Legacy Therapeutics

There is no losing; only learning.
There is no failure; only opportunities.
There is no problems; only solutions.

All you can do is learn and come back bigger, better, stronger. All it's going to do is leading you to the right direction.

Don't bury your failures, let them inspire you.

At some point in our lives, we've all been touched in one way or another by someone facing mental health challenges. We've all had those moments of struggle, whether we admit it or not. It is just a reality we can't escape.
In today's fast-paced world, we live in a totally individualistic society that teaches us: 'You've got this,' 'You'll be fine,' 'Self-improvement,' 'Self-esteem,' 'Self this' and 'Self that,' and nothing to do with group affiliation. We are encouraged to be solo, which there is nothing wrong with, but in my opinion, true growth only happens within a community. Never in history, but now, humans have not lived in tribes, and I want to thank , our Mental States Transformation therapist, for reminding me of that.
You cannot get to the next version of yourself unless you deal with the old version of you, both mentally and physically, and just because no one else can heal or do your inner work for you, doesn't mean you can, should, or need to do it alone.
📸 Yusufoisinproductions

Teach people how to think, not what to think!
I’ve discovered over the years that teaching people how to think, not what to think, is a game changer. When you preach values and choices over rigid rules, it sparks creativity and a sense of ownership within your team and that is a recipe for success.
Let’s be honest, nobody likes to be told what to do and that’s why I try to break the traditional norms with my team. I’ve always focused on empowering them by nurturing their ability to think in their own rather than making strict rules.
When your team can envision your vision and see what you see, the true magic happens 💪

Let me take you back to the day I met Jill ( ABLY BY JILL ), the force of nature who has graced our team at . From the very beginning, I saw sparks of her potential, but little did I know the magnitude of her dedication and hard work. The more I got to know her, the more she reminded me of my early days with Legacy Therapeutics. And let me tell you, with all humility, Jill put in more effort than I ever did back then. She's a force to be reckoned with! No finger-pointing when things didn't go as planned. Instead, she rolled up her sleeves, ready to dive headfirst into the beautiful chaos of our ongoing mission.

In my six years of running this business, I've never encountered someone so willing to go above and beyond, pouring their heart and soul into their work with infectious enthusiasm.

Jill, my dear friend, words simply fail to express how blessed I am to have crossed paths with you. You've become an integral part of our Legacy Therapeutics family, and our gratitude knows no bounds. As you spread your wings and embark on your own incredible journey, opening your own business, I want to take this moment to express my deepest gratitude.

For the next few days, while Jill is still with us, seize this golden opportunity to experience her incredible talent firsthand. Book a session with Jill, and prepare to be amazed by her magic touch. Trust me, you won't regret it!

And to Jill, remember that you've got an army of support behind you. We believe in you with every with every fiber of our being, and we cant wait to witness the incredible heights you will reach.
📸.eyemedia

Whether you're recovering from an injury or just trying to get back into your regular routine, the path to recovery is often a little bit confusing. On the one hand, you want to feel better - It's not fun to be hurt! But on the other hand, you also want to get back out there and do what you love.
We know that recovery is important. It's how we get back to our baseline performance after an intense workout or injury. We also know that it takes time for our body to recover fully, sometimes even longer than it did before the injury!
That's where recovery and adaptation come in. These two concepts are often used interchangeably but they are not the same thing at all. Recovery refers to the acute restoration of performance capacity (short term) and adaptation refers to the changes that happen over time such as improvement in muscle capacity, and the cardiovascular system.
Over the last few years, studies have shown that what may be good for short-term recovery may not necessarily be good for long-term adaptation.
Let me give you an example. If you're recovering from an Achilles tendon tear, icing the area may help reduce inflammation and help with soreness by removing the signal of pain, but in the long run, it may reduce adaptation by delaying the healing process because inflammation is an essential part of recovery and anything that reduces inflammation also delays healing (Wang & Ni, 2021).

www.legacy-therapeutics.com
📸

Jeukendrup, A. (2015). Rapid recovery versus long-term adaptation. Retrieved from: http://www.mysportscience.com/single-post/2015/06/15/Rapid-recovery-versus-long-term-adaptation
Wang, Z. R., & Ni, G. X. (2021, June 16). Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? Retrieved from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173427/ #:~:text=Although%20cold%20therapy%20typically%20slows,not%20hasten%20the%20recovery%20process.

You've probably heard about the "six-pack," but you may not be too familiar with the term “core”. That's because there's more to core training than just having a nice six-pack.
Our core is made of many different layers of muscles including transverse abdominis, multifidus, internal and external obliques, erector spinae, diaphragm, pelvic floor muscles, and the re**us abdominis (THIEME, 2021). Altogether these muscles that made up our core have the function of protecting and controlling posture, stabilizing joints, generating movement, and transferring energy between limbs and between the upper and lower body as well as participating in breathing (Shveyd, 2014).
Core muscle weakness can lead to health problems such as lower back pain according to Dr. Stuart McGill an expert in back pain mechanism and rehabilitation (McGill, 2014). We can optimize our core health through bodybuilding type of exercises but, a great program is designed by taking into consideration variables such as lifestyle and sports. For example, a powerlifter will benefit more from a plank exercise rather than crunches or sit-ups because that specific sport requires less spinal mobility and more spinal stiffness.
Core stiffness is essential for injury prevention, and it can't be optimized through various types of exercises, the most popular being crunch exercise. There are many ways to develop a strong core according to experts including adding an instability/imbalance component to your routine.

www.legacy-therapeutics.com
📸:

📚
McGill, D. S. (2014, 11 30). Why Everyone needs Core Training. Retrieved from backfitpro: https://www.backfitpro.com/everyone-needs-core-training/
Shveyd, L. (2014, March 03). Core Composition and Function: The Core of 2014 Part 1. Retrieved from functional movement: https://www.functionalmovement.com/articles/406/core_composition_and_function_the_core_of_2014_part_1
THIEME, T. (2021, Jan 25). What Trainers Mean When They Talk About Your 'Core'. Retrieved from menshealth: https://www.menshealth.com/fitness/a35307843/core-muscles/

The prevalence of tendonitis has risen in recent years, and it is estimated that as many as 90% of patients will experience some form of tendon pain at some point in their lives.
We know that tendon pain can be a real bummer. It's frustrating, it makes you feel like you're not living up to your fullest potential. But what if I tell you that your diet can lower the risk of tendon pain, would you believe me?
Well, here's the thing: Visceral fat is very pro-inflammatory, and it drives a lot of systemic changes and inflammatory changes in the body. In turn, this increases a person's chance of developing diabetes and insulin resistance which can lead to high cholesterol. As regards the implications in tendons, cholesterol can deposit in tendons and a very high systemic cholesterol can directly affect tendons. More importantly, diabetes has a profound effect on tendons. It stiffens the tendons, gets more cross-linking, and changes the response of the tendons to the load.
So if an increase in weight has been noticed during the period of time the patient has started experiencing tendon pain, it is wise to recommend them to have some test done to check their level of cholesterol, to check if they are insulin resistant or sensitive and if they have type 2 diabetes.

www.legacy-therapeutics.com

📚 Ahmed, A.S. (2016). Does Diabetes Mellitus Affect Tendon Healing? Advances in Experimental Medicine and Biology, 179-184.
📚 Ranger, T.A., Wong, A.M. Y., Cook, J.L.,& Gaida, J. E. (2015). Is there an association between tendinopathy and diabetes mellitus? A systemic review with meta-analysis. British Journal of Sports Medicine, 50(16), 982-989.

When it comes to injury prevention, there's a lot of talk about flexibility and strength. It's important to be able to understand the relationship between stiffness and elasticity in order to understand why strength training is so important in limiting the risk of injury.
Flexibility refers to the ability of our muscles and tendons to recover their original length quickly after they've been stretched or compressed.
What happens when we're not strong enough? Well, our muscles can't absorb all the energy from an explosive movement (like jumping) or from a sudden impact with the ground (like falling). So instead of absorbing this energy and returning it to us as kinetic energy (energy of motion), it's lost as heat and heat means in this case tissue damage.
We need to make sure our muscles and tendons have enough resistance for explosiveness so that they can absorb potentially harmful energy without becoming damaged themselves!
www.legacy-therapeutics.com
📚
Bahr, R. and Holme, I. (2003). Risk factors for sports injuries - a methodological approach. British Journal of Sports Medicine 37, 384-392.
.
Cos, F., Gómez, A., Guitart, M., Pons, E. (2015). Muscle Injuries Clinical Guide 3.0. In Futbol Club Barcelona and Aspetar (eds.). Prevention of Muscle Injuries (pp.30-41). Barcelona, Catalonia.
Watson, A. W. (2002). Sports injuries related to flexibility, posture, acceleration, clinical defects, and previous injury, in high-level players of body contact sports. International Journal of Sports Medicine, 22 (3), 222- 225.

You know what they say: it's not the pain that kills you, it's the soreness.
Working out is great. You feel better, you look better, and you're more likely to live longer. But there's a catch: no matter how hard you work out, your body is going to be sore the next day.
The good news is that this doesn't have to be a bad thing! The soreness you experience after a workout is a sign that your body has endured a stress higher than usual (NHS, 2017). The body's response to higher muscular stress, is to adapt, meaning that it will get stronger and more efficient to endure a similar type of exercise (Waehner, 2020). Once your body has learned how to cope with the stress it has gone through, you will less likely get sore the next time you do the same training.
The key is making sure that your muscles have enough time to recover between workouts so they can continue adapting and getting stronger (Roberts, 2019).
So, if you've been feeling sore after working out lately and want to get back into the swing of things without feeling stiff or tired while training or if you just want to work harder than ever before, try adding in a recovery program into your routine. And then go crush it!

www.legacy-therapeutics.com
📚
NHS. (2017, november 30). Why do I feel pain after exercise? Retrieved from NHS: https://www.nhs.uk/live-well/exercise/pain-after-exercise/
Roberts, C. (2019, July 28). Workout recovery: Why it's so important. Retrieved from Cnet: https://www.cnet.com/health/why-workout-recovery-is-so-important/
Waehner, P. (2020, February 11). Adaptation and Its Relation to Your Fitness. Retrieved from Verywell fit: https://www.verywellfit.com/fitness-term-adaptation-1230984

You know what's good for you? A healthy lifestyle. You know what else is good for you? Good posture.
Posture is a dynamic state that changes constantly, throughout the day. You're never just "standing" or "sitting." You're always moving from one position to the next, even if that movement is very small. And because of this, you can't treat postural disorders by just isolating posture from the locomotor system as if it was a static state unrelated to the musculoskeletal system—it doesn't work that way! Roaf (1978) defined posture as a temporary position assumed by the body in preparation for the next position. Therefore, static standing isn't really "posture."
When working on posture correction, the purpose of physical exercise is to enable patients to stabilize themselves (developing strength and muscles endurance) (Solberg, 2008). A treatment is intended to improve bodily function as a whole entity and not to cure the isolated symptom of a specific problem alone. If you've ever tried to build a wall, you know that the mortar is what holds it together. If you only use bricks, the wall will fall. Posture therapy works the same way: exercises are important, and they can help improve your posture, but they're not enough on their own.
If we want our patients' postural problems to be treated, we need to look at all aspects of their lives including their diet, exercise habits, sleep patterns, stress levels… basically everything!
Only a balanced combination and integration of therapeutic exercises, posture habits modification and movement patterns correction will yield results overtime.

📚
Solberg, D. G. (2008). Postural disorder and musculoskeletal dysfunction. Elsevier.

📸

Pneumatic Intermittent Compression:
Recovery is the most important part of a training program, and with modern society’s lifestyle, it is crucial to find ways to speed up recovery so that we can move, work, and perform better quicker.
Manual therapy, both the assessment and the hands-on application, is without a doubt the key to optimal recovery.
One of my favorite tools (and probably the one I use the most for my personal recovery) is the Pneumatic Compression device. It is a Class Two medical device that helps with blood circulation. It is used in clinical setup to help prevent the formation of blood clots in deep veins (hopkinsmedicine, n.d) as well as to treat lymphedema (clevelandclinic, n.d). Athletes of all disciplines use compression therapy to improve blood flow, reduce inflammation, increase athletic performance (increase mobility and flexibility), prevent DOMS etc. (Capritto, 2019). That being said, it is important to note that tools cannot diagnose or fix a condition. They are used as helper to assist in the process of regaining health.
Why do we need to improve blood circulation? Veins have small valves that help with blood circulation. A blood clot can damage those valves, causing them to weaken or become leaky, which will affect proper blood circulation. The same damage can happen when we stay immobile for too long or after a recent surgery (ROM limitation) (hopkinsmedicine, n.d).
📚 Capritto, A. (2019, 08 31). What’s a NormaTec? The compression therapy elite athletes love. Retrieved from cnet: https://www.cnet.com/health/fitness/whats-a-normatec-the-compression-therapy-elite-athletes-love/
clevelandclinic. (n.d).
📚 Intermittent Pneumatic Compression (IPC) Device. Retrieved from clevelandclinic: https://my.clevelandclinic.org/health/treatments/14791-intermittent-pneumatic-compression-ipc-device
hopkinsmedicine. (n.d).
📚 DVT Prevention: Intermittent Pneumatic Compression Devices. Retrieved from hopkinsmedicine: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/dvt-prevention-intermittent-pneumatic-compression-devices

If you are into MMA, you‘be probably heard about (Connor McGregor) recent injury during his last fight with . Connor underwent surgery to repair his broken tibia and Fibula, and now that he is no longer in a cast, he has started a pretty intense rehabilitation program.
One of the secret weapons of Connor recovery program is called BFR (Blood Flow Restriction) also known as occlusion training. Personally, it is my favorite method of training and It has been used in clinical setup for decades and it consists of applying tourniquet like device (cuff) proximal to the torso ( as close as possible to the heart) (RUCKLEY, n.d) which limit arterial inflow and fully restrict venous outflow of the muscles involved in the exercise (Stephen D. Patterson, 2019). This exercise/rehabilitation method originated from a training method called Kaatsu. It was created by Dr. Yoshiaki Sato back in 1966 (Jacobs, n.d).
The goal of this type of therapy is to increase muscle strength and mass with minimal load. A regular hypertrophy program requires the participant to perform at 75% - 85% of one repetition maximum (RM) (SMITH, 2021). After an injury/surgery, it is common to notice some muscles hypotrophy and restricted weight bearing on the affected side. By using BFR, we can get a patient to start exercising at a much lower weight (~30% RM) and get the same result as a regular hypertrophy program (Abbasi, 2021).

📚 Abbasi, D. D. (2021, August 23). A Surgeon Explained the Upside of Conor McGregor's Blood Flow Restriction Training. Retrieved from Mens health: https://www.menshealth.com/fitness/a37373217/conor-mcgregor-blood-flow-restriction-training-doctor-explains-david-abbasi/
📚 Jacobs, J. (n.d). New Treatment Trend: Blood Flow Restriction Therapy. Retrieved from BTE: https://www.btetechnologies.com/therapyspark/blood-flow-restriction-therapy/
📚 RUCKLEY, J. (n.d). WHAT HAPPENS PHYSIOLOGICALLY WHEN YOU DO BFR TRAINING? Retrieved from BFRPRO: https://bfrpro.com/blogs/news/blood-flow-restriction-bfr-training-what-is-it-where-did-it-come-from-and-how-can-i-utilize-it-in-my-training
📚…

Muscle contraction refers to the tension on the muscle that produces sufficient force to move an object (Anthony, 2018). When we move or exercise, we display various types of contraction, two of those being concentric and eccentric.
In concentric movement, muscles shorten as they contract, and in eccentric movement, they lengthen under load. Concentric contractions initiate movement or create an acceleration and eccentric contractions slow down or stop movement in order to protect the joint from muscle damage.
For over a decade, eccentric contraction has been a cornerstone of sports training and musculoskeletal chronic health management, which leads us to believe that eccentric contractions are much more efficient for rehabilitation (Hody, Croisier, Bury, Rogister, & Leprince, 2019 ). Let me explain you how it works.

During a concentric contraction, the tension in our muscles increases to meet a certain resistance, which makes us use more motor units, whereas during an eccentric contraction, our muscles lengthen due to an opposing force being greater than the force produced by our muscles, requiring fewer motor units. Eccentric contractions require less oxygen and energy to perform a similar exercise than concentric contractions. They produce force through both active and passive elements leading to higher force being developed. This results in faster hypertrophy, (Beardsley, 2018) which makes this type of contraction more efficient and metabolically less costly, causing less metabolite accumulation as the muscle fatigues. (Proske & Morgan, 2001).
Research by Hackney has shown that for both trained and untrained individuals, an exercise program that focuses on eccentric movement (1 sec concentric & 3 second eccentric) elevates the resting energy expenditure which is the rate at which you burn calories when the workout is over and you are resting (Aaron Bubbico & Len Kravitz, n.d).
📚 Aaron Bubbico, B., & Len Kravitz, P. (n.d). Eccentric Exercie: A Comprehensive Review of a Distinctive Training Method. Retrieved from UNM EDU: https://www.unm.edu/~lkravitz/Article%20folder/eccentricUNM.html
📚…

When we hear posture, we think of a static position, back straight, chin tucked etc.… and overtime it builds in our mind an understanding of posture that is holding our body in a certain way for a certain period.
Traditionally, manual therapists have learned to assess posture by comparing the posture of their patients against images of an upright skeleton. Not surprisingly, the postures of many of us are observed to vary from those represented by the skeletal images that we refer to standard posture. The disadvantage of this approach is that we tend to focus on the parts rather than the whole. What I mean by that is the therapist might observe a client’s neck to have a deviation compared to the standard posture and conclude that the problem is the neck. Yet we need to take a broad view of clients and their bodies to identify the factors causing or contributing to their problems, because where a client experience pain, discomfort, restriction in movement is not necessarily the source of the problem (Johnson, 2012).
The most important basic and fundamental function of our skeletal and muscular system is to create movement. As human, we are a multilimbed dynamic organism meaning that we cannot be defined by only one posture. So, is there such thing as a “good posture”?
Any static state in which the body finds itself is only part of a movement, meaning that posture is a temporarily position held by the body in preparation for the next position. Posture follows movement like a shadow; therefore, a static position is not a good posture (Solberg, 2008).
Our body is designed to move, and we shouldn’t hold a static position for a long period of time.

📚Johnson, J. (2012). Postural Assessment. Human Kinetics.
📚 Solberg, D. G. (2008). Postural disorder and musculoskeletal dysfunction: Diagnosis, prevention and treatment. Elsevier.

Do you have chronic tendon dysfunction? Have you ever wondered why your clinician insists on putting you through a whole range of movements and tests before they treat you? Do you know why your therapist would prescribe you a heel raise exercise versus a jumping box?
When building a rehabilitation program for tendon injuries, different variables come into play. A thorough assessment can allow your clinician to identify the type of load that is causing pain, determine your present load capacity, identify your goal capacity and how to progress from your current capacity to achieve that goal.
.
Excessive loads are what provoke pain. There are 4 types of loads that our tendons can withstand.
- Tensile load: A store and release type of load. This type of load is common with high velocity movement like running.
- Compressive load: Happens when your tendon compress against the bone. A good example is when you raise your foot off the gas pedal of your car (dorsiflexion).
- Friction load: Happens when the tendons withstand low load and repetitive motions.
- Mixed loads: A combination of tensile and compressive load.

These loads do not occur individually, which makes the assessment process more complicated but very important for prescribing the most effective rehabilitation program.
.
It is important to have a discussion with your clinician about your goals from a recovery standpoint. You need to keep in mind that depending on the stage of the tendinopathy, a reasonable treatment goal could be to return to normal (reactive tendinopathy) or in the case of a reactive on degenerative tendon, a more reasonable goal is to manage the pain caused by degeneration. Degeneration is permanent and what we are trying to do as therapists is to improve functionality with minimal to no pain.

Credit photo: Sandy Strikes
📚 Cook JL, Purdam CR. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009;43:409–16
📚 Rogers, K. (2016) Tendon Anatomy [Online image] Retrieved from https://www.britannica.com/science/tendon #/media/1/587171/204856

Understanding Tendon Dysfunction Do you have chronic tendon dysfunction? Have you ever wondered why your clinician insists on putting you through a whole range of movements and tests before they treat you? Do you know why your therapist would prescribe you a heel raise exercise versus a jumping box? When building a rehabilitation p...

Summer is not over yet so I’m going to start operation . My birthday is this weekend and I’m sure I’ll gain an extra 5lbs so I’ll start on Monday 😁
I have 25 more lbs to lose from the first lockdown. I’m currently at 220lbs and need to get down to 190-195lbs.
My normal training routine consist mainly of sprinting, jumping, explosive movements… but at my current weight it’s too hard on my body ( sprint/jump can apply form 6 to 15* body weight pressure on joints and tendons). I like to play it safe so first step is losing weight.
On top of the educational contents, I’ll be also sharing with you guys my weight lifting training and recovery routine.
Onward and upwards! Thanks for the equipments

Tendons were thought to be connective tissues whose only function were to connect muscles to bones. It is true but they actually do a lot more than that.

Their function is subjective to their shape, composition and properties, allowing them to be a mechanical bridge transferring force produced by muscular contraction to bones ( (Bordoni & Varacallo, 2021) and withstand massive loads going up to 15 times the human body weight. Generally speaking, the larger the tendon, the more load they can withstand and the longer they are, the more energy they can store.

Tendons all over our body are not the same. Our fingers and hands tendons are very long and thin which allow greater range of motion as well as skillful movements. They require more glide to perform those movements so tolerating high loads or storing lots of energy is not their priority. That being said, upper and lower appendicular tendons are structurally different.

Understanding tendon loads as well as normal tendon structure and function are critical in order to assess, manage and rehabilitate them.

Contrary to what you have probably learned, tendons are relatively avascular and aneural, meaning that they have very little to no blood supply and nerve tissue. I am here referring to the center of the tendon not the peritendon/paratenon (which is innervated and supplied with blood vessels). The vascularity of tendons is influenced by exercises and muscle contraction meaning that the rehabilitation process of a tendinopathy must include movement-based therapy.

Before getting into the rehab process of tendons, I will be cover in my next post the major things clinicians are looking for when assessing tendons injuries. I will be also touch base on the adaptation to mechanical stress as well as the tendon adaptation difference between men and women.

📸: Elli Yaz
Works Cited
Bordoni, B., & Varacallo, M. (2021, 02 07). Anatomy, Tendons. Retrieved from ncbi: https://www.ncbi.nlm.nih.gov/books/NBK513237/

L-Y Woo, S.,, Góomez, M . A., , Woo Y, & Akeson, W. H. (1982) Mechanical properties of tendons and ligaments: II. The relationships of immobilization and exercise on tissue remodelling. Biorheology.