Accessibility Tools

Posture & Movement Require Brain Education

Our brain controls our posture and our muscles. Therefore posture and muscle tone (i.e. how tight or relaxed a muscle is) is an expression of the brain. We must pay attention to this expression and how it relates to movement.

A frequent cause of disturbance in our movement quality, why muscles get tight, why we display poor posture, and why we may have trigger points or pain is due to insufficient muscular stabilization of our spine.

Insufficiency is our stabilization system is exactly the reason why patients and athletes who have poor body awareness demonstrate poor ability to simply relaxation. Believe it or not, relaxation is easier said than done. If the brain doesn't know how to relax fully certain muscles, the low-grade state of contraction will keep muscles and surrounding joints under constant stress. This constant stress will ultimately lead to trigger points in muscles, dysfunctional movement patterns, and altered posture.

This is why specific exercise progressions that respect the developmental aspects of posture and movement are so critical. Exercise should not only address muscle function, but it must also address brain control to change how our body functions.

"Brain Education" focuses on the efficiency of our postural and movement control to avoid overloading of specific tissues and joints while promoting muscular balance.

Movement and relaxation is a skill. It must be practice daily through purposeful exercise with complete awareness to the feeling of the movement. This is the gateway to change in the body. These changes are valuable to anyone who is simply looking to get out of pain or improve their athletic ability.

However, there are still those that challenge the notion that there is an “ideal” or “good” posture. They will have you believe that there is no such thing as “good” or “bad” posture. The reality is, when it comes down to determining what is “good” or “bad” posture can be simply summed up by saying….”It depends.”

What will dictate “good” or “bad” when it comes to form or posture will depend upon a number of variables specific to the individual. We can find efficient form and ideal posture that someone should respect and when they don’t, the result is excessive wear and tear on their joints and tissues, leading to pain and progression of degenerative changes.

Yes we need to be efficient in movement and have a vast movement capacity. Yes there is no single posture that we should maintain for an extended period of time, no matter how “good” it is.

But those notions go out the window when our body meets increasing external resistance to our movement or we are performing movement at increasing speeds.

What does that mean?

Yes, we should be able to flex our spines and perform a body weight squat with posterior pelvic tilt (aka the dreaded “butt wink”) and resultant lumbar spine flexion. Yes this would be considered normal healthy human motion. But that doesn’t mean that one should perform a loaded barbell squat with the same intent or form. This could be an injury waiting to happen. When increased load or speed of movement comes into the picture (ex. barbell squat), very specific considerations must be made to that individual on the form and posture they express during the squat pattern to maximize their muscular efficiency and minimize stress placed on the joints.

These are the same considerations that must be respected when it comes to rehab and the subsequent development of fitness/physical ability. According to McGill, this breaks down into two stages:

  • Stabilization of the injury and reduction of pain by approaches that follow desensitization and healing.
  • Development of strength and physical ability only begins when the first stage has been achieved.
In order to desensitize the patient, we must promote postures and movement that minimize stress on the joints and injured tissues. Otherwise, as stated by Mosley, most people will “wind up” their nervous system as a way to over-protect because they are aren’t prepared for what they are asking their body to do. Desensitization and reducing perceived threat is critical in the first stage of healing.

Once pain is reduced, the development of specific fitness qualities can take center stage. This is when we address the complexity of the movement system. Panjabi established the importance of the passive, active, and neural systems for trunk/core stability and movement. Jull and Richardson found in voluntary movement, activity of the deep spinal muscles precedes activations of the superficial muscles (aka feed forward mechanism).

The integrated spinal stabilization system (ISSS) serves as the “feed forward stabilization mechanism”. The ISSS consists of the diaphragm, pelvic floor, all parts of the abdominal wall, short intersegmental spinal muscles, deep neck flexors, and serratus anterior. We know that these muscles essentially form the “deep core” that is so important to train for efficiency of posture and movement.

The ISSS required “Brain Education” to work optimally. There is no way around it. We must focus our attention and efforts to ensuring that no matter the task, we must rely of the ISSS if we are going to realize our movement potential, maintain healthy posture, and minimize joint pain.

Don’t fall into the trap of believing someone who says “good” or “bad” posture doesn’t exist. Again the answer is it all depends. Posture and the considerations we make regarding it are always specific to the individual and task at hand. Posture shouldn’t handled in a general approach. Most rehab, training programs and online instruction is handled in an over-generalized fashion. When people need specific, when they need individualized considerations. And that’s the best approach when it comes to helping one learn how to educate their body in regards to what’s best for their posture and movement.

 
For more related reading:

https://gallagherperformance.com/movement-that-enhances-performance-reduces-injury/

https://gallagherperformance.com/a-movement-screen-will-never-show-movement-habits/

https://gallagherperformance.com/low_back_pain_causes_and_treatment_recommendations/

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

https://gallagherperformance.com/a-solution-to-headaches/

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

 
 
 
 
 
 
 
 

Pain Indicates A Health Problem, Not A Fitness Problem




As Gray Cook says, pain indicates a health problem not a fitness problem. In rehab, we deal with pain and dysfunction. In exercise and training, we deal with dysfunction. Pain and health problems should be managed by a licensed professional with appropriate training.

Exercising in pain is not the solution and you should seek proper guidance on how to get out of pain and correct dysfunctions before resuming your regular exercise or training program. Otherwise you may just get stuck in the perpetual pain cycle. The plan is to reduce pain, improve the tolerance to exercise through graded exposure, dose exercise and train to correct dysfunctions.
The management of pain should not be left to unqualified individuals in the exercise/fitness industry. With the rise of continuing education programs and certifications intended to help fitness professionals identify, through screening, an individual's level of training readiness.

Movement screens are generally performed to assess for mechanical sensitivity (aka pain with movement) and/or abnormal motor control (aka movement dysfunction). The screens are usually graded on a scale to reflect a score indicative of that individual's current performance.

A sample scoring system would look something like this:

0 = pain

1 = can't perform movement or has loss of greater than 50% range of motion

2 = performs movement with compensation

3 = performs movement without compensation

Screening provides valuable information and obviously it is ideal to work one towards a higher movement score.

The issue I have taken up with screening is the tendency for some fitness professionals to act as a pseudo-therapist when a client is experiencing pain. In my opinion, unless you have a professional license to work with the human body (i.e. chiropractor, physical therapist, massage therapist, medical doctor, etc.) you have no business providing 'rehab' or 'advice' to a client. The best advice you can provide is to have them seek a professional medical opinion from a trusted source.

Again pain is a health problem, not a fitness problem. Most people within the fitness industry simply have a personal training certification. Managing a client's pain is not within your scope. Pain is a referral to a medical professional. Once pain is managed properly, then exercise is reintroduced.


Got pain?

Give our office a call and let us help you get out of pain by providing you the tools to understand your pain, how to prevent it, and how to improve the way your body functions. The model at Gallagher Performance was developed to bring excellence in both pain management and exercise/fitness education.

 
For more related reading:

 
https://gallagherperformance.com/solution-long-term-improvement-back-pain/

https://gallagherperformance.com/receiving-value-treatment-training/

https://gallagherperformance.com/a-movement-screen-will-never-show-movement-habits/



The Site of Pain Is Rarely The Source of Pain

A testimonial worth sharing:

When I first visited Gallagher Performance 6 months ago, I went for a nagging discomfort around my shoulder on the right side of my back that had stuck with me for the past 7 years. Not only was this uncomfortable, but it was also a major limiting factor in my physical performance. For years on my own, I tried various types of stretches, mobility exercises, and strengthening exercises, all to no avail. Due to its chronic nature, I continued to research the potential issue, and was convinced it was fascial adhesions in that area causing the discomfort and limited mobility. From there, I went to a number of deep tissue massages from various professionals, but those only resulted in short-term relief, not the long-term fix I was looking for. I continued my journey by going to various physical therapists in the area. I would tell them I thought facial adhesions were causing this issue. They would listen, target that area with facial release methods, give me various stretches and mobility exercises, but still no results.

Finally, I found Gallagher Performance one day as I searched for a fix for my shoulder and decided to give them a shot. Since I was still convinced that fascial adhesions were my issue, I went for a deep tissue massage for my first session with Ryan. Ryan listened attentively as I told him about my symptoms and the fascial adhesions that I believed were causing my discomfort and limited mobility in that area. Once the session started, he went to work on those fascial adhesions that I so strongly believed were the culprit. But this is where Gallagher Performance separated themselves from all of the other practitioners that I visited. Even though Ryan started on the facial adhesions, through his extensive knowledge and expertise, he quickly identified that fascial adhesions were not the issue. In fact, I unknowingly had issues in other areas in my body that were the root causes of my discomfort in that area. From there, through Ryan’s genuine desire to help his clients, he introduced me to Sean in order to work through the multitude of issues that caused this chronic discomfort and limited mobility for the past 7 years. Since that first visit, I’ve continuously worked with Sean and have practically eliminated the issue that had limited me for so many years.

Ryan and Sean were the first professionals to take an honest and objective approach to my issue. Instead of allowing my unprofessional diagnosis of my issue dictate their actions and approach, they independently applied their experience and knowledge to diagnose my issue and set me on the correct path for a long-term fix. Sean’s expertise in his field, specifically his knowledge of DNS (Dynamic Neuromuscular Stabilization), gave me the tools I needed to fix the root causes of my issue. His unique knowledge of DNS was imperative to my early success, but as we continued to work together on my path to maximizing functionality and physical performance, his experience and expertise in every area physical therapy allowed him to effectively diagnosis and treat any issue that would arise. Even though my discomfort has subsided greatly, I continue to work with Sean on correcting other problem areas that are limiting the full functionality of my body that I require to perform at a high level as an ice hockey goaltender. Only when I began my work with Sean was I not only able correct a lingering issue, but was also able to (and continue to) maximize my physical performance and functionality in ways I’ve never experienced before.

In addition to my periodic visits with Sean, I have been working with Ryan on the nutrition and training side for three months now, and as with my work with Sean, experiencing results that I have never experienced in those areas. For years, I have tried various exercise and nutrition programs, but the results that I experienced (if any) were short-term. I was never able to stick to a nutrition plan for very long or have a training program that was designed specifically to my needs. Ryan met those needs by developing a nutrition and training program built on a very simple yet powerful concept – sustainability. No longer was I burning out of my nutrition program because it was to strict and unsustainable, nor was I giving up on my training program because I wasn’t seeing any progress. Through the scope of sustainability, Ryan develops programs that not only brings incredible results, but also have the ability to be adhered to for the long-term. In addition, since Ryan and Sean work closely together, Ryan is able to take the feedback from my work with Sean and adjust my nutrition and training plans accordingly. I never had success in the past using various cookie-cutter nutrition and training programs. But once I started working with Ryan, I began to see great results on a consistent basic through the plans that he developed specifically for me.

My experience with Ryan and Sean has been, and continues to be, exceptional. Not only is their knowledge and expertise high-level, but they are truly tremendous people. They genuinely want their clients to succeed and will do whatever it takes to make that happen. The level of support and professional expertise that I have received from both Sean and Ryan is unparalleled, and I can’t thank them enough for success they helped bring into my life.

I would not hesitate to recommend anyone to see Sean and Ryan. Whether you are an athlete or non-athlete, young or old, I have no doubt in my mind that Ryan and Sean will be able to provide the level of support you are looking for. Gallagher Performance is much more than just a chiropractor, a personal trainer, or a massage therapist – they offer a multitude of services that restore health, functionality, and maximize physical performance. If you are looking for a high level of expertise and support in any of these areas, I urge you to give Gallagher Performance a try. They are hand-down some of the best in the business.

-Zaid Alzaid

 
For more related reading:

https://gallagherperformance.com/dns-solves-pain-improves-performance/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

The Essentials of Hamstring Rehab

[embed]https://www.youtube.com/watch?v=oZUKOz1iuhk[/embed]

This video highlights the hamstring rehab with Carter Henderson. Carter was a standout linebacker at Duquesne University, leading the team in tackles the last two seasons. Now he is in preparation for an NFL Pro Day.

Carter came to GP for rehab of a hamstring pull 12 days out from his Pro Day. His initial 5 days focused on manual therapy, eleetromuscular stimulation (EMS), with a primary emphasis on exercise progressions based on his tolerances and weaknesses. Focus was placed on exercise specificity to the stresses the hamstrings encounter during sprinting. We aimed to match joint angles, mechanics, and dynamics as they relate to his sprint form and lateral movement.

Days 6-8 on his rehab focused on tempo runs and flying 40s, keeping intensity below 75% effort. Gradually worked into higher intensities with specificity to pro day drills. Focus still on manual therapy, joint mobilizations and manipulation when indicated.

Effective treatment for a hamstring strain, and for any injury, must address not only the site of pain but ALL possible predisposing factors. There are essentially three ‘reasons’ as to why hamstring injuries occur. Sprinting is not the problem. Focusing on each predisposing factor through progressive treatment and training will best prepare the athlete for return to sport activities.

The act of ‘pulling’ a hamstring usually occurs at high speed running during the terminal swing phase of the gait cycle. As the hip is decelerating the forceful momentum as the leg swings forward, the hamstrings are loaded and lengthening as you are finishing the swing phase before foot strike. There are predisposing factors that ultimately cause the hamstring to be compromised such as:

  1. Poor neuromuscular control of the lumbopelvic region,
  2. Asymmetries in muscle length and/or hip range of motion, and
  3. Sacroiliac joint dysfunction
All of these factors need to be and should be considered when devising a treatment and rehab protocol to ultimately reduce the risk of re-injury and improve rehabilitation outcomes.

The utilization of manipulation, massage, soft tissue techniques, and nutritional considerations to support tissue healing become the foundation of early care and recovery from hamstring injury. Everything used to facilitate healing is based on examination and identification of the presence of any predisposing factor(s).

The transition from rehabilitation to return to sport then becomes dependent upon a process that addresses proper tissue healing and exercise progressions to improve structural balance, lumbopelvic control, strength, and coordination of movement required by sport specific demands in output and movement patterns.

This essentially sums up the process behind Carter's rehabilitation program.

Carter has turned around nicely and tons of credit to him. He wasn't able to walk without pain when we first started his rehab and was able to run a 4.75 sec 40 yard sprint on his pro day at Duquesne University. He did everything right in his rehab. Carter is extremely coachable and great to work with and we wish him all the best.

 
For more related reading:

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

https://gallagherperformance.com/posture-and-movement-linking-training-and-therapy/

https://gallagherperformance.com/makes-sports-rehabilitation-chiropractor/

https://gallagherperformance.com/fascia_muscular-adhesions_how_they_relate-_to_pain_and_overuse_injuries/

https://gallagherperformance.com/best-way-recover-tendon-pain/

A Movement Screen Will Never Show Movement Habits

Movement screens or testing can offer valuable insight into why you have pain or limited function.

However what tends to be more valuable is when someone help you understand your movement habits.

By observing how someone moves and the postures they assume during daily activities - walking, bending, twisting, reaching, pushing, or pulling - we can tell you more about the chronic stresses that may be the major contributors to your current problem.



Without understanding your movement habits, we are missing a big part of the healing process or why you experience plateaus in your training/exercise program.

Once you understand movement habits the focus becomes finding what provokes your pain and discovering your weaknesses. By identifying pain triggers, we can build a plan that enables you to control your pain and improve function while your body heals.

Systems and screens for movement are a useful tool, but they tend to be general in nature. They aren't highly specific to the individual all the time. They might work, but often times you must dig deeper and be more accurate in observation, evaluation, treatment, and self-management to help someone achieve their goals.

 
For more related reading:

https://gallagherperformance.com/3-common-reasons-low-back-pain/

https://gallagherperformance.com/dynamic-duo-chiropractic-dns/

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/tendinitis-changing-treatment-and-improving-recovery/

15 Minutes of Exercise OR 8+ Hours of Pain?

Just because you are in pain or injured does not mean you are fragile. Patient advice, education, and treatment that carries an over reliance on rest, ice, immobilization, and drugs only promotes fear-avoidance behaviors in patients - leaving them feeling fragile. What they need instead is graded exposure and reactivation to physical activity through movement re-education, strength training, and re-conditioning.

Research and clinical guidelines are consistently supporting exercise as THE number one intervention for back and joint pain.

Exercise provides the best long term outcomes. Sadly most people are never introduced to proper exercise for their back/joint pain OR would rather simply mask their pain symptoms with a drug, brace, tape, or some sort of passive modality yet they wonder why their pain continues to return.

These interventions have their merit, I'm not dismissing them as useless. However, when there is an over reliance upon these interventions without a shift in focus to graded exposure to physical activity through movement and exercise - it is easy to conclude why some people fail to get out of pain.

It's one thing to change pain, it's another to change how the body functions and impact the reasons WHY you developed pain in the first place. If you don't change function, this is the reason why patients relapse often.

Exercise become our gateway to change in the body. Exercise is treated like a drug in terms of dose and response. We need to dose (i.e. how much, what kinds, how often) exercise appropriately in order to get the ideal response (i.e. reduced pain, improved function).

Proper movement and smart exercise is the best medicine so let's dish it out!

You can accomplish more than you can imagine in just 15 minutes of daily, targeted exercise that is intelligently implement to address your weaknesses and eliminate your pain generators. Or the other option is to spend the majority of your day in pain, implementing questionable interventions that will do little to solve your problem in the long term.

Exercise should be viewed as a means to improve your quality of life. A means to make every day activities easier on your body. Or a means to improve function and therefore improving endurance, strength, power, and athleticism.

If you are ready to eliminate pain, erase weaknesses, improve how your body functions, or simply get in the best shape of your life - Gallagher Performance will get you on the right track to achieve those goals.


More related reading:

https://www.gallagherperformance.com/blog/a-powerful-innovative-approach-to-improving-how-the-body-functions

https://www.gallagherperformance.com/blog/tendinopathy-changing-treatment-and-improving-recovery

https://www.gallagherperformance.com/blog/how-movement-improves-brain-function

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

Exercise Hacks Ep. 11 - Train the Abdominal Slings for a Functional Core

[embed]https://www.youtube.com/watch?v=YybcsllEkhk[/embed]

Two common sites for pain and movement problems are the low back and sacroiliac (SI) joints. The SI joints are a common site for sensitivity due to biomechanical overload.

Once we have screened for sensitivities, pain generators and movement dysfunction, the presence of SI joint dysfunction is often found along with poor abdominal sling function. Chiropractic adjustments are great for addressing joint dysfunction, but we must train movement through specific exercise.



Addressing abdominal sling function is critical as the SI joints receive stability from the force closure our musculature provides. Poor function of these abdominal slings results in poor stability (and often pain) in the SI joints during walking, running, squatting, lunging, bending, pushing or pulling.

Our abdominal slings are present on the front (anterior) and back (posterior) of our core. The anterior sling being made of the pec major, external oblique, internal oblique, and transverse abdominus. The posterior sling being made of the latissiums dorsi and opposite glute complex.

These exercises demonstrate how to strengthen the abdominal slings as a functional unit. You want to think transverse plane.

Cable chop variations are great for the anterior sling. Cable chops are excellent for building a functional anterior sling for stability and efficient force transfer, especially for front side mechanics as it relates to running, sprinting, jumping, and throwing.

The posterior sling can be targeted with Single-leg Romanian deadlift (RDL) variations as shown. Drawing tension through the lats and glutes provides the stability in the posterior sling to improve motor control of the lumbopelvic region for efficient hip extension. Clean, efficient and - at times - powerful hip extension is critical to a number of athletic movements as well as daily living.

Our hips should be the "King of Motion" in the body, yet many of us deal with tight hips and painful backs or SI joints as a consequence. Our hip movement must be trained and optimized, but the hips will only be as efficient as the abdominal slings allow.

For improved function and less pain, think outside the box when it comes to your abdominal training. Function serves a far greater purpose than aesthetics.

Give these exercises a shot. Let us know your thoughts or questions!

 
For more related reading:

https://gallagherperformance.com/beginners-guide-injury-recovery/

https://gallagherperformance.com/improved-approach-chronic-pain-management/

https://gallagherperformance.com/3-exercises-athletic-mobile-hips/

 
https://gallagherperformance.com/exercise-hacks-ep-8-breathing-bracing/

https://gallagherperformance.com/do-you-really-need-more-mobility/

 


 

3 Common Reasons for Low Back Pain

According to research conducted by Dr. Stuart McGill, "People with back pain actually have stronger backs than people without back pain, so weakness is not the culprit." In our experience in both treating and training individuals suffering from low back pain, there are three common factors that seems to play a central role:

1) Breathing Pattern - of all the factors that play a role in back pain, breathing is the one that gets dismissed the easiest or patient's are quick to write-off as irrelevant. Truth of the matter is breathing plays a HUGE role. The diaphragm is our primary muscle for respiration AND serves as a deep stabilizer to the lumbar spine. If breathing is not normalized, no other movement in the human body can be. Breathing is that critical. Learning to properly breathing and integrate proper breathing into movement must be learned or else the rest of the stabilizing system of the spine will remain dysfunctional, continuing to contribute to pain.

2) Core Stability & Endurance - in order to build a resilient spine, the core must be stable and conditioned well enough to handle the demands of either daily living, exercise, or sport. The core does require higher levels of muscular endurance which must first be established before more specific qualities of strength or power can be trained. While training for endurance or strength, it's critical that one is aware of their core as it relates to static and dynamic postures in order to maintain stability that spares the joints and discs of the low back.

3) Hip Mobility - stiffness or tightness in the hips will ultimately result in more motion and stress being placed on the low back. The hips are designed for movement and when they get tight this will cause one to bend or twist too often in the low back region. Repetitive motions such as bending and twisting are commonly associated with low back pain. Simply put, the lower back is not designed for repetitive, excessive motion. Improving hip mobility will begin with proper breathing and the learned skill of proper core stability in posture and movement (do you see the theme here?) Then from there, specialized attention must be given to the musculature of the hips and core to correct imbalances and improve overall function.

To sum up - learn to breathe properly, stabilize the core, develop mobile/athletic hips.


More related reading:

https://www.gallagherperformance.com/blog/how-dns-solves-pain-and-improves-performance

https://www.gallagherperformance.com/blog/when-should-i-see-a-chiropractor

https://www.gallagherperformance.com/blog/3-ways-breathing-impacts-health-and-movement

https://www.gallagherperformance.com/blog/3-exercises-for-athletic-mobile-hips

Exercise Hacks Ep. 7 - Core Stability for Shoulder Mobility

[embed]https://www.instagram.com/p/BeQzemWjvaa/?taken-by=gallagherperformance[/embed]

In this video we discuss a very relevant truth when it comes to the shoulder - sometimes your shoulder pain is not a shoulder problem.

The inability to properly stabilize the rib cage and pelvis as well as having adequate movement in the thoracic spine can result in problems associated with the shoulder blade or shoulder joint itself. As a general rule, reduced mobility or stability in one area of the body will result in compensations in other areas. These compensations often take the look of reduced movement quality, joint/muscle stiffness, or poor movement control.

To correct the problem you must first identify the true cause.

This video demonstrates an exercise progression that can help improve core and scapular stability as they relate to shoulder motion. The plank variation utilizes single elbow support on one arm and a slider with a reach on the opposite arm all while being performed from support on either the knees or toes.

Some tips and pointers to keep in mind during the set-up and execution of this exercise:

  • Choose a support position (knees or toes) that enable you to maintain proper posture and support without compensation during the exercise.
  • Brace the core with proper intrabdominal pressure (IAP), maintain a neutral spine and pelvis
  • Shoulders, rib cage, and hips shoulder remain parallel to each other. Think about maintaining a 'table top' position from shoulders to hips.
  • Keep the chin tucked and maintain a neutral head and neck position.
  • The only movement that occurs is from the hand/shoulder on the slider. Perform a reach straight ahead and return to the starting position with hand next to the shoulder.
  • Perform 2-3 sets of 5-8 reps per arm and switch sides. Be sure to give yourself adequate rest between sets and allow for enough recovery.
Dealing with shoulder pain? Give our office a call and set up an appointment so we can customize a rehab program tailored to you.

 
 
More related reading:

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/beginners-guide-injury-recovery/

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/solving-movement-problems-entertainment-vs-effective/

Dynamic Duo - Chiropractic and DNS

When it comes to Dynamic Neuromuscular Stabilization (DNS), those that are familiar with the method will often ask me, "How do I find the time to treat my patients with chiropractic, rehab methods, and DNS?"
The reasons for the question is simple - DNS is seen as very time consuming. The challenge with DNS is incorporating the method into a busy practice while remaining efficient and delivering a high level of quality care to your patients.

It's a difficult scenario for me to connect with since I have always maintained a schedule which enables me to spend 30-60 minutes with each patient. However, I realize this is not the norm for the overwhelming majority of chiropractors and they are under more of a time crunch to deliver the most they can in a shorter period of time. Even most physical therapists I know do not have that time to spend with a patient 1-on-1 as they normally have a number of patients blocked together for appointments and rely upon help from their assistants.

That said, the reality is until one has been properly trained in DNS, they will continue to assume that the amount of assessments, patient education, instruction, and exercise-based interventions will all add up to extra time with patients they simple don't have.

In my opinion, the time I have taken to study, learn, and implement DNS concepts into my patient care has only been a compliment to what I do as a chiropractor. Chiropractic, in a very traditional sense, is the healing art based on the science of the nervous system and it's relationship to altered spinal joint mechanics. At its very root, chiropractic aims to improve the functional of the nervous system through manual methods or manipulative therapy of the spinal joints. There is a tremendous focus on the musculoskeletal system and its relationship to the health of the nervous system. Chiropractors evaluate for postural, structural, functional, and movement-based imbalances that play a role in either pain, dysfunction, or reduced expression of overall health.

As a chiropractor, we routinely treat patients to get them out of pain, but we also work with them to restore health and a quality of life they want to maintain. And that's what makes chiropractic and DNS such an awesome combination. They both produce results that enable patients to get out of pain, improve function, restore health and get back to enjoying their life.
As a chiropractor, I use DNS assessments to identify movement patterns that are non-ideal in regard to stability and mobility. DNS is not merely a technique, but rather an overall strategy to better understand the principles of movement. It includes both a knowledge and theoretical base that forms the foundation for assessment, treatment, exercise and functional strategies.

We aren't simply just looking for joints that don't move well or muscles that are too tight or weak. The focus of DNS is correcting faulty movement patterns that ultimately cause tight or weak muscles and joint fixations. By performing basic assessments it is possible to identify what the problems are and what exercise interventions would successfully achieve the desired correction - and this can all be done quickly. This biggest misconception is that providers need to instruct their patients in a large number of exercises in order to correct dysfunction in movement stability or mobility. This couldn't be further from the truth. My patients only perform the most challenging exercises with the proper stabilization and movement control. This means that most patients are leaving with 2-3 home exercises and there are those that will leave with only one exercise.
These exercises are intend to improve the sensory messages our brain receives from movement. We can thank the modern sedentary lifestyle and simply not moving with enough variety for the decline we see in maintaining a healthy brain and nervous system. This decline presents itself in postural abnormalities and altered movement patterns And both can be addressed through exercises and improved proprioceptive control of our joints and movement.

The exercises are intended to be functionally-based and proprioceptively-rich. This enables the patient to create a lot change from just from a few exercises - training economy at it's finest. When it comes to DNS exercises, patients get a great deal of results without having to invest a lot of time.
Furthermore, chiropractic adjustments improve sensory inputs from the spine to the brain and this proprioceptive stimulus opens a window by which we can use DNS to improve our body's control of posture and movement. DNS exercises enable us to provide a regular proprioceptive stimulus that will create change in the body.
And isn't that why patients seek out chiropractors in the first place? They are coming to us hoping we will make a change in their body that not only provides relief, but also results in lasting changes they can maintain.

 
For more reading:

https://gallagherperformance.com/do-you-really-need-more-mobility/

https://gallagherperformance.com/dns-solves-pain-improves-performance/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

 
https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

Exercise Hacks Ep. 5 - Shoulder External Rotation

[embed]https://www.youtube.com/watch?v=IIIQ_DLv6kw[/embed]

In this video, we discuss shoulder external rotation commonly performed on a cable column machine. This exercise is also frequently performed with the use of bands. Regardless of whether you use the cable column or bands, these pointers will still apply.

The quality of shoulder external rotation one can achieve plays a big role in overall shoulder health and upper body strength. Shoulder external rotation is dependent upon the quality of scapular stabilization one can achieve. That said, in order to improve shoulder external rotation, we can apply a hack to reflexively improve scapular stabilization.

By placing an object such as a yoga block, small exercise ball, or folded up towel or sweatshirt between your torso and elbow, we creating a fixed point to improve scapular stabilization. In doing this, it forces pure shoulder external rotation when the movement is performed well - making it very difficult to cheat!

Some key points discussed in this video:

  • The traditional cable column external rotation can be improved to heighten scapular stabilization and the demand on the external rotators/rotator cuff of the shoulder.
  • How to create a fixed point at the elbow to improve scapular stabilization by increased activation of the serrates anterior.
  • Avoiding ulnar deviation and maintaining a neutral wrist.
  • Increased global stabilization and muscular activation by setting the feet, hips, pelvis and spine into correct posture and utilize intra-abdominal pressure (IAP).
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/exercise-hacks-ep-4-dumbbell-press/

https://gallagherperformance.com/exercise-hacks-ep-3-hand-support/

https://gallagherperformance.com/exercise-hacks-ep-2-scapular-upward-rotation/

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

Exercise Hacks Ep. 3 - Hand support

[embed]https://www.instagram.com/p/BcaN02NDlZg/?taken-by=gallagherperformance[/embed]

In this video, we discuss the proper way to create ideal hand support during exercises which require you to have contact with the ground. When it comes to creating ideal scapular stabilization during hand supported exercise, how well someone loads the hand or supports from the hand will directly impact their shoulder.

By creating a stable hand, the scapular stabilizers can work more efficiently at holding your shoulder blade in the proper position during exercise. This applies to exercises such as push-ups, plank variations, hand walks or row variations that involve support from the hands.

Poor hand loading is often a reason for poor scapular stabilization, shoulder pain and poor shoulder function. Learn to properly load the hand and make improvement.

Some key points discussed in this video:

  • What proper hand loading looks and feels like. More importantly what improper hand loading looks and feels like.
  • How to create an awareness of proper hand loading and make sure you are maintaining it during your exercises.
  • How the hand and elbow positioning will influence your shoulder positioning. This is important as the position of these joints can destabilize the shoulder if they aren't position correctly.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/finding-a-solution-to-your-shoulder-pain/

https://gallagherperformance.com/exercise-hacks-ep-2-scapular-upward-rotation/

https://gallagherperformance.com/exercise-hacks-ep-1-dumbbell-row/

 
 

The Beginner's Guide to Injury Recovery

Although we’ve worked with a broad spectrum of athletes - high school, collegiate, professional, former World’s Strongest Man, and elite triathletes - we work with just as many weekend warriors and those who simply love to be active. Whether it’s improving your running distance, increasing strength in the gym, or swinging a golf club without pain, we want to help you achieve your goals.

We also successfully treat those with overuse injuries, enabling them to return to the highly active lifestyle they enjoy.

Being active is an essential part to a healthy lifestyle. The many benefits of movement and exercise are well documented. Unfortunately, injury can become a reality for those that live an active lifestyle. When injury occurs, the effects are not only physical, but psychological as well. It is easy to become frustrated when your active lifestyle has been interrupted and concerned when you aren’t healing or turning around as quickly as you had hoped. Recovery from injury is a process that must be understood, appreciated and respected.

To help you better understand how to manage your own recovery from injury, here is a short list of items to be aware of so that you can respect the healing process and set yourself up for a timely and safe return to sport or activity.

Avoid Complete Rest

When injury occurs, it is often advocated to rest. Rest is a critical part of healing and the amount of rest one needs will be determined by the severity of the injury. Injury is a balance of load and capacity of tissues within the body. Once we exceed the capacity of a tissue (bone, ligament, muscle, tendon, disc, etc.) with a certain load, injury occurs. Rest helps restore the capacity of tissues by minimizing or removing load and thus allowing healing to occur.

As critical as rest is to the healing process, movement is equally, if not more, critical. In the absence of severe injury and conditions where movement would be contraindicated (i.e. fracture, dislocation), movement serves to facilitate healing. The majority of musculoskeletal injuries heal best when we don’t avoid activity, but rather when we modify activity. The important factor here being that one finds activities they can perform without pain and that will facilitate healing through movement. This may be as simple as walking or gentle range of motion exercises. However knowing exactly what you should do for your specific injury can be a complicated answer. This brings me to my next point.

Don’t Rely on Social Media Gurus to Solve Your Injury

When injury occurs, people want a definitive answer when it comes to what they injured and how to manage it. And there are growing numbers that are seeking this information out online without ever consulting a licensed healthcare specialist. This could be due to frustrations with the medical model, a growing consciousness to seek out “non-traditional” or “alternative” therapies, or simply wanting to avoid paying out of pocket when there is free information available online. There can be the mentality of, “Why pay someone to fix me when I can learn to fix myself?” Not that this is wrong, but please understand that there are limitations when it comes to purely trying to self-manage your injury.

Let me illustrate this point with an example of someone who may go onto an internet forum or social media page and state, “If have an L4-L5 disc bulge with sciatica, what exercises should I do to help me get out of pain?”

If you are seeking an answer out online, keep in mind the most appropriate answer you should receive is, “It depends”.

Any advice you receive from someone who hasn’t evaluated you is truly just throwing darts in the dark and hoping something sticks. Most people on the internet and social media who are offering up advice when it comes to injury rehabilitation are not licensed to do so, thus you should be skeptical. Many of these same people try to position themselves as an expert for one reason or another, but reality remains they are not a licensed professional and thus you should be skeptical. Skeptical because how can someone tell you what to do when they haven’t evaluated you – in person.

When it comes to injury rehabilitation, the evaluation process is the most critical step to ensure no time is wasted in the early phases of rehab and to minimize complications. Evaluations should consist of orthopedic and neurological testing as well as biomechanical/functional testing to evaluate for structural pathology, movement sensitivities and functional deficits.

The sharing of symptoms through some online medium is extremely limited in its value and it inherently creates bias. It will bias the feedback and direction you receive from who you are seeking advice from since all they have to operate off of is what you tell them. But when you are evaluated live, in person, by a licensed professional, bias can fall by the wayside when things are discovered that you may not feel are all that important or relevant to your present injury. Yes, history and understanding your problem is important, but it’s only a part of the puzzle.

This is because as professionals, we are trained to evaluate with our eyes and hands to assist in the diagnosis of your condition.

Seek Out Professional Evaluation and Treatment

There are numerous products and programs currently online that essentially attempt to remove the need for someone to see a licensed professional for an injury or ailment. These products or programs will draw people in as they hope to learn what they can do to fix themselves. There is nothing wrong with that, as self-management strategies are important for anyone to learn. People who are dealing with pain or injury must learn why their pain or injury developed in the first place and what they can do to help prevent it from returning.

However the limitation to these products or programs is that they are mass marketed, attempting to appeal to a large audience and, therefore, are very general in nature. They are incapable of being highly specific to the individual. These programs or products may work for some, but when someone needs more individualized solutions they need to turn to a licensed professional such as a chiropractic rehabilitation specialist or physical therapist who approaches injuries and ailments from a functional perspective, not solely based on structural pathology.

Specialists exist for a reason. When your in-home or self-management strategies fail or if you are having persistent or worsening symptoms, you should seek out professional consultation. Specialist such as sports medicine physicians, rehabilitation chiropractors and physical therapists are capable of providing solutions to pain and injury through either diagnosing your condition, devising a rehab plan, and providing treatment. Massage therapists are another specialist to consider as many ailments and injuries have soft-tissue components that respond favorably to massage therapy by reducing pain and restoring muscle function.

Recognize the Gift of Injury

The recovery from injury is as much mental as it is physical. Believe it or not, there is a gift of injury – forced discipline.

What do I mean by forced discipline?

Injury often times forces us to confront the very reasons why we got injured in the first place. The reason could be faulty mechanics, sharp increases in workout or training volume, or ignoring warning signs our brain was sending us.

Professional specialists mentioned above should assist in the process of helping you recognize the reason(s) for your injury and given you the direction needed in your recovery. But it's upon you to be disciplined and mindful during your recovery process and beyond. This new sense of discipline can apply to making better decisions when it comes to your rehab program, your posture, your movement, and the amount of stress or work you place upon your body.

Failure to do so can often lead to someone rushing his or her own recovery, returning too soon to sport or activity or frequent relapses. Be disciplined and regain control of your body.

Understand the Science of Pain

Failure to apply discipline in your recovery can also result in the feeling that your injury will never heal. The reality is all injuries heal. But long after the site of injury has healed, pain can still persist. Pain becomes a reminder to some that they aren’t healed. They will believe they are still injured.

“So if my injury is healed, then why am I still in pain?”

Pain is a message from our brain that is meant to protect us. Even though pain is meant to protect us, pain is not a reliable source of indicating the extent of an injury or even where the injury is located. The classic example here is phantom limb pain. Amputees regularly will experience this phenomenon. One may experience left leg pain, yet they do not have a left leg. If pain is purely related to damage or injury, how would one experience pain in a limb that doesn’t exist?

The reality of pain perception can be a difficult education point as this is typically a new concept for the majority of patients and one they may need some time to understand. But it’s critical as their beliefs about pain can complicate the recovery process. It’s extremely beneficial for patients to learn about pain and address fear-avoidance behaviors and other factors that will interfere with reactivation into normal movement, activities of daily living and sport.

Gradual exposure to correct movement which takes stress of tissues can help to desensitize the brain to pain signals. Movement re-education serves to reduce pain signaling in the brain. As one learns to move better, pain goes down. You need to break your pain cycle with a better movement solution. It’s that simple.

Wrapping Up

Thanks for reading. We hope this post was helpful. Please leave any comments or questions you may have. Share this post with those who you feel can benefit from understanding how to better approach recovering from injury or pain.

 
More related reading:

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/the-hidden-causes-of-sports-injury/

https://gallagherperformance.com/technique_and_performance/

https://gallagherperformance.com/nutrition-for-faster-recovery-from-injury/

https://gallagherperformance.com/improved-approach-chronic-pain-management/

https://gallagherperformance.com/effective-treatment-shoulder-pain/

 

Busting Chiropractic Myths & Misconceptions

The chiropractic profession is an interesting one to be a part of. For some, they more than accept the role chiropractic can play in not only getting them out of pain, but also elevating their overall sense of health and well-being. For others, they remain skeptical and dismissive for reasons that simply come down to myths and misconceptions that have been perpetuated for years. We can thank growing amounts of scientific evidence that has proven many common myths and misconceptions about chiropractic to be false.

In this article, we want to address some common myths and misconceptions regarding chiropractic, addressing them from an educational viewpoint. But before we get into those, it would benefical to define what chiropractic is for those of our readers who may not be familiar with the scope of the profession.

What is Chiropractic?

Chiropractic is the most commonly utilized form of complementary and alternative medicine (CAM) in the United States, focusing on the musculoskeletal and nervous systems. Doctors of Chiropractic perform examinations, diagnose conditions, and determine appropriate and safe treatment plans utilizing an effective, hands-on approach without the use of drugs or surgery. Other than traditional chiropractic adjustments or manipulative therapy, chiropractors can receive additional training in rehabilitation, sports injuries, myofasical release techniques, taping, bracing, passive modalities (i.e. electrical stimulation, ultrasound, laser therapy), as well as nutrition and implement these into patient treatment plans.

Now that we've had a brief overview of what chiropractic is, let's discuss some common myths and misconceptions.

#1 - There is no scientific evidence to support chiropractic

This is probably the number one myth or misconception that I encounter on a regular basis. The reality is, there is a massive amount of scientific research that supports the effectiveness of chiropractic and chiropractic manipulative therapy (CMT) for a number of musculoskeletal conditions.

CMT has demonstrated effectiveness in the treatment of:
  • Low back pain (1)
  • Sciatica (2)
  • Neck pain (3)
  • Headaches (Tension and Migraine) (4)
  • Shoulder pain (5)
  • Hypertension (aka high blood pressure) (6)
  • Certain neurological conditions (7)

#2 - Chiropractors only treat necks and backs

On the heels of our first myth/misconception, the effectiveness of chiropractic goes far beyond simply treating neck and back pain. Yes, randomized controlled trials support the efficacy of chiropractic treatment for common acute and chronic conditions such as headaches, neck pain and low back pain. However, with specialized training, chiropractors are also capable of treating disc injuries, sciatic pain, strain and sprain injuries, nerve pain, vertigo, TMJ, ear infections, plantar fasciitis, asthma, ADHD, whiplash, scoliosis, IT band syndrome, injuries from auto accidents, and symptoms associated with pregnancy. Common overuse conditions such rotator cuff injuries, tennis elbow, carpal tunnel syndrome, and other forms of tendonitis also respond well to chiropractic treatment.

Not all chiropractors are the same in their competency and abilities. It's important that you perform your due diligence to find a chiropractor that will be able to treat your condition effectively.

#3 - Once you start going to a chiropractor, you have to go for life

Many of heard that once you go to a chiropractor, you have to go for life. The same thing can be said of a many healthcare providers, such as regular check-ups with your MD or your dentist. Many people choose to continue getting periodic adjustments and chiropractic therapy to help them feel better. Others may decide to see us from time to time for episodes of pain or relapses in their condition.

It’s your choice.

Now while some chiropractors and their approach to patient management have given all chiropractors a bad name, the majority of chiropractors aren't looking to make you come back regularly for the rest of your life. But what they hope for is that they have a patient for life and that when someone needs to be seen, they know were they can go for trusted treatment and advice.

#4 - All you do is "crack backs", that's easy

This one is probably the most humorous to me as many will imply that what a chiropractor does is "easy". That all we do is simply "crack backs" and that is easy to do. I've had people tell me, "I can do what you do." The reality is that while yes, making a joint "crack" or "pop" is relatively easy to learn to do, the complication is finding where and how to adjust/manipulate. Palpation is the true art and skill - and it takes years to develop and fine-tune.

The chiropractic adjustment or manipulative therapy is what chiropractors are best known for, but thanks to advancements in the management of musculoskeletal conditions, chiropractors also incorporate many facets into their evaluation and treatment of patients.

Not all chiropractors will just place you in a room with heat and stim, adjust you in less than 5 minutes and send you on your way.

I can't speak for all chiropractors and why they practice the way they do. For me, I choose to incorporate a number of treatment options for the betterment of my patients and their goal-specific outcomes.

In addition to chiropractic manipulative therapy, Gallagher Performance offers:
  1. MYOFASCIAL RELEASE. Myofascial release targets adhesions that develop either within a single muscle or between adjacent muscles and other forms of connective tissue such as fascia, tendons and ligaments. Many athletes and patients experience accumulative or overuse trauma (ex: plantar fasciitis due to running or carpal tunnel syndrome due to prolonged computer/desk work). The goal becomes to work a muscle to remove adhesions and restore neuromuscular function to decrease pain while increasing range of motion, strength, and coordination of movement.
  2. FUNCTIONAL REHABILITATION. In addition to providing relief through chiropractic manipulative therapy and treating muscular adhesions, it can prove to be incredibly valuable to identify the source of a patient’s symptoms. The functional approach to rehabilitation includes identifying joint dysfunction, muscular imbalances, trigger points, and faulty movement patterns. These are often the hidden causes of injury. Observing how a patient moves and functions allows us to identify improper movement patterns that become contributors to pain and poor sport performance. By placing an emphasis on strategies to improve movement and function, functional rehabilitation is effective in improving qualities of endurance, strength, stability, balance, agility, coordination, and body awareness.
  3. DYNAMIC NEUROMUSCULAR STABILIZATION (DNS) & VOJTA THERAPY. DNS and Vojta Therapy are advanced approaches used to not only treat a variety of neuromuscular conditions but also used by athletes worldwide to elevate performance. By applying principles and techniques rooted in the study of child development, DNS and Vojta Therapy aim to improve and restore the activation ideal movement patterns. These techniques are used to promote the ideal postures, movements, and degree of body awareness that is essential not only to athleticism, but to also treating the underlying causes of several pain syndromes that are commonly treated by chiropractors and rehabilitation specialists. There are dozens of studies to support the effectiveness of DNS.
  4. NERVE FLOSSING (NEURODYNAMIC MOBILIZATIONS). Nerve flossing is a specialized diagnostic and treatment technique commonly used to diagnose and treat neural tension, which usually expresses symptoms such as muscular tightness, pain, weakness, numbness and/or tingling. Nerve flossing is proposed to help nerves and its branches slide against adjacent structures (muscles, bone, etc.), increase blood flow, oxygen and nutrient delivery, and improve the immune response. (8)
  5. THERAPEUTIC & CORRECTIVE EXERCISE. Exercise progressions and protocols are used to develop strength, range of motion, re-educate the neuromuscular system in order to address the underlying causes of dysfunction and pain.

Final Thoughts

Chiropractic care can prove to be more beneficial than many may realize or want to acknowledge. When combined with manual therapy, functional approaches to rehabilitation, and sound scientific principles of exercise prescription, chiropractors have an ability to conservatively effective treat a wide array of conditions. The evidence shared in this article only scratches the surface. There is more research than I can fit into this blog post. I encourage you to research and read if you are inclined. Become educated and informed so you can make the best decisions for you and your health.

 
More related reading:

https://gallagherperformance.com/before-you-go-to-a-chiropractor-read-this-first/

https://gallagherperformance.com/the-benefits-of-performance-therapy/

https://gallagherperformance.com/best-way-recover-tendon-pain/

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

Clinically Pressed Podcast Episode 38

[embed]https://www.youtube.com/watch?v=3oAEjdiQK1A&feature=youtu.be[/embed]

Clinically Pressed Podcast Episode 38

Had the opportunity to sit down with Joel and Kyle of Clinically Pressed and answer their questions.

Clinically Pressed is committed to sharing as much useful and applicable information as possible to their audience. Comprised of a PhD, DC and ATC, the CP podcast that seeks to make the complicated simple. CP wants to connect you with experts in their fields - all at no cost to you. They want their audience to be able to access information as easy as possible. Be sure to check them out on the web, on their social media, and support them on Patreon. Also be sure to check out their free weekly newsletter - Total Athletic Therapy.

Website: clinicallypressed.com
Facebook: Clinically Pressed
Instragram: Clinically Pressed
YouTube: Clinically Pressed
Newsletter: Total Athletic Therapy
From the Clinically Pressed website, here the notes from the show:

0:00- Episode introduction and check out Paragon Nutrition for some of the most effective and well done supplements on the market. Use code “CP15” for 15% off at check out.

1:26-CP Intro Video: Courtesy of Justin Joy of “Elder Pine Media” Contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

2:04-Welcome Sean Gallagher DC of Gallagher Performance and the connection to Palmer College.

3:38-The sports injury department at Palmer and it being one of the only in the country.

6:00-Dr. Juehring of Palmer and his clinical experience along with his athletic background make him one of the hidden gems in the industry.

Continue reading

Scoliosis Treatment for Children & Teenagers

Scoliosis.

The diagnosis can make anyone uneasy and it can become even more unnerving for parents when they hear that diagnosis for a child. Scoliosis in children between the ages of 10-18 years of age is termed adolescent scoliosis and can be due to many causes. But the most common type of scoliosis in the adolescent period is one in which the cause is unknown and is called adolescent idiopathic scoliosis (AIS). The reason why it is called idiopathic scoliosis is because there are currently no identifiable reasons as to why scoliosis develops in these children.

When we consider the current limited understanding of scoliosis in a traditional medical sense and the limitations in medically accepted treatment of AIS, it makes one wonder if there is a model of evaluation, treatment and management of scoliosis that may provide the potential for deeper understanding of the condition and reasons why it develops. Possibly bringing to light conservative treatment measures that have the ability to stop it's progression - or even reverse it.

Before we get to more detail on these discussion points, lets review what is currently known about AIS, from symptoms to treatment.

Symptoms
AIS generally does not result in pain or neurologic symptoms in children and teenagers. I can't stress this enough as often times this is the reason why the diagnosis of scoliosis can blindside many. Again, your child or teenager often times has no pain and no complaints. They seem to be perfectly healthy, active kids. This is a big reason why often times, scoliosis is either identified by primary care physicians during routine annual exams or during school exams.

While there may be no pain present and the child seems to be otherwise healthy despite curvature changes in the spine, how serious can the condition really be if it isn't that limiting?

While pain and neurologic symptoms may not be present, there can be disturbances within the nervous system on the cerebellar and sensory-motor integration level (1). Often there can be altered reflexes as identified by Janda, hypermobility, and muscular imbalances which create functional changes within the body (1). These functional changes have a direct effect on movement, thus having a direct effect on structure. In this case, the curvature of our spine (structure) is directly related to the function of our musculature and movement system.

Disturbances within our muscular/movement system can be identified by functional evaluation, however these evaluations are not typically part of the traditional medical evaluation process.

Does this lack of functional evaluation potentially leave pieces of the scoliosis puzzle unsolved? Pieces that would aid in determining the most appropriate course of treatment and management - and potentially a patient-specific reason for the development of the condition?

Evaluation & Physical Exam Findings
Classically, the physical evaluation and physical exam of a child diagnosed with AIS has a few key findings:

  • Visible signs of lateral spine curvature along with asymmetries seen in the shoulders or hips, in which one side appears higher than the other.
  • Adam's Forward Bending Test revealing either structural or nonstructural (aka functional) scoliosis. Adam's Test is consider the most sensitive test for scoliosis and the most common test used in the diagnosis of scoliosis.
  • Radiographs or x-ray indicating positive findings for scoliosis. The curves are often measured for angles of the curves to determine severity.
While the physical findings from these objective exams are valuable and necessary to consider, there remains a lack of evaluation into how one's body is functioning. Functional evaluations are extremely valuable in determining possible underlying reasons for the structural changes seen in AIS.

Some functional evaluation considerations that are made from the world of Dynamic Neuromuscular Stabilization (DNS) include:
  • Functional tests to assess movement control and coordination of the musculature surrounding the shoulders, spine, and hips.
  • The central role proper neuromuscular function plays in spinal stabilization and optimal spinal posture.
  • Sensory-motor integration and cerebellar function in the patient's ability to sense their body awareness, posture, and joint position in space.
  • Hypermobility and other present musculoskeletal compensations in response to poor function of the integrated stability stabilization system (ISSS).
The more accurate the evaluation, the more accurately treatment can be applied. Functional evaluation only compliments orthopedic and neurological evaluation. Ideally, functional evaluation such as that provided by DNS would be consider as a necessary component for it's ability to bring to light issues that more traditional orthopedic and neurologic testing are unable to identify.

Treatment
Traditional medical treatment of AIS falls into three main categories:
  1. Observation
  2. Bracing
  3. Surgery
These traditional treatment and management strategies are used in accordance with guidelines based on severity and/or progression of AIS.

But are there other treatment options? Ones that may be considered more "alternative" yet may possess the potential to yield positive results in the treatment and management of children and teens with AIS?

Often interventions such as chiropractic, physical therapy, rehabilitation, and exercise therapy can be considered by some as alternative treatments to prevent progression of AIS. However, when applied appropriately in the treatment of AIS, these "alternative" treatments can offer something that observation, bracing, or surgery cannot - truly addressing the underlying functional causes in the development of structural asymmetries.

Improving the way one moves and functions - through targeted therapeutic exercise, joint mobilizations, and/or spinal manipulation - can have huge impact on preventing the progression of AIS. Coming from the Prague School of Rehabilitation, the pioneers of DNS therapy, they not only have success in treating AIS, they even have cases of reversal. Clearly there is something we can learn from the model utilized by DNS practicioners in improving our model of scoliosis evaluation, treatment, and management.

The hope is that this article has brought to light some reasons why we should reconsider how scoliosis is evaluated and treated as well as treatment options that exist, but can be rather difficult to find.

References:
  1. Cerebellar function and hypermobility in patients with idiopathic scoliosis, Kobesova A, Drdakova L, Andel R, Kolar P. International Musculoskeletal Medicine. , 2013, 35(3): 99-105.
 
For further reading on DNS and the importance of functional evaluation, please check out the links below:

 
https://gallagherperformance.com/dynamic-neuromuscular-stabilization-advancing-therapy-performance/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

https://gallagherperformance.com/resetting-bodys-function-post-injury/

https://gallagherperformance.com/the-importance-of-functional-evaluation/

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

When Should I See A Chiropractor?

[embed]https://www.youtube.com/watch?v=1aaE3CIouTU[/embed]

In this video we discuss some important points to consider when to see chiropractor or why to see a chiropractor, especially one that has a sports injury and rehab specialization and practices in a functional movement model.

Some points to consider:

  • How important is your health to you? Health is an investment and requires a proactive approach rather than be reactive.
  • Do you want to get out in front of rather muscle tightness and joint range of motion/mobility restrictions before they get more serious or painful?
  • Most people are unsure of who to see for back pain and joint pain, even muscle tightness. They may see their PCP, but not receive the answers or solutions they were hoping for. They are looking for a provider they can trust.
  • Those that have a positive experience with a chiropractor or have one they trust, turn to them when they start to "feel off" or they feel their body is moving as it normally does or they start to feel pain.
  • Ideally, chiropractors who have a specialization in functional rehab, sports injury, and movement are the experts you should see for the most musculoskeletal conditions that we commonly deal with.
  • When, or if, you see a chiropractor is ultimately your choice and one that can prove to be beneficial and a worth while investment.
 
More related reading:

https://gallagherperformance.com/the-importance-of-functional-evaluation/

https://gallagherperformance.com/low_back_pain_treatments_that_just_wont_help/

https://gallagherperformance.com/solving-pain-influence-czech-rehabilitation-techniques/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/effective-treatment-shoulder-pain/

https://gallagherperformance.com/solving-movement-problems-entertainment-vs-effective/

How DNS Solves Pain and Improves Performance

[embed]https://www.youtube.com/watch?v=E-6qQsMxUkQ[/embed]

Short video on the principles of dynamic neuromuscular stabilization (DNS) and the role it plays in our office with chiropractic patients, rehabilitation and in our personal and sports performance training program design.

In this video you will learn:

  1. What DNS is and why it's importance for getting someone out of pain and improving performance
    • How we develop our ability to move after birth and important stages of development (i.e. support, rolling, crawling, uprighting, walking)
    • Why these stages of development are relevant in a number of populations who are dealing with chronic pain
  2. How our ability to move properly is lost
    • The importance of proper breathing patterns
    • The power DNS has to "reset" our body's ability to function properly
    • How DNS is used to coach and/or cue our patients or clients to enable them to have improved body awareness and why improved body awareness is associated with less pain and improved athleticism
  3. The role DNS plays in finding the source of pain
    • The site of pain and the source of pain is often times a different story
    • Why rehab or treatment shouldn't always be directed at the areas where you feel pain
    • Why other areas of your body - that seem unrelated to your pain - should be evaluated
  4. How DNS relates to Pain or Performance
    • DNS and it's ability to answer the question "why" your pain developed
    • DNS and it's ability to provide solutions to eliminate pain and improving function in the body to prevent recurrences
 
More related reading:

 
https://gallagherperformance.com/tendinitis-changing-treatment-and-improving-recovery/

https://gallagherperformance.com/powerful-innovative-approach-improving-body-functions/

https://gallagherperformance.com/chiropractic-rehab-dns-treatment/

 

Four Years at Gallagher Performance

April 2017 marks four years since Gallagher Performance opened and with another anniversary passing, I thought it was time to start reflecting back on our fourth year in business.

All our services from chiropractic to massage to personal training to sports performance training continue to experience steady, consistent growth since we first opened. Growth that led us into our own facility in December 2016. The move has been a very positive and necessary one for our continual business development.

On January 2, 2017, Gallagher Performance opened in our new location. After long hours and lots of work we ended up looking like this:



The new facility has enabled us to widen our reach, both within the community and online. Being a community resource is tremendously important to us. We are now able to hold classes, lectures and have been asked to speak to area sports teams and organizations. We are also now able to provide more educational videos on our social media and YouTube channels.

Even with the transition to a new facility, we remain loyal to providing quality of service over quantity. Gallagher Performance is about individualized attention in all our services. This is why our chiropractic and rehab patients are with their doctor every minute of every office visit. This is why Gallagher Performance isn't a gym; it's a training facility. We don't offer an open gym membership, but rather different levels of training services to meet the needs of our clients and athletes. The reason why we set it up this way is because we want people to experience how supervised training by qualified professionals yields amazing results. And our clients are achieving remarkable results in private and semi-private settings that enable individual considerations to be made appropriately.

In regards to our services, it has been another great year. GP’s chiropractic and rehab therapy was recognized as one of the best in the Pittsburgh area for a third consecutive year. The results we achieve through our chiropractic, manual therapy and functional rehabilitation have helped people get out of pain and return to the activities they enjoy. There have been literally dozens of patients who have come to us after a doctor has told them they needed surgery, but we’ve helped them avoid these procedures. We've helped them understand the importance of not only getting out of pain, but why changing the function of their body is the key to a successful outcome and long-term recovery.

Our personal and performance training services continue to generate tremendous results for our clients and athletes. The results keep our clients loyal and the referrals coming in. We have truly cared about delivering quality in all services since we opened. It’s a great feeling to see how much our clients appreciate the attention, know-how, and confidence they receive while working with us. When you focus on quality of service and improving the consumer experience, only good things can happen.

During our four years, we have seen tremendous growth in our distance/online training services as we have gone international. Now while we are growing and our reach may not be that impressive by some industry standards, it is humbling to see how our distance services are being sought after by people beyond the state of Pennsylvania. We have seen the reach grow to 12 states (AZ, CT, GA, IA, IL, MT, NJ, NY, NC, OH, TX, WI), into Canada (Alberta, Ontario), and into Portugal, Italy, and Japan.



The reason for our growth isn't a big marketing budget. Rather, we work hard to set up everyone we work with for success in any way possible – trusting that those efforts will lead to referrals and retention. At Gallagher Performance, we don’t try to just “factory line” our clients/athletes through the same program with a "cookie cutter" approach. This is because we understand training and rehabilitation is a very individual experience and everyone we work with needs very individual considerations made for them. That's what it takes to produce lasting, meaningful results.

Our sports performance training services continue to be utilized by a variety of athletes from a growing list of amateur/club organizations, high schools, and colleges. In addition, GP continues to direct the Strength & Conditioning program for the Franklin Regional Hockey Club as we move into our fourth year.

During the past year, we've seen new names join of list of athletes who have reached the collegiate level. This is tremendous accomplishment on their behalf and we are privileged to work with such determined and hard working athletes. Here's the list we have worked with, from sports performance to chiropractic and rehabilitation, and where they are coming from:

Collegiate Athletes

  • Wes Ashley, University of Wisconsin - Stevens Point (NCAA DIII) - Hockey
  • Andrew Brncic, Alderson Broaddus University (NCAA DII) - Football
  • Colin Childs, California University of Pennsylvania (NCAA DII) - Football
  • Ben Dipko, Slippery Rock University (NCAA DII) - Football
  • Noah Dipko, Indiana University of Pennsylvania (NCAA DII) - Football
  • Justin Gismondi, Robert Morris University (ACHA DI) - Hockey
  • Ryan Grieco, Seton Hill University (NCAA DII) - Baseball
  • Carter Henderson, Duquesne University (NCAA DI) - Football
  • Evan James, Penn State University Greater Allegheny (NCAA III) - Baseball
  • Colin Jonov, Bucknell University (NCAA DI) - Football
  • Katie Kimmich, Seton Hill University (NCAA DII) - Soccer
  • Dante Luther, Washington & Jefferson University (NCAA DII) - Football
  • Jake Roberge, Northwestern University (NCAA DI) - Soccer
  • Mike Roberge, Northwestern University (NCAA DI) - Soccer
  • Charan Singh, University of Massachusetts (NCAA DI) – Football
  • Todd Summers, Villinova University (NCAA DI) - Football
  • Ryan Watson, Lake Erie College (NCAA DII) - Soccer
  • Christian Wilson, Mount St. Mary’s (NCAA DI) - Track & Field
We could continue on about each of these individual athletes and the people we have had the pleasure of working with during our short time in business, but suffice it to say that we are very proud of each of each person we work with and what they’ve accomplished.

The same goes for our general fitness and weight loss clients. The fat loss and strength gains they experience are awesome and measurable. They consistently prove to be hard working and determined, month after month. But beyond that, we love knowing that they’re training pain-free and will be able to reap the benefits of regular exercise for a long time.

Another Year in the Books
In wrapping up, we acknowledge that Gallagher Performance would not be what it is without the consistent support we receive. A sincere thank you goes out to all you – clients/athletes, parents, family, friends, and professional colleagues – for your continual support over the past four years. Special thanks to our marketing firm, 4C Technologies, for their continual support and expertise. Without you all, Gallagher Performance would not be what it is today, and we look forward to many more years to come.

Resetting the Body's Function Post-Injury

"After an injury tissues heal, but muscles learn. They readily develop habits of guarding that outlast the injury" - Janet Travell, MD
Guarding after an injury is normal and it is to be expected. However, when left unidentified and untreated, guarding or protective patterns can become common reasons for chronicity and why someone "hasn't got better". This is why we must go beyond structural injury and think function in treatment rehabilitation.

From the functional viewpoint, we must evaluate for these guarding patterns that patients readily default to due to injury/pain. Identifying and treating these guarding patterns appropriately will often times enable patients to feel better almost immediately.

While yes it is important to evaluate for structural injury (fracture, dislocation, ligament sprains, tendinopathies, disc herniations, etc.) and manage them accordingly, the reality is these tissues will heal in time. However, after these injuries heal, there can be presentations within the body that create complications in achieving full recovery or become reasons for relapse.

Often times patients will complain about tight calves and hamstrings after spraining an ankle or tightness in their low back and hips after a disc rupture. Or they may have developed pain and/or sensitivities in other areas of their body seemingly unrelated to their initial site of injury.

The ankle ligaments will heal. The disc will heal. But the body will guard and protect and this becomes programmed within the nervous system. This is exactly what we need to treat for patients to get better and this new reality becomes very liberating for patients.

When patients come to understand that their injury has healed, but it's their brain and muscles that must re-learn how to work as they did before the injury, they become less fearful and more confident in a positive outcome. Essentially, they come to understand that we must reset their body so their neuromuscular function returns to pre-injury status.

To reset the right things in the body, we must assess and analyze the problem then utilize corrective measures in treatment and/or training. This system helps us develop efficiency in treatment and enables us to expect results.

What type of corrective measures? The gold standard becomes manual therapy and therapeutic exercise. When combined, these serve to get patients out of pain and improve the function in their body.

Yes these results can often times be rather immediate, however in some cases recovery can test a patient's patience as the process may be slower than they aniticipated.

When progress is slow, it is important to remember the following:
  1. Therapeutic exercise is the most evidence-based treatment.
  2. Passive treatments (tape, modalities,etc.) may offer temporary relief but are not helpful in medium and long term recovery.
  3. Injections and surgery have been not shown any greater effectiveness in outcomes than exercise.
  4. Seek advice and treatment from a licensed professional who specializes in functional movement. Ideally this would be a rehabilitation chiropractor or physical therapist with movement specializations are the gold standard here. These practitioners focus on the functional paradigm of manual/physical medicine. And no, your "functional trainer" at the gym doesn't count.
  5. Self-management is key. Reduce activities that provoke pain, apply gradual exposure to activities to build confidence and tissue capacity through exercise. Exercise must be tailored to you to reduce pain and improve strength and function throughout your entire body.
  6. Progress load and exposure gradually. The key is to be consistent with your exercise therapy. Forget about how much you were doing before the injury and what others are able to do. Everyone responds differently. Focus on your recovery and what works to get you back on track.
  7. Getting back on track can take a long time. In some cases, upwards of 3 to 12 months depending on a number of factors including duration of symptoms, functional deficits and patient compliance during their exercise program. Keep in mind, other treatments can offer faster recovery but nothing has demonstrated better long-term results than progressive exercise.
When patients understand that guarding is normal, that we must reset and improve their body's function and they understand the process, they in turn are very likely to experience a positive outcome.

More related reading:

https://gallagherperformance.com/the-importance-of-functional-evaluation/

We love to hear your input. Tell us about your experience on Google.

Connect with Us

Contact

  • 4484 William Penn Highway

  • Murrysville, PA 15668

Hours of Operation

  • CHIROPRACTIC
    Monday-Thursday: 9am-1pm, 3pm-6pm
    Friday: 9am-1pm, 3pm-5pm
    Saturday: by appointment only
  • MASSAGE & TRAINING
    Hours are by appointment only