Accessibility Tools

Single-Leg Hip Thrust Technique Fix

[embed]https://www.youtube.com/watch?v=pmkt-yv3JZ0[/embed]

Nothing beats properly performed squats, deadlifts, lunges, and RDLs for glutes that not only look great but work even better. Proper glute function is critical to hip extension that is prevalent in every day life (walking, sit to stand, hip hinge, lifting) as well as sport (running, sprinting, throwing, jumping, skating) Problem is most people don’t perform the big exercises well and therefore resort to ways to “activate” or better “isolate” glute function. This is why hip thrusts exist. They have their place when used with a plan and purpose. The single leg hip thrust is an advanced progression that is often performed incorrectly. The biggest mistake being the unleveling of the hips that can occur during the movement. By using the external cue of a tennis ball, we can promote better technique that results in improved muscular coordination of the glutes and core. This translates into more efficient movement mechanics, not only in this exercise, but in life and sport as well. Hopefully the video explains the set-up and execution well enough for you to give it a try.

 
For more related reading:

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

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

https://gallagherperformance.com/the-essentials-of-hamstring-rehab/

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

Clinically Pressed Ep. 59 - Hockey Training



https://www.youtube.com/watch?v=ti_igKUCEvM&feature=youtu.be&utm_source=Clinically+Pressed+Episode+Mailing+List&utm_campaign=347aa58189-EMAIL_CAMPAIGN_2018_05_07_COPY_01&utm_medium=email&utm_term=0_e91bc99944-347aa58189-445544773



Dr. Sean Gallagher is a former high level hockey player that has turned into a hockey training and treatment guru. His experience of playing at the highest levels along with a full academic career in chiropractic school have brought him a unique perspective on how to approach training hockey players.




This episode we get further into hockey training and what all goes into it. The planning for the year of training is difficult when it the playing season never ends. We also dive into the specific demands that the sport places on the body and the unique ways that you have to approach exercises without forgetting to focus on injury prevention and resilience. If you play hockey at any level you want to listen to this episode.




This episode we get further into hockey training and what all goes into it. The planning for the year of training is difficult when it the playing season never ends. We also dive into the specific demands that the sport places on the body and the unique ways that you have to approach exercises without forgetting to focus on injury prevention and resilience. If you play hockey at any level you want to listen to this episode.




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Podcast Notes:

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Fitness is Not Sports Performance

One of the biggest challenges plaguing sports performance is the prevalence of general fitness programs masked as "sports performance" programs.

Sadly the concept of sports performance has become so polluted that most parents and young athletes buy into programs that ultimately are just heavily fitness-focused with very little or poor instruction in regards to true development as it relates to sport.

True sports performance addresses much more than how fit you are or how hard you are willing to work. It's much more than cleans, sled drags, sprints, and conditioning circuits. You can use all these methods and more to sell someone on the "look" of sports performance. But if you truly analyzed most "sports performance" programs they boil down to general fitness and that's it.

Some will say, "Well fitness is important in sports. You got to work hard. You got to be in shape. You got to learn how to push through." Fact is anyone can workout tired. Anyone can workout sore. If they want it bad enough. The problem is none of that matter when it comes to performance. The reality is once an athlete has to go up against another human being, only one thing matters - is their ability greater than their opponent?

It doesn't matter how fit you are and how hard you train if you show up on competition day and fail to be at your best. Sport performance is multi-faceted and should never be treated in the context of fitness-focused training. There are general fitness attributes that are important in sport, but true sport performance must move beyond fitness in order to allow athletes to truly realize athletic potential by focusing on specific adaptions relevant to their sport.

It's important to do your homework and look beyond what may seem like sports performance. Despite what you may see on Instagram or hear from a friend, what you sign up for may not be exactly what you were looking for.

For more related reading:
https://gallagherperformance.com/4-things-you-need-to-know-about-sports-performance/

 
https://gallagherperformance.com/physical-preparation-vs-fitness/

 
https://gallagherperformance.com/learn-how-to-spot-the-fitness-frauds/

 
https://gallagherperformance.com/training-maximize-athletic-potential/

 
https://gallagherperformance.com/athleticism-requires-more-than-just-strength-speed/

 
https://gallagherperformance.com/training-tip/

Sleep - The Foundation of Health And Performance

Roughly 1/3 of our life should be spent sleeping yet there is an epidemic of sleep loss and deprivation. If we fully appreciated the benefits of sleep when it comes to health, mental performance, and physical ability, it would reshape the way we view the importance of sleep.

1 out of 2 Americans get less than 8 hours of sleep per night and 1 out of 3 Americans get less than 6 hours of sleep per night. Sleeping less than 7 hours a night results in objective declines in health markers as well as mental and physical performance.



Let's talk health and sleep. The shorter your sleep, the shorter your life. It's a sad truth but it's a reality that less sleep is correlated with a shorter life span. Getting 6 hours of sleep per night or less is associated with increase in risk of chronic diseases such as obesity, diabetes, cardiovascular disease, Alzheimer's, and cancer as the immune system is suppressed on a genetic level.

Let's talk sleep and performance. Sleep is the greatest legal performance enhancing drug available to us. Sleep deprivation of 6 hours or less will decrease physical performance in strength, power, peak running speed, cardiovascular function, and time to exhaustion by around 30%. It is also harder to loss body fat when sleep deprived - so if you are trying to loss weight, you need 7-9 hours of sleep per night as diet and exercise alone won't be enough. Sleep is the foundation for diet and exercise progress.

Getting 7-9 hours a sleep per night is critical in motor skill acquisition and learning. Meaning if you practice and get adequate sleep, you will perform 20-30% better in those same skills the following day. Sleep smooths out motor learning and is critical in skills becoming automatic.

Sleep isn't all about quantity as you want to focus on getting quality sleep as well. To maximize the quality of your sleep it's ideal to sleep in a cooler environment. Try putting down your phone, turning off the TV, and dimming the lights an hour before bed. Avoid alcohol or other sedatives as they block the ability of the body to get into the deep stages of sleep critical to rejuvenating the body. It's advised to avoid stimulants such as caffeine and even exercise in the hours before you plan to go to bed. Start a sleep routine and stick with it.

Sleep - Get some!

Source: Dr. Matthew Walker

 
For more related reading:

 
https://gallagherperformance.com/stop-chasing-shortcuts/

https://gallagherperformance.com/a-few-words-on-athletic-development/

https://gallagherperformance.com/clinically-pressed-podcast-episode-38/

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

Athleticism Requires More Than Just Strength & Speed

 
There's no single blueprint coaches follow when building an athlete. There are no shortcuts. Those cool looking, cookie-cutter programs found online, they often result in failure. In the training world, athletes aren’t built by copying the same program and applying it across the board. At GP, we are in the business of individualized architecture – intelligently designing personalized programs for each athlete. Whether in the weight room or on the field, it should be individual-specific.

We dial in to specificity instead of just saying let’s just go train hard and get bigger, stronger, or faster in the generic sense. Coaches and athletes can be obsessed with bigger, stronger, faster. Yes these are important elements of training but not at the expense of movement skill.

Sometimes athletes need more specific work when it comes to the quality of their movement in regards to stabilization, sequencing, rhythm, relaxation, timing, etc. Developing movement skill is often ignored or disregarded. The problem is there can be a huge disconnect between what an athlete thinks they are doing during a specific movement and what they are actually doing. We must improve their perception and awareness of movement. When combined with proper strength and conditioning, Improving an athlete's body awareness and movement skill will yield far greater results than just focusing solely on strength and speed numbers.

Movement skill acquisition should increase with as strength and speed development increases. This will only enable the athlete to move more efficiently and with less risk of injury.

There are different methodologies, philosophies, systems and styles used in the strength and conditioning industry. Reality is there is no gold standard by which everyone should follow. It’s about finding the right fit for both athlete and coach. Every athlete is slightly different and there won’t be one method that will work for every athlete. That's exactly why individualized decisions should be made for the athlete.

 
For more related reading:

https://gallagherperformance.com/thinking-of-taking-your-child-to-a-trainer-read-this-first/

 
https://gallagherperformance.com/understanding-the-benefits-and-concerns-of-youth-strength-training-programs/

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

https://gallagherperformance.com/how-do-you-build-an-athlete/

https://gallagherperformance.com/guidelines-for-selecting-a-strength-coach-or-personal-trainer/

 
 

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. 12 - Do You Even Hoop?

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

In a Clinically Pressed podcast episode, I was presented the question of an influential purchase for under $100. I said the jump rope and Mark Bell's hip circle. If we take it a step further and go with a purchase under $10, I'd say the hula hoop.

Why the hula hoop?



Put your preconceived notions and research aside. The hula hoop may be one the most simple - yet challenging - tools to improve closed-chain mobility and motor control of the pelvis over the hips. The hips must move quickly in and out of rotation while the abdominal sling system of the body (see Exercise Hacks Ep. 11) works to move the pelvis. There's a balance of muscular stiffness for motor control as well as the rapid contraction and relaxation of musculature essential to athleticism. These same muscular qualities are critical in preventing back and SI joint pain.

The hula hoop first peaked my interest in a rehabilitation video featuring Jacob Chychrun of the Arizona Coyotes. There certainly seems value in its use as a rehab tool. In my opinion, there is value in its use for performance as well. From my experience, if used strategically, the hula hoop can offer similar benefits and muscular activation that the 'Stir the Pot' exercise offers. In the video we demonstrate the Stir the Pot and then hoop it up.

Rather than generating movement at the shoulders, we are generating movement at the hips while maintaining a stiffness through the spine to resist spinal motion. Hula hoop long enough, your obliques will be fried. That or your nervous system will be shot from the level of intramuscular coordination required in your functional core - the spine, shoulders and hips.

Dr. McGill has described the obliques as responsible for directing 'hoop stresses' in the body. It's a critical part of the Stir the Pot exercise. Maybe the hula hoop can be used to train the obliques how to better handle those hoop stresses as well. I'd really like to get Pavel Kolar's thoughts on this as well as other colleagues that may have some experience or insight.

 
For more reading:

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

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

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

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

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/

 


 

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/

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. 4 - The Dumbbell Press

[embed]https://www.instagram.com/p/Bcsrzr2jLxq/?taken-by=gallagherperformance[/embed]

In this video, we discuss the dumbbell press and how the position of the wrist impacts pressing strength and shoulder stability.

Wrist position is often overlooked during the dumbbell press but is a critical part of ideal mechanics. The wrist should maintain a neutral position during the entirety of the lift. Often you'll see wrist extension and/or ulnar deviation as a compensation when the wrist falls out of neutral position. We discuss ulnar deviation and making sure to avoid this position as it can place too much stress on the wrist and feed into reducing pressing power.

As usual, the key is finding and maintaining optimal stabilization of the shoulder and upper extremity. Avoiding wrist extension and ulnar deviation will keep the wrist and shoulders more stable, healthier and stronger. The goal is to improve performance while reducing the risk of injury and pain developing in the shoulders, elbows or wrists.

Some key points discussed in this video:

  • What ulnar deviation looks like and how to avoid it while holding dumbbells.
  • How to press through the dumbbell with correct hand and wrist position.
  • How ulnar deviation will cause the shoulder to destabilize and fall into internal rotation. This isn't ideal for shoulder health and pressing mechanics.
Thanks for watching and as always, let us know your questions or comments.

More related reading:

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

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

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

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

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/

 
 

Training to Maximize Athletic Potential

When it comes to athletes, critical developmental stages begin at an early age. As children mature, they progress through these important developmental stages during their growth and maturation process. If long-term athletic development is of any importance to the coach, parent, or athlete, specific aspects of athletic development must be addressed at appropriate time periods, otherwise the chances of the athlete reaching elite status is reduced.

The model used at Gallagher Performance began with a review of research and methods utilized in child and athletic development around the world. Through the review of current and past training methods used with elite athletes, it was concluded that to truly address athlete development, a new way of looking at how to properly structure “Strength and Conditioning” programs must be considered.
The reason is because early specialization in sport is becoming increasingly more common amongst children in the United States, and it’s not working. The rationale behind such a decision typically being if a child plays one sport, year round, they will be more advanced than their peers, more likely to be the ‘star’, get recruited, and/or possibly go on to make millions.

Recent research from UCLA reveals that early specialization in sport has very poor connection with young athletes achieving elite status. A survey of almost 300 NCAA Division I athletes found that 88% played two or three sports as children and 70% did not specialize in one sport until after the age of 12. These findings were already understood in former East Germany and USSR within their youth development programs.

Studies in former East Germany and USSR found that children who went through an early specialization program did have more immediate improvement in their performances. But these children also had their best performances between the ages of 15-16, had greater inconsistencies, many quit or ‘burnt out’ by the age 18, and they had greater rate of injuries because of forced adaptation compared to children who played multiple sports and specialized later in life.

Long-term athletic development is a process that occurs over many years. This is not an “8 week program”. Rather, it starts at an early age and continues on into adulthood. Long-term athletic development is about progressive development and must be approached accordingly. It is not simply a linear process, but is one that must be highly individualized to assist the athlete in reaching their full potential.

The greatest challenge to coaches, parents, and athletes is the understanding of how difficult this process is. Young athletes are continually dealing with massive changes in physical attributes, brain function, and sport skill acquisition. These all must be managed simultaneously while stressing the concepts of hard work in a positive environment.

For more reading on how we approach sports performance training for athletes, click on the links below:

https://gallagherperformance.com/the-value-of-in-season-training-for-athletes/

https://gallagherperformance.com/why-specificity-in-your-training-plan-matters/

https://gallagherperformance.com/early-specialization-in-sports/

https://gallagherperformance.com/guidelines-for-selecting-a-strength-coach-or-personal-trainer/

https://gallagherperformance.com/commonmistakesindevelopingyoungathletes/

https://gallagherperformance.com/3-benefits-of-integrated-training-and-therapy/

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
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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/

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  • 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
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