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    HIIT or Miss?


    Too many people continue to be caught in the belief that performing long durations (>30Min) of steady state exercise is smart and beneficial for your overall well-being. Whether you enjoy running, bicycling, rowing, or walking; the notion is that the more volume you perform will result in greater weight loss, better conditioning, and/or improved health.  This perspective has since been deemed by a vast amount of research to be completely false, and is no longer recommended and for good reason.  However, it is mind boggling how I still encounter so many people day in and day out that refuse to accept this. At the same time, they are willing to quickly adapt new information on diet fads, but fail to compliment their new eating regimens with the correct and proper training methods.

    Now for the alternatives: circuit and interval training. Collectively the term commonly being thrown around these days is “HIIT”, or High Intensity Internal Training.  HIIT is a short period of vigorous, all-out effort activity, followed by a period of rest. Interval training should not extend any longer than 20 minutes (8-15 min is an average length of time for one session). You can perform HIIT on a treadmill, cycle, elliptical or outdoors, and you can even use equipment such as battle ropes, kettle bells, sleds, barbells, jump ropes, or just your own bodyweight.

    OK now let’s quickly review some research.  A recent study, done in Canada at McMaster University and often referred to as the Gibala Study after lead researcher Martin Gibala, compared 20 minutes of high intensity interval training, consisting of a 30 second sprint followed by a four minute rest, with 90 to 120 minutes in the target heart rate zone. The result was amazing. Subjects got the same improvement in oxygen utilization from both programs. What is more amazing is that the 20 minute program only requires about two minutes and 30 seconds of actual work.

    A second study that has become known as the Tabata study again shows the extreme benefits of interval training. Tabata compared moderate intensity endurance training at about 70 percent of VO2 max to high intensity intervals done at 170 percent of VO2 max. Tabata used a unique protocol of 20 seconds work to 10 seconds rest done in seven to eight bouts. This was basically a series of 20 second intervals performed during a four minute span. Again, the results were nothing short of remarkable. The 20/10 protocol improved the VO2 max and the anaerobic capabilities more than the steady state program.

    Prolonged steady state exercise can have a positive effect on resting heart rate, blood pressure, and other cardiovascular markers. However, it also exposes you to unnecessary cardiovascular stress, and sure this stress can be actually good for you but only up to a certain point. Excessive amounts of it can keep your body in this “stressed-out” state for too long which can hinder fat loss, as well as promote muscle catabolism (breakdown of muscle tissue). In addition, performing too large of an amount of steady state exercise puts you at a significantly higher risk for overuse and repetitive use injuries.

    In contrast, with HIIT you are still able to attain the same positive cardiovascular effects, but over shorter periods of time as documented in the research studies previously mentioned. In addition, you enter “EPOC”, or Excess Post-Exercise Oxygen Consumption which means after you stop working out, your body is still burning through calories while you go about your daily routine. Not to mention, your resting metabolism increases, and your body becomes more efficient at using fat for fuel. This is something not attainable at the intensity levels of most joggers and cyclists.

    With all that being said, stay active people. Whether it is going for a long run or maybe beginning to supplement some circuit training into your daily regimen, the biggest mistake you can make is to stop moving….

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    Dry Needling vs. Acupuncture

    Dry needling is fast growing treatment option that can be performed by trained physical therapists with proper secondary training. Many patients are sometimes confused what dry needling treatment is and how it is different compared to acupuncture.

    According to the Federal State Board of Physical Therapy in 2015, dry needling was defined as the following:

    Dry needling is a skilled technique performed by a physical therapist using filiform needles to penetrate the skin and/or underlying tissue to affect change in body structures and functions for the evaluation and management of neuromusculoskeletal conditions, pain, movement impairments, and disability.

    With that said, here are a few differences between dry needling treatment by a physical therapist and acupuncture:

    • Acupuncture is a treatment based on eastern medical diagnosis requiring training in Traditional Chinese Medicine. Evaluation of a patient often includes tongue and pulse diagnosis. Based on the diagnosis, the practitioner inserts needles into specific points that lie along the merdians or channels of the body through the life force or “qi”.
    • Dry Needling treatment is based on western medical philosophy. The evaluation includes patient history, symptoms, pain patterns, movement, muscular and articular function utilizing functional and orthopaedic tests and measures. Based on this information provided, treatment is guided by the impairments and limitations and the physical therapist will insert needles into muscle tissue that’s causing dysfunction.
    • Physical therapists must have extensive and proper education and knowledge of the muscular and nervous system, along with orthopedics in general skills including manual therapy and re-education in movement.

    These are just a few things that differentiates dry needling from acupuncture treatment. If you would like to learn even more about this treatment and if it would be a good treatment option for you, please visit PEAK Physical Therapy to learn more from our physical therapists that are certified in dry needling.

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    Healthy Habits: Everything in Moderation?

    The expression “everything is ok in moderation” is a commonly used axiom among today’s society. In most cases it’s logical as well as being applicable for a wide variety of topics and activities. However, the latest research is now concluding that this is no longer the case pertaining to health and nutrition topics.

    In a recent article published by Tech Insider, Dr. David Ludwig who is an obesity and nutrition expert from Harvard, actually deemed the notion “useless.” Dr. Ludwig believes in an approach that heavily involves considering what it is you eat rather than the amount you consume on a daily basis. He made reference to the Mediterranean Diet, applauding its emphasis on consuming some foods in abundance meanwhile limiting or even eliminating others. For example, a diet that includes moderate intake levels of vegetables and sugar is not healthy nor recommended. According to his research and a number of other studies, a diet with a large quantity of fruits and vegetables and a limited sugar intake will decrease the risk for a number of heart diseases and cardiovascular conditions.
    One of the more riveting references Ludwig made was concerning a study published in the New England Journal of Medicine. In this study they gave a group of more than 7,000 people at risk for heart disease either a Mediterranean diet with lots of olive oil, a Mediterranean diet with lot of nuts, or advice to eat a low-fat diet as a control. The rates of heart disease dropped so low in the groups eating lots of healthy fats that the researchers were forced to discontinue the study leaving Ludwig in disbelief and reporting “it would have been unethical to keep the control group eating the low-fat diet.”

    In general it is difficult to disagree with many of the points Dr Ludwig made in this article. I do think our society is more knowledgeable and less ignorant than he leads on here. For instance nobody is in line ordering a Big Mac one second and then thinks they can counter that decision by stopping and hitting the veggie aisle at the local Food Lion on the way home. And truthfully, the secret has been out for a while about the health benefits of diets with large amounts of quality fat. In retrospect I would have more so appreciated a study on the difference between the health effects among say the Mediterranean Diet in comparison to the ever growing popular Paleo Diet. Or possibly a retrospective analysis of the difference in impact from choosing one of the previously mentioned diets compared to simply trying to attain similar health effects via over the counter vitamin and mineral supplementation. Regardless, this article should serve as a strong reminder for all of us on how impactful our eating habits can be on our overall health.

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    Frozen Shoulder…Are you at risk?

    Shoulder pain and decreased mobility are common impairments for many of us. For some, a chronic history of these impairments may lead to a diagnosis of Adhesive Capsulitis, more commonly known as Frozen Shoulder. Many people have heard of this condition before, but aren’t always educated on exactly what it is and what they can do to treat the issue.

    Adhesive capsulitis is a pathology where there is a chronic history of pain and joint stiffness of the glenohumeral joint of the shoulder complex that can lead to decreased shoulder range of motion, strength, and loss of ability to use that arm for activities. Some risk factors of this disease includes:

    • Overuse of shoulder
    • Prior shoulder injury
    • Immobilizing shoulder such as with wearing a cast or splint
    • Patients with diabetes and thyroid conditions
    • Age: Patients that are 40-65 years of age are more prevalent
    • Sex: Females are more at risk then men

    Fortunately, this condition is a common one treated by health care professionals including physical therapists. A variety of treatment options available through physical therapy in the treatment of this condition include:

    • Patient education to learn more about the pathology process and promoting modifications to everyday activities improve level of function
    • Therapeutic exercise including range of motion exercises and stretching regimen
    • Manual therapy techniques such as joint and soft tissue mobilizations
    • Modalities such as electrical stimulation, laser treatment, and ultrasound to improve pain levels

    Visit the Peak Physical Therapy page on Facebook to learn more about Peak PT and what we have to offer to assist you in your care.


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    Preparing for a healthy and active 2016!

    As we begin the near calendar year, many of us make a new year’s resolution of “losing weight” or “being more active” to try and return to a more healthy lifestyle. Although it sounds like a great idea, it can be very difficult for people to prepare and maintain the changes they want to make whether it’s eating a better diet, maintaining a workout schedule, or attempting to stop our bad, unhealthy habits. When it comes both physical wellness as well as prevention of injuries or diseases, the physical therapy profession plays a prominent role in this area. Physical therapy would be a great outlet for people attempting to improve not only their physical health, but mentality of themselves and their lifestyle. Here are some ways physical therapy can help you prepare and accomplish your new healthy goals for the year:

    • Perform a full body assessment including ROM, functional strength, and other mobility and stability assessment to give you the information on your impairments and deficits
    • Collaborate and develop a plan of care program to based on both the client and physical therapist’s goals
    • Educate you on the proper exercise regimen including technique and function to accomplish goals both safely and successfully
    • Utilize skills and information in behavior changes to improve your overall lifestyle
    • Communication with the client throughout the program to give them the motivation, education, and support to maintain and continue with their plan of care


    Please feel free to contact Peak Physical Therapy for more information on how we can assist you in reach your goals in 2016!

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    The Truth Behind Concussions

    According to the Center of Disease Control and Prevention, there are approximately 300,000 sport-related concussions that occur annually in the United States. Hence, why this topic has become one of the more popular amongst news and social media outlets. Comparisons between concussion studies continue to be considered complicated because of a general lack of agreement pertaining to the actual definition and how to differentiate between the severities. An early definition frequently cited by the American Association of Neurological Surgeons group defines it as “a clinical syndrome characterized by immediate and transient post-traumatic impairment of neural functions, such as alteration of consciousness, disturbance of vision, and equilibrium due to biomechanical forces.” The most commonly reported symptoms associated with concussions are confusion, amnesia, and headaches. The injury is most often produced by the acceleration/deceleration of a freely moving head, making its significance even more relevant with the growing interest our society has in sports and athletics today.

    Sports-related concussion have gained increased prominence, in part due to media coverage of several well-known athletes who have died from the consequences of what is now termed chronic traumatic encephalopathy (CTE). The emergence of CTE is becoming more understood and has increased awareness due to film being released on Christmas Day, “Concussion”, that is starring Will Smith who portrays Dr. Bennet Omalu, a forensic pathologist who was able to discover the disease after an autopsy performed on a former NFL player. Since the discovery, Dr. Omalu has fought against efforts by the National Football League to suppress his research on the brain damage suffered by professional football players. In the past 10 years, it has been one of the most discussed topics associated with not only football, but all contact sports.

    CTE was first described by Martland in 1928 as a syndrome seen in boxers who had experienced significant head trauma from repeated blows. The classic symptoms of impaired cognition, mood, behavior, and motor skills also have been reported in professional football players, and in 2005, the histopathological findings of CTE were first reported in a former National Football League (NFL) player by Dr. Bennet Omalu. These findings were similar to Alzheimer’s disease in some ways, but differed in critical areas such as a predominance of tau protein deposition over amyloid. The pathophysiology is still unknown, but involves a history of repeated concussive and subconcussive blows followed by a period of lag before CTE symptoms become evident.

    Along with Dr. Omalu, there has been an increasing amount of research performed recently to find more evidence of brain damage that may be related to prior or current concussions. Many of the research performed includes conducting a battery of tests on the brain and other tissue from former professional , college, and high school football players. Research has shown, including a study performed by researched at the John Hopkins School of Medicine found that on average, former NFL players showed an injury to the temporal lobe of the brain, specifically the amygdala, The amygdala is a part of the brain that plays an important part for people to regulate their mood. The same study also found that these players had lower scores than normal when tested for memory and verbal learning.

    Concussions and the lingering effects from this injury will continue to be an important topic for years to come when it comes to the protection of athletes. It will be important for us as health care professionals to learn more about the disease process as well as what diagnostic tools and treatment options to successfully care for these athletes.

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    The Truth Behind your Reoccurring Ankle Injuries

    Foot and ankle injuries are a common cause that forces us into orthopedic offices day in and day out.  Unfortunately, for the current reigning NBA MVP Steph Curry, the case was no different.  In 2011-2012 Curry missed significant portions of the season (60 of 82 games) due to reoccurring ankle sprains which at one point put his entire career in jeopardy.  So how did Curry go from having a questionable future in the NBA to now being considered one of the most exciting players in NBA history? The answer is simple, Curry and his team shifted their focus to fixing the root of his issue; hip and core weakness.

    It began when the Warriors brought Keke Lyles on staff, a world renowned expert in maximizing body potential and injury prevention. He was the first to realize Curry was under utilizing his core and hip muscles, and therefore, over-reliant on his ankles. Thus, creating a significant risk for injury during dynamic movement.  The quick, explosive movements required in basketball put a lot of stress on the ankles.  If other muscles do not help, injuries such as ankle sprains will occur.

    With exercises that emphasize glute and core strengthening as well as balance, you can gain control of your body and prevent injuries.  This is how Curry is able to make those amazing, seemingly impossible moves and shots.  All parts of his body, his core, hips, and ankles, are supporting each other and none are over-worked. Curry continues to work on his strength and even added a few exercises to his pre-game warm- up to ensure his hips are activated and ready to go. You can often see him doing what look like diagonal step outs with a resistance band on the court before a game.

    Want to test your strength and stability? This is how Curry was tested.  Keke Lyles used a pose often found in yoga called the single- leg hip airplane.  Stand on one leg, hinge at the hip, and get as long as possible with arms outstretched and other leg straight behind you.  You should resemble an airplane.  Then open your hips towards the sky.  Do you sway and wobble? Steph Curry did, and this may be a sign you too are not utilizing your hips and core properly.

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    How Physical Therapy Can Reduce Your Risk for Falls

    For adults over the age of 65, falling can be a major concern. Many factors could lead to falls whether it’s from physical limitations such as weakness, or difficulty with balance due to neurological deficits.

    According to the Center for Disease Control and Prevention, approximately 1 in every 3 adult the age of 65 or over has reported experiencing a fall. In addition, about 2 million elderly adults are treated each year in the emergency department of hospitals due to fall-related injuries.

    Fall prevention is an important area to address, and physical therapists can have a major impact in reducing your risk for falls. The Physical Therapist’s guide for Fall Prevention comes from the Move Forward website, the official consumer information website of the American Physical Therapy Association. It includes great information such as conditions and symptoms related to falls and tips on how physical therapists can help you reduce the risk of falls.

    Come visit Peak Physical Therapy or give us a call at 757-564-7381 and see how we can help reduce your risk for falls.

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    As of July 1st, 2015 the Virginia Board of Physical Therapy passed a law granting and extending licensed physical therapists the ability to evaluate and treat patients for 30 days without a physician referral instead of the previous 14 days. To view the full details on the most up to date physical therapy laws and regulations please Click Here

    What is the significance of these recent modifications? The logical question you may have at this time is in regards to how you or someone you know may reap the benefits of our latest healthcare changes. The answer is simple; no matter what the circumstances of your situation are, gaining direct access to an additional existing healthcare provider, is certainly a positive option to have at your fingertips.

    Therefore, if you are someone that is growing weary of the daily aches and pains, attempting to cope with your symptoms as you wait for your doctor’s appointment, wait no longer. Don’t be that athlete in the middle of training, trying to fight through the pain until after competition. Allow us at PEAK Physical Therapy & Sports Rehabilitation to help you continue in your training while minimizing your symptoms and optimizing your performance. No matter what your situation, our team can offer you the chance to be fully evaluated and given an individualized plan of care within 24 hrs of initial contact. We take pride in what we do, and utilize proven treatment methods and state of the art equipment to assist you in meeting all of your performance goals, while improving your quality of life.

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    Women – This May Save Your Life

    Heart Disease is the number 1 killer in the U.S., in fact, it kills more women than all cancers combined!

    Visit msnbc.com for breaking news, world news, and news about the economy

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