Resilient Performance and Wellness PLLC

Life is busy. Lots of good things are happening. Kindergarten graduation, or as they call it, continuation, today.

How can we not believe that humans are wired to be inherently good after seeing these little kids singing songs and proudly marching through their ceremony? So thankful for the good people at our school.

For me, I saw 4 patients. Wednesdays are normally when I am not in clinic and see clients at home. Today I did both.

I still got a workout in. It was simple. 10 x 10 followed by a walk to the gym and some heavy bag practice. 5 rounds of 2 minutes.

About 30-40 minutes total I squeezed in during a very busy day.

This is all to say that you CAN find the time. It does NOT have to be long and complicated workouts. We have to get in our training some way, some how. Busy parents for sure need the wellness break.

As Ross fron Friends would say, at times we need to "pivot" from our initial plan.

Just get it done. Your body and mind will thank you.



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Mild back pain is not something to freak out about. We are all human. Especially those of us in our late 40s and beyond..

I do not give out specific medical advice on here, this is just a personal example.

I have had about 2/10 back pain for a few days.

After exercising, including some nerve glides, light deadlifts, leg work, prone press ups and stretching, I have ZERO back pain.

Yes, proper deadlifts without going super heavy can actually alleviate back pain for many people. We need to have strong backs.

The research, and vast experience from thousands of patients I have worked with over the years, support the undeniable conclusion.

Exercise is the most effective way to conquer back pain and maintain your back.

Movement IS medicine.

Video of press ups and nerve glides coming soon, as promised to one of my clients.

I am excited to be teaching a lab session for 18 PTs this weekend.

The topic is spinal mobilization and manipulation.

Game changing techniques when performed safely for the right patients.

Maximizing my fellowship training by teaching and learning from others.

Collaboration and continued learning is how healthcare gets better.

4 ways to save time at the gym -

1. Superset upper and lower body exercises.
Rest just enough to stay strong and safe yet keep moving along.

2. Do mobility, physical therapy stuff and flexibility exercise in between sets
Do your working set. Set a timer for whatever your rest period is. Ideally on a watch not the phone. Then do some maintainence and stretching instead of sitting slumped on your phone. Example, I did barbell overhead presses and while waiting 90 seconds I worked on some dynamic stretching drills.

3. Superset pushing and pulling exercises.
Pullups. Rest a minute. Then dumbbell press. And so on.

4. Minimize phone use!!!!
This is the worst ever now. People are sitting hunched over on their phones at the gym. 5 minutes rest between sets is wqy too much unless you are a competetive powerlifter. Okay, changing music is one thing. But prolonged phone use wastes time and takes space up that others may want to use. And of course neck, shoulder and back stress from prolonged forward head posture. People who say they don't have time to go the gym in particular need to take note of this.

And finally the bonus - do not put on a bunch of cologne. (OK just a side note not really a time saver directly).

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Stay resilient!

Solid rule for over 40 lifters -

Just because you CAN lift x amount of weight, that doesn't mean you SHOULD.

Leave a couple reps, and some lbs, in the tank. That is how we stay in the gym rather than visiting PT for multiple sessions.

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Actively practicing gratitude helps with pain, depression amd anxiety.

Mindset is everything!

As I tell patients daily, if you know you hold tension in your neck or somewhere else, that is a good thing. Because then you can actively practice NOT doing that. Breathing. Stretching. Walking. Working out. Intentionally relaxing.

Then you can focus on when things feel GOOD in your body.

Gratitude can stem from the sense of having zero, or very minimal pain.

This extends to everything else in life too. Rather than focusing on the stress of a mortgage, I am grateful that we have a house, for example.

To be fair Julie does the bills...but anyway you get the idea.

Thought patterns can make or break your quality of life.

We all need to give ourselves time to breathe, slow down and relax. Give yourself some credit for the things you do for others and even yourself.

It matters!

How long does it take for a nerve injury to heal? We don't know for sure when it comes to mild to moderate nerve insults. Neurologists will say after 1-2 years that's all the time you get.

Surgery left me with zero quad strength because the nerve was "offline" which was super disheartening.

I persisted. My quad is strong and I have focused on gentle hypertrophy to build muscle. Lots of high reps and tension on the muscle. Lots of riding the bike. I also utilized electric stimulation and the evidence based to use less load while building the muscle.

16 months into this mess and I continue to make progress.

Muscles are the armor for your joints.

My knee joint sill sucks due to whatever is going on in there mechanically. I have no control over that. But physical therapy and strength training has put me in the best position to recover from whatever is next.

Stay resilient and consistent. We have to be strong enough to tolerate life and activities. Adversity breeds strength.

Whatever you are going through, keep working at it. Be patient. Seek help. I believe things tend to happen for a reason. Don't be discouraged by pain or limitations.

Often the solution is out there if you keep working and attend to the mental, physical and spiritual domains.

Stay resilient! You got this.

Merry Christmas!

For years I was not interested in going to church. Our family has found a welcoming church that we actually enjoy.

Our Pastor, in my interpretation, understands that religion as an institution can be problematic. Yet one can have a relationship with God that is personal, ever- evolving and also loaded with doubt and questions at times.

Religion and relationship can be mutually exclusive, I think.

Religion for me. raised as a Catholic, was more about fear and consequences. Not to mention disgusting acts of abuse by immoral people.

This and other factors such as corruption and control drove many people all over the world away from organized religion. Myself included.

Yet now here we are wondering how to teach our girls about one of the most powerful questions and influences in our entire society. The question and mystery of God is incredibly deep. As an agnostic I could not commit because, well, what do I know? Who am I to say something so profound does or does not exist?

Jesus was one of the most influential people who has ever lived. That is what this holiday is about. Everything I have learned, felt and experienced deep within my being have led me to embrace Christianity. I was reaffirmed when our oldest daughter was baptized. Our girls can choose if and when they are ready.

People in various denominations interpret things differently. Some of it is ridiculous in my opinion. But I can only control what i participate in, not others.

What we believe in is love, kindness, morals, being open to others and not living with hate and anger.

Jesus taught these things. Others such as the Buddha, promoted similar values.

The long-winded point is that this church community has immensely improved my own personal wellness and has helped our family.

Wellness is all the things including physical, mental and spiritual. EMDR therapy has opened my brain and heart. Healimg. Evolving. This church has quietly and organically pushed me as I have learned.

My career as a PT and Trainer necessitate that I personally work on wellness so I can better educate others.

With two young daughters in a tough world, my job is to be the best dad and person I can be. That requires I tackle my own biases and issues. Lucky they have a super mom in Julie Gustafson

I will keep at it. And I hope you will too. Use the tools you have at your disposal. Find other tools as you go. Open your mind. Read new ideas and opinions. Learn what has historically been validated. Be okay with change or being wrong.

Well, that was a lot!
Thanks for anyone who hung in to the end. I welcome your thoughts and comments as always.

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Which one is better for conquering chronic back pain?

PIlates, yoga, Tai chi, mediation, physical therapy? All of these things offer a wide range of techniques and approaches.

The answer is - whichever works best for you.

The research does not specifically support that ome modality is better than another across the board. Lots of things work depending on the person.

Evidence does clearly support movement and exercise as THE best treatment for long term back pain.

Of course I will say that intelligent strength training and even intentional walking programs are also well supported and work very well.

So, find what is best for YOU. Don't give up on movement as medicine.

It works!

Does alignment of your knee matter when it comes to function or pain?

We see people who have varus aka "bow legged" and other with increased valgus, or "knock-kneed" performing just fine in sports amd life.

When these anatomical variations do cause problems and are fully evaluated, movement professionals should be examining the hip and feet of clients who have problems.

We cannot change our anatomy but we can improve function.

Knee alignment extremes are often related to what is happening at the hip joint. Clinically, i see this often. Weak hips contribute to, or even cause, painful knees.

Over time, the knee can develop pathologies due to these anatomical issues. We need to train specific muscles and integrate all of that into movement training.

Studies on ACL injury prevention support the notion that working hard on core and hip stabilization along with global strengthening throughout the quads and hamstrings is the best formula we have to minimize ACL tears.

I tore my ACL and cartilage a long time ago. The injury and subsequent surgeries led to arthritis that prevented me from doing lots of things I love. Hiking was the biggest limitation for me. As a Colorado guy with a super fit wife and two young kids, I was simply not okay with that so we opted to get this thing fixed.

After knee replacement I have struggled. We took this picture the other night. Amazingly I have never really looked at my knee like this. It is wobbly and painful and constantly swollen.

I can do things with my feet planted, such as ketttlebell exercises, but walking is a nightmare still.

The alignment of my knee is screwed up. In this picture, my tibia is way out of alignment. It was never out to the side as it is now. Basically they did not perform a good surgery. My surgeon said about five degrees angle is normal. If I measured I'm sure this angle on the inside of my knee is much more than that

I had a nerve injury initially. We conquered that after about 6-8 months. Now, my leg seems to be crooked. It feels like it is dislocating inwardly and then sliding back in. No wonder why this thing has hurt so much.

This is not my fault. I do the things. It's getting worse and there is nothing I can do except go in for another surgery.

This must have happened for a reason. Maybe it is for me to better help others as I move forward. And teach students.

Though it sucks, there must be something good that will come out of this.

So, alignment matters a lot when it is not your native alignment. If you have knee or hip issues, the best thing you can do is work on muscle imbalances and build strength and control.

In this way hopefully less people will need knee replacements down the line.

Let me say though that most people do very well with knee replacement and they are very glad they did it. My case is a major outlier.

For me, I'm staying in shape to the extent I can and will go into the next surgery with a good mindset and physical readiness.

The other point is that sometimes s**t happens. It happened to me. I don't understand why but I have to keep moving forward. You don't have to remain a victim.

Adversity always teaches us something if we look for the meaning and apply what we learn.

Never hesitate to get a second opinion.

Keep the faith and you will overcome. Stay resilient!

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Please remember that strength training is not body building.

You will make excellent strength gains without putting a ton of muscle on by training 2-3 days per week. Full body workouts are great for this.

As gym bro status continues and the new year approaches, there is no need to do one body part per day. You don't need a "shoulder" day and a "back" day. And remember the legs have lots of muscles so they should be trained not just on 'leg" day but rather included on every workout ideally.

This is for those of us looking for general fitness and strength as well as longevity and confidence. Not to mention if you are trying to conquer pain.

Biceps only need a few sets to stay or get stronger, for example.

You can be way more time efficient and get excellent results with strength training.

Being stronger makes you more resilient and have less joint pain. The arms will get trained a lot just by doing pushing and pulling exercises. So if time is a factor, you can skip the arm isolation.

Use the big movements for best results.

Strong legs and hips means less back and knee pain.

Just a friendly reminder.

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Chilly morning for a bike ride to work!

I do believe we need to embrace a little discomfort here and there. Makes us tough and resilient.

Maybe that is also the east coast, blue collar guy in me.

Things are too physically easy now in our culture compared to the old days.

Just some thoughts.

High reps with light weights will not help you lose weight, get stronger or reach your goals.

Challenging - heavy weights with mixed rep ranges including higher reps such as 10-20 and occasionally even more, WILL do the the job.

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Great time doing a kettlebell workshop with these amazing people.

Degenerative disc disease might be the worst term ever.

Imaging will always show normal changes related to aging. That doesn't mean you have a "bad back" but it does mean you are a human being.

There can be times when a nasty image shows something relevant. But generally, having "degeneration" in your 30s, 40s and so on is NORMAL.

Please understand you are not your x- ray or mri. Don't fall into the trap of radiology reports defining what you are capable of. Our spines are not fragile. Make yourself stronger and more mobile, and your spine will be happier.

Stay resilient.

Just a point of clarity.

I do not accept insurance with this business model.

Some people ask why that is.

If you want to use insurance, I can help you get that set up or refer you out to another provider.

Insurance companies often try to tell us what to do and restrict us. You have deductibles, co-insurance, co- pay etc...

This is a concierge model where i work for you, without any insurance stuff to deal with.

Sometimes, paying per visit and getting whatever you need addressed on your own terms is easier and less costly.

There are no referrals and minimal paperwork needed here.

In most insurance-based settings, maintenence and prevention, unfortunately, are not covered service.

Yet those are two of the areas that I specialize in.

I am trying to keep you out of the doctor's office and out of the PT clinic.

My point is - there are different methods to get the care you need and deserve. It depends on your current situation. Both routes have merit.

It doesn't matter to me to be honest. I just want YOU to get what you need.

If you need to be seen periodically, it probably doesn't make sense to go through your insurance.

For example, I see a psychologist. I pay her out of pocket. My insurance has some degree of mental health coverage, but I don't feel like going through all the BS and then paying whatever co-pay, having restrictions and denials, not to mention the privacy factor.

If, on the other hand, you had a surgery and need ten visits of PT, it makes more sense to do that in the clinic setting.

Up to you. Just realize you have options and choices.

Please let me know if you have questions.

Here to serve.

Stay resilient.

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Worth a repost.

Finished our Advanced Spinal Manipulation course with a presentation. My partner and i talked about cervical imaging and i led the talk on concussion. It was great meeting with some very intelligent PTs.

I treat lots of people with neck pain, concussion and headaches. The research is very supportive of manual therapy to help these conditions.

Cool thing is, I feel like my understanding of treating the neck and back has gone to the next level.

If you need help with neck pain and headaches, I am here for you.

There is no need to live with discomfort when sometimes the solution is a good evaluation and hands on treatment.

Last week I was able to eliminate a headache for a patient who has been dealing with it off and on for 3 months. All it took was two techniques!

That is not always the case, but when it works, it can be life changing.

Stay resilient!
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Struggling with your activity of choice sucks.

I am nearly 11 months post knee replacement. Unfortunately I had some complications and am still not where I want to be.

My sweet 5 year
old year old daughter handled the hike today better than I did. Of course my machine of a wife had no problem. Our older girl was complaining but that is a different story...

I felt like a weak old man.
My head was spinning as I had trouble going up the unsteady surfaces and worse on the way down. Cateful and cautious. Stuff that should be easy. I don't trust my as***le of a leg still.

To be fit and strong yet not able to hike well really sucks.

We live in Colorado, in part because we love the mountains.

What I realized is that I absolutely have to keep working at this, as upsetting as it is.

Many people face all kinds of adversity all the time. It can be tiring. Mentally exhausting.

But you know what - keep fu***ng moving. Keep challenging yourself. Lest we fail to improve.

Face the hard things head on.

The last portion of the hike I tried to pick up my pace a bit. I was pi**ed. I didn't fall and I finished the hike.

Adversity is something that makes us stronger and gives us perspective.

We need to learn from the hard times. Keep faith and keep going.

I see patients daily dealing with all kinds of hard s**t. And I will keep reminding you all that it is okay to have struggles and be upset. But is is NOT okay to roll over and give up.

Never.

When you need help, reach out.

Stay resilient!

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This is the first official weekend of Fellowship training in the orthopedic manual physical therapy program. This class is advanced spinal manipulation. Not chiropractic, Many people are not aware that physical therapists also are licensed to perform spinal manipulations.

A Fellowship, as people have asked me what that means, involves advanced training in a particular area of study. I think of it as Jedi level training. It is hard work, but worth it.

The medical field is not in a very good place and we all know it.

I refuse to let patients slip through the cracks. Patients deserve to be heard by practitioners who listen, care and THINK about how to help you.

This is the main reason I keep pushing my career to the next level. I strive to be the best non-surgical orthopedic provider you have ever worked with. And to help you get better.

These classes teach high level skills with sound clinical reasoning. In other words, everything has a purpose rather than everyone getting the same treatment.

I thank my amazing wife Julie for supporting me in this endeavor.

Hope you are all doing well. Let me know if you need anything.

Just an update in case you don't hear much from me on social media.

Stay resilient!

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How do we take care of spirit and soul? Do we even know what those things are? Big existential questions with answers lying withing each person as an individual.

Could be getting into nature. Or church. Therapy. Or vacation. Go for a walk. Watch a movie. Read a book. Meditate. Practice breathing exercises. Thinking well. Apologize for something you did. Go on a date with your spouse. Be honest with yourself and others. Be kind and generous.

Lots of options. Life is busy for most people and we can forget to take care of our own soul.

Tune in to your inner self and see what it thrives on. Are you anxious and in a state of unrest? If so, why.

Just don't ignore that pillar of wellness and try to push it down. Whatever it means to you - it matters.

These things can contribute to physical pain, which is ultimately what I help people conquer as a PT.

But pain is SO mutifactorial...

The Body Keeps the Score, as written by Van Der Kolk.

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How do you feel?

Meaning how do you feel inside and out?

Consider all pillars of wellness including:

Mind
Body
Spirit/Soul

Are you attending to all of these needs?

Because all of the above are part of the wellness equation. Left unattended, any of these pillars can create an imbalance throwing off the whole body.

This has become crystal clear to me. Finally, more than halfway done with my life.

Working with a psychologist and finding a welcoming church we love, have both been game changing factors for me personally.

I wanted to share my thoughts because many people are struggling in one way or another.

ALL the things matter - mind, body and spirit.

Some people are in extremely good shape physically, yet their mind is in constant turmoil.

Or, you can be mentally healthy and happy yet be out of shape, physically weak and have health problems like pain, obesity and high blood pressure.

See what I mean?

Assessment of your own situation should offer insight.

Have a great week folks.

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Of all the health problems that have become "normal" these days, high blood pressure and high total cholesterol are on top of the list.

Obesity and diabetes, the cousins with a precursor of metabolic syndrome, are two other related conditions.

The cool part is, we can increase our good cholesterol, HDLs, with strength training. LDLs are the not so good cholesterol. We want the total number to be below 200 at most. High HDLs (over 40 -60) are a good thing. High LDLs are not so good.

Diet is of course pivotal as is cardio.

We see yet another benefit of strength training. It's not just about the bones and muscles. Our entire physiology improves too! That includes mental health.

You can take a pill. The easy way out. Or you can go lift some weights. Challenging weights, programmed intelligently, 2-3 times per week is all it takes to realize the endless benefits over time.

Being strong mentally and physically is protective against all the challenges in life.

You are not too old. Or too broken. And you do have time. Can you tell i have heard all the excuses?
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Stay resilient!

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