#PTonICE Daily Show

Dr. Lindsey Hughey, a physical therapist specializing in extremities, talks about latissimus dorsi muscle anatomy and improving overhead movement. She discusses practical methods and a rehabilitation program for enhancing lat mobility, including isometric contractions and eccentric training. The podcast explores the importance of lat mobility for athletes and individuals with stiff shoulders.

Dr. Christina Prevett discusses the role of physical therapy in male fertility, emphasizing the importance of educating men on fertility issues. Topics include lifestyle influences on male fertility, the impact of cycling on sperm health, and the significance of exercise for fertility and overall male health.

Alan Fredendall, Fitness Athlete Division Leader, discusses knee injuries in fitness athletes, focusing on identifying and managing common issues like patellar tendinopathy and meniscus problems. The podcast emphasizes the importance of comprehensive knee strengthening, optimal exercise routines, and targeting muscle groups to prevent overuse injuries in fitness athletes.

Topics discussed include: avoiding medical imaging for new fitness routine injuries, staying in the gym & modifying around injuries, maintaining motivation through goals, managing musculoskeletal pain, focusing on tissue health, psychological impact of injury images, skill building post-injury, empowering health choices for long-term impact.

Dr. Julie Brauer shares insights on creating meaningful therapy sessions for older adults, emphasizing the emotional 'why' behind patient goals. She discusses the importance of understanding abilities and fears in movements, using real-life activities in therapy, and strategic planning for goal attainment through load adjustment. The episode offers practical tips for therapists working with this population.

Dr. Mark Gallant discusses using isometric exercises for structural adaptation beyond pain relief, highlighting key dosage points. Topics include tissue adaptation, collagen generation, load variation for tissue stimulation, and isometric exercises for tendon remodeling and tendinopathy.

Dr. Rachel Moore, ICEPelvic faculty member, discusses pelvic floor screening tools and a new resource on the ICE Physio App. Topics include creating a screening tool, referral recommendations, screening female athletes, and promoting upcoming pelvic floor PT courses and resources.

Dr. Jason Lunden // #FitnessAthleteFriday // www.ptonice.com  In today's episode of the PT on ICE Daily Show, Endurance Athlete Division Leader Jason Lunden discusses three factors to consider when transitioning from biking indoors on a trainer back to riding outdoors: equipment, road/weather conditions, and controlling training volume on the road. Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog If you're looking to learn from our Endurance Athlete division, check out our live physical therapy courses or our online physical therapy courses. Check out our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION INTRODUCTIONHey everyone, Alan here, Chief Operating Officer here at ICE. Before we get into today's episode, I'd like to introduce our sponsor, Jane, a clinic management software and EMR with a human touch. Whether you're switching your software or going paperless for the first time ever, the Jane team knows that the onboarding process can feel a little overwhelming. That's why with Jane, you don't just get software, you get a whole team. Including in every Jane subscription is their new award-winning customer support available by phone, email, or chat whenever you need it, even on Saturdays. You can also book a free account setup consultation to review your account and ensure that you feel confident about going live with your switch. And if you'd like some extra advice along the way, you can tap into a lovely community of practitioners, clinic owners, and front desk staff through Jane's community Facebook group. If you're interested in making the switch to Jane, head on over to jane.app.switch to book a one-on-one demo with a member of Jane's support team. Don't forget to mention code IcePT1MO at the time of sign up for a one month free grace period on your new Jane account. JASON LUNDEN Good morning. Happy Friday, everyone. Welcome to another edition of PT on Ice. My name is Jason Lunden. I am the lead for our endurance athlete division, which entails rehab of endurance athletes, including our professional bike fitting course and both our online and live versions of the rehabilitation of the injured runner. So today I am going to be talking about a very timely topic, transitioning back onto the road after training all winter indoors for especially those of us in the northern climates. And here in Montana, we are definitely seeing our transition back to spring and everyone's getting back out onto the road. after being on the trainer for the past four to six months. So I just wanted to give some tips for either yourself or your clients on how to make that transition as smoothly as possible and not interrupt their training cycle. So we're going to cover three things, equipment, conditions, and then the actual mechanics and transitioning of back on the bike in terms of volume. EQUIPMENT So first thing being equipment. Obviously, when you're on a trainer, you're not really all that concerned about, you know, are your brakes working? Is your headset working, et cetera? Do you have like your kit already with a spare tube and… Spare tube and… Pump etc. So first and foremost Making sure that you're checking that your headset is indeed tight. So that is going to be the top bolt where the handlebars go into the steer tube and Way to check that tightness is depressing the front brake and rocking the back the bike back and forth and you shouldn't feel any clunking at all. If you do feel clunking you need to tighten the headset. Things can get loose over time so it's an important thing to do. So loosening the two screws on the sides and then tightening the top down and then tightening the screws on the sides back too. And then also making sure brake wear and everything are okay as well. Because typically in the spring, you're going to be encountering wetter conditions. So it's really important that your brakes are working and to avoid any catastrophic, traumatic injuries. And then probably lastly is just making sure that you do have the supplies with you if you do break down. Again, typically at the end of the season, when transitioning back indoors, We always think that we're going to get those new CO2 cartridges, replace the used ones that are in our pack that we used already, as well as making sure that that spare tube is still working and adequate. So making sure that you're kind of restocking your kit or at least reassessing your kit for while you're out on the road, as well as making sure you got those tire level levers with that too. ROAD CONDITIONS Number two is conditions. Uh, obviously biking outdoors, there are a lot more environmental conditions and biking indoors. Uh, and that's really important to, to take account of. So again, in the spring, we're typically going to be dealing with some wetter weather, uh, some cooler temperatures, uh, especially for us, uh, working folks, uh, working athletes. We're going to be having to try to fit our rides in around our work schedule. So typically in the early morning. um, or after work where temperatures are already going to be cooling down. And so making sure that you, you are, you or your patient are dressing and layering appropriately. Uh, as if you're, if you are riding in cold weather, um, it can get cold really quickly because of the wind resistance and all of that. Um, and your muscles can get cold, which, uh, you know, anecdotally, I think a lot of us think, well, you know, we're more likely to actually strain or have injuries in the cold with not being warmed up and there's actually some very limited evidence on that but there is some evidence on that in looking at exercises in different temperatures and the incidence or likelihood of increasing the incidence of tendon strain or muscle strain. And anecdotally, this is the time of the season when I really the only time I see cyclists coming in with quadriceps tendinopathy or tendinitis, more acute. And I think there is a correlation with the colder weather and just not muscles being warmed up as well as maybe not quite being acclimated to the volume that they want to do. in the style of riding that they want to do. So just tucking that in the back of your head and just making sure that you're prepared for that. CONTROLLING ROAD VOLUME And then lastly, looking at how you're going to approach your volume in your training with transitioning outdoors. Training indoors is really efficient, especially you know, more recently with our direct drive trainers that can add resistance and simulate hills, et cetera. But we're still very, it's very easy and more comfortable to have your hands up on the flats of the bars and not all the way out on the hoods or in the drops. And I think a lot of us have the tendency to ride in that position of comfort. Either if you're watching the virtual screen of racing on Zwift, or you're watching a show, just being in more comfort even with putting that effort out. So realizing that your body may not be adapted to being in the drops or being on the hoods for a long time, as well as the increased instability of being on the road where you're having to balance more. So not maybe necessarily having the core stability strength for that as well. So ideally before transitioning into back onto the road for the month prior, making sure you are getting time in the drops on the hoods, making sure you're getting time where you're getting efforts standing up on the bike, and then doing an assessment of your core and spinal extensor strength to make sure you can sustain those positions. And then even with that, when you're transitioning back onto the road with your training, Have those first rides be just shake out rides, totally, um, just going out for, for fun rides, not really, uh, equating that into your training and keeping the volume on the lower side. One to make sure your equipment's working, uh, to, you know, the, the conditions are going to be more variable. And then three, just to, to be able to have a smoother transition back onto the road because of the. wide variety in terrain, conditions with the wind, and again, that instability and maybe being in slightly different positions and having slightly different mechanics while you're out on the road. And then after a week or two of that, well, two weeks of that, then diving back into your training plan with that. So while you're doing those shakeout rides, continuing your actual training indoors. It's easy to get excited when it's nice out. I've certainly been a culprit of it, too, where, you know, we're just stacking rides back-to-back days when it's nice out, especially here in Montana, in the mountains, where the weather can be changing rapidly, and we're getting to really try to take advantage of those nice days and getting in as much as we can. set ourselves up for success and pumping the brakes a little bit and just having those rides be enjoyable a little bit a little bit lower volume before really getting after it back to our training to prevent injury. So just some practical advice for you on again transitioning from the trainer back onto the road things to consider Double checking your equipment, making sure that's functioning well, especially the headset and the brakes, and that your emergency kit is dialed. Two, preparing for the weather, mainly in terms of layering so that those muscles, you don't get too cold, perhaps increasing the likelihood of a strain or a tendinopathy. And then three, just going easy with that volume back out onto the road and having those first few rides just be shakeout rides just for fun not really training rides. SUMMARY So hopefully that's that's helpful for you and you are getting back outside onto the road or if you've been in the south you've been on the road all along and you know If you're interested in treating endurance athletes, please join us for one of our offerings. We're really starting to ramp up here with professional bike fit certification. Matt Keister and I will be in Asheville, North Carolina, April 19th and 20th. We still have some spots for that. This should be a great time. It's the only time that we have both lead faculty at the same course for the year. And then I'll be in Minneapolis in the middle of May. Matt will be in Denver in June. For Rehab of the Injured Runner Live, we only have two offerings so far for 2024 until Megan Peach gets back from Austria later in the fall. Uh, first offering will be in Milwaukee the first weekend in June that is filling up. So, uh, if you have an inkling to, to, to join us there, uh, sign up sooner than later. And then second offering will be in Maryland in September. Uh, we're getting some signups there too. So hope to see you at a course. And then next, um, online cohort for rehabilitation of the injured runner is May 7th. Uh, everyone have a great weekend. Get outside, do something fun, get out on your bike if you can, or get out running. See ya. OUTRO Hey, thanks for tuning in to the PT on ICE daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you’re interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you’re there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Dr. Jordan Berry, Spine Division lead faculty, discusses five ways to correct lateral shifts in low back pain patients. Topics include standing, sidelying, and prone variations. The podcast also covers assessment techniques, side lying technique, gentle mobilization, and passive techniques with a belt for lateral shift correction.

Dr. Jeff Musgrave discusses ways to keep older adults moving while injured in group fitness, focusing on symptoms, guardrails, and modifications. The podcast explores adapting exercises for individuals with acute arthritis, emphasizing pain management, seated positions, and core work. Strategies for modifying exercises in group fitness classes are also highlighted, emphasizing the importance of movement for fitness and social connections.