Monday, September 24: off
So yeah, you know how I said that I should really prioritize my recovery better?? Yeah. Well, I didn’t. I have a lot of fun work projects going on with the PrePose Method that I co-created. We have a yoga retreat coming up. We’re developing content for online programs. (PS there is a series specifically for runners.) All that being said, I just focused on treating my patients and other work related tasks. When I got home at 8 PM, I knew I just wanted to make dinner, shower, and go to bed. But I also gave myself this day, knowing that other days I will prioritize it. Yeah, I definitely could have made time, but I didn’t WANT to make time. I really just didn’t want anything else on my to-do list. And that’s ok. But I knew it would be on my to-do list the rest of the week.
Tuesday, September 25: strength training
Purpose: improving thoracic spine and shoulder mobility
PrePose overhead progression
This is one of my favorite warm ups. If you have good overhead mobility, you probably have decent thoracic spine mobility. This is so critical for running. You want to more easily stay upright while running? You want to breath more easily while running? You want to carry your vest filled with 1.5L of water? Yeah, then you need adequate thoracic spine flexibility. I love this progression.
Purpose: level change, core, upper back
Warm up: foam roll glutes, quads, Crab walk 3x50’, supine shoulder ext walk out 3x10
Workout: Pause FS 5x3x3 sec 30k, alternating with windmills 4x10 18#
Cool down: tricep/lat stretch 5x1 min, hamstring/calf stretch 3x30 sec, fire log stretch 3x30 sec
As you can see these strength training workouts are barely even workouts. However, I am focusing this first month on challenging more of my flexibility and reacclimating my body to level change activities. It’s not going to take much to get my body to a threshold where this feels somewhat challenging. I am really focusing on the quality of the movement too. I paused in the bottom of the front squat to make sure that I was contracting my glutes, hamstrings, and quads evenly as I was coming up. My right side tends to be my tighter and lazier side, so I can feel that I start shifting to the left side. I try to be deliberate about pushing my right foot into the ground and consciously thinking about contracting my glute, hamstring, and quad throughout the entire motion. This will translate to hiking or running when I start to get fatigued and find that I’m mostly pushing off of my left side.
Wednesday, September 26th: run
Thursday, September 27th: yoga
Surya Namaskar A x3 with 5 breaths in up dog (sun salutation A)
Surya Namaskar B x3 with 5 breaths in up dog (sun salutation B)
Padangushthasana (forward fold)
Padangushthasana with toes elevated
Pasarita padottasana 1 and 3 (wide leg straddle)
This was a short, quick practice just to get me breathing and moving. Admittedly, I was a bit distracted, and that’s one of the reason I practice yoga. My mind was busy with the weekend’s upcoming Olympic weightlifting competition that we run. I was thinking about my patients, making cookies for the competition, and setting up the food area. By the time that I got about ¾ of the way through, my mind started to settle a bit. I knew that if I kept recentering my attention to my movement and breath then my mind’s speed would slow down and I’d become more focused on what I was doing.
That’s what I love so much about yoga and running, specifically running on trails. You have to be mindful of what you’re doing. (Or else you’ll fall ha.) This practice reminded me that as I’m checking off my checklist that I need to be focused on what I’m doing, and ultimately continually refocus when I get distracted (because I definitely will.) It’s more beneficial to be thinking of the one thing you're doing on a checklist than thinking about all of the other things on the checklist as you're doing the one thing. You just kind of end up doing everything less than optimally. So I continue to remind myself to recenter.
Friday, September 28th: run
Saturday, September 29th: strength training
Purpose: level change, posterior chain strengthening, back strengthening
Warm up: umm… I’m lazy. Kinda foam rolled and stretched in a squat position
Workout: Front squat 7x5 at 35k, alternating with 4x12 posterior delt flies 2.5k
Good mornings 3x12 25k
Supinated rows 3x15 20k
I was increasing my mileage, I could definitely tell that my legs were feeling it. That’s why it was even more important to be to be specific about what I was doing in this workout. Like I’ve said in pretty much every workout commentary about front squatting, I was analyzing the symmetry in the joint motion and muscle activation throughout the motion. I continued to keep it simple with level change/squatting, posterior chain strengthening, and some back/shoulder work. We did this after the competition was over, so neither John nor I were looking for a long workout. I stretched a bit before leaving.
Sunday, September 30th: run
Things I’m happy about this week:
Prioritizing more mobility work. I did less yoga, but I did more mobility work. In the way that I practice, they overlap.
Being flexible and adaptable with my training! I am a rigid person who likes structure and control, and I know that about myself. Sometimes it’s useful; sometimes (read: often) it’s detrimental. But in the more recent years and months, I’ve learned to be more flexible, and changing my program to suit the needs for the race and the logistics of my schedule is another expression of that.
Thing I want to change:
I spoke a bit about needing to increase my continuous running time to prepare for the course at Blue Marsh Lake. That got me thinking about other changes that I should make in my program.
I realized that I shouldn’t have designed my plan so that my highest mileage day and largest elevation gain day are in the same day. Part of that is a product of the trails, in that if I am going to increase my elevation, I’ll inherently gain more mileage based on the routes. But some if it is realizing that I’m not at that point quite yet where I can be increasing both on the same day. As I get more of a base, I’m sure I’ll be fine, but I realized that I needed to rework it. I had originally put this in, because that is kind of how I got into trail running. One day a week, I would go for a hike and then run where I could when it was flat or I was going down hill. Now that I’m running more frequently, I need to allow my body to accommodate to the increased mileage.
Also I decided that my cycle will be 6 weeks instead of 4. Part that is drawing on my experience with strength training. When you’re just building a base, you can make the cycles longer and you don’t need a true deload after 4 weeks, because you’re building more a base. Also, logistically speaking, I will be in San Francisco, visiting my brother and his girlfriend, during the end of week 6. That will be a good time to get in a hike at Muir Woods with John and go on one medium distance run.
Monday, September 17th: OFF
My Monday work days typically start at 7 AM and end at 7 PM, and this pretty typical. So typically I get manage to get in whatever I need to. But on this day, I had focused solely on work. In hindsight, I should have spent a bit of time doing at least some foam rolling, because my legs were trashed. After a day of standing and moving around, they felt particularly bad on my walk home.
Tuesday, September 18th: yoga and running
Purpose: ProPose forward fold (uttanasana)
I had originally planned to do this workout before work just running on the road around Bethlehem with a headlamp prior to work. But like, I said, I was lazy, neglected foam rolling/stretching and made a mental excuse for myself about how much I work, blah, blah. But really, I missed out on an opportunity to do my workout. So instead practiced PrePose yoga in the morning in order to prepare myself to feel a bit better before the workout at night. My calves, hamstrings, and back felt the most tight, so I focused on that with my PrePose yoga progression. This helps to make sure that my pelvis and femurs are moving the way that they’re supposed to, because that’s kinda imperative for running. I’ll be posting more videos on PrePoseMethod.com, and eventually I’ll be creating series for runners! Oh. I finished with headstand. It feels so good on my legs.
I did the running workout in the evening after work. Ugh. I do not enjoy running at night. Actually, it’s kind of amazing how much resistance I feel toward it. You’d actually think I don’t like running. Once I got going it was ok. I was able to just focus on my turn over, what rep I was on, if both of my glutes were firing evenly. Spoiler: they don’t; the right one is the lazy side. I know many of my patients can identify with that ;) The workout itself was interesting in that I added an additional 30 sec to the workout. I was so aware of the minute that I would look down at my watch at 59 seconds almost every time. Sometimes if I tried to hold out, it would still be about 1:11 or so. The last 30 sec or so for the last 3 or 4 reps, I focused on my counting to 10. With each step I tried to make the foot placement, hip movement, arm swing, and muscle firing feel the same. It actually sped me up a bit too, though I tried to control the pace, realizing I’m running at 25k, not a 5k.
Wednesday, September 19th: yoga
Purpose: long duration yoga practice with emphasis on breathing
Ashtanga’s primary series up to the marichyasana 3
This practice, for me, was mostly about just breathing and calming my nervous system down. Mid-week is a great time to do that for me. It is so easy for me (and so many) to get fully engulfed in the wave of momentum of the week. It’s a lot of forward folding, which was a nice way to just let my head hang. At first my mind is filled with so much chatter, but eventually it subsides. It set me up for a good rest of the week.
Thursday, September 20th: strength
Purpose: level change/hip hinge, rotational core, lats
Warm up: foam roll quads, ITB, calves 1 min each, headstand 3x1 min
Front squat 6x5 30kg, alternating with windmills 4x10 18#
Supinated rows 3x10 15kg, alternating with 3x10 z press 5kg
Cool down: Foam roll: quads ITB, glutes 2 min each, brettzel 2.0, ½ supta virasana
My body is doing a lot of adjusting in terms of getting used to more consistent running, with more consistent elevation gain, with more consistent speed, so I’m trying to not blow out my legs. In the spring, I was comfortably front squatting 65k for 5. I’m not conditioned to do that now, and that is also not my goal. It’s really easy for me to pluck out one instant in time where one thing was “ideal” or “preferred” or “the best” and just try compare it in a vacuum to a current circumstance. I can’t really compare my front squat then when I was only doing strength training to my front squat now when I’m running, hiking, and haven’t regularly been lifting. Yet I still do, but I actually just try to not to engage with it too much at all. I don’t even try to “defend” my current self. I see that I’ve made that comparison and then just move on. Nothing good is coming from that, and it’s only distracting me from what I’m trying to do.
This workout is perfect in terms of what I’m trying to accomplish. I want to be able to make sure that I feel my glutes and hamstring contracting when I’m coming out of the front squat. It is great for my hip flexibility in making sure my hips are below my knees. If I’ve been negligent with stretching and foam rolling of my glutes and hip flexors and quads, then squatting becomes much more difficult for me. Then rows and z press are good for back strength to make sure that I’m staying as upright as possible while running and hiking.
Friday, September 21st: run
It was a special treat to be able to run before work, particularly during the fall, because the first light is only around 6:30/6:40 AM now. I saw so many deer on the perfectly crisp morning. I felt really good overall. Maybe it was starting my day that way, being in the woods, knowing it was Friday, or probably a bit of all of those. I was noticing how much easier it is to run the rocky, uphill portions at South Mountain. That was probably the best part.
When I was done I had to pretty quickly get to work. And here is where I need to be more diligent. When I plan my workouts, I need to plan the adequate amount of time to stretch afterward. Stretching afterward is the most effective time to increase the resting length of your muscles. Instead, I got in my car to go home to shower, and then I went to work to treat patients, where I’m either sitting or standing in a bent over position. That’s kind of the opposite of what I want to be doing. I could feel how much tighter my calves and hip flexors were getting as the hours progressed. I realize now that I need to make sure to emphasize to my patients how important it is to stretch immediately after running, because your body is most ready to improve its resting length. Next week, I am going to make sure to hold stretches for at least 1 minute for multiple reps following my run, before I even get in my car. Then I’ll stretch later in the day too.
Saturday, September 22nd: run
This week I added one mile to my longest run/hike, and originally, Ihad planned to do more elevation. However, I’m still getting my bearings with knowing where to add on elevation and how to plan that into my run. I was originally thinking of doing two loops of pulpit and pinnacle, but that would have increased my mileage and elevation too much. So I didn’t really add any more elevation this week relative to last. Oh. But I still ran faster this week, like much faster, like too fast. There was a decent amount of downhills to assist in that, but I still kind of missed the point. I couldn't help but be pleased that I could do that after the 9 mile run yesterday. During the end of this run, I could feel how burned out my quads were from all of the downhill. I went up the tiniest incline right before finishing my run, and I felt like I was going in slow motion.
After this run, I stretched my calves, hamstrings, and quads for 1 minute each for 2 rounds before getting in my car. This allowed my heart rate to come down, and I could feel the unraveling of my body. My quads and hip flexors were particularly tight from the downhills. I was happy I took the time to do it, because when i got out of the car after a 45 minute drive, I could actually stand upright. Later that day I foam rolled and stretched my quads and calves. I also stretched my glutes (piriformis stretch), since those muscles get so fatigued from jostling around on the rocks.
Sunday, September 23rd: yoga and strength
Purpose: long duration hip flexor/quad, posterior chain, thoracic extension
Surya Namaskar A x3 with 5 breaths in up dog (sun salutation A)
Surya Namaskar B x3 with 5 breaths in up dog (sun salutation B)
Padangushthasana (forward fold)
Padangushthasana with toes elevated
Pasarita padottasana 1 and 3 (wide leg straddle)
½ kneeling hip flexor stretch with posterior rotation
Lunge with knee flexed, posterior rotation
Reverse bridge with finger tips forward then back
Area Baddha Palma Paschimottanasana
½ supta virasana with opposite knee flexed, then extended
Mobility wheel for thoracic spine
Box stretch for triceps/lats with elbows extended then flexed with block
Urdhva Danurasana x5
Sarvangasana x1 min
Halasana x1 min
Sarvangasana x2 min
As you can see, this is a pretty long practice. I took this time to do at least 5-10 breaths in each pose. Particularly after running, my neck, thoracic spine, and rib cage area get kind of stuck. I find myself running a bit like a person seated with poor posture. My neck is a bit too extended with my chin forward; my thoracic spine is flexed with my shoulders draping on the sides of my rib cage. So it is nice to unwind it. Also it’s really important to practice slow, controlled breathing, because that isn’t exactly happening when I’m running up a tail, jumping from rock to rock. After that practice I was reminded how much I need yoga.
Purpose: just lift. Do something some level change/hip hinge, something for my back, and some flexibility work.
Warm up: foam roll quads, glutes, ITB, calves
Front squat 5x5 35k
Supinated rows 4x10 25k
Rear delt flies 4x10 2.5k
Lat/tricep stretch 3x30 sec
Then I did a bit of strength training, because I’m committed to 2x/week. I have still kept my volume and intensity pretty low. It actually looks pretty similar to what I did earlier in the week. I felt good. Oh. And I foam rolled. I did a ton of stretching in yoga, but there is definitely a difference in foam rolling vs stretching. I was able to localize those tight areas throughout my glute, quads, ITB, and calves. I was happy that I prioritized doing some strength training, considering I was more than happy to just skip it.
Things I’m happy about this week: lifting twice, foam rolling and stretching more, and
Things I want to work on: do a real warm up, increase elevation. I know that the point isn’t to get a ton of hiking/elevation, because I won’t need that around Blue Marsh. But I like the way it challenges my VO2 max and muscular endurance.
Week 1 is in the books! So here’s what I’ll do in my weekly post: I’ll obviously recap what my running workouts looked like, but I’ll also detail what I did in terms of my yoga practice, recovery work, and strength training. Then I’ll give a short little impression of the day and the week as a whole in terms of what worked and what needs tweaking. As always, feel free to comment and ask questions!
Monday, September 10th: Yoga
Purpose: posterior chain flexibility
Yoga is a great way to start my day. It is something that I can do when I get up early, and with the later sunrises, it doesn’t affect my ability to practice. Being someone that is pretty neurotic, it is so helpful to start my day with finding my breath and flexibility. That way I can come back to my breath and be figuratively flexibility throughout the rest of the day. That’s in theory of course ;)
While I’d much prefer the trails, I figured a weekday speed work would be able to increase my VO2 max given the time constraints of the week. Monday through Thursday, I’m practicing physical therapy 10-12 hours per day, and Fridays I treat patients 7-12/1 and then have meetings and do admin/managerial stuff in the afternoon. So this is perfect for me.
Wednesday, September 12th: Yoga and recovery work
Purpose: hip flexor/quad length
If this table makes no sense to you. That’s totally ok. It will make more sense. I co-created The PrePose Method which teaches you how to move mindfully in any activity. This is the PrePose Yoga progression. Click here to learn more!
Thursday, September 13th: Yoga and mobility
Purpose: thoracic extension and breathing
So this practice was all about relaxing and finding my breath. By Thursday, I’m already so amped up from the week, I find it really useful to try to calm myself a bit.
Friday, September 14th: yoga and strength
Yoga purpose: thoracic extension flexibility with shoulder external rotation and scapular protraction
This idea of shoulder ER, scapular protraction, and thoracic extension is something that I talk about a lot. It is so important if you’re going to be doing anything with your upper body, even swinging your arms while running. The better you’re able to position your shoulder and spine, the less likely you are to do that body-cross swing while running. That just wastes energy. You want to be moving forward, not side to side when you’re running. That seems obvious cognitively, but your body doesn’t always listen to that. Therefore, I work on it.
Strength purpose: finally start strength training again.
It is soooo easy for me to totally forget about strength training while running is in my forethought. I much prefer running and hiking. I like being outside. I do like weight training, though it inevitably falls by the wayside when I start doing any type of endurance activity. So let me try to be consistent with it. Clearly I wasn’t that consistent considering I only did 1 day this week. But next week will be 2. It felt good to front squat, though I knew not to push it considering I was going to be super sore. And yep. I was. Just in time for my long run/hike
This is why I like trail running. I like hiking and then running what’s runnable. I just love being out in nature for several hours. I’ve run/hiked for around 3 hours several times throughout the summer, and each time I try something slightly different when it comes to hydration and nutrition. I am someone who ran 15 mile long runs without water or food when I was in college. I also am aware of the fact that that was nearly a decade ago. So I take a 1.5 L pack and some salt tabs. I eat breakfast before hand too. I have taken some fig newtons and a lara bar before, but lately I hadn’t been eating it. I’m thinking that if i went any longer than 3 or 3.5 hours, that I’d need something more. So I’ll keep that in mind for the future. Suggestions are welcome!
By running at South Mountain, I could still get on the trails with some technical pieces and elevation while still being able to run the whole thing. I could definitely feel my legs from the previous day. That’s mostly, because I was lazy about actually doing anything to prepare myself to feel remotely good the next day. But surprisingly I warmed up pretty easily. I was definitely ready to be done. And you would have thought that I would have learned my lesson about not foam rolling or stretching after, but no. I may tell my patients all of these sorts of things, but sometimes I don’t even listen to myself when I know better. And I definitely paid for it after standing and cooking all day on Sunday afternoon. But, at least, the run was good!
Things I’ll do differently:
Overall, I’m really pleased with my first week particularly given the fact that I had just gotten back from vacation and was pretty jet lagged. Next week will build on this week with similar runs but will have an increase in volume or elevation or intensity. I’m already looking forward to it.
As always, please leave any comments or questions! You can also email email@example.com!
So I’ll just come out and say it: I’ve started training for a 25k trail race. (For those of who don’t think metric, that’s 15.5 miles or so.) I wanted to use this space to share my weekly training with you, but I first wanted to start by sharing a bit about myself in terms of my athletic background, my inspiration, and my training plan
I ran competitively for 10 years, and when I stopped racing, I pretty much thought that I was going to be done forever. To say that I was a headcase would be an understatement. I’m generally a less anxiety-ridden person (extra emphasis on generally and less). I’ve also been able to put racing and training into perspective. When i get into something, I get really into it to the point of total consumption. For 10+ years I only ran. Then I decided that I was inflexible so I started yoga, though running was still the most important part of my day. Then I decided that I was weak, so I almost exclusively did some type of weight training for 4ish years. I would still periodically come back to running, because one thing that I couldn’t deny was that I loved the feeling. Over the last few years, I’ve done a mix of running, yoga, and weight training with the addition of hiking, but even then, I would be consumed by 1 of them for a few months. Temperance is not a strong suit of mine.
More recently, I have been so inspired by so many of my patients. I hear about their training; I’m a part of their training and recovery; I get invested in their training and racing. First, it got me to transition some of my hiking to some running, and I quickly fell in love with trail running. So gradually, I’ve been doing a bit more of it. Well really, I’m kind of a weekend warrior. I choose to work long hours during the week, which leads to the majority of my running/hiking to the weekends. Regardless, I’ve been really enjoying these past 2 or 3 months. I’ve been enjoying telling my patients about it, and they’re all quick to ask what race I’m training for. Well nothing really. But over the past 3-4 weeks, with each passing inquiry, route planning, run, and discussion of my run, I’ve been getting more and more excited about trail running. It’s all because of my patients. The people that I’m helping are helping me.
My training plan
So since I’ve been feeling more inspired, I’ve been thinking about transitioning my running into something with more structure. I started thinking about it being more like training. I think training implies that there’s a plan. I currently have no plan; my schedule looks like 2 massive mileage days on the weekends (about 23-27 miles over 2 days, hence the weekend warrior status), 2-3 days of yoga, walking to/from work, and inconsistently lifting weights.
So I decided to create some structure and simultaneously practice some temperance. I regularly help my patients to balance their endurance activities with mobility and strength work. I should really be no exception, so I want my training to be balanced between running, yoga, and weight training. So here is the general idea:
3 days a week of running/hiking
4 days a week of yoga
2 days a week of weight training.
I will detail my training each week. I realize that what I have planned is a general template, and that it will need to be adapted. I only wrote 4 weeks right now for that very reason. I will get a baseline in this first month. At the end of each week, I’ll be writing a post about my training including what I did, how it went, how I felt, and if anything needs to be adjusted. I hope you follow along, and I welcome any comments, suggestions, and questions!
A Coach's Guide To Hacking Movement
I wanted to take a moment to speak to the following scenario: you have an athlete that looks like they’re incapable of squatting without falling over. Do you prioritize flexibility, spend time on developing technique, or just program a variety of types of squats using high reps to build strength? Unless you have some specific information pointing to an obvious solution you should almost always assume ignorance first.
So much valuable time can be saved by assuming that the athlete simply just doesn’t understand the movement. If you don’t take the time to clarify technique and instead you move forward assuming that the athlete is just weak, you will not only waste time heading down the wrong path, you run the risk of strengthening bad technique. Always start with technique.
Let’s pretend that you’ve ruled out bad technical understanding. What’s next? Move on to mobility. Is the athlete even capable of getting into the required positions? Imagine a back squat, if you will. The athlete has demonstrated that they understand how to back squat, but they still don’t look right while squatting. Did you take the time to see if the athlete can perform an air squat? Can they even perform a goblet squat? Strength is what helps you to move between two points. Flexibility is required to get into both points. Once you’ve ruled out bad technique, focus on flexibility.
Once you’ve ruled out both technique and flexibility you can move onto strengthening. Now, that doesn’t mean that you have to work only on one of the three at a time. You most certainly can work on all three concurrently. What you can’t do is strengthen the back squat when the athlete lacks the required mobility to perform the back squat. But I didn’t say you couldn’t strengthen split squats if the athlete is capable of that. You most certainly can identify variation lifts to strengthen while simultaneously developing technique and flexibility for other lifts. That simple statement is the most complicated part of coaching.
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Mindfulness has become a hot topic. In life, and in fitness, people are being told to be more mindful, or present, in each and every moment. But what is it? How do you achieve it? Mindfulness without specific directions is a meaningless word.
I recently attended the PrePose Method launch. This new system, developed by the brilliant minds of Dr. Chloe Costigan and veteran yoga teacher Carrie Morgan, directly addressed the absence of mindfulness in human movement. In their systematic approach to mindfulness, skillful movements are deconstructed down to their simplest biomechanical pieces, and then transitioned into PrePoses, or corrective exercises, before ultimately layering the pieces back into the full movement. Breaking down skillful movements into biomechanical pieces creates a common language to build more complicated movement from. The PrePoses use that language to bridge the gap between the biomechanical pieces, and more skillful movements. The inaugural PrePose class focused on bringing mindfulness to yoga poses, but it also showed how the method could be directly applied to any skillful movement. At Mobility-Doc we’re already using the PrePose method to teach weightlifters how to achieve a better overhead position with a barbell.
PrePose taught me that mindfulness can be achieved when you have a system that helps you to constantly check back in on the most important parts. That without a common language coaches and healthcare professionals run the risk of their cues getting lost in translation. True movement efficiency is subconscious. But before you can achieve that you must first be made consciously aware of the movement. You can’t be mindful without knowing what you should be mindful about.
Save time and improve your results with these 5 easy steps.
The barrier to entry that we see with most patients when it comes to stretching, foam rolling, and the rest of the mobility/recovery works is that they don't have enough time to do it. However, your mobility/recovery routine really shouldn't take you all that long. It's often a case of doing too much instead of not doing enough. Here is how you can trim the fat, and still get the best results, from your routine.
I hope you found this to be helpful. Please share with your friends so that I can make a larger difference. If you have specific questions you are more than welcome to ask us. We can't consult on medical conditions without certain formalities in place first, but we can always point you in the right direction. Last year I developed custom mobility programs for two Rio olympians and world team members across 3 different sports. Not to mention for a very large number of our regular patients. I'd be more than happy to do the same for you.
MobilityRx Online Recovery Program
We've helped numerous clients around the world with their movement and mobility issues. Using our video chat software we will speak face to face with you for 30min to get a feel for your issue. Then we will create a corrective strategy fo you. We won't stop until we've got it perfect.
MobilityRx Recovery Program
The MobilityRx program is perfect for anyone who wants their movements analyzed and is looking for a corrective exercise program to take home with them. We've created our own functional analysis using manual muscle testing, isolated range of motion testing, and whole body movement testing. Essentially we will break you deconstruct you into pieces and then put who back together into a story that explains why you are having the difficulty you're having. These visits last about one hour and then we will work on your corrective plan afterwards. You will receive a full narrative explaining what we've found so that you can share the information with whoever you want.
What is PrePose yoga?
It a method based on biomechanics to improve your yoga practice. It was developed by Chloe Costigan, a Doctor of Physical Therapy, and Carrie Morgan, a ERYT-500 yoga teacher with 12 years of teaching experience. The goal is to improve your understanding of the biomechanics to be applied to a variety of poses in your practice. It will help you to identify and address asymmetries or limitations in both flexibility and strength.
Why did we develop the PrePose method?
Your body does its best attempt at whatever it sees or hears, and you try to replicate that. But there was a gap between the instruction and the practitioner’s interpretation. We want to develop a common language for understanding movement. So then you can learn how to adapt any pose to fit your body instead of trying to fit your body into a pose.
How is this different than a typical yoga class?
So to be clear, we love that there are so many amazing studios and teachers in this area. We want you to continue with that. This is a supplement to your existing practice. It’s taking the gray out of the physical practice of yoga by applying physical therapy principles.
You will be in a guided yoga class that teaches you how to fit the poses to your body in a three step format: 1. biomechanical exercises, 2. The PrePoses, or modifications to poses, and 3. The poses. The biomechanics (step 1) teach you a common language of how to move each joint and activate each muscle. The PrePoses (step 2) bridge the biomechanics for the poses by applying the biomechanics to a modified pose. Step 3 puts all of the pieces together.
Who is this for?
Well. Everyone in a way.
It’s for beginners who want to ensure that they’re learning the proper technique.
It is for the experienced yogi who wants to gain a deeper understanding of the biomechanics of each pose and learn exactly what is going on with their joint and muscles from the vantage point of a physical therapist.
For those with a history of pain whether in yoga or a different activity, it will help to identify flexibility and strength limitations on a more specific level.
What will a class look like?
It will be based on a central theme. There will be an upper body and lower body section, each having the 3 step process of 1. Biomechanics, 2. PrePoses, and 3. Yoga poses.
There will be a demonstration to provide a clear visual of the biomechanics, PrePoses, and poses. That way you know exactly what you’re supposed to do. That will be followed by you doing those on your mat while receiving instruction.
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Every patient deserves to be treated as an individual. There may be some overlap in the treatment between two patients but your experience with physical therapy and chiropractic should not feel like a medical assembly line. Here's an example of how we treat our patients at Mobility-Doc. You can use a guideline for your own care no matter where you live in the world. That's not to say that our way is the only way to help someone, but we get great results, and this is how we do it.
The New Patient Consultation
We spend at least 60 minutes with every new patient. If the case is more complicated it could be longer. Every first visit begins with a doctor seeking to understand three things:
The third question is often the most important one to answer. Its never as simple as just wanting to not have pain anymore. Usually the end goal is layered with beginning or resuming an activity, and reinforced with the proper habits to avoid arriving back to us as a patient. Getting rid of your pain is the easy part. Sustaining an active lifestyle for the rest of your life takes work.
Almost every visit begins with testing three things:
If you didn't read our blog about testing and retesting, then you really should. We teach that concept to all of our patients, and it's the guiding force for our treatments as well. If your doctor isn't physically examining you on some level then I'm not sure how they know if you are improving or not. New patients may go through some functional capacity testing or a movement screening. Something more in depth that we will test again later. The testing might even be specific to a sport or activity. Established patients will almost always go through the basic three tests at the start and end of each visit.
The treatment you receive should depend on three factors:
For our patients we almost always provide hands on physical care. One of the reasons why we've been so effective as a physical medicine practice is that most hospital affiliated rehab centers don't spend enough time physically treating their patients. Instead they push them to do therapeutic exercises from the start. Hoping that the pain or dysfunction will work itself out. The issue is that you can't build strength and stability in the presence of pain or dysfunction. The main reason why typical therapy settings push patients to do therapeutic exercises, often never physically touching the patient, is because they can see more patients and make more money with therapeutic exercises. Don't fall into that trap. Here's a blog we wrote explaining that idea in more detail.
Therapeutic exercise is a generic term for the strength, stability, and flexibility work that you do during your appointment. We will use another blog to go into greater detail about what exercises you should be doing. For the purposes of this blog all you need to know is that at Mobility-Doc we take pride in developing customized rehab protocols for every patient. We don't follow the same script for everyone. There will be some overlap, but we don't hand everyone the same sheet of paper and then send them to their respective corners to perform their exercises. Avoid practices where everyone is doing the same exact thing.
There are many wonderful physical medicine practices out there but it isn't always easy to find the right one. Hopefully you can use our outline above as a reference point during your search. Also, do your research about the doctor and the practice. Read the reviews from previous patients. At the end of the day, even if you become a patient at Mobility-Doc, the only thing that matters is if you are getting better or not. It takes the right intervention, not just any, to help a patient.
At Mobility-Doc a large number of our patients and clients come to us seeking out a better system for improving their ability to recover. What we've found is that the problem isn't that most people aren't doing too little stretching and foam rolling. They are going in blind and doing too much of the wrong thing. You might think that the book or the app you just purchased is giving you a system, but most likely it's not. Take a closer look at it. At best you've probably purchased a generic template or an encyclopedia of exercises. You need to test and retest. If not you are just pressing and guessing.
Testing and retesting is simple. At least it should be. Remember KISS? Keep it short and simple. Is your knee hurting when you squat? Then thats your test. Pick a mobility exercise and perform it for time or sets and reps. Right after you finish performing the exercise, retest. Did it help? Do more of it. Did it hurt? Stop doing it. Do you feel exactly the same afterwards? Then you're wasting your time. Try to develop a 15-20 minute routine. Once you have what works exploit it until it doesn't work anymore. Let test and retest be your guiding principle.
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The Mobility-Doc Blog
Drs. Chloe Costigan and John Giacalone are both physical medicine specialists, former competitive athletes, and strength and conditioning coaches.