Category: Uncategorized

When Can I Run Again After an Ankle Sprain?

Ankle sprains are such a bugger and take some time to heal. But once you’ve let swelling and such run it’s course, when is it safe to run? We answer that in the video below. Here, you’ll learn my criteria and progression that I look for when having someone safely return to running. Watch and learn! Ankle sprain red flags The first thing you have to do after an ankle sprain is make sure you don’t have a fracture. There are these rules to follow called Ottawa Ankle Rules, which are a cluster of findings that would indicate getting some imaging done. These findings include: Inability to weight bear Pain within the viscinity of either malleolus If you have these findings, you most definitely need to get some imaging. Do not pass go, do not collect $200. But if you do not have these findings, move along to the next part 🙂 Returning back to running after an ankle sprain Running is merely a series of bounds (jumping from one leg to the other) for an extended period of time, so after an acute ankle sprain, we have to make sure components leading up to this go okay without any issues. To determine the course of action for this return, we can start from the most fundamental actions of the bound, then build our way up. The steps below are the progression that I use. You want to make sure that you have minimal increases in pain/swelling before moving onto

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When You Only Feel Quad During the 90-90 Hip Lift

The Lewitt postion (or 90-90 hip lift) is supposed to target hamstrings and distal glute to drive hip internal rotation all…day…every…day. But what if you feel quads only? Is that okay? Uhhh….no fam. Find out in the video/post below what is going on here and most importantly, what the heck to do about it! Why are quads contracting during the 90-90 hip lift? The quadriceps extend the knee, but there is no “pure sagittal” movement. There is a rotational action through the knee joint as you drive extension. That rotation is tibal external rotation and femoral internal rotatio. Since the lewitt position aims to increase femoral internal rotation, the quads can compensatorily contract to drive internal rotation, but attempting to do so at the distal femur. This cheat could be because you are asking the individual to posteriorly tilt the pelvis against gravity. But fam, we want internal rotation at the proximal femur, so this action is likely not going to get you a whole lotta femoral internal rotation and subsequent sacral nutation. In fact, quad activity is often paired with lumbar extension in this case. So what is one to do? I’m glad you asked!!!! Other interventions to use when you feel quads during the 90-90 hip lift Your first line of defense will be to coach the snot out of this move. Make sure they can create a pelvic tilt without engaging abs as well as keeping the lower back flat on the floor. That can help your

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Toe Touch, Big Toe Extension, and Snoring – Movement Debrief Episode 89

Movement Debrief Episode 89 is in the books. Below is a copy of the video for your viewing pleasure, and audio if you can’t stand looking at me. Here is the set list: Do I use a toe touch? What information does the toe touch tell me? Is being able to palm the floor desirable? How do I improve someone’s toe touch? How can big toe extension become limited? How does the first ray influence big toe extension? How does calcaneal position influence the big toe? How do I go about improving big toe extension? Are there any modifications to consider for hallux rigidus? What course of action should someone take who both snores and does not feel rested upon waking? What are some key hygiene measures to consider? What are key exercises to focus on? When should referral occur and who should you go to?

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Challenges of Home Exercise Execution, Do You Really Have Sagittal Plane? and PT in 25 Years

[iframe style=”border:none” src=”//html5-player.libsyn.com/embed/episode/id/5716224/height/100/width/480/thumbnail/no/render-playlist/no/theme/custom/tdest_id/568557/custom-color/#87A93A” height=”100″ width=”480″ scrolling=”no” allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen] Here’s what we talked about: What makes getting patients to do their home exercises challenging. Strategies I implement to increase adherence. How I determine when sagittal plane control is adequate. What I think PT will be like 25 years from now. Check out this episode!

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The 6-Step Method to Reading the Shit Out of Books

What Were We Talking About Again? If there is one thing I’ve struggled with over the years, it’s long-term retention. Though remembering course materials has had its challenges, the struggle is worse with books. Overconsumption was part of the problem. Trying to read faster, and across multiple unrelated books caused more detriment than use. Much as our attention spans can be overstimulated by abundant information on the internet, so to can we suffer this fate with reading? There are a lot of books after all. While narrowing my reading focus has helped quite a bit, improving my reading strategy was equally important. I remember one summer I made it my goal to learn how to shuffle cards. We played A LOT of cards on my family vacations, and I was tired of having to use the automatic shuffler or having someone else shuffle for me at the family card game. It was time to become a man, damnit! I shuffled anytime I had some free time during the day; which back when I was a kid led to multiple bouts of daily shuffling. By the end of the summer, I was unconscious with shuffling, and still am to this day. Frequent, quality repetitions at any task will likely lead to improvement. Learning material is no different, we must just foster an environment of multiple exposures to said material. Here’s my latest attempt at doing so.

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Course Notes: PRI Cervical Revolution REMIX

Note: I made some errors on the first rendition of this blog that were corrected after speaking with Eric Oetter. Courtesy to him, Lori Thomsen, and Ron Hruska for cleaning up some concepts. Four Months Later When the Lori Thomsen says to come to Cervical Revolution, you kinda have to listen. I was slightly hesitant to attend since I had taken this course back in January. I mean, it was only the 3rd course rendition. How much could have changed? Holy schnikes! It is simply amazing what four months of polishing can do. It was as though I attended a completely different course. Did I get it all figured out? No. But the clarity gained this weekend left me feeling a lot better about this very complex material. This is a course that will only continue to get better with time; if you have a chance to attend please do. Let’s now have a moment of clarity.   Biomechanics 101 The craniocervical region is the most mobile section of the vertebral column. This mobility allows regional sensorimotor receptors to provide the brain accurate information on occipital position and movement. The neck moves with particular biomechanics. Fryette’s laws suggest that the cervical spine produces ipsilateral spinal coupling in rotation and sidebending. The OA joint, on the other hand, couples contralaterally. C2 is the regulator of cervical spine motion; much like the first rib regulates rib cage movement. C2 is also important for the mandible, as it balances the cervical spine during mandibular

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Course Notes: BSMPG 2015

#Bestconferenceevaahhhhh I shipped off to Boston to attend my first ever BSMPG summer symposium. And it was easily one of the best conferences I’ve ever been to. There was an excellent speaker lineup and so much of my family. Art Horne really put on a fantastic show. If you haven’t been to BSMPG before, put it on your to-course list. It is one of the few courses that has a perfect combination of learning and socializing. I hope to not miss another. Instead of my usual this person talked about that, let’s look at some of the big pearls from the weekend.   Why Sapolsky Doesn’t Get Ulcers In one quote Robert Sapolsky summed up my current foundational premise to rehabilitation and training: “The stress response returns the body to homeostasis after actual or potential threats.” ~ Robert Sapolsky   Regardless of what your malady is, it can probably be linked back to the stress response gone awry. The specifics become irrelevant because the stress response occurs nonspecifically. This response works best against acute crises. Guess how we screw it up? Chronic stressors. Human stressors are quite different from other species’ as we have the capability of inducing this stress response psychosocially. Gazelles on the Serengeti don’t have to worry about student loans.   We can see how chronic stress becomes an issue when you look at what occurs in the stress response: Glucose travels to the bloodstream to mobilize energy. Increased cardiovascular tone, heart rate, and blood pressure. Decrease long-term building projects such as

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Course Notes: PRI Interdisciplinary Integration 2015

A Stellar Symposium Back in April I had the pleasure of finally attending PRI’s annual symposium, and what an excellent learning experience. The theme this year was working with high-powered, extension-driven individuals. The amount of interdisciplinary overlap in each presentation made for a seamless symposium. Common themes included the brain, stress response, HRV, resilience, and drive. These are things altered in individuals who are highly successful, but may come at a cost to body systems. If you work with business owners, CEOs, high-level athletes and coaches, high level positions, straight-A students, special forces, and supermoms, this symposium was for you. And let’s face it; we are both in this category! There were so many pearls in each presentation that I wish I could write, but let’s view the course a-ha’s. The Wise Words of Ron Ron Hruska gave four excellent talks at this symposium regarding high performers and occlusion. Let’s dive into the master’s mind. People, PRI does not think extension is bad. Extension is a gift that drives us to excel. Individuals who have high self-efficacy must often “over-extend” themselves. This drive often requires system extension. Extension is a consequence, and probably a necessary adaptation, of success. If this drive must be reduced to increase function and/or alter symptoms in these individuals, we have to turn down the volume knob. How can we power down these individuals? Limit alternate choices – These folks take a wide view of a task Set boundaries – These folks attribute failure to external factors Making initial

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