mobilization of the anterior tibialis muscle.
Improve your mobility. Mobility issues and myofascial restrictions in the lower legs are highly correlated with the development of shin splints. Use the foam roller to address any lower leg tightness or restrictions. To learn how to use a foam roller, please refer to Foam Rolling for Rehabilitation.
Strengthen the stabilizing muscles of your hips and ankles. Strengthening the muscles of your hips and ankles will help to maintain normal gait mechanics during exercise and running. Not only will this help to prevent shin splints, it will likely help to prevent developing other orthopaedic issues such as plantar fasciitis and hip or knee pain. Please refer to Ankle Resistance Exercises and How to Safely Self-Treat Low Back Pain for my recommended hip and lumbar stabilization strengthening exercises.
Improve your balance. Poor balance is often associated with muscle weakness in the foot and ankle as well as the knee and hip musculature. Weakness and balance deficits can lead to poor foot mechanics, which can lead to excessive strain on the plantar fascia. Improving your balance can help to reduce the risk of shin splints and is an important part of the rehabilitation. Please refer to Improving Balance by Using a Water Noodle, How Do I Improve Balance? (Part I), and How Do I Improve Balance? (Part II).
Train for running downhill. Running downhill forces the anterior tibialis muscle to work much harder than it would otherwise. Running downhill causes the anterior tibialis to perform more eccentric (when the muscle gets longer) loading and repetition. This can overload the muscle, particularly when running downhill very fast. Although running downhill may not be as aerobically taxing as running uphill, it’s actually physically much harder on your body.
If you experience pain, seek help early. Don’t ignore those little aches and pains that can develop as you exercise and train. They may be early warning signs of a developing problem. If you experience pain in your shins, start implementing my recommended treatment protocol. If the pain persists or continues to progress, please seek assistance from your medical physician or a physical therapist. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

Have you ever experienced shin splints? If so, how do you prevent them from re-occurring? Please share the treatments that have been the most effective for you by leaving your comment below.

Looking for that exercise or book I mentioned in a post? Forgot the name of a product or supplement that you’re interested in? It’s all listed in the new Resource Guide. Check it out today!

Posted on Monday, January 5, 2015

My Top 5 Most Popular Posts of 2014!

For many of us, the healthcare system is too expensive or unapproachable as we try to improve our health and live life to its fullest. My desire is to provide you with useful information to achieve both objectives. Thank you for supporting The Physical Therapy Advisor website since its launch in April. I appreciate your questions and feedback, and I look forward to serving you in 2015!

My Top 5 Most Popular Posts of 2014:

My Top 7 Tips to Prevent Low Back Pain While Traveling – Low back pain is one of the most prevalent and pervasive problems in the western world. Whether you’re traveling or working in an office, review these 7 tips to prevent low back pain.
7 Reasons Why the Squat is Fundamental to Life – When was the last time you moved into a full squat? Why does it even matter? Find out 7 reasons why we should continue squatting as a lifelong pursuit.
How to Self-Treat Plantar Fasciitis – Plantar fasciitis is a very painful and potentially very debilitating condition. Don’t let foot pain stop you from reaching your goals in 2015! Learn how to self-treat plantar fasciitis and prevent it from slowing you down.
Q & A: How to Prevent My Mom From Falling Out of Bed – Falling is the number one cause for fracture in the elderly. Many times, a fracture will lead to a cascading decline in mobility and function. Finding methods to limit falling, without restraining or inhibiting important functional mobility, is critical. Discover tips to keep your loved ones safe.
5 Ways to Improve Range-Of-Motion (ROM) – As we age, we naturally lose elastin, an important component to our skin, muscles, and tendons. Elastin is responsible for the elasticity in the body’s tissues. Maintaining Range of Motion (ROM) is critical to maintaining our mobility and for injury prevention and sport performance. Poor ROM can also lead to pain and dysfunction as the body’s ability to move freely is impaired. Discover different methods to maintain your ROM and prevent injury.

2014 was a wonderful start for the blog. I look forward to empowering you to reach your optimal health in 2015! Don’t forget subscribe to my e-mail newsletter! I will send you weekly posts on how to maximize your health, self-treat those annoying orthopaedic injuries, and gracefully age. To thank you for subscribing, you will automatically gain access to my FREE resource, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain.

Posted on Sunday, December 28, 2014

15 Strategies to Make 2015 Your Healthiest Year

With the upcoming New Year, we begin to make many resolutions. However, many of us don’t truly intend to follow through with them! In regard to our health and fitness, we may not feel capable of improving. Maybe you think you are too young or old, overweight, or just have too many medical problems to make a difference. Many of us feel exactly the same way! Let’s first acknowledge the positive. You are aware of your need to address this issue. You’re likely to live well into your 90’s, and you’re already taking action. It is never too late to start! The key to aging well is to maximize your health and wellbeing now!

Where we are now in our physical lives is the sum total of choices we have made, and a few random events all sprinkled with the genetics we inherited. We need to accept ourselves for where we are presently and acknowledge that our fitness and our health is not a destination, but a journey. Each person’s journey is different. We need to be realistic with our goals and give ourselves time to undo what we have done to ourselves for years. Leading a healthy lifestyle must include balancing the five pillars of one’s life including: physical, mental, emotional, social, and spiritual. Each one will affect the other both positive or negatively.

15 Strategies to Improve Your Health:

Do not diet! Be more concerned with counting chemicals on labels than calories.
Do not eat anything that comes in a package. Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil). Any animal fat should be from organic and grass fed animals. Your body tissue needs nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development.
Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Adequate water intake is critical to avoid dehydration which can negatively affect your training and becomes increasingly more common in older adults. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Water intake supports proper brain, muscle, and hormone function as well as lubrication of the joints and skin appearance. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names that you can’t spell or pronounce.
Manage your weight. Excessive body weight causes abnormal wear and tear on your body (particularly in the knees and feet). It also places additional strain on your cardiovascular system and increases your risk of diabetes—thus increasing your risk of stroke, heart disease, and dementia. As we age, our metabolism begins to slow. Tips to help you to manage your weight include: eat a healthy diet; stay hydrated; and move more frequently throughout the day. For every two hours of sitting, get up and walk around. A strength training and high intensity training (HIT) program can help you to maintain a suitable weight by insuring your metabolism stays elevated and your hormone levels remain balanced. When attempting to lose weight, aim for 1-2 pounds per week.
Stop sitting so much. The latest research indicates that sitting for more than two hours at a time can significantly lessen your life span. The real headline should be: Even if you are a regular exerciser, sitting for more than two hours a day will still lower your life span. The take home message is that frequent movement throughout the entire day is critical for health. Standing still for long periods of time is as equally hard on the body (particularly in the lower lumbar, knees, ankles, and feet) as sitting. It can cause negative effects in the joints as well as cause circulation issues.
Walk daily after dinner. To optimize your walking program, consider taking walks after dinner. It has a greater benefit on your metabolism and may reduce the risk of diabetes by stabilizing blood sugar levels. If you can only walk in the morning, try walking before your morning meal. This will train your body to perform more efficiently on its fatty tissue stores and not to be carbohydrate dependent.
Sleep more. Your body must rest in order to grow and develop. Most people are not getting adequate sleep and rest. Sleep is critical to maintaining your growth hormone and testosterone production as well as stabilizing your metabolism. Rest more! Training every day is not the best way to improve. It can lead to injury and burn out. Take a rest day and have fun. Participate in a yoga class, take a leisurely bike ride, or take a walk in the park. If you are participating in a yearly training cycle, be sure to incorporate an off season which involves a change of pace from your regular training to active rest instead.
Improve your growth hormone production. Strength training (focusing particularly on large muscle groups with appropriately heavy loads) has been proven to improve growth hormone levels. High intensity training (HIT) performed once or twice per week may also help to increase growth hormone levels. A proper diet is also the key to improving hormone levels by including adequate protein and fat levels while avoiding excess sugar. An adequate amount of sleep also plays a major role in growth hormone production.
Regulate your insulin production. Strength and endurance training have a positive effect on your body’s ability to regulate insulin levels. Strength and cardiovascular training are a critical part of a maintenance program for diabetes. To maintain an even energy level throughout the day, a stable insulin level is critical. Limit your carbohydrates and increase your protein and healthy fat intake. Diabetes prevention is important in order to avoid cardiovascular disease and dementia.
Perform high intensity interval training. Perform cardiovascular fitness in short bursts (ranging from 30-60 seconds at a time) followed by a 1-2 minute recovery. The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high. You should be breathing heavy. If you are overweight or have arthritis, this may be performed while using a stationary bicycle or in a pool. You can also walk up hill at a quick pace, then stop and rest. This is performed in intervals. High intensity training (HIT) or high intensity interval training (HIIT) will produce the best result for weight loss and fitness. HIIT is a superior approach to increase cardiovascular fitness, improve hormonal regulation, increase insulin sensitivity, and burn more calories and fat in a short amount of time.
Maintain your strength. Although all muscle fibers show some decline as you age, the fast twitch (Type II) fibers show the most decline. Strength training is a critical component to maintaining and growing additional Type II muscle fibers. The stronger you are, the more resistant to injury you are. Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain. Low back pain can be a rehabilitating condition. If you’re experiencing pain, please refer to How to Safely Self-Treat Low Back Pain.
Use a foam roller. As a person ages, the body tends to become stiffer as it loses elastin. This negatively affects a person’s range of motion (ROM). It also makes the muscle and tendon fibers more likely to tear if overstretched. I recommend that everyone participate in a flexibility program. (The older you are, the more important this becomes.) Mobility and flexibility become more difficult if you aren’t purposefully working on it. Yoga is an excellent choice as well as utilizing the foam roller. Using a foam roller can help keep tissues pliable. Regular use may also beneficial as it helps improve arterial stiffness and can improve arterial and vascular function. To learn how to use a foam roller, please refer to Does Foam Rolling Help or Hurt Your Performance?
Find an accountability partner. It is critical to have someone who will hold you accountable for the goals that you set and your choice of lifestyle. We all get off track from time to time. An accountability partner can nudge you back onto that path. Exercising with someone is an excellent way to insure consistency. Be sure to push one another–friendly competition is healthy!
Seek help early. If you are experiencing chronic aches or pain or are struggling with an aspect of your training, seek help immediately. A healthy lifestyle is a lifelong pursuit. If you are injured or not enjoying an activity, you will not stay engaged or motivated in the long term. Seeking advice specifically from a running coach, weight lifting coach, certified personal trainer, physical therapist, or physician can be beneficial.
Choose your influences. Jim Rohn once said, “You are the average of the five people you spend the most time with.” Choose wisely! Our thoughts and actions are greatly influenced not only by people we spend time with, but the audio and visual input we consume. Choose healthy influences and regulate what you read and watch on TV.

The New Year is an excellent time to make positive changes in your life! To optimize your health, seek balance in your physical, mental, emotional, social, and spiritual health. If you are deficient in one area, it will likely affect the others. Don’t get discouraged! Small incremental steps can positively affect your health. After setting your goals, get started and enjoy the journey. Cheers to a happy and healthy 2015!

Bonus Tip: Don’t forget subscribe to my e-mail newsletter! I will send you weekly posts on how to maximize your health, self-treat those annoying orthopaedic injuries, and gracefully age. To thank you for subscribing, you will automatically gain access to my FREE resource, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain.

If you have a question that you would like featured in an upcoming blog post, please e-mail contact@thephysicaltherapyadvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor where you will receive additional health and lifestyle information.

Posted on Sunday, December 21, 2014

Q & A: How Much Protein Do I Really Need?

Q. Depending on my level of activity, how much protein should I be consuming in my diet? -Amy

A. Thanks, Amy, for this excellent question! Opinions on this controversial topic vary widely. Your dietary belief system and what type of exercise or activity you participate most in may determine your protein consumption. Most power lifters, body builders, CrossFitters, and Paleo diet followers partake in a very high protein diet. Vegans and many endurance athletes do not. The research is still mixed on whether a high protein diet can be helpful or harmful.

The answer may be more subtle and complicated than you think. It depends on how your body responds to protein in general. The type of protein you eat (and its bioavailability) is also a factor when considering health optimization. An important point may not be about protein at all. Instead, how many carbohydrates do you eat and from which sources?

Plant-based protein sources, such as hemp, pea, and quinoa, and animal-based protein should be included in your diet for two reasons. First, animal protein is a complete protein, a protein with a full amino acid profile. Amino acids are the building blocks for protein. Some amino acids can be manufactured in the body. Others cannot and must be obtained from dietary sources. This is why you must ingest a full amino acid profile either through an animal source or multiple plant-based sources. Finding the right combination of plant-based foods to obtain a complete amino acid profile can be tricky.

Second, certain types of important fats come with animal protein. Fats, such as Docosahexaenoic Acid (DHA) found in fish, can be synthesized via alpha-linolenic acid (ALA), which is plant-based, but the conversion rate is very poor. Animal protein sources should include fish, chicken (free range), beef (free range), turkey (free range), and any wild game. Why wild game and free range animals? They are relatively free from likely contamination, hormones, or other chemicals used in commercial processing, and their fat profiles are healthier. They also tend to be leaner protein, especially wild game. A good percentage of calories from protein should be 20% (although it may be higher based on your dietary beliefs). I recommend taking in a variety of protein sources that are both animal and plant-based.

Although there are different methods to calculate protein needs, the following is the most common. The standard minimum amount of daily protein needed is .37 grams per pound of body weight (or .8 grams per kilogram of body weight). This is the bare minimum. Research has shown between 1.2 and 1.8 grams of protein per kilogram of body weight (approximately .5-.8 grams per pound) is important to maximize health and for athletes. (Use 2.2 lbs. divided by your body weight to calculate kilograms). Other methods recommend even more protein, but I’m not convinced it is necessary.

Please see the following examples for the average male and female. Then enter your own weight to determine the recommended amount of protein per day.

Male, 180 lbs. 180 lbs. / 2.2 = approximately 82 kilograms. 82 kg. x 1.2 = 98 grams. 82 kg. x 1.8 = 148 grams. The range is from 98 to 148 grams of protein per day.
Female, 130 lbs. 130 lbs. / 2.2 = approximately 59 kilograms. 59 kg. x 1.2 = 71 grams. 59 kg. x 1.8 = 106 grams. The range is from 71 grams to 106 grams of protein per day.

Another method to calculate protein needs is based on lean body mass rather than total weight. You will need to know exactly how much body fat you have. This calculation is not practical for most people, and it’s typically an inaccurate body fat percentage number. The method asserts that fat tissue needs less protein to support it.

If you’re interested in reading more about this method, please refer to Enter The Zone: A Dietary Road map by Barry Sears and Protein Power: The High-Protein/Low Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health-in Just Weeks! by Michael R. and Mary Dan Eades.

Precautions regarding protein:

Excessive protein intake may be hard on the liver and kidneys. If you have kidney or liver related issues or a predisposition, I recommend that speak with your physician prior to over consuming protein.
Many protein powder supplements contain artificial sweeteners, preservatives, and other chemicals. Choose the healthier options, and read the labels on the products.
Many protein powder supplements contain whey protein. Whey, a complete protein, has an excellent price point. However, many people may be intolerant to whey. While supplementing, keep track of how you feel to insure that you aren’t experiencing a negative reaction to the protein source.

My Top Protein Supplement Recommendations:

I prefer to supplement with a plant-based protein source because I regularly consume animal-based protein. I also supplement with a goat-based protein source. Goat protein is a smaller particle size and may be more easily digested and utilized by the body.

Mt. Capra Double Bonded Goat Milk Protein is an organic goat-based protein. Mt. Capra offers multiple flavor options. I prefer the chocolate, which is only flavored with organic cocoa powder. It doesn’t have any preservatives, chemicals, or sweeteners. If you are used to mass produced supplements, your taste buds will have to adjust.
Lifetime Life’s Basics Plant Protein is an organic vegan option that contains a blend of proteins which makes a complete amino acid profile. I prefer the vanilla, but it’s available in chocolate as well. It doesn’t have any other preservatives, chemicals, or sweeteners. Again, if you are used to mass produced supplements, your taste buds will have to adjust.
If you’re interested in a whey supplement, Thorne Research Whey Protein Isolate doesn’t contain artificial flavors, colors, sweeteners, carrageenan or gluten. It is sourced from cows not treated with hormones.

I am often asked how I prefer to consume protein supplements. I typically mix the protein supplement with black coffee and a teaspoon of organic coconut oil, which is full of medium chain triglycerides (MCTs). The coconut oil has no added flavor. It helps to stabilize my blood sugar and keeps me satiated for hours. I typically purchase Kirkland Organic Coconut Oil at Costco. Nature’s Way Coconut Oil is another option.

Obtaining the proper amount of protein from a quality source (via both food and supplements) as well as diversifying protein sources are important components to healthy eating and maximizing performance. To maximize your benefit and performance, you will likely spend time self-experimenting to determine how much protein you need to consume and from which sources.

Runners and endurance athletes should pay particular attention to protein intake as maintaining muscle mass is critical for performance and injury prevention. Consuming amino acids before and during endurance events is an excellent way to keep your blood sugar stable and to maintain a high level of performance. I recommend Hammer Nutrition Perpetuem Ultra Endurance Fuel, which includes a carbohydrate source, protein, and fat source, and Hammer Nutrition Hammer Gel, which contains some amino acids.

As we age, it’s important to continue to eat adequate amounts of protein. Sarcopenia is a condition in which muscle mass decreases with age. Strength training and consuming an adequate amount of protein is critical in avoiding sarcopenia and aging successfully. Red meat is a complete protein source. Consuming an adequate amount of red meat is an easy method to increase your iron consumption. Iron can help to reduce anemia, a common condition in women and the elderly population. Proper protein consumption is also critical to effectively manage diabetes.

For a conservative opinion on the subject of protein supplementation, watch the following video, How Much Protein Do You Really Need? by Yuri Elkaim. Elkaim is a nutritionist with an interesting history and has a wide range of experience working with athletes (particularly soccer players).

For a more aggressive opinion and information on the general physiology of protein use in the body, please refer to 7 Rules to Optimize Protein Intake by Barbell Medicine.

How much protein do you typically consume? What is your favorite protein supplement? Please leave your comments below.

Looking for that exercise or book I mentioned in a post? Forgot the name of a product or supplement that you’re interested in? It’s all listed in the new Resource Guide. Check it out today!

Thanks, Amy, for your question! If you have a question that you would like featured in an upcoming blog post, please submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!