tag:blogger.com,1999:blog-6186397928378807102024-03-14T02:12:31.674-04:00Dedicated to the High School Athletic TrainerThe application of the scientific to the practical by way of learning through sharing; with the ultimate goal of better care & prevention of adolescent athletic injuries.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.comBlogger486125tag:blogger.com,1999:blog-618639792837880710.post-46289358651982395422011-08-09T16:30:00.000-04:002011-08-09T16:30:52.947-04:00Flexion & the Spine"To Crunch or not to Crunch: An Evidence Based Examination of Spinal Flexion Exercises, Their Potential Risks, and Their Applicability to Program Design"- Contreras, Schoenfeld JSCR 8-11.<br />
<br />
I probably have disagreed with every article these two guys published. Which is why its important never to throw the baby out with the bath water sort of speak. I have to admire this work, they really took on some sacred cows regarding spinal flexion exercise in general. They make a lot of great points...<br />
<br />
"The studies in question attempted to mimic the loading patterns of occupational workers by subjecting spinal segments to thousands of continuous bending cycles, which is far beyond what is normally performed in the course of a normal exercise program".<br />
<br />
They also note research by Battie & Videman which indicates much of disk injury to be related to genetic factors and not exercise.<br />
<br />
They note that many of the en vitro spine studies involve porcine models (which have very different mechanics than the human spine), or human cadaveric spines with most of the supportive structures removed.<br />
<br />
They conclude by saying that based on current research its premature to conclude that the human spine has a limited # of bending cycles...and variety in spinal loading is associated with a lower risk of spinal pathology. And you want to do a good warm up before doing spinal flexion exercises early in the morning, or after prolonged periods of sitting; or save them for later on in the day.<br />
<br />
Great work guys.<br />
<br />
Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com8tag:blogger.com,1999:blog-618639792837880710.post-86208945944415639442011-08-04T19:02:00.001-04:002011-08-04T19:03:20.394-04:00It's whats between the notes that counts!<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-2ICMeOJqbPA/TjskpwX2LJI/AAAAAAAAAyE/Yc2nFKs7YCM/s1600/Picture1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-2ICMeOJqbPA/TjskpwX2LJI/AAAAAAAAAyE/Yc2nFKs7YCM/s1600/Picture1.jpg" /></a></div>"Anatomical Structure determines Function, this determines Exercise Selection & Prescription- Richard Lieber<br />
<br />
I'll agree with that...but I'll follow that with a quote by anatomist Jaap Van Der Wall...<br />
<br />
<span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;">"typically researchers "<i>dissect what they have in their mind and lose</i></span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><i><br />
</i></span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><i>the continuity of the tissue</i>." He goes on to say, "Muscle spindles</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;">and GTOs are mostly concentrated in areas of muscular tissue directly</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;">intermediating distal and proximal regular dense collagenous</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;">connective tissue structures. These mechanoreceptors occur often in</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;">muscle/connective tissue transition."</span><span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="border-collapse: collapse; font-family: arial, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;">Let's use the hamstring musculature as an example. We've known for a long time that strains occur NEAR, but not actually AT the musculotendinous junction. Recent MR imaging has also demonstrated tears at the epimysial boundries between muscles.</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;"><br />
</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;">The anatomy of the hamstring muscles are complex, and even vary between individuals. They not only have osseous attachments, but also numerous fascial expansions that attach muscle to bone, AND to other muscles. They are innervated by 2 different nerve branches; the long head of the bicep femoris, semimenbranosus & the semitendinosus by the tibial, the short head by the peroneal. Some anatomists consider the adductor magnus muscle a 5th hamstring muscle, as it shares a common nerve and thick fascial expansions.</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;"><br />
</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;">When we attempt to understand the function of the hamstrings, like music, we need to understand what's going on proximal to distal, but also in between. Not only in the sagittal plane, but in the frontal, and especially in the transverse. The plane that a muscle is the most powerful in is not always the most important. What the opposite side of the body is doing during a particular task; and whether it's setting the hamstrings up for success. Now we have MR images documenting morphological improvements in an individual muscle from specific exercises. Yes that's useful in indicating the degree of healing, but not the whole picture:</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;"><br />
</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;">"Movement is not an isolated event that occurs in one plane of motion. Rather it is a complex event that involves synergists, stabilizers, neutralizers and antagonists all working together to produce efficient triplanar movement"- Vern Gambetta.</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;"><br />
</span></span><br />
<span class="Apple-style-span" style="font-family: arial, sans-serif;"><span class="Apple-style-span" style="border-collapse: collapse;">The current trend of prescribing exercise by muscle architecture is subjective, and can be misleading. Rehab the athlete, not the injury...and let them leave you a little more athletic then when they came in. And never feel like you have to squeeze any muscle injury or prevention program into a traditional weight room exercise just because its there.</span></span>Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1tag:blogger.com,1999:blog-618639792837880710.post-38900694431370920932011-08-02T21:56:00.000-04:002011-08-02T21:56:47.259-04:00Yoga & Rotator Cuff RehabThank you Tracy Fober PT (www.ironmaven.blogspot.com) for the heads up on this article:<br />
<br />
<a href="http://www.nytimes.com/2011/08/02/health/02brody.html?_r=2&src=me&ref=health">http://www.nytimes.com/2011/08/02/health/02brody.html?_r=2&src=me&ref=health</a><br />
<br />
This variation of a traditional Yoga posture was found to be more effective than traditional physical therapy in treating rotator cuff tears. I don't think there is anything magic about the technique. It is very similar to the wall slides I have described previously in this blog. The concept of shortening lever arms, unloading the shoulder by way of the hand resting on a wall, and changing the limbs orientation to gravity gets the shoulder back into its envelope of function & helps normalize muscle recruitment patterns. I'll often add lower extremity drivers to the hand motion to enhance the exercise. I tried linking some of my old posts on the topic but the search command doesn't seem to work very well.<br />
<br />
Sorry by the way about my lack of posting, they will probably be scarce for the next few weeks as we get the fall sports rolling here at EHS.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com2tag:blogger.com,1999:blog-618639792837880710.post-46812115496508790752011-07-21T10:47:00.000-04:002011-07-21T10:47:27.785-04:00<iframe allowfullscreen="" frameborder="0" height="349" src="http://www.youtube.com/embed/Xtye5uCSojY" width="560"></iframe><br />
<br />
Haven't missed a tour since high school, but this one will be tough. Two nights in NY on nights I have soccer games.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1tag:blogger.com,1999:blog-618639792837880710.post-61158569604535814552011-07-18T14:23:00.003-04:002011-07-18T14:28:14.645-04:00Video of Dr. Luigi Stecco performing Fascial ManipulationFor those who want a look at the Fascial Manipulation technique...he doesn't begin actually performing the technique till about 9m into the video. In FM, you treat AWAY from the injury site, which is a bit different from other myofasical techniques.<br />
<a href="http://youtu.be/dPgzwNEbcMU">http://youtu.be/dPgzwNEbcMU</a>Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-72736586829482818842011-07-17T12:10:00.001-04:002011-07-17T13:57:57.544-04:002nd Annual ATSNJ Concussion SummitSome great points made by Dr. Robert Cantu,<br />
...you will not know the true severity of a concussion until the athlete returns to their baseline.<br />
...concussions are not created equal. One may be too many, while three may not necessarily prevent an athlete from future competition.<br />
...the football helmet will never be the end all in concussion prevention.<br />
...the most sever concussions involve blows directly to the head.<br />
<br />
Neuropsychologist <span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 5px; -webkit-border-vertical-spacing: 5px;"><span class="Apple-style-span" style="font-family: inherit;">Reuben Echemndia presented research indicating post concussion neurocognitive testing (<i>Impact</i> et al) is beneficial even in the absence of baseline testing.</span></span><br />
<br />
At the roundtable discussion I asked the possibility, based on the research by Sandra Black and David Viano, of neck strengthening playing a role in concussion prevention. The consensus was, at least from a theoretical standpoint, yes. But what kind??Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-46001662596078705612011-07-15T09:24:00.001-04:002011-07-15T09:26:41.041-04:00Makes ya go hummmm..."Motor Neuron Pool Excitability of the Lower Leg Muscles After Acute Lateral Ankle Sprain"- Klykken et al, JAT 6-11.<br />
<br />
I'm really impressed at the quality of the research in the Journal of Athletic Training in the last decade or so. This was a good one. The researchers took 10 athletes with recently sprained ankles, placed them in a relaxed prone position, then measured the motor neuron pool excitability of the soleus, anterior tib, & peroneus longus. The soleus was facilitated, the anterior tibialis inhibited, & no difference in the peroneus longus.<br />
<br />
The authors go on to explain the reasons for the results. Included was the possibility the CNS was re-organizing to compensate for the loss of posterior talar glide, ie loss of dorsiflexion in the ankle. In running & gait, remember the soleus is a knee extensor. So in this scenario it is helping to limit the degree of knee excursion to control the degree of ankle dorsiflexion at the ankle joint.<br />
<br />
A thought: What if this loss of dorsiflexion is not restored? Could the facilitated soleus persist? Could the articular complications resulting from an unresolved ankle sprain(s) be a culprit in chronic calf cramping in middle age runners?Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-37905182109290226152011-07-14T08:41:00.004-04:002011-07-14T08:44:04.209-04:00Return to Play Concepts<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-rYLFen8ZOeU/Th7j5yR9_wI/AAAAAAAAAww/h_FxgvwwM-M/s1600/R2Play_GAIN_11.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" m$="true" src="http://4.bp.blogspot.com/-rYLFen8ZOeU/Th7j5yR9_wI/AAAAAAAAAww/h_FxgvwwM-M/s320/R2Play_GAIN_11.jpg" width="320" /></a></div>Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com3tag:blogger.com,1999:blog-618639792837880710.post-34579070910836550432011-07-14T08:38:00.000-04:002011-07-14T08:38:32.496-04:00<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-df8ybPfaSu8/Th7i4zJM9OI/AAAAAAAAAws/HMeTBuqpcS0/s1600/R2Play_GAIN_11.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" m$="true" src="http://2.bp.blogspot.com/-df8ybPfaSu8/Th7i4zJM9OI/AAAAAAAAAws/HMeTBuqpcS0/s320/R2Play_GAIN_11.jpg" width="320" /></a></div>Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-71650499641205766972011-06-28T22:34:00.000-04:002011-06-28T22:34:59.473-04:00Everything is Everything...an old Donny Hathaway song, and the topic of today's blog post.<br />
<br />
<br />
"Can Balance Training Promote Balance & Strength in Prepubertal Children?"- Granacher et al, JSCR 6-11.<br />
<br />
"Is There an Association Between Variables of Postural Control & Strength in Adolescents?"- Granacher et all, JSCR 6-11.<br />
<br />
No & No.<br />
These are two studies that measured balance as the ability to control pertubation- that incuded tests for static as well as dynamic. The first test had 6&7 year olds trying to keep still on air cushions & wobble boards for 45 minutes 3x per week for 4 weeks. Funny, but predictable if you were ever an elementary school teacher, the testors had problems with the subjects "attentional focus". Another words, as soon as the teacher had their back turned, the students were off task. The protocol failed to produce impovements in "postural sway"- the traditional method balance is measured.<br />
<br />
In the 2nd study, the researchers tested a group of 16 year olds on their horizontal leg press performance, a counter movement vertical jump, & the ability to keep still on a stationary/moving surface balance testing device. No correlation between static & "dynamic" balance, and muscle strength.<br />
<br />
Both studies began with stating the importance of adequate balance in preventing injurious falls in the respective age groups. The problem, as I see it, is the definition of balance. That concept of "stillness". Very different than what goes on the athletic field, or real life for that matter. The eyes looking one way, legs moving the opposite, with the arms maybe moving in another.<br />
<br />
The other problem is the idea of trying to <em>isolate</em> balance. Good balance is more than just the vestibular system. It requires a certain degree of single leg power, core strength, agility, and even flexibility. I don't believe its possible to <em>effectively</em> train it independent of other neuromotor skills. Did those elementary school kids really have attentional focus deficits? Or did they want to do REALbalance training- skipping, hopping, jumping, stopping & just plain having fun.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com3tag:blogger.com,1999:blog-618639792837880710.post-63011441940504859932011-06-27T09:04:00.000-04:002011-06-27T09:04:35.400-04:00GAIN 2011, Rice University- Houston TX USAI apologize for the lack of posting, I've been decompressing a bit.<br />
<br />
It comes every year right at the end of my school year when I'm wiped & need uplifting. And it didn't disappoint. It is a jam packed schedule beginning at 6am "movement madness" sessions with the faculty- no passive learning here. Just short breaks for meals, and we're on the go till 9pm for 6 full days! Diving into function with the likes of Blatherwick, Gambetta, Fober, Giles, Radcliffe, Ryan, Winkler...Carl Valle getting us up to speed with technology...with Greg Thompson giving us the latest updates on motor learning & control. EVERYTHING from the individual exercises to year round performance planning. What a ride!!<br />
<br />
But GAIN is only as good as it's "delegates". That is, the people who are hand picked by Vern to attend every year so NOTHING gets watered down. I mean come on, how many times have we paid good money to attend stuff that winds up looking like high school biology? <br />
<br />
EVERYONE there had something to bring to the table. Performance coaches, Sport Scientists & physiotherapists from college & professional sports, high school ATCs & physical educators, physiotherapists from European Rugby...phew! Just imagine what it was like to have to get up in front of them & present!<br />
<br />
Please consider joining us in '12.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1tag:blogger.com,1999:blog-618639792837880710.post-86619692299213874922011-06-10T09:58:00.000-04:002011-06-10T09:58:36.889-04:00Off to GAIN '11!Sorry I haven't been posting. I've been preparing for my presentations at the GAIN APPRENTORSHIP 2011<br />
<a href="http://www.gambetta.com/Merchant5/merchant.mvc?Screen=CTGY&Store_Code=gambetta&Category_Code=Aprentorship">http://www.gambetta.com/Merchant5/merchant.mvc?Screen=CTGY&Store_Code=gambetta&Category_Code=Aprentorship</a><br />
at Rice U in Houston next week. I'll be doing <i>Return to Play, Functional Anatomy, </i>as well as assisting Kelvin Giles with his<i> PCA presentation</i>.<br />
<a href="http://movementdynamics.com/products/view/physical-competence-assessment-manual%202011">http://movementdynamics.com/products/view/physical-competence-assessment-manual%202011</a><br />
In addition, I'll be running the AM workout sessions on <i>functional balance progressions</i> & <i>functional flexibility</i>. It is a very cool experience...really diving into function. As usual I'll be over my head, but I wouldn't have it any other way. Think about joining us in '12.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-32397787069134060392011-06-02T08:45:00.000-04:002011-06-02T08:45:02.853-04:00In the end, it all comes down to Physical Competency<span style="font-family: Arial;"><strong>"The Effects of Exercise for the Prevention of Overuse Anterior Knee Pain : A Randomized Controlled Trial"- </strong>Coppack et all, AJSM 6-11.<br />
<br />
Pretty simple, 4 PRE's & 4 static stretches caused a 75% reduction in anterior knee pain among military recruits. Some of the exercises were "functional", & some were not. What I found interesting was 3 of Kelvin Giles' PCA assessments (although not referred to by name) were used as exercises. As budgets tighten & P.E. programs begin to disappear we see the decline of physical competency & literacy. You cannot have a decent athletic development program without it. Depending on the task at hand, it could be a knee injury, a shoulder, back etc. Let's not get so nit picky with our assessments that we lose site of the big picture. Do they have the right stuff or don't they? And if they don't, weave it in to their return to play repertoire. Believe me, the greatest gift you can give an injured athlete is to let them leave you a little more athletic then when they came in.</span><span style="font-family: Arial;"></span>Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com3tag:blogger.com,1999:blog-618639792837880710.post-71729367876780376692011-05-29T19:31:00.000-04:002011-05-29T19:31:11.148-04:00Memorial Day 2011<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-A-Vqmv3v-vg/TeLWexGFNgI/AAAAAAAAAwA/dDzSr_jwqDk/s1600/pedro-milletjpgjpg-de7fc698c2a845e6_large.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-A-Vqmv3v-vg/TeLWexGFNgI/AAAAAAAAAwA/dDzSr_jwqDk/s320/pedro-milletjpgjpg-de7fc698c2a845e6_large.jpg" width="246" /></a></div><div class="separator" style="clear: both; text-align: center;"></div>To most people they are only faces you see on the news. This is Pedro Millet, my 3rd student athlete killed in action.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-31340698299372219912011-05-28T11:20:00.000-04:002011-05-28T11:20:03.536-04:00Integrated Isolation...Right Subscapularis On Ground Function.<a href="http://4.bp.blogspot.com/-hAr4dhPVenk/TeESFPaSqvI/AAAAAAAAAv0/WNnOc501qnE/s1600/DSC00413-1.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="http://4.bp.blogspot.com/-hAr4dhPVenk/TeESFPaSqvI/AAAAAAAAAv0/WNnOc501qnE/s320/DSC00413-1.JPG" width="320" /></a>"Subscapularis Strain from Swinging a Baseball Bat in an Adolescent with Closed Physis"- Higgins et al, Sports Health 6-11.<br />
<br />
The top picture represents a "traditional" exercise for the subscapularis. Sounds practical, right? I mean the subscapularis IS an internal rotator of the shoulder, no? Not as simple as you think. Especially in batting, yes the shoulder is going through external rotation, which is loading this muscle. The conundrum is the muscle originates anteriorly on the scapula...which is moving on the rib cage...which is also moving in the same direction, but at different speeds. BTW, just like my previous post, the injury occurs no where near end range.<br />
<br />
Here's an exercise that simulates the function of the subscapularis in batting. Begin in the traditional pushup position. As you begin the descent, sneak your right leg under the left, enough so that you feel the pelvis rotate, without it touching the ground. Return to the starting position and repeat. The bottom picture represents a "tweaked down" version of the same exercise, that might be used earlier in the rehabilitation process.<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-oanHfz207g8/TeER6PTdneI/AAAAAAAAAvs/S2Mf4XTWX3o/s1600/DSC00409-1.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-oanHfz207g8/TeER6PTdneI/AAAAAAAAAvs/S2Mf4XTWX3o/s320/DSC00409-1.JPG" width="266" /></a></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-qaO24YXYndI/TeER-blSvMI/AAAAAAAAAvw/e8WcbOOikvg/s1600/DSC00410-1.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="212" src="http://2.bp.blogspot.com/-qaO24YXYndI/TeER-blSvMI/AAAAAAAAAvw/e8WcbOOikvg/s320/DSC00410-1.JPG" width="320" /></a></div><br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-vIi0iCpy8XY/TeESJljKpOI/AAAAAAAAAv4/PLPYuUiXUJQ/s1600/DSC00414-1.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://2.bp.blogspot.com/-vIi0iCpy8XY/TeESJljKpOI/AAAAAAAAAv4/PLPYuUiXUJQ/s320/DSC00414-1.JPG" width="205" /></a></div>Please don't give me that "it's dangerous" or "my kids can't do that stuff". Remember I just lost a book contract because they said the guy in the pictures was too fat & old. The alternative is to go bore your athletes to death like that spine guy.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com3tag:blogger.com,1999:blog-618639792837880710.post-60308204365519365952011-05-24T21:23:00.001-04:002011-05-25T10:54:08.669-04:00You can get with this...or you can get with that!<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-ymZwkqV9FEc/TdwY-4nDxJI/AAAAAAAAAvo/_Fub0L_YjAI/s1600/Capoeira.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="http://3.bp.blogspot.com/-ymZwkqV9FEc/TdwY-4nDxJI/AAAAAAAAAvo/_Fub0L_YjAI/s400/Capoeira.png" width="373" /></a></div><br />
A nationally renowned spine specialist criticized one of my blog posts because I had an athlete doing the exercise in this post: http://joestrainingroom.blogspot.com/2010/05/hips-in-hips-out.html<br />
<br />
Described me as, " a strict follower of Gary Gray who goes overboard especially when he gets his hands on a med ball &s; working <strong>the spine in full flexion under load."</strong><br />
<br />
First of all, while it is true I have been heavily influenced by G2 & Dave Tiberio, I'm also influenced by Vern Gambetta, Warren Hammer and others. But I would hate to think anyone thinks of me a wannabe clone. I'm not even sure what qualifies that as "A Gary Gray exercise". And are we not supposed to do capoeira (pictured) because the spine is in full flexion under load? Or is that OK because they are upside down, or not holding a medicine ball? I understand the theory about soft tissue creep, the stress on the intervertebral disks etc. But Stuart McGill himself, in his book (Low Back Disorders p.105) described a vertebral subluxation (documented under fluoroscope) occurring while a guy was doing a deadlift- with his spine in good posture; not even close to end range!<br />
<br />
Fortunately for me, another one of my influences is the great orthopedist Dr. Stephen Levin (on the right of this page is a link to his website). Here is his take on this topic:<br />
<br />
"Never believe a ''spine specialist', particularly if they are surgeons. If this 'specialist' is a surgeon, he does more harm in one day than you will have done in your lifetime. It is nonsense to consider the spine as 'weak' or 'strong' based on posture. A person instantly knows when their posture is appropriate for a task at the moment they begin to institute the task. Think of lifting a box of an unknown weight. Weightlifters start a 'clean and jerk' from a crouch because it is the strongest position. As soon as there is an attempt to lift, the body recognizes the load, and the posture adjusts. Weightlifters start a 'clean and jerk' from a crouch because it is the strongest position. Nowadays, I rarely think of any muscle, or muscle group performing a particular task. I think in closed chain activities, with all muscle involved, all the time. It is impossible to contract only one muscle, you must always involve all muscles".<br />
<br />
You can get with that- but Se baila así, se goza más.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com5tag:blogger.com,1999:blog-618639792837880710.post-19481850582971989992011-05-21T22:06:00.000-04:002011-05-21T22:06:55.099-04:00Phil Donley weighs in on Long TossingThanks to my buddy & ATSNJ president Eric Nussbaum for getting Phil Donley's<br />
(<a href="http://joestrainingroom.blogspot.com/2010/02/phil-donley-real-deal.html">http://joestrainingroom.blogspot.com/2010/02/phil-donley-real-deal.html</a>) response to my recent long toss post( <a href="http://joestrainingroom.blogspot.com/2011/05/long-toss-for-pitchers-is-questioned.html">http://joestrainingroom.blogspot.com/2011/05/long-toss-for-pitchers-is-questioned.html</a>)...<br />
<br />
"I am on the long toss side, also weighted balls. Just need to introduce them in the proper sequencing of the total program. It is amazing how many professional pitchers find a place to long toss,over 250ft) when they are out of sight of those organizations that limit pitchers to 120 ft. there is a time and place for all sorts of overload training."<br />
<br />
Well said.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-71447508863319723022011-05-21T14:50:00.000-04:002011-05-21T14:50:53.676-04:00Integrated Isolation, R TFL, Trail leg in Gait<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-FwgSK8p9nDw/TdgJShSc2TI/AAAAAAAAAvk/lakIpfcQvco/s1600/Grabbed+Frame+35.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-FwgSK8p9nDw/TdgJShSc2TI/AAAAAAAAAvk/lakIpfcQvco/s320/Grabbed+Frame+35.jpg" width="112" /></a></div>RLE Balance, LLE L anterolateral reach @ ankle height/BUE posterior @ overhead reach & return.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com0tag:blogger.com,1999:blog-618639792837880710.post-31073201978556105842011-05-18T09:11:00.002-04:002011-05-18T12:51:47.780-04:00New Joe P. Ankle Rehab E-book"Functional, Integrated Rehabilitation of the Sprained Ankle: A Practitioners Manual"<br />
<br />
After I signed a contract with a publisher, I figured I was good to go. But one obsticle after an other forced it to be abandoned. But I'm sticking to my promise of keeping it under $20. Its available on Amazon and Barnes & Noble for 9.99 as a Kindle & EPub respectively. I resisted doing this for a while becaues of the risk of it being labled as what we used to call a "vanity press". But, Dan Cipriani P.T., PHD, associate biomechanics professor at Chapman University, did the technical review for the book which gives it ligitimacy. I had Ray Fowler (<a href="http://www.rayfowler.org/digital-services/">http://www.rayfowler.org/digital-services/</a>) do the e-book coversion, and he really did a great job. In my opinion, it is better than a hard copy because its easily searchable and navigated. It definately does not look like your typical e-book, with lines disappearing and what not.<br />
<br />
If you don't have a Kindle or Nook, no problem! The book can be easily read on any PC or Mac by downloading the free software below:<br />
<br />
Download Kindle Reader for PC:<br />
<a href="http://www.amazon.com/gp/kindle/pc/download/ref=amb_link_151449822_1?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-1&pf_rd_r=0GA1PY8MZHJ175E8QP1W&pf_rd_t=1401&pf_rd_p=1289134842&pf_rd_i=1000426311">http://www.amazon.com/gp/kindle/pc/download/ref=amb_link_151449822_1?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-1&pf_rd_r=0GA1PY8MZHJ175E8QP1W&pf_rd_t=1401&pf_rd_p=1289134842&pf_rd_i=1000426311</a><br />
<br />
Download Kindle Reader for Mac:<br />
<a href="http://www.amazon.com/gp/kindle/mac/download">http://www.amazon.com/gp/kindle/mac/download</a><br />
<br />
Download Epub Reader for Mac or PC:<br />
<a href="http://www.adobe.com/products/digitaleditions/">http://www.adobe.com/products/digitaleditions/</a><br />
<br />
To purchase my book:<br />
Amazon:<br />
<a href="http://www.amazon.com/Functional-Integrated-Rehabilitation-Practitioners-ebook/dp/B0051BOA1S/ref=sr_1_1?s=books&ie=UTF8&qid=1305724069&sr=1-1">http://www.amazon.com/Functional-Integrated-Rehabilitation-Practitioners-ebook/dp/B0051BOA1S/ref=sr_1_1?s=books&ie=UTF8&qid=1305724069&sr=1-1</a><br />
<br />
Barnes and Noble:<br />
<a href="http://search.barnesandnoble.com/Functional-Integrated-Rehabilitation-of-the-Sprained-Ankle-A-Practitioners-Manual/Joseph-Przytula/e/2940012415851/?itm=1&USRI=ankle+sprain">http://search.barnesandnoble.com/Functional-Integrated-Rehabilitation-of-the-Sprained-Ankle-A-Practitioners-Manual/Joseph-Przytula/e/2940012415851/?itm=1&USRI=ankle+sprain</a><br />
<br />
Both sites give allow you to add your comments of your opinion on the book; and I encourage you to do so. There are not many books on the topic. The best selling one is written by a personal trainer.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com7tag:blogger.com,1999:blog-618639792837880710.post-27895901981504607642011-05-16T17:47:00.000-04:002011-05-16T17:47:17.224-04:00Flexion/Rotation Test for C0-C1 ROM<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-xitrHSnBOCw/TdGbLAtIbnI/AAAAAAAAAvg/CFhnDLO5Gyg/s1600/Presentation1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="http://2.bp.blogspot.com/-xitrHSnBOCw/TdGbLAtIbnI/AAAAAAAAAvg/CFhnDLO5Gyg/s320/Presentation1.jpg" width="320" /></a></div><br />
<br />
With the C-spine in axial extension (aka retraction, posterior chin glide), the athlete's chin is passively flexed, then rotated. Normal ROM would be between 30-35 degrees. At that point you'll feel an abrupt change in the quality of movement. That's where the motion reaches C2. If you look at the athlete's eye brows you can see there is a restriction. This is fairly common in combative & collision sports.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com2tag:blogger.com,1999:blog-618639792837880710.post-71419512502178214802011-05-15T19:57:00.000-04:002011-05-15T19:57:37.291-04:00"Bailing Out", better known as compensation<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-59WtqfHDEKk/TdBhTqH_l3I/AAAAAAAAAvY/HyodkznmTgQ/s1600/FotoFlexer_Photo3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-59WtqfHDEKk/TdBhTqH_l3I/AAAAAAAAAvY/HyodkznmTgQ/s320/FotoFlexer_Photo3.jpg" width="238" /></a></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-BopMtE1G6K8/TdBhOZsDS2I/AAAAAAAAAvU/fvlwjTmwvzE/s1600/FotoFlexer_Photo1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-BopMtE1G6K8/TdBhOZsDS2I/AAAAAAAAAvU/fvlwjTmwvzE/s320/FotoFlexer_Photo1.jpg" width="207" /></a></div><div class="separator" style="clear: both; text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-sWZZmWvDKi4/TdBhclVg9HI/AAAAAAAAAvc/XZo_-lyKGvo/s1600/FotoFlexer_Photo.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-sWZZmWvDKi4/TdBhclVg9HI/AAAAAAAAAvc/XZo_-lyKGvo/s320/FotoFlexer_Photo.jpg" width="239" /></a></div><br />
According to Fryette's laws of spinal motion, if motion is lost in one plane, it will steal it from the other two planes. Here I'm affording the thoracic spine increasing degrees of rotation by way of positioning the lower extremity. In throwing, the eyes are a powerful and important driver of motion, so its important for them to focus on the target. Take a look at the position of the head in relation to the shoulders. The increasing degrees of thoracic spine rotation require greater degrees of cervical counter rotation as so the eyes can remain on the target. The cervical spine is compensating into left side bending. What do you think? Where do I go from here?Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com2tag:blogger.com,1999:blog-618639792837880710.post-936615693670972992011-05-08T09:39:00.000-04:002011-05-08T09:39:40.068-04:00Long toss for pitchers is questioned."Biomechanical Comparison of Baseball Pitching and Long-Toss: Implications for Training and Rehabilitation", Flesig et al JOSPT 5-11.<br />
<br />
Basically the authors are saying that you get to a point where kinematics are changed too much to have any transfer value to pitching. That point is well taken. What I'm wondering though is if it will be beneficial in producing the soft tissue adaptations to the shoulder & elbow that might carry over to the sport. And, will adding in a little long toss a few times a week be enough to interfere with the motor learning process of pitching. Is long toss something we need to throw out all together?<br />
<br />
Remember Frans Bosch's definition of strength training; "coordination training with resistance", which states, "an ideal form of training should be able to provide a greater workload than an athlete's current stress handling capacity can deal with, while also complying with the criteria that must be met for an optimum transfer of training. However, overload and specificity are not mutually compatible. If one wants to include a large overload in training, then one must always deviate from some of the characteristics of goal or competition oriented forms of training" (Bosch '05).<br />
<br />
Does (long distance) long toss meet this criteria...provided it is done in the right context?Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com8tag:blogger.com,1999:blog-618639792837880710.post-85593824493827179212011-05-04T18:48:00.000-04:002011-05-04T18:48:39.722-04:00"Fascilitation"?From the May '11 JOSPT: Effects of Kinesio Tape Compared With Nonelastic Sports Tape and the Untaped Ankle During a Sudden Inversion Perturbation in Male Athletes, Briem et al.<br />
<br />
<br />
" Kinesio Tape had no significant effect on mean or maximum muscle activity compared to the no-tape condition. Neither stability level nor taping condition had a significant effect on the amount of time from perturbation to maximum activity of the fibularis longus muscle"<br />
<br />
Fascia practitioners are crazy about this stuff, but I don't know.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1tag:blogger.com,1999:blog-618639792837880710.post-54309838068588927872011-05-02T08:55:00.001-04:002011-05-02T08:56:01.280-04:00Don't nitpick.<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-ZcWZ39oDb-U/Tb6nXrpVL9I/AAAAAAAAAvQ/bzHE-MyHOJM/s1600/Ghosts.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="237" j8="true" src="http://3.bp.blogspot.com/-ZcWZ39oDb-U/Tb6nXrpVL9I/AAAAAAAAAvQ/bzHE-MyHOJM/s320/Ghosts.jpg" width="320" /></a></div>If you go looking for ghosts you will find them. A prominent therapist stated this pistol squat was dysfunctional because of "compensatory lumbar flexion due to insufficient posterior capsule hip mobility." An athlete with TRUE hip capsule insufficiency would NEVER be able to squat that deep in the first place. The deeper you squat the closer the thigh comes to the torso & reduces sagittal lumbosacral flexion. Sure there are a few coaching points here put overall its a pretty damn good pistol squat that does not require remedial work.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1tag:blogger.com,1999:blog-618639792837880710.post-85908568171035968982011-05-01T17:46:00.000-04:002011-05-01T17:46:13.203-04:00Postural Fascism<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-WUirclXgjHk/Tb3SJG4Qf-I/AAAAAAAAAvM/GQl-YwHO2Po/s1600/PCS-065.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" j8="true" src="http://1.bp.blogspot.com/-WUirclXgjHk/Tb3SJG4Qf-I/AAAAAAAAAvM/GQl-YwHO2Po/s320/PCS-065.jpg" width="193" /></a></div>The painting above is on display at the Museum of Modern Art in NYC. Its called, "Woman Ironing, by Pablo Picasso. Its a painting from Picasso's "blue period", in which his work was defined by the disparity between the rich & poor. In this one you can see how the skeleton almost serves as a close hanger for the flesh. You've heard me say many times in this blog, "asymmetry is the norm". Its not my phrase. I borrowed it from Norwegian physiotherapist Freddy Kaltenborn. Posture is very much influenced by environmental, morphologic, cultural, and emotional issues. Of course there are many interventional methods of influencing structure through function. Do you really think structural work is what this 19th century French woman needed? Probably just as much as your athletes do in the 21st.Joe Przytulahttp://www.blogger.com/profile/17872659808449420318noreply@blogger.com1