Instrument-Assisted Soft Tissue Mobilization: Why Quality of Care and Quality of Product Matter

If you have read my previous posts, you are aware that I hold a healthy bias toward a realistic, sustainable diet plan and a constantly varied fitness routine.  Hopefully, we can all agree that all diet plans are not created equal, there is no ‘magic pill’ or ‘perfect’ diet.  Do your best to avoid processed foods 80-90% of the time and it’s safe to say that you are ‘eating right’.  We can also agree that all exercise plans are not created equal, there is no ‘magic machine’ or ‘perfect’ movement.  Move properly with solid form, have a good coach with smart programming who constantly varies the implemented weightlifting/gymnastics/skill work/mobility and metabolic conditioning over a period of time and it’s safe to say that you have yourself an effective exercise routine.  As a healthcare provider, when I hear a patient say ‘I have a good diet’ or ‘I exercise’, I cannot move forward to help them help themselves until I qualify their diet and exercise.  In order for me to truly treat a patient, I must make sure they are educated on what to eat and what not to eat as well as how to move and how not to move.

Just as all diet and exercise plans are not created equal, all recovery modalities do not have the same effectiveness for each patient.  If I broke my leg, I would not want to see a Chiropractor or Physical Therapist, not matter how much I prefer conservative treatment modalities.  Likewise, surgery is not a good first option for athletes that suffer from overuse, have a chronic sprain/strain, bulging discs or other non-stenotic forms of spinal degeneration.  In these situations, Physical Therapy, Chiropractic, Massage Therapy and Acupuncture are much better options to correct those biomechanical issues that are causing the problem in the first place.  Take care of the area of complaint, teach the patient how to move better and they will have a much better outcome.

With that, do all PT’s, DC’s, LMT’s, or LAc’s have the “tools” to treat the millions of patients that I’m referring to?  They literally do not.  First, they themselves must know how to move properly, diagnose and communicate to their patients how to functionally move.  Second, they much be able to treat the area of complaint to their best ability.

In my professional career, Instrument-Assisted Soft Tissue Mobilization (IASTM) has been a game-changer.  These tools have the ability to steep into the soft tissues and break down scar tissue that is typically the culprit for many chronic complaints.  With scar tissue, not only does it change the integrity of the tissue itself, but changes in biomechanical movement patterns and movement compensation tend arise.  On top of that, free nerve endings pop up within the scar, creating pain and further movement abnormalities.

To break down scar, it is infinitely more efficient to use an instrument.  I have taught seminars across the country on IASTM and had my hands on literally hundreds of different tools.  Graston, SMART, Gua Sha, ConnecTx, SASTM to name a few.  They all pale in comparison when it comes to the quality of manufacturing and versatility of HawkGrips.

HawkGrips took feedback from many practitioners (including myself) who used other instruments and found that there were many similar complaints:  “The instruments slip out of my hands.”, “I need to use gloves which is costly and time consuming.”, “The instruments start to pit after a few years of use and cleaning.”, “There is less feedback from the instrument than I would get from my hand.”

HawkGrips addressed every complaint with their line of instruments.  If you are have a chronic injury and think the culprit may be scar tissue, find a healthcare provider in your area that uses HawkGrips in his/her office.  If you are a healthcare provider and are interested in learning more about IASTM, do yourself a favor and take a look at HawkGrips.  They now offer certification courses across the country to make sure you can use these instruments properly.  Your patients will thank you and your return on investment will be worth-while.

 I have been implementing IASTM treatment techniques for over 5 years and cannot say enough positive things about HawkGrips as a product and company.  Truly second-to-none when it comes to quality, customer service and education.

I have been implementing IASTM treatment techniques for over 5 years and cannot say enough positive things about HawkGrips as a product and company.  Truly second-to-none when it comes to quality, customer service and education.

Off the Carbs, Off the Couch

First, let me say that my objective here is not to offend, anger or belittle your perspective, regardless of your current practices in exercise and diet.  That being said, I do ask that you remain open-minded and consider that the opinions shared below happen to be backed-up with clinically tested and peer-reviewed research.

How Should I Workout?

It can be agreed that all exercise is not created equal.  The days of bicep curls and leg presses are long gone; we cannot simply isolate a muscle on an expensive piece of machinery and expect to become a better athlete or healthier human.  If you are trying to become healthy, we must be variable in our activities.  We cannot deadlift 6 days/week and expect to get a stronger cardiovascular system.  We cannot run 50 miles/week and expect to get a bigger/stronger upper body.  We cannot do yoga 6 days/week and expect to increase our deadlift or decrease our 5K time.

To vary our workouts, we focus not only on strength, cardio, and mobility, but also balance, agility and coordination.  This is considered “functional” exercise and is the foundation of CrossFit’s philosophy:  constantly varied functional movement performed at a high intensity.  With that, DO NOT ATTEMPT CROSSFIT (or CrossFit-esq workouts) WITHOUT SUPERVISION.  In order to get the cardiovascular benefit of a variable program, we must first move properly.  A few weeks ago I visited Life Time Athletics in Mount Laurel, NJ.  What a beautiful facility.  With that, every single person using free weights, barbells, performing “gymnastics” or general core work were doing something incorrectly.  Even the members with personal trainers were receiving improver cues or putting themselves into dangerous positions.  If you do not have a program or a trainer that knows what he/she is doing, you are leaving yourself open to injury and setback.  Does it have to be “CrossFit”?  Absolutely not, but do not start a variable workout program conceding that injury is inevitable; avoid injury by finding yourself a facility with programming and coaches that know what they’re doing.

What Should I Eat?

There will be a separate post dedicated only to diet and nutrition but we can certainly expose the tip of the iceberg here and go over the basics.  The most simple diet to start is the following:  Lean meat, vegetables, nuts, seeds, some fruit, little starch and no sugar.  This should be thought of less like a “diet” and more like a lifestyle change; if you follow this formula, you can worry less about portions and “counting calories”.  We’ll get into MACROS in a future post.  Until then, it is important to realize that not all calories are created equal.  You can have a calorie-deficient diet and still gain weight.  Even a diet as low as 2,200 calories/day for a mildly active 30-year old 200 lb male will result in weight gain if the diet is exclusively processed carbohydrates (bread, rice, pasta).  Likewise, that same person can eat 3,500 calories of vegetables, nuts and seeds and lose a little more than 2 lbs/week.  When your body starts to digest processed carbohydrates, it becomes sugar.  This is why we, as a society, have a very real addiction to sugar.  Do yourself a favor and consider all breads, rices and pastas as sugar and AVOID.  Once they are eliminated, you can slowly begin to incorporate brown rice and quinoa into your diet to hit those carbohydrate numbers.  Lastly, if you are drinking your calories, STOP.  Even those drinks that have artificial sweeteners have chemicals that ultimately slow our metabolism.  I have heard some people say “But I HATE water”.  Guess what?  You are made up of 60% water, start to like it.  If you don’t drink water, you are not healthy.  Period.  Take your body weight (lbs), divide by 1.5 and drink AT LEAST that many ounces per day.

To Summarize

Constantly vary your workout program with someone that knows what he/she is taking about.  Even the best athletes in the world have specific programs, coaches and trainers working with them, it is valuable.  Left to your own devices is equal parts dangerous and ineffective for our ultimate goal: becoming the healthiest, fittest versions of ourselves possible.  It’s human nature stay in a comfort zone, but as the saying goes, “if it doesn’t challenge you, it doesn’t change you”.  For your diet, drink water and eliminate sugar (this includes breads, pastas, rices and all processed carbohydrates).  I understand that this protocol, while simple, is not easy.  You have to look inside of yourself and ask “What am I willing to sacrifice to live a healthy, fit life?”  The answer is in this blog.  ‘Simple’ does not mean ‘easy’.  It’s hard to get off of the couch and off of the carbs but always keep in mind that Fitness is Freedom.  No one wants to be obese, suffering from a number of chronic diseases.  Who doesn’t want to travel without having to worry about bringing medication(s) or wondering if they can handle a scenic hike?  You have the ability to control your health, take the wheel!

 Simple does not mean easy.  Hard is not always complex.  It's a simple solution to a vexing problem but it is hard to execute.  Find your motivation and get started!

Simple does not mean easy.  Hard is not always complex.  It's a simple solution to a vexing problem but it is hard to execute.  Find your motivation and get started!

My Fitness Journey

Part I: Practice What You Preach

I’ll open my first blog by saying that this is, in fact, my FIRST blog.  One of my New Year’s Resolutions includes being more interactive via social media with Blogs or Vlogs at least 1x/month.  I have had an interesting journey over the past 4 years when it comes to my fitness, wellness and health and as a Chiropractic Physician, I believe my story provides value and perhaps and relatable perspective for those that are interested.

R.I.P. Dave Thomas

Let me first say that my “journey” 4 years ago does not start with significant adversity.  I was never over 300 lbs, I was not involved in a devastating accident or diagnosed with a malignant disease.  Instead, I recall my ‘enough is enough’ moment in the parking lot of a Wendy’s, where I was enjoying my SECOND meal that day from the fast food establishment.  In February 2014, I was 6 months out of Chiropractic School, assisting with a seminar in Boston, MA.  My business partner, Dr. Charlie Annunziata, and I were famished after lecturing all weekend and decided to stop by Wendy’s before we hit the road back to NJ.  About 4 hours later, we were hungry again and mutually decided to stop at ANOTHER Wendy’s before we got back home.  Misery ensued as the Baconator coursed through our veins, Charlie & I decide that we need to make some changed to get healthy.

Accountability and Motivation

As former athletes who never really had to worry about weight gain, we both certainly put or diet and exercise routine on the backburner.  Without a team, sport or other motivation, we knew we had to lean on each other for accountability.  We embarked on a “weight loss challenge” where the individual who lost the most percentage body fat over the next 3 months wins.  The winner would get diamond dugout seats to a Phillies game, food/drinks/parking included.  If there’s one thing I love more than winning, it’s going to a Philly game and not have to worry about paying for food or drinks.  The next day, we jumped on the scale and scanned.  I was about 220 pounds, with 25% body fat and a BMI of 33.  All of those numbers fall into the “overweight/obese” category, Charlie reluctantly jumped on and wasn’t much better.  We knew we had a lot of work to do.

I played football in middle school and hockey in high school/college, my “strength training” was showing up to hockey practice, essentailly non-existent.  I was premed in undergrad, with one exercise sports science elective my senior year.  There, we were taught to “isolate our muscles for maximum results” (bicep curls, bench press, leg press, tricep extension, etc).  In Chiropractic school, I was trained to handle on-the-field injuries and taught to manage patients’ pain conditions by getting them more active in their recovery by stabilizing the core.  Long story short, I had no idea where to start for my personal fitness improvement.  As I mentioned earlier, accountability is the key for many former athletes so I reached out to my friend of 27 years, Dr. Tom Lizzio (DPT).  As it turned out, he was struggling with similar diet and lifestyle issues.  We both decided that the best course of action would be to revamp our diet (a topic for another blog post) and start a running program for our weight loss: 5 minutes of jogging, 2 minutes of walking.  We started out in February of 2014 not being able to run more than a mile and, together, we slowly improved each and every week.  Four years later, Tom is still an avid runner and recently finished his first marathon; over the years, I have ran in 3 half marathons, three 10-milers and a handful of 10/5K’s but my primary focus is CrossFit, which I will talk about in Part II of this post.

Sticking with It

As far as the weight loss challenge, I did end up winning but more importantly, Charlie also lost significant weight and percentage body fat.  We both had a long road ahead of us but I am happy to report that 4 years later, we are still sticking with our respective fitness program and a clean diet.

This introductory post boils down to this:  If you are unhappy with your overall health there are people in your life that can help.  I decided 4 years ago in that Wendy’s parking lot that I would start practicing what I preached to my patients; eating clean and working out.  However, I would not be able to maintain my healthy lifestyle without the accountability and support group that I currently have.  If you feel like you do not have anyone that you can contact in your friend/family circle to get you started, I am more than happy to point you in the right direction and keep you motivated, just reach out!


Part II:  Finding CrossFit

I found my way to CrossFit in an unconventional way.  It was a combination of running boredom, hitting a physical plateau and a bad relationship.  It was September of 2014, I was completing my first year in practice, down 25 lbs following the clean diet and running program.  As a Chiropractor, I had many patients coming in with CrossFit-related injuries, most notably shoulder and low back.  For many physicians, this would be a major red flag, but I saw more.  I noticed that all of these athletes had common denominators: they were in phenomenal shape, followed my rehab protocol, ate extremely clean and recovered incredibly fast.  If nothing else, CrossFit had my attention.  I told my girlfriend at the time that I was thinking about trying CrossFit and she answered, “If you try CrossFit, we’re breaking up…my ex did CrossFit and it’s all he would talk about…it’s a cult.” 

We broke up that week.

Drinking the Kool-Aid

I tried a handful of boxes out in September 2014 but I just couldn’t find the right “fit” for one reason or another.  Then I found a box that had solid coaching, great programming, a fun, welcoming community and they were less than 15 minutes from my house.  For me, it was the perfect recipe to start with and commit to, giving CrossFit a fair shot to reach my goals.  The more I learned about CrossFit movements and philosophies, the more ‘dots’ were connected to my Chiropractic school training and practice.  I was really buying into the process and got myself down to 165 lbs in August 2015, less than a year after starting CrossFit; that’s more than 50 pounds 18 months after committing to a healthier lifestyle.  A loss of a little more than half a pound a week will get you to your goals; slow and steady wins the race!

Becoming a Coach

In July 2016 I became CrossFit Level 1 Certified and started my shadowing process at my box where the in-house coaches helped me become a stronger, more disciplined trainer.  We must hold ourselves to a higher standard than just a weekend course.  In the right hands, CrossFit can transform lives.  In the wrong hands, serious injury could occur.  Six months after the shadow process, in October 2016, I opened my own facility in Lumberton, NJ.  Although I had to move onto a Chiropractic opportunity and we had to close our Affiliate in Lumberton, I am here today with zero regrets.  I became a stronger athlete, a stronger coach, a business owner and, most importantly, we created a strong community of likeminded individuals, many of whom are lifelong friends.  I still see my former athletes and have the privilege of coaching them every so-often; I have a strong sense of pride as I see our athletes continuing on their own fitness journey and happy that I am able to continue to be a part of that.

Routine

As far as my fitness since the 50 pound loss reported in August 2015, I have ‘tweaked’ my macros numbers over the years and found that my ideal weight floats around 175 lbs.  At this weight, I feel that my body performs to its highest potential.  More importantly than that, I’m happy, proud and confident in my skin.  My advice to those of you looking to start a fitness program:  Have a realistic goal weight that you would like to get to but listen to your body along the way.  A number on the scale is meaningless if you have no energy and are miserable most of the time.  Think of the scale as just one small variable or affirmation that your diet and exercise protocol works; it should not run your life.  My workout schedule is as follows:  CrossFit M, Tu, W, F, Sa.  Active recovery day on Th and/or Su (yoga or run).  I will mix in a complete rest day, on the Thursday or Sunday that my body 'tells me' that I need rest.  If you are just starting CrossFit, I suggest 1-2 COMPLETE rest days/week.  Get into a comfortable routine and increase from there.  I can honestly say that at age 33, I am in the best shape and happiest I have ever been in my life.  One way or another, I have CrossFit to thank for my transformation and journey.

 What a difference a decade makes.  In 2006, I was playing college hockey 3-4 days/week, no other exercise to speak of and poor diet, a "soft" 180 lbs.  I would balloon up to over 220 lbs. between 2006-2014 before starting on my Fitness Journey.

What a difference a decade makes.  In 2006, I was playing college hockey 3-4 days/week, no other exercise to speak of and poor diet, a "soft" 180 lbs.  I would balloon up to over 220 lbs. between 2006-2014 before starting on my Fitness Journey.