Original Article Published on Premax
Article by Sasha Kolbeck
Ski season is approaching, and in the US, 50 of 100,000 skiers per day will tear their ACL. Overall, women are 2-8x more frequent to injure. Females are at higher risk for various reasons, some of which can be changed and some which cannot. The modifiable factors for females per Dr. Noyes research are Quadriceps dominance and Neuromuscular control:
- Quadricep Dominance…The hamstring is the guardian of the knee. Women tend to activate the quadriceps, then the hamstring and have decreased hamstring strength, which puts the ACL at risk.
- Neuromuscular Control…sensing, reaction time, and muscle pattern for movement and landing.
The modifiable factors for both male and female include: technique of jumping, cutting, pivoting, fatigue, knee position, and postural control.
What happens if I already have an ACL injury?
Despite the best efforts at modifying the above, you sustain an ACL injury, now what? Research supports the importance of prehab physical therapy to establish baseline for return to sport testing measurements, increase motion and strength, improve outcome, and increase return to sport.
After surgery, research shows physical therapy is again crucial. It should be at least 6+ months in duration. Patients who stopped treatment after 3 months were not able to pass return to sport testing. Treatment should be quality and comprehensive including hands on manual therapy, Blood Flow Restriction (BFR) training, sensory training, strengthening, neuromuscular control, and testing to adjust and progress as appropriate. Long term deficits for months to years including change in brain activation requiring reliance on vision, running deficits, and weakness. Blood Flow Restriction training leads to strength and increased muscle mass, and benefits of heavy resistance training without the strain on healing tissues. (Watch for future article for further information).
How soon can I return to sports after an ACL injury?
After working hard in physical therapy, what is the return to sport timeline? For recreational and elite athletes, it is 9-12 months and for those less than 20 y/o – 12-24 months is recommended. For every month you delay return to sport after ACL reconstruction, the risk of re-injury is reduced by 51%, until 9 months post-operatively. Our local US Ski Team downhill skier, Jaqueline Wiles, will return to competition December 2019, after her extensive knee injury February 2018.
Part of the criteria to return to sport (RTS) includes testing. Of 62 patients, only 3.2% passed all RTS at 6 months and 11.3% at 9 months. It is important to note, that you can still re-injure with passing testing, but your risk is greatly reduced if tested at 9 months and you meet criteria. Testing needs to be comprehensive with multiple tests. Even professional athletes are at a 4x increased risk of 2nd knee injury by not meeting all criteria, so those of us that are recreational, without the same amount of resources, definitely need to put the time in and pass testing.
What is my risk of re-injury after an ACL injury?
What is the data regarding re-injury? The greatest risk is at 1-2 years post injury. ACL graft remodeling takes 12 months for autograft (your tissue) and 24 months for allograft (cadaver). The graft needs loading for healing, but too much can stretch the graft; hence, need physical therapy guidance. Women more commonly re-injure, but the most concerning statistic is 21% for those under age 25. Overall, there is a 20% re-injury rate for those that return to sport. A second ACL surgery has a higher failure rate and decreased patient satisfaction, prolonged physical therapy due to slower healing, delayed return to sport, and decreased performance, so it is best to put in the work and time to decrease risk of re-injury.
How can I prevent an ACL injury?
Research shows the importance of injury reduction programs such as Sportsmetrics®, to decrease the risk of an injury in the first place, or an additional injury. The injury reduction with these programs is a significant 40-65%. Maintaining strength also helps support the knee to decrease risk of arthritis. The added benefit of these programs is increased performance for power, strength, sprint time, agility, single leg hop, and jump height.
In closing, once you are given the go ahead to click into the skis, it’s imperative to continue your strengthening and injury reduction program. And before each ski session, complete dynamic warm ups such as below, to prepare your tissue to tackle the slopes.
About the Author
Rose City Physical Therapy’s Sasha Kolbeck, DPT has extensive experience in knee injury rehab and incorporates sound principles in testing and rehabilitation from the SportsMetrics™ program and extensive research from the teaching and mentorship by George Davis, DPT, MEd, SCS, ATC, FAPTA to provide evidence based knee injury and post-surgical rehab programs.
She provides free community lectures on ACL Injury and Return to Sport as well as Increased Performance and ACL Injury Reduction to local clubs and groups from the youth through adult audience. Contact us for more information, or to express interest in having her present to your group.
Article Featured on Complete Concussion Management
Concussion is a serious concern for all athletes, particularly for those involved in contact, high-speed or collision sports. These injuries have become a significant issue for certain sports. In fact, some contact sports, such as American or tackle football, are seeing a decline in registration and participation year over year.
But, what sport – or sports – has the most concussions? What sports have higher concussion rates? What sports pose the greatest risk to athletes?
Looking at the research on concussion rates
There have been several large-scale epidemiological studies, which have examined the incidence rate of concussions in various sports for male and female athletes. Many of these studies look at the concussion rates in practices compared to games as well as youth sports compared to adult sports.
We went through some of the research using recent systematic reviews and meta-analyses – which are basically a collection of ALL the research put together – to bring you a summary of the sports with the highest risk for concussion.
The results may surprise you…
Athletic exposures: how we measure concussion rates
The rate of concussion is generally measured in ‘Athlete Exposures’ (AE). This is defined as one athlete participating in one game or practice.
The numbers for concussion incidence rate are typically shown as “X” per 1,000 AE.
This means that there are “X” number – or a certain number – of injuries for every 1,000 times one athlete plays in one practice or game.
Let’s look at a sport like football. A football team has about 50 players on the roster. Therefore, a practice would equal 50 AE, and a game played between 2 teams would be 100 AE. In other words, 10 games is equal to 1,000 AE in American football.
Adult athletes (18 years and older)
According to a recent systematic review, examining the concussion rate in team sports, men’s rugby was found to have the highest incidence of concussion in both match play (3.00/1,000 AE) and practice (0.37/1,000 AE).
Men’s tackle football came in second for match play concussion rate at 2.5 per 1,000 AE, and third for concussions experienced during practice (0.30/1,000 AE).
Women’s ice hockey came in third for match-play concussions with 2.27 per 1,000 AE and second for practice concussions with 0.31 per 1,000 AE.
Check out the full list below:
- Men’s rugby match play (3.00/1,000 AE)
- Men’s American football (2.5/1,000 AE)
- Women’s ice hockey (2.27/1,000 AE)
- Men’s Ice hockey (1.63/1,000 AE)
- Women’s soccer (1.48/1,000 AE)
- Men’s football (or soccer) (1.07/1,000 AE)
- Men’s rugby (0.37/1,000 AE)
- Women’s ice hockey (0.31/1,000 AE)
- Men’s American football (0.30/1,000 AE)
- Women’s football (or soccer) (0.13/1,000 AE)
- Men’s ice hockey (0.12/1,000 AE)
- Men’s football (or soccer) (0.08/1,000 AE)
One important finding is that in sports played by both men and women, women sports typically had a higher rate of concussion. This is especially interesting in sports like hockey. Women’s hockey is non-contact, but has a higher rate of concussion compared to men’s hockey – which is full body contact.
Youth athletes (18 years and under)
Concussions in youth sports are particularly concerning as recent evidence suggests that the earlier in life a concussion is experienced, the higher likelihood of having prolonged complications. This is potentially due to injuring a brain that is still developing.
Similar to adult sports, the youth sport with the highest rate of concussion is rugby at 4.18 concussions per 1,000 AE. Unlike the above study, the youth study did not separate injury rate by male or female, or by games or practice.
Ice hockey had the second highest concussion rate with 1.20 concussions per 1, 000 AE. American football came in third (0.53 concussions/1000 AE). See the full list below:
- Rugby (4.18/1,000 AE)
- Ice hockey (1.20/1,000 AE)
- American football (0.53/1,000 AE)
- Lacrosse (0.24/1,000 AE)
- Football (or soccer) (0.23/1,000 AE)
- Wrestling (0.17/1,000 AE)
- Basketball (0.13/1,000 AE)
- Softball & Field Hockey (Tie) (0.10/1,000 AE)
- Baseball (0.06/1,000 AE)
- Cheerleading (0.07/1,000 AE)
- Volleyball (0.03/1,000 AE)
Concussion vs. other injuries
Concussions account for a significant number of injuries in high school sports. In a 2012 study, researchers found that concussions account for over 15% of all injuries in some very popular sports.
- Boys’ ice hockey: 23%
- Girls’ lacrosse: 21%
- Cheerleading: 20%
- Boys’ lacrosse: 17%
- Football: 17%
- Girls’ soccer: 15%
There are some significant limitations to these studies. It’s important to realize that as many as 50% of all concussions are not reported. This could be for a variety of reasons such as the culture of toughness in sport or for fear of missing games, for example.
There are also many sports that are missing from these lists because they do not have reliable tracking metrics at this time. Please take the above information with a grain of salt.
Involved in sport? Concussions are bound to happen in sport, but how we manage these injuries can make a big difference. As part of our commitment to athletes and sport, we develop, implement and enhance evidence-informed concussion management programs for sports and schools. What are you doing to help keep your athletes safe? Provide the program that’s right for you and your athletes!
Original Article By hvmn.com
Table of Contents
The goal of exercise is to break the body down. Yes, you read that correctly.
Looking back at our evolutionary biological roots, when we put our bodies through difficult situations, we wanted them to adapt–maybe to go for longer without food, maybe so we could detect a smell that told us certain berries were poisonous, maybe to jump higher to reach fruit in a tree.
Whatever the goal, we always had to fall short the first few attempts. Adaptation took failure, centuries of bodily breakdowns (and lucky DNA mutations) before our primordial ancestors developed the physical tools they needed to survive.
When we exercise, this happens on a much shorter timeline (hopefully). We put our bodies through strenuous activity with the goal of being stronger from it. In reasonable amounts, this cycle of stress and regeneration is normal and good and pushes our bodies to grow.
That’s where supplements come in. You’ve no doubt heard the long list of the best supplements and what they can do for overall health: whey protein for recovery, magnesium for bone health, branched-chain amino acid for muscle-building. Each supplement targets a different need and together, they can have holistic benefits in all aspects of training and recovery. Most target either acute performance boosts or long-term health benefits.
We’ve gathered some of the best supplements for training, race day and recovery to incorporate into your everyday training regimen.
Scientific research is a good launchpad when choosing supplements. But it can be hard to find a definitive answer; sports studies are limited, and most are conducted on well-trained young men (so if that’s not you, it’s hard to conceptualize those results).
One of the most important considerations is the personal subjective experience when using a supplement: How do you feel? How are your training times? How are energy levels outside of training?
Of course, there are objective, numerical tests that aim to measure the effect of supplements. But many athletes rely on the subjective approach–those intangible feelings of motivation or energy–instead of tracking performance metrics to see if a supplement is working.
Science supporting supplement use is aplenty (and of varying quality), but remember some effects will be subjective.
Training isn’t finished when those running shoes are untied. There are big gains in performance to be had by looking at training comprehensively, which should include considerations for diet and its impact on bone health and muscle mass.
In training, supplements help whole body health, working together to build a body on race day that’s ready for peak performance.
Muscle building isn’t usually a top priority for runners, but it’s essential for keeping those legs strong. Many runners enter a calorie deficit, which can trigger the loss of muscle mass–but BCAAs provide the body with building blocks to maintain muscle mass.
Branched-chain amino acids, commonly referred to as BCAAs, are a type of essential amino acid, meaning the body cannot produce them–they must be obtained through protein-rich food or supplementation. BCAAs include leucine, isoleucine, and valine. Other essential amino acids include histidine, lysine, methionine, phenylalanine, threonine and tryptophan.
The body produces non-essential amino acids; they’re “non-essential” because it’s not essential to consume them through diet–the body makes them. They include alanine, asparagine, aspartate, cysteine, glutamate, glutamine, glycine, proline, serine and tyrosine.
The body breaks down protein into amino acids, which are absorbed and transported throughout the body like bricks on a conveyor belt, sent to create new proteins and build houses of muscle.
Other benefits of BCAA include protein synthesis (from a study on rats) and alleviated skeletal muscle damage (from a study on humans).
Many BCAA supplements combine the three types of BCAAs: leucine, isoleucine, and valine. Try the Do Vitamins BCAA Supplements, which are free of animal byproducts and fillers, or the Bulk Supplements BCAA powder.
and Vitamin D
For runners, joints can be one of the first things to go after countless hours of pounding feet on pavement. Creaky knees are a familiar but unpleasant sound.
Glucosamine is the supplement of choice here; it’s a natural compound found in cartilage, the all-important tissue cushioning joints. Made from chains of sugars and proteins bound together, glucosamine can be made synthetically, but can also be harvested from the shells of shellfish.
Possessing a natural anti-inflammatory property, glucosamine is used to treat arthritis and osteoarthritis. The body needs glucosamine to help synthesize proteins and fats that form important tissues (chief among them cartilage) and helps form fluids that provide joints with lubrication. Glucosamine is like the body’s WD-40.
There are several kinds of glucosamine, but most supplements feature glucosamine sulfate. Over a three-year period, one study found that long-term treatment with glucosamine sulfate slowed the progression of knee osteoarthritis (osteoarthritis is the most common form of arthritis). Glucosamine sulfate also had a greater influence in reducing joint pain during function and daily activities, one study found.
We suggest the Schiff glucosamine tablets, which contain MSM–a source of sulfur important in the formation of collagen in joints, vital for its support of structural cartilage; the Bluebonnet vegetarian glucosamine also contains MSM.
In conjunction with glucosamine, Vitamin D is a powerful supplement to improve bone health.
Vitamin D and calcium have a complementary relationship: Vitamin D helps our bodies effectively absorb calcium and phosphorus, strengthening our bones and muscles. The easiest way to get Vitamin D is through sunlight, spurring our skin to synthesize the hormone (but remember to avoid too much sun); it can also be garnered via some foods like salmon, milk, cheese and egg yolks.
Vitamin D is important because runners’ bones take a beating, but interestingly for most, running actually builds bone health (one study found that impact and resistance training in female breast cancer survivors combatted bone loss).
In healthy people, bones respond to stress by reforming to better handle that stress, in what’s called Wolfe’s Law. For runners, that means bones in the spine and legs, which are exposed to constant stress, should generally be stronger than in non-runners.
Kado-3, a super-charged omega-3 by HVMN, maximizes the effects of Vitamin D with Vitamin K, as they work together to protect bone health.
Supplements consumed on race day should work acutely, giving runners quick performance boosts to hopefully shave seconds off their times.
Caffeine is the classic runner’s supplement, providing quick energy in an easily consumable fashion. We have been using it since the Stone Age, chewing the seeds or bark or leaves of certain plants to affect fatigue and awareness.
Caffeine works like this: as countless neurons fire throughout the day, a neurochemical called adenosine builds up. The nervous system uses receptors to monitor the body’s adenosine levels, and as the day progresses, more adenosine passes through those receptors (making us tired). Caffeine is the same size and shape of adenosine; it attaches to the A1 receptor and when docked, adenosine molecules can’t enter.
Studies have shown that caffeine intake improves exercise performance while also decreasing the perception of pain. However, there’s a genetic split in response to caffeine: for some, it could actually make performance worse. Best try it before race day to ensure it’s right for you.
Along with caffeine, carbohydrates and carb-loading have been other race day staples for runners. Things like pasta, bagels, rice and other high-carb foods are often used as fuel before starting a race. During races, the most common are gels and energy drinks.
Carbs eaten pre-race are stored as glycogen in the muscles and liver, while carbs eaten during the race will be directly burned.
Glycogen is the body’s most readily-available fuel, powering racers through early miles. But when those carbs run out? Body–meet wall.
Ketone esters like HVMN Ketone can also provide an alternate fuel source for the body; your muscles will first burn ketones, saving glycogen stores for later in the race (more on this below).
But you can also produce ketones while on a ketogenic diet. Recently there has been more interest in training with a ketogenic low-carb diet to achieve a body adapted to use fat and ketones as a fuel. Runners following this diet showed a huge boost in fat burning capacity, and there were positive effects of a ketogenic diet on endurance in animal experiments. But there isn’t any conclusive evidence of increased performance in humans (maybe because other changes to metabolism cancel out the increase in fat burning capacity that occurs on the keto diet).
Turns out baking soda isn’t just for baking–the supplement, called sodium bicarbonate, is used to provide athletes with a boost during sessions of intense exercise. Essentially, it protects the body against acidity.
We’ve discussed lactate previously; during periods of intense anaerobic exercise, lactate accumulates as a result of rapidly burning carbohydrate when the demand for energy is high, and oxygen availability is low. It’s often associated with muscle fatigue but it’s actually the acidic hydrogen proton attached to lactate that’s to blame. When our blood becomes acidic during intense exercise, the brain triggers nausea in the hope of decreasing activity level and thus allowing the body to recycle lactate and regulate blood pH.
Sodium bicarbonate is able to bind the protons that cause acidity, thus reducing overall change in blood pH during exercise. It can potentially provide resistance against fatigue caused by acid accumulation from intense exercise, especially for intense exercise lasting up to seven minutes.
Sodium bicarbonate should be taken about 60 – 90 minutes before exercise, at about 200mg – 300mg. While it mostly comes in powder form, there’s also a gel (Topical Edge) you can use that helps to reduce the risk of stomach upsets caused by the salty sodium bicarb drink.
Also on race day, in the early morning darkness of warm-up hours, you might see fellow runners downing shots of beetroot juice. They’re trying to get nitrates–which were once villainized by association with processed meat in the 1960s.
Nitrates trigger vasodilation (the dilation of blood vessels), which allows more oxygen to be delivered to the muscles. It’s a molecule produced by the body in small quantities, but is mostly obtained by eating vegetables; chief among them is beetroot juice, but spinach, arugula, turnips and even dark chocolate (as this study in cyclists found) can also be good sources of nitrate.
The benefits of nitrate peak at about two or three hours post-ingestion, so a morning smoothie (with spinach, mint, arugula, celery and beetroot juice) on race day might be the best way to get the necessary nitrates before the race kicks off.
Research suggests that beetroot juice can also help reduce blood pressure, and taking about 5-8 mM of inorganic nitrate may positively influence physiological response to exercise.
Ever felt completely gassed hours after an intense workout? Maybe you aren’t approaching muscle recovery correctly.
The goal of any type of recovery is to put your body in the best possible position to accomplish more intense workouts in the following days. Exercise is cyclical; tending to those worn-down muscles can be the first step to fueling your next run.
Protein is just for weightlifters, right? Absolutely not. Both runners and weightlifters seek to slow the catabolic process of muscle breakdown and kickstart the anabolic process of building muscle.
Post-exercise, muscle enzymes are like construction workers on standby–ready to build but needing the right tools to do it.
So in the two or three hours after a workout, protein can repair muscle damage, reduce the response from cortisol and speed glycogen replacement. High protein availability accelerates resolution of muscle inflammation and promotes muscle-building after training. But there are several different types of protein supplements (which usually come in the form of protein powders) to choose from. Whole foods chock-full of protein include: chicken, eggs, milk, yogurt, and beans.
“After challenging sessions when I know I’ve really worked my muscles, I make sure to have protein right away. Giving your muscles what they need to rebuild is key to locking in performance gains. For me and many others, protein makes me feel less sore in the days following a hard session, so I can get back out there and do it again.”Michael Brandt, HVMN co-founder and avid triathlete
Whey protein–which you may recognize from milk and cheese–is a great source of BCAAs, which can aid in muscle protein resynthesis (specifically, the BCAA leucine). What’s more, whey is also absorbed the fastest out of this list of proteins. It’s largely considered the most effective type of protein for muscle protein synthesis. There have also been studies showcasing the weight loss benefits of protein.
We recommend Muscle Feast Grass Fed Whey Protein for its absence of additives and artificial ingredients. Also try Myprotein Impact Whey Isolate, which contains over 90% protein and 1% fat. For athletes or highly-active people who want to build lean muscle mass while attempting to lose body fat, about 1g of protein per pound of body weight per day is a good target. Less athletic / active people should aim for 0.45 – 0.69g per pound of body weight daily.
For longer-term recovery, try casein protein–it composes about 80% of the protein from milk, and takes hours to absorb. You can leverage both casein and whey protein but they should be used differently; whey for immediate recovery, casein for long-term muscle building.
One interesting use of casein protein is taking it before bed. Since muscles enter a catabolic state while you sleep (read: since you’re fasting, your muscles are eating themselves), casein can help lessen and delay this process because it takes longer to digest.
Casein protein releases a steady stream of amino acids that slow the digestive process; one study showcased consuming it before bed led to a 34% reduction in protein breakdown.
The other type of protein isn’t milk-based; it’s soy protein, which is made from soybeans. A good source of amino acids, it’s the choice for many vegetarian or vegan athletes. There’s also protein made from peas, brown rice, and hemp for those allergic to soy.
Since the science of soy protein points to be less effective than milk-based proteins, we recommend staying away from this form of plant-based protein.
When people talk about taking fish oil, they’re seeking omega-3 fatty acids, hoping to prevent inflammation; they’re a key nutrient all runners should have in their diets. Inflammation can come in many forms, from muscle soreness, to joint pain, to heart disease to autoimmune diseases. While acute inflammation can be good for our bodies to encourage health, chronic inflammation can detrimental.
The two main fatty acids in omega-3 fish oils are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These can block inflammation pathways in the cell.
Studies suggest omega-3s can help alleviate inflammation. Research has also shown that fish oil supplementation helped subjects decrease airway inflammation (during exercise, airways can narrow and thus restrict airflow) and improve post-exercise lung function by 64%.
The US Department of Health suggests about 250mg of fish oil daily, but in one study, the American Heart Association gave patients four grams daily and saw benefits in heart health.
Kado-3, by HVMN, is a supercharged krill and fish oil stack designed to assist daily brain and body metabolism. Ingredients in Kado-3 work together; like astaxanthin oil (a powerful antioxidant) to fight against the buildup of free radicals, and Vitamins K and D to protect bone health. Kado-3 compounds the beneficial effects of Vitamin D and omega-3 fatty acids on the brain and body.
Hard training sessions can lead to sickness; bolstering the body’s immune system with polyphenol and antioxidants is important to keeping up training over the long-haul.
Polyphenols are another supplement for reducing inflammation, a category of chemicals naturally found in plants. While the idea of polyphenol benefits isn’t new, research has only begun to be conducted on the subject. Many of the health benefits associated with polyphenols are connected to these substances being antioxidants, which are known to combat cell damage.
A great source of polyphenol is tart cherries. Animal tests suggest they’ve been effective in reducing inflammatory and oxidative stress signaling in rat cells. For athletes, the data is less conclusive; still, polyphenol supplementation can increase the capacity to quench free radicals. But it’s an exciting area of research, especially in regards to muscle micro-damage.
Look to things like cherries, blueberries, or green tea to help reduce the possibility of exercise-induced illness.
Look at the list of supplements above; few traverse all situations for runners, from training day to race day to recovery day.
HVMN Ketone, the world’s first ketone ester, is being used by elite performers in sport and military. It’s so unique partially because its applications for endurance sport are so broad.
Ketones are a fundamentally different fuel source from carbohydrates and fats that cells typically use for energy; in fact, your body will preferentially burn ketones over carbs.
Professional cyclist, Vittoria Bussi will be attempting to break “The Hour” record using HVMN Ketone as fuel.
“The first time I tried HVMN Ketone in training, a 50-minute time trial felt like 30 minutes. I was so focused and had much more energy in my legs. The combination of mental lucidity and extra physical energy was strong and effective.”Vittoria Bussi
When taken before or during exercise, D-BHB (the ketone body in HVMN Ketone) is 28% more efficient than carbohydrates alone, helping your body do more work with the same amount of oxygen. In one study, cyclists went ~2% further in a 30-minute time trial.
Athletes of all levels can benefit from making improvements to their recovery protocol. Those using HVMN Ketone have seen a decrease in the breakdown of intramuscular glycogen and protein during exercise when compared to carbs alone.
It also expedited the resynthesis of glycogen by 60% and boosted the signals for protein resynthesis by 2x when added to normal carb / protein post-workout fuel. D-BHB from HVMN Ketone acts as an anti-inflammatory recovery tool, helping reduce exercise-induced oxidative stress from the buildup of free radicals that can cause damage to the cells.
Everyone from ultramarathon endurance athletes, to speed specialists, to casual after-work 5k runners can benefit from introducing the right supplements into their diet.
While some supplements are still in the early stages of research, things like amino-acids, protein and caffeine have been decades-long staples for runners–but it’s always especially important to supplement nutrients the body needs but can’t produce naturally (looking at you, omega-3).
When there is more pressure on your training, mile times start going down, training volume goes up and recovery time gets shorter. Maybe then it’s time to begin introducing more advanced and targeted supplements and testing with newer, elite technology like HVMN Ketone.
We suggest researching and then testing out what works for you–everyone is different. Also don’t forget to pay attention to the macronutrient composition of your diet, sleep quality and other health barometers when introducing supplements. Start with some of the basics like BCAAs, protein, Vitamin D and fish oils, gauging how you feel. Remember, continued use of these supplements over a period of weeks often yields the best results; don’t expect to notice the difference from one Vitamin D pill.
Don’t Get Left in the Dust
We’re developing training guides for athletes, focusing on supplements, dieting, and training to help you get to the next level. Be the first to know when they’re published.
Karl Kolbeck is a physical therapist and along with his wife Sasha they own Rose City Physical Therapy located in NW Portland. He’s been practicing for 25 years with specialties in treating the shoulder as well as runners. Karl is dual board certified in both orthopedic and sports clinical specialties, is certified in manual and manipulative therapy and is a fellow of the American Academy of Orthopedic Manual Physical Therapists. He teaches rehab based continuing medical education courses to physicians, physical therapists and athletic trainers across the nation. He and his staff are involved with multiple running groups in the Portland metro area, offering educational sessions and athlete screenings. Karl also provides care for the Bowerman Track Club Nike professional running team based in Portland.
Motivation for sports participation includes enjoyment, social outlet, stress management, and cardiac, musculoskeletal and general health. As we age, there is the desire to continue to be active and avoid injury.