Dr. Tucker discusses simple, home-based routines for rehabilitation of PFPS that require little or no equipment and have the advantage of resembling activities of daily living. Read more…More
One of the most important functional roles of the hip abductors takes place during the single-limb support phase of walking to maintain frontal-plane stability.
Just about every sport requires athletes to laterally walk or run with abduction. In real-life circumstances, we also have to move laterally in situations such as moving around people in a crowded mall or on sidewalks. This action requires stability as well as balance and awareness.
Weakness or poor timing issues (motor control) in the gluteus medius region can reduce athletic performance and serve as a catalyst for lower-body injuries and changes in gait. There are a number of factors that contribute to gluteus medius weakness. Lifestyle factors contributing to gluteus medius weakness include sleeping on your side (predominantly the same side), and flexing and adducting your top leg over your bottom leg. In addition, standing predominantly with all of your body weight on one leg can cause the pelvis to move sideways and the hip joint to adduct; this can contribute to weakening of the hip abductor muscles.
Iliotibial band (ITB) syndrome may result from gluteus medius weakness. The lack of control during thigh abduction and external rotation places greater tension on the tensor fascia lata and ITB.1 Gluteus medius dysfunction can also contribute to patellofemoral pain syndrome (PFPS), resulting in decreased hip control and increased femoral adduction and internal rotation.2More
Muscle strains and joint dysfunctions caused by asymmetrical movements over time can generally be reduced by treatment using the Deep Muscle Stimulator (DMS).
The DMS is a hand held device that delivers strong vibration, oscillation and percussion. Use of the DMS appears to reduce stiffness by signaling inhibition of the sympathetic nervous system. Palpate tight or stiff fascial tissue or a taut and tender muscle fiber, and then apply the Deep Muscle Stimulator (DMS) device for approximately two to three minutes, the post treatment/application will leave the skin red, warm and it will palpate as “softer.” This probably has to do with local changes in the arterioles and capilliaries and the mixing up of tissue viscosity.
Read more at http://www.atpracticeinsights.com/mpacms/dc/pi/article.php?id=56505
I work every day with chronic pain clients and I am often not satisfied with the results. I search for educated answers and I look for innovative therapy for clients to improve there problems. This has led me to use many cutting edge modalities early on in my practice, such as being in a multi-disiplinary practice, laser, kettlebells, ropes, suspension training, vibration and percussion, radial shock wave therapy, instrument-assisted soft tissue tools and SCENAR therapy…
Want to run faster, jump higher, move quicker and get in better shape, all at the same time? If you’re answer is yes, it’s time for a lesson in plyometrics. Exercises based on plyometrics repeatedly and rapidly stretch muscles and then contract them, improving muscle power. And don’t we all want a little more muscle power, whether it helps us compete in our favorite sport or just perform our daily physical activities a little easier? Here’s your introduction to plyometrics and a sample routine you can do today.
I recall being in awe watching Jamaican sprinter Usain Bolt flash across the finish line at the 2008 Summer Olympics in Beijing and being so impressed with his speed and ability. I continue to be amazed at top basketball players, tennis players, football players, and other athletes as they jump up in the air repeatedly, skillfully maneuver their arms and legs while airborne, land on a small portion of one or both feet, and then move immediately to the next position – all without falling (usually). I shake my head and say to myself, “Now that is power!” One of the best ways to develop this type of power is through plyometric training.
Plyometric training is used to produce fast, powerful movements and improve the function of the nervous system for explosive power. This helps you create muscular movements in the shortest period of time and is especially beneficial to sprinters and athletes who need to accelerate quickly. Plyometric movements train the muscle to load, unload and then reload in rapid sequence, allowing you to jump higher, run faster, throw farther or hit harder, depending on the desired training goal. In short, plyometrics help us improve our speed because we train the body to jump and land with speed.More
Day in and day out, we – and our patients – feel rushed and stressed. Is it any wonder we’ve all distanced ourselves from the body’s signals of discomfort in an effort to get things done? Such messages and signals may manifest as a particular ache or in overall stiffness in the body.
As people sit, stand and walk throughout their day, shouldn’t we provide them with greater consciousness of their poor habits?
Faulty Repeated Movements
One of the first important concepts I try to educate patients on is that repeated movements (especially faulty movements) and prolonged postures result in changes in tissues and movement patterns. This results in a segment developing a susceptibility to move in a specific direction, and this may cause pain because of microtrauma from the stress on the tissues.
For example, consider failure of the stability muscle to hold the lower-limb segments in good posture during the stance phase of running or walking. If the gluteus medius, vastus medialis and tibialis posterior are not functioning optimally, there will be an increase in internal rotation of the femur and valgus positioning of the tibiofemoral joint from heel contact to mid-stance phase. The patella will track laterally, leading to an increase in activity of the tensor fascia latae and vastus lateralis, and the foot will excessively pronate. Such faulty mechanics can be the precursor for Achilles tendinopathy, medial tibial stress syndrome (MTSS) or iliotibial band syndrome.More
In previous articles, I have written about normal postural alignment versus abnormal postural alignment, and how abnormal postural alignment can be detrimental to muscle function, is aesthetically unpleasing and might contribute to joint pain.
Since kyphosis is natural in the thoracic spine, we have to identify what excessive kyphosis is, which is typically the problem. Generally speaking, normal for a thoracic kyphotic curve measures 30-35.* Excessive kyphosis is greater than 35.* As doctors, we are used to looking at the static spine from the side to determine kyphosis. Using the Functional Movement Screen (FMS) or other movement analysis, we begin to see the interrelationships of muscle and fascial tissue attachments that may contribute to hyperkyphosis.
For treatment of hyperkyphosis, I often take the “bottom up” approach and teach patients how to lengthen the lateral column of the body, the peroneal group, iliotibial band, tensor fascia lata, lateral gluteal complex, quadratus lumborum, oblique complex, latissimus dorsi, and shoulder musculature to influence the kyphosis. When treating hyperkyphosis, always check the flexibility of the ankles, hips, adductors and anterior shoulder complex. The hip flexor tissue is fascially attached to the abdominal fascia, which connects to the external obliques, connecting to the pectorals, joining to the deltoids. As these structures become tight, they can influence thoracic kyphosis.More
Patients often ask me, “What causes bad posture?” I often hear myself answering with something like, “How many hours do you spend at work each day?” The patient responds with, “On average, about eight to 10 hours,” to which I say: “During your work time, you probably sit unconsciously in a slumped posture and in improper body positions.
Some people just engage in repetitive movements. Either way, this can create muscle imbalances leading to poor posture.” For those patients who really “get it,” I might add, “I think that the mind and body communicate and that psychological distress from work, family, finances (or whatever else I have heard them share with me) shows up in our posture.”
Would you agree that poor self-esteem and depressive symptoms are displayed in our posture? Another cause of poor posture is a lack of a variety of movement in our activities of daily living and overall poor flexibility. In essential ways, our unique cultural, mechanical and spiritual histories are part of what affects overall posture and health.
Last year, I was given the opportunity to teach a thoracic spine rehab course. I had never been to a “thoracic spine seminar,” let alone put together eight hours of teaching material on the subject. The seminar could have been called, “The Thoracic Spine – The Forgotten Area Between the Lumbar Region and the Cervical Region.” I continue to learn the compelling interconnection between the thoracic spine and the cervical and lumbar regions.More
Most of the time when we think of a winged scapula, we simply think of weak serratus anterior muscles. But the longer you are in practice, the more you notice posture and become a better “muscle whisperer.” And then you begin to realize so much more. Let’s explore the posture impairment of winged scapula as it relates to the serratus anterior, rhomboids, lower trapezius, and pectoralis muscles.
The biggest tip I can offer you to look for during static posture evaluation for scapular winging is this: If you can see the entire medial border of the shoulder blade, you should suspect serratus anterior dysfunction. If you see only a portion of the medial scapular border or the inferior angle (usually the lower half or third of the medial scapula border), then you should suspect excessive shortness of the pectoralis minor, and lower trapezius and serratus anterior muscle weakness dysfunction. Again, if you only see half or a third of the scapula border protruding away from the rib cage, this is known as “pseudo-winging” and implicates shortness of the pectoralis minor, along with lower trapezius and serratus anterior underactivity or weakness…More
Let’s discuss normal shoulder resting posture so we can determine if there is a link between a postural deviation and pain. Static postural analysis is performed before range-of-motion examinations, orthopedic testing, movement pattern assessments and palpation analysis. When I perform a static posture evaluation, I focus on subtle asymmetries or deviations from normal patterns to aid my diagnostic decisions and treatment transition decisions (passive care to active therapy). I allow myself the time to pause and focus on what I see posturally before beginning other procedures. The changes I see in static posture and functional-movement assessments, visit to visit, help me navigate through the treatment process.
I ask the patient to stand with their shoes off, hands at their sides, in their normal, relaxed position. The evaluation is done with the person in a standing position, which accounts for the normal effect of gravity on the individual. I observe the patient from the front, side and posterior. I look to see the person’s chronic holding patterns.
Look for postural deviations, including forward head, forward shoulders (scapular protraction), humeral internal rotation, and increased thoracic kyphosis. All of these deviations have been implicated in the development of shoulder pain.1-4More