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• “Muscles drive the motions, motions drive the joints, joint position drives the CNS.” –Charlie Weingroff

1. “If we aren’t physically fit, maybe our environments are perceived as more threatening than they really are so we become more rigid and tense in an effort to protect us from too much movement that could be dangerous. It’s a perceived mismatch between us (our self-image) and our environmental demands. The bigger the gap between what we need to do and what we think we need to do, the more tension and threat we will perceive.” -Seth Oberst and Ben House with an article on autonomics

2. “Hypertrophy of the masseter muscle often causes tension type headache.  This review concluded that conservative treatment such as counselling, exercises, occlusal splints, massage and manual therapy are the best way to treat TMDs. ”

3. Unless you’re getting paid to play, what’s the rush? “Athletes who wait at least 9 months after an anterior cruciate ligament reconstruction and/or regain quadriceps strength compared with the uninjured limb may be at lower risk for reinjury than those who fail to meet these criteria.”

4. It’s changing the expectations, educating on the long term recovery, and teaching tissue remodeling principles – “Metabolic activity evident six months after an Achilles tendon rupture”

5. If you’ve been reading this blog you know the importance of isometric contractions to reduce pain.  Here’s another study supporting this empirical finding.  One thing I have found clinically is that it’s important to re-assure the patient that the discomfort they feel from the isometric contraction is okay and is safe.  Sometimes there’s a delay in the pain reduction.

6. This doesn’t really fit what I see clinically.  “Subjects with LBP displayed less lower lumbar extension than control subjects during prone extension. These differences should be considered when evaluating and prescribing prone extension”  Maybe the take-home point is that people with LBP have poor motor control and a loss of segmental spinal dissociation that leads to decreased extension?  Maybe it’s high-threshold strategies or guarding against a perceived threat?  Or maybe like the study says, it’s just less motion and poor movement.  Regardless, quadruped cat-camel seems like a safer way to assess this rather than forcing end-range in a painful patient.

7. Christine Ruffolo goes over ankle plantarflexion from an isolated joint ability (CARs) to a full functional use.  Worth the read.  I really like the idea of using an unloaded knee flexion to add some degrees of freedom to the system.

8. Eye motion drives neck motion and vice versa.  “This study suggests that people with nonspecific neck pain have an increased COR (cervico-occular reflex)” Continue reading “Late Summer Hits 2016: Clinical”