Health and Performance Made Ridiculously Simple
Let’s navigate through compensations seen not just the ankle, but up the chain! Do you have ankle problems? Done a bunch of wall ankle stretches to no avail? Perhaps you have to look elsewhere. Namely, how ankle restrictions link up through the rest of the body. How are ankle limitations commonly seen manifested through common compensatory strategies? That’s what we dive into in today’s post. Check out Movement Debrief Episode 155 below to learn more.
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If you are having trouble sleeping, snore at night, or mouth breathe like none other, you definitely have to listen to the Nourish Balance Thrive Podcast that I was recently on. In it, we touch on A GANG of topics! Chris and I discuss the impact of mouth and face structure on breathing, sleeping, and overall health. We go through some of the causes of abnormal facial development, and the resulting problems which can include sleep disorders, crowded and crooked teeth, and worsened athletic performance. I also describe the best way to assess for breathing problems at night and offers some tips for prevention and intervention. You won’t want to miss this, check it out in the link below: Airway Dentistry: What to Do When You Don’t Breathe Right At Night Interview outline Utilizing breathing to enhance movement The Amazing Shrinking Face Tongue and Lip Ties My journey into improving my upper airway The importance of tongue space Nasal breathing and implants The MMA surgery When you should do a sleep study Pulse oximetry vs sleep study The different things measured with a sleep study Upper airway resistance syndrome vs. sleep apnea The risks of untreated sleep apnea How to measure progress with upper airway improvements Factors leading to airway problems Image by Clker-Free-Vector-Images from Pixabay
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Those pesky people who have infrasternal angles right in the middle. What do you call him? Well in this case study, we talk about some tips and tricks for pinpointing the ISA that you are dealing. We also dive into the following topics: A couple quick tests to confirm the infrasternal angle Why the xiphoid process is an unreliable reference point How to prioritize treatments for someone who is compressed in all directions with asymmetries. How shifting at different degrees of flexion changes the pelvic mechanics
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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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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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What do you do if you have someone who is a narrow infrasternal angle, stiff as all hell, with some glaring asymmetries? Check out this video below, where a colleague and I walk through a case who presents in this manner. It in, you’ll hear about the following: How to test shoulder flexion more reliably How to build someone into half kneeling Moves to utilize for this type of individual Watch the video to learn what we did!
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Many of the moves we use to improve range of motion are a little weird. What if I have a client who wants to lift them heavy-ass weights? They want to feel like they did something. How can we bridge this gap? Watch this video to learn how. Applying the movement model to fitness Don’t underestimate the power of some of these simple breathing moves. When coached well, your clients will shake and get absolutely cooked. It’s a beautiful sight. Often, the key differentiator between feeling nothing and feeling a whole lot with some of the simple breathing moves is the stack. Make sure you have the stack. But remember folks, these moves are not something we just throw into the program willy nilly. These moves are merely regressions of the common moves that we perform in the gym. The Lewitt position is a regression of your midrange depth of the squat. If we understand the different positions we need to utilize to improve various ranges of motion, we can pick common gym moves to get range of motion changes. For example, if someone has a loss of external rotation, we might choose a 2 kettlebell front squat: If I need internal rotation in the arms and legs, pushups could be MONEY: Need to rotate like a boss? Well fam, a 1 arm press could change da game!
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In order to move more, you have to be able to both create and reduce tension. But what if you have someone who is tense AF? When they move, they tighten EVERYTHING? Check this video to learn what to do. Ways to get people to move without tension Folks who are SUPER TENSE when they move often benefit from manual therapy, foam rollers, and things of that nature. Think of using these strategies as an “assisted” way to get them to move. Movement-wise, you want to get these peeps to move with as little tension as possible. These folks benefit from very slow segmental rolling strategies. In order to complete these rolls, you have to move with as little tension as possible. The lower body roll is a great starting point: But if you are feeling frisky, try the upper body roll. It…is…brutal: Even doing things where they are moving individual joints as slow and with low tension as possible. Breathing-wise, focusing on nasal breathing that is silent, easy, and effortless can be a great way to reduce tension in these individuals.
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Although external rotation and supination are paired, so too with internal rotation and pronation, sometimes you must drive pronation and external rotation. This need is especially common if you see a twist through the knee joint. In today’s post, we dive into when you have to do that. Steps for combining pronation with external rotation With these types of folks who present with hip external rotation loss and inability to pronate the foot, you have to untwist these folks. The first line of defense if you have manual skills is to perform manual therapy of the foot. I would look at restoring the following movements: Ankle dorsiflexion Calcaneal eversion First ray manipulations Cuboid manipulations If you don’t have manual skills, wedging the calcaneus laterally to drive eversion can work. You can also perform offset exercises, such as an offset wall squat, to drive rotation and further external rotation: Be mindful as you drive these motions, often people can cheat calcaneal eversion by plantarflexing the first ray even further!
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It’s UBER important to seek out counterpoints to your thoughts. Not only will this help fill any gaps in your knowledge, but it’ll also help both parties get closer to the truth. But there is a tactful way to do this and a less tactful way. We go over the tactful way in this video, and why I’m having a hard time finding detractors who truly grasp the way I approach my movement model. So if you disagree with me, hop on Office Hours, and let’s talk about it! Watch this video to learn more! A better way to criticize I’m not one to criticize peeps much on the internet, mainly because there is not much to learn for either party unless a conversation is had. And uh, fam, those social media fights we get in are NOT conversations. I’m talking good ole’ back and forth dialogue. The goal of any critical discussion should be for both parties to get closer to the truth. In order to do that, the person who it providing the critique ought to be able to steel man the other person’s point of view. What is steel manning? I’m glad you asked! Steel manning basically involves summarizing the key points of a person’s argument in teh strongest manner possible. You want to be able to understand the other person’s process so well that they say: “daumn fam I wish I would’ve said it that way.” From there, you can then poke any logical holes that
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Many times if you don’t get the result you are looking for movement-wise, it is often related to losing the stack (and not talking to Zac). How do you know where the failure occurred? That’s exactly what we sift through in this video. In it, we walk through a failed case, and look at where tweaks could be made to improve the outcome. Watch it to learn more! Looking at each component of the stack In this case of a person with shoulder pain, we look at some of the big limitations this person had: Decreased shoulder internal rotation biliaterally Decreased left shoulder external rotation Narrow infrasternal angle From here, you then need to look at each piece of the stack to determine how to design the activity with the best possible chance of success. What are those components? I’M GLAD YOU ASKED!! Here are the pieces we focus on for the stack in order of importance (though fam, you need to build it all!): Pelvic positioning Full exhale Pause and inhale with ab tension and relaxed upper thorax Reach without crunching Now based on what we need to maximize this person’s movement options, we can then engineer exercises with a high probability of increasing available movement. The keys we need to respect are restoring external rotation before internal rotation, respecting their anthropometric structure, and address asymmetry (shoulder rotation limitations indicate this person has a right rotation bias). Therefore, we can engineer activities that can create high odds for success:
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Ever get pain going down the outside of your arm when you are weight-bearing? Numbness, tingling, the whole shebang? If you notice issues that resemble this, you are likely dealing with radial nerve sensitivity. In order to make the radial nerve less sensitive, you need to increase movement, space, and bloodflow to the nerve. How do you do that? Watch this video below! Reducing strain on the radial nerve Nerves need three pieces to be healthy: Movement Space Bloodflow In order to maximize radial nerve excursion, we have to look at the maximally lengthened position of the nerve, which is as follows: Wrist flexion and ulnar deviation Forearm pronation Elbow extension Humeral internal rotation Humeral abduction Scapular depression Contralateral cervical sidebending You can check the test for this below in this video: When you take a look at these motions, do you notice a common theme of where you need to drive motion? If I want to create space around the nerve (or day I say….EXPANSION), you need to drive what? Internal Rotation And if you need internal rotation, you gotta put air where? Anterior Chest Wall So the first line of defense to maximize nerve excursion, you have to maximize anterior thorax expansion and internal rotation. If you do that, you’ll maximize space around the nerve, which can reduce sensitivity. But fam, that may not be enough! You may also have to restore the mobility of the nerve. The neurodynamics. Basically, you can start with moving the nerve along
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