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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Stress Response, Proximal First, Sensation Loss, and Your Health – Movement Debrief Episode 12

Let me guess, you are devastated you missed last night’s Movement Debrief. You should be. It was by far the most interactive debrief we had yet. Loved how active everyone was, and definitely some people help me get better. Kudos to Steve, Jo, Yonnie-Pooh, and the many others who commented on today’s Debrief. Here’s what we talked about: How the stress response impacts many areas Treatment hierarchies How to restore sensation loss post-surgery Functional Medicine Why taking care of your health helps others If you want to watch these live, add me on Facebook, Instagram, or Twitter. (occasionally) They air every Wednesday at 8:30pm CST. Enjoy. Stress Response Proximal First Sensation Loss Your Health

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Lat Stretch Arm Position, Exercise Programming, and Staying Neutral? – Movement Debrief Episode 10

Episode 10 of the Movement Debrief, we went straight up q&a from readers. It was a lot of fun and I got a lot of great question from people. Here was what we discussed: Should the arm be in internal or external rotation when stretching the lats? If general exercise works, why should we incorporate specific exercises? Why coaching exercises well is of utmost importance Is staying neutral in a good joint position important? If you want to watch these live, add me on Facebook or Instagram. They air every Wednesday at 8:30pm CST. Enjoy. Lat Stretch Arm Position Exercise Programming Staying Neutral?

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How to Treat Pain with Sitting – A Case Study

Case studies are much more valuable than many give credit for. It is this type of study that can often lead to sweeping changes in how further research is conducted, often create paradigm shifts in their own right. After all, there was only one Patient H.M. One thing that I wish I saw more in case studies was the clinician’s thought process. Why did they elect to do this treatment over that, what were they thinking when they saw this? How do they tick? I was fortunate enough to have an online client of mine suggest to that I make her a case study, and it was a very rewarding experience on both fronts. My hope is that you can see how a clinician thinks first-hand, and see the challenges a clinician faces… When you can’t work with your hands.

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90/90 Hip Lift – A Movement Deep Dive

The Fundamental Rehab Technique It’s a classic that does so much more than the naked eye can see. This round of “Movement Deep Dive” focuses on the 90/90 hip lift, and some of my favorite variances off that move. I hope you have your pen and paper handy to take notes, because this video is a long one. If videos aren’t your thing, I’ve provided a modified transcript below. I would recommend both watching the video and reading the post to get the most out of the material. Learn on!

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Hamstrings and the ACL, Explaining Hip Range of Motion, & Meeting the Patient’s Needs – Movement Debrief Episode 4

If you missed me live, you can check out Episode 4 of Movement Debrief below. We hit a small technical difficulty early on, but it all ended up working out. We discuss the following concepts: Why I Emphasize Hamstrings before quadriceps after ACL reconstruction Why Hip Rotation isn’t always a reliable measure Interpreting the Ober’s Test Meeting the Patient’s Needs vs the Clinician’s Needs I apologize that the quality is not so great. I’ve moved to a rural part of Arizona, which as of right now does not allow for the best of streaming. If you friend me on facebook, however, you can watch the live stream, which has surprisingly much better quality. Click here for the post I mentioned discussing combining blood flow restriction training with E-stim. Hamstrings and the ACL Explaining Hip Range of Motion Meeting the Patient’s Needs    

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The Squatting Bar Reach: A Movement Deep Dive

Aka How I Mastered the Sagittal Plane In our first episode of “Movement Deep Dive,” we go over one of my favorite moves, the squatting bar reach. It’s an excellent technique and I hope this video explanation is helpful. If videos aren’t your thing, I’ve provided a modified transcript below. I would recommend reading and watching to get the most out of the material. Learn on!  

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Movement Debrief Episode 1: Meet the Patient at Their Story

A Live Movement Video Series Hey party people. I recently started doing some live feeds on the interwebz. You can check me out on Facebook and Youtube if you want to see me live. Otherwise, I thought I’d share with the very first episode of “Movement Debrief.” Here we dive into the following topics: The importance of reflection Using similar language to the patient. De-threatening that language Restoring sagittal plane control A case for manual therapy Enjoy!

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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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Course Notes: PRI Postural Visual Integration: The 2nd Viewing

Would You Look at That It was a little over a year ago that I took PRI vision and was blown away. A little bit after that, I went through the PRIME program to become an alternating and reciprocal warrior. I had learned so much about what they do in PRI vision that I was feeling somewhat okay with implementation. Then my friends told me about the updates they made in this course. I signed up as quickly as possibly, and am glad I did. This course has reached a near-perfect flow and the challenging material is much more digestible. Don’t expect to know the what’s and how’s of Ron and Heidi’s operation. And realistically, you probably don’t need to. Your job as a clinician is to take advantage of what the visual system can do, implement that into a movement program, and refer out as needed. This blog will try to explain the connection between these two systems. If you want more of the nitty-gritty programming, I strongly recommend reading my first round with this course. Otherwise, you might be a little lost. Let’s do it.

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Course Notes: Cantrell’s Impingement and Instability, 2015 Edition

Third Time’s a Charm  A trip home and hearing Mike Cantrell preach the good PRI word? I was sold. Impingement and Instability is one of those courses that I could take yearly and still get so many gems. In fact, I probably will end up taking it yearly—it’s that good. I took I&I last year with Cantrell (and the year before that with James), and the IFAST rendition was a completely different course. Cantrell provided the most PRI clinical applications I have seen at any course, which is why he continues to be one of my favorite people to learn from. Basically, if you haven’t learned from Mike yet, I pity you. Get to it! I have way too many gems in my notes to discuss, so here are a few big takeaways.

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Manual Therapy Musings

When I think About You… Prompted by some mentee questions and blog comments, I wondered where manual therapy fits in the rehab process. To satisfy my curiosity, I calculated how much time I spend performing manual interventions. Looking at last month’s patient numbers to acquire data, I found these numbers based on billing one patient every 45 minutes (subtracting out evals and reassessments): Nonmanual (including exercise and education) = 80% Manual = 20% Modalities = 0%!!!!!!!!!!!! Delving a bit further, here’s my time spent using PRI manual techniques versus my other manual therapy skill-set: PRI manual = 14% Other manual = 6% As you can see, I use manual therapy a ridiculously low amount; skills that I used to employ liberally with decent success There’s a reason for the shift I want my patients to independently improve at all cost and as quickly as possible. The learning process is the critical piece needed to create necessary neuroplastic change; and consequently a successful rehab program. Rarely is learning involved in manual therapy.

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