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badchad

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About badchad

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    http://absolutept.com/index.htm

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    Phoenix, AZ
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    Chad Reilly

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  1. Yeah, that's an interesting phenomenon isn't it? I think it can take weeks to months to get the tendon to remodel and back to full strength, but the pain reduction is almost immediate. Years ago I used to do all the same exercises followed by massage and ultrasound and I thought the exercise made the muscles and tendons stronger, while the massage and ultrasound made the tendon feel better. It took me years to figure out that it was the exercise itself that makes the tendons feel better and the massage/ultrasound was doing almost nothing. Counter-intuitively the exercises didn't work unless the weights were heavy enough to really stress the tendon. Even having read all the research on the subject, I didn't get a true appreciation for how it worked until the last time I got 'shooter's elbow' myself. If I missed a few days of training my pain came back worse, but if I did the exercises daily, strength rapidly returned while pain dissipated. So it's really cool to see you are finding the same thing. I tell people to just "keep trudging," and way more often then not I tell them to "go heavier."
  2. That makes perfect sense, but I can vouch that even if all you own is one pair of 10lb weights (or 1 pair of 15lb weights), and even if they are in a froofy feminine color because you stole them from your wife's old aerobics gear from her 20's, you can see terrific results. I have literally zero elbow pain now. I pretty much just added the exercises to my very light 25 minute twice a week weight routine, and then I also use them for cooldown after dry-fire once or twice in between lifting. Yeah, I expect you are right. If you only had 3 lb or 5 lb dumbbells it might not work very well, nor would it probably work with only 50 lb, but 10-15s is probably getting in the ballpark. If I just had one fixed set of dumbbells I'd be inclined to progress by just adding reps. Maybe doing sets of 20 or 25 reps, instead of just 15 reps. I'm trying a new thing with Achilles tendinopathy where I just have people do single leg calf raises, 3 sets of as many reps as they can, and just adding reps as they get stronger. So far it seems to be working fine, and doesn't require any equipment other than a step. I think you want to get the stress from the exercise higher (but not too high too fast) than it is during daily activities, in this case shooting, or else the tendons won't be forced to adapt positively. Too light a weights seems to be the case when most people go to physical therapy and the therapist is so worried about making things worse that they don't use enough weight to make things better, then they drop therapy, and get a cortisone shot that in the long run is worse off than no treatment.
  3. You're welcome on the info, glad it's working for you. Even if things aren't exactly like I do them, I think it should still work. I still experiment with variables to see if things work better or worse, but with everything working pretty well, it's hard to tell the difference. Most of the research on exercise and tendinopathy shows any exercise is better than none, so right now I think it's all about honing in on the right amount; resistance levels, sets, reps, exercise selection, rate of progression, etc.
  4. Thanks for the exposure, I hope this works out well. I wouldn't sweat the pain from the pipe wrench, those things tend hurt for a few days but I don't think really set you back. I tell my patients to just keep lifting and shooting, and that it's better if they don't think of their tendinopathy and the ups and downs as a big deal. Sounds like you are doing things about 90% like I do them so I expect it will work. Difference I usually do is, use each exercise with an easy set (kind of a warm-up) a medium set (where you are working pretty hard but technique is real clean) and a hard set (where when once you have worked up to, you can't get all 15 reps with full ROM or without a little cheating). Also I don't intend for all the exercises to be done with the same weight. Curls might be more than triceps, wrist curls should definitely be done with heavier weights than reverse wrist curls. If you or anyone has any questions let me know. Oh, and don't let your doctor give you any shots!
  5. I would have my patients stick with the 40s on 3rd/heavy set even if they can't get 15 reps. For rehab I stick with a goal of 15 reps, but if on the last set someone can only do 8 or 12 reps, or whatever, I just have them stick with that weight until they can do 15 clean reps, hoping to add maybe a rep or two every day or every few days until they get 15, then move up again. I think you should be training at an intensity where you CAN'T get 15 good clean reps on the 3rd/heavy set after maybe 5 workouts or so. 40 lb is pretty strong BTW and better than most of my patients get to when their symptoms resolve. If your bad arm is still weaker than your good arm I would still recommend daily exercise but once they are equal you might reduce the frequency to doing the exercises 2-3 times per week to give you a bit more time for recovery and at that point the pain is generally down enough that daily exercise isn't as important. For general fitness I think 15 reps are on the high side, so I would lean towards increasing the weight and decreasing the reps to maybe 8-12, which in my rehab programs for tendinitis 8-12 clean reps is probably where you will start to end up on your 3rd set anyway when you do plateau. Usually a plateau isn't usually a true flatline, it's just where the gains get slower and harder. Also I think it's important to either shoot or dryfire daily (even if only 10-15 minutes) so your elbow gets/stays used to the stress of gripping the gun. Also the best case scenario is the pain goes away in a few weeks, the worst case scenario is 75-90% of the pain goes away in a few weeks but the last 10-25% lingers for a few weeks or maybe 3 or so months. That's still pretty good, and fairly normal if you had a bad case of tendinitis to start with, but if you keep plugging away eventually the pain will be less and less and then gone for good. Thanks for the questions and let me know how it turns out, or if you have more questions, my treatment improved by listening to the feedback of other shooters so I'm always interested in individual experiences.
  6. That's worth extra emphasis. The exercises target all the right muscles and tendons, but if you don't increase the weight they won't cause enough adaptation to do any good. I want the weights heavy enough to hurt some. I do back off a bit though if it bothers a persons wrists, but that's not too often.
  7. There are pros and cons with doing both knees at once. The pros are exactly as you say, you just get the surgery over with and the rehabilitation is half as much. I've worked with a few bilateral knee replacements and they went great, and I even made a video of the rehab of one patient just 5 weeks post op. https://www.youtube.com/watch?v=A2G_994rSrw The con is that it's a more risky procedure, with greater risks of serious complications during and afterwards so there is debate regarding whether the benefits offset the risks, and subsequently only some surgeons perform them and generally only on lower risk patients. The patient in the above video was otherwise healthy, wasn't overweight, etc, so her risk factors were few.
  8. I'm glad you guys like the video. If you haven't seen it, here's the accompanying blog... http://absolutept.com/shooters-elbow/ ...in which I talk about the research behind the exercises, my experiences, and other details like whether you should rest or not, how often to train, how much weight to use, how much pain you should train through, how well and how fast it works, what not to do etc. Thanks again for the feedback!
  9. I hear that often and it puts people off from getting replacements but research suggest the total knees last a lot longer than that. Greater than 85% survive at least 20 years. http://www.ncbi.nlm.nih.gov/pubmed/20814772 I tell my patients that if their knee arthritis is really holding them back from physical activity they should probably get it replaced. If you wait too long inactivity will make the rest of the body fall apart, which could include things as bad as heart attacks. So I don't think anyone should rush into the procedure but I think a lot of people put it off for too long. Also besides enduring the pain and health problems from inactivity, weight gain from inactivity makes you a higher risk surgery with much larger risk of serious complications. http://blog.tarlowknee.com/2012/10/obesity-doubles-failure-rates-after.html
  10. Partial knees generally recover faster than total knees because the surgery is less invasive and you save more of your normal anatomy, which is usually still better than artificial anatomy, so if you are a good candidate for a partial I would recommend you do it. As someone else mentioned you want a surgeon who does your surgery all the time and that's true. Statistically outcomes are best with the surgeons that do the most of that particular surgery. You could likely do stand and shoots in a couple weeks but you probably won't be moving well until some time after that. I would recommend you shoot when you feel like you can. If you start shooting too early you might swell up and have some more pain for a while but it's unlikely you will ruin something. Some kind of compression wrap or stocking might help prevent the swelling. What might be a problem early on is how long you can tolerate standing on your feet, so maybe test that out before you go to a match and when you do go, bring a folding stool that's not too short. Most people get better (than they were before surgery) in 2-3 months but compared to uninjured control subjects of the same age, they never get full strength and speed back. I think this is for a lot of reasons, including people stopping working on it too soon as they are happy to feel better, and they don't even remember what "normal" feels like. Other factors include insurance running out before you are full strength, your doctor discharging you because you have good range, and PTs who like to massage more than they like to work on strength and stamina. Hip abduction strength is very important (and correlates more with function than quadriceps strength after knee replacement) and can be started immediately as it does not stress the knee. Be sure to strengthen your good leg too because one of the best predictors of outcomes after knee replacement is contralateral (other) leg strength. Probably one of the best things you can do is prevent muscle loss after surgery in the first place rather than try and get it back later with electric muscle stimulation to the quadriceps and hamstrings immediately after, if not before surgery, which is supported by a lot of research but I believe is underappreciated by most surgeons and physical therapists, so you might have to ask for it. I've recently started blogging and I go into a lot more depth on most of these factors here: http://absolutept.com/tag/total-knee/ Good luck! PS, I was Rob Leatham's physical therapist for both his knees.
  11. But aren't the 10 commandments more of a Jewish thing? I personally have never met a Christian who made any efforts with the 2nd commandment regarding graven images or the 4th about not working on the Sabbath. Like others have said, I figure if you don't mind watching the murders, you shouldn't mind hearing the blasphemy.
  12. I posted this gun and gear a while back but never sold it.

    http://www.brianenos.com/forums/index.php?showtopic=131680&st=0&p=1492030&hl=badchad&fromsearch=1entry1492030

    I would sell it for $700 plus actual shipping. I have a guy who says he wants to buy it but he hasn't come up with the money it, so if you want it let me know.

    Chad

  13. I would be worried the .45 might not run reliably at 135PF. I don't know of anyone that's done it with an XDM but I know others have had problems doing the same with other platforms. I'd would, and do, shoot a 9mm over a .40 myself.
  14. How much more is OD worth these days?
  15. I finished my spreadsheet with a lot of new material since I wrote my paper. http://absolutept.com/tendinitisresearch.php I'm working on a tendinitis/tendinopathy FAQ that I plan to place above the table that I can continually update as I add new research to the table, and I plan to have one of the questions address shooters elbow in particular.
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