Clinical
- “Knowing how to think empowers you far beyond those who know only what to think.” -Neil deGrasse Tyson
1) Great stuff from David Butler. He goes over tennis elbow and shares several manual and exercise treatments. A very generous post.
2) “Overextension refers to not just a position of one or more joints, but also a state of mind.” -Michael Mullin
3) Great post by Sian on patella tendinopathy. This article seems to cover all the current concepts with a clinical perspective.
4) The tongue is more important than you think. “When the teethers restricted movements of the tip of the tongue, the infants were unable to distinguish between the two “d” sounds. But when their tongues were free to move, the babies were able to make the distinction.”
5) “The key factors in the onset of tendinopathy appear to be repetitive energy storage and release, and excessive compression. The key word here is compression, not tearing in the collagen.”
6) Great article summarizing exercises benefits on the brain “The fact that physical activity benefits both gray and white matter is the primary reason that exercise is the No. 1 way to keep your brain young” #ExerciseIsMedicine
7) Todd Hargrove always puts out good stuff. Here’s his latest tactful article on “tightness” – “So tension is not a threat, but the absence of adequate rest or blood flow is a threat, which could cause metabolic stress and activate chemical nociceptors. So the problem that a feeling of tightness is trying to warn us about is not the existence of tension, but the frequency of tension or the lack of blood flow (especially to nerves, which are very blood thirsty.)”
8) It’s complex. Erson gives a brief example on the ecosystem of patients. For a more in-depth understanding check out these two articles. #Variables
9) “Tall-kneeling hits ‘save’ on the document of thoracic spine mobility and hip extension. Half kneeling hits ‘save’ on the document of the 3-D hip and the ankle. Both add integrity to the lumbar spine. Half kneeling adds integrity to the knee by keeping that knee tracking over the foot and training that in your warm-up so that you don’t have to think about it when you’re doing lunges or split-stance work.”
10) A simple and concise post on returning to athletic activities (running) by Chris Johnson. Take 2 minutes and read this one.
11) This is an interesting neurological (Arthorkinetic Reflex) trick from Z-Health: compress a joint to inhibit, distract a joint to facilitate.
Here are some examples (neck, back/pelvis, cervical/thoracic, hip, shoulder, elbow, ankle, weird stuff)
Seems similar to Andreo Spina’s CARs, but with a different intention
As with any neurological change, the questions are: how long does it last? how do you make it last longer?
12) Zac shares some info from the Omegawave course including some training recommendations
13) More great stuff from Charlie Weingroff. It’s great that he shares his thoughts to make everyone better. “Sleep is when motor skill acquisition goes from adjustment to adaptation. If you can’t control sleep, I don’t know that motor skill acquisition is a great idea that day. Instead getting after a fitness or pain quality passively is better suited to that day.”
14) Charlie mentioned Bosch exercises. I had no idea what they were. Looked it up to find out more (here & here). Seems like it’s based on dynamic systems theory, specificity of training, stiffness, and adequate muscle isometric to take advantage of elastic properties of tendons (no muscle slack).
15) “Almost any amount and type of physical activity may slow aging deep within our cells, a new study finds. And middle age may be a critical time to get the process rolling, at least by one common measure of cell aging.” #ExerciseIsMedicine
16) Share this easy read on the importance of strength with your patients. “In other words, the greater your muscle mass, the lower your risk of death,” concluded Dr. Karlamangla”
Pain & Neuroscience
- “Everytime we choose safety we reinforce fear”
17) Here’s a great interactive lesson on exposure therapy, pain connections, conditioning, and neuroscience. It’s presented in a way that can help people understand why they have pain in certain situations.
18) “the nervous system subconsciously monitors energy use and continuously re-optimizes movement patterns in a constant quest to move as cheaply as possible“
19) “This study is the first to show that mindfulness meditation is mechanistically distinct and produces pain relief above and beyond the analgesic effects seen with either placebo cream or sham meditation”
20) “The current study supports a bidirectional temporal association between depression and fibromyalgia such that each disease occurring first may increase the risk of the other subsequently.” You mean it’s not just myofascial trigger points and peripheral hypersensitivity? #Variables
21) “When you change your beliefs about a situation, your brain changes the emotions you feel.”
22) A good argument for why healthcare providers should learn a Cognitive Behavioral Therapy – “I think health professionals who see people are probably exerting greater influence over thoughts, beliefs and emotions than many of us acknowledge. And given that’s the case, I think it’s only ethical to learn to craft that influence in ways that are positive rather than inadvertently doing harm because of ignorance.”
Attention Focus & Awareness
23) “And that’s what we’re doing in treatment and training – restoring and reinforcing a robust sense of self thru awareness and behavior modification.” -Seth Oberst
24) “Attention’s place in this architecture is to help us structure our internal world so that the thoughts, emotions, or motivations that are most relevant to our goals will get preferential processing through the brain”
25) “By paying attention to internal sensory information, your brain can map a better homunculus. This improved representation gives the brain a better reference point from which it can select the optimal motor strategy for a task.”
26) No one knows how many hours it takes to become an expert. There are way too many variables involved. But we do know two things that are necessary: attention focus and feedback.
Exercise of the Month
Can you pronate and supinate your hip? If not, your foot, knee, or back will likely do it instead.
I use this exercise to help cortically map the transverse plane in patients that can’t perform a single leg deadlift correctly (open chain hip rotates towards ceiling during downward phase).
Training
27) Chris Johnson shares a great advanced hip exercise for athletes – Barbell Lateral Taps
28) Dean Somerset shares some interesting information on lifting with a flexed versus and neutral spine. I like the study he provided on disc shape.
29) There’s also a lot of research out there that shows that torque is the major problem with spine injuries. And think about this, if you have an asymmetry and you perform a symmetrical lift, then you just created torque.
30) “Our goal as a coach is to help them commit to a challenge that emotionally drives them and stretches their abilities.”
31) GMB share an easy and modifiable body weight circuit that everyone can do.
32) I completely agree with this article. Everyone that exercises should understand this concept. “What if, instead, you approached lifting like it was your job and you got paid to not only make the lifts, but to also to look good and be entertaining while you are doing it? How often would you attempt to set a new record lift 1 rep maximum? How ambitious would that attempt be?”
33) I owe GMB a ton for improving my movement. Working on their stuff has really cleaned things up and given me much more true, connected, strength. Try their progression on the L-Sit.
Research
- “Everything that irritates us about others can lead us to an understanding about ourselves.” – Carl Jung
34) Many times in rehab, education has the most profound change. Here’s one to instantly decrease PFPS stress:
“Step rate significantly affected peak contact force magnitudes. Increased step rate induced a 16.6% lower patellofemoral force. The effects of an increased step rate also changed the medial component of the patellofemoral force. Step rate modification is an attractive option given that is easily trainable via auditory cues and can induce notable changes in loading patterns. An increasing step rate (i.e. shortening step length) can effectively decrease cartilage contact area and the peak and average cartilage contact pressures that arise in mid-stance. It can also reduce knee energy absorbtion, with the latter effect primaraliy due to running with a more extended limb. The vastus medialis strength did not affect pressure magnitudes, but did shift the location of contact pressure medially on the patella.”
35) Research that everyone loves: “Research conducted by the University of Alberta in Canada has found that health benefits in resveratrol, a compound found in red wine, are similar to those we get from exercise.”
36) “Decreased range of internal femoral rotation results in greater ACL strain and may therefore increase the susceptibility to ACL rupture with athletic cutting and pivoting activities.”
37) Exercise improves sleep which decreases anxiety. #ExerciseIsMedicine
38) “To maximize tensor fasciae latae stretching, patients should be positioned with their hip adducted and extended and with more than 90º of knee flexion.”
Diet, Nutrition, & the Microbiome
40) My good friend, Jesse Cullen-DuPont, is one of the smartest guys I know. He has a passion for diet/nutrition and has dug deeper on this subject than anyone I know. I asked him to send me some of his favorite links, here’s what he gave me:
Chris Kresser Podcasts (American Gut Project, Leaky Gut, Altered Intestinal Microbial Balance)
41) This is why I always take diet advice with a grain of salt (no pun intended) – “Different diets work for different people, and now new research reveals that it may be possible to predict how people will react to different diets, based on the composition of the microbes in their gut.” Unless you’re a dietician, please don’t prescribe specific diets to people. #OutOfYourScope #Microbiome
42) This is one of my favorite reads by Andrew Rothschild on the holistic nature of the gut microbiome and how it affects pain.
43) “A growing body of data, mostly from animals raised in sterile, germ-free conditions, shows that microbes in the gut influence behaviour and can alter brain physiology and neurochemistry.” #BellyNeurotransmitters #LessDrugsBetterFood “
44) “No Sugar” Foods with Maltodextrin Mess with Your Gut Microbiome – Effects are Significant and Could Explain Rise in IBD, Crohn’s, Ulcerative Colitis & Co” #EatLessProcessedFood
45) Great article on our nation’s diet problems – too much fear of fats, too little understanding of glycemic index/load. “glycemic index influences human physiology, clearly demonstrating its importance to preventing and treating obesity, diabetes and cardiovascular disease”
46) Here’s a list of 100 common food’s glycemic index and load.
47) “Irregular eating patterns, including not having consistent meal times or eating late into the night, can affect health, metabolism and circadian rhythm.”
Other Good Stuff
- “You don’t get frustrated because of events, you get frustrated because of your beliefs.” -Albert Ellis
48) “The academic disparity between young children in poverty and children from wealthier families is not a result of what their parents can offer. It is a result of the different types of learning experiences they are afforded at school. In other words, it is not the “word gap” but the opportunity gap that is the problem.”
49) “Repeating aloud boosts verbal memory, especially when you do it while addressing another person”
50) Why we sleep – including a great video.
51) A friend that only shakes your hand is no friend at all. “The closer the person in social relationship, the larger the body area this person is allowed to touch.” Hug it out.
52) 4 Relaxation Techniques for Decreasing Anxiety
1) Autogenic Training
2) Progressive Relaxation
3) Applied Relaxation
4) Meditation
53) Great advice on walking on how to get more out of it
54) “the U.S. is one of only two countries worldwide in which drug companies are allowed to advertise directly to consumers” #SolveHealthcare
55) Sleep deprived or darkness deprived? “Electric light can delay or shut down nighttime physiology, whereas light from a wood fire or flame cannot.”
Best of Twitter
- Seth Oberst
@SethOberstDPT- when you base your livelihood on definitions, your perspective narrows a bit#getprefrontal - Nick Winkelman
@NickWinkelman – The benefit of teaching w/ analogy/metaphor… “Storytelling reveals meaning without committing the error of defining it.” –Hannah Arendt - Jenn Reiner
@drjreiner – Great clinicians have an exceptional command of biomechanics, but can also appreciate the unpredictability of the nervous system. -
Aaron Swanson
@ASwansonPT – Finding weakness is a prerequisite to finding strength
Best of Instagram
Gif of the Month
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The main reason I do this blog is to share knowledge and to help people become better clinicians/coaches. I want our profession to grow and for our patients to have better outcomes. Regardless of your specific title (PT, Chiro, Trainer, Coach, etc.), we all have the same goal of trying to empower people to fix their problems through movement. I hope the content of this website helps you in doing so.
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