Athletic Performance
Heart Rate Variability: What It Reveals About Your Health
Heart rate variability (HRV) is the measure of time variation between successive heartbeats, regulated by the autonomic nervous system. A high HRV indicates a healthy, responsive system capable of adapting to stress and recovery, while low HRV reflects physiologic strain or diminished resilience. Unlike resting heart rate, which provides a simple snapshot of cardiac workload, HRV gives insight into the balance between sympathetic ("fight or flight") and parasympathetic ("rest and digest") activity.
Myo-Inositol: A Natural Molecule for Metabolic Health and Hormone Balance
Myo-inositol is a naturally occurring nutrient that acts as a key intracellular signaling molecule involved in hormone regulation, metabolism, and neurological health. While it is synthesized in small amounts by the human body, individuals with insulin resistance or metabolic dysfunction often have increased requirements. Myo-inositol is abundant in the brain, liver, ovaries, and skeletal muscle and is also available through dietary sources such as fruits, beans, and grains. Unlike traditional medications, it supports cellular communication and hormone sensitivity at the receptor level without overstimulation.
Creatine: Powering Muscle and Mind
Creatine is one of the most researched and effective supplements in sports nutrition. Naturally found in red meat and synthesized in the liver, kidneys, and pancreas from amino acids (arginine, glycine, and methionine), creatine plays a critical role in short-duration, high-intensity energy production. Supplementation helps saturate muscle stores of phosphocreatine, which fuels ATP regeneration, the energy currency of muscle contraction. Athletes across disciplines use creatine to increase strength, muscle mass, and performance.
Blood Flow Restriction: Maximizing Muscle Recovery With Minimal Load
Blood Flow Restriction (BFR) training is a clinically validated method of stimulating muscle growth and strength without placing excessive mechanical stress on joints, tendons, or healing tissue. Originally developed in Japan, BFR has gained traction in rehabilitation, orthopedic, and athletic performance settings because of its ability to produce robust physiological adaptations even when used with light weights.
When Building Muscle Becomes a Problem: Understanding and Treating Bigorexia
Most people have heard of body image issues like anorexia, where someone fears gaining weight. But fewer people know about Bigorexia, also known as muscle dysmorphia. This is a condition where someone becomes obsessed with building muscle and never feels muscular enough, no matter how much they work out. It’s a form of body dysmorphic disorder (BDD), and it can have serious effects on mental and physical health.
Modern Tendinopathy Treatment: Beyond Rest and Injections
Tendinopathy is a degenerative condition of tendon tissue that impairs function and often resists standard treatment. Tendinopathy can be broadly divided into two categories: tendinitis which is the early onset of tendon injury, and tendinosis which is a chronic, painful, degenerative state. Traditionally, management involved rest, NSAIDs, corticosteroid injections, or even surgical debridement. But modern research has shown that these strategies often miss the underlying problem: tendinopathy is not primarily an inflammatory condition, but a failed healing response driven by mechanical and molecular dysregulation.
Muscle Fibrosis and Aging: Why Strength Fades and What Can Be Done
As we age, many people assume that weakness and muscle loss are inevitable. While some decline in strength is expected, much of what we attribute to “aging” is actually due to specific biological processes, particularly muscle fibrosis. Unlike muscle atrophy alone, fibrosis involves a shift in tissue architecture, replacing healthy muscle fibers with stiff, disorganized collagen. This change reduces mobility, strength, and responsiveness to exercise.
Avoiding Cryotherapy is Beneficial in the Treatment of Many Musculoskeletal Injuries
For decades, ice packs were a cornerstone of injury management. Coaches and clinicians routinely prescribed “RICE” (Rest, Ice, Compression, Elevation) for everything from sprains to muscle soreness. But in recent years, our understanding of muscle physiology and tissue repair has evolved, and so has our use of cryotherapy.
How Blood Sugar Damages Tendons: The Hidden Role of AGEs
Tendons are resilient structures, built to transmit force from muscle to bone. But like other tissues in the body, they are vulnerable to the damaging effects of elevated blood sugar. One of the most important biochemical contributors to tendon degeneration in metabolic disease is the formation of advanced glycation end products, or AGEs.
Prescription Preworkout: Tadalafil and L-Citrulline for Vascular Performance, Increased Strength and Muscle Pump
Traditional preworkout supplements often rely on stimulants like caffeine or yohimbine to deliver short-term energy and vascular effects. While these ingredients may enhance alertness and temporary vasodilation, they often come with side effects like anxiety, rapid heart rate, and crashes. At the Performance Medicine Institute, we offer a prescription alternative grounded in vascular physiology: a combination of daily tadalafil (5mg) and L-citrulline (750-1500mg) to safely and sustainably enhance performance, blood flow, and muscle pump without overstimulation.