The Rundown My good friend Erson Religioso of The Manual Therapist fame recently contacted me to do a consult for some back/leg trouble he has been having. It was a very interesting eval for many reasons. Online consults are a completely different animal, as you cannot do any hands-on testing. Moreover, when you have a therapist who is initiated into pain neuroscience, you don’t have to go so much the Explain Pain route 🙂 So with this eval, we looked at things a lot through a PRI lens, and were able to get him strategies to modulate his pain experience. The eval runs a smidge over 1 hour, so here are some vids with a quick rundown. Subjective – Getting paresthesia down the R LE that began 2 weeks ago after a car ride…has peripheralized since initial event. – Symptoms are aggravated with static sitting or standing…onset ranging from seconds to minutes. – Has tried loading/unloading MDT strategies, neurodynamics, Mulligan techniques, IASTM, compression wrapping, etc…all to no avail. Objective (major findings) – Limited B Apley’s scratch (1 per FMS scoring) – Negative slump and ASLR – Painful lumbar motions of extension, right rotation and sidebend. R sidebend was limited. – Negative thomas test on left, positive on right – Slight limitations in active seated hip IR B, R>L. – Adduction lift scores 1/5 B. My Impression If I were to classify Erson, it seems his symptoms would seems to be more dominant as peripheral nociceptive ischemic and central sensitivity (he stated he has
Read MoreTag: the
Movement Chapter 10: Understanding Corrective Strategies
This is a chapter 10 summary of the book “Movement” by Gray Cook. Mistakes, I’ve Made a Few When we are talking corrective exercise design, people often make 4 mistakes: 1) Protocol approach: Exercise based on category. Problem – 1 size fits all. 2) Basic kinesiology: Target prime movers and some stabilizers. Problem – fails on timing, motor control, stability, and movement. 3) Appearance of functional approach – Use bands and resistance during functional training. Problem – If the pattern is poor, adding challenges to it can increase compensation. There is also no pre-post testing. 4) Prehabilitation approach – Prepackaged rehab exercises into conditioning programs as preventative measures to reduce injury risk. Problem – Design is based on injuries common to particular activities as opposed to movement risk factors. There are also certain mistakes that are often made when utilizing the FMS and SFMA: 1) Converting movement dysfunction into singular anatomical problems. 2) Obsessing over perfection in each test instead of identifying the most significant limitation/asymmetry. 3) Linking corrective solutions to movement problems prematurely. The overarching rule is to address these movement deficiencies first, as we do not want to put strength or fitness on top of dysfunctional movement. The Performance Pyramid When designing an exercise program, we look for three areas to improve performance: Movement, performance, and skill. It is important that program design is based on the individual’s needs and has these qualities in a hierarchal fashion. For example, if one performs excellent on functional performance
Read More