ITs important to maintain the balance of good and bad in your gut with a good diet.
ITs important to maintain the balance of good and bad in your gut with a good diet.
A good starting position is key to creating proper stability in the hand, elbow and shoulder.
Injuries are an everyday part of sports, regardless of the level of competition. The higher levels have fully trained and licensed staff to care for and see to the rehab process but what about the weekend warriors and younger athletes that may not know what to do to recover quickly and efficiently.
Shoulder pain is common theme in sports medicine and with the general public as well. If you want to fix it you should understand it first.
Which one fits your posture most closely?
You may like the look of the glorious "6-pack" of the abdominal wall but if you're serious about being a competitive athlete or pain-free you'll focus more on the obliques and transverse abdominals. These muscles together are responsible for maintaining inter-abdominal pressure once the diaphragm does its job. More importantly, the muscles are not fine-tuned with crunches or twisting exercises. Yes, They are strengthened this way but strength does not make for stability, directly. Stability requires proper posture followed by dynamic movements while maintaining this posture. In order to achieve this posture these muscles are engaged at a high level which translates into functional stability with time and repetition. So for those of you constantly in the training room rehabbing low back, shoulder, elbow or knee pain you might consider having a look at your abdominal stability!
The Obliques..... The oblique abdominals (internal and external) are mentioned all the time from your personal trainer types. My questions to them: "do they know what they actually do?" Most folks would simply say they perform rotary movements, twisting of the trunk. And they would be right, partially. What they're leaving out or perhaps unaware of, is the Obliques do more than just twisting. If you look at the bigger picture you'll see the obliques perform rib stability during respiration. With proper activation of the Internal and external obliques the lower rib cage becomes more rigid, providing a solid anchor from which the diaphragm can effectively anchor when contracting and descending into the abdomen. Without this activation the diaphragm cannot properly descend equally which results in decreased Intra-Abdominal Pressure (IAP) and decreased lumbar stability
A good indicator of insufficient oblique activation is a flaring of the ribs (laterally) when ab bracing, think bracing before getting punched in the stomach. This happens because the rectus abdominus is the primary source of the brace. This is also a good indicator of bad posture, improper neurological stabilization patterns. Overactivity of the Rectus can contribute to an increased kyphotic curve of the Thoracic spine, much like you see in senior citizens that can no longer stand up straight to hold their head high. The "six-pack" look is not stable and can be causing bad posture! If you want to know what a good, stable core looks like, have a look at Roger Federer. There's a reason he's he's still on top at 35+ years of age! So if you have back pain it's not due to a weak core but a core with improper stabilization from a neurological dysfunction.
Which one looks like a fit, healthy, stable specimen?
With the Soccer World cup starting today there will be loads of action for the next 4 1/2 weeks till the final July 7/15. Along the way there will be numerous goals, hard play and more than a couple injuries/flops. And why not!? When there's so much on the line I can't blame them for embellishing a little. The only problem for us spectators is, how do we know when it's real or fake?
I'd say that's easy! You ever watch a soccer game and a player goes down after a hard tackle from a defender? He immediately starts writhing on the ground in what seems like a career-ending injury, based on his reaction that is. The trainers sprint out to the player with the kit bag of goodies for the injured player. He or she grabs the leg and starts looking and feeling for what's broken. After a minute the trainer reaches into the bag and pulls out the "Can-O-Magic" and proceeds to hose down the affected body part. And what happens next, just moments after it looked the player was about to be carted off? He's MIRACULOUSLY up running just like new again!?
So what is that magical concoction that can make a broken player perfectly healthy in a matter of seconds? Well it's not just one thing, there's a number of different things it could be. Most trainers are using a cold spray that when applied to the skin has a numbing effect on the body part. It can be useful for sharp, short pains, similar to stubbing of the toe. Overall these sprays won't do anything for a serious injury but can be helpful in the short term. It's definitely a psychological boost for players and we all know how big of a role psychology plays in sports. This is a big reason why you still see the "magic spray" used for high-level athletes. If they think it works, it MUST work!
So while you're enjoying this year world cup and you are lucky enough to witness such an occurrence, where a player goes down after a hard tackle and the trainer scrambles to his aid with the magic spray you can rest easy knowing that it actually has a place and that they may not be TOTALLY full of manure! Enjoy the tournament and be sure to let me know if you enjoyed this explanation when I see you next.
For all you mothers out there, The post-pregnancy period is hard, right? Not that I would know, but I've been told...... by all of you!! haha, #funnynotfunny. On a serious note though, I was working with a patient, just the other day, on her breathing when she made an interesting comment about her pregnancy. As I was describing the importance of utilizing the diaphragm to drive inspiration she noted how impossible it was the last couple months of her pregnancy. She then described her mindset was that of "whatever it takes to get this kid out of me". I understand not all women share the same sentiment but everybody has their breaking point and not all of us are strong like an Oak.
The more I thought about this interaction I realized postpartum stabilization is generally overlooked. Post-pregnancy can wreck the female body; abdominals, pelvic floor, hormones, breast tissue, back, feet, hips..... I'm sure there are many more I'm forgetting, but for now, we get the point, right? For most mothers, the most common "recovery" tools utilized are Kegel exercises, spa days, massage etc.. Unfortunately not all mothers have the opportunity or funds to splurge on the later of those options. Luckily, of the options mention above the one that is free and can be done anywhere is Kegel exercises. If you are among the minority of females that haven't heard of Kegel exercises, they are exercises designed to target the pelvic floor muscles. Considering the amount of trauma the pelvic floor goes through during labor, not to mention that it controls bowel and bladder function, it's probably the most important to pre-hab and rehab before, during and after pregnancy.
For you overachievers out there; if you want to retake your pre-pregnancy glory (assuming you aren't that unicorn that does it naturally) then I would urge you to spend some time working on Transverse abdominus and diaphragm function. Uhhhh, yeah! Good point! How do I do that? Easy, just breath! Ok, it's not that easy, but it's not hard!!
So to rehab your breathing pattern from dysfunctional (chest breathing) to more functional (diaphragm) you start on your back with your legs elevated (hips and knees at 90 degrees). You then place one hand on your chest and the other over the belly button. This is the setup position that allows you to offload the lumbar spine from any weight-bearing and the hand position allows you to monitor the areas of movement while breathing. Once you've gotten into the proper position you know just breathe. Now the key to this is breathing into the lower hand keeping the upper hand (on the chest) still. Many of you will find this difficult at first. The idea is to, during inhale, you push your lower hand (belly button) to the ceiling as best you can. You will want to relax everything in the abdomen to do so. Once you can do this with ease and good expansion in the belly you are on the right track. At this point, you are able to contract the diaphragm functionally and that is the start of re-establishing transverse abdominal activity by resisting expansion at the belly button and redirect that expansion into the love handle area (area between the ribs and hip on your side) and lower abdominals (below the belt line, in the groin area). If you can do this you are on your way back to a stable core and lumbar spine.
If any of the above instructions are unclear feel free to call the office for a free 15-minute consultation with Dr. Aylor. If you have mastered the above skills and are keen to progress from there to more functional movements to further stabilize the trunk, pelvis, hips or shoulders schedule an appointment from the website or call the office for your first appointment with Dr. Aylor. I hope this helps, take care and hope to see you in the office soon. Cheers
What is functional Stability? I'd define it as the ability to perform work while maintaining a neutral joint position. Ok, sounds great but what the heck does that mean? Well, let's see..... Let's try a little self-check: Do you have unexplained low back, neck, shoulder, knee or hip pain? If you answered yes, then you are not functionally stable! If you can't remember an event that caused your pain then there is something about your movement pattern, stabilization, that is flawed. You have dysfunctional movement stemming from improper stabilization patterns that have culminated in pain!
So how can you tell? It starts with breathing patterns, then we go to the abdominals and no I'm not looking at your six-pack or lack thereof. Matter of fact I'd say those of you that have a six or 8-pack of abdominals are just as dysfunctional as those without! Why is that, you may ask! That's because they aren't the abs that stabilize the spine. The Transverse Abdominals are the ones that I'm concerned with. Their ability to resist expansion in all directions while inhaling and maintain tension during the exhale is what provides core stability more than any other abdominals muscle. The Diaphram is #1 followed closely by transverse abdominals. The deeper the muscle is the more stability it's designed for and the more superficial muscle the more its meant to perform gross movement or locomotion.
So what does this have to do with my shoulders, hips, or knees? When the shoulder, knee or hip move they require a stable foundation to move properly, maintaining optimal joint centration during movement. When the abdominal area of the body is properly stabilized (appropriate activation of the diaphragm and Transverse abdominals) the muscles designed to move the extremities are now required to work overtime to both move the joint AAAND stabilize it on the torso, which is inherently unstable at this point. These muscles are terrible at stability, which results in faulty movement and eventual pain due to premature joint deterioration.
For those of you not in pain at the moment and curious about your stabilization mechanisms please take advantage of our free Functional Movement Screen, offered for a limited time. There is no obligation for care with this screen. Its simply offered as an education tool so you can be aware of where you are and what you may need to change going forward. IT only takes 15 minutes and is a brilliant tool for establishing your movement I.Q..
For those of you out there constantly on the move, I would like to introduce you to the Functional Movement Screen (FMS). If you haven't already heard of the FMS its something with which you should be familiar. Whether you're an aspiring athlete or well established one, the FMS is the gold standard for assessing quality movement. Since being introduced back in 1997 by Gray Cook, a well-known name in the physical therapy world, it has become the one tool used to screen for potential injury in active people.
So what is the FMS then? Simple, the FMS is a series of 7 movements that combine strength, stability, and flexibility. With movements like the overhead squat and inline squat patients are required to stabilize numerous joints and segments in order to achieve whole body movements. The inability to achieve these movements, some or all, allows the physician to predict the likeliness of injury in the athlete going forward. The test is scored on a 0-4 scale for every movement: 3 points for full movement as described. 2 points for limited, mild difficulty, achievement of the motion described. 1 point for inability or moderate to severe difficulty achieving the movement. 0 points are awarded if pain is experienced at any point during the movement. It's important to understand that the FMS is not designed to elicit painful movement
It's important to understand that the FMS is not designed to elicit painful movement. If at any point during the FMS you experience pain the FMS should be stopped and done at a later date when the painful movement has been remedied. When painful movement is present it is important you find a healthcare professional for a Selective functional movement assessment (SFMA). The SFMA is better designed for painful movements. It's structured so that the pain can be isolated and identified. But the SFMA is another topic for another day.
So if your concerned about yourself or even your children experiencing injury due to your activities the first step is to get your movement screened for dysfunctional movement. After we know how well or poorly you move we can provide exercises that will help to prehab your movement that will help to prevent those silly, inconvenient injuries that never seem to go away.
In the Golf world, there are 3 setup postures: C-Posture, S-Posture and neutral posture. I'm sure somebody somewhere is the exception to that rule but we're not talking about them today! Today we are talking about the C-posture. So what is the C-posture?
The C-posture presents with overly rounded upper shoulders over the ball. When setting up to hit the ball this player rounds his chest over the ball instead of bending at the waist. The same player usually walks around with a similar posture. His/her head is forward of the shoulders and the shoulders are pulled forward from the spine. These folks have an abnormal posture in general and it carries over into their golf game.
So what the problem with C-posture? Is it bad for me and my game? Why do I care? You should! if not for your golf game then for your everyday activities! This bad posture can cause a number of problems in life and golf! Another name for C-posture, in general, is upper crossed syndrome and it can contribute to breathing complications. With C-posture a player will most likely have problems achieving a full backswing in a good position. The lack of motion in the thoracic cage will limit thoracic rotation and extension meaning the player will recruit from other joints for the motion. This recruitment causes instability and results in excessive wear and tear in the joint which will manifest as pain and injury at some point.
So how do we fix this "C Posture" then? That's easy! Find your nearest TPI golf or Medical Pro and have them put you through the TPI 16 part golf specific movement screen. From there we can isolate each player's physical limitations and treat specific dysfunction. Without a proper diagnosis, the physician is just guessing. If you're going to spend the money and the time on getting better you desrve specificity!
If you're scratching your head as to why these two are being compared, keep reading! It'll be very clear in a few short paragraphs. And just to make sure you are on the right page; Yes, these 2 problems both apply to the average golfer. I'm pretty sure if you're experiencing elbow pain you're nodding your head in agreement. So let's get to it, shall we!
I'll first explain the difference between the two problems. Tennis Elbow, or lateral epicondylitis, is inflammation of the extensor muscles of the forearm. There can be a number of explanations but when treating a golfer or tennis player its usually due to excessive forces created when the wrist is held in extension too often under load. Over time these excessive forces irritate the bone on the lateral side, outside, of the elbow. What does this mean? It means your extending the wrist during your swing when you shouldn't be. Most times its occurring in the lead hand, it can happen on the trail hand as well but is much more frequent in the lead hand.
Golfer's elbow is caused the exact same way but with excessive flexion of the wrist during load. Meaning, for a golfer, during the swing your wrist is cocked far too much, resulting in excessive load into the medial epicondylitis or inside of the elbow.
Both of these scenarios can be very painful, even debilitating, if not given the proper medical attention and rest. If by chance you find yourself struggling with this frequently, you may need to seek out professional swing help. The most common symptom for Tennis elbow in golfer's is "chicken winging". If not familiar with this term you DEFINITELY need to seek help with your swing. The reason being is that in the scenario in which you are suffering from Tennis elbow, seek proper medical treatment and don't identify the faulty swing mechanics causing the problem you will be back to the medical physician regularly for the same thing over and over again!
So now the good stuff! So how do I keep this from happening? Easy...... Kinda!! It's easy if you go to the right folks but it's gonna be hard work fixing it once you have a proper diagnosis. With a proper diagnosis of physical limitations, both painful and nonpainful, the medical physician can identify areas for improvement in the physical screen as well as areas that may be constants (things like anatomical anomalies that can't be changed no matter the amount of treatment, scoliosis is a good example) that have to be worked around. Once these variables and constants have been identified communication occurs with the fellow golf pro that now takes this information and uses it to find the most efficient swing for you, as a golfer. This is important because it's important you understand its not about turning you into Tiger Woods or Dustin Johnson but rather finding the swing that is most efficient for your body and body movement.
For the Golfers out there I would just like to announce I am officially a certified Medical professional registered with the Titleist Professional Institute (TPI), Level 1. So what does this mean? For you, as a golfer, it means a number of good things like golf specific care and understanding of the biomechanics of what may be affecting your performance or causing injuries. It also means I have a access to a network of golf professionals that are able to take care of any and all of your golf related needs: fitness, medical and swing coaches.
In the event you've never heard of this so-called TPI, I've already met a few golfers unaware of its existence, you're missing out! The TPI takes pride in assembling great teams of like-minded professionals to help all golfers return to healthy play, stay healthy and get the best from their clubs and body. Whether you're a junior or seasoned veteran that's played every course in the western US, the TPI pro can help.
So what do we do? Although many of us come from a spectrum of different disciplines we are all trained to identify swing characteristics, movement screen and golf specific terminology. This is the meat of the level 1 certification. After level 1 we are allowed to go into discipline-specific further education as it applies to our profession. The golf pro would delve into more swing mechanic specific material, the fitness professional would go further into golf-specific fitness material and the medical professional dives into golf specific injuries and how to rehab for return to play.
What does this mean for the average player? Simple, it means that when you seek out assistance from a TPI pro you are privy to a team of professionals to get you back on the course faster, stronger than before, fitter than before and with a more efficient game which should result in lower scores in no time!
"So what is the medical side of things", you might ask? Simple, with the experience of the TPI's staff, led by the infamous Greg Rose who helped to create the functional movement screen and selective functional movement assessment, they have constructed a 16 part movement screen that identifies limitations in any golfer that can help to identify possible swing deficiencies. Why is this important? Even easier, when movement deficiencies are identified we are able to recognize compensations and predict injuries. When movement deficiencies are identified they can then be eliminated with appropriate interventions including chiropractic adjustments and rehabilitative exercises to stabilize or mobilize areas in need.
The TPI also goes the extra mile to ensure every TPI pro is familiar with the game of golf. Not necessarily that we all play, which I do, but more by way of requiring us to understand the terminology of the game. This may not seem important but when my golf pro sends me a player that has a problem with early releasing, chicken winging and elbow pain I need to know what that means straight away. Without that understanding of those terms, I would be wasting both our time screening something that I've already been given the keys to the castle to jump straight into treatment. Oh, by the way, I do play! I even have my own clubs, that may or may not fit my taller frame. Haha, make sure to ask me when you see me, I may be getting some new ones in the near future.
So if you're serious about your golf; getting out of pain, dropping your score, being able to play more than just 9 holes before you fatigue or fix that "Charles Barkley-esque" hitch in your swing got to MYTPI.com today, click the link "find an expert", enter your postal code and find the fitness, medical or golf pro for your needs. And if they are doing their job they will have a network of pros to refer you to for the areas they don't work in.
Notice the core and its shape, perfectly rounded to stabilize the enormous weight being lifted.
DNS BASIC B class day one and good stuff already being shared! Although some of us may already know this I’ll share anyway: when it comes to child development, mentally and physically, for sport it’s best to expose your kids to as many different activities as possible. This exposure increases their physical and mental development by challenging the body in many different ways. These challenges are most effective before the age of 10 when they are the most impressionable. Soccer, basketball, baseball, ultimate, etc. AMYTHING and everything you can make time for, whether they are good or not makes no difference. These early challenges make for a more well rounded child and adult later in both physical awareness and cognition.
Nearly all of us out there are active folks. Ever notice excessive soreness or tightness in the low back, hips or neck after a regular day of golf, Ultimate or soccer? Have you ever noticed PAIN during or after activity? I know most of us have and yes, we aren't as young as we used to be but that's just an excuse and doesn't need to be the case on a daily basis.
The folks over at the TPI (Titleist Pro Institute) recently brought to my attention something I already knew but had slipped my mind. They were so kind to point out mobility of a player's joints can play a big part in their swing, effecting ball-striking efficiency. The golf swing, for example, requires movement of the hip, low back and thoracic spine (to name a few) in numerous directions, simultaneously, and when mobility is lost in one, it is pulled from another.
The body is designed to alternate mobile joints with stable joint. Whats this supposed to mean? Well as you look at the body in terms of "joints" you will see a pattern of alternating types of mobility. A mobile joint would be one that can and does move in multiple planes/directions freely. A stable joint would be one that moves in one plane primarily, they all move in multiple planes but in a stable joint the motion is disproportionately in one direction. Mobile joint examples would be the shoulder and the hip. They are easily moved in all three anatomical planes with little effort, when healthy. Stable joints would be best described by the elbow and knee. These joints primarily flex and extend in the sagittal plane (front to back) with little rotation or side to side movement.
Ok, so why the anatomy lesson? That's easy!! Based on the above model, the golf swing involves everything from the arch of the foot all the way to the wrist. With a loss of joint motion in one area, specifically a mobile joint, the mobility requirements are transferred to the joint above and below. A good example is mobility restriction in the hip that requires an increased mobility requirement from the lumbar spine and knee. Although this may not cause immediate pain or discomfort, if done long enough the system will fail and at this point, pain is introduced.
Why is this important? A couple reasons: 1. Painful activities aren't very fun. 2. You don't play as good when you're in pain. 3. Pain causes altered stabilization patterns that can affect the stability of the system long term. I could go on..... The point is that proper flexibility and mobility of your joints is imperative for long-term enjoyment of ANY activity.
How do I get fixed? The "old-school" approach to back pain was simply strengthening the abs or "core" muscles. That's good and all but if your problem is mobility (lack of) what good does it do to strengthen? If there's a lack of mobility in a joint it needs mobilization. Strengthening only applies to joint instability, which may apply to the low back that's compensating for an immobile pelvis or thoracic spine. Mobilization (chiropractic care) is what is needed for an immobile joint. But before that, proper screening and assessment are required to isolate the primary causes of your pain and dysfunction. Without a proper diagnosis, we are just shooting from the hip hoping what we are doing fixes the problem.
Those of you out there with newborns be sure to get them screened regularly for neurological developmental stages. It's important to monitor their progress physically to confirm the proper neurological progress. It's important you stay on top of this aspect of development so you can catch flaws early and correct them. No one wants to think their child is anything but perfect but the truth is that you have to acknowledge when something isn't right and the sooner you do so the better off the child is. If caught early you can find the proper care and help to decrease the deficit while the child is still moldable, if you wait too long their ability to rehab the deficit is substantially hindered. They are absolute sponges and much like Play Dough in the first 5 years of life, after that they have a foundation of mental and physical competence that is significantly harder to un-train. At the end of the day a birth defect isn't a reflection of your parenting it's just a fact and the sooner you acknowledge its presence the sooner you can seek treatment and provide the child with the life tools needed to be successful in life. We can't be there to take care of them forever so do them a favor and give them the skills they'll need when you're not around to do it for them anymore.
Heres a few things to look for an approximate time you should notice it:
- at 4-6 weeks: optical fixation, primitive reflexes diminish, Co-activation of muscles, Postural activation of phasic muscles, the fencer's stance.
-3 months: when face down they are head up with weight on the elbows and pelvis, Galant reflex and grasp reflex diminish, lateral grasp, foot to foot touching when on their back.
-4.5 months: tripod support (elbow, hip and opposite knee) in prone and grasping object, asymmetrical trunk lengthening.
-5-6 months: rolling (back to front only), grasping across the midline, they push up onto their hands and thighs, hand to foot coordination, most primitive reflexes should be gone at the end of 6 months.
7-9 months: rolling (front to back), quadruped position (hands and knees, 7 months), grasping a toy in quadruped in month 8, crawling by month 9, pincer grip (thumb and forefinger opposition) 9 months.
Hope this helps. For any clarification please don't hesitate to make an appointment and clarify. --Cheers
When rehabbing an injury it's important not to lose sight of your goals. Many time in traditional, old-school thought of rehab, the clinician and patient get so focused on individual muscles to be activated they fail to recognize the dysfunctional system, hence the "forest for the trees" comment.
Rehabbing individual muscles does not make a dysfunctional system functional. that sort of thinking would be no different than thinking a replacing the engine of a rundown old junker suddenly makes it a hot rod! There can be some muscular rehab for some injuries but to apply that to all scenarios and limit rehab to isolated muscle activation would be ineffective.
The emerging trend in rehab is to train the system. The muscles you would normally rehab have to function appropriately within the system they are a part of in order for the system to be efficient. Therefore it only makes sense to train the system as a whole.
In order to do so, you have to remove the stress of being upright, weight bearing. If/when the system fails in weight bearing you take it down to non-weight bearing, like kneeling or sitting. If that is still too much for the system take it down further to a suspended spine (hands and knees). And if this is still unstable then you take it back to the most basic of positions, on you your back. From here you are in the simplest of position and have removed all postural stability requirements. In this position you can perform any exercise without a need for postural stabilization, allowing the brain to focus on the unimpeded motion in the joint. Once you can perform proper ranges of motion without pain with stability, you start climbing the ladder back to standing.
For some people even laying on their back is unstable. For those folks, we focus on breathing, because when the diaphragm isn't being utilized as designed, nothing can be stabilized. It may not seem like much but relearning to breathe with the right muscles is the foundation of spinal stability which is necessary to achieve extremity stability.
Anybody can get by without stability for a period of time but eventually, the compensations will fail and the system fails. This is where you start noticing pain, some worse than others. At the point of pain you know has dysfunction, to postpone rehabbing said dysfunction means you move in pain regularly which also means you move differently in an attempt to reduce painful movements. These compensation further destabilize the system and only prolong the road to recovery.
We are proud to be a part of GRU, the Boulder county community and support its players in their health and wellness. GRU hosts ultimate frisbee leagues year-around in Boulder, Longmont, and Broomfield.