Friday, July 10, 2020

Hair Salon "Experiment"

by: Mark McMahon

Photo by Tai's Captures on Unsplash

Since very early in the pandemic, public health officials have strongly urged all of us to WEAR MASKS when in public. Ongoing scientific research continues to bear this out; mask use is possibly the single most important thing we can do, if we are going to venture out of our quarantine bubbles. Laboratory experiments have shown that the virus’ main transmission vector is through exhaled aerosolized droplets - and that well-made masks do a fine job of limiting the spread of those droplets.

Two hairdressers in Missouri, however, may have given us a genuine field test of this principle. Before they shut down, two ASYMPTOMATIC (unsuspecting) COVID-carrying stylists together saw 140 clients, mingled with 6 co-workers, and - wait for it - according to the local health department, there were NO transmissions of COVID-19 resulting from those interactions! Read the article HERE:

In this salon, everyone wore masks, they staggered appointments to spread out client traffic, and they put extra space between work stations - all steps which we have been taking at RIF since the first day we reopened over a month ago.  Of course, we’re also maintaining social distancing, and scrupulously cleaning all treatment items and surfaces between clients. We are doing everything we can to keep everyone safe while visiting RIF. We are all in this together!


Thursday, June 4, 2020

Having a pain in the A** while sitting on your saddle? How to select and optimize your saddle using pressure mapping

By: Morgan Connor, DPT and Justin Lucke

In bike fit, oftentimes small changes can lead to profound improvements, but in practice it can be hard to quantify the impact. In this blog post Morgan talked about her quest to find a better seat and how using trial and error found something that worked a lot better. And it is true that trying out multiple seats is super helpful in solving the saddle pressure dilemma. A poorly fitted saddle or bike fit can contribute to or exacerbate already existing pelvic floor pain.  

In fact, one cause of pelvic floor pain, pudendal neuralgia, was long considered to be a problem that only happened in male cyclists! The pudendal nerve arises from sacrum, taveling through alcocks canal with the pudendal artery and vein to innervate the pelvic floor. It is the only nerve in the body that has both sensory and motor functions as well as autonomic functions. This means that it is involved in controlling the contraction and relaxation of pelvic floor muscles (motor function), transmitting sensation information (such as pain, pressure, or touch) to the brain (sensory function) and regulating urinary, bowel and sexual function (autonomic function). Getting back to anatomy, the pudendal nerve has a tortuous course through the pelvic floor and can be compressed when cycling leading to pain, numbness or tingling in the genitals or pelvic floor muscle dysfunction. The good news is that it does have to! We teamed up with Curtis Cramblett and Justin Lucke at Revolutions in Fitness to talk about one way to help improve your bike saddle fit and comfort. 

But in addition to trying seats, at Revolutions in Fitness we use pressure mapping to measure an extra dimension that helps isolate cause and effect from small changes.  While the broad approach might be to start switching saddles and look for subjective feedback on the saddle to improve, along with objective markers like visual stability, pressure mapping provides a more focused assessment to help choose the right saddle and then optimize the position. 

In this case, pressure mapping showed that the saddle was broadly appropriate (no pressure in the center on nerves and blood vessels; pressure on the outside focused on bony structures). Even so, at the start, saddle pressure was still pretty awful, with pressure creeping over 1000 milibars there was room for improvement:

The current setup was based around a 100mm long stem (attaches the handlebar to the bike) with +17 degrees of offset (offset is the angle of the stem relative to the bike’s steering, where positive means the stem is pointing up while negative is pointing down). Typically, a rider would use a stem with more positive offset to help raise the bars and take pressure off of the neck and back and help open up the hips. The flip side of higher bars, however, can be a reduction handling and stability and less ability to powerfully recruit the glutes. In this case, the rider had improved mobility, so strain on the neck, back and hips was less of an issue, and wanted to improve handling and performance. So we were lowering the bars to help achieve this goal.  

Using an adjustable fit stem, we were able to move between several different setups and benchmark using pressure mapping. Starting with a switch to a +8 degree offset, pressure was better -- more stable (shown by the red line being shorter, flatter and more centered), lower and better balanced left to right:

But the benefits of using pressure mapping start to really appear when we overshot the likely best option.  Moving from a +8 offset to a zero offset saw pressure go back up:

Clearly something is going on here that subjective experience -- how does that feel? -- might not capture.  Making the next step, from zero offset to -8 offset really shows the trend:

Pressure goes up once again so going lower is not the right path in this case. Re-setting the stem to +8 offset validates the original observation that a little lower, and a little longer, has a big impact and is the right move at this point for the rider:

The takeaway is that pressure mapping allows us to benchmark the starting point, document the changes and establish one way to define improvement. In this case, pressure mapping allowed us to move towards the rider’s goal -- performance improvement -- while increasing comfort.

You might find that the right bike saddle fit clears up your symptoms while riding but if not you may want to consider seeing a pelvic floor physical therapist to see if there are any muscular or connective tissue contributions that may need to be addressed. If you are wondering what a pelvic floor physical therapy evaluation is like check out this blog post.

To schedule a bike fitting with Curtis or Justin you can find information at the Revolutions in Fitness website: or call their office at (650) 260-4743. 

To schedule an in person appointment for a pelvic floor physical therapy evaluation with a physical therapist at PHRC you can contact us here or if you are interested in a digital health appointment you can schedule one here.

If you cycle at least once per week (e.g. cyclist, triathlete or duathlete) and aged 18 years or above, you are invited to participate in a PhD research survey related to the bicycle saddle and pelvis, conducted by Jason Hynd from Leeds Beckett University. Do you want to be part of a research study? RIF supports this study. Click Here to learn more.

Wednesday, August 14, 2019

Plantar Fascia and Foot Intrinsic Muscles

By Meghan Taff

The pendulum is swinging once again. A few years back it was determined that rearfoot (or heel) striking was dysfunctional in running gait and that mid or forefoot striking was more "natural". And as "Born to Run" would tell us, a more natural gait pattern would help us prevent injuries. While this is true in some runners, many other runners continued to struggle to 1) change over to this style of running and 2) get relief from their injuries after they've done so.

Our foot has 2 functions during the gait cycle. It has to be pliable during the heelstrike phase of gait in order to allow the foot the conform to the ground and absorb shock and then as the foot gets ready to transition from accepting our body weight to pushing off of the ground, it has to become a rigid lever or platform for us to push off of. This recent study suggests that by changing our gait pattern to mid or forefoot striking, we are preventing our foot from conforming to the ground, by bypassing straight to hitting on the mid / forefoot vs landing on the heel. In essence we skip over the stretchy phase of the gait cycle and go right into the rigid phase. Per the study, "A less elastic fascial tissue was more easily strained under loading. Tissue overstrain is frequently related to the incidence of plantar fasciitis."

I've always been a fan of making sure that the body has a nice balance between mobility, flexibility and strength around the joints. I find that more times than not, addressing these deficits within a runner have a nice way of correcting not only gait deviations like arch/knee collapse, or hip drop, but can also allow the runner to use a comfortable, more self-selected gait pattern. 

Click HERE to see our link for exercises to help with mobilizing and strengthening the plantar fascia and foot intrinsic muscles. 

Ultrasound elastographic assessment of plantar fascia in runners using rearfoot strike and forefoot strike

Saturday, June 15, 2019

The Case for Strength Training

By Meghan Taff

Strength training is imperative for endurance athletes. There are numerous benefits and really no draw-backs for having a consistent strength training routine during the training cycles. In the off season, strength training can be done more often to build a strong base and also help the muscles hypertrophy. Most endurance athletes fear hypertrophy, but know that it doesn't always have to equal size or bulk. The muscles can hypertrophy, or grow in number muscle fibers, and therefore increase strength. However, using circuit training to work key muscle groups as well as condition the cardiovascular system is a great way for athletes to not only get stronger, but avoid any unnecessary "bulking up" as they are still working the aerobic system moving continuously from one exercise to the next to keep the HR elevated. The increase in the number muscle fibers will improve the muscle's ability to use oxygen, which as we are all familiar with the concepts of VO2 max, will only help performance and recovery. Not the mention the benefits of strengthening bones as well as smaller, less utilized stabilizing muscles. All of which with help us prevent injury during the season as we start to ramp up the repetitive aspects of our sports (ie swim, bike, run).

Strength training still has a place during the competitive portion of the season, but can be reduced as the athlete moves onto the more sport-specific training. Conditioning younger athletes to learn and respect the benefits of strength training will only set up good habits for the future and thus ensure they have a long and fulfilling endurance career. Those of us that started later in life would also greatly benefit from beginning a strength training program ASAP. We may not have the skill set to perform the activity with good form initially and supplementing a good strength training routine will help prevent injury until we can master those skills. While you would never have a basketball player only perform weighted squats in lieu of practicing free-throws or form-specific drills, strength training is an important aspect of all sports. It can help with the neuromuscular or motor planning component (ie efficiency of movement) required to coordinate movements for a particular activity. 

Strength, injury-prevention, improved cardiovscular function and motor planning are just a few of the many reasons endurance athletes should be incorporating strength training into their training seasons. 

Read more about strength training for cyclists here.

Monday, March 11, 2019

Got GAS (Gluteal Amnesia Syndrome)?

Do you have GAS? 


Gluteal Amnesia Syndrome Or “I can’t find my butt syndrome" occurs when your glutes lose the ability or forget how to fire properly due to tightness in other areas like your hip flexors. 

If you have ever experienced Gluteal Amnesia Syndrome, here is an exercise for you! RIF's own Jamie Wong, PT has engineered the Single-leg Sliding Wall Squat to help reactivate your glutes and remind them how to fire properly.

1. Stand sideways to the wall. Press the side of your knee into the wall. 
2. Hinge at your hips, keeping your spine straight. 
3. Slide your knee backwards.
4. Make sure to keep your chest vertically aligned over your foot. 
5. Keep pressing your knee into the wall as you return to standing. 

*Hip-knee-foot alignment: Check to see that your knee is tracking in the middle of your foot, between your 2nd-3rd toe. 

Frequency: 2 sets of fatigue (both sides)

Try doing this as a warm-up before your activity, be it running, cycling, swimming, etc. 

Research shows that gluteal exercises are beneficial for reducing knee pain. In fact, a recent review found that middle-aged and older patients are unlikely to benefit from surgery to repair meniscus and cartilage tears in the long run. Rather, treatment with physical therapy and anti-inflammatory medicine may be more helpful.

Thursday, January 31, 2019

Patient Spotlight - Sylvia Haultain

Sylvia first came to Revolutions in Fitness after sustaining a head injury and was looking for some help with concussion recovery and to regain her ability to enjoy her outdoor passions. Sylvia lives next to Sequoia National Park and loves hiking, cycling, and spending her time among the redwoods. 

Although her drive to and from Revolutions in Fitness was long (3+ hrs), Sylvia would not let that stop her from regaining her freedom and health! Sylvia had this to say about her experience:

"I came to Revolutions in Fitness because I wasn't ready to hang up my hiking boots. Their unique approach to treating the body as an integrated whole is exactly what I needed to get back to doing the things I love...RIF always gives me a feeling of unlimited potential for getting better, which is so motivating. It makes recovery feel like flow, rather than fight".

It was amazing to be a part of Sylvia's success and to watch her improve with every session. Her determination and willingness to follow Curtis' lead was nothing but inspiring. Congratulations on getting back to hiking, biking, and reveling in the great beauty that is Sequoia National Park! 

Wednesday, August 29, 2018

Katie Kennedy - The Power of Kinesio Tape

Katie Kennedy, DPT helped her client Tom who was experiencing significant achilles pain by applying Kinesio Tape!

"The best Physical Therapy anywhere. And now Dr. Katie Kennedy does kinesiology tape art! Hurt my ankle and last week I couldn’t really walk. After some attention from Dr. Katie, walking is now fine and with some strengthening work, I’ll be back on my bike in no time!" 
                                         - Tom

Interested in experiencing the power of Kinesio Tape for yourself? 
Contact us: Phone: (650) 260-4743 | Email:

OR Schedule an Appointment Online HERE!