Domination!

Congratulations to Coach Jack Martin and the Westfield Blue Devils for once again wiping up the competition at the Union County NJ Cross Country Championships.  5 of the top ten finishers were from Westfield!

The rest that's best

Treatment of chronic radiculopathy of the first sacral nerve root using neuromobilization techniques: A case study -Journal of Back & Musculoskeletal Rehab 9-10, Talebi et al.

A good book for every A.T.'s personal library should be Australian David Butler's "The Sensitive Nervous System".  It's full of great, safe, easy to learn neuromobilization techniques.

This is the kind of stuff I think belongs in the recovery/restoration phase of training.

Where did that day after the high school football game lifting/running deal begin?  All you see is a bunch of sore, tired kids using bad technique and slogging.  After a collison sport like football or rugby, why not an extended dyamic flexibility routine; something that looks like yoga or thai chi?  It's a great way to get some neural mobilization going before the fibrin and elastin from the inflammatory injury response bites down on the axons.

Taking advantage of the topography.

We have a  40 degree hill outside the front of our gym that I'll frequently use when treating patellofemoral issues.  The two exercises pictured are backward walking up the hill, then frontal plane walking down the hill with the affected leg on the down side.  The exercise creates a great  "integrated isolation" in the lower quad/VMO muscles.  The movement naturally creates a slight backward lean of the torso which tweaks out the glutes and erector spinae.  I like the athlete to do enough reps that it creates a good burn in the lower thigh; about a 2 minute rest, then 10 sets.

For some reason, running the movements doesn't work as well; not even as a progression.  A good progression is weighting them (pictured), or resisting them with a belt & bungee cord.  Sometimes athletes ask me what the difference would be walking backwards up a stairway.  My simple answer is it hurts and it doesn't work.

It's great for any patellofemoral issues, i.e. "jumpers knee", patellofemoral stress syndrome.

Finesse!

This is Pat Fisher, an NFL hall of fame defensive  back for the Washington Redskins back in the '70s.  He is 5'8" tall, and 170 lbs was the most he ever weighed.  The greatest tackler I've ever seen; had no problem bringing down the biggest guys in the league and I don't recall him ever being injured.  Sure there were guys who hit harder.  They are either dead or seriously incapacitated.

Someone who new I was a big fan sent me a recent picture of him surrounded by Hooters girls signing autographs.  You go Pat.

Make failing to tackle without "wrapping up" a 15 yard penalty.

Transitioning/Sequencing

Come on, its happened to the best of us.  An athlete has a muscle injury, you tested them well, you thought they were ready to return to play and they wind up with a re-injury.  It could mean you didn't transition them well and sequence their return to the activity.  The example here is a grade 2 rectus femoris strain of the right leg.  The plane here is to transition to straight ahead running by sequencing what movements we do in what planes, in what directions, in what tempo, in what speed, at what amplitude, and at what degree of fatigue environment is appropriate for that degree of healing. On ground, the athlete is doing frontal/T-plane with a sagittal plan bias.  That include activities like lateral lunges, slide board, and icky shuffle in the agility ladder.  I'm using the accomodating resistance of aquatic therapy for my sagittal plane work.  The exercises pictured here are deep water pikes/rotational pikes, and B-skips in the low end of the pool.  With the help of the water, you can get pretty agressive without concern of re-injury.

Don't throw like a girl! Don't land like a girl either?

With all the great ACL prevention programs out there, why are these injuries not going away?  Kinesiologist Scott McLean is going to make you think:

http://journals.lww.com/acsm-essr/Fulltext/2010/10000/Complex_Integrative_Morphological_and_Mechanical.7.aspx

Biomechanics and Motor Control come together

This article reminded me of that old peanut butter cup commercial where the peanut butter truck and the chocolate truck run into each other and make a delicious treat.

Great article in this months Journal of Sport Science Research by Natalia Dounskaia, a kinesiologist from Arizona State U.

"Control of Human Limb Movements: The Leading Joint Hypothesis and Its Practical Applications".

Ever since I read Dr. Lederman's book and heard Frans Bosch speak and do in Florida this past June I realized I was behind the 8 ball a little.  They drove the point home that not all movement is driven by the proprioceptive system.  Rather it's the muscles communicating with each other; much of it independent of the CNS.

"The LJH is based on the idea that the CNS exploits the biomechanical properties of the limbs for movement organization.  One of the most influential biomechanical properties of human limbs is that they are linkages of several segments.  This multijoint structure causes motion-dependent mechanical interactions among the segments represented by passive ‘‘interaction’’ torque (INT) exerted at each joint. INT has a complex, highly nonlinear nature, making motions at all joints of the limb interdependent."

"An advantage of the LJH is that it makes organization of joint control during each movement transparent. Revealing the leading and subordinate joints clarifies both the control strategy applied to the entire limb and to each participating joint."

Funny...its getting simpler and more complex at the same time.  Stay tuned.

Applied Osteopathics

Here is an actual exercise I used to follow up my on table manual muscle energy technique for an injured athlete.  The athlete had hurt his back doing a maximal deadlift while I was down in Florida with GAIN this past June.  By the time I got to him a few weeks later he had no lordosis in his spine and a left lateral shift.  My evaluation revealed a type 2 dysfunction of his lumbar spine.  Nomenclature it L3 ESRL.  That is, lumbar vertebrae 3 was stuck extended, sidebent, and rotated left.

The exercise is a right side lying modified (bottom knee bent to shorten the lever arm) rotational plank.  We're using gravity to gently mobilize the spine through muscle contraction, yet  prevent the trunk from going through the interbarrier zone of the injured joints; in all three planes.  In other words, the body position, ground, and gravity are blocking the body from where it can't go yet.  The starting position takes us deeper into the dysfunction so we can use the explode out of it to assist the correcton.

Don't Inhibit...Facilitate!

I am so sorry about my lack of posting this fall.  Tons of stuff to get to, just haven't had the spare time to sit down and put any coherent thoughts together.

I probably use the least amount of athletic tape of any ATC here in northeastern N.J.- about 25 cases of 1.5" Zonas Speedpack per school year.  In comparison, some of my colleagues go through 60-80 cases- all that wind up in the garbage and finally in that landfill in Staten Island that is large enough to be seen from outer space now.  But my athletes are no different, they want to look like the kids from the other schools and the guys on TV.  So they sneak in and steal some tape to spat their shoes because I refuse to do it.  I feel bad- most of the teams we play even have fashion team color spatting!  Of course I tell them there is no evidence what so ever that spatting is effective and it's a waste of money and time.

Why would you want to inhibit ankle motion- especially dorsiflexion?  How can you play low and get underneath your opponent and knock them off their feet if the knees can't translate over the toes?  Yet many of my American footballers would have a tough time passing the PCA test for ankle dorsiflexion.

Natrally the healing ankle requires support.  Most ankle braces do their job, but aren't of a low enough profile to fit inside the shoe without distorting it or causing blisters (the ASO comes close).  I've been experimenting with a technique that uses 4-5 strips (specific to the injury) of Coverroll Stretch and Leukotape P.  If you cut the strips ahead of time, with a little practice you can apply it just as fast as a traditional Gibney Basket Weave.  If the ankle is shaven, all lotions removed from the skin and pre-treated with Cramer Tough Skin, the tape will usually stay on 2-3 days.  As long as they don't go swimming or sit in a bath, I instruct them to blot it dry with some paper towel after they towel off from the shower.

Go ahead and give it a try and let me know what you think!