Lessons from a Student: The Brain

Oh It’s On Believe it or not, I currently have someone interning with me for the next 12 weeks which is has led me to thinking about many things: 1)      People trust me with the youth of America? 2)      I have to justify what I am doing now? 3)      I hope I can teach her something. It has been a great and even nostalgic experience thus far. I remember just a couple years ago being in this young lady’s shoes having the same successes, failures, and questions she has now. I think working with me may have been quite a difference from the scholastic framework that she was accustomed to. This difference is because our common theme for the week was wait for it…………………………………….The Brain. Most schools, especially in the orthopedic realm, teach about developing physical therapy diagnoses and treating various pathologies. However, we had a couple different cases in which we didn’t necessarily nail down a pathology yet got fantastic results. Case 1 The first patient we saw was a lovely middle aged woman who was classic for the biopsychoscial treatment model I espouse. She comes into seeing us with chronic low back pain over the past 3 years, has had several TIAs, been diagnosed with an eating disorder, and generally lives a stressful life.  Our comparable sign for the day was flexion which was at 50% range and painful (or DP for you functional movement folks out there). We discuss what we think is going on and the

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Explain Pain Section 6: Management Essentials

This is a summary of section 6 of “Explain Pain” by David Butler and Lorimer Moseley. Management 101 The most important thing you can understand is that no one has the answer for all pains. Pain is entirely individualistic, hence requiring different answers. There are several strategies which one can undertake to triumph over pain. Tool 1: Education Knowing how pain works is one of the most important components to overcoming pain. Instead of no pain, no gain, the authors like to use “know pain, or no gain.” Understanding pain is essential for squashing fear of pain, which leads best toward the road to recovery. Here are some important concepts to be known about explaining pain. Anyone can understand pain physiology. Learning about pain physiology reduces pain’s threat value. Combining pain education with movement approaches will increase physical capacity, reduce pain, and improve quality of life. Tool 2: Hurt ≠ Harm It is important to understand that when someone feels pain it does not equate with damage. The same can be said with recurring pains. These pain types are often ways to prevent you from making the same mistake twice. If your brain sees similar cues that were present with a previous injury, the brain may make you experience pain as a way to check on you and make sure you are okay. Just because hurt does not mean harm does not mean you can get crazy though. Because the nervous system is trying to protect you, it will take

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Course Notes: The Elite Speed Seminar

I just finished up the Elite Speed Seminar at what has become my home away from home, Indianapolis Fitness and Sports Training. The presenters were Lee Taft and Nick Winkelman, and I learned a great deal in an area that I am weak in. Here are the notes and quotes. Multi-Directional Speed Tools That Make Change – Lee Taft Lee talked about 5 qualities to train that separate great from good athletes. Performing well under urgency, as sympathetic states change how we move. Reactivity – These are reacting to finite reactions, such as a gun going off in a sprint. Random reaction – This uses the stretch-shortening cycle more frequently by foot repositioning. Think a shortstop. Tactics – Reacting to fakes and deception. Mistake Recovery – Training to recover from worst case scenarios. Here were Lee’s recommendations for program design. Skill acquisition – The ability to control desired movements. This portion can be trained by either skill components (3-4 exercises), skill itself (1-3 exercises), or linking skills (shuffle to sprint). Force application – Performing the desired movement patterns with increased force or resistance. Random reactive training – Challenge movements under a random setting, but make sure the above 2 components are rock solid first. Here were Lee’s recommendations to progress to reactive training Acceleration → deceleration → Change of direction →One direction reaction → Multi-direction reaction. Some great cues that Lee used Stay in the tunnel. Arms long and strong. Tear the paper – Get in the athletic position, load the big toes, and try to rip

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Explain Pain Section 5: Modern Management Models

This is a summary of section 5 of “Explain Pain” by David Butler and Lorimer Moseley. So Many Clinicians There are several people who would like to help someone in pain, with each person offering a different explanation and solution for someone’s pain. Research has shown these conflicting explanations can often make things worse. The one who has the most power over pain is the person who is in pain. Here are some general guidelines for someone dealing with pain. Make sure any injury or disease which requires immediate medical attention is dealt with. All ongoing pain states require a medical examination. Make sure any prescribed help makes sense and adds to your understanding of the problem. Get all your questions answered. Avoid total dependence on any practitioner. Make sure your goals are understood by you and the clinician. The clinician’s ultimate job is to assist you in mastering your situation. Models of Engagement There are 5 interchangeable models which enable both the patient and the clinician to identify the processes underlying pain. The orchestra model – Pain is a multi-component process that manifests itself in the brain and goes through many pathways. There are many players involved in the pain experience, hence the orchestra, with the brain as the maestro. The Onion Skin Model – Helps describe all the factors that go into the pain experience; including nociception, attitudes and beliefs, suffering, pain escape behaviors, and social environment. Fear-based models – Fear of pain and reinjury are major forces

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DNS B Course Notes

Whew, I recently finished (and still trying to process) the B level DNS course from the folks at The Prague School. Instructors were Martina Jeszkova and Dr. David Jeurhing. There were a lot of things covered during this 4 day course and I definitely learned a few things. Here are the highlights. Developmental Principles The focal point of DNS is the concept of joint centration, a static and dynamic maximal joint surface approximation.  When joint surfaces achieve optimal bony congruency, the muscles surrounding the joint achieve optimal activation and highest mechanical advantage.  The reverse is also true. If muscles coactivate properly, then joint centration occurs. Conversely, if optimal joint centration is not achieved then muscle imbalances occur. The reverse is also true. This change becomes very problematic, as decentration at one joint effects centration at all the other joints. This may lead to decreased performance at best and at worst increased wear on joint surfaces. Take lower crossed syndrome (or open scissors if you are a DNS fan) for example. Let’s say we had a problem with our lower back. In order to cope with this trouble, we increase lumbar lordosis and decentrate the lumbar spine. See how it affects the surrounding structures. The pelvis anteriorly tilts, which affects length tension relationships to glutes, hamstrings, and hip flexors. Thoracic kyphosis increases as well, affecting the shoulder girdle and cervical muscles. Basically, play with one body region or joint position and see how it affects the others, and you can develop

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