Dr. Mitchell Tanner, PT, DPT, CSCS

The SI joint is not designed to move a lot, so exercises that focus on surrounding muscles are best. This can include deep extension and flexion of the back, as well as exercises like lunges and step-ups which work one side of the hips at a time.
 
Transcript: "What is a good exercise to increase SI joint mobility or sacroiliac joint mobility? So the SI joint is at the bottom of the spine and it sits right in between your two big pelvis bones and this joint is actually not supposed to move a ton. I think that oftentimes whenever we have SI joint pain, we think that that means we need to get it moving better. You might have been told that that's something that has to happen, but it actually just doesn't move that much at all and it's not supposed to. So Good et al did a systematic review in 2008 that showed the SI joint only moves 0 to 8 millimeters, like maximum, and that's all you really need. This isn't supposed to be a super mobile joint. And so oftentimes whenever we think about needing to improve SI joint mobility, really more than likely we just need to work on moving the muscles that surround the SI joint rather than think about moving the joint itself. And so any type of movement where you are going into deep extension or flexion with your back in a comfortable range tends to work well. And spending time doing things with one leg, so lunges, step ups, things like that can be helpful for moving one side of the hips at a time around the SI joint. But yeah, the SI joint really isn't supposed to move that much. It moves very little, so if it feels like it's not mobile, that's okay."

There could be a number of causes for feeling tired even after getting eight hours of sleep and regular exercise. These include things such as caffeine intake late in the afternoon, having to go to the bathroom during the night, having a partner moving in bed, noise interruptions, a hot room, and possibly sleep apnea or a hormonal imbalance. It is recommended to consult a primary care physician to further explore these potential causes.
 
Transcript: "Why might I feel tired even though I get eight hours of sleep and exercise regularly? So when we are getting good sleep, we're exercising but we still don't feel well rested, oftentimes that is because of the quality of our sleep. So it's good that you're getting the right quantity but quality of sleep can be impacted by a number of things and ultimately to feel rested we want to spend time in our deep sleep state which is called our REM cycle. And if we are having interruptions throughout the night that wake us up and impact that quality then we won't wake up feeling as rested. So things that might make you feel or that might interrupt your sleep quality are things like having a caffeine serving later in the afternoon can interrupt your sleep, it keeps you up at night because it is a stimulant, as well as having to go to the bathroom throughout the night can interrupt your sleep quality or having a partner moving beside you in bed might wake you up. So when we sleep we want to limit the amount of noise interruptions, we want to have a quiet room and a very dark room as well as a cooler temperature room. So if your room is really hot that can interrupt the quality of your sleep. And additionally things like a sleep apnea where you actually momentarily stop breathing at night can interrupt sleep quality because that stopping of the respiration can startle you awake and that might not be something that you notice but if you are a snorer that is definitely worth exploring with your primary care physician about getting a sleep study done or potentially having blood work done to make sure that all of your hormones are in check so that you know that there is not some sort of systemic hormonal dysregulation that is causing this fatigue."

If the asymmetry is not causing you pain or limiting your performance, there may no need to fix it. Unilateral movements may be helpful if there are asymmetries present, but it's not always necessary to fix them.
 
Transcript: "Question says, my right side is taller than my left, especially when doing a plank. It's obvious. Any advice on how to fix that? So whenever you say taller, I'm not sure if that means like your shoulder is higher on one side or your hip is higher on one side, like in standing too, or if you mean like in a plank, you're tilted one way or the other. And regardless of the scenario, I think a bigger question is, is this discrepancy in symmetry causing you pain, or is it inhibiting your performance? Because if it's not painful, and it's not limiting your performance in your sport, then is it really something that you need to fix? Ultimately, it is more common to have asymmetries in the body than it is to be perfectly symmetrical. So not being the exact same on one side versus the other isn't necessarily a bad thing, but it becomes problematic when you have pain or you feel like it's limiting your ability to perform. And so if neither of those things are true, you might be okay to just continue working and progressing at your sport. But if it is causing you pain, it might be worth looking into, maybe doing some exercises on one side of the body at a time. Unilateral movements can be helpful when there are asymmetries present, but ultimately it's not always something that you have to fix."

Strengthening exercises are the best way to prevent Achilles tendonitis. Some examples of strengthening exercises include calf raises, where you can start by standing on the ground and coming up on your toes, going up on two feet and going slow on the way down, and stepping up with your heels hanging off of a ledge or step and performing the same activity. Taking your time and pausing at the bottom of the movement is important for getting a good stretch and strengthening your Achilles tendon.
 
Transcript: "What are good stretches to prevent Achilles tendonitis? So Achilles tendonitis occurs when the strain that you put on your muscle and and the Achilles tendon, it exceeds your ability to tolerate that strain and so ultimately you want to allow that muscle and that tendon to calm down and then build up strength with it. So having a strong calf and good calf range of motion is going to be the best way that you can prevent Achilles tendonitis. So strengthening exercises is the best prevention of Achilles tendonitis because you'll be able to tolerate more and so some people might say that you shouldn't stretch your calf in a standing position but ultimately the standing activities are the ones that are challenging. So practicing a calf raise there are a couple ways you can do it. You can start by standing on the ground and coming up on your toes like this. If that's too easy for you, you can go up on two feet and go slow on the way down to strengthen or you can do one foot at a time and if you want to make it even harder you can step up and have your heels hanging off of a ledge or a step and perform the same activity coming up tall, getting a big stretch at the bottom and then you can repeat that process with going up on two feet, coming down on one or just doing one at a time but taking your time and pausing at the bottom of that movement is going to give you a good stretch and you're strengthening it at the same time so that your Achilles tendon can tolerate more activity."

Hi everyone, I'm Dr. Mitchell Tanner and I'm a physical therapist and certified strength and conditioning specialist. I have a background in exercise science and I have worked with athletes preparing for the NFL combine and other Elite level athletes. I have a background in powerlifting and martial arts and offer a holistic approach to health, wellness and Rehab.
 
Transcript: "What is up everybody? My name is Dr. Mitchell Tanner. I am a physical therapist and certified strength and conditioning specialist. I work in Miami, Florida with Old Bull Athletics where I'm a physical therapist as well as a performance coach. And just to share a little bit about my background, I have a background in exercise science where I studied at the University of South Carolina and worked with their D1 athletics program with sports science doing evaluations and collaborating with coaches to improve all of our athletes games. Additionally, during PT school, I went to the Medical University of South Carolina in Charleston where I had awesome opportunities to work with a company called Exos where we worked with athletes preparing for the NFL combine as well as other elite level professional athletes. I've worked with University of Florida's running medicine team doing rehab there. And personally, I have a background in powerlifting and martial arts. So I competed in martial arts at the national and international level as a junior and I won the South Carolina Junior Powerlifting State Championships in 2019 as well. So those are just some little tidbits about me. But you know, with my page, you can expect to see a holistic biopsychosocial approach to health, wellness and rehab. So thank you for joining and I'm excited to answer all of your questions."

Changing ankle position does not affect the stretching of your hamstrings, but it can affect how much tension you have on the calf and nerves that run down your back to the bottom of your ankle. Elevating the heel and having toes slightly pointed may give you a better hamstring stretch if you're limited in your ability to stretch your hamstrings due to ankle mobility.
 
Transcript: "How does bending of the ankle affect hamstring stretching? This is a great question and the short answer to it is that changing ankle position does not affect the stretching of your hamstrings at all. But bending the ankle and changing ankle position like elevating the toes for example might feel like you are stretching the hamstrings more. But what's actually happening is you are stretching the calves which cross over the back of the knee and can feel like the hamstrings sometimes. But whenever you lift the toes up you are getting a bigger hamstring stretch. But if you are feeling a greater hamstring stretch with the toes up it's either calves or the nerves that run all the way down your back to the heel. So you are stretching those nerves but you are not actually changing the position of the hamstrings or how much length change you are getting from the hamstrings by moving the ankle. So it might feel like you are getting a bigger stretch when you lift the toes but it is probably not. On the inverse side of that if you elevate the heel and have your toes a little bit pointed this actually could give you a better hamstring stretch if you are limited in your ability to stretch your hamstrings by ankle mobility. So if your ankles are really tight and you feel a stretch in your calves when you are trying to stretch your hamstrings maybe lifting the heel could be better but ultimately the hamstrings do not cross the ankle joint. So any change in ankle position is mostly going to affect how much tension you have on the calf and the nerves that run from your back down to the bottom of your ankle."