Slip-not

Knee Strength Capabilities and Slip Severity; Wyszomierski, Chambers, et al. Journal of Applied Biomechanics- May '09.

This studied the influence of knee strength on recovering from unexpected slips during self paced walking. Knee strength was determined isokinetically, so only ant/post sagittal plane was studied, & non weight bearing. No surprise, young males were stronger & recovered from their slips faster than their female counterparts. May I emphasise again, to a certain extent adolescent male athletes can get away without strength training, female athletes cannot.

In a reverse way, I use slip training as part of my ACL rehab. I buy some cheap carpet runner at Walmart, cut them up into 12" squares, and toss them randomly on a gym floor. The athletes will sprint, skip, hop or jump in 3D patterns onto the carpet & slide.

Another technique I use is to have them walk up & down grass slopes outside the school in the AM when the morning dew is on it.

ART Recert

Rough weekend. After tonight's game ends about 8pm, it's a 4.5 hour drive to upstate NY for my ART recertification. The instructor is Dale Buchberger, a chiropractor/physical therapist. He does a lot of work with the Toronto Bluejays baseball club, and just a brilliant guy. At one time he was right around the corner from me in East Brunswick N.J.; but I know it will be worth the trip.

Disturbing

The other day a teacher in the high school approached me about their niece. The niece was hampered by chronic bilateral knee pain & she sought my advice. I asked this person about their niece's activities, and they told me the athlete was injured at a very popular strength & conditioning coach's "speed school".

Oh, I forgot to mention the athlete in question is a 9 year old.

I'm sure my European readers are laughing right now. Come on everybody, how did this get stolen from the physical educator? More important, how can we re-claim it? Click on the picture to enlarge it. It is the movement paradigm from a book Vern Gambetta recommended to me years ago, "Physical Education for Children" by Gabbard, LeBlanc et al.

Yeah, I still follow it. As the years go by, the more athletic training has become remedial physical education. Print it out & try it yourself- it works.

642 Wins!

Congratulations to our baseball coach, Ray Korn! Yesterday he became Union County NJ's winningest baseball coach in history. The Minutemen had to come from behind to defeat our next door neighbor & rival Union high school. Coach is retiring this year, but I'm sure he will be involved with the sport one way or the other for a while yet.

One thing I will miss is his quirky comments. Like when when the ball would keep popping out of one of our infielder's mitt before he would recover & throw it. Coach asked him if it was a glove, or a toaster on his hand.

FMR Setup

This is a functional manual reaction setup for left midtarsal joint mobilization. The calcaneus is everted on a BAPS, the forefoot is inverted on a slant board. Here we're over exaggerating the natural motion of the FRONT foot in gait & running. The pelvis is rotated right; the knee is internally rotated; with the left shoulder rotating left. The athlete rhythmically shifts weight from the right foot to the left.

I can use this as a self mobilization, or I can get my hands down on the MTJ for a little over pressure. It's very easy now because I have gravity, momentum, & the ground assisting me in a functionally consistent manner. I'll begin with table mobes/manipulation, but switch over to weight bearing mobes as soon as the athlete can tolerate it. This athlete is doing well. We're now 9 days post gr.2 inv. ankle sprain & I've begun BLE 3D mini jumps.

Obviously as you can see in the picture we've got some regional interdependence issues that probably wouldn't be addressed in traditional physical therapy but that can be easily integrated into an athletic training rehab session.

The enigmatic ankle sprain

I wish more attention was paid to ankle sprains in the professional journals. This is a 4 day old inversion ankle sprain. There was a lot of internal rotation involved, so the deltoid ligament was torn in addition to the posterior talofibular ligament. The “high ankle sprain” is very popular in the media. However, I believe any ankle sprain with a good deal of rotation involves the distal tibiofibular ligaments/interosseous. So, I think it would be safe to say MOST ankle sprains have a high ankle sprain element. A new classification system is seriously in order. So be wary of the cookbook protocol approach. Every ankle sprain is a little different.

Because the sprained ankle is so common, it’s looked at as no big deal. Which makes for a tough sell to coaches when you’re trying to keep this athlete out of competition.

Grade 2 inversion L ankle sprain rehab, day 5:

A.M. session:
3D BLE ankle excursions, 100 each
FMR
Rockfit trainer, 5 minutes

P.M. Session:
3D BLE ankle excursions, 100 each
L stagger squats, 3x12
Squats, hip width apart, heels elevated 1.5”, 3x12
Eccentric heel drops, up on 2 feet, down on L, 3x12
RLE pivot lunge, 3x12
Rockfit Trainer, 5 minutes
HVES(-) c/ RICE, 30m

Gracilis top down

Here's the gracilis integrated core I'm using. I'm staying consistant with gait by having the pelvis rotating R at gound contact, then rotating left at midstance. The idea being the pelvis going too deep into left anterior rotation, R frontal plane rotation, & R transverse plane rotation. Sequencing the core to correct it.

If you chose another sequence, it doesn't mean that you were wrong. Kevin's idea of LLE balance BUE med ball chops is not a bad idea. After all, it's doubtful the pelvis was only unstable in the above mentioned planes.