Behind the scalpel: Spotlight interview with Dr. Eve Hoffman

 

I recently had the pleasure of interviewing Dr. Hoffman, a spine surgeon from Summit Orthopedics, in the latest edition of the CHP Spotlight Interview Series. The mission of the CHP Spotlight Interview Series is to provide you with valuable insights from leading experts in the fields of sports medicine, physical therapy, personal training, and performance. With the overwhelming amount of information available today, it can be challenging to find the most credible advice, especially when it comes to managing back pain. We’re here to help by bringing you the best information from top professionals in Bethesda, Chevy Chase, DC, McLean, and Northern Virginia.

If you or someone you care about is dealing with chronic back pain or has suffered a spine-related injury, you won’t want to miss this interview! Dr. Hoffman shares her expert perspective on managing back pain, from non-invasive treatment options to when surgical intervention may be necessary. She explains how patients can take control of their back health, what factors increase the risk of injury, and what you can do today to reduce your chances of developing serious back problems.

As a highly skilled spine surgeon, Dr. Hoffman specializes in treating a wide range of spinal conditions. Her approach prioritizes non-surgical treatments whenever possible, such as physical therapy and lifestyle modifications, to help patients manage pain and improve function. However, when surgery is the best option, Dr. Hoffman is experienced in performing complex spinal procedures, including minimally invasive surgeries and advanced reconstructions.

If you are experiencing back pain, whether you’re an athlete, someone with an active lifestyle, or simply trying to manage daily activities, this interview is for you. Dr. Hoffman offers valuable insights into how to prevent, manage, and treat back pain for long-term relief.

 

Spotlight Interview with Nutritionist, Dana Monsees

How Do We Protect Our Lower Back When Lifting Or Playing Sports?

We had a blast hosting the CHP deadlift lab right here in Bethesda!

During the workshop we learned how to optimally create internal pressure in order to protect our lower back when lifting weights. This is one of the first things that we teach in physical therapy and is of particular importance for people that lift weights or play sports.

As human beings, we protect our lower backs by creating intra-abdominal pressure. This is the pressure that we create within our abdominal cavity and increases the stability of the spine.

As an example, imagine that you are going to lift the heaviest object that you can off of the floor. What is the first thing that you do?

Most people take a big breath in and then brace their abs.

The purpose of this action is to create as much pressure as is possible within your abdominal cavity, thus creating the maximum amount of stability possible for the spine.

This is a great thing to do as you are performing one repetition of an activity with maximal effort, however is not sustainable for a longer period of time.

In the video below, Dr. Cody is teaching us how to most effectively create pressure when deadlifting so that we can protect our lower back. The principles Dr. Cody is teaching applies to all activities that we perform in the gym, and many out of the gym as well!

How to brace effectively

The next time you are lifting something, it may be worth asking yourself if you are feeling your lower back. If so, attempt to exhale fully to find your abs before inhaling to build pressure. In addition to abdominals, you should be feeling hamstrings and glutes.

Now give it a shot!

What Can You Do To Avoid Skiing Injuries This Winter?

Every winter here at Cohen Health and Performance, we see a rise in a very specific type of injury that brings people in for physical therapy.

Bethesda is full of skiers and related injuries start as soon as the snow starts falling.

The injury rates in skiing and snowboarding are particularly high for a variety of factors.

Many new skiers or snowboarders simply do not know how to fall properly. Falling is a part of these sports and there is an effective way to do it. This is typically the first thing that a ski or snowboard instructor will teach a student and may be worth a second lesson!

Most injuries that higher-level skiers or snowboards experience are related to overuse injuries.

These overuse injuries often occur due to mobility restrictions in the hips. Both sports (specifically skiing) require an adequate amount of hip mobility as the body bends into and out of turns. Furthermore, ankles are locked into bindings that limit ankle movement and place more emphasis on the hips to take up the slack.

How do you know if you have enough hip mobility? I’m glad you asked!

The video below illustrates a drill called a hip CAR (Controlled Articular Rotation). This drill provides an opportunity for you to explore all of the available range of motion that your hip currently has. It is also a great drill to do daily to keep the hips moving!

Hip CARs

With this drill you may notice that your hips feel stiff. If so, it would be beneficial to increase your available hip motion so that you can reduce your risk of skiing or snowboarding related injury.

Commonly hip internal rotation and hip external rotation are limited. If you noticed limitations in either of these motions, give the exercises below a try! Remember to stop the activity if any pain or discomfort is present.

Hip External Rotation PAILs

Hip Internal Rotation PAILs

Should You Be Purchasing A Fitness Gadget This Holiday Season?

Recently, my inbox has been filling up with all kinds of holiday offers. Black Friday, extended Black Friday, cyber Monday, and various other holiday sales.

Many of these sales and offers have been for health, fitness, sports medicine and rehab related tools such as foam rollers, hypervolts, smart watches, fitbits, etc.

How do you know if any of these tools are beneficial to you?

The answer ultimately comes down to whether or not it will help you reach your health and fitness goals, and if you will actually use it.

The first step to determining this is to figure out what your goals are. Most people have an idea of why they are exercising, however, rarely are they crystal clear on what they are trying to accomplish. What are you trying to accomplish by going to the gym, playing a new sport, or running regularly? Are these goals clear enough to write down? Are they measurable so that you can easily determine whether or not you have achieved them?

If you cannot answer these questions, then I would think twice about purchasing a fancy piece of fitness equipment/technology.

Once you answer these questions, ask yourself if the tool in front of you will help you achieve your goals. Will a foam roller help you lose 10 pounds? Will a smart watch help you set a new personal record on your half marathon? Will a fit bit help you move every day?

It is easy to see how a piece of tracking software can help you monitor your runs, allowing you to optimize your performance. Therefore, this would make sense if you are an avid endurance athlete.

Furthermore, a fit bit is a fantastic tool when your goal is to move every day (it also helps make your goal measurable!)

A foam roller or hypervolt is a great purchase if it helps you feel better, thus, allowing you to exercise more effectively and reach your goals. However, if you have never noticed any results from using these tools, then do not buy them, no matter what the advertising says.

Soft tissue tools such a foam rollers and hypervolts work based on the placebo effect. If it feels good and you think that it is working, then it likely will. However, these tools do not “break up” tissue, or “re-align” muscles as is often advertised. If our bodies were that fragile, we would fall apart walking up the stairs!

Finally, you need to determine if you will actually use the fitness tool that you are thinking about purchasing. Even the best tool is useless if you do not use it.

Is the tool difficult to use? Is it a challenge to take to the gym with you? Is it a pain to set up? Does it take a long time for it to be effective?

If the answer is yes to any of these questions, then it is far less likely to be used for more than a short time period.

This is not a fault of yours, it is simply human behavior!

There are many great health/fitness tools and gadgets out there, however, no single tool is right for everyone. Make sure that the tool you choose is right for you. Sometimes the right tool is none at all!

Why Sprinting Is Essential For Distance Runners

At CHP, we often see distance runners for a variety of injuries including knee pain, plantar fascitis, and hip and lower back pain.

We also see many runners for performance improvement.

There are many things that can be done to help a runner both recover from an injury and positively improve their performance. However, one of the most overlooked pieces of a runner’s training program is sprinting.

Simply put, sprint training teaches the body how to move fast. This is important because the greater speeds that a runner is capable of running, the easier it is to run fast for extended periods of time.

For example, if someone wishes to run a marathon in 4 hours or less, this person needs to average 9:09 minutes per mile. Prior to incorporating sprint training into their routine, this person may have been capable of running 14 mph at maximum speed. After sprint training, this person is now capable of running 15 mph at maximum speed. Due to having a faster maximum speed, running a 9:09 minute mile is now less taxing on the body, therefore requiring less energy to sustain this pace.

Sprinting also helps to improve running technique because it requires a great deal of hip and knee flexion (i.e. action of the legs in front of the body). It can break a runner’s habit of kicking their legs far behind them, which often causes them to reach their leg far out in front of the body at initial foot contact.

Furthermore, when sprinting, the body is generating and absorbing forces that are far greater than what the body experiences when distance running. This prompts the body to adapt and become more resilient of tolerating more stress.

So how do you incorporate sprinting into your training program?

Begin by performing the drills below 2-3 times per week. These drills train the body to generate more force into the ground. The more force you put into the ground, the faster and more efficient you are as a runner!

In the video below, Dr. Alex Immermann is performing all 4 activities.

The first activity is “A Skip”. If skips are a bit too difficult, slow things down and perform “A March” (activity 2). Next, practice snapbacks and stepover drills. Start with 4 sets of each for a 10-meter distance.

Let us know if you have any questions, or would like help in learning how to optimize your training.

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