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Open WOD 18.1

20min AMRAP:

8 Toes To Bar

10 DB Hang Clean Jerk – 50/35 lbs

14/12 cal Row

MOVEMENT TIPS

Toes-to-Bar:

  • Efficient Kipping – Sorry to ruin the surprise, but your biceps will probably blow up during this one. Even though there aren’t many T2B in each round, 8 will still add up over the course of a 20 minute workout (I believe Sam and Kristin both just did 160ish). Even if you happen to get super-fatigued in the mid- to late stages of the workout, don’t waste time hanging from the bar. This will fatigue out all of the small stabilizing muscles around the shoulder joint and upper back, and cause even more chaos with your kip. Rest until you’re absolutely ready to get as tight as possible, get some good reps in, and then come back down before things get sloppy.
  • Break Early – This is the movement that will get none of the credit if it’s on point, but will get all of the blame if it ruins your workout. Nobody will win this workout because of amazing toes to bar, but plenty of CF’ers will find themselves standing under the bar staring up wondering “why didn’t I go 4-4 or 3-3-2 earlier?!” Each person’s gymnastics capacity will be different. That being said, if your max set of toes-to-bar is <20, go hard in the other two movements, and plan on taking a good amount of “planned rest” during this one. Even if your max set of T2B is measured in hours instead of reps, you may want to consider only doing the first 4-5 rounds unbroken. Basically, once you feel any sloppiness in your trunk (aka “core”), and your kip starts to get funky, break it down into a smaller rep scheme of your choosing.

DB Hang Clean + Jerk

  • 1 Armed DB Swing – I really feel like that sums it up. Sit those hips back, load up the hamstrings and the glutes, and swing that sucker up to your shoulder. The only movement your arm should be doing would be to pull you down under the DB after the hips come through. The weight should be light enough that a simple dip+drive from shoulder to overhead will not be an issue.
  • Stay Tight – This movement will challenge you in the transverse plane, something we rarely train in CrossFit. As the dumbbell comes back down from overhead between the legs, you will need to resist the rotational force with your trunk and hips. If you get loose, you’ll quickly feel a massive back pump that will be miserable on the rower. Stay tight, Keep your Chest Up, and Hips Back.
  • Don’t Curl The Dumbbell – I don’t think I really need to elaborate on this one, but I couldn’t sleep at night without adding it in. This will blow you up, and make your toes-to-bar miserable. Try to avoid using your arms as much as possible during this workout.

 

Rower:

  • Open the hips up – This is crucial. If your hips are stiff, you will need to rely on your low back and spinal erectors to do the majority of the pulling. This will not only make the DB’s much more challenging and fatigued, but will also throw off your rhythm on the T2B. Get into a good squat or deadlift position at the catch (beginning) of each stroke, and drive with your legs.
  • Big Pulls, ALL THE WAY THROUGH – One of the first things I noticed when Sam started gaining ground on Kristin (other than Sam figuring out how to do a DB Hang Clean on the spot) was that Kristin repeatedly kept trying to short-change the row calories. Do you ever do that thing where you tell yourself “1 more pull….okay, maybe just 1 more small pull…” and so on? In a workout with this many transitions, this will be a huge time waster. I would say she probably wasted 2-4 seconds per round doing small arm pulls hoping the rower hit 12. Sam was rowing like she was aiming for 14, and just jumped off when it hit 12. It is worth it to do one extra “big” pull and use those extra seconds for resting or transitioning.

 

PACING STRATEGIES

Pacing here is going to be highly individual based on strengths/weaknesses, so I’m going to break up two different strategies into two different “avatars” of people.

  • “Toes-to-Bar Monster, Somewhat Slow of a Rower” – Unbroken T2B (or at least 5-3 or 4-4), Go easy on the rower and just try not to spike your heart rate. Think: 100%, 90%, 80% efforts on the three movements, respectively.
  • “Rowing Animal, but Just Trying to Get Away From The Rig” – Be prepared to let people pass you in the beginning. Your not the most gymnasty person in the gym, but that’s okay (I’m talking to myself here, too). Break the T2B early into 2-3 sets, because there’s a good chance you’ll be doing doubles or singles past minute 15 if you don’t. If you read the movement tips above, get fast, crisp sets in, then drop down, breathe, and go again. Then try to crush the DB’s and the Rower, because there will be plenty of built-in rest breaks under the pull-up bar.
  • Either way, the dumbbell should NOT hit the floor until you’re either done with 10 reps, or done with 5 reps at least. You can’t switch hands until you’ve done 5 on your first arm, so just try to get 5 done as fast as possible, and rest between arms if needed. Personally, I am going to try to limit the number of times I have to bend over and pick it up off the ground, so I will be resting a little bit extra both before and after those 10 reps.

Now, let’s talk overall pace per round.

Basically, the rule for this one is pick a pace that might seem slow at the beginning, because it won’t feel slow at the end. You can always decide to pick up the pace once you’ve got the adrenaline butterflies out of the way in round 2-3, but if you blow up early, there’s no coming back.

I think Sam put up one of the top 10, if not top 5, scores of this workout. Other than a few missteps on the DB hang cleans in the first 2 rounds, I don’t see where much more time can be made up. She paced the first several rounds to make sure she could hold on, and then gradually started going faster each round. Kristin Holte started off flying. Then her pace dropped off 24 seconds in the FIRST HALF of a 20 minute workout. (For any stat-nerds like me who might be interested, I laid out Kristin’s progress through the workout.)

To find your individual pace, I’m actually going to recommend that you do 1 full round of the workout, at near-max intensity as the last real piece of the warmup. See how long that takes you, then plan on starting out at 75% of that speed per round. If you’re someone who paces things really well over long bouts of time, but isn’t that explosive through one round, you may start out closer to 80-85% of that max speed. If you can knock out one round in around 60 secs, you may want to start out somewhere around 60-65% to save some of that energy.

Like I said, if you feel good after the first 2-3 rounds, you can start increasing your speed. But it rarely works the other way around – if you blow up by minute 6, its going to be a long 14 minutes.

 

Kristin Holte – Pace of 18.1

Round Time per Round Time at Each Completed Round
1 79 1:19
2 86 2:45
3 87 4:12
4 96 5:48
5 92 7:20
6 97 8:57
7 103 10:35
8 101 12:16
9 103 13:59
10 100 15:39
11 102 17:21
12 99 19:00

 


 

THE WARMUP

20 minutes is going to be a long time. For that, we need to really tap into both the oxidative and the glycolytic energy systems. This is CrossFit’s version of the 5k run for this Open year (I’m assuming they won’t have another 20min workout, but you never know).

General Warmup:

  • 10min Easy Assault Bike, Jog, or Jumping Rope – Go 45 seconds Easy, 15 seconds Moderate Intensity. Just break a sweat, but don’t start burning or gasping for air.
  • 20-30 Band Pull-Aparts – Get that upper back and shoulders warm.
  • 10-15 Pushups to Downward Dog – Pause at the top to get a good stretch, and make sure your chest, shoulders, and upper back are opening up in prep for the toes-to-bar.
  • Foam Roll or Lacrosse Ball (if necessary): Lats, Shoulders, Chest, Thoracic Spine (extend your upper back over the roller)

 

Dynamic Movement Prep:

30sec Each Movement x 3 Rounds:

  • Spiderman’s – in a pushup position, bring one leg up and outside your arm. Try to sink your elbow down to the ground, then reach back up to the ceiling. Switch sides, and repeat.
  • Deep Squat Hold – get into a deep squat, focus on getting your back upright, and driving your knees out to exaggerate the demands of the rower. Use a rig or band around hips for support if needed
  • Twisting Lunges – lunge left, twist left, lunge right, twist right, repeat.
  • 1-Arm Russian KB Swings – Light-Moderate Weight, Focus on driving those hips through
  • Scap Retractions on Pull-Up Bar

 

Specific Workout Prep:

1 Round:

8 Hollow-Arch kips on Pullup Bar

8 DB CJ’s (4 each arm) – use a lighter weight than you plan to use in the workout

10/8 cals on Rower

Rest 1:1

1 Round:

6 Knees-to-Chest or Toes-to-Bar (depending on skill level)

8 DB CJ’s (4 each arm) – use the weight you plan to use in the workout

12/10 cals on Rower

Rest 1:1

 

1 Round for Time:

8 Toes-to-Bar

10 DB CJ’s (5 each arm) – workout weight

14/12 cals on Rower

 

At this point your heart rate should be spiked pretty high. Allow 10-15 mins to let it come back down. Grab some water, but don’t get cold. Keep doing any general movements that you feel work for you before a workout. If you have 15+ minutes of down time after you finish the warmup, you may need to hop back on the Assault Bike and just keep it spinning to keep from getting cold.

At this point, you should have a good idea of how this workout will make you feel, and what pace you are actually capable of maintaining. All that’s left to do execute.

 

-Go crush it.

 

Sean Jacobs, PT, DPT, CSCS, CF-L2

Pelvic Floor

What combination of muscles is the most active during all activities of daily living, yet tends to be the most neglected or misunderstood? The CORE! Your core is made up of 4 major muscles/muscle groups: possibly the most forgotten of which is the group of muscles that make up the Pelvic Floor.

 

The pelvic floor serves 5 purposes. It stabilizes the lower portion of the core – assisting with stabilization of the LE and the spine. It supports the organs, keeping them from falling with gravity. It helps with drainage of blood/lymph from the legs. It provides control of bowels and bladder – allowing you to either hold or empty. And it is vitally important in sexual appreciation – either allowing or improving the sexual experience.

 

So, what happens if the pelvic floor isn’t functioning correctly? Keeping in the order used above – the pelvic floor functions to stabilize the body/spine. Without it, your body will have to depend on other structures to assist in stabilization. If you ask a muscle that typically would only fire with quick motions to begin firing for a majority of the day…it can lead to pain or dysfunction of that muscle group. This is similar to asking a sprinter to participate in a marathon – without the proper training, that sprinter may not be able to adequately adapt. The pelvic floor supports the organs – instead of the strong hammock that should be the pelvic floor muscles, there’s an inside out tent. This can lead to organ prolapse. The muscles making up the pelvic floor assist in helping move out fluid from the legs back to the heart. Without this function, there could be fluid build-up or swelling in the legs. The pelvic floor assists in maintaining bowel and bladder function. Without the proper control of the bladder, you may feel you need to urinate more frequently – or you may notice that you have a hard time making it to the restroom on time. You could feel that you’re not emptying your bladder all the way or you leak with sneezing, coughing, jumping, squatting, or running. Or it’s possible that you notice you’ve had some urine leakage you weren’t aware of. Very similar issues occur without proper bowel control – including constipation, difficulty with bowel movements, or having a bowel movement without realizing it. The final function of the pelvic floor is sexual appreciation. It is the ability to have sex or engage in any sexual activity. It is not normal for a woman to have pain with sex, nor is it something any female should have to endure. Also, has been proven in the research that individuals who have a strong pelvic floor have better sex overall.

 

So, what if any of these (not exhaustive examples) of dysfunction of the pelvic floor applies to you? Pelvic Floor Physical Therapy can help. It can assist in relaxing the pelvic floor, decreasing pelvic pain, reducing an organ prolapse by at least 1 grade, decrease or eliminate urine leakage, and improve overall quality of life. If you’re reading this blog thinking about yourself – reach out! I’m happy to answer any questions or assist in finding a Pelvic Floor therapist in your state!

 

-Dr. Tristan Faile

 

PBFR Monthly Membership

Vertex PT Specialists is proud to offer Personalized Blood Flow Restriction (PBFR) via the FDA approved Delfi Personalized Tourniquet System (PTS).

We currently have 5 spots available for PBFR monthly memberships at a rate of $50/month.

Your monthly membership includes:

  • Screening to ensure you are appropriate and have no contraindications to use the Delfi PTS
  • Training on operating the Delfi PTS for upper and lower extremity exercise protocols
  • Training on the evidenced based strength, endurance, and cell swelling PBFR protocols

Upon completion of initial training, your membership will allow you to come in and use the Delfi PTS 3 days per week during regular office hours at our Millwood location only.  Please note, PBFR is already included as part of the rehabilitation process, therefore you do not have to be an established patient to sign up for a membership.

In addition to being a powerful tool to improve and enhance the recovery of our patients, the Delfi PTS is also scientifically proven to increase strength and hypertrophy at very light loads (20% of 1 rep max).  This means that an athlete can make considerable gains without causing muscle damage, making the PTS perfect to use as a supplementary tool and/or on rest days.  More info on this topic can be found at vertexpt.com/pbfr.  For well-trained endurance athletes, PBFR has been shown to increase VO2 max by 11.6% in as little as 2 weeks!

If you’d like to sign up for a membership, or need more information on personalized blood flow restriction, please email us at info@vertexpt.com or call us at 803.851.3506.

 

 

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Doc and Jock Podcast

Dr. Vaughn was recently interviewed on the Doc and Jock Podcast.

Some of the topics discussed:

  • The Vertex PT Specialists business model
  • Running gait correctives
  • The pec major tears at this year’s CrossFit Games Regionals
  • Tiger Woods
  • Lumbar spine surgeries
  • The opioid epidemic
  • and more…

Click this link to listen.

Or click this link to download on iTunes.

 

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TMJ Dysfunction Case Study

Temporomandibular Joint Dysfunction Case Study

14 year old male baseball player presented to Vertex with a chief complaint of left sided jaw pain that occurred after being hit on the chin by a ground ball at practice.  Additionally, he complains of his jaw “locking” and “clicking” with end range mouth opening, specifically while eating.

Clinical Exam:

Palpable Click with opening and 25mm left mandibular deviation (ipsilateral)

Apical breathing pattern

Decreased left upper cervical rotation (+ left cervical flexion rotation test)

Tenderness to palpation left masseter and left medial pterygoid with patient reported familiar pain

 

Treatment:

HVLAT directed to bilateral C1/C2 with + cavitations.

Upper and mid thoracic HVLAT

DN with electrical stimulation to left masseter, medial pterygoid, and joint capsule.

Manual TMJ distraction

Home Exercise Program:

Cervical SNAGs, cervical retraction with over-pressure applied to maxilla, postural resets, diaphragmatic breathing

Patient Education:

Postural considerations; specifically with school and smart phone use consisting of spending less time in forward head posture in order to minimize mandibular retraction.

Result:

Chief complaint of “click” and “locking” resolved within session. 25mm deviation reduced to <5mm.  Patient followed up 6 weeks later and maintained treatment effect.

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Owens Recovery Science BFR Course

Lifters Clinic and Vertex PT Specialists are partnering up later this year to bring you an Owens Recovery Science Blood Flow Restriction (BFR) course!

The course will be held at Vertex PT Specialists on August 5, 2017. Register here:

www.owensrecoveryscience.com/certification/columbia-sc/

 

Biering-Sorensen Test

 

The Biering-Sorensen test is used for evaluating the isometric endurance of the hip and back extensor muscles. It is a great tool for predicting if a patient/client is at risk for nonspecific lower back pain. This can also act as an important training tool before someone begins a program that involves deadlifting. The two things that you will need for this test are a timer and a GHD machine, which can be found in most gyms. Begin by having the person being tested get on the GHD machine in a horizontal prone position with their arms crossed over the chest, chin tucked, and the upper edge of the iliac crest on the pad. Make sure the person contracts their glutes and abdominal muscles to help maintain a neutral spine. Once they are in this full position, start the timer and see how long they can hold it. Stop the timer and end the test if the shoulders drop, they no longer can hold the position, or when 240s (4min) has been reached. Refer to the table below to see what category they fall in.

– Jeff Spraker

 

Males Females
Healthy 198s 197s
Prior Low Back Pain 176s 210s
Current Low Back Pain 163s 177s

 

Demoulin, C., Vanderthommen, M., Duysens, C., & Crielaard, J. M. (2006). Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine73(1), 43-50.

Join Vertex’s 2017 MuckFest Team!

 

Join Vertex and Run with a Purpose

What?       

MuckFest MS, a 5km Obstacle Course Race (OCR) with over 17 obstacles.

Visit www.MuckFestMS.com for more info.

Where?

Concord Speedway

7940 U.S. Hwy 601 South

Concord, NC 28025 (Less than 2 hours from Vertex)

When?

Saturday, May 6, 2017

Why?

The “MS” part of MuckFest MS stands for multiple sclerosis, an unpredictable, often disabling disease of the central nervous system that interrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million worldwide. This is the reason we come together—to rally friends in support of people living with MS in our community.

How Can I Help?

Run, Volunteer, or Donate (or all three!) today.  100% of all donations go directly to the National MS Society, providing research towards treatment, prevention, and a cure for MS.

 

Contact: Dr. Reed Handlery at reed@VertexPT.com

 

You can join or donate by visiting:
main.nationalmssociety.org/goto/Vertex

 

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Sissy Squat Variation for Patellofemoral Pain

Quick video of Dr. Faile experimenting with Donnie Thompson’s sissy squat variation.

One of the reasons why we like this for patellofemoral pain patients is because it allows for a more vertical shin (which = less patellofemoral compression) and you get the added close chained terminal knee extension moment at the top.

Four Exercises to Improve Dance Technique and Strength

 

1. Hip Flexor Pulse
a. Purpose: Improves strength in hip flexors, especially Iliopsoas, to increase leg height. This exercise works best in combination with stretching the hamstrings to allow greater mobility and active range of motion.
b. How to do: start sitting with legs extended and leaning back on hands. Perform a posterior pelvic tilt and lift one leg with the knee bent. Pulse the leg closer to your body for about 4 reps while concentrating on using the Iliopsoas. Repeat 4-6 times.

2. Attitude Raises
a. Purpose: To increase turn out (external rotation of hips) and leg height in second position (to the side).
b. How to do: Start lying on one side. Raise top leg (both knees facing forward and knee bent). Turn out the leg into attitude al second (to the side with knee facing ceiling). Repeat this while bringing the leg closer to the trunk with each rep. Repeat 4 reps 4-6 times.

3. Hip Flexor Stretch
a. Purpose: To stretch hip flexors more efficiently
b. How to do: Start in lunge with both knees at 90 degrees. Perform strong posterior pelvic tilt. Add more of a stretch by bending the trunk to the same side as the front leg. Hold for at least 30 seconds.

4. Calf Raises with ball
a. Purpose: To improve strength and control of plantar flexion in heel raises without inverting at the ankles.
b. How to do: Place small ball in between the ankles. Raise heels off the ground while squeezing the ball. The goal is to not let the ball fall to the ground. This helps train the muscles to not invert, but to remain neutral in plantar flexion.

 

-Lauren Rowell