Fixing Radial Nerve Pain in Weight Bearing

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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SI Joint Pain, Slideboards, and Bulging Discs – Movement Debrief Episode 31

Movement Debrief Episode 31 is in the books. Here is a copy of the video and audio for your listening pleasure. Here is the set list: How does pelvic position influence SI joint pain? Is there a difference between right and left SI joint pain? Where do slideboard variations fit into the program? When are bulging discs relevant? When is flexion vs extension warranted in treating bulging discs? When ought to neurodynamics be performed with disc bulges Who are my top R&b artists   If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 7:30pm CST. Enjoy!                    Here were the links I mentioned: Michael Shacklock Clinical Neurodynamics Book Notes Clinical Neurodynamics BJ the Chicago Kid blackbear Anderson .Paak Musiq KCi & Jojo Ginuwine Case Joe R. Kelly Enhancing Life Method Strength Andy Mccloy  Trevor LaSarre Here’s a signup for my newsletter to get nearly 3 hours and 50 pages of content, a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies:   SI Joint Pain Slideboards Bulging Discs

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Recommended Resources

I oftentimes get asked what resources I recommend. The resources listed below have been essential at putting me down the path that I am currently going, and have shaped how I practice today. The cool thing about this list? None of these are set in stone. If I find a better resource, or one of the blogs I recommend starts to resonate with me less, it leaves the list (no pressure). I want to give you guys the most up-to-date resources as humanly possible, so please check back here frequently. If you’d like articles and such that are tripping my trigger as of late, you may want to sign up for my newsletter. You’ll also get some access to almost 3 hours and 40+ pages worth of exclusive content on pain and breathing. Here are my resources: Foundational Sciences Video series Makemegenius – A youtube page dedicated to explaining scientific concepts that a kid could understand. Crashcourse – Another series of short videos explaining complex scientific topics and more in 15 minutes or less. I wish I had this in undergrad. Books Gilroy Atlas of Anatomy – Easily the best paper anatomy atlas you can find in the land. The angles drawn, the clarity of pictures, this atlas has it all. Wait until you see the subocciptals from the side. #mindblown Guyton and Hall Textbook of Medical Physiology – Easily the best and most comprehensive physiology textbook in the land, the depth at which this book dives into with concepts

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Scoliosis, Morton’s Neuroma, and Just in Time Learning – Movement Debrief Episode 22

Movement Debrief Episode 22 is in the books. Here is a copy of the video and audio for your listening pleasure. Here were all the topics: Thoughts on Treating Scoliosis Thoughts on Treating Morton’s Neuroma Why I prefer Just in time vs just in case learning If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 8:30pm CST. Enjoy.                  Here were the links I mentioned tonight Advanced Integration Day 4: Curvature of the Spine PRI Advanced Integration Ipsilateral Hip Abductor Weakness After Lateral Ankle Sprain Method Strength – Dave Rascoe Here’s a signup for my newsletter to get a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies:   Scoliosis Morton’s Neuroma Just in Time Learning

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Thoracic Outlet Syndrome, New Grad Advice, and Interview Questions – Movement Debrief Episode 21

Movement Debrief Episode 21 is in the books. Here is a copy of the video and audio for your listening pleasure. Here were all the topics: The step-by-step process of treating someone with Thoracic Outlet Syndrome How to leverage your strengths as a new grad searching for a job Why new grads need mentors My favorite questions to ask interviewers and to find out about a company If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 8:30pm CST. Enjoy.                  Here were the links I mentioned tonight How to Design a Comprehensive Rehab Program All About Jobs – Movement Debrief Episode 20 “The Briefcase Technique” by Ramit Sethi Join my mentorship program, get a movement consultation, or let me design an online fitness program for you. Here’s a signup for my newsletter to get a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies:   Thoracic Outlet Syndrome New Grad Advice Interview Questions

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Death of Vertical Tibia, Usain Bolt, Complex Patients, and More – Movement Debrief Episode 13

Movement Debrief Episode 13 yesterday involved quite a few rants. Must’ve been the ketones talking. Here’s what we talked about: Restoring sensation with my patient with low back pain Why it’s okay to have an angled tibia during squatting Would any intervention help/hurt Usain Bolt? The complexity of Usain Bolt Struggling with a complex patient Dealing with uncertainty Embracing the struggle If you want to watch these live, add me on Facebook, Instagram, or Twitter. (occasionally) They air every Wednesday at 8:30pm CST. Enjoy. Here were some of the links I mentioned in this Debrief. How to Deadlift – A Movement Deep Dive Squatting Bar Reach – A Movement Deep Dive The Sensitive Nervous System – Read my book notes here Clinical Neurodynamics- Read my book notes here A Study of Neurodynamics: The Body’s Living Alarm Mobilisation of the Neuroimmune System – Read the course notes here Explain Pain– Read the course notes here Extreme Ownership The Obstacle is the Way Ego is the Enemy The Subtle Art of Not Giving a F*ck Restoring Sensation Death of Vertical Tibia Usain Bolt Complex Patients

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Master the Fundamentals of PT, Neurodynamic Tricks, & Check Your Ego – Movement Debrief Episode 7

Episode 7 of the Movement Debrief (aka The Movement Awakens) occurred last night. I can only imagine how devastated you are that you missed it. But hey, though I think it’s way more fun live, I have a copy of the video below, where we discussed the following topics: Why fundamental PT skills are still relevant Why the basic clinical exam is incredibly important Determining if you can or cannot help your patients A simple trick to making any movement a neurodynamic test Doing what is best for the patient, not your ego or agenda If you want to watch these live, add me on Facebook or Youtube. They air every Wednesday at 8:30pm CST. Enjoy. Master the Fundamentals of PT Neurodynamic Tricks Check Your Ego

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Master Sagittal Plane, Coaching Progressions, Detaching, & TFL Inhibition – Movement Debrief Episode 5

Did you miss Movement Debrief live yesterday? Though much more fun live, I have a video of what we discussed below. This debrief was quite fun, as we had an impromptu viewer q&a. Thank you Alan Luzietti for the awesome questions! If you follow along live on Facebook or Youtube, I will do my best to answer any questions you ask. Yesterday we discussed the following topics: Why you should emphasize sagittal plane activities longer than you think How to coach exercises to maximize client learning and compliance Why detaching from your client encounters makes you a better clinician Viewer Q&A – “centering from the chaos” & TFL Inhibition Lastly, if you want the acute:chronic workload calculator I spoke about, click here. Without further ado: Master Sagittal Plane Coaching Progressions Detaching Refocusing TFL Inhibition

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The Ultimate Guide to Treating Ankle Sprains

A Humdinger No Doubt   Ankle sprains. Such a bugger to deal with.   Ankle sprains are one of the most common injuries seen in basketball. The cutting, jumping, contact, fatigue, and poor footwear certainly don’t help matters. Damn near almost every game someone tweaks an ankle. Treating ankle sprains in-game provides quite a different perspective. Rarely in the clinic do we work with someone immediately post-injury. Instead, we deal with the cumulative effects of delayed treatment: acquired impairments, altered movement strategies, and reduced fitness. The pressure is lower and the pace is slower. You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree. I had a problem. Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol. The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game. It’s a tough business. The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹.    Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective. Here’s how.

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9 weeks with Bane, I mean Zac…Oops Sorry Wrong CI

Note from Zac: This is my first guest post, and to start things up is the one and only Trevor Rappa. Trevor was my intern for the past 9 weeks and he absolutely killed it. Here is his story. It’s very exciting for me to get to write a guest post for Zac’s blog that I have read so many times and learned so much from. The experience I have had with him over these past 9 weeks has been incredible and I hope to share some of it with all of you that read this. He challenged me to think critically in every aspect of patient interaction: how I first greet them, which side of them I sit on, the words I use, and how I explain to the patient why I chose the exercises they’ll go home with. All of this was to create a non-threatening environment to help to patient achieve the best results they can. He also taught me how to educate patients with a TNE approach, incorporate other interventions such as mirror therapy into a PRI based treatment model, and deepened my understanding of the neurologic concepts behind performance. Therapeutic Neuroscience Education Perception of threat can lead to a painful experience which will cause a change in behavior. It’s the PT’s role to introduce a salient stimulus to attenuate the perception of threat in order to cause a positive change in experience and behavior (Zac and I came up with that, I really like it). Pain

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Come Hang With Me: Courses At My Clinic

Dear Readership  We are hosting several courses at my clinic this year, and we would love to have you, the readers, attend. The three courses that East Valley Spine and Sports will be hosting are all excellent courses. I have taken two of these classes prior, and the third I have taken a prior rendition of. And let me tell you, these courses are boss. Aside from us bringing some excellent content, you will also have the opportunity to hang out with a good group of people, and imbibe in some good beverages with me. Here is what we are bringing. PRI Pelvis Restoration: March 28th-29th  I took this course a little over a year ago (read the review here) and I am very excited to be learning from Lori again. She presents this very complex material in a systematic and understandable fashion. Most importantly, she’s funny! Signup for the course here. ISPI Therapeutic Neuroscience Education: Educating Patients about Pain: June 6th-7th Adriaan Louw is one of the best speakers I have heard, and the material is priceless (read my review here). This course gives several practical insights as well as easy-to-learn neuroscience education that will help you become adept and educating patients on pain. Signup for the course here. ISPI Neurodynamics: The Bodies Living Alarm: October 17th-18th  I took a version of this class when Adriaan spoke for the NOI group, and I am excited to see what tweaks have been made since. This time we are bring Louie

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Post 100: Sexifying Upper Quadrant Post-Op

I Wrote a Lot It’s interesting to think how much this blog has changed since I started writing in February 2013. We’ve gone from cliff notes of books, to cliff notes of courses, to the occasional self-musing. While I still plan on reviewing and assimilating courses I take, my hope is to expand and reflect upon whatever is in my brain a smidge more. It makes sense to start this trend with post 100. And today, postoperative care is piquing my interest.   Yes, post-op intervention is a guilty pleasure of mine. And it’s not because it’s easy. Far from easy. Post op treatment gives you a license to create under various constraints. Meaning you have to dig a little deeper to achieve desired goals. I think it can be way sexier, and effective, than your typical post-op protocol BS. So let’s create some successful post-op fun. The First Constraint Before we even talk about specific patients, we have to first look at the largest constraint yet: available tools. At my current digs, I don’t have much of anything in terms of heavyweights. So here is what I have at my disposal that I can implement: 1-on-1 care for 60 minutes Kettlebells: 10, 15, 25 pounds Therabands and theratubes of various sizes Cook bands of various resistances PRI trial orthotics (mouth splints, arch supports, reading glasses, yada) Steps Tape IPAD 3D stretch cage (aka very expensive equipment to tie therabands to) Access to higher level brain centers Heart of gold

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