Question: Nate, tell us a bit about yourself, what are your hobbies, outdoor activities, etc.
Answer: Scorpio. Grew up in a small town in Illinois. Went to Physical Therapy school at Saint Louis University. Worked 3 seasons for the St. Louis Rams. Then moved to AZ, started Endurance Rehab in 2003 and lived in AZ total of 18 years. Moved to Wenatchee in 2015 to allow our 2 young boys to grow up close to family (wife’s family) and to experience the four seasons in a recreational outdoor mecca.
I enjoy spending time with my wife and 2 boys outdoors – mountain biking, trail running, nordic skiing, downhill skiing, rock climbing, soccer, etc.

Question: We have heard that you are a physical therapist and have done physical therapy for Trek bicycling team in Europe for multiple years in a row? Please tell us about it.
Answer: Yes, I am a Physical Therapy Consultant for a men’s and women’s professional road cycling team, Trek Segafredo. They race in all the big races across the globe, including the Tour De France. There are over 35 riders between the 2 teams. I am entering my 5th season in this role. I provide physical and performance assessments to look for opportunities in the athletes body’s to improve performance and reduce injury. Working closely with bike fitters and engineers we optimize the cyclists body positioning on the bike for peak performance. During the season I also provide injury consultations. This job takes me to Europe 1-2 times per year and once a year to Wisconsin to Trek Headquarters.

Question: How do you prepare for the different activities you do outside using a physical therapy mindset? Stretching etc.?
Answer: In general I pay attention to 3 things: 1. How much I increase training volume and intensity. 2. Mix up my activities and allow for adequate recovery. 3. Work on mobility and strength at least a couple days per week.

Question: What difference in injuries do you see between those who get outdoors every so often and those who get out A LOT? Does this differentiate between the different activities the person does and if so, what are the differences?
Answer: Difference in injuries really depends on how consistent a person performs a specific activity. Typically, those people that get outdoors for exercise on a consistent basis will experience less injury since their bodies are more used to the stress and strain required to perform the activity.

Question: Do you have any food or pre-activity things that you do before you get outdoors for a bigger day? Or specific things you do after a big day outside…Tell us your ways!
Answer: Before I get outdoors for a bigger day I do dynamic stretching/mobility to prepare my spine and legs before a long run, hike or ride. Making sure I am hydrating well the day before a bigger day. After a big day, for me eating salty foods, having a beer and maybe a bit of static stretching.

Question: What do you recommend each person who likes to get outdoors a fair bit do to prevent injuries and/or long term chronic injuries (this could be for specific outdoor activities as well)?
Answer: Consistent stretching/mobility and a strength program (2-3 times per week). Focus on specific areas of weakness/limitation and areas specific to your sport.

Question: Coming from someone who likes to exercise a lot (about six days a week) what do you recommend in the way of maximum activity per week or maximum hours of activity a day?
Answer: This is definitely more of a question for an “endurance coach” but in general, there is not necessarily a max. It just depends on what you are training for and if you have a solid periodized training plan. If you increase volume or intensity too quickly its a recipe for disaster. Everyones tolerance to training or exercise is a bit different due to training history, genetics, injury history and our unique musculoskeletal design.

Question: What is the most chronic injury you treat..being a physical therapist?
Answer: Low back pain is the most common chronic injury in general. Chronic use or overuse tendon injuries are the most common in endurance athletes.

Question: What is the most interesting injury you have treated?
Answer: After 23 years as a PT its tough to single one out. An interesting injury that I recently saw was a young high school runner that had some hip pain, the pain resolved and he returned to running with his team. He came back to the PT complaining he was running “weird” and teammates and coaches were concerned. The treating PT couldn’t find anything wrong with him and asked me to consult. After watching him run I suspected a femoral (thigh bone) stress fracture. We sent him back to MD for imaging and a fracture was confirmed.

Question: What tips or tools can we take away to help prevent injury?
Answer: Cross training, mix up your activities. Make time for mobility and strength work. If the activity is new, do not overdo it, take your time and enjoy it.

Question: How do you feel about cross training? I personally always have a hard time fitting in the activities I want to do without overlapping them in some way. It can be hard to juggle the activities so that you aren’t burning out one area of your body too much.
Answer: You have to pick and choose, first – do what you love. Second – do what you have to do so you can keep doing what you love — ie/ weights/core/mobility (This can be as little as 20-30 min 2-3 times per week if you are focused and not chatting with friends at the gym).

Question: Anything else you would like to tell the outdoor community?
Answer: The best injury prevention for your body is just moving…the best for your mind is being outside, so keep combining them!

Question: If someone would like to see you for physical therapy, how do they get a hold of you?
Answer: Email is best, nate@endurancerehab.com

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