August 28, 2010

8:00am – 8:30am Check-in and registration

8:30am – 8:45am Welcome and Introduction – Professor Paul Hodges

8:45am – 9:35am Professor Stu McGill

• Opinions on the links between back pain and motor control: The disconnect between clinical practice and research

9:35am– 10:25am Dr. Lorimer Moseley

• Talk title TBC

10:25am – 10:40am Morning Coffee Break

10:40am – 11:30am Professor Paul Hodges

• Motor control changes in spinal pain: effects mechanisms and efficacy of interventions.

11:30am – 12:20pm Associate Professor Peter N. Reeves

• Spine Stability: the six blind men and the elephant

12:20pm – 1:00pm Lunch

1:00pm – 2:00pm Clinical Update – Professor Paul Hodges

• Emerging trends in exercise management of spinal pain

2:00pm – 2:30pm Symposium Update

• Panel discussion on areas of convergence and divergence

2:30pm – 3:00pm Question and answer session.

3:00pm Symposium Close

Register here

Related posts:

1. Dr. Stuart McGill in Toronto A recent publication by Dr. McGill and an upcoming course...
2. Thinking About Thoughts Cognitive aspects of treatment of lumbopelvic pain. From the upcoming...
3. Dr. Richards on Biomechanics & Stretching A lecture by one of my university professors and mentors...

Related posts brought to you by Yet Another Related Posts Plugin.

Related posts:

1. Optimum Body Mechanics A brief summary of maximizing Optimum Body Mechanics in activity...
2. Dr. Stuart McGill in Toronto A recent publication by Dr. McGill and an upcoming course...
3. Negative Effects of Static Stretching Negated? It goes without saying that the “commonly” held belief about...

Related posts brought to you by Yet Another Related Posts Plugin.

Here’s a brief summary of the study:

Study Purpose:

• To determine the presence of a relationship between hamstring length and PFJ stress at 3 specific knee joint angles of flexion.

Study Population:

• 16 recreationally active males divided into two groups based on knee joint angle-measured hamstring length.

Methodology:

• A biomechanical model incorporating knee joint angle, knee extensor moment, and PFJ contact area was used to quantify PFJ stress.
• MRI and 3D motion analyses were also utilized in this study.
• A one-way ANOVA to determine the variations in PFJ stress between the 2 groups (with and without reduced hamstring length) was used.

Main Findings:

• Patellofemoral Joint stresses differed significantly between the two groups at specific angles of knee flexion.
• No significant differences in hip angles between the two groups.

Clinical Application:

• This study demonstrated that subjects with reduced hamstring lengths have increased PFJ stress during various positions of the squatting movement.  As a result, such a decrease in length MAY contribute to the pathogenesis of various conditions relating to the knee.
• These results enable us to consider another factor when managing those with knee pathology.

For a complete and “evidence-informed” understanding of the study, look out for my review. I have obviously left out specifics from this study in this post as Research Review Service is a paid membership site. However, if you would like more information, please do not hesitate to ask.

Photo source

Related posts:

1. Zygapophyseal Joint Pain Patterns: Part 1A (Cervical Spine) This one's for the manual therapists out there. A brief...
2. Jump-Landing Biomechanics Knee pain. Knee Injury. “Certain athletes are at higher risk...
3. Research Review Service for Fitness Professionals A continuing education resource for those of you looking to...

Related posts brought to you by Yet Another Related Posts Plugin.

A new released article from Dr McGill :

click here

See Below for details on his upcoming course:

Building the Ultimate back: from Rehabilitation to Performance

November 20 and 21, 2010 in Toronto

• 4 hours – Building the foundation
• 2 hours – Interpreting patient presentation
• 1 Hour – Preventing Back Disorders
• 4.5 hours – Rehabilitation Exercise
• 4.5 hours – Training for performance

This 16 hour lecture / workshop weekend with Dr. McGill will be located at  the Westin Harbour Castle, 1 Harbour Square, Toronto. I am also thinking of hosting a social this weekend so if you are attending please let me know.

For more information on Dr. McGill visit www.backfitpro.com

Visit  www.msk-plus.ca/Courses.htm for more information and online registration, or email info@msk-plus.ca for more details.

See you there!

Related posts:

1. 2010 Spinal Control Symposium – Toronto McGill, Moseley, Hodges, Reeves...
2. Flexion Endurance Testing: V-Sit vs Plank Comparing the V-sit flexion endurance test vs the front plank...
3. Dr. Richards on Biomechanics & Stretching A lecture by one of my university professors and mentors...

Related posts brought to you by Yet Another Related Posts Plugin.

The Functional Movement Screen (FMS) is a ranking and grading system that documents movement patterns that are key to normal function. By screening these patterns, the FMS readily identifies functional limitations and asymmetries. These are issues that can reduce the effects of functional training and physical conditioning and distort body awareness.

The FMS generates the Functional Movement Screen Score, which is used to target problems and track progress. This scoring system is directly linked to the most beneficial corrective exercises to restore mechanically sound movement patterns.

Exercise professionals monitor the FMS score to track progress and to identify those exercises that will be most effective to restore proper movement and build strength in each individual. (…cont’d)

The Selective Functional Movement Assessment (SFMA) is a series of 7 full-body movement tests designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain. When the clinical assessment is initiated from the perspective of the movement pattern, the clinician has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main musculoskeletal complaint, but contribute to the associated disability. This concept, known as Regional Interdependence, is the hallmark of the SFMA.

The assessment guides the clinician to the most dysfunctional non-painful movement pattern, which is then assessed in detail. This approach is designed to complement the existing exam and serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of movement into musculoskeletal practice. By addressing the most dysfunctional non-painful pattern, the application of targeted interventions (manual therapy and therapeutic exercise) is not adversely affected by pain. (…cont’d)

To describe the above in layman’s terms, the FMS is a screen to identify who may be at risk based on their presenting movement patterns. Why they are at risk is not the objective here, it is simply a filter. On the other hand, the SFMA is an assessment tool aimed at determining one’s cause of pain.

If you are interested in learning more about these systems and especially how to apply them in a clinical / rehabilitation setting, I urge you to join Sports Rehabilitation Expert.

Related posts:

1. Assess and Correct: A Review On Friday, I finally received my DVD copy of Assess...
2. Zygapophyseal Joint Pain Patterns: Part 1B (Cervical Spine) A study testing the reliability of their pain charts by...
3. Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation is...

Related posts brought to you by Yet Another Related Posts Plugin.

Just wanted to give you all a heads up on Hockey Develepment Program, a new website by professional strength and conditioning coach, Kevin Neeld. Along with such professionals as Eric Cressey, Nick Tumminello, Chris Boyko, and Kim McCullough, I was asked to do an interview for this site.

Some of the topics I talk about are:

• The #1 injury in men’s and women’s hockey and the long-term implications no one is talking about

• Preventing the injury that can end your career

• Pain vs. healing: How returning too quick can put you right back in the stands

• Assessments that you can use to identify performance limitations and injury risk factors

• How to minimize your risk of hip flexor and groin strains and what to do if you do suffer one of these injuries

• How to minimize your risk of suffering a hip labral tear and sports hernia

If you are a hockey coach, strength and conditioning specialist, medical professional, or hockey dad, I highly suggest you visit The Hockey Development Coaching Program!

Related posts:

1. Going Back to School Lacing up your shoes for someone whom you've never met,...
2. Quantifying Quality A note on the Functional Movement Screen and Selective Functional...
3. Play It Cool An online platform to promote safe hockey as skill enhancement...

Related posts brought to you by Yet Another Related Posts Plugin.

• The data from this study came from two sources (firefighters and kinesiology students).

• The main objective of this study was to assess the relationship between the V-sit test and the plank test for torso flexion endurance.

• The pearson correlation was r=0.34 (low correlation) as well as the r-squared value. It almost seems obvious that these two wouldn’t correlate well as they are two totally different positions.

I think the main reason McGill did this study was because people were using the PLANK test in place of the V-SIT to test flexion endurance (which has plenty of data correlating poor endurance times with low back disorders).

• The moral of the story is to use the V-sit when doing your tests for flexion endurance.

• He also cautioned against “training the test” due to the high compressive loads.

I do not have an image of the V-Sit test but can send you a copy of the full article if you would like. Just reply below with your email and I’ll shoot it over.

Related posts:

1. Dr. Stuart McGill in Toronto A recent publication by Dr. McGill and an upcoming course...
2. Core Values (NY Times) Dr. Stu McGill demonstrates some "early" phase low back and...
3. Thinking About Thoughts Cognitive aspects of treatment of lumbopelvic pain. From the upcoming...

Related posts brought to you by Yet Another Related Posts Plugin.

DO YOU SWIM?

If you answered “yes” to the above, please proceed to the next question. If not, thanks for visiting!

Question # 2:

DO YOU PREPARE YOURSELF TO SWIM?

If you answered “no” to the above, please view the following videos to help you prepare for your next run using the GRID by Trigger Point Performance Therapy.

Quadriceps – 60 seconds each leg (Total = 2 min)

Tensor Fascia Lata – 30 seconds each hip (Total = 1 min)

Mid – Latissimus Dorsi – 30 seconds each side (Total = 1 min)

Thoracic Spine Rotation – 30 seconds each side (Total = 1 min)

Quadruped Reach & Roll – 60 seconds

Related posts:

1. The 6 Minute Run Prep A 6 minute run prep using the Grid by Trigger...
2. Don’t Forget About the Swim: How the swim affects triathlon performance The ability to perform well during a triathlon is dictated...
3. Optimum Body Mechanics A brief summary of maximizing Optimum Body Mechanics in activity...

Related posts brought to you by Yet Another Related Posts Plugin.

FOOT AND ANKLE

Pes Planus

During the movement screen, we examine your foot to determine if the movement in your foot is optimal.  Specifically, the most common type of dysfunction in the foot that can lead to energy leaks is a pes planus.  Pes planus, or flat feet, is a very common finding among the general population.  When dynamically tested, individuals with pes planus will exhibit turning out of their feet and a collapse of the main arch of their feet (longitudinal arch).  This finding can also contribute to the other findings within the movement screen.

Limited Dorsiflexion

This finding represents a limitation ankle joint’s range of motion.  Specifically, it means that the top of the foot does not get as close to the shin as it should while being loaded such as while performing a squat.   What this means is that those who have limited dorsiflexion in their ankle are likely make up for this lack of range by compensating somewhere else to get to the same depth of a squat.  Often times, people will use their backs predisposing them to injury due to overuse/misuse, or they may simply not be able to achieve the same range of movement while performing the specific movement in question.

External Foot Flare

This finding represents turning out of the foot while under dynamic load.  This may be a result of poor foot posture stemming from over pronation or pes planus.

KNEE

Dynamic Valgus

This finding represents the knees inability to maintain its dynamic integrity (position during movement) while under load.  What we see is a collapsing medially (inward) of the involved knee representing poor control, weakness of the hip musculature, and/or poor foundational support from poorly controlled foot motion.

Sagittal Control

This concept represents the importance of muscular control of one’s knee while under dynamic load.  What we see at times is a “shimmy” in the knee while the patient attempts to control knee movements such as a single leg squat.  This can represent poor muscular control and coordination  of the knee, hip and foot musculature.

LUMBOPELVIS AND HIP

Where your spine and hip attaches to your pelvis

Hip Hinge

This finding represents the correct way to perform a squat and generally to “bend at the hips”.  A good “bend” is initiated at the hip and not the low back where, as the name implies, you literally hinge your movement at your hips.  Those who cannot perform this movement and tend to favour bending through their back are predisposed to developing low back pain and poor performance, because instead of using their legs they use their spines to lift. Correcting this movement yields tremendous improvements for patients or athletes in terms of low back pain and performance.

Hip Mobility

This finding represents your hip range of motion in flexion, extension, internal and external rotation, and all combined movements of the aforementioned ranges. As a car needs lubricant to function properly you need hip mobility to keep your hips, low back and knees functioning properly. Tightness in the hips lead to stress and strain into joints that can create many musculoskeletal conditions that overtime can easily lead to arthritis in the previously mentioned sites. Sitting and our normal activities of daily living reduce our hip mobility. Therefore to be able to achieve your full athletic potential combined with staying injury proof requires you to constantly maintain proper hip mobility.

Hip Strength Quality

This finding examines the strength and ease of movement the athlete or patient displays during the various movements assessed. It is seen during low load testing as the depth the individual is able to achieve for example during the squat, lunge, and single leg squats. During high load conditions it is the individuals’ ability to absorb forces through the muscular system and to develop power (rate of force development)

Spine Buckling

This finding represents the spines inability to handle load.  What this means is that the spine is unable to support itself due to poor core musculature support.  Much like a mast on a ship, the spine requires guide wires to tightly hold the mast upright otherwise it will crack and the ship will lose its sails.  Similarly, without appropriate conditioning of the core muscles around the spine and pelvis, the body’s mast (your spine) will buckle causing you to lose the wind in your sails and the spring in your step.  Simple movement such as bending forward becomes painful.  This finding tends to become apparent while perform any bending movement.

Sandwich Movement

This finding represents when a person has does not display a hip hinge, has poor mobility through their hips, and favours using their back while perform a specific movement.  Essentially, what is seen is the torso and legs form the “bread” of the sandwich while the space in between becomes the filling.  A well conditioned pattern finds that the torso is in a neutral position with the chest up; while a “sandwich pattern” finds the chest bent into the legs and facing down – they look like a sandwich. In this position the low back is doing the lifting not the legs. Adopting this pattern negates the most powerful muscles in your body in favour of the back which predisposed the individual to developing chronic low back pain. Correcting this movement pattern and developing a proper hip hinge would be tremendously beneficial. In fact, most people with low back pain display this dysfunction that once corrected no longer have back pain.

Pelvic Control

Much like the above three findings, pelvic control reflects the patient’s ability to dynamically (through movement) maintain a stable pelvis (foundation) while performing various movements.  Dysfunctions are seen as aberrant movements of the pelvis; shifting, tilting, hiking and rotating. These dysfunctions occur largely because of an inability to maintain neutral spine control and are linked to the findings throughout the other anatomical sites, such as your ankle and foot. The impact of poor pelvic control relates to its’ central position in the body. Your pelvis is the transfer point for forces generated in your hips (the main power centre in the body) combined with force contributions from other areas of the body. Pelvic control is like the drive train of a car which functions to transfer power developed from the engine to the wheels. Many problems throughout the body will occur with poor pelvic control such as low back pain, hip problems, knee problems, and even shoulder problems.

Something to Think About:

Regardless of whether you are an athlete or not, pelvic control is essential. If you are an athlete the demands for pelvic control are much higher and are reflective of the demands of your sport. For example it well known that hip and leg contribution to pitching velocity and tennis serve velocity is over 50 percent. This is only possible through pelvic control, or “THE CORE”. Many athletes that fail to develop the core suffer injuries by trying to make up the power elsewhere, such as the elbow and shoulder for both pitchers and tennis players.

SCAPULO-THORACIC HUMERAL

Where your arms attach to your spine

Thoracic Collapse

This is a secondary finding often times associated with sandwich movement.  This finding indicates that the patient is not hinging from the hips resulting in a back dominant initiation of movement resulting in thoracic or mid back collapse.  Essentially, the mid-back often times follows the lead of the low back; if the low back is poorly supported, then the same will be seen in the mid-back.

Thoracic Rigidity/Hyperkyphosis

This finding is the opposite of the thoracic collapse.  It represents the inability of the patient to maintain a “chest up” position while under load and undergoing specific movements, irrespective of the stability of the low back.  In chronic situations, this finding can contribute to thoracic outlet syndrome, neck pain, and headaches.

Scapular Winging

This finding represents poor posture of your should blades (aka scapulae).  This finding indicates that you are chest dominant in your posture with likely tight, forward rolled shoulders and weak mid-back muscles.  This can predispose patients to developing chronic rotator cuff tendons, mid-back, shoulder, and neck pain.

Internal GH Rotation

Internal glenohumeral rotation represents a finding that is often associated with hyperkyphosis and scapular winging.  This can also predispose the patient to chronic rotator cuff injuries leading to pain and poor function while attempting to participate in their chosen activity or job.

CRANIO-CERVICAL JUNCTION

Where your neck meets your head

Anterior Head Carriage

This represents the general finding found in almost all people to some degree or another.  It’s what I call the modern cave man position in which our head juts forward in front of our bodies when we primarily sit in a poor position in front of the computer, read or slouch. This finding can represent poor muscular control of the deep muscles of your neck and may lead to chronic neck and jaw pain as well as headaches due to hyperactive posterior neck musculature.

Lateral Shift

Lateral shift of your head on your shoulders may represent a muscle imbalance present at your shoulder, neck, or upper back.  It may also represent a favoured motor pattern that if not corrected can lead to over stressing specific structures and tissue, resulting in breakdown and injury.

Rotation

Rotation is very similar to the finding of lateral shift and is often found in conjunction with it. Rotation may also represent a favoured motor pattern that can indicate the presence of weak and tight neck muscles.

Courtesy of Dr. Thomas Lam

Related posts:

1. Optimum Body Mechanics A brief summary of maximizing Optimum Body Mechanics in activity...
2. Flexion Endurance Testing: V-Sit vs Plank Comparing the V-sit flexion endurance test vs the front plank...
3. Dr. Stuart McGill in Toronto A recent publication by Dr. McGill and an upcoming course...

Related posts brought to you by Yet Another Related Posts Plugin.

DO YOU RUN?

If you answered “yes” to the above, please proceed to the next question. If not, thanks for visiting!

Question # 2:

DO YOU PREPARE YOURSELF TO RUN?

If you answered “no” to the above, please view the following videos to help you prepare for your next run using the GRID by Trigger Point Performance Therapy.

Calves – 45 seconds each leg (Total = 1.5 min)

Quadriceps – 60 seconds each leg (Total = 2 min)

Tensor Fascia Lata – 30 seconds each hip (Total = 1 min)

Thoracic Spine Rotation – 45 seconds each side (Total = 1.5 min)

Related posts:

1. The 6 Minute Swim Prep A 6 minute swim prep using the Grid by Trigger...
2. Last Minute Gifts to Buy for…..Yourself: The Grid With Christmas rapidly approaching and shopping days swiftly diminishing, many...
3. Optimum Body Mechanics A brief summary of maximizing Optimum Body Mechanics in activity...

Related posts brought to you by Yet Another Related Posts Plugin.