Core stability and pain: Is it time to stop using the word stability to explain pain?

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Published on: December 26, 2020

Purpose: To cherry pick a few research articles to suggest that even though our knowledge of core stability is very impressive its link to pain is poor.

Nutshell summary: People in pain have spines that function differently than those not in pain.  Many treatments can influence pain.  The spine stability model of low back pain does not explain how people have pain and takes an overly mechanical view of the pain experience.  No test has ever shown that a spine is unstable or how “increasing stability” would lead to a decrease in pain.  Thinking that our spines need more stability or control may be the completely wrong path in explaining how people have pain or how our exercises help them.   Our treatment “corrections” occur not via one specific “corrective” mechanism (e.g. improving stability) but rather through global non-specific mechanisms that our better explained by our understanding of pain neuroscience.  Making the shift from believing that “stability” is the issue with pain can thus free up to choose completely different exercise programs.  Exercise and treatment prescription thus become simpler.  We have preliminary evidence to support this view with the clinical studies that show benefits with the various exercise conditioning programs that train different schools of thought on stability or the just as effective programs that completely ignore any concepts of stability.

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Какому часовому поясу соответствует время на сайте?

Categories: physiotherapy
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Published on: October 12, 2020

Improving running form course at Runner’s Connect

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Published on: August 29, 2020

I was one of the lecturers at Runner’s Connect Improving Running Form Course.  The other speakers were excellent: Irene Davis, Pete Larson, Brian Heiderscheit, Matt Phillips and Jay Dicharry.

 

You can see the course at Runner’s Connect

 

p.s. I am promoting this because I liked the course content.  I do not get a fee for this promotion.

Strength first, core last: Modifying core training for runners

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Published on: May 18, 2020

front bridge from knees

 

 

Don’t get me wrong.  I love respect the core. But you can’t open a running book, magazine or blog without hearing how important it is for runner’s to train the core.  I agree with this to some extent but for 10 years I have advocated for three points to keep in mind when it comes to runners and core training: (more…)

Ditching the Plank? Strength training is core training.

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Published on: May 18, 2020

Background

The piece was part of a companion piece on resistance and “core” training for runners.  The thrust of that piece was that general resistance training should come first before gut-blasting 5 session/week plank marathon sessions should occur.

Purpose: core exercises are rampant and extremely hyped. They are much too popular and I think many athletes not working with strength coaches focus on the core and perhaps neglect other body parts.  A not at all new thesis is that many simple core exercises can be replaced by compound exercises that have other goals (e.g. train the legs) but still require great core activation.

deadlift down

 

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Trail running clinics with duathlete Jennifer Faraone

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Published on: May 6, 2020

Elite Duathlete Jennifer Faraone is hosting two trail running clinics at Rattlesnake Point, Milton Ontario.

June 2 Trail Running for Beginners

July 7 Getting Stronger and Faster on the Trails.
Both sessions will be held at Rattlesnake Point Conservation Area (Milton) and space is limited.

Static stretching: not evil, not a panacea just a

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Published on: April 4, 2020

This brief post has two main points:

Static stretching is not going to kill your performance

and

Static stretching is not a cure-all

Further, nothing in this post is even remotely new.

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Neurodynamic Nerve Slider Pictures - helping people with pain

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Published on: March 1, 2021

Below I have created neurodynamic nerve slider pictures.  I use them in handouts for patients and now you can too!  They are strongly inspired (ahem, completely based on) David Butler’s work.

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Stu McGill Course in Toronto February 23-24

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Published on: February 18, 2021

Dr McGill is teaching a two day course on his research behind spine stability.  I have been an admirer of Stu for more than 17 years and was lucky enough to do more MSc under his supervision.

 

I consistently learn a great deal from Dr McGill and encourage anyone with even a passing interest in spine stabilty and athletic performance to see him speak or read his work

 

Course information at The msk-plus website.

 

 

 

 

Dear Julie: In defense of the crunch

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Published on: February 14, 2021

Dear Julie,

You wrote an interesting letter on your beautiful website (www.juliewiebept.com) to the coach of your girl’s gymnastic program.  You wished to

 

share with you and your staff how a decade or so of research is transforming our understanding of how we create a strong sturdy center that anchors all of our movements

As a father of two young girls (5 and 3) I really appreciated your views on healthy sports participation, concerns about body issues and the importance of fun in physical activity.  Like you I am also a physiotherapist with a special interest in spine function. I am also a chiropractor, was a spine biomechanics researcher, I completed a MSc in Spine Biomechanics with one of the authors of the references you cited (Stu McGill), I have published a few papers on trunk muscle function (here, here and here) during a variety tasks and was initially very interested in doing research on the lowly and often derided abdominal crunch (here and here).   I love talking about spine stability and how much of this actually old research (I don’t think it’s emerging, most has been around since the 90s) is applied to clinic or sport in ways that the research does not actually support.  I am also a former recreational gymastics coach and regularly “threw back tucks” after two beers at parties well into my twenties. (more…)

Quick EMG Review: Training the rotator cuff trains the scapulothoracic muscles

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Published on: February 8, 2021

I had a discussion with a Physio friend of mine about a blog he wrote championing performing scapular stability exercises before rotator cuff exercises.  Because I am bit of a picky bitch I immediately thought that while I can see the clinical rationale for it I don’t think the muscles actually do this in practice and thus we had a respectable difference of opinion.  From some old EMG reviews I knew that some of the best exercises to train the lower traps (with out upper trap activity) were actually lame old rotator cuff exercises.  A couple of  years ago I made a few graphics that illustrated this (prompted by a similar discussion on Mike Reinold’s blog).

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