Monday, December 28, 2009
I know, sometimes the athlete is in so much pain & you have no choice. But if you think you're improving PF kinematics, think again. This study took a look at various types of patellofemoral alignment types & how quadricep contractions influenced them. The study comes to the conclusion that we functional A.T.'s knew all along...that it's the track, not the train.
There's a lot of cool stuff you can do with on ground function if you just can't get the athlete pain free weight bearing. I'll be giving some examples in future posts.
Wednesday, December 23, 2009
"Childrean & Sports Training" by Jozef Drabik, PHD, 1991.
Doc Drabik is a Polish P.E. professor who spent plenty of time in the trenches. From page 1 you can tell he knows what he's talking about. A lot of times now I find myself scratching my head & wonder if some of these academicians ever spent one day in a gym or classroom.
This is a cheap book that will give you tons of ideas.
Friday, December 18, 2009
I drove down with my friend Gerry Nisivaccia. Gerry holds a high school record for being the only NJ wrestler to win 3 consecutive state championships. He missed winning a forth when he dislocated an elbow during a match. Stuck his arm between his two legs, snapped it back into place, then finished the match with one arm. His opponent was so grossed out he couldn't concentrate and lost the match. However, the tournament officials would't let Gerry continue in the tournament. Coach Nisivaccia went on to be one of the most winningest high school wrestling coaches in NJ history.
The reason we drove down was to hear our friend Dave Costello speak. Dave is the boys/girls track coach at Viera high school, Fla. Retired, Dave moved down there about 5 years ago with every intention of playing golf & watching his son play baseball. When his son registered for school, his guidance counselor happened to be familiar with high school track. He asked, "Your dad wouldn't happen be the former track coach at Elizabeth high would he? And your uncle Frank coached at Maryland? Well, go home & tell your dad he is no longer retired". Dave is in his early 60's now, and I've never seen him more enthusiastic. He's already won two regional champioships.
I am proud to call these two guys my friends.
Thursday, December 17, 2009
Wednesday, December 16, 2009
Agree 100%. When my alarm went off at 4am my dog would start pulling the covers off me. Could care less if it was raining or snowing. Never complained about aches or pains. Ran with me step for step without a leash, just happy to be out there.
The researchers in this study were amazed how canes & walkers disappeared. Dogs get us back in touch with our primal side.
Monday, December 14, 2009
John Madden was in the Oakland Raiders locker room back in the 70's giving his pregame speech, when the players started asking too many questions. He blurted out, "Don't worry about the horses, just load the wagon!"
That's a good analogy for function. Don't get tied down in what individual muscles are doing. DO make sure the athlete can load the wagon. If the athlete cannot sufficiently dorsiflex, one of the most powerful musculotendinous units in the body is not getting loaded. It can contribute to everything from tibial stress fractures to glenohumeral impingement.
This study found that in athletes with a pes planus foot, dorsiflexion improved an average of 6.4 degrees by supporting the longitudinal arch. A little adhesive felt in this population goes a long way.
Saturday, December 12, 2009
If you have never heard of Vladimir Janda, well, you probably do and don't know it. He is a Chek neurologist who invented a system of therapy to ameliorate his symptoms of polio. His theories form the basis of NASM. "Upper Crossed Syndrome", "Lower Crossed Syndrome", and "Pronator Distortion Syndrome" are all his terminology. The idea that certain muscles are inhibited & weak & need to be strengthened, and others are hypertonic & tight and need to be stretched.
The Australian method is openly dissed here.
Does anyone know if this DNS stuff has ever been put through the scientific method in the journals?
Saturday, December 5, 2009
Jack Blatherwick, strength coach of the famous '80 miracle on ice U.S. hockey team, reminds us to not just read the abstracts in these professional journals. Read the whole thing and dissect it. A good case in point:
"The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome" Yin-Hsin Hsu a, et al-
Journal of Electromyography and Kinesiology 12/09.
The reseacher came to the conclusion, "elastic taping (Kinesiotape) significantly increased the scapular posterior tilt at 30 and 60 during arm raising and increased the lower trapezius muscle activity in the 60–30 arm lowering phase (p <>
Wednesday, December 2, 2009
In the April 2005 "Journal of Orthopedic Research", the ACL in mice was found to have a direct connection with the spinal cord, brain stem, & cerebellum.
This research inspired some Greek researchers to investigate this phenomenon in humans. Some key brain MRI findings in ACL deficient athletes:
-visual information contributes more to the configuration of movement.
-these athletes unconsciously "plan" their movement.
Tuesday, December 1, 2009
Showed me some video of stuff he has going on in his gym, the Millburn-Short Hills Athletic Club. Like Tracy Fober, he also uses olympic lifting hybrids to enhance athleticism. He's got alot of female clients, and I like the way he goes buck wild on laying down that bone mass in this population.
He's also working on his own hybrid of an old Romanian core training gadget that is pretty cool.
...an old Run DMC Song, and my theme for today's blog.
Both Tracy Fober and Vern Gambetta recently made references to this article in the NY Times a few days ago:
It brings up an interesting point that Vern always drives home regarding function:
ITS MORE THAN JUST AN EXERCISE!
Of course I always give examples of remedial exercises to address specific issues, like my recent one on the pec minor stretch. However, it would be silly to believe that repeating any one stretch (even my own) would be a panacea. Rather than master the stretch its more important to understand the steps that came before it. Where were the hips in relation to the shoulder, what were my drivers? The article brought me back to my days when I worked with physically disabled students; where neuro pathways were destroyed & you needed to create new ones.
If the pec minor is ornery, there are also other issues going on. Inability to load the front side & some weak anti gravity muscles always go hand in hand. If you understand this, you can integrate this theme into the athlete's repertoire, rather than just coming up with a few ancillary exercises.
Monday, November 30, 2009
Dive into the stuff we talk about on this blog. Don't worry, we'll all be in the deep end over our heads! Believe me when I tell you not a minute of the 6 days from the 18th to the 23rd of June is wasted. Our Australian mate Kelvin Giles makes sure of that- "if you're on time you're 5 minutes late!" No passive learning here; we're all learning, working out, eating, and just hanging out together.
Besides all the great presenters from last year, Frans Bosch will be joining us. If you haven't read his running biomechanics book you are really missing out.
In addition to the meeting, you join our community of learning & sharing. We've got a website where we continuously send documents & videos back & forth to re-enforce & apply what we've learned in Florida. We hope you can join the revolution.
Sunday, November 22, 2009
This is my idea of a pec minor stretch. In front of the edge of a wall, in a right stride stance, do a RUE L45 reach @ thigh height. From there do a thumb down R120 reach @ shoulder height. As you do the reach, attempt to tap the R AC joint to the wall the best you can. Hold for 2 seconds @ return to the starting position for 3 sets of 10.
Saturday, November 21, 2009
A hypertonic pec minor muscle was identified as a big trouble maker at this years Scapular Summit in Kentucky. This is the recommended stretch for the muscle, the "doorway" method.
Here's the problem the way I see it. We're assuming the scap is staying put while the ribcage rotates away. We're also assuming we're stretching the pec minor & not the major. We're assuming the athlete has no anterior GH laxity. My thought is if the pec minor is tight, what's to stop it from dragging the scap with it? In this scenario all you would be stretching are the muscles that insert on the proximal humerus (pec major, ant. deltoid, biceps etc), no?
Thursday, November 19, 2009
We had girl's rugby game this past spring where a lot of player's from the other team were getting hurt. Some of our girl's tackles looked like NFL highlight films. They're really I nice bunch of kids- they just like to hit and they're good at it. The best is this little Puerto Rican girl, all 5'2" of her! The coach came out onto the field and admonished the ref for "letting the game get out of control" and threatened to pull his team off the field. To keep the game going our coach actually had to tell our players to bring them down a little easier, and took our 5'2" assassin off the field. It was a playoff game to boot.
Tuesday, November 17, 2009
In the coming weeks I'll be commenting on some of the highlights. Several of the presentations focused on the neuromuscular issue of the upper trap overpowering the mid/lower & the scapular dyskinesis that goes with it. I was a little disappointed all the solutions appeared to be isolated ones. Most of the exercises look like manual muscle testing positions.
I'm not sure what percentage of my functional approach has been scientifically driven, and how much comes from the population I work with. Remember I work with the adolescent population who by nature just cannot sit still; with a wide variety of learning disabilities mixed in. Getting them to lie down, put their elbow here, shoulder over there etc is just not going to happen.
At GAIN '10 I presented some of my ideas of how I approach the trap issue. It sure looked a lot different than what was presented at the scap summit. It's kind of paradoxical how my almost 30 years of experience in one job has enriched me in so many ways, yet boxed me in so many others.
Sunday, November 15, 2009
Patellofemoral joint force and stress during the wall squat and one-leg squat.
Escamilla RF, Fleisig GS, Wilk KE, Andrews et al, Med Sci Sport.EX 4/09
Doesn't make a difference how close you position the feet to the wall, they beat up the osteochondral surface of the patella.
Saturday, November 14, 2009
First of all, welcome to the blog Rachel- Glad you found us!
2nd- Your athletes don't even know what the core is? GREAT!!! You are one step ahead of the game because they haven't been corrupted yet!
When you get a chance, be sure to visit my archives. YOU will be corrupted (in a good way) to my version of "the reactive core". A core that can brace the body to take a punch or handle a collision with another athlete; as well as blasting a soccer ball into a net. Like any other muscles of the body, the core is loaded by ground, gravity, and momentum. The core muscles are loaded with proprioceptors; and fascia which links it with the rest of the body. It loves when the hips are moving one way & the shoulders another; or in the same direction but different speeds.
There are some exercises which I consider core-ready, give your athletes a good dose of this stuff Rachel:
-3D jumping jacks
-3D mountain climbers
Got to go. A weekend off, the first since July!
Friday, November 13, 2009
Relationship Between Hip and Knee Kinematics in Athletic Women During Cutting Maneuvers: A Possible Link to Noncontact Anterior Cruciate Ligament Injury and Prevention
Imwalle, Lauren E; Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E
Journal of Strength and Conditioning Research:
November 2009 - Volume 23 - Issue 8 - pp 2223-2230
placed biomechanical markers liberally on the upper & lower extremities & had them do 45 & 90 degree cutting maneuvers. At least in this study, frontal plane adduction moments at the hip were the biggest predictors of how much the knees abducted. They site Brent's research from a study published 3 years ago in "medicine & science in sport & exercise" that showed steady increases in hip abduction strength in adolescent boys; with no such similarity in girls. The authors recommend strategies that increase hip abduction control, & include protocols that include plyometrics, dynamic stabilization, & trunk neuromuscular training.
Much like in Hodge's work on spine stability, we have to be careful on the application side of this. Resist the temptation to run to those 4 way hip machines. Neuromuscular is a lot different & complicated than muscular. Neuromuscular adaptation takes longer. Neuromuscular integrates myofascial slings throughout the body that contribute to hip & knee stability. Neuromuscular understands the foot is on the ground dealing with artificial turf, or wet grass, or improper footwear; that the eyes are driving movement from above with the head & shoulders reacting.
Dave Tiberio, P.T. uses the term "resonent frequency" to describe tendon & ligaments (that includes the ACL) ability to react to changes in load intensity & velocity. Re-setting that resonent frequency is the key. We forget the ACL is living tissue & loaded with proprioceptors! It will tell the rest of the body what to do, provided the body has been trained to work in what G2 calls, "the transformational zone".
Neuromuscular takes planned performance training-muscular does not.
Thursday, November 12, 2009
Vern states he would not use the Bulgarian squat for football, soccer, or hockey. He is correct, groin strains & athletic hernia are prevelent in these sports, and alludes to this squat contributing to it.
While it might be appropriate as a lead up to a SLS (single leg squat), it's important to move on. The problem begins when you load the movement. The trail leg is used to stabilize, creating isometric contractions about the hips & pelvis that are not conducive to rythmic, flowing movement. Of course you can argue that isometric contraction happens naturally in a traditional SLS, and you would be correct. But, in the Bulgarian Squat, that stabilization is initiated top down since it is traveling through the pelvis first- "neural confusion" if you will.
Tuesday, November 10, 2009
Friday, November 6, 2009
I am jealous of the fact he is able to get away & work with the Pittsburgh Steelers (american football), and travel to the U.K. to work with Welsh Rugby. I doubt I would be able to swing that here at EHS. This past weekend was typical for me, flying out on a Sunday morning to recert a soft tissue technique, flying back that same night to be back at EHS monday morning.
It made me cognisant of the intellectual isolation we high school A.T.'s experience. School funding for our continuing ed is slim or none, plus we deal with more teams than a typical collegiate A.T. does. The annual GAIN meeting means a lot to me. It takes place just as school gets out in June and gives me a chance to recharge my batteries. SHARING (actively) with professionals from all over the globe. Much smarter, & just as passionate as I am about the profession. Guys just as nuts as I am- Jim Radcliffe from Oregon flying in on the AM to give a workshop, then flying back that afternoon to work with his volleyball team.
I hope you guys enjoy my posts as much as I enjoy your comments. Although I don't always respond, I read every one of them. I hope it helps bridge the intellectual isolation gap.
Thursday, November 5, 2009
There are hundreds of ways to squat, both good or bad depending on the context in which they are used. If you are working with a football lineman , there are situations where a traditional squat could be a good thing. On the other hand, single leg squats may be contraindicated for an athlete with a patellar osteochondral defect. Once you consider foot placement & angle, what the opposite leg is doing, what the arms are doing, the implements you are using to load (or unload), the combinations are endless. If you’re looking for a great, inexpensive video on the subject, consider Vern Gambetta’s, “Legs, Legs, Legs”. It will not only demonstrate 3D squats, but as with all Vern’s stuff will provide you with great ideas to build on.
Wednesday, November 4, 2009
The lumbar multifidus: Does the evidence support clinical beliefs? Manual Therapy, Volume 11, Issue 4, Pages 254-263D. MacDonald, G. Lorimer Moseley, P. Hodges 2007
“Although there is support for the importance of the lumbar multifidus and the specific contribution of this muscle to intervertebral control, several of the clinical beliefs have little or no support “.
Feedforward Responses of Transversus Abdominis Are Directionally Specific
and Act Asymmetrically: Implications for Core Stability Theories, JOSPT 5/08
"bilateral activation of the TrA in isolation does not reflect the normal
motor pattern for rapid unilateral ballistic patterns of movement and, therefore, future research may examine if such training may detrain individuals who require such fast actions (eg, elite athletes).”
There is an article in the NSCA's "journal of strength & conditioning" this month that makes the statement, "development of the core is accomplished first through ISOMETRIC STABILITY with progression to multi joint movements involving the hip, torso, and scapular region". Readers of my blog know I believe in the concept of a "reactive core". One that emphasises training in the "zones of transformation"; that is when the body is switching directions and injuries occur. There is nothing wrong with doing isometric bracing movements (planks et al). As long as it is understood they occur in a neutral zone. A truly strong core is one that can take a direct blow, protect us from falls, as well as coordiate the upper & lower extremities in a fluid, coordinated manner.
The article makes references to Hodges original work in the 90's. I think that's where this "rigid pillar" isometric-style core gets it's origin. I know Doctor Eyal Lederman of London's Center for Professional Development in Osteopathy (www.cpdo.net/myth_of_core_stability.doc) occasionally tunes into this blog. If you're out there doctor, I'd really appreciate your opinion on this.
Monday, November 2, 2009
"we need to focus not only on the ankle but also huge emphasis on the proximal musculature/joints and the coordination of movement between the shank and rearfoot."
Which was what I was getting at with rotational squat/glute inhibition question. That squat would unlock the foot & load the soft tissue. If it was compromised by trauma, then I think it's safe to conclude we're not getting the proprioceptive input up the chain. The answer lies somewhere in a combination of both- restoring soft tissue integrity/mobility at the ankle, and addressing the proximal issues.
I think what you're alluding to suggests a shift to the more functional styles of joint mobes that integrate U-LE, ie Mulligan & FMR. Then the next step; what do we do about the soft tissue integrity? I've just begun using Graston. I know Stacy Walker, A.T. professor at Ball State is a reader of my blog. They do a lot of Graston research. If you're out there Stacy I would really appreciate your comments.
Sunday, November 1, 2009
was playing a practical joke when he sent me this until my step son said he had seen the infomercial on TV the night before. Use your imagination on this one.
Thursday, October 29, 2009
"A COMPARISON OF 2 REHABILITATION PROTOCOLS ON STAR EXCURSION BALANCE TEST PERFORMANCE IN SUBJECTS WITH CHRONIC ANKLE INSTABILITY"
He compared a "traditional" ankle rehab program (that focused in on the ankle) with one that focused on the hip & knee. The hip/knee program contained half functional (SLS variations) & half open chain supine (SLR's et al). His conclusion was:
"Proximal joint rehabilitation may be as effective, or more effective
than traditional ankle rehabilitation, for improving dynamic postural
control in subjects with CAI."
Along the same lines, some researchers from Ireland (Coughlan et al) in their study came to the conclusion,
"that a 4-week dynamic lower limb training program resulted in no significant changes in the ankle position or velocity during treadmill walking, jogging, and running. This study raises issues regarding the methods of ankle sprain rehabilitation and the measurement of their effectiveness in improving functional activities. "
Kind of sounds like when I say "rehab the athlete, not the injury", no?
Now I need you opinion. In other research, Dr. Gribble found that CAI subjects had less glute max activity in a same side rotational SLS at the point of maximal excursion than the control group. Any ideas why?
Wednesday, October 28, 2009
Monday, October 26, 2009
Thursday, October 22, 2009
Tuesday, October 20, 2009
"The neutral spine principle, M. Wallden DO".
"The migratory fascia hypothesis, P. Lelean."
From page 351, "being able to dissociate the spine from the hips is a foundational movement skill".
First of all, Dr. Wallden did a great job of articulating his view on the topic. However, I'm still not buying into this. Yes, the neutral spine is something to be desired, but is it something that needs to be taught? Or, is the neutral spine a chain reaction of everything that went before it? On page 358 he gives a chart of pathological findings, and corrective exercises to ameliorate them. The problem is every one of the exercises focuses in on the spine itself.
At GAIN '09 I spent about 3 hours going over 2 case studies of athletes I worked with personally with low back back pain. In both cases, there were upper & lower extremity reasons why the athletes could not maintain a neutral spine. Not one isolated "spine" exercise was performed.
I think the second article I referenced kind of backs me up. The author discovered abnormal fascial folds throughout the pelvis & hips in patients , which produced facial strain patterns , which could contribute to iliolumbar strain patterns. The concept of rather than a weak spine, a spine that is biomechanically fed erroneous neural input.
I'm not sure if there is one size fits all here. I'll continue to rehab it as I see it.
Saturday, October 17, 2009
JH and others who work in the clinic please give us your input of the mind set. If any readers have made the switch over, or switched over & come back to traditional, I would really enjoy your input.
Thursday, October 15, 2009
Tuesday, October 13, 2009
"CLAIM AND COUNTERCLAIM: FOOTWEAR AND FOOT AND ANKLE MECHANICS DURING PHYSICAL ACTIVITY"
RICHARD SMITH, Discipline of Exercise and Sport Science, University of Sydney, Sydney, Australia.
Compared lower leg & foot mechanics during barefoot running to running with so called "neutral" & "dual-density" shoes. Their conclusion was, "The change is not always that which was intended by the shoe maker. The ground/shoe/rearfoot interface with the shank can be the
promoter or recipient of the motion drivers." Across the board there was more ankle motion/less mid-tarsal joint motion with the shoes. In the "stability" shoes, they noted tibial external rotation began much earlier than in barefoot-even while the knee was still flexing at ground contact. What do you think? Can this make one more susceptible to ankle sprains?
Sunday, October 11, 2009
High School ATC's who work with collision sports stay vigilant. Remember we get paid to watch the athletes, not the game. Athletes (some coaches too) think it's macho to ignore head injuries & will hide it from you. Here is an interview from the NY Times with an ex-Gators linebacker. He's only a year older than me yet has paid all his life from injuries 30+ years ago. He talks about how much has changed from those days, but has it really?
Saturday, October 10, 2009
1. It's difficult to overcome heavily developed biceps/pecs/subscapularis without a forceful technique.
2. Even if you un-hook the shoulder pads, you still have the tight jersey to contend with.
3. Considering #2, it's very difficult to get enough ROM to do a Milch.
4. Along with Sarah's comment about the "audience", I've seen practitioners (including orthopedists), fail to reduce, get frustrated & embarrased, and use more & more forceful techniques.
5. The extra 1 minute walk or so to your A.T. table behind the bench is worth it compared to an ambulance ride & ER wait (remember I'm a hs ATC, no team orthopedist!)
6. Finally, in the spirit of this blog, it's only my opinion on what works best for me.
Friday, October 9, 2009
"A Randomized Sham Controlled Trial of a Neurodynamic Technique in the Treatment of Carpal Tunnel Syndrome", Bialosky et al JOSPT 20-09.
NDT reduced temporal summation in this population. I believe these techniques have a place in the recovery/restoration phase of conditioning. It should be noted that the sham NDT also provided a therapeutic effect. This drives the point home that as A.T.'s we shouldn't be afraid to use our hands. Have the technique manual nearby so the athlete understands what you're doing.
I've used NDT in American football brachial plexus (aka "stinger") injuries, hamstring strains, shoulder dislocations, and other injuries that create neural stretching. Any comments Juan?
Thursday, October 8, 2009
Monday, October 5, 2009
Saturday, October 3, 2009
Thursday, October 1, 2009
It is part of the rehab circuit for an athlete with a complete ACL tear. In this athlete's sport the ground is a dangerous place to be and needs to get up and back onto his feet quickly after a fall.
Tuesday, September 29, 2009
"Running: Biomechanics & Exercise Physiology Applied in Practice"
a book that came out in '05 by Frans Bosch & Ronald Klomp. They nail running biomechanics. Oh, by the way- we're keeping our fingers crossed but we may get Frans Bosch at GAIN '10!
Be sure to give us a shout out coach when you release the video.
Monday, September 28, 2009
A rare gene mutation caused a family in Turkey to walk like our ancestors. A physical therapist got tired of all the scientists coming over to study them & applied some kitchen chemistry. Function can change structure and give DNA a run for it's money.
Sunday, September 27, 2009
Tuesday, September 15, 2009
The athlete will typically present a pinching sensation in the vacinity of the anterior talofibular ligament with weight bearing dorsiflexion. A few mobes combined with the recommended taping procedure usually brings a pretty significant relief. It's not a wait & see thing-either it works or it doesn't.
The theory is when the ankle inverts it gets locked against the ground; but gravity continues to drive the fibula down & forward onto the talus. It's not hocus pocus- it has been documented in the literature. I just don't think it's as common as they say it is; but when it works it works. The problem is coming up with a exercise protocol to keep the correction. Haven't found one yet.
Friday, September 11, 2009
Sunday, August 30, 2009
Close your distances,
drive your angels,
Lose your fears and meet your dangers"
The European Society of Cardiology says, "Get the world on it's feet!"
(p.s.- that means we ATC's too. Get your athletes off the plynth):
Soft tissue lesions about the mouth increased more than threefold during a D1 (American)football season. The authors concluded over the counter mouth guards "may have a significant influence in producing oral disease". When cultured, the mouth pieces themselves "yielded 339 bacterial isolates, 20 yeast isolates, & 108 fungal/mold isolates".
The authors recommend replacing a mouth piece every 14 days, and daily cleaning with a denture cleansing solution.
I'm not going to get mad at the kids for losing them any more.
Thursday, August 27, 2009
Monday, August 24, 2009
Monday, August 17, 2009
Monday, August 10, 2009
I am beginning my 3rd week of working on the sprain. Not that bad of a sprain, I would say a mild grade 2. But it had been neglected a full month before I got my hands on it. The athlete still has about a 3cm functional dorsiflexion deficit. I will keep you posted.
Friday, August 7, 2009
PAUL W. M. MARSHALL1, AMANDA D. MCKEE1, and BERNADETTE A. MURPHY2- Medicine & Science in Sport/Exercise; August 09.
My blog readers know ankle injuries are "my bag" as Austin Powers said.
Wednesday, August 5, 2009
Carl W. Nissen, MD†*, Melany Westwell, MS, PT‡, Sylvia Õunpuu, MSc‡, Mausam Patel, MS‡,
Matthew Solomito, BSBE‡ and Janet Tate, PhD§; AJSM, August '09
The researchers came to the conclusion based on the kinematic and kinetic data that the rising incidence of shoulder and elbow injuries in pitchers may not be caused by the curveball mechanics. The fastball actually produced higher shoulder & elbow moments.
Coach Korn told me this decades ago. The way he teaches it, you use the whole body to throw it, not just just the wrist & elbow. However, he chooses not to teach it until the high school years because he feels developing sound throwing mechanics comes first. He is officially retired as of last month. What will we do without him?
Tuesday, August 4, 2009
A 10 year study showed a 150% jump in P.E. class injuries over a 10 year period. I think the conclusions the authors come to are right on the money for the most part. By the way, are "heart palpitations" & "fainting" considered bonified injuries now?
Thursday, July 30, 2009
You really begin to appreciate the similarities, & how fascia links the body together as system. Manual therapists bring up an interesting point- that the human body's center of gravity doesn't really pass through the spine, but rather through the gut. We begin to see how soft tissue can influence structure. It creates new possibilities for us. For instance, we can understand how we need the entire body working correctly to prevent lower leg stress fx, not just strong legs.
It is the essense of what "core" is all about.
Tuesday, July 28, 2009
I've gotten over 25,000 hits in the past year. Don't get me wrong, I am grateful to all my blog readers. I'm not just blowing smoke when I say you guys keep me on the ball. It's humbling when I check my hit tracker & see readers coming from almost every continent around the world to read what some high school guy from New Jersey USA has to say.
Unfortunately, barely any are from my home state. And almost none from the high school level. I would really appreciate everyone's opinion as to what I'm doing wrong, and where to go from here. I realize it's not just me. The ATSNJ has had a decline in enrollment in the past 2 years. The new ATC's coming out of college have figured out you can join the NATA BOC without actually joining the NATA. And I hate to sound sarcastic, but we're getting what we deserve. The ATC certification is not carrying much weight any more. I would like to give you specific examples, but I can't without using names.
I'm going to end this post with a quote from Bob Wiersma's "performance builders" blog, referring to the fact that more & more U.S. citizens are going uninsured each year.
"This is about real people in your community in crisis - they have real problems that they can not afford to address in the current health care system. Their solution is not in "the box" of traditional providers and services. What is need is a solution that is out of the box... There is something you can do about it!"
Guys, this is the environment I've worked in for almost 30 years. Most of you have been insulated against it. Get ready because it's coming.
Monday, July 27, 2009
1949, Architect Buckminster Fuller develops 1st working model
1970’s, Orthopedist Stephen Leven applies tensegrity principles to human gross anatomy (biotensegrity)
2004, French orthopedist J.C. Guimberteau publishes “Promenades sous la peau”.
2007, Tom Flemons publishes, “The Geometry of Anatomy – the Bones of Tensegrity”
Saturday, July 25, 2009
“Tensegrities are self–contained non–redundant whole systems. All components are dynamically linked such that forces are translated instantly everywhere; a change in one part is reflected throughout. These features distinguish tensegrities from all other tension structures, e.g. a sailboat’s mast is fixed at the base and needs that fixed point to keep it upright. The boat does not need the mast for it’s integrity but the reverse is not true.”
- A Biotensegrity Explanation for Structural Dysfunction in the Human Torso, Flemons ‘07
Now we need not be concerned how are bodies are oriented to gravity. Many core training enthusiasts use the term, "you can't fire a cannon from a canoe!" But what if you must? Volleyball players do it all the time. As do divers & swimmers.
Biotensegrity is no new-age thing. It has sound engineering roots going back to the 40's and makes perfect sense. And, it fits in perfectly with the new fascia research that has come out in the past few years. I will elaborate more on this in the coming weeks.
Friday, July 24, 2009
Saturday, July 18, 2009
Friday, July 17, 2009
"I will look into posting something. I would love to do it with video for you Joe. Our plan is to have 24 modules with video clips for sale in the fall through Beacon Athletics. As Joe said, the program is designed to be used in concert between the PE teacher and classroom teacher. The exercises are taught in PE class then led by students in the classroom. Our push up numbers were excellent this spring and we hadn't done a regular push up in 5 months or so. Feel free to contact me with questions:
Thursday, July 16, 2009
I'm suprised no one called me out on a good exercise for training the glutes in gait/running. Here is a good exercise to train the posterior oblique sling system in a manner that is functionally consistent with running.
R SLB, LLE anterior/posterior pivot reach @ankle height c/ toe touch;
The R knee flexion/extension are a chain reaction from the LLE motion, NOT a single leg squat. Yeah, some balance is involved so there is a learning curve here. However, once you get the hang of it try to go as quickly as possible with good form.
Tuesday, July 14, 2009
Be careful about choosing exercises for conditioning or rehab based on EMG studies. The authors conclude their study by dividing the exercises into "tiers" based on the level of muscle activation. It would not be surprising then that a sagittal plane exercise like a SLB & reach to the toes would be the nominated as best exercise for activating the glute max. The same for frontal plane side lying adduction & the glute medius.
Every muscle has a 3D function, and the most obvious one may not be the most important with regards to joint function. For instance, let's say our athlete has patellofemoral dysfunction with running. While the SLB c/ toe reach may indeed create MVIC >60, the exercise is not consistent with gait, and may not be useful in this case.
Monday, July 13, 2009
"I would like to get a better understanding of the approaches Gary Gray uses in his assessment and rehab. I know you are well versed in this area. I noted on his website that they sell educational materials. Which ones would you suggest (tape titles, etc) I get to obtain a basic grasp of his approaches and methods (kind of like a Cliffs Notes summary of his approach). Any suggestions is greatly appreciated."
I've gotten the thumbs up from Gary & Dave T to do a presentation at the nationals on just that subject. Been turned down about 5 years in a row. As a high school ATC I am a non person as far as the NATA is concerned . But, I believe they did approve Pat Donovan (U.Ill@Chicago) for 0-10 in Philly. I believe they are giving him several hours, and he plans to go through the whole spectrum. Be there. I know Pat will do a great job.
Friday, July 10, 2009
Wednesday, July 8, 2009
Sorry I've been neglecting my P.E. peeps somewhat.
Monday, July 6, 2009
Sunday, July 5, 2009
Thursday, July 2, 2009
Wednesday, July 1, 2009
Porterfield & DeRosa discuss this phenomenon in their excellent book, "Mechanical Low Back Pain"- "Tissue that is significantly injured or degenerated cannot attenuate stresses with the same efficiency as normal, uninjured tissue", and go on to say, "to assume that 3- 45m sessions 3X per week alone will significantly impact long range outcome is unrealistic." (p.226)
This is part of the problem when discussing core. We typically think of core training as strengthening the muscles.
Never forget that ligaments are part of the core system. They don't just connect bone-to-bone. They are rich in Pacinian Corpuscles & Ruffini endings. They are an important part of the core. If we are doing "stiffness" or "bracing" training in the neutral zone, are we stimulating these proprioceptors??? Do most injuries happen in the neutral zone, or rather in the "transformational zone"-where the body is changing directions?
Remember proprioceptors are the spirit of function. When we speak of neuromuscular training, or re-education, this is where it's at. If there is no proprioceptive stimulation, there is no load, therefore no explode. However, as Juan said so well, we need to work at the edge of their envelope of function if they are to improve, and not be injured. We need to safely take the back patient, or healthy athlete into-and out of the transformational zones. On to you guys- by the way, where have all the ladies been???
Monday, June 29, 2009
It is the "pirate ship" concept. That is, a ship mast (spine) with a skull on top (head), with 2 sets of guy wires attached. An "inner unit" (multifidus, TA, Ext. Oblique et al), and an "outer unit" (erector spinae, rectus ab. et al). The inner unit providing inter segmental stability, with the outer unit in control of column movement in general.
My question was, what would happen if you took this model and tossed it in the air (gymnastics, platform diving etc)?...or tossed it in a swimming pool upside down or on it's side (swimming)? Is not core stability required in these environments?
I believe the problem is spine stability is interchangeably used with core stability. That's where we get the concept of the core as a "rigid pillar". Core strength expressed as "stiffness", connotating something isometric in nature. It's very rare someone injures their spine lying down, so this makes sense.
But when we think of core, we're not only thinking the external's influence on the internal, we are also thinking vise versa. That is, the role of the core in ACL prevention, or hustling up off the ground after a fall. I've seen McGill's bracing exercises used in ACL prevention programs. Is this the proper application of a bracing exercise?
Juan & other physios & A.T.'s that treat backs, I would really enjoy your input on this. Did Vleeming intend this to be a core stability model?
The following link from THE ONION is a great satire of what goes on at the Jersey shore in the summer, and is not too far from the truth. BadaBing indeed.
Well, I'm refreshed from the long school year & ready to get the blog rolling again.
Friday, June 26, 2009
Wednesday, June 24, 2009
Saturday, June 13, 2009
I'll be leading the group in a smorgy workout, then giving a long talk on core training. Preparing for this has been an interesting experience. In attendance will be Dr. Dan Cipriani, biomechanics professor at San Diego State. He is the acid test as to whether I'm track or not. But I've really done my homework and certain I'm solid ground. I'll be looking forward to sharing my ideas with my blog readers in the coming weeks to get your input.
I finish at the end of the week with injury prevention concepts for the throwing athlete. Wish me luck.
Wednesday, June 10, 2009
It is described on the web site, but there is also a hand out you can get if you call or email them.
However, remember it's all about mostibility- the ability to take advantage of just the right motion, at just the right time, at just the right speed, in just the right plane in just the right direction, not flexibility.
For rehab documentation of functional ROM, I use Gary Gray's 3D testing pole.
Tuesday, June 9, 2009
Monday, June 8, 2009
Saturday, June 6, 2009
These gangsta rappers that you hear on the radio singing about how tough life was growing up had a cake walk compared to my mom & dad. Mom grew up through the great depression as an orphan; my dad without a father.
On his 17th birthday my dad and my Uncle Dick dropped out of school & joined the army to send money home to support their mom. They joined the old horse calvary together. It was the only way two poor kids from Brooklyn would ever get to ride horses. Within a year, their unit was mechanized, & at 19 years of age my dad & my Uncle Dick were storming the beaches of Normandy. Omaha beach, dog green sector. As my dad said it, the source of his wildest dreams soon became the source of his worst nightmares.
The calvary unit, which was now 102nd recon, was supposed to set up communication systems once the 1st & 29th cleared the way. Things didn't go that way. The beach got jammed up & they became sitting ducks on the water. They wound up jumping over the side to avoid fire, with 80 pounds of equipment on their backs. Fortunately, dad & uncle Dick were strong swimmers from their summers at the city pools. Others were not so lucky, & drowned.
Only 8 of the 60 soldiers from that calvary unit made it back home alive from world war 2. Fortunately for me, both my dad Joseph sr. & my Uncle Dick were two of them.
Friday, June 5, 2009
JOSPT June '09- "Fitness, Motor competence, and Body Composition Are Weakly Associated With Adolescent Back Pain"
Here's what I get out of this article.
1. This is not the first study to find a correlation between low back pain & increased trunk flexor strength (Newcomer et al in Acta Paediactrica, '96)
2. Watch that waist line
3. I don't think you can have a healthy back without strong, powerful 3D leg strength.
4. The Sit & Reach Test is a waste of time.
5. I said this before in previous posts, but I believe that athletes in sports of a repetitive nature should spend some time in the recovery-restoration process running backwards, throwing with the opposite arm etc.
Monday, June 1, 2009
...hey Jonathon- didn't consider the BUE drivers. Good call. I'm jealous.
Our next question. Notice Marty recommends an anterior pivot lunge combo, perhaps using our BUE drivers anterior this time. Anyone take a guess why?