By dr on January 1, 2014
Adriaan Louw, PT, PhD, CSMT
Adriaan Louw is a busy man. Between running ISPI (International Spine & Pain Institute), performing research, treating patients, drinking beer, and watching football he doesn’t have a lot of free time. However, he was kind enough to answer some quick questions to help me understand pain, central sensitization, and the clinical application of neuroscience. As always, his answers were very helpful and I thought I’d share them with everyone else. Continue reading “11 Questions with Adriaan Louw”
Posted in Professionals |
By dr on December 15, 2013
The Hits
1) Human movement isn’t always as simple as basic kinesiology and anatomy. James Speck gives a great example of this in his detailed article describing the soleus as a knee extender. “When a muscle contracts, it doesn’t think about which direction in needs to pull. It just shortens.”
2) More on pain science: “…they used newer MRI technology to see how flexible people could be in responding to pain. The mind-wanderers were more flexible.” Pain isn’t a pathological structure; it’s a central processed perception.
3) I recently had a medial elbow tendinosis patient. When I screened him with the SFMA his single leg balance was terrible. He had some severe ankle/foot stability deficits. This study was in a recent JOSPT. Regional interdependence. SFMA. Continue reading “December Hits (2013)”
Posted in Professionals | Tagged The Hits |
By dr on December 1, 2013
I have been following Erson Religioso, a PT and blogger, for quite some time now. He has repeatedly (no pun intended) discussed the effectiveness of Mechanical Diagnosis & Therapy (The McKenzie Method or MDT). He’s a very knowledgable clinician and runs his social media with integrity. Over the years he has provided a great deal of clinically applicable information and I have seen results in my practice using some of his methods.
I decided I had to check out MDT first hand and learn about their method. This past July I took McKenzie Part A – The Lumbar Spine with Dave Oliver. Continue reading “23 Things I Learned From McKenzie Part A”
Posted in Professionals | Tagged assessment, Lumbar, Pelvis / Sacroiliac, Review |
By dr on November 15, 2013
-OverheadShoulder-Jerk-ALL-Hammy-Memory-FrontSquat-Speed-Mistakes-GMI-LowerTraps-Pain
1) Down and back isn’t always right for our shoulder patients. In fact, some people need the opposite. This months article goes over how to assess and treat someone for overhead shoulder exercises.
2) This is awesome – slow-mo clean & jerk video with analysis from olympic lifting coach Jim Schmitz.
3) A new knee ligament? Researchers have found an Anterolateral Ligament (ALL) in the knee. Is this a profound advancement in anatomy? Or is this just a carved out fascial thickening?
4) Great perspective on hamstring tightness. Mike Reinold discusses how a tight hip flexor can pull the pelvis into an anterior pelvic tilt, thus decreasing the contralateral straight leg raise. You could use the 90-90 active posterior chain test in hooklying to further Continue reading “November Hits”
Posted in Professionals | Tagged The Hits |
By dr on November 1, 2013
In Part I you learned the concepts behind upward rotation and the overhead shoulder. This article builds off of these concepts and will show you how to properly assess and treat for the overhead shoulder.
I cannot emphasize enough how important a thorough assessment is before prescribing overhead shoulder exercises. Without an assessment to determine any impairments or movement dysfunctions you will not be able to properly prescribe the correct exercises. Before someone starts overhead movements you should make sure they’re clear in all of the overhead shoulder characteristics (Part I). Failure to do so could result in injury. Continue reading “The New Overhead Concept (Part II)”
Posted in Professionals | Tagged assessment, Shoulder |
By dr on October 15, 2013
– Upper Trap – Thought Viruses – Deadlift – 5×5 – Reciprocity – Sensory Fascia – E5 – Perception – Anti-Valgus – Bad Medine – Cook’s 3’s – Doga
1) The poor upper trapezius. It might be the most understood muscle in the body. It’s not a major shoulder elevator and it isn’t a big problem in shoulder patients. In fact it’s usually the opposite. Check out this months post to learn more. Continue reading “October Hits”
Posted in Professionals | Tagged The Hits |
By dr on October 1, 2013
Traditional Down & Back
At this point we all know the importance of a stable and strong scapula for shoulder function. Almost every PT, athletic trainer, and personal trainer trains the shoulder with a “down and back” cue. This cue allows for a better stable position of the scapula and enables the rotator cuff to work more effectively. Kolar has summed this concept up in a single sentence: Continue reading “The New Overhead Shoulder Concept (Part I)”
Posted in Professionals | Tagged Biomechanics, Prevention / Recovery, Shoulder |
By dr on September 16, 2013
Kettlebells – Runners – Habits – Longevity – Med Ball – Tightness – Goblet – Yoga – Elbow Grease
1) Kettlebells are becoming more and more common in fitness and rehab. If you don’t use them, you should. Here’s this months article on my expirience at the premier kettlebell workshop.
2) Erson goes over 5 things to look for in runners. “Running is one sport that arguable needs more symmetry than most. I tell my runners it’s because you’re doing the same thing over and over for 1000s of steps until you stop!” Continue reading “September Hits”
Posted in Professionals | Tagged The Hits |
By dr on September 7, 2013
I loved my undergraduate time at the University of Tennessee. Probably a little too much, because I wasn’t accepted into any PT schools the first time I applied. One program even recommend that I try a different profession.
In the following year I worked hard to gain experience, volunteer, retake some science courses, and contact schools. The 2nd time around I was accepted into multiple schools. I ended up at one of the top schools in the nation, graduated with a 3.8, and now have one of the best jobs in the city. Continue reading “9 Ways to Increase Your Chances of Getting into Physical Therapy School”
Posted in Uncategorized |
By dr on September 1, 2013
On June 1st I had the pleasure of participating in a StrongFirst Kettlebell Workshop with Phil Scarito. It was a 1-day course that went over the intricacies of the basic kettlebell movements (Deadlift, Swing, TGU, Goblet Squat, Press). The theory is that it’s better to master the fundementals than to be average at a bunch of different lifts. Plus, it’s these basic KB movements that that have the greatest impact on improving one’s physical abilities and movement patterns. Continue reading “Course Review – StrongFirst Kettlebell Workshop”
Posted in Patients, Professionals | Tagged Hip, Knee, Prevention / Recovery, Review |
By dr on August 15, 2013
– Lumbar Extension – Selling – Pain&Expection – Evolved Shoulder – Posterior Hip Pain – Posterior Chain – Gray Cook – EBP? –
1) Our profession and our society has become so afraid of lumbar flexion that it’s almost a phobia. This obsession of avoiding lumbar flexion has allowed another problem to slip by – excessive lumbar extension. I’ve been noticing more lumbar extension dysfunction in the clinic. Read about it in this months post here.
2) The more I practice the more I start to think the most important aspect of PT is the patient’s mindset. I look for 2 things in the eval Continue reading “August Hits”
Posted in Professionals | Tagged The Hits |
By dr on August 1, 2013
Low back pain is one of the most common injuries we see. Traditionally you always hear a lot of information regarding excessive lumbar flexion. And with the amount of information readily available in our society, many patients already know this as well. This has caused some therapists and patients to walk around terrified that the next time they bend over their L5-S1 disc will splatter against the wall behind them. But what about the other direction? What about the potential problems in extension patterns?
We’ve concerned ourselves so much about “blowing out a disc” with flexion that we’ve completely overlooked extension problems. Continue reading “Lumbar Extension Dysfunction”
Posted in Professionals | Tagged assessment, Hip, Lumbar, Pelvis / Sacroiliac, Prevention / Recovery |
By dr on July 16, 2013
– Fatigue – High Heels – Motor Learning – Mobility – Threshold – Strengthening – Parachute – Protocols – Armbar – Neuro –
1) I think exercise programs like crossfit and P-90X are great. They get more people moving and interested in their health. And in today’s society, decreasing the amount of sedentary people is very important. However, when exercises are performed past failure a ton of things go wrong. A new study showed there is a deterioration of lower extremity biomechanics when fatigue hits. This causes a dangerous cascade of events: compensations, inefficient movement, substitution movement patterns, and an increased risk for injury. While many of us already know this, many of our patients don’t. Educate them. Continue reading “July Hits”
Posted in Professionals | Tagged The Hits |
By dr on July 1, 2013
Understanding the difference between low and high threshold strategy is a very important part of rehab and training. If a patient is using the wrong strategy for the task they will not only be inefficient, but they can make the injury worse and cause more harm. Continue reading “Low vs. High Threshold Strategy”
Posted in Professionals | Tagged assessment, Prevention / Recovery |
By dr on June 17, 2013
– Butler Cliffnotes – Deep Squat – MDT Reset – Hip Thrust – Hamstring Strains – DNS & Powerlifting –
1) So Zac Cupples does Cliffnotes for PT books. Here’s his post on the Sensitive Nervous System by David Butler. If you aren’t familiar with Butler and the NOI approach you should check it out. “Pain is an unpleasant, sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
2) As a deep squat advocate, I loved this post by James Speck. To perform the deep squat you must have BOTH mobility and stability. This alone makes it a great assessment and intervention. Continue reading “June Hits”
Posted in Professionals | Tagged The Hits |
By dr on June 1, 2013
The quadruped position is a very important developmental posture. From this posture we learn to crawl and transition to half-kneeling (which then transitions into standing). Through this posture we develop core, shoulder, and hip stability, learn reciprocal UE/LE motion, and begin to control our spine through our weight-bearing extremities. The quadruped position has many details that are often lost or forgotten when training. Mastering these subtleties and progressing within the edge of your ability will lead to a great effect on your stability. Continue reading “Quadruped”
Posted in Professionals | Tagged assessment, Cervical / Neck, Core, Hip, Lumbar, Pelvis / Sacroiliac, Prevention / Recovery, Shoulder |
By dr on May 16, 2013
Language – Hip Hinge – Ankle/Hip – Weingroff – Boyle – Core Exercise – Knee Valgus
1) “An alteration of the language output may be as clinically potent in desensitising pain neurosignatures and it certainly has not been considered as deeply in rehabilitation.” David Butler discusses how correcting patients language & thoughts relating to their pain is just as important as it is to correct their movement output. This month’s JOSPT has a related article on the how movement system diagnostic labels can prevent the disconnect between diagnostics and treatment processes that pathoanatomic labels create.
2) The hip hinge is one of the most important movement patterns for anyone that moves. This months article goes over what it is, how to assess it, and how to correct it. Continue reading “May Hits”
Posted in Professionals | Tagged The Hits |
By dr on May 3, 2013
The hip hinge is a basic movement pattern that everyone must have. When people have atrophy of this movement pattern they end up compensating in all sorts of ways (trendenlenberg, dynamic valgus, knee dominant movements, lumbar flexion). This leads to decreased performance and increased risk for injury. Continue reading “Hip Hinge”
Posted in Professionals | Tagged assessment, Hip, Lumbar, Pelvis / Sacroiliac |
By dr on April 15, 2013
Joint Laxity – Davis’ Law – Deep Squat – Foot Types – Standing Help – Step Up
1) Beighton Laxity Scale gives a good indication of your patients congenital laxity. If your patient is extremely hypermobile then you shouldn’t be spending alot of time doing joint mobilizations and/or manipulations. These patients require a great deal of stability.
2) Davis’ Law, the soft tissue equivalent to Wolff’s Law, describes how soft-tissues adapt to stress. It describes how muscles adapt in a reciprocal manner. For example, a strong and inflexible gastroc will usually cause the anterior tibialis to become weak and flexible. With this law in mind, you should always consider the antagonist when trying to achieve an increase in strength or mobility. Continue reading “April Hits”
Posted in Professionals | Tagged The Hits |
By dr on March 15, 2013
5 Ways to Expand – Lateral Stability – Video Analysis – RTC Myths – Breathing – SIJ – Carbs
1) PT School lays down the necessary foundation to develop your career. There are many important things that we don’t learn in school. Erson goes over 5 of these things. I completely agree.
2) This might be a nice progression for patients that have already mastered the sagittal plane and have topped out with isolated hip strengthening (bridges, clamshells, side-step, etc.). Eric Cressey goes over advanced lateral stability training.
3) Chris Johnson goes over the details of how to videotape your runners for analysis.
4) Mike Reinold describes his 4 RTC myths in this article. Mike makes a great point on Continue reading “March Hits”
Posted in Professionals | Tagged The Hits |
By dr on March 4, 2013
Part I of this series dealt with breathing anatomy and mechanics. Knowledge and understanding of the anatomy and mechanics of breathing is essential for a proper assessment and intervention. This post will expand on the previous post and go over some indications, assessment, and intervention for breathing. Continue reading “Breathing – Part II – Indications, Assessment, & Intervention”
Posted in Professionals | Tagged Core, Lumbar, Pelvis / Sacroiliac |
By dr on February 15, 2013
Breathing – Thoracic Mobility – FMS – Neuro – Pendulum Theory – Warm-Up – Glutes
1) Bill Hartmen uses the downward dog to increase pre-load on the diaphragm, activate the serratus anterior, and unload the scalenes while facilitating deep neck flexors. All this can significantly help your breathing patterns. Check out this months post on breathing.
2) This is a great thoracic mobility technique using the NMT T-Bar. A good way to increase thoracic mobilization and
integrate with scapular movement.
3) Nice summary of FMS corrections (from Mike Reinold’s site). Continue reading “February Hits”
Posted in Professionals | Tagged The Hits |
By dr on February 1, 2013
The average person takes about 21,000 breaths a day. This makes it one of the 3 biggest aspects of our patients life that we can have a profound effect on (other 2: posture & walking).
This post will discuss the holistic effects of breathing, anatomy, and the important cascade of events for proper breathing and inner core stabilization. Continue reading “Breathing – Part I – Anatomy & Mechanics”
Posted in Professionals | Tagged Biomechanics, Core, Hip, Lumbar, Pelvis / Sacroiliac, Prevention / Recovery, Shoulder |
By dr on January 15, 2013
Coordination – TRX Y’s – Nocebo – Hallux Mobility – Neuro Approach
1) Maybe we should slow down a little bit. Todd Hargrove goes over why slow movement is important for coordination and movement efficiency. This can be very useful when attempting to teach the “motor morons” how to move right. I specifically liked the Weber-Fechner Law, which describes that the relationship between the physical magnitiudes of a stimuli and the perceived intensity of the stimuli.
2) Overhead movements are usually butchered by patients. When trying to activate the lower trap many patients compensate with a rib cage flare, hyperlordosis, forward head, and unusual grunts. Cressey quickly goes over how to teach the TRX Y’s in this 2 minute video. Continue reading “January Hits”
Posted in Professionals | Tagged The Hits |
By dr on December 17, 2012
Pain – Deadlift – IPSI – Ankle Torque – Front Squat
1) Pain is usually the main reason why patients come to see us. The traditional orthopedic approach always uses a pathoanatomical explanation for pain, but this might not always be correct. Lorimer Moseley gives a very entertaining presentation on explaining pain. My recent post also goes over some of these central processing mechanisms. And Todd Hargrove has a great review (part 1, 2, 3, 4) of Moseley and Hodges conference on pain and this neurologic approach.
2) The dead lift is an essential movement pattern. It is hip hinging at it’s best. Gray Cook and Brett Jones go over the dead lift and some great variations with kettlebells. If you think the dead lift is a bad exercise than Continue reading “December Hits”
Posted in Professionals | Tagged The Hits |
By dr on December 3, 2012
On November 3rd & 4th I had the pleasure of taking the NeuroOrthopedic Institue course – Mobilisation of the Nervous System. I was lucky to have Adriaan Louw as the course instructor. I learned a tremendous amount over the weekend and returned to the clinic on Monday with an additional approach to treat patients with. The NOI provides a paradigm shift in the way we view the nervous system and pain. While it is impossible to cram a weekends worth of great information and techniques into a post, I’ll try to provide some key points I learned from the course. Continue reading “NOI – Mobilisation of the Nervous System”
Posted in Professionals | Tagged assessment, Review |
By dr on November 16, 2012
November Hits
Eccentrics – TPI – Foot Intrinsics – Rib Cage – Upward Rotation – Cubiod
1) My co-worker, Michelle Briancisco, has been talking about using eccentrics to increase ROM for years. She has found it really works well when patients aren’t responding to traditional muscle lengthening techniques. She hypothesizes that it neurologically alters the afferent motor output and also provides the patient with a sense of control during the lengthening.
2) Saw this on Erson’s site. I remember doing this at the TPI course. There’s a plethora of good shoulder warm up exercises to choose from for your patients. Continue reading “The Hits”
Posted in Professionals | Tagged The Hits |
By dr on November 7, 2012
I’ve been in over 25 clinics and worked with over 75 physical therapist. While this helped me gain knowledge and experience in the field, it has also shown me the different “types” of physical therapist out there. Most PT’s are great clinicians and want to help people to the best of their knowledge. However, there are some PT’s out there that become “that guy”. If you’ve worked in a couple different practices or if you think back to PT school you have probably met one of these “guys”. There are 3 types of “that guy” in the PT world: the hipster PT, the research snob PT, and the ancient PT. It’s fun to humorously classify these types of PTs, but it’s also important to make sure you don’t become one of them. Continue reading “Don’t Be “That Guy””
Posted in Professionals | Tagged Review |
By dr on October 15, 2012
October Hits
Atlas Glide – Turkish Get Up – Pelvodiaphraribcage – High Ankle Sprain – Deadlifts
1) The suboccipitals and occiput-atlas articulation are paramount when it comes to normal cervical function. The fact that our society is spending an increasing amount of time in the forward head posture makes this area even more important for cervical patients. Adding THIS to my soft-tissue work when appropriate has been very helpful.
2) Everyone seems to be talking about the Turkish Get-Up (TGU) these days. I’ve been adding more kettlebells into my own workouts and have been working on the TGU. It’s much harder than it looks when done correctly. It takes a great deal of mobility and stability throughout the entire body to complete it without compensations. Mike Roberton has a great step-by-step and Gray Cook has a video demonstration. Continue reading “The Hits”
Posted in Professionals | Tagged The Hits |
By dr on September 29, 2012
It is widely known that hip strenthening plays a significant role in the rehabilitation of knee pain. When it comes to our sagittal-plane loving runners the hips become even more of an issue. However, in 2011 Wiley and Davis published an article in JOSPT that found hip strengthening alone was not enough to alter running mechanics. This gave movement hipsters and research snobs more fuel to trash talk exercises that aren’t “functional” or that “research shows” it doesn’t elicit some desired EMG number. While I find remedial exercises to be an important step in rehab, I do agree that there needs to be a better transition between rehab and sport specific training. Continue reading “Functional Hip Strengthening”
Posted in Professionals | Tagged assessment, Hip, Prevention / Recovery |
By dr on September 15, 2012
September Hits
Popliteus – Hamstring Syndrome – Gray Cook – Calf Strain – Pavel Tsatsouline
1) The popliteus is an important structure of the knee that is often overlooked by many clinicians. While it may not be the main contributor to knee dysfunction, it can still have a major impact. Some patients need greater activation of this muscle, while others
benefit from a release. This is a good post on the popliteus and it’s functional role in the knee joint.
2) I recently had a patient with hamstring syndrome. She had been previously mis-diagnosed with piriformis syndrome, ischogluteal bursitis, lumbar radiculopathy, and hamstring tendonosis. Understanding how to differentially diagnose these patients may lead to a more specific treatment and a better outcome. Continue reading “The Hits”
Posted in Professionals | Tagged The Hits |
By dr on September 1, 2012
Chubbs was right. It’s all in the hips!
Hip strength is extremely important for your musculoskeletal health. The hip muscles are connected from your pelvis to your femur. This connection means they will not only have an influence on your hips, but also effect your back and your knees. In other words, your hips help stabilize and translate forces from your legs to your trunk and vice versa. In addition to this anatomical/biomechanical relationship, our society has a very high prevalence of back and knee pain. So maybe instead of another “core” program or a new squat technique we really just need some hip strengthening. This post will discuss the importance of hip muscles, the effects of hip strength, and how to start strengthening them.
Posted in Patients | Tagged Hip, Lumbar, Pelvis / Sacroiliac, Prevention / Recovery |
By dr on July 27, 2012
Regardless of the patho-anatomical etiology, most shoulder injuries involve a disruption in the delicate subacromial space (SAS). Once this space is altered the structures (joint capsule, articular cartilage, rotator cuff, biceps tendon, bursa) have increased risk for damage and misuse. This also leads to subsequent changes in muscle length-tension relationships, arthrokinematics, and motor patterns. Continue reading “Subacromial Space”
Posted in Professionals | Tagged Shoulder |
By dr on July 1, 2012
On June 9th I went to Chicago, IL to run in a half-marathon with my brother and girlfriend. Prior to this I had never ran more than 6 miles at once and had spent my time playing sports and lifting weights as opposed to endurance training. I trained for 3 months, ran the half-marathon, and learned a lot about myself and running. Continue reading “What I Learned from Running a Half-Marathon”
Posted in Patients | Tagged Prevention / Recovery |
By dr on May 12, 2012
The half-kneeling position is a great way to assess and treat your patients hip and core stability. While it seems like an easy exercise, it has many subtleties that can make or break the position. Having a greater understanding of the half-kneeling position will help ensure that your patient achieves the maximal benefit. Continue reading “Why You Should Use the Half-Kneeling Position”
Posted in Professionals | Tagged assessment, Core, Hip, Lumbar, Pelvis / Sacroiliac |
By dr on April 8, 2012
This past month I had the pleasure of taking a University of St. Augustine continuing education course with instructor Larry Yack. The course went over spinal evaluation and manipulation (skilled passive movement of a joint). There was a tremendous amount of useful information and techniques. Here’s some random notes. Continue reading “Paris Course – S1 – Spinal Evaluation & Manipulation”
Posted in Professionals | Tagged Lumbar, Review |
By dr on February 15, 2012
When prescribing home exercises for my patients I often try to keep it to a minimum of 3 exercises. I understand it’s the last thing people want to do at the end of a long day, especially when they require great effort and concentration. Luckily for those of us that experience pain and discomfort there is an exercise that is easy to perform, doesn’t require a great deal of mental energy, and gravity does all the work for you. Continue reading “Constructive Rest / Passive Alignment / 90-90 Position”
Posted in Patients, Professionals | Tagged Lumbar, Prevention / Recovery |
By dr on December 28, 2011
Dynamic Stabilizers of the glenohumeral joint include the contractile tissues and the associated sensorimotor system involved with proprioception, kinesesia, and the sensation of resistance. For optimal shoulder stabilization the dynamic stabilizers must be working in an efficient synergistic fashion. Continue reading “Shoulder Stability – Dynamic Stabilizers (3 of 3)”
Posted in Professionals | Tagged Shoulder |
By dr on November 30, 2011
Force Closure
Force closure is a biomechanical myofascial system that helps to produce a “self-locking” mechanism for joints. It occurs when contraction of the muscles/fascia that cross a joint results in increased stability of the joint. This external dynamic myofascial force can increase stability by producing a closed pack articular position (increased congruency), generating segmental stiffness, and increasing compression perpendicular to the joint. Continue reading “Force Coupling for the Lumbo-Pelvic-Hip-Complex”
Posted in Professionals | Tagged Lumbar, Pelvis / Sacroiliac |
By dr on November 14, 2011
Static stabilizers are the non-contractile tissue of the glenohumeral joint. They are very important in shoulder stability at end-range ROM and/or when there is a dysfunction of the dynamic stabilizers. These static stabilizers set the base of support for the shoulder joint. Continue reading “Shoulder Stability – Static Stabilizers (2 of 3)”
Posted in Professionals | Tagged assessment, Shoulder |
By dr on October 24, 2011
October is always one of my favorite times of the year. The weather gets a little cooler, the football season is in full swing, pumpkin flavored food is available, Oktoberfest beers are on tap, and most of all Halloween is right around the corner. Before the time comes for ghouls, ghosts, and demons, it is important to prepare and protect your neck. Continue reading “Protect Your Neck”
Posted in Patients | Tagged Cervical / Neck, Prevention / Recovery |
By dr on October 16, 2011
It doesn’t take a subscription to a peer-reviewed medical journal to gain knowledge and understanding in the orthopedic world. Today there is a plethora of websites and blogs with so much free information that you can practically get free continuing education online. Here’s a list of some helpful sites. I’ve tried to focus on the ones that are more focused on concepts and education instead of product placement and marketing. Let me know if there is anything I’m missing.
Continue reading “Links”
Posted in Patients, Professionals | Tagged Links, Review |
By dr on October 4, 2011
The shoulder is one of the most complex joints in the human body. It has an amazing amount of inherit mobility, which in turn requires an adequate about of dynamic and static stability to function. Then if you consider the manner in which we use our shoulders and the lack of anatomical support, it’s easy to see why Continue reading “Shoulder Stability (1 of 3)”
Posted in Professionals | Tagged Shoulder |
By dr on September 19, 2011
Today there are so many healthcare professionals/salesmen out there that are repackaging the same old wheel and selling it as the newest innovation to medicine. It seems like all it takes to innovate in the medical industry is a good marketing plan and a thesaurus. However, this is by no means what Tom Myers does in his book Anatomy Trains. Myers has created an easy to read, easy to understand book that truly advances our understanding of the human body. Anatomy Trains is a fresh new perspective on fascia and the human body and it leaves the reader with an addition “lens” of which to view the body through. Continue reading “Book Review: Anatomy Trains by Tom Myers”
Posted in Professionals | Tagged Review |
By dr on August 21, 2011
Sensitivity and Specificity
Often when reading peer-reviewed articles I feel like I need an advanced degree in statistics to understand how the hell they analyzed the information and quantified the results. There is an amazing amount of jargon when looking at the objective measurements. This is rarely a clinical problem since understanding the statistical analysis is not applicable to the patient. I’ve never been mobilizing a patients shoulder and been concerned of whether it was a pearsons analysis or t-something in the article I just read.
However, the one part of statistics that is very important clinically is understanding specificity and sensitivity. Continue reading “Sensitivity and Specificity”
Posted in Professionals | Tagged assessment |
By dr on July 23, 2011
The 10% Rule
A common rule that has become widely accepted is the 10% rule. This is a general guideline to help prevent injuries. The rule simply states that you should not increase your duration, frequency, intensity, or load by more than 10% per week. Failing to abide by this rule can lead to maladaptive compensations, tissue overload, subsequent injuries, and a possible loss of that rug that really ties the room together. Continue reading “The Big 10 Percentowski”
Posted in Patients | Tagged Prevention / Recovery |
By dr on July 14, 2011
Article Review: Acetabular Labral Tears
Lewis CL, Sahrman SA. Acetabular Labral Tears. Phys Ther. 2006;86:110-121
In 2006 Lewis and Sahrmann produced a great article on acetabular labral tears. They provided great information regarding the anatomy and function, the concepts on the eitiology, clinical characteristics, diagnosis, and treatment of labral tears. This is an important article to read since labral tears have become more prevalent in the past few decades and surgical management of this disorder continues to progress. It’s important to fully understand labral tears before attempting to manage a patient’s care. This article provides the information that can help orthopedic professionals better understand this pathology. Continue reading “Article Review: Acetabular Labral Tears (Lewis & Sahrman 2006)”
Posted in Professionals | Tagged Hip, Review |
By dr on July 8, 2011
Ice is good for more than just keeping your favorite cocktail cold. It can have a profound effect on preventing and healing injuries. In fact, it’s been used as a healing modality (cryotherapy) for centuries and continues to be one of the main methods for reducing pain and accelerating tissue healing.
Continue reading “Ice: Nature’s Miracle Healer”
Posted in Patients | Tagged Prevention / Recovery |
By dr on July 6, 2011
Pressure
Pressure is an important aspect of physical force systems. It can have a profound affect on the body from both external and internal forces. The results of pressure depends on many different variables, indluding: the body position, type of external force orientation, and medium through which the force is applied. Manipulating these variables can help a clinician to use pressure as a therapeutic stress as opposed to a noxious stimuli. Continue reading “Basic Biomechanics: Pressure”
Posted in Professionals | Tagged Biomechanics |
By dr on July 6, 2011
Gravity
Gravity is a very important force to consider when dealing with biomechanics. It is constantly affecting the body in both static and dynamic movement. It can be looked at as the gravitational downward pull on an object. Whereas the center of mass is the mean position of matter in a body or system. Gravity, like all forces, has a point of application, a magnitude, and a direction. Continue reading “Basic Biomechanics: Gravity”
Posted in Professionals | Tagged Biomechanics |
By dr on July 3, 2011
Moment Arm
The first step of understanding and calculating torque is identifying the moment arm. The moment arm (lever arm) of a force system is the perpendicular distance from an axis to the line of action of a force. In other words, moment arm determines the quality of the torque. Continue reading “Basic Biomechanics: Moment Arm & Torque”
Posted in Professionals | Tagged Biomechanics |
By dr on June 30, 2011
A lever is a rigid object that is used with an axis to either multiply the mechanical force (effort) or resistance force (load) applied to it. The efficiency of the lever is called mechanical advantage (MA). The greater the mechanical advantage, Continue reading “Basic Biomechanics: Levers”
Posted in Professionals | Tagged Biomechanics |
By dr on June 29, 2011
Sir Isaac Newton formulated 3 physical “laws” that became the basis for classical mechanics. Through these laws he describe the relationship of forces, objects, and motion. For three centuries this has been the foundation for understanding motion and physical force systems. Continue reading “Basic Biomechanics: Newton’s Laws of Motion”
Posted in Professionals | Tagged Biomechanics |
By dr on June 28, 2011
The most important aspect of biomechanics to consider is force.
Continue reading “Basic Biomechanics: Force”
Posted in Professionals | Tagged Biomechanics |
By dr on June 27, 2011
Basic Biomechanics
Over the years there has been an abundance of different theories and concepts as to how to best treat orthopedic patients and athletes. With so many different approaches to assessment and treatment it is easy to get overwhelmed. Even evidence-based practice has contradicted itself over the years when new research arises proving the old research obsolite. However, there is one concept that never changes and is always the foundation for treating orthopedic patients. Continue reading “Basic Biomechanics”
Posted in Professionals | Tagged Biomechanics |
By dr on June 20, 2011
Low back pain patients are not a homogeneous group, but unfortunately they are often times treated like one. There is an overwhelming amount of causes of pain (disc, ligaments, facet joint capsules, muscle strain/spasm, stress fracture, etc.) and possible diagnosis for low back pain. However, research has shown that the specific “diagnosis” of low back pain rarely correlates with Continue reading “Treatment-Based Classification System for LBP”
Posted in Professionals | Tagged assessment, Lumbar |
By dr on June 19, 2011
Recently, there has been some research that states stretching prior to exercise has lead to a reduction of muscle strength. Of course when something this radical comes out it leads to all sorts of bandwagons, assumptions, and un-educated advice. While this research has helped set a trend toward dynamic warm ups, it has done a big disservice to individuals participating in activities by giving them the notion that they shouldn’t be stretching. Continue reading “The Truth About Stretching”
Posted in Patients | Tagged stretching |
By dr on May 29, 2011
When examining and assessing patients it’s easy to get caught up in all of the esoteric and minute details. With the overwhelming amount objective measurements (joint mobility, AROM, PROM, MMT, DTR, etc.) and the endless list of special tests, it can be difficulty to obtain a clear clinical picture. While a full examination is necessary to prevent overlooking any possible impairments/pathologies; it is also just as important to make sure you come away with a strong simple assessment and clear clinical picture of your patient. I have found that focusing on 3 simple assessments helps to maintain clinical clarity throughout the plan of care.
Continue reading “The Trio of a Simple Assessment”
Posted in Professionals | Tagged assessment |
