Click here for this edition’s Table of Contents
- “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)”
9. “It looks like high daily activity levels (60-75min) DOES counteract high levels of daily sitting (8 hrs).” -Noah Harrison
10. Breathing is pretty important. Here’s my dissection of it (1 & 2). Here’s Seth Oberst’s lesson. Here’s Noah Harrison’s monster article on it.
11. Sustained Isometrics: go below 30% or above 70% for increased activation. “MMG amplitude (motor unit activation) had a cubic relationship (p=0.001, R2 = 0.94) that increased from 10-30% of the time to exhaustion, then decrease from 40-70% of the time to exhaustion, and then markedly increased from 70% to task failure.”
12. It doesn’t always have to be rocket science or novel…”Thus, conservative rehabilitation focusing on rotator cuff and posterior deltoid strengthening may reduce instability recurrence and pain and increase function in PGI (posterior glenoid instability).”
13. “For individuals with chronic ankle instability (CAI), the somatosensory feedback necessary for postural adjustments, walking, and running may be hampered by a decrease in soleus spinal reflex excitability, according to a new study in the Journal of Athletic Training.”
14. Shoe shape matters. “This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot.” You wouldn’t want your shoulder patient to wear a shirt that pushed their humerus forward…
15. This is such a great concept from Michael Mullin – Perceptive MMT.
16. “We all know that a good history can yield some superb differential diagnosis choices. This can only happen in environmentally appropriate silence. We already know what we know. Therefore we can keep quiet about it. We don’t know what the patient knows… so we must listen” – –Matt Dancigers
17. Functional Hallux Limitus – less than 1/3 of unloaded hallux dorsiflexion
18. Cross-over effect of foam rolling – the opposite leg that wasn’t foam roller showed improved ROM. #Neurological #DynamicSystem
19. Here’s an interview I did on FreePT about my philosophy on patient care, diagnosis, treatments, and other stuff related to physical therapy.
20. Michael Mullin shares his advice on sitting position – finding neutral to allow the rib cage to move. Great internal cues in this one.
21. Todd Hargrove with an excellent review of Bosch’s S&C book:
“the intention-action model, which hypothesizes that movements are primarily organized according to their intention, as opposed to the required combinations of joint movements and muscle activations.”
“Repetition and practice is necessary to get better, but if it leads to monotony and reduces motivation, learning will suffer. Variation in training increases motivation and avoids monotony. If the load in strength training is kept low, more variation as possible. Periodization probably works not because of the exact order in which work is done, but in the simple fact that it increases variability and thus motivation.”
22. Do you know where the Fabella is on the human body?
23. I love biomechanics. Here’s another solid one from Chris Beardsey – why are we stronger at some joint angles?
“Bigger muscles have longer moment arm lengths (Vigotsky et al. 2015)”
“some studies have reported that muscle stiffness (as measured by passive resistive torque and not during active contractions) decreases after eccentric training (Mahieu et al. 2008; Kay et al. 2016)”
“the research that has reported differences divides roughly into those studies that have reported greater neural drive at short muscle lengths, and those that have found greater neural drive at long muscle lengths. In reality, both may occur, with a peak at either end and a trough at the optimum length (Altenburg et al. 2009).”
24. Charlie Weingroff’s Lowest System Load and why swinging a kettlebell may be a safer choice than deadlocking a barbell – “What is clear is manipulating the A in F=MA can lead to significantly increased Force with signficantly less Mass. This is a higher return on training investment.”.
25. “We tend to assume that people’s movement behaviors are driven by internal states of the mind, or the fitness of the body, or personal preferences, or discipline, or intentions. All these factors certainly matter, but in some cases, the environment is the most powerful determinant.” – Todd Hargrove with a nice short post on bike riding and how the environment effects us
26. Red Flags? Pancoast Tumor?
27. Seth Oberst shares a great post on how it’s important to have options, because when we don’t, we can perceive it as a threat – “Anxiety and physical tension are often the manifestations of being in a reactive state that is deprived of choice.” He offers a potential solution – being able to reverse your movements (not letting yourself go beyond the point of no return).
28. Sian with a nice post on the TFL. I like the closed chain pure hip ER exercise.
29. Doug Kechijian reviews SFMA, PRI, & FRC from a clinician’s perspective. If you haven’t heard of any of these approaches I highly recommend checking this series out.
30. Erson shares a Positional Inhibition technique for the rhomboids
31. “Reducing the Time Between Concussion and Exercise Restores Motor Impairment, Short-t Memory,and Alt Gene Expression”
32. I loved this article integrating the pelvic floor training with ortho patients: “Getting back body diaphragm expansion while holding a side plank will change your patient’s world. Start with sideplanks from an elevated surface, then advance to the floor, then finally add a balloon.” This is some great coaching for the rotational lunge.
33. Good advice from Seth Oberst – “feeling is understanding”
34. Eric Cressey goes over why shoulders respond better than the lower extremity (ZOA and patterning). Sometimes the best intervention is the correction of the failed assessment.
35. I always learn more everytime I look at anatomy. Here’s some picture of the lateral knee I’ve been meditating on recently (1, 2, 3, 4, 5)
36. “30.4% of subjects (285) had severe central stenosis but only 17.5% (50) had symptoms” #painiscomplex #TreatTheManNotTheScan
37. A hilarious title and a nice review of disc herniations from Sian.
“The probability of a spontaneous regression was:
96% for disc sequestrations.
70% for disc extrusions.
41% for focal protrusions.
13% for disc bulges.”
38. It’d be nice to have the full article – Underlying mechanisms of neuro-fascial body interactions
39. Maybe the hamstring is an important muscle? “Hamstring strength asymmetry 3 yrs after H-graft ACLR associated with altered knee mechanics during gait, jogging.”
40. “Finding the position in which a move is most difficult emphasizes any gaps you may have overlooked.” -Ruffolo with a great post on hamstrings and knee mechanics. I love her integrative perspective on hamstring function (relation to dorsiflexion, use for pulling into hip flexion, ect.).
41. It’s often not tight hamstrings. It’s often neurodynamics. Try this one next time someone is asking for a “hamstring stretch”.
42. Mechanotransduction is probably the most important concept for movement professionals to understand – “Cells only have two ‘senses’ to interact with their environment,” Wang said. “They cannot see or hear, but they can ‘feel’ mechanical forces and ‘taste’ chemical signals. Many studies have detailed chemical-signaling pathways, but it’s important to understand how the mechanical forces affect the cell as well. Mechanical signaling is as important as chemical signaling, and this study shows it’s a direct pathway.”
43. Mechanotransduction will always be a primary principle of health and movement
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