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    Dry Needling and Low Back Pain

    Dry Needling assisting with Discogenic Low Back Pain

    Recent research study shows that the combination of Dry Needling with Physical Therapy is very beneficial with pain and improvement with disability.

    2016-07-14 08.26.34 am“Therefore, supplementary Dry Needling application may enhance the effect of the standard intervention considerably.”


    If you have low back pain that has not been resolved, dry needling may be a adjunctive therapy you may benefit from.   If you have any questions, contact the experts at PEAK Physical Therapy.

    Be Well!



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    My Dirty Kanza 200 Ride


    For those of you have heard, I’m “racing” (aka riding) the Dirty Kanza 200.  A single day 200 mile gravel bike ride through the flinthills of Kansas. More about the race can be found here:  http://www.dirtykanza200.com


    Here is the race details: https://ridewithgps.com/routes/12313551?privacy_code=4EeBWdbfOnkFgWje

    So if you want to follow me you via 2 ways:

    I’ll be wearing a spot that should show my progress every 5 minutes.  It does show roads but it shows where I am in Kansas.



    The Second option is this one which shows me as I cross the 3 checkpoints.



    Thanks and hope I have a great ride to share and chat about.


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    The BodyFloat difference

    The BodyFloat difference

    I was very excited to get the BodyFloat out of the box, onto my bike, tuned up, and on the road.  It was very well packaged and labeled with easy to read instructions.  Charlie, one of the owners of BodyFloat, personally reached out to me to see if I had any questions or concerns and if so, to contact him right away.  Awesome customer service!

    IMG_7502 IMG_7511IMG_7507

    After un-boxing the BodyFloat, I put it on the scale to see the true weight difference between it and my Specialized FACT carbon CG-R post.  My Specialized post weighed around 9 ounces and my carbon BodyFloat was 16.08 ounces.  The difference between the two was that the BodyFloat was just a hair over 7 ounces heavier.  Heavier yes, but not a deal-breaker if it lives up to their promise.  Heck, I could make that up by skipping a few desserts or beverages.

    I’ve noticed there is a small give on my stock post but not enough to provide 3 hr+ rides without back discomfort/tightness.  With the BodyFloat springs, there was much more movement, not sloppy, but controlled in a gradient manner.IMG_7515IMG_7521The top picture is my Specialized post while the bottom picture is the BodyFloat.  I do love the fact the BodyFloat springs provided are orange and the frame is black matching my bike perfectly.  In a couple of days, I will be taking it on a test ride and report back to you on it’s ride.  Stay tuned!


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    It’s Here!

    I just received my new seatpost from the amazing crew of Cirrus Cycles in Washington state.  It’s a BodyFloat Isolation Seatpost.

    FullSizeRender 2







    Most of you haven’t seen this type of bicycle seatpost.  It’s a one-of-a-kind seatpost, where you as a rider is suspended, allowing the bike to move underneath you.  They term as “Isolation Seatpost” because you, the rider, is isolated from high frequency vibrations of the road surface.  They also claim it reduces back fatigue. This post may not only benefit cyclist who are looking for increasing their performance from decreased fatigue, but may also allow cycling to be more enjoyable by the average cyclist and even allowing those with back pain to once again go for a ride.

    bodyfloat1In the upcoming days, I will be un-boxing, installing, and providing my feedback on this device.  Should it pass my mini-tests, I will keep it installed on my bike as I tackle the Dirty Kanza 200 this June.

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    MRI Back Scans Do Not Predict if You Need Surgery

    Physical therapist are constantly evaluating and treating patients with back pain.  Individuals usually present to physical therapy with a MRI scan or findings in hand with a myriad of questions.

    Often, patients are seeking alternatives to surgery.  MRI’s are utilized by medical professionals to determine if symptoms may be caused by an abnormality located in or near the spine.  There are times when a MRI shows no abnormality but symptoms are still present.  What should an individual do when this occurs?  Surgery may not be your best option per this article.

    Here is an article published by the Huffington Post worth a read:  http://www.huffingtonpost.com/richard-c-senelick-md/sciatica-_b_4098475.html?utm_hp_ref=tw

    If you you are faced with debilitating back pain, surgery may not be your first best option.  Physical therapists should always be a part of your medical team when dealing with back pain.  Should you present with back pain of any sort, seek out a knowledgeable physical therapist who may be able to assist you with your pain and abnormal movement patterns.


    Be Well!

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    Return to Normal

    We will be opening tomorrow, Wednesday February 18th, at 10 am.

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    Williamsburg Snow Day!

    Due to the inclement weather, PEAK Physical Therapy will closed tomorrow, February 17, 2015.  We plan on re-opening on Wednesday.  Enjoy and Be Safe!

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    Epidural Injections may put you at risk with meningitis

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

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    A topic everyone should aware and knowledgeable about.

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

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    Sitting…could be harmful to your health!

    Sitting for just a couple hours has measurable (and negative) health impact

    Last week a fascinating study was published by SBRN member David Dunstan and colleagues in Australia, which examined the acute (e.g. short-term) impact of uninterrupted sitting on metabolic health.  In this new study, individuals with overweight or obesity were asked to perform 3 separate conditions in random order.

    1. Uninterrupted sitting – participants sat for 5 consecutive hours
    2. Sitting plus light intensity breaks – similar to the uninterrupted sitting condition, except that participants had a 2 minute walk break at a light intensity every 20 minutes throughout the day
    3. Sitting plus moderate intensity breaks – similar to the light intensity breaks condition, except that the breaks were at a moderate intensity

    The figure below nicely demonstrates the basic protocol for the three conditions.

    Dunstan et al 2012 (Diabetes Care)

    In all three conditions participants were given a standardized 760 calorie test drink at baseline (for reference, that’s about the same as a medium McDonald’s triple-thick milkshake), and had blood taken every hour to determine the glucose and insulin response.  This is pretty similar to an oral glucose tolerance test, except that the test drink included both sugar and fat, while an oral glucose tolerance test involves only sugar.  This sort of drink will produce a spike in insulin and glucose levels in the blood, but a healthier person will have a lower spike than an unhealthy person.  A big spike in glucose or insulin levels suggests that your body has to work harder to get sugar into your muscles, which is a sign of insulin resistance and a risk factor for diabetes.

    So what happened?

    Plasma insulin and glucose levels were higher on the day of uninterrupted sitting, in comparison to the days with light or moderate intensity breaks.  And not just a bit higher – more than 20% higher!  I’ve graphed the average insulin and glucose levels during each condition below.

    Glucose response (Dunstan et al 2012)

    Insulin response (Dunstan et al 2012)

    Even more fascinating is that the groups seem to diverge almost immediately – in the figure below, you can see that the glycemic response to the test meal during the uninterrupted sitting seems to be distinctly higher than the other two conditions even just 1 or 2 hours into the session.

    Glucose area-under-the curve (Dunstan et al 2012)

    While that may seem surprising, another recent study published in Applied Physiology, Nutrition and Metabolism found that sitting for 2 straight hours (e.g. 120 consecutive minutes) following a standardized meal increased the glycemic response by >45%, in comparison to a combination of 40 minutes of very light intensity walking and 80 minutes of sitting.  In other words, these people had a clinically significant increase in metabolic risk simply because of an extra 40 minutes of sitting following the test meal.

    What does this mean?

    Taken together, these studies strongly suggest that sitting for several consecutive hours has a measurable and negative impact on metabolic health (at least in individuals with overweight or obesity).  This could go a long way to explaining the relationship between sedentary behaviour and mortality – if you are engaging in uninterrupted sitting for periods of a couple hours on a regular basis, that could be exposing your body to elevated glucose and insulin levels following every meal, which over the long term could have serious consequences.

    On the bright side, these studies also suggest that simply taking an occasional walk break at a very light intensity could substantially reduce the impact of prolonged sitting. In the Dunstan study participants walked at just 3.2 km/h (2 mph),  which is a leisurely stroll for most able-bodied individuals.  In addition, participants were asked to identify how hard they were walking in the light intensity condition using the Borg scale.  The scale goes from 6 to 20, with 6 being “no exertion at all” and 20 being “maximal exertion”.  The average rating was 8, which falls between “extremely light” and “very light”.  In other words, these participants were not “exercising” in any way – they were just standing up and walking around at a very easy pace, just as you might when walking from your desk to the washroom.

    These studies are of particular interest to me since my thesis work is examining similar issues in children.  With any luck I will have some data to report from that study later this year.  Along with other members of our research group I have also recently completed a systematic review on the acute impact of sedentary behaviour, which found a surprisingly large body of evidence linking short bouts of sedentary behaviour with increased metabolic risk (e.g. reduced insulin sensitivity and increased fat levels in the blood).  That review is currently in press, although it is currently available as a provisional pdf for those who don’t mind the formatting.

    For those interested in learning more about the new study by Dr Dunstan and colleagues in Australia, I have embedded below a presentation by Dr Neville Owen who co-authored the above paper.  Thanks to Dr Owen and SBRN member Ernesto Ramirez for recording the session and making it available online.  And if you are interested in learning more about the impact of acute and chronic bouts of sedentary behaviour, be sure to check out the Sedentary Behaviour Research Network.

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