Accessibility Tools

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/

Exercise Hacks Ep. 10 - Loaded Progression for Shin Box Get-Up

[embed]https://www.youtube.com/watch?v=WwIba7PpgXA[/embed]

Keeping with the concept of core stability and hip mobility, the shin box has become a popular drill for improving hip rotation, eccentric loading of the hips, as well as reinforcing ideal intra-abdominal pressure (IAP) and core stability.

Ideally the shin box is performed in a progression of static to dynamic variations. Progressions are dependent upon the ability to achieve ideal external rotation in the lead leg and internal rotation in the trail leg while maintain an upright, braced torso with sufficient IAP.



While the shin box and its get-up variations are most popularly used as a warm-up/movement prep or 'mobility' drill, loaded progressions can be an awesome tool for increasing hip strength and neuromuscular coordination of force transfer through the hips and core.

This advanced progression of the shin box involves the hanging band technique with a safety squat bar. The hanging band technique is great for cleaning up technique and reinforcing proper stability and motor control. Failure to control your technique or movement will result in the hanging weighs to sway uncontrollably. The fight your body goes through to maintain stability and the control needed to avoid excessive sway does plenty to 'coach' one how they should be moving. There's tremendous value in utilizing exercises or movements that allow one to problem solve on their own. That's what makes this loaded progression an awesome tool.

Not only are you improving 'mobility' but you're also developing strength and doing so in a way that movement quality won't be compromised because of load. It's something that happens all too often with exercise. You see people sacrificing form and quality of movement for the sake of more weight on the bar. With this exercise it isn't going to happen. If you try to perform this exercise with too heavy a load that causes form breakdown, the movement isn't happening at all. Arguably, one of the biggest contributors to 'mobility' issues is poor form associated with mismanaged loading strategies - or basically trying to 'muscle through reps' at the expense of quality in movement. This ultimately will cause joint issues and mobility restrictions as you place too much stress on your joints on a repetitive basis.

So what's the best solution to mobility issues?

Sometimes the best mobility drill is building the foundation of ideal technique in a well-designed strength training program that erases your weakness. And this loaded progression of the shin-box get-up does just that.

 
For more related reading:

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

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

https://gallagherperformance.com/the-best-exercise/

https://gallagherperformance.com/unlock_your_potential_with_this_powerful_tip/

5 Reasons Not to Be Skeptical of Chiropractors

You've thought about seeing a chiropractor before, but have hesitated because you:

  • Heard it was "BS" or "quackery"
  • Thought that once you start going, you'll have to go for life
  • Were afraid of being adjusted
  • Thought they just won't be able to help
Let's first address the reality that all chiropractors are not the same. While "chiropractic" refers to the profession as a whole, what many people experience - from one chiropractor to the next - can be quite different. There are numerous techniques and specialization within chiropractic that enable chiropractors to do more than "just crack necks and backs".

In fact, chiropractors have the ability to successfully treat a number of common musculoskeletal problems. Below you will find five reasons why you shouldn't be so skeptical of chiropractors and why finding a great chiropractor can prove to be a priceless investment to your health and well being.

1. Solve joint and muscle pain without unnecessary medication or surgery

Let's illustrate the significance of this point with an all-too-common experience for many of us. You begin to experience joint (neck, back, shoulder, knee, etc.) pain seemingly for no reason at all. Your pain has just appeared and you are puzzled as to why.

What do must people do first?

Most commonly, they start in the medicine cabinet with common over-the-counter (OTC) medications like Tylenol, Motrin, Advil, or Aleve. They may ice the area or apply pain-relieving gels. Others may just give it time and play the waiting game to see if the pain goes away on its own. If OTCs, ice, pain-relieving gels or time don’t do the trick, then they pay a visit their primary care physician only to receive a script for either anti-inflamatories or muscle relaxers and a referral for an orthopedic consult. The orthopedist will likely perform a physical examination along with possibly ordering imaging studies such X-ray, CT scan, or MRI. Based on your examination and imaging results, one of two recommendations is often made - physical therapy or surgery.

Too often surgery can be recommended before more conservative approaches are given a chance. Disregarding the risks associated with surgery, what happens when the procedure fails? Surgery is not a great choice when pain is associated with a positive — often incidental — finding on an MRI. These incidental findings are well document and often times structural adaptations to functional problems.

When assessed properly by a trusted conservative musculoskeletal care specialist, whether a chiropractor or physical therapist, many muscle and joint problems can be resolved without the need for surgery.

Seek conservative care first. If you don't respond to care within 6 weeks, then it wish to consider more invasive procedures if they are indicated.

2. Manage complicated disorders

Remember when I said all chiropractors are different? It's true.

Just like the medical profession, there are many areas of specialty in chiropractic. Those who specialize as a sports injury & rehabilitation chiropractor (such as Dr. Gallagher) have undergone the traditional education on joint manipulation or adjustments. However, in addition to their core curriculum, sports injury & rehabilitation complete hundreds of hours in continuing education learning about exercise and sport-related injuries, manual therapy, and functional rehabilitation methods.

Chiropractors who utilize a sports injury & rehabilitation approach incorporate joint mobilization/manipulation, soft-tissue treatments, various manual therapies, and functional rehabilitation techniques to provide a gold standard of care in treatment for individuals with exercise and sport-related injuries. This combination of complementary approaches uniquely positions sports injury & rehabilitation chiropractors to manage complicated disorders that other specialists may have difficulty in treating.

3. Prevent future episodes of pain by changing function

Imagine a world where patients get the advise, education, and treatment they need. Imagine doctors who:
  • Make sense of what a patients says
  • Know exactly what a patient needs
  • Confidently provide gold standard advice and treatment interventions
This world is obtainable, but it must first begin with better quality, order and structure to our thinking patterns. One of the fundamental challenges with healthcare is that the human body is amazingly complex and adaptive. In response to the complex nature of dealing with the human body, doctors and therapists may have the tendency to routinely provide services that serve their own skill set better than appropriately addressing the patient’s needs. Often times this leaves both the patient frustrated with lack of response to care.

As ac chiropractor it's my job to educate my patients and help them problem solve. I have to help them understand not just what their problem is, but more importantly why it started.

In understanding why their problem started, we aim to change the function of their body. If patients don't commit to changing their behaviors and habits that got them into pain in the first place, then how can they expect to find a solution to their problem?

4. Enjoy a healthier lifestyle

As stated in the point above, chiropractors should be educators. As educators, we teach individuals how to live their best life and do so in a model that promotes our patients's have a sense of independence, capable of making informed, intelligent lifestyle choices.

Regardless of specialization, a universal truth to chiropractors is that they generally practice a “holistic” approach to patient treatment. Meaning chiropractors view the individual as a whole, identifying and focusing on more than just physical symptoms such as pain. By employing a combination of manual treatments, ergonomics, postural education, exercise prescription, nutritional interventions, lifestyle advice, and other strategies (practitioner dependent), chiropractic is more than just cracking backs to reduce pain. Chiropractors want their patients to enjoy a healthier lifestyle.

5. Enhanced performance

We put our bodies through the ringer daily (some more intensely then others). Periodic treatment from a qualified chiropractor will help keep your body running like a fine-tuned machine, improving your ability to perform and progress in your training programs by optimizing the body’s ability to function at it’s best.

How?

By combining chiropractic with functional rehabilitation and strength and conditioning principles.

It's exactly why we do what we do at Gallagher Performance.

Almost every case involving muscle or joint pain requires some level of strengthening exercise progression and education. We will make sure you are doing the most appropriate exercises for your situation and your level of ability. By clearly educating each patient on why they are performing their prescribed exercises or stretches, the focus becomes about patient empowerment and providing them with a sense of what they can do for themselves to keep pain from returning.

Regardless of the number of treatments you receive, the goal remains the same – to make a lasting change in your body through posture and movement re-education.

Wrapping Up

There are many great reasons to visit a chiropractor. Every chiropractor is different, so just because one didn’t work for you it doesn't mean that all chiropractors are useless. You just haven't found the right one for the job and that can prove to be a difficult task. Yes there are some bad ones out there (like any profession), but there are plenty of good ones that can be trusted.

No matter who you see, keep in mind that it is critically important that you understand your problem, your treatment plan, your expectations for recovery, and how to manage your problem during as well as after treatment.

At Gallagher Performance it is our intent to get you back to what you love doing and as quickly as possible. We create clarity by helping you understand your problem, why it behaves they way it does, and apply the right tool to make a lasting change in the way your body functions.

 
More related reading:

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

https://gallagherperformance.com/busting-chiropractic-myths-misconceptions/

https://gallagherperformance.com/are-you-promoting-independence/

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

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

Exercise Hacks Ep. 8 - Breathing and Bracing

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

Ideal movement and optimal strength development first begins with using the diaphragm as the primary muscle for respiration and for Intra-abdominal Pressure (IAP) or what is also known as the abdominal brace.

A frequent piece of feedback we receive at GP is that much of what we coach is the opposite of what most people have always heard. In regards to breathing and bracing, too many people have either heard or been coached to 'draw' or 'suck' in their abdominal wall. These tips only serve to rob people of stability and strength and play a role in low back pain.



In this video series we discuss how to test IAP for yourself. This is much more challenging that it seems. Insufficient IAP is many times due to poor diaphragm activity and its functional relationship with the abdominal muscles. Poor IAP indicates an underperforming core.

If you're dealing with acute/chronic pain, frustration with progress in the gym, or plateaus in athletic performance and haven't had your breathing and IAP assessed - you're missing out! Learning to properly breathe with the diaphragm can be the stepping stone to the realizing the potential you have when it comes to physical ability. Since breathing is foundational to correct IAP, the core cannot function as it is intended until breathing is normalized. The core is our body's powerhouse and it starts with breathing. It sounds too simple to be true, but improving your breathing can have profound impacts on pain and performance.

Re-training the breathing pattern and creating sufficient IAP cannot be fully covered in a series of 60 second videos. Want to learn more? Set up a consult with us. Assessing, coaching, and learning is very individual. When it comes to getting rid of pain and improving how your body works, GP's level of care, attention, and progressive instruction with our personalized training, chiropractic, and rehab will get you to your goals.

 
More related reading:

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

https://gallagherperformance.com/3-ways-breathing-impacts-health-performance/

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

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

 

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/

12 Week Distance Training Client Results

This training client sought out our services for three primary reasons:

1) Rehabilitate a chronic recurrent low back condition that has prevented him from training with any type of intensity or frequency for over two years AND get back to training while staying healthy in the process

2) Get stronger while packing on some quality size, and

3) Regain the feeling of athleticism from when he played college football.

We recently concluded 12 weeks and during that time he had three BOD POD evaluations. Debate on the accuracy of the BOD POD aside, impressive changes were made in only 8 weeks. These evaluations occurred on 11/21/17, 12/19/17, and 01/16/18.

Some of the BOD POD highlights include:

  • Fat Weight lose of 3.786lbs
  • Body Fat % decrease from 12.6 to 10.3
  • Fate Free Weight gain of 6.745lbs
  • Body Weight increase from 182.9 to 185.9

Images 1-3. BOD POD results from 1/16/18. This was the third, and most recent, analysis during an 8-week period.

Included below are photos of a few of his training weeks to give you a glimpse of how his training was structured. Along with the changes seen in his body composition, his strength continues to progress and he is training with weights and a frequency that he has not seen in over two years while maintaining a healthy feeling body.

Continue reading

Exercise Hacks Ep. 6 - Deadlift Variations for a Functional Core

[embed]https://www.youtube.com/watch?v=W6qNeTnJdyU[/embed]

In this video we discuss two deadlift variations that will build rock solid functional core strength - the suitcase deadlift and pitchfork deadlift.

The suitcase deadlift and pitchfork deadlift are two deadlift variations that will expose energy leaks and strength imbalances real quick. Building a functional core often requires unconventional methods that go beyond aesthetically driven exercises. While unconventional these exercises force the lifter to generate total body tension to complete the lift - which makes them an awesome tool to teach lifters how to generate and maintain tension during squats, deadlifts or heavier training.
Each variation offers something unique.
1) The Suitcase Deadlift - targets the lateral stabilization system or lateral line in the body as detailed in Anatomy Trains. The lateral line will create or resist lateral bend in the body and serves as a 'brake' for lateral and rotational movements of the trunk. The lateral line runs in balance on both the right and left side of the body from the skull down to the trunk and lateral aspect of the hips, thighs, calves and mid-point of the foot.
2) The Pitchfork Deadlift - this variation of the pitchfork deadlift also targets the lateral stabilization system while forcing the lifter to resist rotation. It really hammers the spiral line detailed by Thomas Myers in Anatomy Trains. The spiral line is responsible creating or resisting rotations in the body. The spiral line is a myofascial sling that includes musculature that begins in the neck down to the opposite shoulder and then to the same side hip, knee, and foot arch, then up the back of the body to rejoin the fascia on the skull.
The bonus is both these exercises will reinforce patterns of stabilization in the body that are essential to movement.
These exercises are advanced and it is not recommended to go try them just to see if you can do them. They require a certain level of stability, coordination and strength to be able to do. Respect the process needed to progress to these exercises.
 
More related reading:

https://gallagherperformance.com/movement-improves-brain-function/

https://gallagherperformance.com/athletes-do-not-need-balance-to-be-successful/

https://gallagherperformance.com/the-essentials-of-speed-training/

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

https://gallagherperformance.com/the-best-exercise/

 
 

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/

 
 

Exercise Hacks Ep. 2 - Scapular Upward Rotation

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In this video, we build off our previous video on the dumbbell row and discuss scapular upward rotation. Scapular upward rotation is a critical component in overhead activities performed regularly in daily life, the gym or sport.

If your scapula cannot rotate properly as you reached overhead, it will play a role in shoulder pain and problems such as tendinitis, bursitis, or impingement syndromes. This exercise variation would be a great inclusion in the strengthening of the rotator cuff musculature and scapular stabilizers.

Some key points discussed in this video:

  • Most rehab exercises for scapular upward rotation will address bilateral movement at the same time. Training support on one limb while training movement on the other will enhance the quality expressed in stabilization.
  • Performed correctly, this exercise targets scapular stability on the support side and scapular upward rotation on the movement side while training proper core stabilization.
  • To heighten the global effect on the body, focus on creating a tripod with the support foot as well as hip external rotation to get the glutes involved.
  • This variation respects reflexive patterns of stabilization in order to improve movement quality and performance.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

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

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

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

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

 

Exercise Hacks Ep. 1 - The Dumbbell Row

[embed]https://www.instagram.com/p/BcSuHV9jXz4/?taken-by=gallagherperformance[/embed]

In this video, we discuss the dumbbell row and how to improve both scapular stabilization and thoracic spine rotation during the exercise.

The dumbbell row is a fantastic exercise for building mass and strength in the upper back and arms. When done for reps (and no straps), it will build a solid grip. However, an often overlooked and undervalued aspect of the exercise is how awesome it can be in developing scapular, core and hip stability in the supporting limbs.

Some key points discussed in this video:

  • The traditional bench supported DB row utilizes hand support on the bench, which can be problematic for those with poor scapular stabilization.
  • Scapular stabilization on the support arm and be improved by elevating the bench to an incline position and supporting from the elbow instead of the hand.
  • With proper attention to posture during the support from the elbow will also improve thoracic spine rotation and mobilize the rib articulations during the exercise because of the increased spinal musculature involvement.
  • This can be a great variation of the DB row for those with shoulder pain, poor scapular stability or stiff upper back.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://gallagherperformance.com/why-therapists-should-understand-strength/

https://gallagherperformance.com/the-truth-about-functional-exercise/

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

 

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

The BEST Way to Recover from Tendon Pain

[embed]https://www.youtube.com/watch?v=yzgQdT5KcI0[/embed]

Based on updated modern knowledge of tendinopathy, tendinitis, or tendon pain, let's shed some light on the best ways to rehabilitate for complete recovery. Part of this discussion will bust several "myths" or "misconceptions" that have existed about the treatment and management of tendon pain.

  1. MOVE! It is best to avoid complete rest as movement and blood flow is the driving force to the recovery and healing mechanisms of the body. Complete rest is ineffective as it decreases the ability of a tendon to handle load. Rather, you should reduce loads to a level that the tendon can tolerate and gradually rehabilitate the tendon back to proper function. It's important to understand what your movement sensitivities and limitations are and adapt accordingly. Being told to completely rest is poor advice as medical understanding of healing tendinopathies has greatly improved.
  2. PRIORITIZE ACTIVE REHAB OVER PASSIVE TREATMENT. Again this builds off our first point. Active rehabilitation that requires the movement of your body through proper joint range of motion under appropriate pain-free loads is proving to be the golden standard in recovery from tendon and joint pain. Passive treatments such as electric stimulation, laser, ultrasound, taping and cupping have very little evidence to support their long-term efficacy in treatment outcomes. But people love them cause they are easy. They are done to you, not by you. Sure they may provide short-term symptom relief, but they do little in regards to long-term progress. Why? Because these treatments do nothing in regards of improving the ability of the tendon to absorb and handle load. Therapeutic exercises aimed at restoring proper movement patterns with progressive loading is the key to retraining the ability of the tendon to handle load appropriately. Thus resulting in successful long-term outcomes from tendon pain. The reality is, the most effective stuff is usually the hard stuff. This is true in training, nutrition, and recovery. The hard stuff is always more effective than the easy stuff. Sure you may need some passive treatment to help control pain, but you will never fully heal a tendon without long-term focus on exercise-based rehabilitation.
  3. STOP IGNORING YOUR PAIN. Pain is the your body's way of telling you that the load you are placing on your tendon is too much. You must stop ignoring this and reduce your training load, volume or frequency. Again tendon pain is caused by routinely overloading the tendon. If you continue to overload your tendon, why do you ignore the pain or expect it to magically heal? Don't ignore the pain and realize your body is sending your a message that's worth your attention.
  4. DON'T STRETCH YOUR TENDONS. Stretching your tendons will only serve to further irritate and exacerbate your tendon pain. Stretching tendons can be detrimental to their structure and health. Our tendons work like a spring, absorbing and releasing forces as we move. Tendon stress is at it's highest when we do activities such as sprinting, jumping and throwing. This is when the spring function of a tendon is most critical. This is important to understand, as for many people they may only experience tendon pain during sports or exercise. If you stretch a spring, you will compromise it's function. Springs don't need to be flexible so please don't stretch your tendons.
  5. AVOID SHORTCUTS WITH REHABILITATION. When it comes to tendon pathologies or tendon pain, there are no shortcuts in rehab. There is no magical potion or pill or modality. Treatments or interventions that promise cures often provide short-term pain relief only for the pain to come back again. Even injection therapy has shown to be effective only when exercise-based rehabilitation is not. You must realize that our tendons need time to rebuild strength and proper function. Often they need a significant amount of time and rehabilitation can take months. If exercise-based rehabilitation is not a priority, then we have our answer as to why many deal with chronic or recurrent tendon pain as they aren't addressing the reason why their tendon pain developed in the first place.
More related reading:

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

https://gallagherperformance.com/prevent-re-injury-integrated-training-rehabilitation/

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

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

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/

3 Exercises for Athletic & Mobile Hips

Please watch: https://www.youtube.com/watch?v=RRZL6Y6gtZI

In this video, we discuss exercises aimed at training proper hip dissociation - an often overlooked and undertrained function of the hips. Poor hip dissociation is commonly a reason for pain and poor performance.

Some key points discussed in this video:

  • What hip dissociation means. Hip dissociation is the ability to independently move the hips without compensations from the rest of the body.
  • Why poor hip dissociation and compensations are often a reason for low back pain, hip pain, and even pain within the knees and feet/ankles.
  • How poor hip dissociation is related to increased risk of injury.
  • Why the inability to move properly though the hips limits athletic potential and will negatively impact your performance.
  • And most importantly - what to do to improve your ability to move your hips independently with simple exercises that you can perform at home, at the gym, or basically anywhere with just a few simple tools.

Thanks for watching and as always, let us know your questions or comments.

More related reading:

https://www.gallagherperformance.com/blog/advanced-training-for-elite-athletes

https://www.gallagherperformance.com/blog/2-exercises-for-groin-and-knee-pain

https://www.gallagherperformance.com/blog/the-solution-to-long-term-improvement-of-back-pain

https://www.gallagherperformance.com/blog/pistol-squat-or-skater-squat-which-is-better

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

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

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