The Hits

This is just a collection of some of my favorite articles from the past month.  I bolded the numbers of the articles that I found most remarkable.  Of course, this is just my bias.  I think all the articles here have value.  I just realize that some readers may be looking for something more brief.

Also, I want to encourage any reader to share their favorite articles, books, or podcasts of the month in the comments below.  There’s only so much information that I can go through in a month.  I know there’s a ton of great stuff out there that isn’t on my radar.  It will not only help introduce me to new perspectives, but it will provide other readers this opportunity as well.

Phone Addiction

• “Only one thing made him happy and now that it was gone everything made him happy.” -Leonard Cohen

A big part of our ability to live longer comes from the knowledge of what harms us.  Smoking, aluminum production, lead, high fructose corn syrup, artificial sweeteners, poor sleep, sitting, and now smartphones.

Unfortunately, not many people are open to the idea that their cell phones are bad for them.  At least not beyond a surface level acknowledgement.

I wrote this article on 25 reasons why your cell phone is bad for you.  It has a ton of resources for many different categories.  Hopefully it will serve as a resource to bring awareness of the hazards of smartphone overuse.  Share it with those that you think need to hear it.

Here’s a similar article with detailed recommendations on how to “Break Your Smartphone Addiction”

Clinical

• “What gets measured gets managed.” -Peter Drucker

1) “Proprioception is the same way, it is an active process, not a passive one. Many of the our movements have a primarily epistemic purpose – they are not done so much to directly accomplish a physical goal, but to create proprioceptive information that optimizes or simplifies motor control.“ -Todd Hargrove with another great post on the importance of feel

2) The insurance problem and how to get patients to understand by Aaron LeBaur

3) How much true ankle dorsiflexion does your patient have in a squat?  Have them lift their toes and THEN squat.  Removes the ability to pronate as a compensation.

4) Gait Guys teach you about the dreaded banana toe and offer some solutions (rocker bottom shoes, FHL exercises).

5) I remember during my cardiopulmonary affiliation I asked why nose breathing was better.  No one could supply a detailed answer.  Some PTs had a vague idea, most MDs just dogmatically believed it.  Luckily, Noah Harrison lays out an in depth article on the benefits nose breathing and hyperventilation.  He covers a ton and this is well worth the time.  Very good work here.

6) The STarT LBP Tool – “Overall, the results of this study indicated that stratified management of patients with LBP lead to improved efficiency of care, better outcomes and reduced costs. Significant improvements in secondary measures were also noted.”

7) If you have any interest in asthma or the reasons why nose breathing is superior, then you should read this article from Noah Harrison.

8) Erson goes over 5 reasons why thoracic manipulations are good.

9) If you want to know more about the PosteroLateral Corner of the knee read this post.  I think I’m going to start incorporating that prone dial tests.  Provides some solid information when used in conjunction with knowledge of osseous structures and active ROM (i.e. torsions).  This post also made me think about how the popliteus and lateral hamstrings both attach to the same area, but can function as antagonists (open chain: poplitieus IR tibia, biceps femoris ER tibia)

10) Acupressure Mats?

11) Erson shares some great TMJ exercises / correctives / resets to give your patients.

12) When someone has cross-over gait, “ the time usually used to move sagittally will be partially used to move into, and back out of, the frontal plane. This will necessitate some abbreviations in the left stance phase timely mechanical events. Some biomechanical events will have to be abbreviated or sped through and then the right limb will have to adapt to those changes.”

13) “Improving thoracic “extension” is not about extending the thorax and/or thoracic spine, particularly over an object of some kind (I.e. foam roller). It is about influencing the tipping of the thoracic vertebrae in the horizontal plane and the corresponding ribs in the rotational plane, although it is a rotational influence affecting the horizontal resting position. If the anterior aspect of the thoracic vertebrae is tipped up, it’s extended.” –Michael Mullin

14) Small study size, but interesting content.  “The comparison of all chews showed a highly significant preference towards the R side” (via Michael Mullin)

15) This one from the Gait Guys starts out as a simple pronation compensation for lack of hip IR and ends up with a complex movement thought experiment – “If the hips are not clean, gait is not clean, and that means repetitive arm swing-thoracic-respiratory mechanics are not clean.”

16) Gait assessment is always important – slower gait associated with a higher mortality risk.

17) “The point here today, if you have loss of external hip rotation, it could be crying for you to evaluate the range of motion of the 1st MTP joint , it could be crying for you to evaluate the skill of toe extension, strength or endurance or all of the above. Impairment of the 1st MTP has great inroads into ineffective locomotion. You must have decent range of motion to effectively supinate, to effectively toe off, to externally rotate the limb, to effectively acquire hip extension to maximize gluteal use.  Thus, one could easily say that impaired hallux/great toe extension (skill, ability, endurance, strength) can impair hip extension (and clean hip extension patterning) and result in possible terminal propulsive gait extension occurring through the lumbar spine instead of through the hip joint proper.” -Gait Guys #ExternalRotationHappensWithHipExtension 

18) Inform Your Patients on the Dangers of Sitting with this easy 3 minute video – Deskbound by Kelly Starrett

19) Another interesting movement thought experiment from the Gait Guys “One last thing, rushing to the right forefoot will force an early departure off that right limb during gait, which will have to be caught by the left quad to dampen the premature load on the left. They will also likely have a left frontal plane pelvis drift which will also have to be addressed at some point or concurrently. This could set up a cross over gait in some folks, so watch for that as well.“

20) The Gait Guys offer some rational advice on how to view the short foot exercise – “The foot has to be prepared at the time of contact with its’ most competent arch, not busy reacting after the fact trying to achieve the competent structure. The value in the short foot is earning competence in its loading ability and learning to control its adaptive eccentric lengthening, this must be possible in both toe extension and toe flexion (ground contact).”

21) Quick Book Reviews

Cranial Intelligence by Ged Sumner and Steve Haines

Ron Hruska recommended this book.  It is very well written and goes over craniosacral concepts from a modern science perspective.  Some of these concepts are far fetched, while others provide a solid connection to the questions many clinicians have.  I really enjoyed the humble and holistic approach.  Overall, it gave me a novel view on the human species and another method for assessment and intervention.  

Fully Present by Diana Winston and Susan Smalley

This is a must read for any clinician.  Each chapter has a thorough evidence-based science section and an accompanying “art” section that goes over practical implications.  The book is very concise, yet very dense with useful information.  It will make both the clinician and the patient better.  And if you either think mindfulness is new-age fluff or are worried about religious implications, then you should read this book as it will reverse those assumptions.

22) I listened to Aaron LeBauer’s lecture on Cash-Based PT and marketing.  He had a very important point – we shouldn’t refer to physicians, surgeons, general practitioners, internists, cardiologists, etc. as doctors.  Because as physical therapists we are doctors!  Asking patients “what their doctor said” not only empowers the other professional, but it belittles us.  We should all jump on board with this.  We shouldn’t be discrediting our profession by referring to our peers as something above us.  #DirectAccess

Pain, Neuroscience, & Psychology

• “Everything we hear is an opinion, not a fact.  Everything we see is a perspective, not the truth” -Marcus Aurelius

23) “This tension is not only physical, that of the neuromuscular system, but also cognitive such that thoughts become repetitive and lack flexibility. ​When the gap between our self-image and our perception of the environment is large and pervasive enough across several domains, we experience these tensions in a way that is difficult to relieve and affects both function and performance.” -Seth Oberst

24) “Inability to avoid visual distractions linked to poor short-term memory”

25) “Mastering the art of ignoring makes people more efficient”

26) “When you combine pleasure and meaning, you’ve got happiness.” -Eric Barker on 5 ways to find happiness

27) Why bromances are a good thing – “Human studies show that social interactions increase the level of the hormone oxytocin in the brain, and that oxytocin helps people bond and socialize more, increasing their resilience in the face of stress and leading to longer, healthier lives.”

28) “A socially engaged lifestyle often involves cognitive stimulation and physical activity, which in turn may protect against the neurological and physical factors underlying cognitive decline,”

29) A good read from Tim Cocks and David Butler on Though Viruses “If a person says “it hurts”, then no one can say it doesn’t – there is only one witness to the event.”

30) Erson shares a video that goes over his patient pain education approach

31) “A series of studies have found a connection between economic insecurity and physical pain.”

32) Maybe we were wrong. Maybe there are no limits to willpower. “The more we begin to see that we can learn effectively and believe that our effort and stamina is not exhaustible, the more we develop resilience in the face of challenges.”

33) “Don’t use the term “depression,” which is loaded with negative and clinical connotations, without considering other labels that might be more appropriate. “Loneliness” or “isolation” are two common substitutes which are not just more precise but more actionable (the term “depression” doesn’t suggest a solution).”-Tim Ferris with a great post on depression and gives some useful advice

34) Jeffrey Schwartz 4 Step Process to Improve Behavior

Step 1: Relabel

Step 2: Reattribute

Step 3: Refocus

Step 4: Revalue

Training

• “Enjoyment depends on increasing complexity.” -Mihaly Csikszentmihalyi

35) Mike Robertson shares 5 mistakes he’s made with training the core: too much supine work, not training hip flexion, avoiding spinal flexion, not having more progression, not including contextual core training in the warm-up.  

“I’ve never seen an athlete meekly flex their hip, and then powerfully extend it back. There needs to be balance on both sides of the joint, both for safety and control.”

36) The devil is in the detail…or the triceps in the deadlift.

37) 5 Ways to Increase Your HRV by Joel Jamieson

38) Great article on Steph Curry‘s ankle problems

39) Dean Somerset goes over mobility in a very FRC kind of way.  Solid explanations in this one.

40) Hex-Bar Deadlift vs. Conventional Deadlift

“the net joint moment in the straight-bar deadlift is for knee flexion, which is produced by the hamstrings, while in the hex-bar deadlift it is knee extension, which is produced by the quadriceps. Because of co-contraction, both muscle groups will be contracting hard, but this still indicates that there is a difference in terms of which muscle group is exerting the most force in each variation”

“not only does the hex-bar deadlift make the quadriceps work harder, but also cuts the low back, hip extensors, and ankle plantar flexors some slack into the bargain.”

“the hex-bar deadlift is probably more effective for developing force and power in the lower body, compared to the conventional, straight-bar deadlift.”

41) The Landmine Press – “if you have clients that struggle to go overhead, this is a great way to “bridge the gap” between horizontal and vertical pressing”

42) Here’s a thorough review of cryotherapy from Travis Bruce (Part 1 & Part 2) – “Ice baths blunt the acute molecular response to resistance training and impair long-term gains in muscle mass and strength. Athletes should reconsider using ice baths after strength training, particularly in the off-season or preparatory period when the focus is on adaptation rather than performance.”

43) I think the power of the mind in training is one of the most overlooked exercises by all movement enthusiasts.  Here’s a great article that goes over how to use motor imagery for weight lifting.  Overall, you want to make it as similar to the real life situation.  You can do this by using PETTLEP.  Which is Physical, Environment, Task, Timing, Learning, Emotion, and Perspective.

44) Eddie Hall Broke the World Deadlift Record at 1025 Pounds

Quiet Eye Technique

45) The Quiet Eye Technique “refers a gaze behaviour observed immediately prior to movement in aiming tasks”.   “Theories as to why the QE is so effective as a trait of expert performance appear to base around the increased processing time.  When more time is taken to view the target before initiating a movement more relevant information can be processed subconsciously about the target and what is required to hit it.“  Or like Lexi Thompson, you could putt with your eyes closed.  #FinalFixation #ContactPoint

Research

• “Intuition tells the thinking mind where to look” -Jonas Salk

46) ““This means two things: that facial imitation is, at least in part, lateralized – that is, it copies the expression it observes – and that it is asymmetrical in an anatomical rather than specular manner”, explains Korb. Therefore, when we observe an expression that begins on the left side of the face, we mimic it with the left side of our face, and not with the right side as if we were in front of a mirror.”

47) “Six weeks of a dynamic injury prevention warm-up program results in biomechanical improvements that last up to 6 months after stopping the program.”

48) “Participants with CAI (chronic ankle instability) display hip-centred changes in movement and motor control patterns during a DVJ (drop vertical jump) task compared to LAS (lateral ankle sprain) copers. “

49) Aerobic exercise is better than high-intensity interval training which is better than strength training for neurogenesis.  #ExerciseForYourBrain #BDNF

50) “Contrary to popular belief, shoes with cleats that improve their grip on grass surfaces are likely to be associated with less stability than flat-soled shoes.”

51) “The researchers found that, during moderate-speed running in lightweight, zero-drop shoes, foot orthoses designed to limit arch compression by 80% increased metabolic cost by about 6%—a figure that would likely be higher at faster running speeds.”

52) “the soleus motoneuron pool excitability increased following lumbar paraspinal fatigue” #GottaStayUpright

53) Crack ‘em.  “A significant difference was present between the manipulation group and the mobilisation/ exercise group. Statistical analyses show that patients in the upper cervical and upper thoracic manipulation group experienced less frequent headaches.”

54) Every once in awhile the human body will give me a WTF moment.  Here’s a recent one – “Neck-tongue syndrome (NTS) is defined as neck and/or head pain accompanied by ipsilateral dysesthesia of the tongue with sudden rotation of the head. Proposed causes include compression or irritation of the C2 nerve root as it courses behind the atlantoaxial joint or hypertrophy of the inferior oblique muscle.”

55) “The current study established that heightened levels of myofascial tenderness in the upper trapezius and temporalis muscles showed a positive correlation between high levels of jaw and neck dysfunction…The fact that neck and jaw disability are strongly related stresses the importance of assessing and treating these two separate body segments concurrently.”

56) “the potential effects of WBV (whole body vibration) on muscle strength (facilitating neuromuscular conditioning by stabilizing joints via the tonic vibration reflex) balance (for obvious reasons) and neuropathic pain are promising.”

57) “This study investigated the novel approach of combining the squat exercise with local muscle vibration (LMV), whole body vibration (WBV) and compared the results to the squat exercise without any vibration. The group which had received the WBV, as well as the LMV group showed significant improvements of the quadriceps function compared to the group without vibration.”

Other Good Stuff

• “If someone succeeds in provoking you, realize that your mind is complicit in the provocation.” -Epictetus

58) “When a life or plan feels ultimately unsatisfying, I find it’s because I’ve forgotten to include:”

what makes me happy

what’s smart (long-term good for me)

what’s useful to others

Diet

59) 6 Foods That Cause Inflammation: Sugar/High-Fructose Corn Syrup, Artificial Trans Fats, Vegetable and Seed Oils, Refined Carbohydrates, Excessive Alcohol, Processed Meats

60) Anti-Inflammatory Diet – great overview of the latest evidence of the causes and treatments

61) 13 Anti-Inflammatory Foods: Berries, Fatty Fish, Broccoli, Avocados, Green Tea, Peppers, Mushrooms, Grapes, Turmeric, Extra Virgin Olive Oil, Dark Chocolate & Cocoa, Tomatoes, Cherries

62) Inulin supports the growth of beneficial gut bacteria. This keeps the gut bacteria balanced and may have various health benefits.

63) 9 Ways to Influence Your Hormones to Lose Weight

64) “New evidence suggests when the gut is inflamed, it may affect the brain and lead to psychological dysfunction.”

65) 20 Nutrition Myths Debunked with Research

66) 50 Reasons Why You Should Buy Organic

67) “the results of a huge new meta-analysis published this week in the British Journal of Nutrition adds to the evidence that organic production can boost key nutrients in foods”

Sleep

68) Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality

An Important Perspective

• “You are never dedicated to something you have complete confidence in. No one is fanatically shouting that the sun is going to rise tomorrow. They know it’s going to rise tomorrow. When people are fanatically dedicated to political or religious faiths or any other kind of dogmas or goals, it’s always because these dogmas or goals are in doubt.” -Robert Pirsig

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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.

If you enjoyed it and found it helpful, please share it with your peers. And if you are feeling generous, please make a donation to help me run this website. Any amount you can afford is greatly appreciated.

 

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