Physical TheraPT

Daily Foam Rolling

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Myofascial release is a hands-on technique using sustained pressure to the connective tissue restrictions to relieve pain and restore motion. But does it work? Dr. Betsy Webb certainly thinks so, stating “this is one of the most common modifications I suggest to patients. Maintaining soft tissue and joint mobility is so important in preserving joint health and building strength.”

According to a systematic review conducted by Beardsley and Škarabot, myofascial release can help to increase flexibility and reduce soreness. Regular maintenance helps with joint and soft tissue extensibility and mobility, will improve tissue length and pliability and its ability to accept force and load. This allows the body to do more work with less strain overall. Methods like foam rolling, gua sha and massage can improve arterial and vascular endothelial function, or the flow of blood and lymph through the tissues. Self-myofascial release allows for consistent and cost-effective management. Athletes of all levels most commonly use a foam roller or ball of varying density.

Despite being versed on the benefits, Betsy has trouble incorporating soft tissue work. “I love working on strength and cardio work,” she laughs, “but often under prioritize mobility in my own physical fitness. I know how valuable mobility work is, yet I struggle to incorporate it into my routine.” As part of our Athlete Within Challenge, Betsy agreed to spend 10 minutes foam rolling everyday for two weeks. Here’s how it went:

As with any new habit, the most challenging part about for Betsy was adherence. “I started out really strong for the first week but then the weekend hit and falling out of my daily routine made it more challenging to stay diligent,” she says. Sound familiar?

In order to stay consistent, Betsy found three different techniques to be most helpful: routine, external accountability, and increased accessibility. “I found using an alarm worked really well. I set an alarm for 9:15 every night to remind me.” (As an added benefit, myofascial release can also help to improve parasympathetic nervous system activity, allowing us to mentally and physically calm down so our bodies can regenerate. Soft tissue work in the evening can set you up for a great night’s sleep!)

Betsy shared her goals with her fiancé, finding that having “someone to hold me accountable, who knew to remind me if I hadn’t done it for the day” helped to keep her on track. The last thing she found to be helpful? Relocating her foam roller. “I ended up putting it next to the tv,” says Webb, “so that when I would sit down to watch tv at night I would see the roller and be reminded to use it.”

So is it worth the time? After the two weeks were up Betsy’s body was thanking her. “Foam rolling is something I know I should do more of, especially for my thoracic spine, but never was able to get into a routine." Like so many of our patients, Betsy saw tremendous benefit from going back to the basics: “After the first week I felt good but not too much different, but a full two weeks really started to make a difference in how I felt from a mobility standpoint.” The true payoff for myofascial release work is in the consistency. Studies have yet to show if any of these improvements in flexibility and tissue quality have longterm effects once treatment is stopped. “I fully intend to maintain this behavior. As I saw with the two weeks, the longer I remained consistent the better I felt,” states Webb.


Our vote? Yes to myofascial release!

Looking for Dr. Betsy Webb? As of July 1st, she will be practicing in the Chicago Area!


Self-Limiting Pitfalls

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Elite performance requires us to be vulnerable. It is essential to have an honest view of our skill set to grow and improve. Working with a coach, or using tools like biofeedback technology can give a clear picture. In the clinic, we use a variety of motion and force capture to enhance the assessment process. Outside of the clinic, wearable technology can track heart rate, speed, and sleep metrics to give you a more complete picture of your performance.

But, ultimately, it’s how we interpret that information that matters. Use the self-assessment below and see if you fall into any of these 4 protective strategies that may be limiting your potential:

1. Self-Handicapping:

Intentionally limiting your effort to give yourself an “out.” If you didn’t really try your best, then the results don’t matter.

2. Feedback Avoidance:

Bubble alert! By only surrounding yourself with people who flatter you, you are distort you outlook.

3. Self-Serving Bias:

Only taking credit for success, and not failure. When you win, its because of your hard work and natural talent, but if your fail it could be the refs, the weather, the astrological calendar…

4. Downward Social Comparison:

Rather than look at how everyone performed, you only compare yourself to those who did worse to protect your ego. Maybe you only scored twice, but he didn’t score at all.

Being mindful of these common mental traps helps us build awareness of the role our mind plays in performance.


Adapted from @stevemagness, author of Peak Performance


Superbill Best Practices

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Choosing to work with a provider not covered by your insurance has advantages and disadvantages. It can be gratifying to do your research and select the practice that best meets your needs, and in some ways, simplified to know exactly what you owe from the start. However, paying the full amount for services can add up.

Every patient is eligible to receive itemized medical receipts, or superbills, detailing their care with us. These receipts can be submitted to most insurance plans for reimbursement consideration, as well as qualify for select employee wellness incentives or tax credits. Because reimbursement costs the insurance companies money, the process is often tedious. We’ve put together our top four suggestions on how to maximize your returns, taking full advantage of your plan:

 

1. Gather your paperwork

Most insurance companies still require you fill out a paper application with your plan information to mail in along with your superbill. We recommend printing and filling out one application, leaving the date blank. Make copies of this, and reuse for each submission adding the individual dates each time. 

2. Read the fine print

Double check which payment options you select for your reimbursement. Some forms offer the choice to make payments to the providing clinician instead of the patient, aka YOU. Selecting the wrong option could require you to wait much longer to receive payment. 

3. Increase your odds

Submit your receipts individually, as soon as you receive them. It's a 6 week process, at minimum, and your insurance could require more information from your clinician.Having to resubmit decreases your chance of payment.

4. Pay it forward

Share any feedback from your insurance company with our team. Remember, they are looking for any reason to not pay out on claims. If they don't cover the services billed, we can work with you to better understand what they will cover in the future


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As the Director of Operations + Patient Success, Shannon navigates our Out-of-Network team. After pairing you with the best provider for your goals, she continues to be an essential part of your care by ensuring you have all the information you need for insurance claims.

For specific questions, or for help managing an existing claim, schedule a call

 

How Can I Heal?

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This week, Dr. Heather McGill shared in conversation with Crina Okumus on her podcast How Can I Heal. The two discussed Heather’s vision for how to build robust, durable athletes through three healthy habits. Read more about Okumus and her podcast below:


THIS PODCAST IS A WEEKLY CONVERSATIONS WITH PEOPLE THAT I ADMIRE TO IMPROVE YOUR OWN LIFE FOR THE BETTER.

Subscribe on Apple Podcasts

To give you a little background about me. I have an experience for more than 15 years in the fashion industry, running my company successfully selling in more than 40 countries and being highly profitable. 

One day, I received a call that my father died in a car accident and my whole life completely changed. I started to ask myself who am I and why I am here? The process of healing took more than five years, during which I was also facing my inner calling to move away from fashion and figure out what is next for me.It was certainly not an easy journey and I thought that I will never figure out what I will do for the rest of my life. But one day, I chose to listen to my heart and let it guide me to my future.

And with that decision, everything started moving in the right direction. 

The biggest insight I had during this time was that I could not change the world. I'm too small for that. But I can certainly change myself and the people around me who would be inspired by my story. And that’s when I decided to start a series of interviews with people that I love and who have made a big change in my life. 

So I hope you will join me in my journey and find inspiration in the stories of known personalities but also those of normal people. And please share your own journey with me and let's make a little change and make this world more beautiful. It’s up to us to make this change happen.

With love,
Crina

Make It Subtle

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The show must go on! For so many performers and athletes, sitting on the sidelines isn’t an option. Kinesiology taping can be a beneficial treatment modality to help minimize time off when combined with progressive reloading. A 2018 case study demonstrated successful conservative management of FHL tenosynovitis with care including kinesiology taping, manual therapy, rehabilitative exercise, and laser therapy. The patient was able to continue two hours of dance training per day within the first two months of treatment, and gradually build back to 6 hours per day without re-aggravation of the condition.

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Figure 2 Kinesiology tape application to the FHL. The ankle was dorsiflexed and pronated with no stretch in the tape as it was applied. This application provided a “lifting” of the skin as the patient assumes a plantarflexed ankle position.


When working with performers, presentation matters. While neon colored kinesiology tape may be permissible for other athletes, dancers may need to prioritize appearance. Enter KTape MySkin. This simple design change allows for all athletes to receive the support and care they need to perform at their highest potential.

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Dance medicine providers or teams can order a mixed box to ensure that each performer has a color that matches their skin tone, allowing the audience to focus on the dancer rather than their injury.

To learn more, check out this article: 

  1. Wentzell M. Conservative management of a chronic recurrent flexor hallucis longus stenosing tenosynovitis in a pre-professional ballet dancer: a case report. J Can Chiropr Assoc. 2018;62(2):111-116.