Weight Training & Shoulder Injuries; What is The Pose Method?

Episode 14.17

Segment One – Weight training & Shoulder Injuries 

Dr. Anthony Romeo discusses the evolution of weight training, cross-training and Plyometrics related to shoulder injuries; causes, treatment and proper technique to avoid injury.

Dr. Romeo is a distinguished orthopedic surgeon with over 20 years experience working in academic medicine. In addition to his role as professor in the Department of Orthopedics at Rush University Medical Anthony A. Romeo, M.D.Center in Chicago, IL, he serves as the program director of the Shoulder and Elbow Fellowship, and section head of Shoulder and Elbow Surgery in the Division of Sports Medicine at Rush. Dr. Romeo also serves as co-team physician for the Chicago White Sox and the Chicago Bulls.


Segment Two – What is the Pose Method?

With Shilpi Havron from Accelerated Rehab

Developed by three-time Olympic running coach Dr. Nicholas Romanov, the Pose Method uses gravity, key body poses and body weight to increase efficiency. It consists of three elements: “Pose – Fall – Pull” and uses gravity as the primary force for forward movement instead of muscular energy.

Guided by an Accelerated physical therapist certified in the Pose Method who uses video analysis of a patient’s gait and form, Pose Method runners learn how to adjust their body position and use gravity to conserve energy and increase speed. This is typically done in in an Accelerated clinic, but can also be taught outdoors.

running pose sequence

The Pose Method emphasizes a whole body pose, which vertically aligns shoulders, hips and ankles with the support leg, while standing on the ball of the foot. The runner then changes the pose from one leg to the other by falling forward and allowing gravity to do the work. The support foot is pulled from the ground with efficient use of the hamstring, while the other foot drops down freely, in a change of support. This creates forward movement, with the least amount of energy use and effort. This simple sequence of movements: the fall and the pull, while staying in the pose, is the essence of this technique.

Shilpi Havron received her Doctor of Physical Therapy from University of Southern California and has been a physical therapist for 11 years. A running injury specialist, she sees patients at the North Naperville Accelerated center at 115 E. Ogden Avenue in Naperville.  An avid runner herself, she has been hitting the pavement for 30 years.  She works with the Nequa Valley High School track and cross country teams and recently ran the Ragnar Relay with a former patient. The relay starts in Madison, WI and ends in Chicago.

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From Kids to Kids at Heart: Common Summer Sports Injuries

ATI Sports Medicine looks at common summer sport injuries.Now that summer is finally here, outdoor sports and activities are in full swing. From little league tournaments, to friendly pick-up games of basketball, kids and adults alike are playing their favorite sports.

Unfortunately, with any activity, there’s a risk for injury. Randy Highbaugh, Certified Athletic Trainer with ATI Sports Medicine, talks about some common summer sports injuries and offers tips to stay safe.

“With any physical activity, it’s important to remember to take a few minutes to stretch before you start,” says Randy. “Also, if you are going to use modalities such as heat and ice, remember to heat before activity to loosen muscles, and ice after to control soreness and swelling. Most importantly, listen to you body. If you are start to feel pain, stop and take a rest.”

Overuse: Injuries caused by repetitive motions over time.

  • Elbow and Shoulder: A common area of injury among baseball and softball players. Be sure to properly warm-up and adhere to pitch-count recommendations offered for both sports.
  • Golfer’s Elbow: Inflammation and pain in the tendons found on the inside of the elbow. The key to prevention is to proper warm-ups, avoid overuse and stop activity if you feel pain.
  • Tennis Elbow: Caused by injury to the tendons on the outside of the elbow. Help prevent this injury by properly warming-up, avoid overuse and incorporating rest time in your schedule.

Muscle Strain: A strain is caused by a quick pull, twist or micro-tear of the muscle or tendon, especially when muscles are not stretched or warmed-up properly.

Muscle Sprain: Unlike a strain (which many use interchangeably) this injury affects the ligaments and is caused by the ligament being stretched beyond its capacity.

Concussion: When players suffer a blow to the head, it is important to check for signs of a concussion: feeling confused, difficulty thinking clearly, memory loss, feeling sluggish, headache or blurry vision and nausea or vomiting after a blow to the head. Players with symptoms after a blow to the head should NOT return to play the day the injury occurred, and should seek medical attention immediately.

If your injury presents with the following, Randy suggests seeking immediate medical attention:

  • Severe swelling, pain or numbness.
  • Inability to bear weight on, or utilize a limb.
  • A dull pain that increases, and is accompanied by increased swelling or joint instability.
  • Obvious fracture or dislocation.
  • Feeling confused, difficulty thinking clearly, memory loss, feeling sluggish, headache or blurry vision and nausea or vomiting after a blow to the head.

If you are not experiencing the above symptoms, you can try treating the injury at home at first to see if symptoms decrease. Randy recommends the R.I.C.E. method during the first 48 hours:

  • Rest – rest and/or stop using the injured body part and avoid painful activity.
  • Ice – place a covered ice pack on the injured area for 15 minutes at a time, every 1-2 hours.
  • Compression – use an ACE™ elastic wrap or compressive devise and wrap the injured area to help decrease swelling.
  • Elevation – elevate the injured body part above the heart. Use a pillow to prop-up an injured limb.

If symptoms don’t subside after R.I.C.E. within 48 hours, Randy recommends seeking medical attention.

ATI Physical Therapy

Hot tips for summer running

As the weather heats up this summer, so does marathon training. Be sure to use caution when running in the heat. High temperatures can lead to overheating and dehydration—two problems known to harm health and performance.

According to a recent study in the Journal of Athletic Training, runners who began a 12K race on an 80-degree day already dehydrated completed the race about two and a half minutes slower than when they ran fully hydrated.

Kate ReicherDehydration occurs when too many fluids are lost through sweat and/or not drinking enough. In the process of sweating, water and electrolytes are lost and, after prolonged periods of time, body functions are compromised. Common signs of dehydration include thirst, headache, confusion and abnormal fatigue.

Overheating occurs when your body is unable to cool itself due to the amount of water evaporating from your skin. The most common symptoms of overheating are headaches, fainting, dizziness, and after long periods of time, heat stroke.

According to Denise Smith, Accelerated Physical Therapy running specialist, dehydration and overheating can cause serious symptoms, but simple adjustments to your training schedule can help you avoid these conditions altogether.

She suggests these five tips for hot weather running:

  • Run at the right time–Even at the hottest time of the year, temperatures are coolest in the morning and at night when the sun’s rays aren’t as strong.
  • Wear appropriate clothing–Running gear that is a light color, lightweight and is breathable will help cool you down significantly. Light colors absorb less heat and clothes with vents or mesh will allow for air-flow and breezes to decrease your body temperature.
  • Consume sports drinks–In high temperatures, electrolytes are so crucial and just drinking water isn’t enough. Many sports drinks increase your water-absorption rate and replace the electrolytes lost through sweat. Drink a sports drink about one hour before your run to fill your body’s electrolyte stores. Always drink again after you run.
  • Be smart–It can take some time for bodies to fully acclimate to the high temperatures and humidity. Instead of starting your training with high intensity runs, take your time and gradually increase the length and speed of your runs.
  • Embrace the breeze–If possible, begin your run going with the breeze and finish your run against it. The wind will cool you down when you are running into it, so use that to your advantage when you are at your hardest part of the run… the end.

If you would like to discuss your summer training program or are experiencing pain that concerns you, call Accelerated Physical Therapy at 877-97-REHAB and ask for a running specialist. We can schedule you for an appointment within 48 hours at your nearest Accelerated location.


Obstacle Course Racing after Microfracture Surgery

On October 15, 2011, I participated in my very first Spartan Race, the Midwest Sprint. I’ve been participating in sports for as long as I can remember and I’ve had some experience running a few obstacle course races before, so I thought I was prepared for this race. About a mile in I knew I was in for one of the most difficult races I have ever done. It was 4.5 miles of gnarly terrain plus obstacles that included 8ft wall climbs, 40lb sand bag carries, mud crawls, and fire jumping. When I crossed that finished line completely exhausted, I was hooked. I couldn’t wait to do my next Spartan Race. Unfortunately the reality of my situation hit me like the sand bag I had carried as my right knee pain was just too much for me to consider doing yet another Spartan Race.

Three days later, Dr. Cole performed my scheduled right knee microfracture. I woke up in the recovery room and remember hearing that there was not 1 articular cartilage defect in my knee but 2 and microfracture was done at both sites. It wasn’t exactly what I wanted to hear, but my faith was in Dr. Cole and his staff. I knew I was in good hands and the only thing I could do was move forward.

The first few months post surgery were tough, not so much physically, but more mentally. I spent my life being active and having to slow my activities to an almost literal crawl was hard. I’m sure I drove Dr. Cole and his P.A.s Kyle & Natalie nuts with all my questions and e-mails. But I will tell you, every question I had, and every e-mail I sent was answered in record time. I can’t say enough about how much that meant to me and my recovery. I can’t thank them all enough for being ‘available’ and taking time to show that they really do care.

I put in a lot of time and hard work, dedicating myself to getting back to where I was before my injury, if not better. Throughout the entire year long process, there was always one thing in the back of my mind – would I be able to do another Spartan Race again? There were times that I seriously questioned if I would even be able to run again, much less participate in an obstacle course race. If it wasn’t for the support and encouragement from everyone in Dr. Cole’s office, I’m not sure I would have been able to deal with the whole recovery/rehabilitation process.

I’m happy to say that on October 11th I was finally given a clean bill of health and told I could move forward with my normal activities. The only thing that was on my mind was participating in the next Spartan Race, the Midwest Super. So on October 27th, I laced up my shoes, joined my friends at the starting line and raced with nothing but my heart. I finished the 8 to 9 mile course in just over 3 hours. Three weeks later, I found myself at the starting line at another Spartan Race. This time it was at the first ever Fenway Spartan Race Time Trials inside of historic Fenway Park in Boston. This once in a lifetime opportunity allowed me to climb a cargo net along the Green Monster, carry a 70lb sandbag throughout the outfield bleachers, do burpees on the warning track in center field, and do box jumps in the Red Sox dugout.

It really is amazing how much difference a year can make. I have already started training for my next race season which currently includes 7 obstacle course races.

None of this would have been possible if it wasn’t for Dr. Cole, his staff, and everyone at Midwest Orthopaedics at Rush. While dealing with injuries and surgery is never something anyone wants to have to go through, it does happen, and I would never trust my care with anyone else.

Thank you for EVERYTHING!

    — Missy Morris

More Patient Experiences

Summer Training Tips for the Chicago Marathon

July 14, 2014 – On October 12, 2014, over 45,000 people will hit the ground running for the Bank of America Chicago Marathon. The course, which boasts four world record times, is a flat and fast paradise for runners from all over the world. The Chicago Marathon is notably one of the best races for runners to reach for their personal record.

With cool and dry temperatures, the month of October brings perfect racing conditions. At the same time, this means that runners must train for the Chicago Marathon in the hot and muggy summer months, which can be very challenging.

Experts claim that the higher the temperature the higher the risk a runner has of suffering from dehydration, exhaustion and reduced blood flow to the muscles used for running.

Training in heat not only affects a runner’s body and health, it also affects their pace. According to a recent article in Runner’s World, for every 10-degree increase in temperature above 55 degrees, runners can expect a 1.5 percent to 3 percent increase in their finish time.

Dr. Jeffrey Mjaanes, Midwest Orthopaedics at Rush sports medicine physician, and one of the official team physicians for the Chicago Marathon offers advice for training in the heat. Dr. Mjaanes recommends:

  • Get a physical before beginning marathon training.
  • Hydration is key. It is important to begin each training session hydrated and to remain hydrated throughout each session by drinking 16 to 28 ounces of fluid per hour.
  • Help your body adjust to the temperature changes by running at the same time every day.
  • On very hot days, run either indoors on a treadmill or in the early mornings or evenings.
  • When a long run is scheduled for a very hot day, consider moving the run to a cooler day. Remember that skipping a day will not affect your performance – in fact, a break may improve your overall time.
  • Create your own shade by wearing sunscreen, a hat and sunglasses.
  • Seek help and get out of the sun if you feel dizzy, chest pain, heart palpitations, shortness of breath, or you’ve stopped sweating and get the chills.

Team Össur Athlete Rudy Garcia-Tolson Attempts World’s Largest Ironman-Distance Triathlon

2 x Paralympic Gold Medalist, Rudy Garcia-Tolson will attempt to complete his second Ironman at Challenge Roth (Germany) – a 2.4 mile swim, 112 mile bike ride, and 26.2 marathon. Garcia-Tolson, 25, became the first double-above knee amputee to complete an Ironman in 2009 at Ironman Arizona.

Garcia-Tolson will be one of six athletes featured in the film “Challenge Roth,” a documentary that showcases the physical and mental toughness one must exhibit to rise above various obstacles. He has also recently announced that he will attempt to compete in 3 sports at the 2016 Rio Paralympics – athletics, swimming and triathlon.

“Having no legs is really a gift,” says Rudy Garcia-Tolson. “If I wasn’t an amputee, I probably wouldn’t have the same drive to do what I do.” What Rudy does is spend six or seven hours a day in athletic training, routinely break world records in swimming, compete in triathlons, and tour the country as a motivational speaker to spread his message that “A Brave Heart is a Powerful Weapon.”  He’s been picked to carry an Olympic torch and named one of People Magazine’s 20 teens that will change the world. Oh, and he’s buddies with movie star Robin Williams and has appeared on Oprah. All of that would be a staggering achievement for any young man, but Rudy was born with multiple birth defects: a club foot, webbed fingers on both hands, and a cleft lip and palate.

Follow Garcia-Tolson’s Challenge Roth Ironman and Paralympic journey onhttp://rudygt.com.


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Deep Sea Fishing: 7 Tips for Prevention of Low Back Pain

By Sarah Clough for Athletico

Fish on! Hook up! Fresh one! These are all common phrases to yell out when your reel is screaming and the line is taken hundreds of feet into the ocean. It is also in that moment that you may realize your back is in for a workout.

Deep sea fishing Injury Prevention tipsI have caught 50 lb. blue fin tuna, barracuda, albacore, yellow tail, and more on over 20 trips off the coast of San Diego, approximately 75 miles offshore. I have also caught a nice 30 lb. brown trout off of Lake Michigan. Each takes me about 20-30 minutes to bring on the boat, providing my body with quite the endurance-based workout. The physical therapist in me can’t ignore back pain, so there are strategies to help land that fish and assist with eliminating that back pain in the upcoming weeks.

  1. Use the waves: Even if the fish you have hooked up isn’t too big, the ocean can fight against you. Here are a few tips to fight back. Wait for the boat to go up the wave. Once at the top, wind, wind, wind, wind as you ride down the wave! This allows the wave to bring up your rod, saving your arms and body the trouble of pulling up on a fighting fish against the swells of the ocean.
  2. Keep your back straight: The fish will be heading out and towards the bottom of the ocean floor, pulling you into the boat’s railing. Keep your back straight, with contraction of your core muscles. This will support your back best. With some fish, you will have to slump over the rail. Habitually, you will want to stand up using your back.
  3. Use your legs: If the waves are not big (i.e. Lake Michigan or a calm day on the ocean), use your legs to try and eliminate the cause of back pain. Instead of pulling up on the rod with your arms and back, bend your knees then wind as you straighten them. Sit back to counter the forward pulling force of the fish. This will give your quads and gluts a great workout and save your back from some undesirable positions.
  4. Stagger your feet: I have noticed some pain in my low back even when I haven’t yet hooked up a fish. My bait is swimming and the weight of the pole pulls my center of gravity forward as I lean into the boat railing. Staggering your feet allows a more upright position and will better prepare you for that huge tug as you hook up that fish.
  5. Anchor your rod: If you are truly strong enough to place your rod under your arm as you fish that’s great. However, for those of us who need to control the rod a bit better for whatever reason, you will want a place to anchor your rod. I place the end of my rod in my side, about 3 inches left of my belly button. Using my body helps to stabilize the rod and allows me to use my legs and keep my core muscles tight as I bring in the fish.
  6. Follow your fish: The fish will move sideways and even swim all the way around the boat. Follow it! Torquing your body at different angles is stressful on your back. Staying in front of your fish and moving your feet with it will help keep the fish on the line as well!
  7. Bend backwards: After a successful fishing trip and reeling in that huge prize winning fish, bend backwards a few times to counteract
    the forward force that your body just fought against.

Deep sea fishing Deep sea fishing creates great memories stories! Don’t let your back pain be part of that! Fish on!

Receive Your Complimentary Injury Screen from Athletico


Elbow Injuries – PCL Injuries – CardioFree Workouts

Episode 14.16

Segment OneDr. James Andrews talks with Dr. Cole and Steve Kashul about the recent passing of sports medicine pioneer Dr. Frank Jobe, his contribution to their profession and his impact on research, their careers and the history of the Tommy John elbow  surgery.

Dr. James Andrews is internationally known and recognized for his scientific and clinical research contributions in knee, shoulder and elbow injuries, as well as his skill as an orthopaedic surgeon. Dr. Andrews is a founding partner and medical director for the Andrews Institute in Gulf Breeze, Florida. In addition, he is a founding member of the American Sports Medicine Institute (ASMI). Dr. Andrews has been the mentor for more than 250 orthopaedic/sports medicine fellows and more than 45 primary care sports medicine fellows. Involved in education and research in sports medicine and orthopaedic surgery, he has made major presentations on every continent, and has authored numerous scientific articles and books.

Segment TwoDefensive Tackle Matt Conrath from the St. Louis Rams talks with Dr. Cole and Steve Kashul about his PCL and other injuries that occur with NFL players. Focusing on causes, treatment, recovery as well as training and diet considerations in the on & off seasons. Matthew Conrath is an American football Defensive tackle currently playing for the St. Louis Rams of the National Football League. In 2012, he signed with the St. Louis Rams as an undrafted free agent. He played college football at Virginia.

Segment ThreeJim Karas, Lifestyle Fitness Expert and Personal Trainer, discusses his Cardio-Free Philosophy and how it can change your perception of the preferred workout program as Hugh Jackman, Diane Sawyer and many others have discovered.

Don’t be fooled by the words [CARDIO-FREE]! You’ll get your cardio but never have to step foot on a treadmill again! This innovative workout guarantees to transform your body with just three, 45-minute sessions a week. The [CARDIO-FREE] workout is specifically designed to give you a metabolic makeover, turning your body into a fat-burning machine.

Shock your Metabolism- Workouts change every month. Just when you have mastered one workout, we change it and disrupt your body again. The more you disrupt your body, the more it is forced to change.

Power in numbers – working out with others allows you the benefit of personal training while saving time and money. Plus, you’ll get to meet people who are just as passionate about looking and feeling great!

Variety – We offer a variety of workrouts! Give them all a try to experience the benefits of each one.

People turn to Jim Karas Personal Training (JKPT) when they’re looking for more than the typical trainer and nothing less than unrivaled results. With an unmatchable business model that allows his staff to solely focus on their clients, JKPT continues to be the reliable source for highly professional and knowledgeable personal trainers. Handpicked by Jim Karas, his team has been delivering real solutions in real time for over 24 years by applying the latest techniques, methods and research. JKPT offers private and semi-private training sessions in your home, building exercise room, office or in one of its studios.

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Stitcher Announced as App Launch Partner for Android Auto

We hope your summer is off to a great start and we hope to make it a little better with Stitcher’s announcement that will make it easier for you to discover and listen to Sports Medicine Weekly. Get your free app today!

Android Auto
Stitcher was named as one of Android Auto’s first developer partners. Inclusion in Android Auto will make Stitcher available in an even greater number of vehicles including Acura, Audi, Fiat, Kia and many more. We’re thrilled to bring our show to an increasing number of people through connected car experiences. We are dedicated to making listening fun and easy through mobile devices, in-car experiences and other products like the Aether Cone, where Stitcher was also recently announced as an app launch partner.

Tennis Elbow and Golfer’s Elbow: Not Limited to These Sports

If you’re on the court, or at the greens, you may hear the terms “tennis elbow” or “golfer’s elbow.” However, you don’t have to play these sports to suffer these common overuse injuries. This inflammatory process affects the large tendons that attach the forearm muscles to the bony prominence of the elbow. Pain usually increases with gripping, pushing/pulling and lifting (especially palm down).

 You may hear the terms “tennis elbow” or “golfer’s elbow.” However, you don’t have to play these sports to suffer these common overuse injuries.  We called on one of our occupational therapists, Todd Cobler, to learn more about these conditions that he often treats at the ATI Hand Therapy Clinic in Carol Stream, IL.

Why are these conditions coined “tennis elbow” and “golfer’s elbow”?

Tennis elbow, known as lateral epicondylitis, involves inflammation at the insertion point of the tendon at the outer portion of the humerus bone at the elbow joint (the epicondyle). Tennis backhand requires a lot of exertion from the wrist extensors and when tired, strain eventually occurs at the elbow where the tendon attaches to the bone. Most people with lateral epicondylitis, however, acquire it from activities other than playing tennis.

In contrast, when the tendon that attaches at the inner portion of the elbow is inflamed, the condition known as medial epicondylitis is referred to as “golfers elbow.” Golfers commonly injure this area after striking the ground to take a deep divot.

Can these conditions be prevented?

“Like most overuse injuries, many people don’t know they are overusing an area of their body until it is overused,” says Todd. “However, there are ways to prevent these types of injures.”

As it relates to the sports of tennis and golf, players can benefit from lessons teaching proper gripping and hitting techniques. With daily overuse injuries, pay particular attention to your body and what it is telling you.

“If you have constant aching or fatigue in your forearm with the activity that you are doing, you need to stop, take breaks and know the proper ways to stretch out your forearm to keep various forearm muscles loose,” adds Todd. “A tight muscle is an inefficient muscle, which makes it susceptible to strain within the tissues.”


Someone dealing with these symptoms should consult with a physician first. Based on the patient’s report, the physician may consider options such as splinting, medication, referral to occupational/physical therapy, and rest and temporary leave from work.

According to Todd, these two conditions can be difficult to treat unless the patient is completely removed from the environment that has caused this overuse strain.

“If a patient comes into therapy and has the luxury of being off work, or can stop the activity that caused the injury, it is much easier to treat, and the prognosis is much more favorable,” says Todd. “I often incorporate Active Release Technique (ART) to treat these two diagnoses, and it has been very successful.”

Complimentary Injury Screenings Available

If you’re feeling aches and pains in your elbow, ATI can screen your injury and provide suggestions or recommendations for further care if appropriate. Injury screenings are provided by a licensed provider, however are not inclusive of a comprehensive physical therapy evaluation or treatment. Find a clinic near you by visiting www.ATIpt.com or call 1-855-MY-ATIPT to schedule your complimentary injury screening.