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.

Also make sure to check out the following posts as scapular dyskinesia may play a role in both:

• Neurovascular Problems in the Athlete’s Shoulder
• Rotator Cuff Tears: Predictive Factors for Management

Related posts:

1. Rotator Cuff Tears: Predictive Factors for Management This review was recently posted on ResearchReviewService.com and integrated the...
2. The Shoulder in Sport The Shoulder in Sport: Management, rehabilitation, and prevention Andrea Fusco,...
3. The Rotator What is it? A device that can be used in...

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.

What we need:

• Dorsiflexion mobility

Why we need it:

• Minimize stress on knee

How we can get it:

KNEE:
What we need:

• We need to realize that the knee is often an innocent bystander

Why we need it:

• We need to realize this because the research says so

How we can get it

• We can achieve optimal knee mechanics by looking both above (the hip) and below (the ankle) this joint.

HIP:

What we need:

• Saggittal plane mobility
• Extension strength

Why we need it:

• Minimize stress on lumbar spine

How we can get it:

• Glute Bridge
• Glute Bridge – Marching
• Glute Bridge – 1 Leg

What we need:

• Frontal & Transverse plane dynamic stability

Why we need it:

• Minimize dynamic valgus at knee and dynamic internal rotation at knee

How we can get it

• Side Lying Abduction
• Clam Shells (Hip – External Rotation)
• Mini Band – External Rotation
• Airplane (I’ll get a video of this up soon)

LOW BACK / CORE:

What we need:

• Antirotation, Antiextension, Antilateral flexion STABILITY

Why we need it:

• To be able to transfer forces THROUGH not TO the “joint” (aka Core”)

How we can get it:

• Antirotation: “Pig on a Spit” Roll
• Antiextension: Front Plank series including the Body Saw
• Antilateral flexion: Farmer walk / Suitcase carry

What we need:

• Lumbar intersegmental stability

Why we need it:

• To be able to transfer forces THROUGH not TO the “joint” (aka Core”)

How we can get it:

• Effective “core activation” methods

THORACIC SPINE:

What we need:

• Rotation & Extension mobility

Why we need it:

• Lumbar relief & Shoulder mobility

How we can get it:

SHOULDER:

What we need:

• Scapular stability

Why we need it:

• Shoulder mobility

How we can get it:

For those of you who are unfamiliar with this approach of looking at the body, please have a look at Coach Boyle’s The Joint by Joint approach and FITS Toronto’s 5-site Integrity

Anatomical photos courtesy of Primal Pictures

Related posts:

1. Common Movement Dysfunctions What to look for when screening and assessing the moving...
2. Minimizing Hip & Groin Injuries Considerations for minimizing hip and groin injuries in activity and...
3. Jumping Rope: A triathlete’s off season secret weapon? As I was jumping rope in between workouts yesterday (thats...

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

I am really looking forward to what Mike Reinold and Eric Cressey have to offer since I visit their websites on multiple occasions each week. In my opinion, they bring together what drives my passion in everyday practice: a blend of evidence-based sport medicine and athletic performance.

Mike Reinold

Eric Cressey

Unfortunately, I have come to a realization that my continuing education budget is much higher than what my entire tuition was.

Related posts:

1. Final Sports Rehab to Sports Performance Teleseminar Tonight's guest will be Strength Coach, Eric Cressey....
2. Sports Rehab to Sports Performance Teleseminar Sports Rehab to Sports Performance teleseminar reminder....
3. High-Performance Sports Conditioning *Going back into the archives for an oldie but...

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

But is this the most effective way to apply strain to the posterior capsule?

Using a cadaver-based study, Izumi et al examined and measured posterior capsule strain of 8 different shoulder positions.

What you need to know:

• 3 male and 5 female fresh cadavers were included (74 – 96 years of age)
• Bodies were disected and prepared so that only the posterior capsule was preserved and exposed.
• A displacement sensor (Pulse Coder, Levex, Kyoto, Japan) was used to measure posterior capsule strain
• For specific strain measurements, the posterior capsule was sectioned into 3 parts (upper, middle, and lower)
• Passive internal rotation was used as the primary motion for strain measurement.

Measurement positions:

• Internal rotation + 0 deg. elevation in scapular plane
• Internal rotation + 30 deg. elevation in scapular plane
• Internal rotation + 60 deg. elevation in scapular plane
• Internal rotation + 90 deg. elevation in scapular plane

• Internal rotation + 60 deg. flexion (IR in 60 deg. elevation + 60 deg. horizontal ADDuction)
• Internal rotation + 60 deg. ABDuction (IR in 60 deg. elevation + 30 deg. horizontal ABDuction)
• Internal rotation + 30 deg. extension (IR in 30 deg. elevation + 120 deg. horizontal ABDuction)
• Internal rotation + 60 deg. flexion + horizontal adduction (IR at 60 deg. flexion + 30 deg. horizontal adduction)

More information pertaining to this study’s methodology:

• A reference length (R0) was first established and indicated the point at which the stress-strain curve first indicated a sudden decrease in strain
• Strain of the capsule was measured at the terminal range of passive IR. This was determined by grade III mobilization after Kaltenborn procedure.
• Beyond this point, a stretch was applied to the joint for 10+ seconds until no further strain was observed
• To determine the Glenohumeral joint positions that demonstrated significant increases in strain from R0, a one-way repeated measures ANOVA was used.
• The differences in strain among the positions were assessed via paired t-test.

Glenohumeral positions that significantly stretched the posterior capsule:

• Internal rotation + 30 deg. elevation in scapular plane: significantly stretched the UPPER and MIDDLE sections of the posterior capsule

Self stretch

Rotater – assisted

• Internal rotation + 30 deg. extension: significantly stretched the UPPER and LOWER sections of the posterior capsule

Rotater – assisted

Caution:

It should be noted that joint capsule strain seen in aged cadavers may not be similar to that seen in younger adults. In fact, strain rates in younger populations may indeed by larger.

Related posts:

1. Jump-Landing Biomechanics Knee pain. Knee Injury. “Certain athletes are at higher risk...
2. Got Hungry Bum? Everyone stand up. Come on, off your chairs. By now...
3. Last Minute Gifts to Buy for…..Yourself: Thera-Band With Christmas rapidly approaching and shopping days swiftly diminishing, many...

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

• A device that can be used in physical and manual therapy settings, as well as in the sporting arena.

What is it used for?

• The Rotator can be used for increasing both shoulder mobility and strength in clinically indicated situations.

When does Dr. Jeff like to use it?

• Aside from those situations listed on the Rotator website, I personally find it most useful with larger athletes and patients. The reason for this is essentially to make my life easier when performing manual therapy techniques. For example, when performing soft tissue therapy on structures in the region of the posterior shoulder girdle (i.e. posterior capsule, glenohumeral external rotators, etc), the Rotator allows the patient to use his/her opposite arm to assist the necessary motion that might not otherwise be possible in those with “larger” chest sizes.

How can the Rotator be improved?

• While I have yet to find a “be all – end all” product, the Rotator IS a useful device. However, a few patients have noted to me that the velcro strap isn’t the most comfortable and that a softer, cloth-type strap, may be more user friendly.

Here is a clip of the Rotator in action:

Photo source

Related posts:

1. Rotator Cuff Tears: Predictive Factors for Management This review was recently posted on ResearchReviewService.com and integrated the...
2. Are You Sleeping on the “Sleeper” Stretch? There are more effective ways to stretch the posterior capsule....
3. Good Neck Reads Two good reads on the neck. One on the suboccipitals,...

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

Let me tell you why:

• POSTURE: In order to jump rope efficiently and for long periods of time, it is important that one maintain an ideal posture throughout the exercise. As such, improving ones posture will effectively facilitate a neutral spine position in each of the Cervical (neck), Thoracic (mid/upper back), and Lumbar (low back) regions, thereby promoting proper function of each of the active, passive, and neural components of spinal stability. Perfect posture promotes movement efficiency (see MovementU) and therefore, training to maintain ones posture may translate into increased efficiency during running.

• BILATERAL SHOULDER EXTERNAL ROTATION: In general, the glenohumeral joint is isometrically held in a bilateral external rotation position throughout the jump rope exercise. Reinold et al. recently demonstrated that the concentric bilateral external rotation exercise facilitated scapular control without the need for arm elevation, while simultaneously utilizing a good lower trapezius to upper trapezius activation ratio. While isometric contractions certainly differ from concentric contractions, one may hypothesize that isometrically maintaining the shoulder girdle complex in this position may facilitate optimal patterning of the thoraco-scapulo-humeral joints…especially  since isometric contraction of the glenohumeral external rotators play an important role in force coupling with the powerful pectoralis major during the early pull phase of swimming (this force coupling helps keep the head of the humerus centered within the glenoid fossa: aka dynamic stability). Similarly, bilateral external rotation may  also play a rehabilitative role in those athletes presenting with signs of Type 1 “SICK” scapulae (inferior prominence of the medial border) for the same reasons noted above.

• ECCENTRIC HIP ABDUCTION: During the stance phase of running, the hip plays a contributing role in absorbing ground reaction forces sustained by the body upon impact. This is so via eccentric contraction and control of the abductors of the hip (i.e. Gluteus Medius). Each “foot contact” of single and alternating leg rope jumping is not dissimilar to the stance phase of running as the hip abductors are called into action with every repetition. As such, incorporating rope jumping in the off season may result in preventing dynamic valgus (aka “buckling in”) of the knee, thereby minimizing energy leakage while running. The end result: A more efficient, powerful running gait.

• Low Intensity Stretch Shortening: Plyometric exercise has been scientifically demonstrated to be effective in improving performance and economy in certain distance runners. Since, jumping rope can be viewed as a lower intensity form of plyometric exercise, improving the stretch shortening capabilities of the deep flexors of the foot and ankle may translate into similar effects. At the very least, since mid- and forefoot runners tend to have a single and greater peak force upon impact (as opposed to the double peak seen in rearfoot strikers), performing low intensity stretch shortening exercise may strengthen the ability of the lower leg musculature to act as shock absorbers, subsequently minimizing chances of dynamic instability (i.e. overpronation) and/or tendinopathy (i.e. of the achilles).

Unless I am mistaken, the efficacy of jumping rope for triathlon performance has yet to undergo scientific investigation. Therefore, definitive conclusions from the above statements must certainly not be made. However, as with many currently performed exercises, the theoretical rationale for rope jumping as an off season exercise in triathletes may seem plausible and thus, may enable this exercise to be performed without much scrutiny.

So…JUMP AWAY!

Photo source

Related posts:

1. Optimum Body Mechanics A brief summary of maximizing Optimum Body Mechanics in activity...
2. Compression: What the sock? The use of compression garments have increased in popularity in...
3. Don’t Forget About the Swim: How the swim affects triathlon performance The ability to perform well during a triathlon is dictated...

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

The Shoulder in Sport is a specialty text, authored by expert physiotherapists, Fusco, Foglia, Musarra, and Testa. This book illustrates a multidisciplinary approach to the shoulder health of athletes and through its specific application to sport, is a valuable educational tool for all professionals involved in sport injury management.

The Shoulder in Sport is divided into 5 sections. Section I, Functional Anatomy and Recent Biomechanical Discoveries is the blueprint of this book, detailing the normal structures, congenital anomalies, and vital mechanics of the complete shoulder system. Section II, Pathology, Clinical Aspects and Diagnostic Imaging systematically and comprehensively includes the components of shoulder injury and dysfunction in sport. Its first two chapters cover the two most common pathologies  (shoulder instability and impingement syndromes) and are followed by the epidemiology of shoulder lesions in sport, specialist examination, and diagnostic imaging. The final chapter in this section pertains to functional examinations and describes a thorough approach for clinical shoulder evaluation in manual therapy. Section III, Surgical Treatment, details the indications, methods, and solutions of operative management in sport-related shoulder pathology. Section IV, Rehabilitation, Training and Prevention incorporates the progression of rehabilitation principles with functional training considerations and transitions its chapters into a practical manual for the sports specific demographic. Lastly, Section V, Current Trends in Surface Electromyography, outlines the theory, methodology, and practical application of surface EMG in sport injury prevention, as well as its potential role in sport injury management.

The Shoulder in Sport is rich in content and up to date, and excludes very little in the medical management of shoulder injuries in sport. Supported by dozens of articles per chapter, this text can be utilized by many different professionals to gain a better conceptualization of this functionally important anatomical region.  For the clinician, a broader knowledge and understanding of the etiology of shoulder pain in sport is given. For the surgeon, a better appreciation of the rehabilitation principles and determinants is provided. Lastly, for the rehabilitation specialist, a complete surgical picture and the application of electromyography are rendered. Irrefutably, The Shoulder in Sport is an educational resource highly recommended for the sport medicine community.

Related posts:

1. Concise Guide To Sports Injuries Another feature of this blog will be book reviews that...
2. Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation is...
3. Last Minute Gifts to Buy for…..Yourself: Developing Sport Expertise With Christmas rapidly approaching and shopping days swiftly diminishing, many...

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

Background Information

• Although rare, neurovascular conditions of the upper extremity occasionally present themselves in elite athletes. These may be challenging to detect, but are certainly important for their potential to cause limb-threatening consequences. Early recognition, proper initial treatment, and urgent surgical referral increase the likelihood of rapid return to pre-injury levels of performance and more importantly, decreases the likelihood of serious complications.

Neurogenic Thoracic Outlet Syndrome

• Arm and/or hand pain, numbness, and paresthesia that results from compression, irritation, and chronic injury affecting the roots of the brachial plexus.
• May be caused by cervical ribs and hypertrophy of the scalene and pectoralis muscles.
• Exacerbated with direct palpation and arm elevation.
• Severe cases rarely seen in elite athletes

Subclavian Artery Aneurysms

• Stenosis and aneurysm formation of the subclavian artery.
• Typically associated with cervical ribs and atypical first ribs.
• Thrombus and subsequent embolization, travelling to the distal arteries causing symptoms of exertional arm fatigue and/or acute digital ischemia.
• Full return to activity generally within several months.

Axillary Artery Aneurysms and Occlusions

• Most exclusively in baseball pitchers.
• Humeral head translates forward during end-range extension and elevation, resulting in compression and stretching of the axillary artery combined with fixation against the tendon of the pectoralis minor.
• Extreme repetitive motion
• Symptoms are similar to that of subclavian artery aneurysms and include exertional arm fatigue and/or acute digital ischemia.
• Full return to activity generally within three months.

Digital Ischemia with or without Thromboembolism and Vasospasm

• Numbness, tingling, cold and painful sensations
• Cyanosis or pale discoloration and delayed capillary refill.
• Radial and ulnar pulses may be absent or decreased, and blood pressure may be diminished
• Digital artery thrombosis: due to localized repetitive trauma associated with index and/or middle finger pressure when gripping and throwing the ball.
• Digital artery thromboembolism: seen in catchers and results from chronic repetitive trauma to the base of the hand.
• Digital artery spasm: seen in baseball due to the rampant use of vasoconstrictive tobacco products.

Effort Thrombosis of the Subclavian Vein

• Paget-Schrotter syndrome: the most commonly seen vascular disorder in young competitive athletes.
• Compression of the subclavian vein between the clavicle and first rib.
• Combination of positional compression and arm exertion in elevation.
• Involves the formation of scar tissue, collateral vessels, and subsequently thrombosis
• Swelling, cyanosis, pain, heaviness and/or fatigue.
• Suspected if presenting with sudden onset of arm swelling and cyanosis, especially in overhead athletes (throwers, weightlifters, swimmers).
• Urgent surgical referral is essential for full return to activity

Related posts:

1. Optimal Shoulder Performance The new DVD & Manual by Mike Reinold and Eric...
2. The Shoulder in Sport The Shoulder in Sport: Management, rehabilitation, and prevention Andrea Fusco,...

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