IRONMAN Weekend!!!!

Our clinic specializes in the education and treatment of endurance athletes. This weekend is a “double whammy” of endurance events, with the Ironman World Championships in Kona, HI taking place today (October 13th) and Ironman Louisville taking place tomorrow, October 14th.  (click the links to find out more info about the events, search athletes and track their results)

We have multiple athletes participating in both events, and our staff understands all the hard work, heartache and sacrifices you have endured to get to this day. Best of luck, apply your training, but most of all….enjoy the journey.

Ironman Traverse City 70.3

Well, that happened quickly. Ironman Traverse City 70.3 SOLD OUT in the first hours of general registration. Hoping to see a ton of our friends, colleagues and athletes training and prepping for the first year of this event, scheduled for August 25, 2019.

Dr. Katie Noble Collaborates with Fellow PTs to Discuss Women’s Distance Running

In this blog post, Dr. Katie Noble shows her passion for running, and specifically the education surrounding women’s distance running. All three PTs – Katie, Sam Gerutta, and Amy Yorke – examine challenges female runners face, important aspects of health to consider, and even some of their own experiences as runners/clinicians.


Race Tip #5: Taper

With less activity, athletes run the risk of defeating themselves mentally. A taper period is a crucial part of training that can make or break your upcoming race. Dr. Hannah DePaul reflects on her time swimming at the University of Michigan where she learned a lot about taper.

Two things that resonated with her: “The hay is in the barn and “Control the controllables.” Her coach would preach that all the hard you have put in is done, and now is the time to recover. Let the mind and body prepare for race day. You will not gain any fitness in the last couple of weeks leading up to your big race.

Some things are out of your control, such as who else is racing or what the weather will be like. Do not waste mental energy on those factors. Control what you have the ability to control…your mindset, attitude, and preparation. Focus on your race, trust your training, and good things will come. Having strategies in place ahead of time will help keep you mentally focused. So acknowledge the taper and embrace it!

Race Tip #4: Sleep

A typical response we hear from athletes – when asked how much sleep they are getting a night – is, “not as much as I would like.” Athletes are great at working hard, but sometimes the importance of sleep is neglected. It’s not just the work you put in, but the amount of recovery you give your body. As an athlete, sleep is the most effective recovery strategy that we can utilize. Lack of sleep can increase risk for injury and affect physical and mental performance. A recent systematic review from Bonnar et al. (2018) found that extending sleep had the most beneficial effects on subsequent performance compared to napping, sleep hygiene, and post-exercise recovery strategies. Also, 7-9 hours of sleep per night is recommended for healthy adults but athletes need 9-10 hours to reach their full potential. Make sleep a priority. Set a regular bed time, avoid caffeine late in the day, and limit screen time before bed. Improving sleep can be difficult, but stick with it! It’s worth it. Train hard and rest harder!

Bonnar, D., Bartel, K., Kakoschke, N. et al. Sports Med (2018) 48: 683.

Race Tip #3: Advice From Us

The Bayshore Marathon provided an opportunity for Dr. Hannah DePaul and Dr. Katie Noble to pull from their own experiences and share some advice with our patients and fellow athletes.

Katie advises that instead of concentrating on the outcome of a race, focus on the process. Set small goals during the race to make the task more mentally manageable. Not every race goes to plan, but stay calm and do what you can in the moment. Every race is a learning opportunity that you can benefit from in races to come!

Hannah found that many endurance athletes put so much focus on just the long workouts (example the 20+ mile marathon prep run), but neglect the consistency and frequency in their training to nail the full race. The hero workouts can contribute to injuries and require prolonged recovery time. Instead, she recommends focusing on consistent training rather than hero workouts. Putting in the work week after week will give you confidence and put you in the right mindset to meet your race day goals!

Tweak and Level Multisport

Tweak is a swimming facility that focuses on athletes’ biomechanics and overall fitness in order to help them be more efficient in the water. During a swim analysis you will get into an endless pool and their coaches will capture live video. When going over the footage, they will look at your form, point out aspects to improve and give you feedback that you can immediately work on and integrate into your stroke. It is akin to what we do for runners with a running gait analysis, but for swimmers in the water. You can schedule your swim analysis online or call the facility and talk to the staff! 


Level Multisport is a triathlon store that we have heard so much about from our patients. Since 2011, they have been proudly serving the triathlon and fitness community. Their knowledgeable and friendly team are deeply involved with the multisport lifestyle themselves, giving them an edge on helping you find exactly what you want and need for your training. They specialize in shoe fitting and bike fitting and also offer elite swimwear. Feel free to attend their Saturday morning Spin Lab or just stop in to grab some gear and meet the crew! 

Brian and Hannah Certified in Level 2 Functional Dry Needling

Dry Needling involves inserting a tiny monofilament needle into a muscle in order to release shortened bands of muscles and decrease trigger point activity. This treatment can resolve pain and muscle tension, and will promote healing. 

Patients can experience valuable and effective relief from musculoskeletal pain with this treatment. It is sometimes compared to traditional Chinese Acupuncture but it is NOT. Instead, dry needling is a medical treatment that relies on a medical diagnosis to be effective. 

The actual insertion of the needle causes very little discomfort, if any, being that the needles are so thin. With a sensitive muscle or a muscle that contains trigger points, needling will provoke a “twitch response” that feels similar to a muscle cramp. Over time, this process contributes to deactivating the trigger point, therefore reducing pain and ultimately restoring normal function of the muscle. 

Through KinetaCore, Brian, Hannah, and Katie have all met the requirements to be considered Certified Level 1 Functional Dry Needling Practitioners. This weekend, Brian and Hannah are now advancing their skills to be certified in Level 2 Functional Dry Needling. 

Level 1 entails learning how to treat muscle knots – or trigger points – to help regulate nervous system disfunction.

Level 2 involves treating parts of the body that involve more skill or are harder to get to. This includes muscles that lie over the chest and mid-back

, as well as muscles in the jaw, neck, thoracic spine, hands, and feet.

With this training, Brian and Hannah will be able to be use these skills to treat more patients, more parts of the body, and help even more people reach their goals! 

Cervical Spine Dry Needling

Level 2 Dry Needling Course

Taking Therapy in Stride ::: PT Products Article

Dr. Caitlin Noble

We are always proud to showcase Dr. Caitlin Noble’s physical therapy skills on a daily basis in clinic. She helps so many patients and athletes reach their full potential. But did you know that she is also an amazing journalist? Her undergraduate degree from Michigan State University was in journalism.

Katie was recently commissioned by Physical Therapy Products Magazine ( to author an article on running gait retraining and tools utilized in our sports medicine clinic. The article features research citations and contributions by our own Dr. Hannah DePaul. You can find an online version of the article here: LINK

This article will be in print form in the February 2018 edition, and will also be circulated at the annual APTA Combined Sections Meeting next month in New Orleans.

Dropping Knowledge at HPC!

Last week Dr. Hannah DePaul and Dr. Brian Adams participated in a panel discussion with some of the leaders in the sports medicine and health community. They were invited to talk about and collaborate on a number of topics including injury prevention, off-season training, periodization of training, thoughts about post-season conditioning  and more.

Thank you to Human Performance Collective for hosting such a fascinating collaborative event. Some other members on the panel included Dr. Steve Broglio (UM Kinesiology/Neurology), Jessica Bratus (Sic Transit Cycles) and Darryl Nelson (USA Hockey Strength Coach). We are so grateful to be part of such a knowledgeable group of experts! Such a productive discussion that will help athletes stay strong and healthy!