What does it take to Compete in Iron Man?; Customized Nutrition to Reduce Inflammation

Episode 16.21 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One: Robbie Ventura from Vision Quest Coaching talks about what it takes to train for Iron Man Competition.

Robbie Ventura is the founder and owner of Vision Quest Coaching. With a talented staff of world-class coaches, VQ provides expert training programs for over 300 endurance athletes of all levels, kids and beginners to elite-level, Tour de France champions.

Robbie graduated with honors from Lake Forest College with a double major in Business and Psychology. While working toward his Bachelor’s degree, he played on the Forester hockey team, which advanced to the NCAA Tournament, and was named to the All-American Collegiate Cycling Team. In 2008, he was inducted into the LFC Athletic Hall of Fame for his accomplishments in both hockey and cycling.

Robbie was a professional cyclist for 12 years. A competitive racer on the dirt, road and track since the age of 7, Ventura amassed over 70 victories during his professional career, was a member of the U.S. World Team and rode the Track World Championships in Hamar, Norway, placing 5th in the elimination.

Segment Two: Cole Cruz from Coalition Training talks about the importance of customizing your diet to reduce inflammation.

11 Food Rules For The Ultimate Anti-Inflammatory Diet Hero Image

Related: 11 Food Rules For The Ultimate Anti-Inflammatory Diet


By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • RICE- Rest, Ice, Compression, and Elevation is widely recognized as the most appropriate immediate treatment for many sports injuries in the first hours to few days after injury
  • The recommendation is mainly based on several decades of experience from athletic trainers and team physicians but there is a surprising lack of high level scientific evidence to support the use of ice, especially in the later phases after injury
  • I still recommend RICE for young athletes in the first hours to few days after common sports injuries

The acronym RICE- which stands for Rest, Ice, Compression, Elevation- has been around football RICEanklesince Dr. Gabe Mirkin introduced it in 1978. Since then, healthcare professionals have viewed it almost as religious gospel that immediately after an acute sports injury you apply ice and light compression. I’ve never encountered a single athletic trainer or team doctor that wouldn’t recommend this, and at Sideline Sports Doc we also recommend it for young athletes in the first few days after a joint injury.

Interestingly though, Dr. Mirkin and others have recently raised questions about whether we should actually be applying RICE after injury. Dr. Mirkin states that inflammation after injury is a necessary part of the body’s healing response after injury, and that by reducing inflammation you are actually slowing down the healing process. He has changed his stance and no longer recommends RICE.

Let’s briefly have a look at a few sides of this problem

Authors from the National Athletic Trainers Association wrote a very nice review article about management of sports related ankle sprains, in which they devote several paragraphs to the use of RICE.

They note importantly that injury recovery can be divided into several phases. Immediately after injury (the first hours to maybe 3 days) can be called the “acute phase” in which the goals are to reduce pain, reduce swelling, and protect the injured area from further injury. After this comes the “subacute phase” in which inflammation is less of a factor and the focus is more on tissue and joint recovery. Finally, athletes would go through training for return to play.

They write that in those first few minutes or hours after injury: “Sports health care professionals, athletic trainers in particular, advocate the application of RICE immediately after injury and are arguably the only health care professionals who can consistently apply these interventions within minutes because they are often on site at the time of injury.”

To be clear, we are talking about the very early phase after an injury and I think this should be emphasized.

Once an injured person gets in to the “subacute phase” after a few days, then the emphasis changes more towards mobilization and improved function. This will vary on the type of injury, whether surgery was needed, etc. but the point is that once you get in to this phase then ice is likely less useful.

Interestingly, there isn’t a lot of high quality scientific evidence to support either position- for or against use of ice in the immediate post injury phase. Much of what we advocate is based on decades of clinical experience with athletes and other injured individuals, but we should recognize that evidence might someday appear that challenges our current beliefs.

SideLineSportsDocUntil then, I’m still a believer that application of RICE for about 20 minutes out of every few hours in the first few days after a sports related injury to a joint or extremity is the correct thing to do; decades of experience has established this method as the standard of care.

Understand also that not all injuries can fit neatly into boxes and there will be a lot of individual variability. When in doubt, seek qualified evaluation from a healthcare practitioner and have them assist you with an individualized treatment plan.

Did you know that U.S. Olympian Laurie Hernandez is a tissue recipient?

Golden Child Laurie Hernandez Is the Breakout Star as U.S. Gymnasts Dominate

RIO DE JANEIRO — She led them through the dimly lit hallway at the Rio Olympic Arena, her chin high, a mischievous half-smile shining on her face. The way she looked, she could have been holding a royal flush in a game of poker.

The youngest member of the United States women’s gymnastics contingent was a picture of confidence as she cantered toward the stadium floor for the start of the team competition finals, her teammates in star-spangled leotards following behind—Aly Raisman, Simone Biles, Gabby Douglas and Madison Kocian. Yes, it was as if 16-year-old Laurie Hernandez already knew what would be confirmed two hours later: This year’s American women’s team may be the best of all time.

“Man, we were ready,” Hernandez said. “So, so ready.”

What followed was as ruthlessly dominating of a performance as there has been in the last half-century of sport—a feat every bit as impressive as what the Dream Team accomplished in 1992 in Barcelona when it vaporized the field to win basketball gold.

Consider: The American women beat second-place Russia by 8.209 points—the largest margin of victory since the 1960 Olympics in Rome, where six athletes’ scores were included in each apparatus total. In Rio, only three individual scores were tallied in each event.

“It just felt like a normal meet, not even like the Olympics,” said Biles, the only American to compete in all four events. “We were so crazy ready that we knew we just had to do what we did in practice and we’d be fine. And we were.”

A three-time world champion, Biles is the overwhelming favorite to win all-around gold Thursday, but the mantle of breakout American star at these Olympics belongs to Hernandez.

About 36 hours before the start of the team competition, Martha Karolyi, the U.S. national team coordinator, told Hernandez she would be participating in three events—the vault, the balance beam and the floor exercise. Upon hearing the news, Hernandez, the first Latina gymnast on the U.S. team since Annia Hatch a dozen years ago, felt like screaming in joy. She was selected over Douglas, the reigning all-around Olympic gold-medal winner, and Kocian, a specialist on the uneven bars.

“I’ve worked so hard for this moment, and I wanted to be out there for my country,” she said. “There was no doubt about my abilities at all in my mind.”

In the preliminary round of the team competition, Hernandez became a trending topic on Twitter after her floor exercise as she danced and tumbled her way into the imagination of fans across the globe. Nicknamed “Baby Shakira” and “The Human Emoji” for her vivid facial expressions, she engaged the crowd with a stage performer’s ease—a prodigy born to be in the bright lights.

In her final floor routine, she again dazzled spectators with her rhythmic moves—first learned in ballet lessons at the age of three. In between opening with a double layout and closing with a tucked double back, she danced like no one was looking, which caused everyone who was looking to roar.

Unable to contain her joy after sticking her final flip—a refreshing trait in women’s gymnastics—she blew kisses to the fans.

Big List of Conditions Physical Therapy Treats

Many people are unaware of the variety of conditions physical therapy can treat.

In addition to common ailments like lower back pain, physical therapy can be an effective treatment option for conditions like vertigo and headaches. Discover what other conditions can benefit from physical therapy by checking out the big list featured below:

ACL Injuries

ACL tears sideline more than 200,000 athletes each year according to data from thephysical therapy for acl injuries American Academy of Orthopaedic Surgeons. To help prevent this injury, Athletico Physical Therapy offers the 3P Program, which helps patients strengthen muscles surrounding the knee, core, hip and lower leg. For those who have already undergone ACL surgery, physical therapy can help with the rehabilitation process.


Arthritis refers to the degradation of a joint surface causing inflammation within the joint. Therapeutic interventions can be helpful in reducing pain associated with arthritis, and physical therapy can also help to improve overall function.

Back Pain

Most people will experience back pain in their life and physical therapy can prove to beathletico-2132 an effective treatment option. Upon meeting with a physical therapist for back pain, the first step is an evaluation followed by an individualized plan to address the patient’s specific needs.


Concussions have increasingly been in the news the last few years, but many people don’t know that physical therapy can help with a variety of long term concussion symptoms, like dizziness, balance problems and headaches. In fact, Athletico Physical Therapy offers a Head Injury and Concussion Management program that assists individuals who have had a concussion or participate in an activity where there is potential for a concussion.


Physical therapy can help alleviate headaches that are a result of musculoskeletalPhysical Therapy for headache pain relief issues, including muscle tension and tightness, disc pathology, lack of neck motion, poor posture or tightness in the back between the shoulder blades. Based on each patient’s individual needs, treatment options range from the use of heat or ice to posture education.

Jaw Pain (TMJ/TMD)

The joint used to move the jaw, called the Temporomandibular Joint (TMJ), is one of the most frequently used joints in the body. Acute or chronic inflammation of the TMJ is referred to as Temporomandibular joint disorder (TMD/TMJ Syndrome). Physical therapy options for this ailment include manual therapy, anti-inflammatory modalities, posture correction, therapeutic exercises, and modifications to physical activity and diet.

Plantar Fasciitis

Plantar fasciitis refers to inflammation of the plantar fascia, which is the connectiveLongsitting Calf Stretch tissue that runs along the bottom of your foot. Treatment options vary and can range from simple calf stretches to conducting a walking analysis.


Sciatica, which is a low back problem that causes pain down the leg, is another condition that can be treated by physical therapy. Treatment can include anything from muscle energy techniques to core strengthening exercises.

Urinary Incontinence

If you are experiencing bladder leaking or the urge to make frequent restroom trips, you may suffer from urinary incontinence. Physical therapy can help by increasing the strength, stability and endurance of the core, transverse abdominals, hip muscles and pelvic floor.


Vertigo, which causes a spinning sensation or feelings of dizziness, can often times bephysical therapy and vestibular therapy treated with physical therapy. Treatment options include canal repositioning maneuvers, exercises to improve balance, manual treatment of the cervical spine and more.


Whiplash describes an injury to the neck area that usually involves a rapid movement into extension and flexion. Often times this type of injury is associated with car accidents, but it can also occur as a result of participation within high-velocity, contact sports like football. Those who visit a physical therapist for their whiplash symptoms will typically go through a spine movement assessment. Based on the findings, a specific exercise program will be put in place along with other treatment options, including massage, manual stretches and range of motion exercises.

That’s Not All…

This is just the tip of the iceberg when it comes to conditions physical therapy can treat. If you think physical therapy may benefit you, please contact one of our clinics for a complimentary injury screening.

Click to Schedule a Complimentary Injury Screen

Bone Fractures among Elite Athletes; Back-to-school: Youth Sports Injuries; Cupping Therapy

Episode 16.20 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Joel Williams, M.D.

Dr. Joel Willams

Segment One: Dr. Charles Bush-Joseph and Dr. Joel Williams from Midwest Orthopaedics at Rush discuss bone fractures among elite athletes. Dr. Joel C. Williams brings seven years of training and passion for complex fracture care, post-traumatic deformity, pelvis and acetabular surgery, and complex hip surgery to Rush University Medical Center. See related article.

Dr. Williams is a native of Michigan and graduated from the Michigan State University Honors Program. He then attended medical school at the Mount Sinai School of Medicine in New York. There, he was awarded a Doris Duke Clinical Research Fellowship and spent a year doing basic science research.

Dr. Williams’ surgical training began at the University of California, Davis Medical Center, where he completed his residency in orthopedic surgery. While a resident, he did a research fellowship and was awarded a grant from the Orthopaedic Trauma Association to investigate fracture healing. Additionally, he was awarded a traveling fellowship from the AO Trauma Foundation to study orthopedic traumatology in Chur, Switzerland with Dr. Cristoph Sommer.

Segment Two: Steve Kashul and Dr. Charles Bush-Joseph talk about back to school-youth sports injuries. Types of injuries being seen in the office; how to minimize the risk and treat youth sports injuries.

Charles Bush-Joseph, M.D.

Dr. Charles Bush-Joseph

Long involved in the care of high school, collegiate, and recreational athletes, Dr. Bush-Joseph is the head team physician for the Chicago White Sox Major League Baseball Club and Associate Team Physician for the Chicago Bulls. Through his experience with high-profile professional athletes, Dr. Bush-Joseph was elected to the Major League Baseball Medical Advisory Board and president of the Major League Baseball Team Physician Association for 2012.

This exclusive group of team physicians advises the Major League Baseball Commissioner on medical policy and emerging trends in training and the medical care of the elite athlete. Academically, Dr. Bush-Joseph is nationally renown with leadership roles in several national orthopedic societies and president-elect of the American Orthopaedic Society for Sports Medicine. He has authored over 140 published manuscripts and book chapters.

Segment Three: Scott Kaylor from ATI Physical Therapy discusses cupping therapy and why its been so popular with Olympic athletes; potential benefits and  patient expectations. If you watched the Olympic games, you may have spotted the spots: large, red and purple circles on the backs, shoulders, chests, arms and legs of swimmer Michael Phelps, gymnast Alex Naddour, and other top athletes. So whats the deal?

Those circles are the marks left behind by cupping, an ancient Chinese healing practiceCupping Olympic Swimmer that involves placing special cups on the skin and using heat to create suction and promote blood flow.

The red marks are due to stagnant blood and fluid that may have been stuck for a long time being brought up by the suction from deep inside the tissue so the body can flush it out. See related article.

Scott Kaylor is a board certified sports physical therapist with ATI Physical Therapy in Greenville, SC. He is a faculty member of the ATI sports and orthopedic physical therapy residency programs. Scott completed his upper extremity fellowship in 2012 spending that baseball season with the Kansas City Royals. Scott is an avid triathlete and the founder of Kaylor Endurance, an endurance athlete coaching company.