Archive for March, 2012

For as long as I have had my driver’s license, I can never remember a time where I actually enjoyed being in the car. Anything longer than 10 minutes? No thanks, I’ll pass. However for about the last 8 months or so, I have suddenly found myself almost looking forward to any time I can spend alone in my white Rav-4 .Why the sudden change? Two words: Howard Stern. You see until recently, I have always driven a car only equipped with terrestrial AM/FM radio. Then, my Dad and I ‘switched’ cars and a whole new world opened. (Ok, I sort of stole his car. That’s a whole ‘nother story.) Quite frankly, my time in the morning listening to Howard Stern is often the most entertaining time of the day. And whether you agree with my super-fandom or not, I think by the end of this article, you can all at least agree that there is certainly some lessons we can all learn from ‘The King of All Media.’

So here we go….

Lesson #1. Take risks and don’t be afraid to do something different- Whether you like Howard Stern or you think he is just a creepy old man, I think we can all agree he is an innovator. In fact, he basically invented a new form of radio as well as the term “shock jock.” To think this was without much opposition would be totally off base. Over the years Stern has been fined over $2.5 million dollars for indecent radio. Why does he keep going? Simply put, he believes in his product and knows he has an audience.  Time after time, Stern has taken huge risks that only someone who is headstrong, confident, and a bit crazy could pull off. And to be honest, it seems that most successful people in this world share a little bit of all these qualities as well. The amount of times Howard and his crew have gotten fired from various radio stations would make most people quit the industry or at least give in and follow the more typical, low-key radio show format. Most people would conform because their fear of consequence outweigh their burning desire to do what they feel is right.

What’s the lesson? A few weeks ago I posted this quote on my Facebook from the blog of Mike Reinold,

“It is great to learn from others, to follow the leader so to say. But there is also something to be said about being the trendsetter. If you are opening a new PT clinic or fitness center, do you want to copy the competitors and be just another person on the block, or do you want to innovate and give the public what they NEED, not what they WANT, or to say even better, what the THINK they want.

As someone who is just months away from entering the healthcare and fitness field, this quote rings so true. It would be easy to go out into the world and give the people what they think they want. However, sometimes what they really need is not what they say they want. I’m sure this may lead to some awkward moments when I first get into practice. A patient may come in expecting treatment x,y, and z because that is what Joe Chiro down the street has done in the past. However, this person may need something totally different. This “different” may include much more active care (done by the patient) and much less passive care (patient lies on table and expects Doctor to ‘cure’ them). That’s not to say I will not do anything for them, it is just saying that I want my patients to learn how to take care of themselves so they won’t always depend on me. This is a much different model than most manual therapists and something my patient’s will certainly have to learn. To be honest, when I explain this model to some friends and family who have been to chiropractors before, they look at me like I am crazy. And while the crazy part may be true, I understand their confusion. “Copying the competitors” as Mike Reinold puts it would certainly make these conversations much easier but to be frank, is not something I believe in. All in all, I think we need to follow Howard’s lead even if that means being a so-called outcast or pariah in our field.

Lesson #2. Surround yourself with great people and find a way to keep them- For anyone that follows the history of The Howard Stern Show, you understand that the “core” of the show has been together for almost 30 years. With Robin, Fred, and Gary by his side, Howard has managed to keep the people around him who make the show go. Take a second to think about the entertainment industry, sports world, or any company for that matter. How many can say that the core has stayed together for 30 years? I would think not many. Howard realized early on that these other people made the show run just as much as he did and he fought to keep them even when his bosses said ‘no’. He made sure they got paid fairly and created an environment in which people wanted to work.

What’s the lesson? Again, this relates directly to any medical or fitness business. I was treating a local doctor a few months back who runs 3 successful clinics and we spoke about this point directly. He said that he isn’t looking to hire an associate who will leave in 6 months. He is looking to hire someone who will stay forever. In order for this to happen, he has to find the best and treat them accordingly. As he puts it, he will “overpay” for an associate and his goal is to make them a deal in which it doesn’t make sense for them to leave. He said that as soon as an associate quits, he loses about 40% of the business at that specific clinic. Even though he “owns” the clinic, the  associate had his/her own patients so once they left, the patients often follow. In reality, there is something to be said for chemistry and continuity. The Howard Stern Show has it and this certainly sets them apart from the competition.

Lesson #3. If people like what you do, they will follow you and be happy to pay for it- Until 2006, The Howard Stern Show hit the air waves on the traditional AM/FM dials. Eventually the show became so popular, it was syndicated all over the US and Canada. After many years of fighting with the FCC, Stern decided to take his show to satellite radio, a pay to listen service. Stern’s critics bashed him saying that the move was a death sentence for his career and that nobody would pay to listen to him. Well my friends, the proof is certainly in the pudding. Business analysts suggest that Stern may be responsible for about $120 million dollars in revenue per year, taking into account what he gets paid and the cost to run the show. The point is that people will pay if they perceive a value above and beyond what the competition does. Just being a tiny bit better is not good enough. Radio is free, yet over 20 million subscribers feel it is a worthwhile investment to pay for Stern and the rest of the  satellite radio team.

What’s the lesson? I have had many conversations with people discussing my goals in the future and it always comes back to one thing. People always ask why would anyone come to my office and pay for my services when I am  so young and inexperienced? My answer is always the same. I have to show them that the care and treatment they are getting or will get with me is better than the guy across the street. Or, if my treatment costs more money, I damn well better offer a service that is worth it. I always tell my classmates that there is one thing we can’t have no matter how hard we try upon graduation; experience. What we can do is offer a better product than that guy who has been doing it for 30 years. The goal is to maximize our perceived value among our customers. If we do that, people will pay if they see value in what we do. Just ask Howard.

Conclusion

So there it is. A few lessons from the King himself. Love him or hate him, there is certainly something to be learned. I think if there is one thing to truly take away from this it may be how similar ALL successful people are. Through my conversations and readings, I have found that no matter what the profession, people who are the leaders in their respective fields share much more similarities than differences. In the end, our ability to find what has made these people successful and translate it in to our own lives will determine how successful we are as individuals.

As many of you can probably guess by the amount of times I mention them on my own blog, I can’t say enough how much I enjoy the work from the guys at Cressey Performance, Eric Cressey and Tony Gentilcore.

Recently, independent of one another they posted a link to a blog from Dr. Johnny Bowden concerning a recent study out of Harvard that makes the ‘claim’ that red meat will kill us. From that, the media took it and ran and it has since become and all out frenzy. Anyway, as often happens, I clicked the link from Eric or Tony (I don’t remember which), started reading Dr. Bowden’s response, got side tracked by something else, and went about my day. Needless to say, I never finished the article…

Fast forward to my ride in to clinic today when I called my Dad just to see how he was doing (on a good day this conversation usually turns into one where he tells me how much money he took from his buddy in their weekly golf match and on a bad day he vents about how awful he hits his 3-wood).

Surprisingly, on this occasion the conversation went elsewhere. After having a good laugh over Tebow-mania, he mentioned that he is thinking of giving up red meat. I asked him why, and he said he wasn’t really sure but he is concerned about his health and he has been seeing a lot on the t.v. and internet about the subject. As I began to try and explain to him why I didn’t think red meat was the problem he got a call at work (probably from Bridezilla herself as he owns a bridal gown shop) and we couldn’t finish the conversation. Luckily, it gave me a chance to go back and read Dr. Bowden’s article  (something I should have done in the first place) so I could explain exactly why Harvard’s study is, ahem, less than stellar and what this ‘study’ really told us.

So, here is basically a summary of Dr. Bowden’s article and what I plan on telling my Dad:

  • This study was not technically ‘research’ or scientific for that matter. It is an observational study where over a 30 year period, people filled out a few food frequency questionnaires which may or may not be very reliable.
  • Yes, the people who ate more red meat had a higher rate of death, Howeverrrrrrrrrrrrrrrr these meat eaters (1)smoked more (2) drank more (3) exercised less.
  • The group that ate more red meat also had a higher Body Mass Index and higher Blood Pressure.
  • The group that ate more red meat had….wait for it, waittttttt for it –> lower cholesterol.
  • Guess who had the highest cholesterol???????  (hint: they don’t eat meat)
  • A book called “The China Study” did something similar to this Harvard study once. The author gathered over 100,000 statistical associations that supported his vegan beliefs yet somehow forgot to include the facts that did not support his theory. Do you think that it may be important to note that wheat flour had a higher correlation with heart disease than red meat? Good, I do too.
  • Back to the Harvard study…. The group that ate the highest amount of red meat also took the least amount of vitamins.
  • Years ago, a doctor out of Britain did a similar correlation type study and found that sugar was more associated with heart disease than fat.
  • This study does not take into account grass-fed vs processed meat. I think we could all agree there is a difference between a grass-fed filet and a fast food thingtheycall meat patty.

To sum this whole thing up, I am in no way shape or form telling anyone to go out and eat red meat. If you don’t want to, that is fine with me. I think the point here is that we need to be able to separate real facts from media facts. In the end, the only thing health care providers can do is give people the truth and let them make their own decision.

Have a great day!

Some Monday Randomness…

Posted: March 19, 2012 in Uncategorized

1. We had quite the eventful weekend here in Long Island/ Connecticut with National Boards taking over as our prime focus. I am glad that they are over (for a few months at least) so I can turn my attention to some more important things like my golf swing, March Madness, and basically anything not involving studying chest, heart, and lung sounds. A few quick stories from the weekend…

  • We were about halfway (one hour) from our house in Long Island to Connecticut when my roommate realized he brought zero forms of I.D. with him for the weekend. After determining that punching the check-in lady in the face and then running into his exam seat probably wasn’t the best idea, I turned the car around and drove back to the house and then back to Connecticut again. Luckily,we left enough time so we were still plenty early for the test. The entire ride I was certainly thinking how I was going to explain missing that exam to my parents. “Um, Mom yea sooooo I won’t really be able to work anytime soon because I didn’t actually take the test today.” That would have went over REALLY well.
  • This previous September,we also had National Boards in Connecticut like we did this past weekend. Just as our luck would have it there happened to be a biker convention that weekend at the same hotel. If revving their collective engines at 3 am wasn’t enough, they luckily broke the monotony with a full on Nick Cannon-esq drumline performance in the hotel parking lot until the sun came up the next morning. Luckily for us, even with our lack of sleep all four of us still passed the test. 

For this trip, I took it upon myself to book the hotel and did an excellent job if I do say so myself. It was clean and quiet and they even had complimentary breakfast! I thought we were in the clear. Great sleep ALL weekend. Boy, was I wrong. Saturday night before our test, I fell asleep around 11:30 pm, peacefully. Around 2:30 am I was awakened by possibly the worst and most annoying sound in the entire world. If I were Superman, this would be my kryptonite. Fire alarm? Nope. Car Horn? Negative. Snoring? OMG the worst snoring I have ever heard. Honestly, I’m pretty sure I saw the wallpaper peeling off the walls. Two of my roommates (who remain nameless) and dear friends were in complete symphony. Instead of the typical one person snoring where a person snores-deep breath out-snores-deep breath out, the two of them had it so their breathing patterns opposed one another. It went something like this: snore-snore-snore-snore. I woke up in pure fight or flight mode. I was either going to elbow drop both of them or leave the room. I left the room. So, at 2:30 am I went down to the hotel lobby and did what any normal person would do the night before National Board Exams…read reseach articles. Finally, about an hour later, I ventured back up to the room and somehow caught a 15 minute window in which the snoring ended and got a few more hours of shut-eye. Luckily, my lack of sleep is nothing that chugging two cups of coffee couldn’t handle and I think the test went well for all of us. Cross my fingers.

2. With March Madness in full force and no team that I root for in the field like usual (Rutgers, Seton Hall), I often find myself rooting for whichever team is the lowest seed. It’s fun to watch guys who aren’t All-World recruits hang with the best players in the country. So far, the one who stood out the most for me was C.J McCollum of Lehigh University. This guy can flat-out play, I don’t care what league he plays in.

After doing some research, I found that C.J. was actually the Ohio Player of the Year in 2009 in his Senior year of high school. However, he was 5’6 going into his junior year of high school and did not reach 6’3 until he actually got to college. It’s just amazing that he did not receive one scholarship to any college and now will probably get drafted into the NBA.

3. Finally, I came downstairs yesterday after unpacking my bag from our Boards weekend and was greeted with my roommate playing something I had never heard before in my life. It is called “Everybody’s Free (To Wear Sunscreen)” and please take the seven minutes to watch this clip. You certainly won’t regret it.  

A few weeks back, I received an email from a friend of mine who coaches high school volleyball. He wanted my thoughts on a warm up  for his team that could be incorporated into the pregame routine.

I told him: Just don’t do any static stretching and everyone would be fine!

That was it.

Ok, kidding (sort of).

After having a few chats over email, I figured out exactly what he was looking for and I thought he made some fantastic points in describing precisely why he wanted what he wanted.

Being in the world of academia for the last three years often gets students (myself included) to see things very black and white. The research shows this, so we must do that. I learned this new concept at a seminar last week so I must apply it… TO EVERYTHING!!!! The athletes need x,y, and z because that is what the science tells us. What I forgot about was some of the hidden benefits of exercises and routines. In other words, what can a great warm up do for a team’s psyche? This is what my friend said,

It’s pretty important for me to have them warm up as one unit.  When we
walk into a hostile environment or we’re playing in front of a large
crowd it’s important to me to have a set warm up that the boys can get
right into and feel familiar and comfortable with regardless of their
environment. It also makes us look pretty badass and intimidating when
we walk out and look crisp and sure of ourselves in our warm-up.

I think these are all great points. Many people in the medical and sports performance community pride themselves on treating each person as an individual. I am certainly one of them. That being said, there is a time and place where the benefit of everyone doing exactly the same thing is useful. Could you imagine having 20 kids run out for a pregame routine and having them all do 3 million different corrective exercises? It would be total chaos. Whether the game is in an elementary school gym or Madison Square Garden, that 15 minutes before the whistle blows should never change. This will always help a team get comfortable with any venue their game may be played. This is exactly the point in this scene from Hoosiers:

Some things to keep in mind:

  1. My friend wanted his players to be able to follow the lines on the volleyball court. This would make it easier to keep everyone organized and crisp.
  2. He wanted the kids to be moving and to avoid static type exercises.
  3. The team has about 15 minutes in pre game to get everything done including sport specific exercises.

In this video, each exercise was performed for roughly 10 yards (and in the friendly confines of my driveway). It will be modified based on the structure the volleyball court allows. My trusty roommate did some spectacular camera work and somehow managed to read my chicken scratch off a piece of paper to call out each exercise. Both acts are quite commendable. Also, I almost trip and face-plant at the 2:15 mark. This would totally lose style points in an actual pregame. Luckily I caught myself and crisis was averted. 

Some things I would add/change to the warm up or simply some more options based on equipment and needs of the athlete:

If I could get all the athletes a thera-band, I would include a bit more Glute activation with a Reverse Walk

For something more ground based but with the same intent (Glute activation), Side-lying clams

or Glute Bridge (with a nice modification for tight hip flexors)

For a little more upper body activation, I may include a Bilateral External Rotation Drill or Shoulder ‘W’ (Standing)

or Supine

As you can see, there are many roads to Rome, multiple ways to skin a cat, or any other analogy you want to use. The main points here are simple:

  1. Keep the warm up active. Pregame static stretching may have a place, I’m just not sure where.
  2. Make the exercises challenging enough that the athletes get a training effect but easy enough that they can all perform them.
  3. Work with the coach to get an idea of exactly what he/she is looking for. Some teams have certain warm up ideas that are almost a religious experience so completely turning the entire thing upside down may get you nowhere fast. Essentially, it’s all about compromise.
  4. Try and think in terms of movement patterns, NOT individual muscle groups as much as possible.
  5. If your team is playing against Chase Budinger, GET OUT OF THE WAY! 


One last thing: For all my classmates taking National Boards this weekend, good luck and remember… the right answers 🙂

With spring right on our doorstep, I think it is a great time for a post on baseball injuries. The amount of children getting hurt while playing baseball or softball is truly  becoming an epidemic in our society.

With that, here are a few quick stories and observations and a few links to articles that you should certainly take the time to read:

Baseball is obviously a topic that interests me greatly as I was involved in playing the sport until I was 23 years old. I realize this topic does not interest everyone BUT  I do feel every health care provider and parent should at least have a working knowlege of the subject. Last year around this time I did a presentation at school to our Sports Performance Club about baseball injuries and I started off by saying whether you want to treat baseball players or not, you really need to know something on this topic. Some of my fellow students want to focus their careers on Pregnancy and Pediatrics and that is fantastic. (I mean, who wouldn’t want to deal with angry pregnant woman?!? Juuust kidding :)) However, these woman who are pregnant are going to have children and those children may eventually play Little League baseball/softball. As a clinician, being able to at least point a patient in the right direction in order to keep their child safe is essential. And a little working knowledge of the subject is even better. Unfortunately as one of the articles below will indicate, many coaches out there simply do not have this working knowledge needed in order to keep our kids safe and on the field.

  • From my experience over the years involved in the sport, I can honestly say I have seen almost everything when it comes to parenting. This includes pre-game WWE style battle royals just like this (sadly I’m not joking):

There are hundreds of other amazingly sad incidents that I probably should write a book about as well. Actually, someone already did. Coach Scott Illiano, a New Jersey high school baseball coach recently published a book titled, Our Time and this is one of the topics he discusses. A quick preview: One story he tells involves a parent defecating on home plate (no lie). From these experiences, I have basically come to the conclusion that there are two types of overbearing parents. 1) The overbearing parent that is so enamoured with his/her child’s ability that they abuse the kid’s arm by making them throw way too much and 2) The overbearing parent that is so enamoured with his/her child’s ability that they baby the kid’s arm and never allow them to throw enough to become an effective player. Luckily, we now have universal guidelines to follow (that I will share a link to at the end of the post) which should be the standard throughout the world.

  •  In high school, my team traveled to a tournament in upstate New York. There, we played a team from Alabama with a pitching staff that was absolutely outstanding. After a game, I remember hearing one of the Alabama team moms speaking to our team moms and basically saying that even though her team had great pitchers now, none really had a chance to do anything in the future because she was afraid they played so much (because the weather allowed for it), that the kids were going to flame out before they got to a high level. Looking back, I think that lady was some kind of genius because the research now proves exactly what she feared. Simply put, The #1 reason for youth throwing injuries is OVERUSE.

As an aside and completely off topic, at this same tournament we faced a team that attempted to use this against us (no, it didn’t work)  

  • Piggy-backing on the point made above, weather in the Northeast used to be a limiting factor for baseball and softball players. Because of the winter months, we simply can not get out to play for long periods of time. However within the last 10 years or so, fall ball, indoor facilities, and all-turf baseball fields (eliminating poor field conditions) have become the norm for our youth and I think it will now begin to show with the amount of injuries. The basic recommendation for any youth baseball/softball player is between 3 and 4 months of rest each year from throwing. Some athletes play spring ball, summer league, go right into fall ball, and then begin a winter throwing program, literally not taking even one month off. This is just an injury waiting to happen. Now please don’t get me wrong, I fully support the indoor facilities. Honestly, I spent every winter there while growing up. All I am saying is that we need to be responsible. If a player finishes his/her season in August, then by December or January they should certainly begin throwing again and working towards the next season. In fact, most indoor facilities have highly qualified instructors who will further help to prevent injuries by working on proper throwing mechanics. Furthermore, I think something that is just as bad as overuse is being under prepared. I remember in high school, we would have some pitchers who literally would not touch a baseball until the first day of spring practice and then wonder why throwing three innings in 28 degree weather bothered their arm a few weeks later.

Wow, that certainly turned into quite the rant that I did not expect…

Really, what I want everyone to read is this fantastic post by Dr. Mike Reinold titled, “The Real Reason Why There are so Many Youth Pitching Injuries”. Dr. Reinold is the Head of Physical Therapy for The Boston Red Sox and is highly involved in the research and treatment of overhead athletes. He is certainly someone who I consider and authority on the subject.

Also, here is an absolutely fantastic post by Eric Cressey called, “Your Arm Hurts? Thank Your Little League, Fall Ball, and AAU Coaches”. Eric is a leader in the field and a pioneer in the baseball strength and conditioning community. In fact, this past off season I read that he worked with a  player representing every Major League Baseball organization except 2. Truly impressive stuff!!

That’s all for today. Thanks for reading!!

Go Yankees!!

Yes, it’s true, I love my foam roll. I love it for myself and for my patients. I love it for everyone!! In fact, when I was in student clinic last summer, I recommended so many people purchase a foam roll that my head clinician asked if I was getting a kick back from the company.(I wasn’t getting a kick back, but I totally should have!!)

So rather than sit here and write an essay about the benefits of foam rolling, I figured it would be much more interesting to come up with a few specific instances in my life where foam rolling or any type of self myofacial release would have been (or was) of great benefit. Specifically for this post, I have used athletes as an example but in reality (as I will talk about at the end of the post), this type of modality benefits pretty much everyone. So without further ado…

1) Any athlete who travels- I remember in college, our baseball team would take a trip to Virginia every year to escape the harsh winter of northern New Jersey and play a few games in the…. harsh winter of norther Virginia. Don’t let them fool you, even though Virginia is ‘south’, it is still freezing in the month of March. Anyway, we would sit on the bus for 7 hours, get off the bus, move around a little, and then play a game. It was brutal. Something that would have surely helped us would have been a 10 minute foam rolling session as soon as we got off the bus in order to “wake up” our muscles that had been asleep for the duration of the trip.

Also, excluding the highest level athletes who may travel with a manual therapist (massage, chiropractor, physical therapist, athletic trainer) tournaments are a place where foam rolling should be the norm, not the exception. In college we would take a trip to Florida in order to escape the harsh winter of northern New Jersey only to encounter the harsh winter of… just kidding, the weather in Florida was usually warm.

except when this happens

But, we would play something like 11 games in 10 days or something crazy like that. This was also usually the first time we actually got onto a real baseball field as our home field was covered in snow for our first month of practice. The point is, our bodies were not ready for that type of schedule. Everyone was tight, sore, and generally exhausted. Foam rolling is something that we could have used as a recovery/regeneration/injury prevention tool. People sometimes fail to realize that for northeastern high school and colleges, baseball’s regular season is basically a 2 month sprint (March and April) so any type of early injury could cause an athlete to miss the majority of that year. Even being out of action for 2 weeks could mean missing as much as 1/3 of the games.

2) An injured athlete (who is currently being seen by a manual therapist)- This one seems a little counter-intuitive so let me explain… Ideally, if I was treating an injured athlete, I would like to see them everyday in the early stages or pretty close to it, especially if they are in season. We would not only be doing manual muscle work with him/her (Active Release Technique, trigger point work, Instrument Assisted, etc.) but also appropriate rehab exercises. Seeing as we don’t live in an ideal world, I understand this is not always possible between school, practice, health insurance restrictions, girlfriends, Facebook, Twitter, Glee, Jersey Shore and on and on. Because of this, I  need my athlete to be doing appropriate foam roll work on his/her own so they can continue to make progress outside of the clinic. If someone has some serious soft tissue issues (adhesions, trigger points) treating them 1 or 2 times per week and having them do nothing else for the rest of the week is simply NOT ok.

3) Any athlete involved in a strength and conditioning  program- I was first introduced to the foam roll during my year of prep school at IMG Academy in Bradenton, Florida. Before every workout, out strength coach would roll out these annoying pieces of junk and make us roll around on the floor with them for about 10 minutes. It looked something like this…

At the time, I had no idea why I was doing it, all I knew was that it hurt!! Most of the time we were coming to train right after spending a full day sleeping in class which is just awful for the body in so many ways. What we were doing was nothing more than giving our muscles and fascia a little kick in the bum so they were ready for a workout.

Ok, so now the confession…

The reality of the situation is that I gave three instances in my own life where I felt that using a foam roll would have been (or was) really, really helpful. Athlete or not, a foam roll is a piece of equipment that should literally be in every gym bag. And if you don’t work out put it in your grocery bag, briefcase, suitcase… Just use it!!!! Unless someone has an acute injury (in which they should be evaluated by a health care specialist for the most appropriate treatment) or has problems with ambulation (laying, sitting, etc.), the foam roll is a non-negotiable must have.

Finally, before I go I want to leave you with a bit of theory… When we talk about the foam roll or soft tissue modalities with patients or clients, they often ask if stretching can do the same thing. Or they simply say, “I stretch, shouldn’t that do the same thing as this?” The simple answer is “no.” What I explain to them is the difference between soft tissue (muscles, fascia, ligaments, tendons) quality vs soft tissue length. Stretching can help to improve how long the muscle is. Foam rolling (or any soft tissue modality) will help improve the tone or quality of the soft tissue. The analogy an Active Release Technique instructor gave me once is as follows: Think of healthy soft tissue as a brand new paint brush. It’s soft, smooth, and pliable and generally awesome (ok, I added the last part). Then think of a paint brush after you have used it, not cleaned it, and then let it dry. Now it is hard, grizzly (not sure if that is a word), and not pliable at all. You could take that paint brush and bend the bristles all you want (stretch them) but unless you clean the junk out (foam rolling or any soft tissue technique), there will still be a problem in the area. While not perfect, people seem to understand this because it really drives home the point of “soft tissue quality.”

Here is a video from the guys at Cressey Performance. This is pretty much the exact foam rolling series (and lacrosse ball) I do before each workout and one that almost everyone should incorporate. Remember that this is just a general foam roll series and should be modified for each individual.