Sleep and Recovery

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

In the world of physical therapy, we often spend so much time on exercise selection and form to help people recover from an injury, but I think there is so much more to it than that. Our nutrition, stress, and sleep also play a huge role in our bodies ability to heal. Whether you're returning from an injury, training for a race, or just trying to stay active and pain-free, getting enough quality sleep can make a massive difference in your progress. For active individuals I think sleep can be a silent contributor to overuse injuries.

When we think about overuse injuries we primarily focus on the activity that led to the injury. We can also look at it in terms of under-recovery. I think it can be especially important factor when an injury occurs without a clear cause. Often injuries happen with a spike in activity levels that our bodies weren’t accustomed to handling. But I do see injuries where volume has not changed much, and at a level and intensity that the person has previously managed just fine. I think looking into other factors can be important. When we are not recovering as well our bodies will not tolerate the same amount of stress.

Sleep isn’t just rest—it’s essential for optimal physical function. In fact, studies have shown that people who regularly get fewer than 7 hours of sleep per night have significantly higher rates of injury. When we get less sleep, our immune system suffers and we often have more inflammation and slower recovery.

If you're dealing with an injury or recovering from surgery, quality sleep is essential for healing.

During sleep, your body:

• Repairs damaged tissue

• Releases growth hormone to rebuild muscles and tendons

• Reduces inflammation

• Processes pain—yes, sleep can literally help you feel less pain!

Without enough deep and REM sleep, your recovery timeline may stretch out longer than necessary. Even worse, poor sleep can lead to reinjury or plateaus in progress. Whether you’re running, lifting, or just keeping up with your kids, sleep affects how well you move and how strong you feel.

Adequate sleep improves:

• Strength and power output

• Cardiovascular performance

• Mental clarity and decision-making

• Motor learning and coordination (critical for rehab and retraining movements)

If you want to get the most out of your workouts—or your physical therapy—don’t skimp on sleep. One of the things I enjoy about my clinic is I am able to schedule out hour long appts. That gives plenty of time get in the exercises needed for recovery but also time for me to spend with patients going over things like sleep. Establishing as many healthy habits as we can, will improve our outcomes. Along with your physical therapy we can spend time addressing other barriers to your recovery like sleep and work together to implement strategies to improve these areas.

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com

Pickleball and Physical Therapy

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

Pickleball is a fast-growing sport, and I think it’s a great sport. Anything that encourages people to get out, be active, and socialize are great for us in a number of ways. It is however associated with a high injury risk especially in those 50 and above. That is not surprising given it is a stop and start sport with quick movements involved. While many different age ranges are picking up the sport, it is especially popular with older adults as it is seen as a safer alternative and not quite as demanding as a sport like tennis.

One thing that happens as we age, we tend to not to perform activities that require quick movements near as often. Our bodies adapt to what we ask it to do. If we do not ask our muscles to move quick for a long time, then pick up a sport where that is often the case, our muscles, tendons, and joints will not be accustomed to this, and thus increase our risk of injury. I think a lot of people go into it thinking they will take it easy, but it is a reactionary sport where we don’t always have time to think about what we are doing and may push it harder than we expected before realizing it.

We can however exercise to prepare our body for the demands of the task to reduce our risk of injury. Our bodies are adaptable, but it does take time and consistency to make significant changes. We need to incorporate some strength training so our tissues are ready to handle the necessary loads that will be placed on them. We also need to spend some time moving quickly to again prepare our bodies for what we will be doing. Another great benefit of exercise is it may improve your performance in pickleball but also have a positive benefit on overall health and function. I do think having an appropriate warm-up more than just static stretching, that gets our heart rate up and us moving can be important for reducing injury risk as well.

If you do find yourself with an injury it can be frustrating to overcome and get yourself back to enjoying the hobbies that you love. That is where working with a trained professional can help you manage your injury, provide a prognosis, and get a clear gameplan to get you back to enjoying those tasks as quickly and safely as possible. One of the great things about people who enjoy pickleball, is they already have an enjoyment for getting out and moving. As a physical therapist, one of our most difficult tasks is often getting people to move more, which is why working with a population like this is so enjoyable. Some of the hard work is already done and that is why I think the pickleball community has such potential to benefit greatly from physical therapy!

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com

Physical Therapy for Runners

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

When we think about sports and injuries, I think most of us think about sports with high intensity demands like basketball. I think people often think of running and jogging as a safer alternative, which is true to some extent. You do not often see the traumatic injuries with running that you do from other sports. But looking at the research, if you are a regular runner, your odds of having some sort of injury in any given year is somewhere near 50%!! That is high and I think much too high. Now a good majority of those are minor, but we do run risks of having more serious injuries like bone stress injuries and chronic injuries like tendinopathy can keep coming back time after time.

When I look around the world of physical therapy for runners, I see a ton of running analysis. I have my doubts at how good we actually are at making positive changes off just running analysis. I do think that gathering a video of yourself running can be a starting point and can give you some basic information, however I feel there are a lot of false promises out there regarding running analysis. I think it often gets promoted as the most important thing when it comes to running performance, injury prevention, or recovery from injury when in reality I think it is much further down on the hierarchy than that. There are some studies out there that correlate running efficiency with certain running characteristics. Now one would think that if you just train and work on those specific characteristics that you would in turn become faster. Unfortantely it is not that simple. Making changes to running form can be very challenging to begin with. We have a lifetime of an ingrained habit that can be difficult to re-train. And even if we are able to make subtle adjustments there is a not much out there to suggest that we actually get faster.

There is so much that goes into running form. Our individual characteristics make up a huge portion of it including our muscles and tendon lengths as well as our individual bone structure. Some of our form is a bit self-determined by who we are and how we are made and what activities we have done throughout our life. There are also other things like our tendon stiffness and muscle tone that can make someone run a bit differently. Even when we look at elite level runners, almost all of them have their own running characteristics, which to me suggests there is no perfect running form we should be trying to achieve. I think we should work on making our own stride as efficient as it can be.

Now back to the running analysis. There are so many different factors that can be measured or tweaked. I have listened to a few talks from people who spend their whole lives dedicated to running coaching/rehab talk about the complexity of running analysis I think it would gives me some doubt about how effective most of us are at breaking it all down correctly and making the appropriate changes. Even those talks have emphasized how difficult it is to actually change someone’s form for the positive and have that change stick. The other thing I would caution someone who is about to make a switch to their running form would be injury risk. I know that probably sounds interesting, because we always hear we need to change our form to reduce our injury risk. I want to look at the other side of it. We have likely ran one way our entire lives. As a result our body has adapted to handle that particular stress. Lets say for example you are a heel striker with knee pain that wants to switch to a forefoot strike to reduce the stress on your knees. While I do agree that pattern would stress your knees less and possibly lead to a change in knee pain over time, we need to think about the new structures that are now taking on the load. The calf complex and achilles are now taking on way more stress than they have been adapted to for your entire life. The risk of eventually having an overuse injury in that area is very high. If you do feel it is necessary to make a form adjustment you need to do this very slowly over time. I typically will go with changing your load not by drastic form changes, but rather changing the terrain (incline vs not incline), footwear (its amazing how different footwear can shift load), and cadence. But often even these are short term changes to unload the structure that needs it to allow healing time before slowly introducing load again over time. There are other components that go into it, like strength and plyo type training while recovery to help build resiliency in that structure.

Most average runners would benefit most from a safe program that lets them run consistently injury free over time. The longer you can train without a significant break due to injury and the more you can eventually run; you will slowly become a more efficient runner. I think that’s the true low hanging fruit and unfortunately there is no short cut around it. Hardwork, patience, and dedication will eventually get you there. Now the trick is trying to figure out a program that lets you run more over time without getting injured. As we discussed earlier the incident can be as high as 50% that a runner will suffer a setback in any given year. There is no failproof method to preventing injuries but 50% is too high. I won’t make false promises that you can “bulletproof” your knees. That doesn’t exist and if someone tells you that I would be wary of their advice. You could do the best knee exercises in the world and if you increase your weekly mileage too much too often you are going to end up with an injury. There are ways however to greatly reduce your risk of injury through smart training and some time in the gym. Every individual is different and requires a different approach based on what experiences, training volume and injury history you have to begin with. I would be happy to help guide you through this process.

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com

Importance of Strength Training

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

Strength and Longevity: Why its important to maintain our strength as we age 

In recent years, scientific research has increasingly linked muscular strength to longevity. While cardiovascular fitness has long been emphasized in health discussions, mounting evidence suggests that strength training plays a critical role in promoting a longer, healthier life.  

The Link Between Strength and Longevity 

1. Lower Mortality Risk 

Studies show that higher muscle mass and greater strength are associated with reduced all-cause mortality. A 2018 study published in the Journal of Gerontology found that older adults with greater handgrip strength had a lower risk of death from any cause. Similarly, a study in BMJ indicated that strength training reduces mortality risk independent of cardiovascular fitness. 

2. Improved Metabolic Health 

Strength training enhances insulin sensitivity and reduces the risk of type 2 diabetes, a major factor in aging and disease risk. Muscle tissue helps regulate blood sugar levels, and those with higher muscle mass are better able to maintain metabolic health as they age. 

3. Reduced Risk of Falls and Fractures 

As people age, the risk of falls and fractures increases due to loss of muscle mass (sarcopenia) and bone density. Strength training has been shown to preserve both, reducing the likelihood of falls and osteoporosis-related fractures. 

4. Enhanced Cognitive Function 

Emerging research suggests that strength training is beneficial for brain health. A study in Neurobiology of Aging found that resistance training helps maintain cognitive function and may reduce the risk of neurodegenerative diseases like Alzheimer's. 

5. Cardiovascular Benefits 

Cardio is not the only way to get cardiovascular benefits (although it is good too). Strength training can provide some of those benefits as well, and structuring your workout in supersets can keep you moving throughout.  

How to Incorporate Strength Training for Longevity 

To maximize the longevity benefits of strength training, experts recommend: 

• Training at least 2-3 times per week, targeting all major muscle groups 

• Using progressive overload, gradually increasing resistance or repetitions over time 

• Incorporating functional movements, such as squats, deadlifts, and push-ups, to enhance daily movement patterns 

• Combining with aerobic exercise for optimal health benefits 

Final Thoughts 

The evidence is clear: maintaining muscular strength is a key factor in extending lifespan and improving quality of life. Strength training not only enhances physical resilience but also protects against chronic disease and cognitive decline. By making resistance training a regular part of your routine, you can improve your chances of living a longer, healthier life. 

At Habits Physical Therapy, we believe in the power of strength for longevity. Contact us today to learn how we can help you incorporate safe and effective strength training into your routine. 

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com

Golf Performance Physical Therapy

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

There are many different ways to go about improving your golf performance. To me, the easiest and lowest hanging fruit for most people is through physical conditioning. Think about it, how many times have you tried to change your swing only for it not to work or to actually get worse. Golf is a hard sport. Changing your swing is challenging, and when you do find something that works often times that success is transient and you're on to the next tip. Improving our strength, power, and mobility is much more predictable. If you are consistent with a properly programmed strength and mobility routine, I can almost guarantee you that you can swing the club faster and hit the ball further. There is a direct correlation between how far you hit the ball and lower scores.

Now this doesn’t mean you shouldn’t work on your swing mechanics. Just like strength and conditioning, working with a good swing coach can make a world of difference, but I think it is less predictable than changing your physical characteristics. Now, getting stronger and more mobile doesn’t automatically get rid of your swing faults. But having the pre-requisite strength and mobility, can make swing changes easier. It can be difficult to address a position at the top of your backswing, when you do not have the mobility required to get into the position you want in the first place.

When it comes to improving your strength, power, and mobility there has to be intent and structure to optimize your program. If your goal is to hit the ball further (who doesn’t want that) each can play a role. Having better mobility can allow you to have greater width in your swing and store more potential energy at the top of your swing allowing you to produce more speed on the way down. I do think the biggest gains when it comes to swing speed comes from strength and power. Look at John Rahm for example… He produces 180+ mph ball speed with what most people would call a short backswing. I often hear people when golfing with a younger population that hits the ball far comment “if I was that young and flexible”. Now I already stated I do think this plays a role, but chances are that youth can also out sprint you, jump you, and throw you. They are likely used to moving faster than you through their everyday life activities and that leads to the ability to produce power. As we age we rarely move fast and our ability to produce power is one of the first things that starts to fade.

Strength is a big pre-requisite for power. Power is the ability to produce force quickly. Strength is the first part of that equation (the force part). In order to build strength we need to challenge our system to get adaptations. I often see people lifting well below that threshold or doing body weight exercises that aren’t providing enough stimulus to get a real change past a certain point. To produce power, there has to be real intent. You have to purposely move fast in order to get faster. They need to be all out movements to optimize your gains. Just because strength is pre-requisite to power doesn’t mean you can’t work on both at the same time. Now I do think if you are not accustomed to these activities, there is an injury risk. Go back to the previous post (how injuries occur). This is where working with someone who is trained can help you know where to start and how to progress safely. When done right, I think these actually reduce your injury risk rather than increase it and hopefully lead you to outdriving your friends and having more fun on golf course. Plus, there are tons of other health benefits along the way. If you are curious about this but don’t know where to start, I would love to hear from you!

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com

How Injuries Occur

By Clint Choquette DPT, Habits Physical Therapy, Nampa, ID

When we think about injuries, most of the time it is as simple as stress vs what a particular structure is designed to take. It can be applied to many different things. A piece of wood can only withstand so many pounds of force, and if that point is surpassed, it breaks.

You can think of our bodies in a similar way. Except we have muscles, bones, ligaments, tendons ect… All of those structures are capable of handling a certain load. We can also think of stress on an object vs time. We can handle a larger load for a short duration but over a long duration we tolerate less load. A good way to think of this would be hanging something from a rubber band. If you put something extremely heavy on the band it will break immediately (think of acute injury like a fall and broken bone). If you put a medium weighted object the band may hold initially but over time it will slowly give way (overuse chronic injuries).

In our everyday lives we encounter different tasks that put stress on our tissues. The tricky part with humans is knowing how much load we can take. With objects there are often structural ratings. Unfortunately, we do not come with such labels. And the even trickier part is we adapt over time to what we have asked our bodies to do. If you haven’t lifted 50 lbs in 10 years and then attempt it, your injury risk is much higher than someone who does that regularly. Allowing our bodies proper recovery (that is a topic for another day) is also very important.

The good news in all of this also comes from the last paragraph. And that is, that we are adaptable. We can change what our body can tolerate over time. If you hurt your back shoveling snow, you can train your body to be ready for that challenge next time and greatly reduce your risk of injury (nothing is fail-proof).

📞 Contact:
Habits Physical Therapy LLC
8 6th St N, Suite 102
Nampa, ID 83687
406-560-1048
habitspt.com