Ted Dardzinski is NOT an ATC

Watched CNN's story about Project Walk (www.projectwalk.org) last night on Anderson Cooper. Sanjay Gupta made a statement that "Trainers" do not have a background in rehabilitation and questioned the value of such a program. Ted is NOT certified by the National Athletic Trainer's Association. Apparently he attended the "Egoscue University" (http://www.egoscueuniversity.com/)-not a real university.

Robbing Peter to pay Paul

The Effect of Posterosuperior Rotator Cuff Tears and Biceps Loading on Glenohumeral Translation- Su, Budoff et al/ Arthroscopy May '10.

The long biceps tendon is one of the shoulder's backup systems to control GH instability. Tendinitis is usually a warning that the tendon is becoming a primary stabilizer.

A pretty simple study; they cut fibers of the subscapularis, supraspinatus, and infraspinatus to different degrees and combinations. Then mesured the amount of anterior/superior translation of the humeral head in the glenoid with and without biceps loading. The long head biceps tendon reduced humeral head translation up to 53%!.

Relocating the tendon from the scapula to the humerus is often a surgical treatment that increases shoulder instability; which is a precoursor to rotator cuff tendinitis.

ATSNJ Concussion Summit

August 2, '10; mark the date! Cantu, Jordan, Brolinson- The top brain injury researchers in the world will be there!

Download the brochure at:

https://www.signup4.net/Public/ap.aspx?EID=20101530E

New Link

On the right side of this page in the "my favorite websites" section you'll see a link to:

http://www.atsnj.org/

The Athletic Trainers Society of New Jersey

Since it's inception I've always believed it's been a superior website that was the brainchild of Mike Goldenberg ATC- A guy that has always been on the cutting edge of this stuff.

Great information for athletes, coaches, parents, and fellow athletic trainers. Be sure to take a look at the new concussion section.

Let's put the Neuro back into Neuromuscular

I just read an article on groin injury rehab in a popular journal. The protocol was divided up into warmup, strengthening, sports specific. The warm up got off to a pretty good start- a good combo of different kinds of squats of lunges. However, the remainder was very much muscle tissue focused on hip adduction. Exercises like a seated adduction machine; squats squeezing a ball between the legs.

Most of the exercises in the protocol all seemed to involve a good deal of stabilizing isometric contractions that I'm wondering if they possibly contribute to the neural confusion that causes these injuries in the first place.

Remember the adductors come off the pelvis; and forces coming bottom up from the same side foot, & top down from the opposite leg, torso, and arms also need to be taken into account. It sounds complicated, but it's really not. Trying to piecemeal individual muscles is what makes it seem complicated. Functional science requires the practitioner to think on their feet- the rehab is customized to the athlete and injury.

"The Plan"

Not as grandiose as "the secret", but it goes like this: This is one of our track & field athletes who has a grade 1 strain of his left semimembranosis from this past weekend. He has an important meet coming up today so I came up with a plan of action:

I pulled him out of practice for 4 days and we did his workouts in the pool; primarily done as combinations of deep water sprints. I supplemented this with plenty of soft tissue work. Graston the first 3 days. I used mainly sweeping strokes to reduce muscle spasm. Today before the meet I did ART. It is important to remember ART is not simply a "pin & stretch" technique. If you do it right, you are not going to get anywhere near their full range of motion. Once you take up the myofascial tension, hip & knee extension will limited.

We followed it up with my favorite hamstring stretch. The affected leg is placed on a bench or chair with the toe pulled toward the head. The contralateral foot is on the floor slightly toed out. The torso is forwardly flexed just enough to meet the muscle barrier. At that point, the hip is actively internally/externally rotated as the arms drive in the opposite direction of the foot for about 30 seconds.

Will the plan work? I've effectively used it many times before with lower extremity muscle injuries, but who knows.

What squat to start with?

This is one of our softball players who tripped trying to run out a ground ball. She smashed her knee into the dirt and wound up with a contusion to the anterolateral patella and lateral retinaculum (see the abrasion?). Some pre patella bursa injury too.

Day 3 post injury, I wanted to get her going on some partial range squats. My goal is to get a good muscle pump going to reduce edema and prevent quad atrophy. A traditional squat subconsciously caused her pelvis to translate to the uninvolved limb, as well as the foot of the involved leg to overpronate. Her body attempting to unload the patella & lateral retinaculum.

I successfully switched her over to R stagger squat; you can see everything line up better. What other squat variations could I have chosen?