Clinical Decision Making in Running Form Interventions
Initially written for Medbridge Education
The purpose of this article is to highlight the clinical decision making process during kinematic running analyses – focusing on evaluating the kinematic risk factors for running injury and not kinetics.
Both predictive and correlational research attempts to identify kinematic variables that are associated with an individual’s future or current injury. Many of those being:
Purpose: To provide a very selective review of Charlie Weingroff’s course and how it actually fits with a neurocentric view of pain and function.
Audience: Therapists and strength coaches. Patients who have trouble sleeping.
1. Jeff Cubos discusses SFMA, DNS and Lorimer Moseley and they inform his practice style
2. My and Bret Contreras’ minor critical analysis of the Joint by Joint Approach
I took 2 days out of Charlie Weingroff’s course, Training = Rehab, Rehab = Training course here in Toronto from MSK-Plus. MSK-Plus is a continuing education company run by Dr. Glen Harris. Dr. Harris has brought in a lot of great educators over the years and this course was not an exception. (more…)
Purpose: To review some of the data on ground reaction forces during running, the significance of this physical loading and how loading can be modified.
WARNING: this post is massive. It is meant as a working and evolving repository of much of the research on this topic. It is a compilation that I would like to update as more work is added. I use a post like this as a living reference library so I don’t have to search through an entire article to get the gist of it. It is not meant to win a writing award. Skip to the bottom for a summary. (more…)
Purpose: Demonstrate a case of an altered nerve tension in a runner that may be exacerbated by their running technique.
Female, late twenties, competitive runner (sub 20 minute 5km, 1:30 half marathon, 3:15 full marathon)
Audience: Therapists and Strength Coaches
Purpose: To justify the use of a variety of exercises (even general exercises) for training, rehabilitation and injury prevention and question the application of movement specificity principles.
The Gist of this Post: Specificity of training is an important component of rehabilitation and strength and conditioning but I think the application of specificity can be taken too far when we attempt to mold our posture. (more…)
Audience: Runners and therapists
Purpose: To summarize the biomechanics of running strike pattern and shod conditions
I feel like in the blogosphere and the popular running media that there is a love affair with all things barefoot. Barefoot running is associated with forefoot striking and there appears to be changes in the biomechanics associated with alteration in running form when compared with heel striking. However, the research gets presented as if it is very neat in tidy when in fact it is quite murky. This post is a work in progress. It attempts to summarize some of the work comparing barefoot running with shod running and the work that compares forefoot striking and rearfoot striking while running in shoes. I hope that I have conveyed that the results are quite conflicting. Hence, what a pain it was to try to summarize this work.
This post will be updated consistently. Please view it as a work in progress. (more…)
Pushup plus protracted
Purpose: I like the idea of quantifying the “dosage” of an exercise. We can do this with EMG and this post will be part of a larger theme that catalogues the EMG amplitude of various shoulder rehabilitation exercises. Further, it will also try to justify a number of exercises for their ability to avoid negative loading on the shoulder and promote a possibly optimal way of working the shoulder.
Caveat: This review only looks at a few papers addressing the Upper Traps (UT) to Serratus Anterior (SA) ratio. Other exercises must obviously be incorporated into a rehab program.
Exercises to maximize the Serratus Anterior (SA) to Upper Trapezius (UT) Ratio
To simplify: SA = good, UT = bad. Basically, activation of the SA moves the scapula out of the way of the humerus while too much or too early activation of the UT tends to
pushup plus retracted
anteriorly tilt the scapula and decrease the space for humeral movement. Ann Cools has done extensive work in this area. Here is a taste of her findings and recommendations. You may want to consider using the exercises when you have a little scapular dyskinesis on your hands – you may see some medial border prominence of the scap, some winging during arm elevation and the scap can get a little jiggy with arm raising and lowering. (more…)
Attached is a basic exercise protocol as part of a large physiotherapy regime I might use for someone with some lower extremity dysfunction. Many of these exercises would be used for non specific knee pain (PFPS, ITB syndrome). The nordic hamstring exercise could be skipped but should certainly be used for anyone with posterior chain weakness/dysfunction. I use that ol’ nebulous word ‘dysfunction’ when something is wrong (e.g. pain) but I’m not willing to commit to some BS therapist jargon about the cause of the problem. You could put in the same room 5 great therapists (physiotherapists, chiropractors, massage therapists, sport med docs) who could all get someone better but they would each explain the problem completely different and often contradict each other. So, I use the general word dysfunction. (more…)
Format: Patient Handouts
Topic: Trunk, hip and knee motor control exercises to improve control of knee position
This post is a handout that I give to patients. As with all exercises they should be done under some supervision (physiotherapist, personal trainer, chiropractor) and always with a health professionals guidance. In no way are these exercises stand alone. They should be tailored to each patient’s needs and progressed or modified accordingly.
Audience: Health professionals
I used to be a researcher (exercise biomechanics, physiotherapy, chiropractic) – one of my goals was to quantify how hard muscles worked during different exercises. This was important for determining which exercises may be best for targeting a certain muscle or determining how modifications to exercises (e.g. doing it barefoot or on a wobbly surface – for a simple paper look here) changed the targeted muscles response.
I used surface EMG which quantifies the electrical activity of that portion of a muscle that was under the electrodes. Surface EMG is messy and you are required to process the crap out of it to get something meaningful. (more…)