Hydration and Nutrition Tips for Better Sports Performance

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ANDREW 0:08  

Seems likely but why don’t people think dietitians like just food Nazis throwing out meals and eating plants like here eat this for two weeks. And that’s not that’s the purview of other types of aircraft practitioners, right? Practitioners. That’s not what we do, like the habits of who you are. The things that you do the eater that you are is a decade’s depending on how old you are. You’ve cultivated those habits over a long period. of time and they don’t just go away.

INTRODUCTION  0:41  

Welcome to the fit and healthy Denver podcast where we discuss all things revolving around health, fitness and wellness in the amazing state of Colorado. So you can get behind the scenes information from industry insiders, special events and more. Coming up is our host, physical therapist and strength coach Dr. Jamie Beauvais. And here we go.

JAMIE 1:07  

Welcome Andrew Doyle to the fit and healthy Denver podcast. Andrew is the owner of body fuel sports performance nutrition, a triathlete coach, a chef, former culinary instructor, the warlock of nutrition What else am I leaving out?

ANDREW  1:25  

You got it man to be a PhD student starting here. And August 1. Yeah, he named the board. I think board certified specialists in sports dietetics is what separates me from the quote unquote nutritionist as far as what we do.

JAMIE  1:40  

Let’s get into that a little bit. Now that shots have been fired. So why don’t you tell us the difference between a dietitian and a nutritionist because everybody sees a nutritionist. I’m a nutritionist. I specialized in this nutrition. And then dietitians are just kind of lumped in with them, but really there is a considerable difference.

ANDREW  1:57  

Yeah, there’s a huge difference and it’s not that nutritionists per se can be good at what they do. As a matter of fact, a lot of PhD researchers that I follow who do a great work in that area who have doctorates and exercise phys and nutrition. They talk a lot about nutrition. But a nutritionist really is anyone like you reading a book. You’re a nutritionist if you read something like I just saw a post on the internet today about how I read The China Study diet and it changed my life. It’s mind blowing and needs a poison. Well, okay, so they read a book now they’re a nutritionist and they start giving out nutrition information in general. There’s no education based on that. I mean, you don’t go, you don’t just go to the person down the street to help you write a contract and you certainly don’t show up to your neighbor and ask him for medical advice. And plus, of course, they’re a doctor but everybody eats so they all think they know stuff. And I think that’s where we get a lot of this myth information. And then say misinformation. I said myth information because it’s all anecdotal. As a dietitian, you know, we do go to a specific program. In which a lot of people can have a bachelor’s in nutrition, we go to a specific accredited program for dietetics for human nutrition, and then post that we have to do a year’s worth of clinical rotations very similar to almost all other health care professions. And as a dietitian, we’re considered a health care profession. We can take insurance, work side by side and collaborative teams with other medical professionals. And then we have a very specific role in nutrition. And then I got a master’s degree in Human Nutrition from K State, or dietetics, actually, where I did research on exercise associated muscle cramping. That was fun. Then I’m also a board certified specialist in sports dietetics, which is a subcategory of dietitians. So there’s lots of subcategories for dietitians like Aspen, so we’ve got it interim. I don’t want to get too complicated. Lots of different subcategories of dietetics you specialize in areas, weight management, eating disorders, those types of people where it can become a board certified specialist in sports dietetics and CSSD. You know, I had to be a dietitian for five years, I couldn’t just go out and become one and then I had to show documentation of so many 1000s of hours of actually working within that group to even sit for the exam that I have to take unfortunately every five years so it wasn’t like a one and done go take the test give ECUs it’s take this test every five years and show me you know what, you know. So I think that’s a big difference between who we are and what we do based on education, relations, and your credibility. Sure.

JAMIE  4:38  

And so with this sports dietetics being board certified, you really become a specialist of specialists for athletes.

ANDREW  4:47  

Yes. And then within there a lot of sports dieticians specialize within their own group. So for example, I don’t work with team sports. I don’t do football, soccer, baseball, basketball, that’s not my jam. You know, I specifically do endurance athletes, swimming cycling triathletes Ultra Trail,

JAMIE  5:08  

and you’ve and you have your own team as well. So you run your team and you write it.

ANDREW  5:15  

Go ahead. Well, I did. So a body fuel multi sport was a group of individuals with clients and things that I had brought together and created a small Facebook group for that. They keep everybody connected. I dropped out of triathlon last year to do some Ultra running and 50k. But I still keep that group intact, and they still manage athletes but I work with other coaching groups, more so than mine. Now I actually like the team dietician for a few triathlon and endurance groups in the United

JAMIE 5:44  

States. Oh, it’s cool. I didn’t know that. And you’re and you’re managing the diet for a lot of these athletes as well.

ANDREW 5:51  

Yeah, putting together fueling strategies. Just day in and day out like some of these athletes this is what they do. All the ones are professionals who are really dialing it in pretty hard and view themselves as competitive amateurs. So what am I eating every day you know, how do I fuel for my work and then my sport and meal timing? What macros should I eat? Am I drinking enough water? What’s my bike to ride during event strategies? What products Am I using? How do I mix those appropriately so I don’t get GI distress? A lot of athletes that come to me are trying to fix a specific problem with the inability to eat or drink enough during the day and be during events that really prevent them from performing as well. As they could.

JAMIE  6:36  

Yeah, and I know I think I am still part of your Facebook page, and I was kind of just admiring from afar and I saw how much your athletes were actually being on the podium and it was super impressive. And it just goes to show you. I mean everybody knows nutrition is a big part, but you know, your team, your small group of people were consistently, you know, on the podium just over and over and over again. And you know, I’m sure I’m not wanting to. I don’t want to discount your coaching obviously but just goes to show how all of that comes together and when it’s really put together and fine tuned. How it just elevates those athletes.

ANDREW 7:12  

Yeah, a lot of the people that we saw towards the end of like last year were being coached by other coaches. So one of my things is a collaborative effort among coaches with health care practitioners to ensure their athletes are healthy and doing the right thing. Not one person knows everything. And then when we get into that situation, we find big problems. I was just listening to one of my favorite podcasts and a guy was interviewing for a PhD. And that guy was a PhD in sports physiology. He was helping an Olympic level athlete who ended up getting amenorrhea missing their cycle. We know that’s a big thing, right? This guy has a doctorate and he is world renowned and very well respected for his knowledge base, but it was an individual who didn’t know about nutrition. He was stepping over his bounds or ignoring his boundaries or thought he knew more than he did. And we find that with all levels of coaches, there’s a reason why the US Olympic center and professional teams and even inside a healthcare facility have very specific professions that come together to collaborate because each one knows something so in depth that you bring something to the table. It’s when a single individual tries to encompass everything that people typically fall down. It just comes full circle to what you were saying about the number of people who are performing and podium podium being they were doing that being trained by other folks when those coaches that hey, you know what, let’s see what you can do what nutrition it’s not my specialty, and boom, you take someone who’s really good coach who can really tease out those physiological differences with myself who then takes all the time and effort into just nutrition that comes together for the athlete and it’s like Tada, the light goes on and they start kicking ass.

JAMIE  8:59  

Yeah, absolutely. And it should be noted you’re quite the athlete yourself and have quite an accomplished career and triathlon and I don’t know what I don’t know about ultra running but I’m sure you kicked ass on that as well.

ANDREW  9:11  

I don’t know if I’d say I’m an accomplished athlete. I try to play the athlete and last year’s Ultra season was the most fun I’ve ever had that revitalized my love for endurance sports, which I wasn’t getting out of triathlon to be really honest. And yeah, I had a great time when I got hurt. I love it so much. As a matter of fact, I just started returning to a running year. A couple weeks ago, actually after about a month.

JAMIE  9:38  

Well, I don’t know if you remember when I first met you, which is probably about eight years ago now. You were just getting out of bodybuilding. And so you know, you were this big dude muscular. And at the time you were like, Hey, have you heard of this Tough Mudder thing? And I was like, not really. I don’t know what it is. I think I’m gonna try it. It’s like next month so what I need to do and is like, Go run I guess I don’t know. And then you ended up just having a kick ass time. And you know, that was the one where I think it went straight up Beaver Creek mountain and you have to have to change it. It was so hard but I was super impressed with that. And then you know, you’ve kind of gone from this super big muscular guy to this thin I will say not skinny but this thin, athletic you know, endurance machine. And it’s just, it’s a testament to you and your focus and dedication. But also I’m sure you know you have changed your nutrition throughout the years. And so why don’t you just quickly kind of take us through that and like what your nutrition was? What changed your focus and then what it is now.

ANDREW  10:39  

Yeah, so what changed my focus and my nutrition has changed a great deal over the years, man so especially after I became a dietician and then started really focusing on research and paying attention to what’s coming out and some of the organizations that I work with. I’ll tell you what to work backwards right now and I’m a very plant based eater and by plant based my definition of plant based, is like 70 to 80% fruits, vegetables and grains and nuts and then you know that 20% lean protein instead of where I was in the past, you know, eight, nine years ago was really heavy meat eater. A lot of grains, a lot of starches and vegetables were kind of like yeah, eating but wasn’t a big part of my day. That has definitely changed. I have received the plate. So one of the things that I am that we didn’t mention is a certified executive chef for the ACF, right, so I started my culinary career, my career actually in nutrition as a chef. And so I’ve taught culinary for 10 years. And that culinary background being a chef, like I thought I knew food and and I did kind of and now I just recenter the plate because the center of the plate for most Americans is like a meat man. You know what I mean? It’s what’s what’s the meat in the center, and that’s been the mantra of Chefs for a long time the center of the plate center the plate and now I’ve just recently been

JAMIE  12:01  

so an interesting way of looking at it. And so I know there’s a lot of different things we can talk about. And I think you have a lot of really interesting stuff going on your various social channels and the amount of research you do into any question always blows me away. You literally have 10 answers that are very specific for any question as well as the research to back it up. But let’s kind of focus so I want to kind of focus a little bit on basically thirst or hydration, because you really recently had a YouTube video that was really interesting and it’s about that Common. Common thought is that you get hungry because your thirst mechanisms are weak. And so your body confuses it and you get hungry and you overeat.

JAMIE  12:45  

Yeah, which isn’t true. You’re not thirsty, you’re actually hungry and in my opinion at the back end of that it’s we don’t know how to differentiate what type of hunger it truly is. Is it physical? Or is it emotional most of the time? In my opinion at the moment? Of course, I’m not doing any research on it. So my research topic is that when we are hungry and we have an insatiable hunger that just can’t be filled, right? That’s not thirst. That’s emotional hunger that we’re dealing with something right now on the east end, right? Just keep it super elemental in that way. The HR expert that I interviewed was an RD PhD researcher who did nothing but century and first and the physiology behind eating and satiety. And he’s like, yeah, that that’s not linked. So they’re not physiologically linked. They’re completely separate. I got a whole YouTube video and then like an Instagram post about the fact that hey, you’re not thirsty, you’re actually hungry, and that drinking water to get rid of that hunger or helpless satiety or sense of fullness is very brief. The body actually adapts to that and will no longer work just because of the tonality of the stomach and as a PT, you’ll get this like, the tone of the stomach being taught the muscles around the outside are nice and firm and then as a flat stomach, stomach something loose think like a kind of an empty sack. That’s just hanging there. Right? That’s a loose stomach and then as we fill it up with water the summit begins to get taught but the body will adjust and drinking water will no longer solve that issue of emotional hunger. So I think that actually there’s a root problem there that we’re trying to solve that we’re not like, hey, drink water, you’re not really hungry. Well, no. How about we address why you’re emotional eating, and then we can see what the problem is.

JAMIE  14:39  

So I’m guessing there’s bits of psychology in that as well.

ANDREW 14:42  

Yeah, there’s tons of psychology and what we do as dietitians and I think, you know, this isn’t about like, Hey, what are dietitians specifically, but a lot of people think dietitians like just food Nazis thrown out meal and eating plans, like Here, eat this for two weeks and, and that’s not that’s the purview. of other types of air quote practitioners, right? Um, I would even call him practitioners. That’s not what we do, like the habits of who you are. The things that you do, the eater that you are is a decade depending on how old you are. You’ve cultivated those habits over a long period of time and they don’t just go away. And so changing your diet may brute force those changes. Right? Let’s say you follow keto, or you follow paleo like your brute force, changing your habits intentionally. But once that structure goes away, you still fall back into the habit and nail problems. Yeah. And so what kind of a long roundabout like you’re not really thirsty, you know, you’re hungry. Yeah, it’s not physiologically you’re not thirsty. You’ll know when you’re thirsty.

JAMIE 15:45  

What about with athletics and hydration? How do you stay properly hydrated during a hot, sweaty athletic event? And let’s say, Ron,

ANDREW  15:55  

yeah, there’s a controversial topic right there because a lot of the research even for older runs is looking at do we drink to thirst, right, like when do I need it? Or do we drink on a structure and a lot of the research out there right now is like, well, you can just drink to thirst you don’t need structure. I tend to really disagree with that on a couple levels right? First when you get an entry level athlete coming into a sport they don’t have any real what’s what’s a good term. I don’t want to be derogatory or condescending. They don’t understand their body really well, right? Like they don’t have the signaling systems and they know like, Hey, I’m really thirsty. Hey, I should eat or hey, what’s going on and correct. People who are innately athletic or have done sports for a long period in their life or even pros, you know, pros write about it all the time. I’ll just drink whenever I want to. Yeah, because you got 20 years of excetera 10,000 titles. Yeah. And so the average person doesn’t do that. I’m very big unstructured plans that help you check battler If This Then That type matrixes. Right. If this happens, here’s what I think you should do. And that way when you get into situations you can make a decision on what you should do without you knowing, hey, I’m thirsty. Besides, like, look, a lot of people getting into sports are getting older. Thirst mechanism starts to lag and not function as well as we do as we get older. We know this. Thirst is a lag. receptor, or signaler. Sorry, once you’re thirsty, it’s too late. And then we know with the gastric emptying rate of the stomach, you can’t catch up so once you’re behind you overload the GI system trying to catch up you create a whole nother problem because the overloading literally stops the emptying, ready for stomach, which means nothing’s going into the intestines. Nothing’s getting absorbed. You’re right back where you were before you started drinking anything anyway. So I think structure , that’s what I think at least to start.

JAMIE  17:56  

So I know part of what you do as a dietitian and as poor sanitation is you really cater that to the individual and I think most people myself included before I talked to you, I thought nutrition was General Good nutrition is good nutrition, right? But from what I’ve gathered from you it is so individual it can be you know, completely different for each individual. So for the average person who’s listening and they just kind of want to know okay, well, how do I figure out how much I want to drink? Is there some sort of rule of thumb to get him in the ballpark?

ANDREW  18:24  

Yeah, it’s a pretty easy task, man. You just got to do a sweat volume test. I think that’s the best way to go because hydration is very individualized nutrition for an individual. And I think one thing that I’m learning as I move into this Ph D program that starts here in August with Dr. Stacey Sims, and I listened to lots more PhDs talk about their topic is to be very reluctant in providing these broad generalities like things that make it to the internet that people gravitate to, like everybody should do this, but that’s not exactly the right. So there are some things that you can do some diagnostics and one of them is to sweat volume tests. Have it actually on my website, people can go pull down the sheet it’s and it’s very simple to me, you. You go to the bathroom, you have breakfast, you empty your bladder, you step on a scale, see how much you weigh. Then you decide to go out and do an activity for 60 to 90 minutes, preferably with no food or liquid right because you don’t want to measure it. Come back if you’re a girl, wring out your hair so it’s not wet. Both male female take off their wet clothes from sweat step on the scale again, and what you do is you look at the Delta, like how much did you weigh before you left and what do you weigh now after you know doing your activity gives us a really good indication of how much sweat volume that you’re losing out of your body in a period of time. And then from there, you can start to work backwards and devise a hydration strategy. A fueling strategy sure has to be paired with food.

JAMIE 19:55  

That’s really simple. That’s cool. I like that. So you just figured out how much you lose per hour essentially, and try to stay ahead. Wow,

ANDREW  20:03  

I can’t stay ahead man. So I’m glad that you said that right. So we can never really stay ahead. We can’t lie. So we’re always going to be a tad bit behind. Unless we’re doing something really slow. Like hiking you could probably stay at and you never want to be hyper right. You never want to be ahead. Very rare. Will you be even we’re trying to minimize the gap and that deficit from being behind however.

JAMIE  20:30  

Okay, what is the downside of getting ahead? slowing yourself down?

ANDREW 20:35  

No kidding, too much volume hyper hyper hydrated. There’s way too much volume in the body. You start to dilute if you’re drinking plain water, which is a shit hydrator you know, plain water is not. You’re not the best to go to for long events. Start to get into the water. You get a demon swelling in the ankles, things like that you start to dilute your electrolytes. And your sodium reserves hyperhydration puts too much stress and strain on the cardiovascular system because now you’ve full of this liquid and we didn’t need it, so hyper hydration is bad. It’s just as bad as being dehydrated or hypo-hydrated. Dehydration will hurt you and so drink too much. There’s a nice balance there.

JAMIE  21:18  

All right now I didn’t know that. And so what is the best hydrator then is if you’re losing a lot of sweat and you know in a hot race

ANDREW 21:30  

The best hydrator is an electrolyte solution with a tiny bit of sugar mixed into water. So the electrolytes in the sugar rack are CO transporters. So the reason why I said that, you know water is a poor hydrator is that it lacks the necessary mechanisms or CO transporters to actually get it into the cell. Right. There’s a reason why when we rehydrate in the hospital, you’re not getting bags of water, right? It’s like sailings lose, you know, ringers, there’s all these things. And so water is best used you know when we’re active with a little bit of carbohydrate and some electrolytes to help actually get that water into those interstitial spaces into the cells where it can be used, just pounding down tons of water really quickly. One it doesn’t get absorbed to where it needs to be. And it’s not helpful and again, slows down the gastric emptying rate of your stomach, which is not good. Yeah. So it’s a mixture and it depends on what you’re doing. So this is that broad range: you go out for 90 minutes, you go out for eight hours, 17 hours, you’re gonna be gone for, you know, two, three days in a stage race. So like there are different products that work really well for different things. And just like anything else, like you don’t use the a hammer to do everything right

JAMIE  22:47  

right. And so the question I asked you before we started recording, because I didn’t want to sound dumb. The Osmo Lal osmolality I was gonna ality Yeah, yeah. And so can you tell us a little bit about that? Like how certain products may not mix well in the gut when running?

ANDREW  23:02  

Yeah, absolutely. So I think the best way to understand I was wild is to think about when somebody’s tried to mix like Kool Aid or a drink mix in the water, and it just simply doesn’t dissolve. Right. It’s just in there and it’s like all this particulate. So that visual particulate is all the stuff taking up space inside the water. Now imagine just dumping a whole bunch of mix like lemonade mix, the more you put in there, the less likely it is to get dissolved and mixed up. And so that’s let’s think about it like it’s just like heavy water. Heavy water is actually a thing so I probably shouldn’t use that. Let’s just talk about water that has a ton of stuff in it right? And in this case, it’s a ton of salt, a ton of sugar, a ton of electrolytes all taking up a weight when we drink that. The body has to dilute it somehow. It’s not absorbed, it’s not appropriately diluted. So when we drink, let’s say juice, if you’re out running and you’re drinking juice or a soda has a ton of sugar in there that sugar has a high osmolality ray in order for the body to successfully use that it has to be diluted appropriately. So you can chase it with water to help dilute it and if you don’t, and you’re out there drinking you know, like really, four or five scoops of Gatorade or you’re drinking a soda and you’re wondering why your guts are all messed up. It’s because of the body. Hydro scoping with a G not hydro scoping, but hygroscopic so sugar is water loving, and it gets into the gut. It’s gonna dilute it somehow the body’s gonna make it a source it can use so it starts to pull liquid water from the tissues into the gut to dilute this really sugary or high osmolality substance. Well, when we think about liquid in the gut, what comes to mind is diarrhea, that’s exactly what it is. So hence the gut right and the diarrhea. thing that occurs when people are out drinking these really sugary, high osmolality drinks, which is why sports drinks that are out there are specifically formulated to be put into a certain amount of water. They’re easy on the gut to have a good osmolality, they digest well and they empty into the intestines appropriately. They got good co-transporters. Some of them offer you extra sugar so you have fuel built in and others don’t and it’s just purely electrolytes. So to circle back to your original question of why things do not mix well together, it’s because most people will go out and eat let’s say a Bonk Breaker or a power bar and then they’re sippin on Gatorade. Well that Gatorade is mixed into liquid, that liquid sets the osmolality or the proper dilution. Now if we add a power bar on to that we’ve increased, that’s like taking the power bar and throwing it into the Gatorade and shaking it up right in the bottle which is gross. Well, that’s what you just did in your gut. There wasn’t enough plain water to dilute the sugar. Yeah, so people are drinking sodas and juice or Gatorade or scratch or EFSS or fluid or tail end or insert whatever product you have that has a sugar load to it. Plus electrolytes and then you’re eating solid food. Yeah, that’s kind of a recipe for disaster because nobody has to dilute it from somewhere and you’re not getting it plain water

JAMIE  26:12  

again. Yeah, that’s, that’s also good to know. And sometimes could this just be like, would this ever happen with like energy chews or some of some of like the human I’m saying? Yeah, like drinking Gatorade, and then you take some Gatorade energy issues as well.

ANDREW  26:28  

Yeah, it’s the exact same thing. So each every 100 calories or so it probably every 20 to 25 grams of carbohydrate depending on how you want to look at that block of food needs to be a bit diluted. With water, you know, six to 10 ounces. I mean, if you think about that, like people who are taking three or six blocks are really solid food, power bars, large bars, and I’m not saying any of those products are bad. I’m just saying that they clean water to light the light to be diluted and that you’re chasing it with Gatorade. And again, I’m not throwing Gatorade under the bus, insert any sugary sports drink there and you’re messing it up. Especially over time, Jamie, like you can kind of get away with anything for 60 minutes, right? Yeah, 90 minutes. You might feel like yeah, whatever. I feel kind of yucky but I’m done. It’s it’s the long endurance events that really get you where it all of a sudden the GI is overwhelmed over time after time after time of doing this, which is again what I do as a sports dietitian is help athletes train their GI systems with appropriate products to accept the maximum amount of water and fluid they possibly can to improve their outcomes.

JAMIE  27:41  

Well, Andrew, I know you’ve got several different social channels and they kind of have different little focuses. Why don’t you kind of tell us where some people can find you and what is on each of those? channels.

ANDREW  27:52  

So YouTube is my long form. As a chef, obviously having cooking videos, right? I do fun things, quick things, quick hacks, things that I learned over the years to make things fun. I also do long, long form. Topics like probiotics for GI issues. You’re not thirsty, you’re really hungry. Alcohol and metabolism are a couple that I do plant evidence for plant based performance diets where I kind of talk about all different aspects of sport endurance sport, lab work, blood work, what to look for. Vitamin D vegan athletes, red ass female triad, so YouTube’s a good place to catch the long stuff. And that’s the endurance chef on YouTube. You can type in body fuel or Andrew Gaul. You’ll find my picture. ugly mug is up there on all of them. Instagram, Guy Instagrams, Andrew D, Chef rd. That’s a great place to find sort of like little snippets of what I’m up to. And hey, I think that’s interesting when we go to YouTube and check it out. Kind of like a small commercial. I use Instagram for commercials, right? Hey, this is cool. This was happening. And then I’m on Facebook. That’s just the meat and we’re I post a little bit of everything and you just kind of be a human

JAMIE 29:10  

and I didn’t encourage anybody to check them out. I think some of the specially lovely cooking videos are really what I’m like, I never knew I could do that. You know, I remember you telling me about this years ago and you’re like yeah, I’m gonna do these quick little videos like how to properly cut garlic. And I was like, Is anybody gonna watch that? And you’re like, I think some people will. And then when I saw you’re talking about I was like, Oh, that’s really cool. I’m gonna do that for now. And then the one year you’re just like skinning a salmon and like 20 seconds and I was like, Oh, I don’t know how to do that.

ANDREW  29:39  

How to make ginger with a spoon. Or? Yeah,

JAMIE  29:42  

I think yeah, I think anybody who sees that is going to do exactly what I did. Like, I didn’t know you could do that. I’m gonna do that from now on. And I think some of that other stuff, you know, I find fascinating the deep dive into the all the dietician, stuff that you’re doing is mind blowing and you know, you’ve always kind of just really impressed me and blown my mind with anything that has to do with diet or nutrition or how that incorporates an athlete’s. And I know so your PhD work is getting ready to come up very soon. You will be traveling to New Zealand, living there for two to three years and you’re going to be focusing on plant based diets and athletes.

jamie

Dr. Jamie Bovay​ | DPT, MTC, CSCS

Founder and Leading Physical Therapist​

Dr. Jamie Bovay is the founder of KinetikChain Denver, a company focused on helping people recover from pain or injury, stay active and exercising, and get back to what they love to do. Jamie and his team are known both locally and nationally for finding solutions even when other providers haven’t been successful. Jamie has over 15 years of hands-on experience and works with many of Denver’s companies, athletic teams, doctors, and orthopedists to keep people active and fully enjoying life.