Could Your Sleep Habits Be Hindering Your Recovery?


Over the past several years I have noticed the word “recovery” being used more and more in the health and fitness world. It seems like every week there is a new gadget that is marketed as a recovery tool. Products such as Normatec boots, Theraguns, cryo chambers, and saunas have all been sold as the ultimate tool to unlocking your greatest athletic potential. While these things may have some benefit, I think most people are overlooking a massive piece of the puzzle when it comes to recovery. The good news is that this puzzle piece is completely free and available to everyone.


I’m talking about sleep!


Let’s look at some ways sleep helps with your health and recovery, then talk about what you can do to improve your sleep habits.


Sleep has been one of the great mysteries of the human experience for many years. We have known that it is important, but for a long time we didn’t know exactly why. While there is still a lot to be discovered about sleep, recent research has been able to uncover a few of the secrets concerning the purpose of sleep.


A recent study published in Science discusses the flow of cerebrospinal fluid in and out of the brain during sleep. They describe this as a “power washing” effect which helps to reduce beta-amyloid plaque buildup (this substance has been linked to the onset of Alzheimer’s disease) and reduces concentrations of inflammatory chemicals. 


Another study published in Physiological Reports details the negative effects that sleep deprivation has on muscle protein synthesis. According to this paper, one night of sleep deprivation (less than 7 hours) leads to a 17% decrease in protein synthesis and a 24% reduction in testosterone. In addition to this, it discusses how muscle and collagen fibers are laid down in a “haphazard” manner when subjects are underslept. This results in poor recovery from training and may lead to an increased injury risk in the future. 


Now let’s look at what you can do today in order to improve your sleep.


When looking to improve sleep there are two areas that we can focus on: quantity and quality. The recommended quantity of sleep per night is 7-9 hours. According to the CDC, an estimated 35% of Americans are getting less than 7 hours of sleep per night. Unfortunately, our busy lives don’t always allow us to sleep as much as we should, which is why I tend to focus on improving quality of sleep rather than quantity. 


When it comes to improving the quality of your sleep there are a few easy lifestyle changes you can make which will provide exponential benefits. These changes include:

  • Go to bed and wake up at the same time every day
  • Keep the temperature in your bedroom between 60 and 65 degrees
  • Make your room as dark as possible
  • Avoid caffeine after noon
  • Avoid alcohol or spicy food three hours before bed
  • Avoid blue light 3 hours before bed (cell phone, TV, iPad, etc)
  • Reserve your bedroom for sleep. Avoid working or watching TV in your bed

My recommendation is to start with one of these habits and slowly add in other ones as you go. I think you will be surprised at how much more rested you feel even if you don’t increase the number of hours you sleep. 


If you have questions about sleep or what other factors may be influencing your pain, recovery, or athletic performance call us today to set up an appointment. 


Blake Thomas PT, DPT, CMPT

Refine PT and Performance – Decatur


Finding your First Job After PT School


You’ve made it through the grind and you’re on the home stretch towards graduation. You’ve started prepping for the NEPTE (or not) and you’ve started the inevitable job search. Luckily, as you move through the end of third year, recruiters stream in daily like a flock of seagulls to a handful of cheetos. 

In my experience, each one promised “patient centered care,” where PT’s would get what I’ve come to call “The Big Three.”

  1. Competitive Salary 
  2. Continuing education and benefits (I know, that’s technically 2 things)
  3. Continued Mentorship 

All these things are easy to say, but much harder to follow through with. So, I’ll outline a few of the lessons I’ve learned through the process so far, since I’ve had a number of friends reach out to me for guidance. 

Let’s go category by category…

1- Competitive Salary

While this seems to be very straightforward, it may not be the case. If you sign on for a position as a salaried therapist, then that means you are no longer making hourly wages. Which means you might be at the mercy of working longer hours, which effectively lowers your hourly wages, unless you’ve got something established for overtime hours or bonuses. For instance, 75K may sound great, but if you end up working 60 hour weeks, maybe not so much. With all that being said, make sure you understand what’s expected of you as far as scheduling and weekly work requirements, and if there’s the potential for longer hours, make sure you will be compensated for those hours. Also, if it is a “high volume clinic (where more than one patient comes in on the hour),” factor in time for notes outside of the clinic, because it is very likely that you will not have time to finish these during the business day. For instance, you may work 8 hours per day, plus 30 minutes to clean up before heading home, then 1.5 more hour of notes at home to finish up the day. Now your weekly work hours have increased significantly (but your salaried pay is based on 40 hrs). Almost every job, in my opinion, will require more than 40 hours from start to finish, but these are just a few things that I wish I had paid more attention to when I was weighing my decision of where to work.

2- Benefits and Con-Ed

I’m not going to dive too deeply into the benefits portion, but just know that matching into a Roth (pre-tax) or traditional 401K (post-tax) can add up quickly. As far as con-ed, if you can do your homework and be specific during your contract negotiations, companies may be more willing to increase your allotted amount of available funds even if they are unwavering on salary. I think this is largely because It demonstrates that you are driven, committed to growing as a clinician, and could benefit the company (certifications etc). If there’s a certification or class you wanted to attend anyway, those ceu funds are as good as cash, and, they aren’t taxed like a signing bonus. Not to mention, they will often help you to better serve your patients, which is always the primary goal.

3- Continued Mentorship 

This is possibly the biggest point. Each company will promise you mentorship opportunities, but few will have exactly what you want personally. Every clinician has his or her own style. One of my clinical instructors once told me that PT is just as much an art as it is a science, and in retrospect, I totally agree. You need to do your homework to see if your co-workers and the DIRECT senior therapist in your work environment has a style that appeals to you, because they will be your braintrust. Just because you did a clinical with a company, you need to make sure those in the area you are applying have goals and styles that mesh with what you are hoping to learn (whether treatment or business related). 

A Couple More Points to Keep in Mind

Sometimes taking an initial salary cut to work with a clinician or in a setting that directly aligns with your mission and goals as a therapist is the best move you can make. We all want to feel fulfilled in our work, and finding a nice fit will always serve as a great base for you to build your work life around.

Think about your long term goals, and don’t just settle for the “stable” position. You are a DPT (once you pass the NEPTE), and companies everywhere need your help. Not only that, you can make good money working part time or PRN while you keep searching for your position of choice. 

So there you have it; some extra things to consider as you graduate and try to solidify the job you’ve been  grinding  through school to snag. 

Hopefully this has been helpful, and if you have any questions, or want to find out more about our business at Refine PT and Performance, don’t hesitate to reach out to us.

Best Wishes, 

Tyler Vaughn


Refine PT and Performance

[email protected]


Owner Pathology Apparel

Meet Our Newest Team Member in Decatur, Alabama


My name is Blake Thomas and I am the newest addition to the Refine team. I will be practicing out of our first North Alabama location in Decatur. I am so excited to help the people of Decatur reduce pain and improve their ability to do more of the things they love. 


I will be combining an extensive background in hands-on physical therapy with my love of strength and conditioning in order to not only improve your pain, but more importantly, to make you a stronger and more resilient human being. 


Whether you are a high school athlete recovering from an injury, a Crossfitter looking to improve your performance, or a grandparent wanting to keep up with your grandkids, I can help you meet your goals. If you have tried physical therapy in the past without success, I would encourage you to come and experience something different.


If you are considering seeking guidance or personalized care, please do not hesitate to give me a call today and ask how we can work together in order to give you the tools you need to thrive. 

Find my Bio Here: Blake Thomas

Blake Thomas PT, DPT, CMPT, TDN

Refine PT and Performance, Decatur

Phone: 256-973-1552

Fax: 256-973-1553


The Truth about “Degenerative Disc Disease”


What studies have shown on the topic of “disc degeneration” and it’s role in back pain might surprise you. In the medical community, it may be easy to look at changes on imaging and use them to justify why pain is occurring in people of all ages; however, research has been challenging this heavily. Specifically “disc degeneration” was a topic that was covered on the Ice Physio Podcast, which I highly recommend by the way. They interviewed the president of AAOMPT during one of their sessions, and it was a great reminder of the positive direction that the field of Physical Therapy is moving.


Did you know that The American Academy of Orthopedic Manual Physical Therapy (AAOMPT) has made a position statement to discourage the use of the term “degenerative disc disease” as a cause or diagnosis for neck or low back pain?


President Dr. Elaine Lonnemann stated, “Despite its name, it is not a disease; it’s a natural occurrence that comes with aging. We know that normal changes take place in the discs in our spine as we get older, and these changes or these conditions really shouldn’t be considered degenerative.”


What’s the big deal? Aren’t these just words?


The reality is that words really do matter. Words have the power to generate feelings of optimism or feelings of doubt. They can encourage confidence to move, or drive fear that can ultimately increase the pain experience. The challenge with this particular example, is that it can drive patients (and often clinicians) to pursue a more aggressive treatment approach (such as surgery) to fix what they feel like will only continue to degenerate/worsen.


Not only that, people deserve the right to be educated on options that can be utilized to manage or improve their symptoms based on available research. While I will not argue that structural changes can cause pain and become symptomatic, I would like to challenge all healthcare providers to embrace the idea that often times pain is a much more complicated experience than that. Very rarely is one tissue implicated alone, and just because changes occur over time, this does not guarantee an increase in pain, or ensure further problems with pain in the future. 


The reality is, about 90% of the population will experience back pain at some point, and often it can get better through a number of conservative means, and occasionally simply through giving it time and working around the pain drivers. 


We need to be careful to use imaging as a way to assign back pain to a specific tissue because people who do and don’t have back pain may find disc changes or even herniations present on imaging. The last time I had read through things, the number of people showing disc herniations on imaging without pain was around 35-40% (at L5-S1 level).


Some things to consider:

  • Disc generation is frequently found on imaging even when individuals don’t have pain. 
  • When imaging a group of 20 year olds without back pain, 37% will show age related disc changes. 
  • When imaging a group of 80 year olds without back pain, 96% will show age related disc changes.
  • If these findings were directly correlated with pain, you’d expect back pain to increase after the age of 80; however, this usually decreases in occurrence in the 70’s.


With that being said, if clinical symptoms and presentation all lead towards a specific diagnosis, and imaging supports this as well, imaging can still be a great option to further pursue answers to decrease pain and return people to function. This is not a charge to throw out the x-ray and MRI machines entirely, just a call to challenge deeper thinking and present some of the research that has been popping up over the last decade in favor of conservative management, our body’s ability to heal, and the importance of understanding that pain is a very complicated experience.


If you have been diagnosed with “degenerative disc disease” and have felt helpless, we’d love to chat with you about it. There is hope that you are not destined for a life of decline in function and pain. Often times, with some guided applications of movement, loading, and proper stresses, you can decrease restrictions and make yourself much more resilient for the demands of life.


We are passionate about keeping people well informed, because movement is imperative to continued health, longevity, and quality of life. We would love to answer any questions you have, and encourage you to reach out if you’re having trouble functioning to your fullest potential.


Tyler Vaughn


Refine PT and Performance