March 3, 2011

One Question, Many Answers #9

So, after missing another month, One Question Many Answers is back. Once again the goal is for me to ask all of you [them] one question and hope that I get some degree of varrying answers back.
If you could/or are attend(ing) one continuing education course in the coming year what would/will it be, and why are you attending?

Jeff Cubos BPHE MSc DC FCCSS(C) CSCS - ”I am probably the wrong one to ask as those who’ve read my blog would know that I’m a CE junkie. That said, I am a fan of learning the process rather than the methods. The why rather than the how. But to give you an idea of my continuing education for the year, I recently presented and attended the 2011 Pan Pacific Conference of Medicine & Science in Sport. This brought researchers primarily from Canada and Australia together (in Hawaii) and it was one of the better conferences I’ve attended. I am also looking forward to the Harvard Sports Medicine conference. As of late my CE has focused on Pain Science and Clinical Thinking, yet I need to return and complement this with orthopaedics.”

www.jeffcubos.com

Selena Horner, PT - I am a fan of the American Physical Therapy Association Combined Sections Meeting (CSM). I am a girl who doesn’t like to settle on one single topic for days on end and loves the variety, clinical relevance and brevity of sessions. Since I am more experienced, courses need to have true participant engagement with thinking, interacting and dialogue. This doesn’t occur on a frequent basis. I’ve learned the best aspect of CSM is the opportunity to meet other physical therapists, geekily discuss various topics and form new friendships. *Those* discussions are gold. I think I’ve come to value solid relationships and the opportunity to build them as opposed to a single goal of learning at a course.

http://twitter.com/SnippetPhysTher

John DeLucchi, SPT, CSCS - I was planning on attending APTA’s CSM but that did not work out as planned. Unless I get lucky enough to hit the lottery in the next week. I will definitely be attending Annual Conference in National Harbor, MD. I was fortunate enough to be an usher in Boston last year and it was a great learning experience not only for content but for networking. I hope to repeat that this year.Twitter;
@JDeLucchiSPT

Patrick Ward MS, CSCS, LMT - One event I’d like to attend this year is “Standing on the Shoulders of Giants” lecture series on June 3-4 put on by the Boston Sports Medicine and Performance Group (http://www.bsmpg.com/future-events/).  It has a great line up of some very influential individuals in the profession – Shirley Sahrmann, Tom Myers, Clare Frank, and Charlie Weingroff.  All four of those individuals have been very instrumental in the thought process I have developed over the years and to have the opportunity to see them all on one stage is very exciting.  Unfortunately, I don’t know that I’ll be able to make it to Boston during that weekend.  Hopefully many will attend. www.optimumsportsperformance.com

Michael T. Nelson  MS, CSCS PhD Candidate - Only one!  Dang it!  That means I have to pick from Integrated Nutritional Ecology at AF Performance in CA, Experimental Biology conference in DC, The International Society of Sports Nutrition Meeting (where you could see me present on Saturday on Metabolic Flexibility)  in Vegas,  The Strength Guild Seminar in Vegas, to the Movement’s course on Pain and Athletic Performance and local NSCA events (yep, I will be at all the events listed, so come up and say hi!).   Since I have to pick only one, I will be incredibly biased and shameless promote the Movement’s Biochemistry of Nutrition course here in Minnesota this summer.  My buddy Craig Keaton and I will be teaching the 2 day certification and it will be unlikely any other nutrition cert, ever.  Our goal is in 2 days to provide you the latest theory on how nutrition affects you and your athlete’s body AND make it extremely practical so you can hit the ground running that Monday, taught from both an academic (not boring though) and practical standpoint.   Email me if you want information since space is extremely limited and it is by invite only.  michaelTnelson AT yahoo DOT com.

Exercise Science -http://www.ExtremeHumanPerformance.com
http://twitter.com/MikeTNelson

Mark Young - Frankly, I don’t like to leave home.  I love being here with my wife and daughter.  If I do go away, I’d want it to have EXTREME value or be a vacation with my family.  With all of the webinars available these days, email, cheap long distance, and Skype I’ve found that connecting with big time fitness professionals is often as easy as making a phone call.  I save my travel dollars for relaxation.

www.markyoungtrainingsystems.com

Charlie Weingroff - I am planning to attend DNS D in September, where I am not only excited to continue to strengthen my weak grasp of DNS but also appreciate how other countries engage in health care.

www.charlieweingroff.com

Bret Contreras - I’m a big fan of the NSCA, and I’d love to attend the National Conference this year in July in Las Vegas.

www.bretcontreras.com

Mike Young - The one continuing education course I’d love to attend would be Sports Performance Enhancement Consortium at ETSU. I’ve always been a fan of Mike and Meg Stone’s work and I’ve heard great things about there research based, high-level seminar.

http://www.hpcsport.com

http://athleticlab.com

Jay Hargrove, PT, ATC - I am interested in attending a spinal manipulation course.  Not much of this was covered when I was in school, and I don’t have a lot of experience with it. I think with the clinical prediction rules and success rates, it make this knowledge an important clinical tool when trying to develop a EBP approach.

Josh Gould - I’m excited and honored to be a part of IHRSA’s National Convention and Conference mid-March in San Francisco. Along with leading a round table discussion on entrepreneurship in training I’m psyched to meet industry leaders and join various continuing education sessions. Though I haven’t decided which ones yet I’ll be including a variety from business programming to training special populations. With so many various health and fitness professionals I’ll be sure to leave humble and smarter.

www.exerciseexpertise.com

Chris Melton - ”I’d like to attend the annual American Sports Medicine Institute conference.  My business partner and I had the opportunity to attend last year in Birmingham and it was great.  Hearing speakers like Mike Reinold, George Davies, David Donatucci, and of course, Dr. James Andrews, was tremendous.”

www.therotater.com

Matthew Johnson, MS - I always try to attend the Perform Better 3-Day Summits. It is the mecca of strength and conditioning. The speakers, presentations and socials are top notch year in and year out.

www.strengthcoachconcepts.com

Brooks Tiller, DPT - FMS/ SFMA course with Gray Cook, Lee Burton, Kyle Keisel, and Brett Jones.  I know that all these guys don’t present together but no matter which one you learn from, it is a constant barrage of knowledge bombs.  I was able to attend the FMS with Gray and Lee, the SFMA with Kyle, and heard Brett speak last year.  The FMS and SFMA courses combined took less than 4 days; I have close to 80 pages of notes of knowledge from these great practitioners.  These courses have helped me to combine my therapy education with my strength knowledge to provide better service to all my patients and clients.

www.thorathletics.com

Michael Boyle - Perform Better Summit, hands down. Lots of choices, lots of stimulation. Great presenters, great participants.

www.strengthcoach.com

www.bodybyboyle.com

Mike Scott, DPT – Well, this is my blog so I can bend the rules a little. I definitely want to make my way to a SFMA course at some point this year, I think that a reason at this point would be mute. I also want to check out DNS A out in Phoenix if I can, or possible Los Angeles later in the year. I have also alway been intrigued by TPI med professionals and the knowledge these guys possess. It also helps I live in LA now and it seems like everyone golfs.

Always Evolve (especially your knowledge!),

Mike Scott, DPT

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February 3, 2011

Revisiting Plantar Fasciitis

Is this the best we can do?

What seems like a long time ago, I wrote about plantar fasciitis (PF). I think it was one of the first posts I wrote for an old blog. I have included it below so you can see what I am referring to throughout this post.  Recently though, I have been running into many more cases of PF that are seemingly not as related to the LOWER leg as I would have previously thought. I know this is because of my continuing education, and continued development as a professional, but I do not think that enough people are receiving as much information about plantar fasciitis as they should.

First, let me re-itterate some of the info from that past post.

Common symptoms:

1. Sharp, or non-specific pain in bottom or medial heel
2. Tightness/pain in the arch of your foot
3. Pain that is worse in AM and lessens during the day
4. Pain returns after sitting/standing for a long time

Common Causative Factors:

  1. Improper footwear
  2. “Flat” feet
  3. Female
  4. 40-60 years old
  5. Rapid increase in activity level, duration,and/or intensity
  6. PROLONGED SITTING

That’s right, if you compare the list below to the one I just mentioned, the new list includes prolonged sitting. I have treated maaany patient with plantar fasciitis who have proper footwear, are male, have a decent arch, and are INACTIVE. Well that doesn’t make much sense based on the list BELOW, so I say go by the one above.

Prolonged sitting usually leads to a multitude of conditions, but the two PF cares most about are weak glutes and tight hip flexors (two parts of Janda’s Lower Crossed Syndrome). But these are at the hips Mike. Well, I hope we are all becoming more aware that the body is made up of different segments, all of which influence the other parts; regional interdependece.

Like I state in the old post, PF can be caused from a tight gastroc/soleus complex. These muscles (mostly the soleus) are postural muscles (meaning they are designed to keep the body upright). When our hip flexors are tight and we stand, we go into an anterior pelvic tilt. This tilt causes an anterior weight shift. Well, well, well. Where does this leave us? Leaning forward. I want you to stand up with your feet shoulder width apart. I want you to keep your knees straight, and I want you to lean forward. Feel your toes grasp the floor, but also, feel your gastroc/soleus complex contract, attempting to keep you upright and off your face.

After sitting all day we then decide to go move. We tie on our running shoes, and hit the pavement or treadmill. However, after sitting on our asses, our glutes decide they aren’t needed to keep us upright so they turn off or don’t receive the correct motor sequencing (search: glute amnesia). So there we are, running in an anterior pelvic tilt, with a forward weight shift (most times it goes unnoticed), and we cannot propel ourselves with our glutes and we lose hip extension, all of which perpetuates the situation, and makes the gas/sol complex tug away at the plantar fascia.

Recommendations to reduce your chances of PF (some/most of these I use with my PF patient’s now):

1. Train(lift)/walk barefoot – Not only does this increase the feedback your brain gets from your foot, which increases proprioception, it strengthens the muscles of the arch, and the foot intrinsics, which are nature’s best orthotics. I did not say RUN barefoot (The jury is still out for me).

2. Perform single leg balance (barefoot of course) – Shoot for up to a minute, look in a mirror, and do not lose any height when you take a foot off the ground. You should feel your glutes going crazy!

3. Squat, deadlift, hip hinge, Glute-Hip-Raise, single leg bridge, or do something else that results in glute strengthening and reciprocal inhibition of the hip flexors. Also, stretch your gastroc/soleus/HF.

4. Get up throughout your day – Do I really need to explain this?

5. Strengthen your back. Sitting all day causes your shoulders to round forward too! This also results in a forward weight shift (see above). Seated rows, pull ups, bird-dogs, good planks, chin tucks, etc can all be mixed in.

6. Deep tissue massage – Gastroc, soleus, hip flexors (if tight), plantar fascia

7. See your physical therapist – There are many things that I have not discussed in either of these posts that a proper physical therapy evaluation can pick up on.

8. Sometimes orthotics are needed in the short term, but usually not enough to warrant getting $200 ones. Research has proven there is no difference between those exspensive ones and the cheap over-the-counter ones. Please read here. There are other studies too, sorry to those of you who make customs.

Always evolve,

Mike

Disclaimer: I used to be all about prevention, but as I have become wiser, I think the correct term that should be used below is reduction.

Now that summer is ending, it is time to start thinking about lacing up the old running or walking shoes and burning off some of those hamburgers and hot dogs. Unfortunately, with the change in seasons, we usually shift away from getting a mix of activities like beach volleyball, softball games, and wake boarding. We tend to hit the treadmill or pavement, or throw our leg over a bike and endlessly drone away while the miles pass us by. Sure, staying active is always good, but it is important to avoid injuries from doing the same activity too much. That being said, it is crucial that we “stay in the game” through injury prevention. This month I would like to share a couple pointers in the prevention of plantar fasciitis (PF), a common condition of the foot, that usually occurs with overuse or a sudden increase in activity level. It doesn’t sound catastrophic, but PF can be one of the most debilitating conditions an active person can encounter.
 
PF is a tightening of the fascia, or covering of the foot muscles, that occurs when the muscles of the calf and arch are stressed more than they are used to. The fascia begins to develop small tears with every step you take due to this tightness.
 
If you have ever experienced PF you know how unpleasant it can be, but for the fortunate ones, here is a list of symptoms:
 
1. Sharp, or non-specific pain in bottom or medial heel
2. Tightness/pain in the arch of your foot
3. Pain that is worse in AM and lessens during the day
4. Pain returns after sitting/standing for a long time
 
Roughly 10-15% of the general population will suffer from PF in their lifetime. Those of you who are active, work on your feet, are female, have flat/pronated feet, have very high arches, or are 40-60 years old are at increased risk for PF.
 
On average PF will decrease people’s activity level significantly for at least two months, possibly longer. So what can you do to prevent this debilitating condition? It is really a combination of five simple things.
 
1. After any cardio or prolonged activity on your feet, it is crucial to stretch your calf muscles (gastroc & soleus). Hold the stretches for 30 seconds and perform three to five times on each leg. Yes, it will take about 5 minutes to stretch these, but it’s worth not being out 2 months!
  
2. Actively stretch your plantar fascia by performing Weighted Dorsiflexion
  
3. Proper footwear is essential. It is recommended that you consult your local physical therapist or experienced footwear specialist for a gait analysis and guidance for proper footwear selection. General advice: Flat/pronated feet usually like “motion control” sneakers. High arched/rigid feet usually prefer a well cushioned sneaker. Ladies, when increasing your activity level, or after being on your feet all day, limit your time in high heels.
 
4. A golf ball massage. Place a golf ball under your heel or arch and apply moderate pressure through your foot. This should not be comfortable, but you should be able to withstand three to five minutes of rolling in a circular motion. This massage will break up scar tissue that may be forming.
  
5. 10% Rule. When increasing any cardio distance or intensity, it is highly recommended that you stick to only 10% increases a week. Also, only increase your distance or your intensity each week, not both.
 
If you stick to these simple tips you are greatly reducing your chances of PF. However, if you do begin to get that sharp AM pain in the heel of your foot, don’t try to run through it. Get in to see your physical therapist, because like many injuries, the sooner you address it, the shorter time you will be on the sidelines. 

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January 31, 2011

Recent Educainment: 1/31/11

It’s been a while, but I think that these 8 links will help you kill some time.

(1/31/11) Now I never have to leave home to work! Knee rehab over the internets.. thanks Al Gore http://www.medpagetoday.com/Surgery/Orthopedics/24566 *If you don’t get the Al Gore reference I apologize*

(1/30/11) If you are a movement based professional read this. Carson Boddicker talking test, treat, retest. http://boddickerperformance.com/?p=1398

(1/30/11) The Lokomat..this thing is awesome http://www.youtube.com/watch?v=-zTgLyqQ3xc&feature=player_embedded

(1/21/11) Where were my scholarship offers when I was 13. I was a promising competitive eater. http://www.cnn.com/2011/LIVING/01/20/making.of.sports.superstar/index.html?hpt=Sbin

(1/20/11) Wow! Orthotics don’t really work either!http://www.nytimes.com/2011/01/18/health/nutrition/18best.html?emc=eta1 Thank you 5 people who sent this to me!

(1/17/11) Gray Cook talks Warm ups http://graycook.com/?p=585

(1/15/11) Rapid cervical spine decelleration at second 22. http://www.youtube.com/watch?v=Ay-jgm3aOiY *This is my favorite educainment to date, and one of my favorite youtube.com videos of all time.

(1/13/11) Heavy Indian club swinging http://www.youtube.com/watch?v=tly6gGE4Xus&feature=related The best part is the young creepy kid staring near the end.

Always Evolve,

Mike

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January 26, 2011

I am: Jay Cutler’s MCL

Disclaimer #1: I did not evaluate Jay Cutler’s knee. I am not on his medical staff, and I have never had a grade 2 MCL sprain. However, I have treated athletes with this injury, but as Kory Zimney (see comments section) pointed out, I cannot in my right mind tell everyone that this is absolutely a playable injury. The following post is designed to have some fun with the situation, and maybe stir up some controversy. It is my professional opinion that before determining if any injury is playable or not, an individual recieve a full medical examination, evaluation, and assessment.

Disclaimer #2 - I am  Patriot’s fan through and through, and this post is sorta out of bitterness that my beloved Pats were not even in the ACF championship game despite beating all teams that were in each of the two games.

I am Jay Cutler’s MCL (medial collateral ligament) and I am sprained (Grade 2 says the Chicago Sun Times). I’m not even completely torn. I’m there to support Jay’s medial knee when he drops back, whether it’s a 3, 5, or 7 step drop, or hurdling himself into the endzone recklessly like he is known to do. I am always there for him and that’s why I am a little upset. I figured Jay would stand up for me and not let me take all the flack for keeping him out of the game. He did make an effort to come back after the half, but I have to wonder why they didn’t jack me up with Lidocaine and throw a medial instability brace on me and say “GO GET ‘EM!” I mean come on! A few years ago that little brat Phillip Rivers  (irony in this clip) TORE his ACL and didn’t just finish the game, he played another on it!

Now that I have the next 4-5 months off, I guess me and Jay can take it easy. Typically I take about 10-12 weeks to recover, but with nothing else except rehabilitation being my job for these next few months, I can’t expect I’ll be out of commission that long. For the first month I will be coddled and soothed with massage, ice, maybe even the dumbfounded ultrasound, all the while Jay will probably be doing press conferences. I might even get to ride a bike if I’m lucky! I guess my only other option would have been to take the next two weeks to enjoy Dallas, and all the positive attention, and Jay could have looked like a stud if he could have put together a solid comeback. But I guess my simple moaning was just too much for a man who once did this. <–*ballsy*

I am Jay Cutler’s sprained MCL, and I’m a playable injury.

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January 20, 2011

Back Pain: What (not) to do

It's amazing what you can do with paint

The following are the current thoughts (at least in my camp) on preserving your low back or reducing the chances of your low back pain getting worse. I call the post “What not to do” but there are definitely some things that you want to do in here as well.

Low back pain is the leading reason besides the common cold, and I think head aches, why people miss work. It’s also just a pain in the ass. It comes, it goes, it’s bad one day, it’s okay the next. There are tons of reasons for low back pain. That is why this post is just a list of recommendations of what you can do, and shouldn’t do, regardless of your activity level, if you want to keep a healthy back. Most of this info is taken from Stuart McGill’s book Low Back Disorders (if you are having back pain I HIGHLY suggest you man up and purchase this book. That pointless back brace you bought probably cost like 4x’s as much).

Dont’s:

Try to touch your toes in the morning – While we sleep our discs fill with water while they are unweighted leaving our spines expanded in the AM. This expansion leaves our spines vulnerable during flexion movements because they make the vertebrae more susceptible to shear forces. Simply put, if you try to touch your toes in the morning you increase the likelihood of a herniated disc significantly! Wait 2-3 hours so your spines can stabilize (lose their water) and then feel free to move as you wish (keeping in mind to avoid end range flexion and extension).

Lumbar rotation - The lumbar spine is designed to rotate 13 degrees. 13 degrees! This is like the short (hour) hand on a clock going from 12:00 to 12:30! It’s nothing. Clearly the lumbar spine is not designed to rotate. So forget about your Russian Twist exercises, or lumbar rotations (which I am guilty of prescribing in my first 3 months as a PT, but did a little reading and decided to forget about them).

Crunches, Roman chair, or superman exercises: Just don’t ever do these… period. I appreciate the business if you do! I don’t even want to show you video of them and put the ideas in your head.

Wear a back brace: So I’m not a huge fan of braces of any sort as a solution, ie motion control shoes and ankle braces, because they actually let your muscles send a message to the brain saying “Don’t worry brain, there’s someone down here helping me. I’m good to take some time off.” Over time, as these muscles atrophy, you actually get weaker! You go to pick up your kid who just scored the winning soccer goal in his U-12 travelling game and BAM! you topple to the ground in astounding back pain because your vertebrae are sitting in a pile like a demolished building now that L2-S1 have literally exploded in your back. All because of a back brace. Your body has the best braces you can imagine; they’re called muscles.

Stretch like an idiot: I love this stretch. Look at that sweet lumbar posture during the stretch. This guy recommends holding it for about a minute. Or this one. I love destroying people’s knees! I think the people at expertvillage need to change their name to idiotvillage.

Walk like there’s a stick up your ass: Just because you’re hurt, doesn’t mean you have to walk like it! McGill actually suggests walking fast, and notes that slow walking actually exacerbates pain. Also, that stooped over position is just making your paraspinals lengthen, in turn weakening them. This goes for the interspinous ligaments as well.

Do’s:

Sit with frequently changing posture - Mike, did you say that right, changing posture? That’s right, change postures frequently to prevent constant loads on certain aspects of the spine. The postures that you chose should still be “good” postures with the lumbar spine supported. Don’t sit more than 50 minutes at a time

Maintain your level of fitness: Obviously if your back is in serious pain you should take some time off, go see your PT, and decrease your pain first, but then you need to stay active, or somewhat active. Walk (discussed above) and keep your extremity muscles strong. Okay, maybe deep squats and heavy deadlifts are out of the picture for a little while. but there is plenty you can still do. Keep your core strong too!

Do core strengthening: With all the rules in mind from above, it is extremely important to stay strong in your core. All the rules above apply, but this means that you can do plenty of standing (chops and lifts), half-kneeling (same), and supine (curls ups, bridges on the ball) exercises to improve your core stability and hopefully improve the motor control of your musculoskeletal system.

See your PT: I read some study a couple months ago that regardless of the reason, back surgery is usually only 50% or less successful at reducing pre-surgical pain levels. I think that it is worth pursuing non-surgical options with those stats.

Learn to breathe: This may be the most important! If you are always holding your breathe, you are essentially wearing a back brace (see above) on the inside. Your lungs are doing all the work while the muscles are checked out. While doing exercises (except HEAVY Olympic lifts), for any body part, if you cannot take a deep breathe during your reps, it is too hard.

I hope that these recommendations come in handy the next time you are in pain, but also remember that if you take them into consideration, there is plenty of research to show that you may be reducing your risk of this debilitating condition.

Always Evolve,

Mike

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January 16, 2011

Bridging the Gap…

http://tinyurl.com/687cszh

About 4 weeks ago I had insomnia as I occasionally do. I stumbled upon a blog post by Patrick Ward of Optimum Sports Performance talking about an upcoming seminar called “Bridging the Gap”. Charlie Weingroff and Dr. Craig Liebenson were to be the presenters at the seminar. Well I literally just got home, ate a piece of turkey and cheddar and here we are.

The seminar was designed to show PTs, Chiros, and Per. Trainers that there is and should be over-lap in both our rehab approaches and in our training. This goes along with Charlie’s recent DVD Training = Rehab, Rehab = Training ( I got my copy today so consider my free time in this coming week consumed). There was a focus on truly looking at the function of muscles, but also looking at this function during MOVEMENT. There was also a big focus on CNS control (motor control) during movements and regulation and centralization of pain with movement. The key with all of these concepts was proper movement. GROOVING correct patterns, (having the patient’s brain figure out how to do it with a little coaching), whether it’s mobility or stability, leading up to larger and more functional movements. In actuality, I found that this seminar simplified things that I had been trying to organize in my head without much success.

I find it quite interesting, and fortunate, that I was actually the only physical therapist besides Charlie at this seminar of ~25 people. I found it interesting because even though I was in a gym full of other professions, we all shared the same outlook on training and rehab. There should not be these turf wars between any professions as long as good training and rehab principles are followed. We all realize that currently, the majority of training, and rehab being performed is not as sound as it can be, and in Charlie’s words, ” no matter what color glasses you wear, we are essentially seeing the same things, and the rest is just semantics.”

Unfortunately, I did find a negative with the course. The negative started to be shown as I was poorly performing the quadruped position, and subsequently poor bird-dogs. The negative of this seminar is that it pointed out how poorly I can stabilize/control my spine and scap. My ability to stabilize my lumbar spine, and scapula is poor at best.  These instabilities lead to bad performance of my deadlift, dead-bugs, squats, hip hinges, planks, and push ups. I will hopefully be getting my flip-cam soon so I can show all you guys how bad it really is. In the coming weeks I will be working on these with ferocity, maybe even stealing a page from Charlie’s book, and sharing my daily work with you guys.

Two other things to consider

  • The body doesn’t know form, it knows movement
  • If you cannot breathe while doing it, it’s too hard

Who else was there:

Charlie Weingroff

Dr. Craig Liebenson

Patrick Ward

Steven Bubel

Carson Boddicker

Once again, I was fortunate enough to spend 14 hours with these guys, learning, absorbing, and changing my abilities as  a PT. If you need to talk sports performance you need to talk to these guys.

Always evolve, I sure did this weekend,

Mike

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January 12, 2011

Recent Educainment: 1/12/11

So we made it through the holidays! Now that people seem to have about 5x as much time on their hands (including myself) I guess I’ll start scouring the internet for educational and entertaining information again. In the meantime, read/watch/listen/consume the following educainment.

(1/11/11) Yup all ones baby! Those damn power bands don’t work, haven’t worked, and will not work. Did it take science to prove this?

(1/10/11) 4 easy exercises to relieve neck/back pain at work http://tinyurl.com/4v28r4k – You know you should probably do a few of these.

(1/3/11) 22 Health Rumors here I found some of these ridiculous, as will you.

(1/2/11) http://www.anatomytrains.com/ The anatomy Trains website. Enough said.

(12/23/10) Eating fish leads to strokes? Under one obvious condition http://news.yahoo.com/s/livescience/20101223/sc_livescience/friedfishmayexplainstrokebeltmystery

(12/22/10) 3D body maps rule! http://health.yahoo.net/3dbodymaps

(12/22/10) Shaq conducts the Boston Pops www.youtube.com/watch?v=bDIe4elr724 Ever since I got his rookie card on Christmas day, and had a heart attack becaue of it, I have had a special attachment to Shaq.

(12/21/10) The healthiest man alive? Maybe he forgot about brushing his teeth http://tinyurl.com/347g5lf

Always evolve,

Mike

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January 7, 2011

Product Review: The Rotater

from www.therotater.com

So, last year I was asked by Chris Melton if I would like to try out a product of his called The Rotater . I kindly said thanks but no thanks. This was not because I was skeptical, or that I didn’t think it would work; it was actually because the clinic I was working in actually had one! I said I would try using it a little more in the clinic and see how it goes. Well I did not do this at all. I continued recommending the “sleeper stretch” for internal rotation, and the “doorway stretch” (not the best option, but definitely the simplest) for external rotation. But only on a rare occasion would I get out the rotater and have the patient perform “passive” range of motion on their shoulder.

If you’ve read up to this point and are still saying what the hell is the rotater, maybe you should click the link above or here. It is a tool used to increase the active and passive range of motion of your shoulder when the hands of a therapist or trainer are not available. It is also a strengthening tool when set up correctly, but I’ll get to this more.

For about the last 6 months of my time in Boston I did not use the rotater much. THEN I MOVED!!! Cue Phantom Planet’s “California” (the old theme music to “The OC”). I actually met a future patient at a co-worker’s spouses’ birthday where my wife convinced this patient she should make the 1.5-3 hour drive (depending on traffic) twice a week to see me (I think my wife missed her calling in sales). So there she was two weeks later once cleared by her MD; status post grade three labral tear with minimal biceps involvement.

To make a really long story short, I’ll give you the need to know. She progressed very quickly but continued to feel restricted in ER above shoulder level, and internal rotation behind her back. Well the more I stretched her the better this got. But this patient had a huge change coming in her life. When cleared for travel, she was going to start travelling all over this great country and Canada as the VP of sales for a cosmetics company. This is where the rotator comes into play. I shot an e-mail over to Chris explaining what had happened last year and saying I’d love to give the rotater another shot.

A couple days later the rotator showed up at work and bam! I put it right to work. I actually gave it to this patient to use for the next couple of weeks while she traveled all over the place. She would come into the clinic when she could, but along with her home exercise program I asked if she could use the rotater for internal and external rotation at 90 degrees, or close to it, of shoulder abduction.

Well it took about 6 weeks of use, but she got full ROM back and is now back to basic yoga and spinning with no pain, but occasional muscular tightness in her upper trap and biceps. She clearly still has some strengthening to do in her periscap and RTC along with active stabilization/proprioceptive work. But I have to say I do not think that she would have progressed this quickly without the rotater.

What I have found to date with the rotater:

Pro’s

  • Light weight
  • Compact
  • Easy to use with visual and written directions
  • One size fits all
  • Portability
  • Effective!

Con’s

  • When using the rotater’s strengthening cord, if the line of pull is not straight the rotater twists
  • The velcro strap can be uncomfortable around the wrist if not perfectly overlapping
  • If directions are not handy, set up can initially be difficult; however with moderate use, set up becomes quite easy

Other conditions I have since used the rotater for:

  • Rotator cuff tendonitis/osis
  • Biceps tendonitis
  • Adhesive capsulitis/frozen shoulder
  • Post-op rotator cuff repair

If you are a therapist or trainer and need a good tool to improve passive and active shoulder range of motion that is portable, easy to learn, and effective, I recommend the rotater. I have been in contact with Chris recently and he tells me that a more sturdy version of the rotater is in the works which would solve at least one of the “con’s” with this tool. If you have further questions feel free to contact Chris at cfmelton@therotater.com.

Always evolve,

Mike

*Disclaimer – I get no kick-backs, payment, or other reimbursements from endorsing this product. I just want my readers to be informed, and have the best available tools and knowledge to assist in a speedy recovery.

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January 2, 2011

2010 in review

The stat monkeys at WordPress.com mulled over how mikescottdpt.com did in 2010, and here’s a pretty nice summary of its overall health: Hopefully in the coming year I can spread the word a little wider so I can educate and entertain more people.

Healthy blog!

The Blog-Health-o-Meter™ reads Wow.

Crunchy numbers

Featured image

The average container ship can carry about 4,500 containers. This blog was viewed about 20,000 times in 2010. If each view were a shipping container, your blog would have filled about 4 fully loaded ships.

In 2010, there were 34 new posts, growing the total archive of this blog to 50 posts. There were 40 pictures uploaded. That’s about 3 pictures per month.

The busiest day of the year was January 25th with 499 views. The most popular post that day was One Question, Many Answers (#2).

Where did they come from?

The top referring sites in 2010 were ericcressey.com, facebook.com, bretcontreras.wordpress.com, twitter.com, and markyoungtrainingsystems.com.

Some visitors came searching, mostly for gluteus medius, million dollar bill, one million dollar bill, ankle sprain, and 1 million dollar bill. <<< I’m hoping that the million dollar bill thing drops off this list by next year.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

1

One Question, Many Answers (#2) January 2010
12 comments

2

Weston High School Career Day April 2010

3

I Am: Mike’s Deep Neck Flexors December 2009
7 comments

4

I AM: Mike’s Gluteus Medius February 2010
2 comments

5

Ankle Sprains: “When can I play?” March 2010
4 comments

I want to thank you all for making 2010 one of the best years of my life. Keep your eyes peeled for new content throughout the year!!

Always Evolve,

Mike

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December 19, 2010

This week’s Educainment 12/19/10

A nice little mix this week. I will be traveling back to Boston Friday, and will be finishing up my ACL graft post hopefully on that flight. In the meantime, enjoy this week’s educainment.

(12/19/10) The Implant Loophole (not those implants)

(12/18/10) How far can you run? http://www.foddy.net/Athletics.html A great time killer!!

(12/13/10) Team Hoyt. If this doesn’t motivate you, you don’t have a pulse. http://www.youtube.com/watch?v=1wS9NyMl_k8 It’s about time to start training for the Boston Marathon.

(12/13/10) Aesthetic foot surgery? Come on Beverly Hills, really? http://www.beverlyhillsfootsurgery.com/experience-the-aesthetic-difference/

 

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