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.

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

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

2. Manage complicated disorders

3. Prevent future episodes of pain by changing function

• Make sense of what a patients says
• Know exactly what a patient needs
• Confidently provide gold standard advice and treatment interventions

4. Enjoy a healthier lifestyle

5. Enhanced performance

Wrapping Up

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

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

Seek Out Professional Evaluation and Treatment

Recognize the Gift of Injury

Understand the Science of Pain

Wrapping Up

https://www.youtube.com/watch?v=ceIcoreYu8o&t=4s

This video illustrates how we integrate chiropractic, rehabilitation and dynamic neuromuscular stabilization (DNS) into patient treatment. For the purposes of this video, these techniques were used to speed up post-workout recovery, ensure structural balance and improve how the body functions. Similar to fine-tuning a race car, the human body can benefit tremendously from fine-tuning to keep body prepared for high performance.

Key take home points:

• Treatment is directed at patient-specific goals and outcomes. There are different levels of care that may need, ranging from symptomatic (i.e. painful conditions) to more performance-based therapy or fine-tuning.
• Chiropractic manipulative therapy (i.e. adjusting) was not filmed but utilized for the spine and hips.
• Soft-tissue work was done manually and instrument-assisted to mobilize muscle and connective tissue to improve recovery.
• Dynamic neuromuscular stabilization (DNS) was used to fine-tune motor patterns and muscular activation. Proper muscular activation and stabilization function of muscles helps to ensure proper muscular coordination while minimizing stress on the joints.
• This all adds up to optimizing performance while keeping the body as healthy as possible.

"After an injury tissues heal, but muscles learn. They readily develop habits of guarding that outlast the injury" - Janet Travell, MD

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

Pain is incredibly complex, making the treatment and management of chronic or persistent pain a unique challenge. After reading this article, the hope is that you have a better understanding of the complexities of pain and how treatment must be directed if one is truly to overcome chronic pain.

Pain has a nasty habit of getting in the way of activities that we not only enjoy, but also the mundane tasks of everyday living. It becomes of paramount importance that treatment not only decreases pain, but also that the individual is able to resume activities that are important to them with improved function and mechanics.

To begin with, let's start with an understanding of pain and the reality behind why we perceive pain.

1) Pain is in the Brain
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 and activities of daily living.

2) Hurt Doesn't Equal Harm
Another key component of the education process is that “hurt doesn’t equal harm”. Just because a movement or activity may “hurt” this doesn’t mean that you are doing harm to the body or damaging tissues. In fact, there is a growing body of research supporting poor correlation between pain and structural changes seen on advanced medical imaging. Just because one has degenerative joint disease, a disc bulge, or rotator cuff tear doesn’t mean they will have pain as these imaging findings are routinely found in asymptomatic individuals.

It’s important patients understand this concept because when it comes to exposure to movement through exercise, you don’t want the fear of structural damage to interfere with the ability to become more active. While not all movement will be pain free, movement isn’t causing harm. And that’s extremely powerful for patients to understand.

3) Movement is Medicine
Movement has the ability to be healing by reducing the pain response in our brain. Thus this is why movement is like medicine and why movement eventually has to take center stage in the management of chronic pain. Similar to manual therapy, graded exposure to movement through exercise will essentially teach your nervous system to “wind down” and not be as sensitive to pain. In doing so, you become more confident and reassured that you can do more without pain or the fear of a relapse in your condition.

4) The Work is Just Beginning 
Unfortunately, the pain fix isn’t an overnight solution. For chronic pain patients, often times the rehabilitation process can take months of consistent work and repeated inputs to the nervous system to make a substantial change on pain and function. Repeated inputs come in the form of manual therapy and home exercise/self management strategies. Thus patient’s must understand the importance of compliance within their home exercise program as this makes a significant difference in their outcomes.

It’s important they understand the nervous system is easily tricked. It's easy to yield immediate change, but these changes should not be confused with lasting results. This concept is illustrated with any number of assessments commonly used in chiropractic and physical therapy offices – from leg length analysis to functional screens - as well as therapeutic interventions – from manual therapy to manipulation. By performing pre and post checks, it's possible to see immediate changes within one treatment. It can be easy to impact pain and create changes in range of motion or body function that have patients leaving your office feeling great.

But no single input can create lasting change. It requires multiple inputs over a period a time to create lasting change within the nervous system. This is why exercise and training is so important. If patients are not provided with the right exercises to compliment therapy, this is why they have pain relapses. Patients must exercise and must train to make a lasting change within their body. Otherwise they will get frustrated with chronic recurrences of leaving a provider's office feeling great only to experience a return of pain symptoms. And this becomes the pain cycle many become stuck in unless a change is made.

Break the Pain Cycle
If you are dealing with chronic or persistent pain or stuck in the pain cycle, the hope is that this article gets you thinking differently about how pain should be managed for successful outcomes. It’s why the management of painful conditions, especially chronic pain, must focus on pain education, the appropriate use of manual therapy (ex: joint mobilizations/manipulation, relaxation techniques such as PIR, soft-tissue and neurodynamic mobilizations) and graded movement exposure through exercise.

More related reading:

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

 

Running season is fast approaching. Spring and summer have a host of events from marathons, to half marathons, to triathlons, to various course races. Many have likely already started their training. And then of course we can’t forget those who will simply take up running in hopes of shedding unwanted body weight for the summer.

Whether you are taking up running to become healthier and lose weight, to qualify for Boston, or if you have your eyes set on crossing a race off your bucket list, your routine training will either build you toward your goal or you will be bogged down with nagging injury after nagging injury.

When you consider that 65-80% of runners will sustain an injury during the running season, clearly there is something that needs addressed to help runners cut down their chances of being sidelined or having recurrent issues during their training.

If there is one thing that most people know about me is that I’m not a distance runner. I’ll make that disclaimer up front. Never been a distance or endurance athlete and never will be. I live in the power-speed world of athletics. However, as a former hockey player and strength athlete, one of favorite past times and off-season training methods was (and still is) sprints.

Between my background as a chiropractic rehabilitation specialist as well as personal and professional experience in speed development, I’ve learned a thing or two about what it takes to build a body that is resilient to the demands of running/sprinting rather than breaking down. And at Gallagher Performance we have developed a reputation for not only building speed demons, but keeping their body healthy and ready in the process.

So what gives? Why is someone like me writing an article about running?

The name of the game in athletics is physical preparation and the same can be said of distance running. Unfortunately there seems to be a misunderstanding in that one only needs to run to be successful at running. While this may be true for some, there are numerous others who simply cannot solely rely on running in order to be prepared to run. Simply just running to be ready to run is an oversimplification of arguably the most complex human movement.

If that sounds ridiculous or confusing, let me explain my logic.

Most runners will eventually encounter their fair share of aches, pains, strains and overuse injuries. Plantar fasciitis, shin splints, tendonitis, stress fractures, runner’s knee, IT band syndrome and joint pain are common to the running community. Once training demands exceed what is one physically prepared for, this is where things start to go south.
These conditions may be present for a number of reasons, including any of the following:

• Sharp increases in training volume
• Foot wear
• Gait mechanics
• Strength deficits
• Joint dysfunction or fixations
• Improper motor control of lower extremities and/or torso
• Overtraining
• Inadequate physical preparation

The problem:
It’s not uncommon for people with recurrent episodes of back pain to become fearful and to start avoiding activities in life. They begin to associate pain with the activity and that the activity is doing harm. Thus, in their minds, pain equals harm and any activity that causes pain avoided. The problem becomes that as this the list of activities grow, deconditioning sets in and begins to feed into back pain. At this point, most figure they are just “getting old” or figure they will need to “learn to live with the pain”. The reality is there is a solution to help you fight against these feeling of fear and limitation and enable you to fight dysfunction in your body.

The solution:
Research tells us that exercise should be part of your back pain solution. This isn’t true of just backs, as exercise should be part of any joint pain solution. Time and time again, more than any other intervention, exercise has demonstrated the ability to provide positive outcomes in back pain relief and reduced relapses. However, too often people use different exercises to help reduce their pain only to find that exercise makes their back feel worse. The solution isn’t just simply exercise, the solution is understanding the right exercises to do while also understanding which exercises to avoid. You need to know what exercises for sciatica and disc herniation are best to do 1st to create a good foundation of movement before progressing to more difficult exercises. Where do you go for that information? Over the past several years we have put together a clinically successful exercise progression program for our patients and clients with back pain. These exercise progressions serve as the framework for rehabilitation and also serve as the foundation for improving athletic performance. Join us for our Core Training – From Rehab to Performance workshop and learn more about what you can begin doing immediately to help reduce your back pain, feel better, and improve your performance in sport or life.

 
 


More related reading:

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

Often I am asked, "What is the best exercise?" or "What is the best type of exercise?"

To answer that question, let's set the stage of what exercise really is - movement.

Teaching patients not only about chiropractic but how to move better all comes back to function and understanding how all the intricate parts of our body make up a highly complex movement system. But here are some key points to understand:

1) Function determines movement. Chiropractic and rehabilitation seek to restore proper movement function. Functional examinations determine WHY movement is painful or problematic. Utilizing the functional model of movement helps to determine who is at risk for injury, which movement patterns or body regions are dysfunctional, and what treatment or exercise strategy is needed to address those issues in combination with chiropractic/manual therapy methods.

2) Function is critical to movement and movement is critical to our health. Our bodies are designed to move. The growing list of chronic diseases and immense burden on the healthcare system associated with an overly sedentary society clearly demonstrates one conclusion – we need to move more.

3) Movement is exercise and exercise is medicine. The medicinal benefits of exercise are numerous. There is a reason why exercise and proper nutrition is being labeled as "lifestyle medicine".

For those who wish to start an exercise program, the public is told to “see your doctor” before starting an exercise program. Most patients are cleared to exercise after history and vitals are considered “normal”. Sure your organ system may be healthy enough for exercise, but nothing is mentioned about seeing a doctor to determine how well you move or how well your muscles and joints are functioning. Why wouldn’t this be considered? Why wouldn’t seeing a “movement specialist” before considering an exercise program be equally advocated?

So, in typical fashion, most of us embark on an exercise program believing we will be healthier for it. We are told to exercise and practice sound nutritional habits, but what do most of us do for exercise?  How about go to the gym, sit on a machine and pull or push weights while hunched over with lousy posture.  Or, after sitting for 40-60 hours per week, let’s go out and put staggering amounts of stress on our bodies through recreational activities like weekend skiing, Thursday night softball league, rec league hockey, golf, or basketball.

There's nothing wrong with those activity choices, yet what happens when pain or injury come into the picture? Most of blame the exercise or blame the activity when, in most cases, we should be blaming our own body.

When it comes to pain and injury, the reality is what our body is capable of performing cannot meet the demands we are placing upon it. The overall function of our body must be ready to handle a specific task or movement otherwise problems will eventually arise. Problems that may range from mild (muscular tightness/stiffness, joint aches) to more severe (pain and/or injury).

The beauty of the functional model is that those regions that have mechanical sensitivity (pain) and/or abnormal motor control can be identified and solutions are discovered. Exposing these compensations and correcting them plays a huge role in not only getting patients out of pain, but improving how their body functions.

Why is changing how our body functions so important?
While pain is why most people seek care, the reality is if we only change pain and fail to change how a patient’s body functions, we have our reason why so many patients relapse. But if we get them out of pain and improve how their body functions then we are doing what we need to do to keep the pain from returning.

Whether we need mobility (improved range of motion) or stability (motor control), that can be addressed with a proper functional examination through movement. After a functional examination, it just makes sense to reinforce functional movement patterns with specialized exercise to build a foundation of proper movement coordination, strength and skill.  Now we are beginning to get somewhere to build form, function and fitness. Now we are getting people to move better through better exercise!

Correct movement is the best exercise
Once people learn better movement, how to project their joints and what exercises they should be performing, their bodies are much healthier for it. There is less risk of injury and most will ultimately start feeling better instantly. Rather than beating their bodies up due to poor movement, movement becomes healing. Correct exercise is the answer. Correct movement is what we need to get out of pain, feel capable and feel healthy.

That’s the essence of the functional model. It’s about promoting health and healing through therapy, movement, and patient-centered education. That’s what we pride ourselves on at Gallagher Performance as our model is truly unique in the services we provide and the results we achieve.

More related reading:

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

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

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

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

Recently, Shannon Perrine of WTAE Channel 4 News in Pittsburgh featured a story on a patient of ours, Karla White. The focus of the story being Karla's same-day hip replacement surgery. It was a short, yet informative piece on the work of her surgeon and the rehabilitative process with special attention to the factors that played a role in a very successful outcome. If you have not seen the story, head to our Facebook page and check it out. All of our social media links are here on the website. You'll find them at the top of the page.

After the story aired yesterday, I had a number of thoughts that came to mind. Primarily these thoughts centered around how many medical professionals and the general public have a misunderstanding of the training and qualifications of chiropractors and strength & conditioning specialists. Especially as they relate to rehab, be it from injury or surgery. Many may find it unconventional and, at times, silly that one seeks out the professional help of a chiropractor or strength coach for the oversight of their rehabilitation.

Traditionally, once a patient is ready to begin post-surgical rehab, this process is guided by a physical therapist. It’s conventional thought and accepted practice.  You have surgery, then you go to physical therapy.

That said, there are post-surgical patients who will seek out a chiropractic rehabilitation specialist to manage their rehabilitation. And, depending upon the setting and patient, strength & conditioning specialists may be involved as well.

Now there may be a few thoughts running through your mind right now. Maybe thoughts such as:

“Wait….chiropractors aren’t qualified to do post-surgical rehab!”
“Why would you use a strength & conditioning specialist for a rehab patient? Those are only for athletes!”
This news story has opened up the opportunity to help educate, so let’s address these questions or concerns.

Are chiropractors qualified for post-surgical rehab?
The reality is, when patients seek a provider for their post-surgical rehab, they may choose to seek a professional who is not a physical therapist. Some may not have the flexibility to make their own decision, but for those patients are looking for the best person for the job and they will exercise their right to make that decision. Regardless of title (PT or DC), patients must be in the hands of a provider who has the professional training and expertise to handle their rehabilitation appropriately. Providers must be competent and efficient for the sake of minimizing post-surgical complications and improving outcomes.

I’ve highlighted this before in previous writings, but my residency truly provided professional training very few chiropractors ever receive. During my 3+ year residency, I managed or co-managed numerous spinal, shoulder, hand/wrist, hip, knee, and foot/ankle post-surgical rehabilitation programs. Our department at Palmer College of Chiropractic worked with local orthopedic and neuro surgeons to co-manage routine as well as highly complicated surgical cases within the Quad City area. Meaning, we saw everything from athletic injuries to total joint replacements.

I don’t stress this to simply pump my own tires, but to convey to our audience that I’m not new to post-surgical rehabilitation and there are chiropractors out there that have similar training and expertise as well. We don’t exist on the level of physical therapists nor are we claiming to be physical therapists. Physical therapists have their own unique training and skill set. The ones I know do outstanding work for their patients.

The point I’m trying to make is that it is possible for chiropractors to have a background in functional and post-surgical rehabilitation. These chiropractic rehabilitation specialists are qualified and are capable of successful post-surgical rehab outcomes.

What is the value of Strength & Conditioning during post-surgical rehab?
For all those that want to be evidence-based, exercise and strength training literally helps more musculoskeletal conditions that all other treatments. The same can be said of post-surgical rehab as it is all about regaining range of motion, strength, and functional capacity. If you have the privilege of having a knowledgeable and qualified strength & conditioning specialist in your corner, they will provide enormous value to the post-surgical recovery process.

Yes, the involvement of strength coaches may be more commonly used in the athletic world, within the collegiate, professional and international ranks. But, when available in the private sector, they add an immense advantage as the rehabilitative process is very time sensitive and it’s critically important no time is wasted. The more quickly a post-surgical patient can regain adequate strength and movement quality through gradual exposure to the functional demands of strength training, the more quickly they are able to return to their activities of daily living, job, or sport with confidence and minimal complication.

Strength coaches are experts in what almost all musculoskeletal conditions will benefit from: exercise and strength training. Keep in mind, they must have the appropriate qualifications. Not all strength coaches are created equal and those that are capable of being involved with a post-surgical patient are rare. I can't stress that enough. These professionals understand their role and the best results are seen when they work together with the rehabilitation specialist to ensure ideal outcomes for the patient.

Post-Surgical Rehab Success is All About Team
The success of the post-surgical rehab program is not solely dependent upon any one specific individual involved in the process. Successful post-surgical outcomes take on a team dynamic. In this case, the surgeon, rehabilitation specialist, strength & conditioning specialist, and patient all had critical roles.

The Surgeon
For Karla, she had a tremendous orthopedic surgeon in Dr. Julius Huebner. Due to a congenital condition and progressively worsening degenerative joint changes to the left hip, Karla underwent direct anterior approach total hip replacement in late May 2016. This surgical approach is essentially a “surgical strike” as described by Dr. Huebner in the video. His surgical procedure resulted in no damage to adjacent tissues and structures. The procedure was a precise as you can get, enabling same-day hip replacement surgery and a faster recovery.

The Rehabilitation and Strength & Conditioning Specialists
In preparation for her surgery, she worked with the team at Gallagher Performance during the months prior to her surgery to improve her post-surgical rehab outcomes. Her pre-surgery rehab program enabled Karla to remain as functional as possible during that time. Pre-surgical rehab programs are never easy and quite challenging. However, Karla is a tremendous patient who demonstrated nothing but commitment and patience, knowing that the work she did prior to surgery meant having that much less to do post-surgery.

Likewise, during the course of her post-surgical rehab program, Karla worked one-on-one with either myself or Ryan. I managed the early phases of her rehabilitation recovery, implementing manual therapy and exercise. This continued as she progressed to more strength training focus in her rehab. That's when Head Performance Coach, Ryan Gallagher, designed and implemented her strength & conditioning program.  The collaborative focus was on developing ideal movement patterns to spare her joints, thus improving the health and relative function of her legs, hips and spine. Exercise selection and progressions were based on post-surgical guidelines, tolerances, and functional capacity all while ensuring adequate strength and movement control were demonstrated.

The Patient
As for Karla, she was the ideal patient.  She was compliant and motivated throughout the entire process. Karla loves to be active and workout, which only added to her motivation. A motivated patient is so refreshing to work with for countless reasons. The rehabilitative process can be frustrating at times, with obstacles and ups-and-down marking the road. As challenging as rehab can be physically, rehab can be even more challenging mentally. To her credit, Karla was always willing to work, even when she was frustrated or progress was slow. She always worked hard and focused on the little details. It’s because of her attitude that she demonstrated and her drive to regain the quality of life she desired that she is where she is today.

Summing Up
The combined team effort was the key to the success of this post-surgical rehab story. This theme must be present to ensure a patient has the outcomes they desire. It’s a privilege to be involved, providing our services to complement the team effort required during the post-surgical process as we recognize our role in the rehabilitative process. We thank Dr. Huebner for his medical expertise, Karla for being outstanding to work with, and WTAE’s Shannon Perrine for her excellent coverage of the story.

At Gallagher Performance, our focus is on developing the resilience of our clients and patients. We are committed to utilizing cutting-edge, patient-focused progressions to help every individual we work with not only achieve but also exceed their goals. With our extensive training and knowledge in chiropractic, manual therapy, sports injuries, rehabilitation, and performance-based training, we work with all individuals who are interested in living healthy, active, and pain-free lives.

More related reading:

https://gallagherperformance.com/3-simple-steps-to-reduce-your-risk-of-sports-injuries/

In light of recent news from the Pittsburgh Penguins regarding Sidney Crosby sustaining another concussion during practice last Friday, the hockey community is a buzz. Crosby’s concussion history is well documented of recent, having sustained three in less than six years. Discussions and speculations of what this means for Crosby's season, and even career, are populating the Internet and sports talk shows.

Despite the advances in sports medicine as it relates to concussion diagnosis, management, and return to play guidelines, concussions remain a challenging condition for all involved.

The reality is concussions are truly challenging. Despite measures to "prevent concussions", concussions are not preventable. There is no such thing as concussion prevention. There is no single piece of equipment, be it a helmet or mouth guard, that is capable of preventing a concussion. Rather than prevention, the focus is on minimizing concussion rates through proper identification, management, and education.

Consider that within the United States, there are over 300,000 sport-related concussions per year and research suggests concussion rates are on the rise. If your child is in contact sports, there’s a risk of concussion. Thus making this is an extremely relevant conversation and one that shouldn't be taken lightly. That said, the goal of this article is to offer insights into what a concussion is, how they should be managed, and the chiropractors potential role in the process.

What is a concussion?
A concussion is a traumatic brain injury defined as a short-lived loss of brain function due to trauma that resolves spontaneously. With a concussion, there is no structural damage to the brain. Simply put, only brain function is altered.

Encased within the the skull, the brain floats in a pool of fluid, known as cerebrospinal fluid.  These protections allow the brain to withstand many of the minor injuries that occur in day-to-day life. However, if there is sufficient force to cause the brain to bounce against the bones of the skull, then there is potential for injury. It is the impact of the brain against the inside of the skull that cause the brain to be injured and interrupt its function. This impact is often due to rapid acceleration and deceleration movements of the head and neck. Rapid acceleration and deceleration of the head and neck can be created from a direct blow to the head or from impact that results in whiplash injury common in motor vehicle accidents and falls.

How are concussions diagnosed and treated?
First and foremost, anyone suspected of having a brain injury should seek evaluation by a neurologist trained in concussion evaluation.

The signs and symptoms of concussion may be obvious or very subtle. Most concussions are sustained without the individual losing consciousness or "blacking out". In several cases, the individual may not be aware they have sustained a concussion or may not connect their symptoms with a head injury. Complicating the picture is the fact that some individuals may have delayed onset of their symptoms, not presenting with concussion symptoms for several hours or days after the initial injury.

Typical symptoms of concussion include:

• Headache
• Difficulty concentrating or feeling “foggy”
• Poor recall or memory of recent events
• Changes in mood or personality
• Slower reaction times
• Dizziness, lightheadedness
• Nausea or vomiting
• Low tolerance of bright lights or loud sounds
• Irritability
• Changes in sleep patterns, such as being unable to sleep or sleeping more

Lately it’s hard to find time to keep up with our blog. Life and business have a way of keeping you busy. Ignoring our social platforms may happen for a period of time, but we always revisit them. If there is one thing I’ve always hoped is that our blog would be informative, educational, and entertaining (at times).

The summer months bring on increased work load. Once May rolls around, we take it up a notch or two at Gallagher Performance. Summer is a grind, but it’s also a blast. We love the grind, love the process. With the volume of high school and collegiate athletes training for strength and performance, along with the patients we see ranging from acute care to rehabilitation to return to play, summer provides tremendous learning opportunities.

Reflecting back on the past several weeks, there are some friendly reminders and lessons learned or re-learn that I wanted to share:

• Power-speed athletes thrive on power-speed drills and exercises. Just because one can squat or deadlift 500+ doesn’t mean they are explosive and fast. Yes athletes need strength and for many they will need a primary focus on strength training. However, those newly acquired strength levels must also be displayed in more power-speed dominant means such as sprints, jumps, throws as they have greater specificity to athletics than anything barbell related.

• Athletes need to rapidly absorb force and rapidly generate force and do it on a level of unconscious activation. That brings me to another point of muscle activation. Muscle activation is a craze nowadays and rightly so. The overwhelming majority of the population will benefit tremendously from learning how to activate and integrate muscles such as their tibialis anterior, glutes, and scapular stabilizers to name a few. A lost art in muscle activation seems to be the use of isometrics. There is always an isometric contraction during the amortization phase of movement. Even during the most explosive movements, there is an isometric contraction. Isometrics are also awesome for reprogramming and generating a powerful mind-muscle connection, making isometrics a great tool for performance as well as rehabilitation. We have been utilizing a select few isometric drills for uprighting, motor control, and priming for improved  force/strength generation. In a relatively short period of time, they have more than demonstrated significant value.

• There is a right way to go about training and a wrong way. The right way will always be dependent on the needs of individual and their specific goals. Don't get caught up in hype, trends, and empty promises. Trust the tradition. There is magic in the basics of the barbell, free weights, sprints, jumps, and bodyweight drills. They have stood the test of time. Fads and trends come and go, the basics remain. Using these exercises is one thing, understanding how to structure them in a training plan is another animal in itself. Find a trainer/coach that understands training specificity or else you are simply wasting your time and money.

• We are problem solvers. Either as a clinician or trainer/coach, the heart of what we do is problem solving. Maybe it’s a matter of ability or effort, but clinicians or trainers either have the ability or they don’t. The ability to problem solve comes from knowledge and experience and even instinct. When it comes to effort, frankly some are just lazy and don’t care to think hard as it complicates their job. Whether it is listening to what a patient/athlete is telling you or just simply watching, you’ve got to process the source of the problem and how you’re going to solve it. When it comes to performance or rehabilitation, everything makes sense. If it is happening there is good reason for it. If we don’t understand it, it doesn’t make sense to us, but it always makes sense. Never dismiss a client or patient as not making sense. Make the effort to make a change. Change your perspective. Learn more.

• We all need a coach. No one gets through life all on their own. We all have needed mentors and coaches at some point in our life. These may have been parents, family members, close friends, teacher, professors, bosses, etc. If we pursue something of significance, chances are someone helped us along the way. We need the help of others than have more knowledge, more experience, more accomplishments. I have had a number of mentors and coaches. For everything they did for me, I hope I can pass that on to those that I work with in the role as a coach.

• Take time to get to know your clients and athletes. Show you care about them. We do more than just simply get kids bigger, stronger, or faster. We have an opportunity everyday to connect with our clients and athletes and hopefully make a positive impact. The reward goes far beyond cash flow. It’s about making a difference for the better.

The Gallagher Performance approach will improve the way your body moves and functions. 
Simple yet effective changes to improperly functioning muscles and joints will allow the body to make immediate shifts toward working as a functional unit. Thus reducing pain and enabling higher levels of strength, speed, and power with greater resilience.

The results are incredible. Time and time again, our patients and athletes quickly change from a state of pain and tension, to a state of relaxation primed for performance. This all comes back to assessment and knowledge. When we do the right thing, the body responds immediately.

The methods used at Gallagher Performance are utilized internationally by elite athletes, sports teams, and health practitioners. Not only are we able to efficiently and effectively treat injuries and enhance sports performance, our methods are also powerful tools for stress management, quickly breaking common patterns of movement dysfunction related to chronic pain. The methods have international recognition and no provider, therapist, or trainer in the Pittsburgh area has  the training and background in these methods that Gallagher Performance offers, making us truly unique. 
HOW DOES THE GP SYSTEM WORK?
Our body is designed to breathe and move. In order to breathe and move, our body finds ways to accomplish these tasks, and it’s willing to do so in efficient or inefficient ways. Our breathing and movement can develop compensation patterns or “key dysfunctions” that become the target of successful musculoskeletal treatment.

These compensation patterns cannot be ignored, as they put us at risk of poor sport performance, tension, or pain.  Our body’s ability to overcome the stress of life can result in reduced movement quality and energy levels. Measurable reductions in stability, strength, power, mobility, and stamina are often the result. Our body becomes less resilient, increasing the chance for fatigue and breakdown.

If you experience a traumatic event or injury, you know exactly what I’m talking about. Post injury, you’ll notice the slow and gradual decline in energy, function, and performance. Compensations begin to manifest in order for us to avoid pain and accomplish daily tasks. The result may range from noticeable decline in energy, to impaired function of muscles and joints, to chronic pain which long outlasts the initial injury.
It is almost inevitable nowadays for the majority of us to experience the effects that stress, injury, and/or compensation has on the human body.  And it can be simple to reverse those effects when you focus on what your body needs to regain ideal function.
The system at Gallagher Performance starts by testing how your body is currently functioning, so that changes can be clearly measured. This is accomplished through evaluating joint restriction, muscle activation and strength, and functional patterns of movement.

Once compensations are identified, we target “zones” to help activate the body to perform better. These “zones” can be a specific muscle, group of muscles, joints, or a combination.

Once we activate, we have to integrate. In order to do this, we run through the body’s movement patterns, testing and activating along the way to enable muscles and joints to regain their ideal function. Then through cueing and exercise, the brain can integrate improved patterns of movement, allowing you to move effectively and efficiently.

A body that moves better has less stress and less pain, allowing you to work at greater capacity and with greater energy.
That doesn’t mean you’ll suddenly be indestructible for the rest of your days. That would be too good to be true. After all, it you enjoy being active and testing your body’s limits, you are going to feel it. Our movement patterns need reminding and that’s why we use targeted home exercises to help the body reinforce ideal function and keep compensations from returning.

The methods and techniques used at Gallagher Performance are proven to be effective in getting people out of pain and elevating performance. We truly offer unique, powerful tools for control over your own health and performance.
More related reading:

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

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

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

The majority of us will not get through life without sustaining some degree of injury. The joints of the back, shoulder, hips, knees and ankles are all very common injury sites for not just athletes, but the general fitness population as well.

Most injuries that develop over time tend to have one thing in common, a breakdown in the human movement system. Meaning it could be that you are performing specific movements with sub-optimal technique or perhaps muscle imbalances are responsible for your symptom presentation. Regardless of the reason for injury, the goal is the same; to make movement more efficient to ensure that once training or competition resumes, the chance of re-injury is minimal.

Efficiency of movement is rarely a goal achieved in therapy. Incomplete rehabilitation in athletes and the general fitness population has lead to a re-injury epidemic. The problem is rooted in either the push to return athletes to the field as quickly as possible or rushing patients through the rehabilitative process.

With the ever changing landscaped of health insurance, the overwhelming majority of athletes and patients deal with increasing out-of-pocket expenses and limited number of therapy visits. Ultimately, many patients never complete their rehabilitation process.

This may be for a number of reasons, but in most cases athletes or patients are discharged once specific objective and ADL (activities of daily living) measures are satisfied. Sure you may have minimal to no pain, full range of motion and seemingly adequate strength resorted, and basic activities are easy to perform, but this does not ensure you are ready to resume training and competition.

And this is exactly where most get stuck.

They are lead to believe they are ready to resume sport training or their exercise program, but soon after resuming they realize they aren't as ready as they thought they were.

The transitional period between rehabilitation and performance-based training is the most critical period to ensure complete rehabilitation and that the transition back into training and competition carries minimal risk of re-injury.
Sadly, due to points made previously about the state of healthcare, many personal trainers and strength coaches are finishing off the rehab process.

Why do I say sadly?

Frankly, the majority of personal trainers aren’t educated enough to be overseeing such a delicate process, yet many position themselves as psedo-therapists. I’ve lost count of how many personal trainers I’ve seen giving “massage” or performing “joint mobilization” during their training sessions. They have no training or qualifications to perform such work and ultimately the person at most risk is the individual they are working on. Word to the wise: if your personal trainer is performing such work on you and has no license to perform such work, run the other way and seek out a qualified professional.
Within the fitness industry, there has been a large growth in facilities that blend rehabilitation with prevention strategies within strength and performance based training programs. Done well and overseen by qualified professionals, this is a great way to manage what is seen both in a rehab and training setting. This process should not be handled improperly. Implementing “corrective” or therapeutic exercises strategies into a performance-based training program should be lead by qualified professional(s). There used to be a gap between the professionals in the therapy and strength & performance world. Progressively though, that gap is slowly closing as more therapists crossover into the world of strength & conditioning.

Returning from injury isn’t and shouldn’t be a quick process. It’s far better to train smarter through the process. Improving on the function of the body while adding qualities such as endurance, strength, reactivity, power, etc. will help ensure successful outcomes. It’s less about isolation and more about training systematically to re-groove movement patterns. For anyone who has suffered an injury, they all want to get back to their previous level of function while also building the confidence they will not re-injure themselves. It can and will be a detailed process that involves rest, manual therapy directed at specific joints and soft tissues, as well proper exercise progressions. And yes, this means regressing, substituting, and even just slowing down exercises until they are owned.

Once movement and exercises are owned, it opens the door to further progressions in a performance-based setting to help ensure a more complete rehabilitation resulting in reduced risk of re-injury. This has become a huge part of what we do at Gallagher Performance as we successfully help our athletes and patients resume an active, pain-free lifestyle.

More related reading:

https://gallagherperformance.com/technique_and_performance/

Back pain was believed to be a self limiting condition for the majority of individuals, meaning that the nature of back pain is that it would "run its course" and eventually pain would go away on its own.  Current research has demonstrated that this understanding of back pain is flawed; yet many clinicians still hold this belief.

In fact, 85% of people with a single episode of low back pain will likely experience future recurrences and 2-8% of those individuals will develop chronic back pain.

Chronic pain accounts for 75% of all healthcare costs related to low back pain, is second only to the common cold in missed days from work, and is the number one reason for workmen compensation claims.

Considering the burden chronic back pain places on healthcare resources, patient management appears to be an issue in need of addressing appropriately as many patients find it difficult to find effective treatment.

Low Back Treatments That Don't Help
Now many experts are questioning the model in which back pain is treated as a growing body of research suggests many common back pain ‘cures’ just don’t work. These include:

• Ultrasound
• TENS machines
• Strong opium-type painkillers, such as diamorphine
• Spinal injections
• Spinal fusion
• Disc replacement

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

• A detailed history, orthopedic and neurologic examination, and functional based examination to create a working diagnosis.
• Functional based examination to focus on the spine, shoulders, hips and feet, as these joints and their respective functions serve as the "key joints" of the human body.
• Joint and muscle palpation to assess the quality of your joint movement, trigger points, and muscular imbalances.

1. CHIROPRACTIC MANIPULATIVE THERAPYGallagher Performance provides the latest techniques, including joint manipulation (adjusting), designed to treat musculoskeletal complaints. The purpose of joint manipulation is to release restricted joints of the body, primarily in the spine and extremities. Joint commonly become restricted as a response to poor posture, imbalanced muscle activity, and/or trauma. By releasing a restricted joint through manipulation, improvements in the quality of motion of the joint are gained that may not be possible with exercise or other interventions. Manipulation also serves to reduce pain and relax tight muscles.
2. FUNCTIONAL REHABILITATIONIn addition to providing relief through 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)By applying principles and techniques rooted in the study of child development, DNS aims to improve activation and neural control of muscles and ideal movement patterns. DNS promotes 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.
4. MYOFASCIAL RELEASEGallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.

What is Fascia?
The soft connective tissue, located just under the skin, is a white membrane that wraps and connects muscles, bones, nerves, organs, blood vessels of the body.

This soft tissue is known as fascia. Think of fascia like the white fuzz inside an orange peel connecting and wrapping around the orange and the individual sections or slices.

At times, muscles and fascia are can become stuck or tear, resulting in soft tissue injuries or adhesions. Adhesions restrict movement and the quality of muscular contractions resulting in either soreness, pain, and/or reduced flexibility.

For a quirky take on fascia or "the fuzz", watch this video by Gil Hedley, PhD. The video provides great visuals as to what fascia looks like, how our muscles have to slide while we move, and what muscular adhesions look like and how they limit movement.

[embed]https://www.youtube.com/watch?v=_FtSP-tkSug[/embed]

How do you treat Fascial/Muscular Adhesions?
Treatment of fascial/muscular adhesions through manual or instrument assisted techniques have clinically proven to achieve successful outcomes in many acute and chronic conditions. Gallagher Performance offers a number of soft tissue approaches to treat painful or tight muscles, tendons, and ligaments. We have extensive training in identifying and treating muscular adhesions that compromise quality of motion and contribute to pain symptoms or reduced sports performance. Many overuse or repetitive use conditions respond well to treatment of soft-tissue structures through myofascial release, including back pain, shoulder pain, shin splints, runner’s knee (IT band syndrome), and plantar fasciitis.

Myofascial release is a manual or instrument assisted therapy targeting soft-tissue structures to reduce the presence of adhesive/scar tissue. Adhesive muscular tissue is arguably the most common yet most underdiagnosed condition in the entire human body. Muscular adhesions act like glue among muscles, fascia, tendons, ligaments, and even nerves. As a result, this reduces flexibility, strength, and stability to the body by altering movement control patterns. Adhesive tissue along nerves can cause numbness, aching, tension, tingling, and in some cases weakness. This is condition is called nerve entrapment and can happen in an estimated 150+ locations throughout the body.

How does adhesive tissue develop within the body?
Often adhesive tissue develops in result to acute injury or from overuse/repetitive trauma injury. Overuse injuries are caused by repetitive stress on the muscle and skeletal system without enough rest to allow the body to adapt. Studies show these overuse injuries account for more than half of pediatric sports injuries and often happen due to intensive focus on a single sport with an intensive practice and competition schedule. Unrecognized and untreated, they can sideline athletes from play and lead to more serious injuries.

Who is qualified to diagnose and treat fascial/muscular adhesions?
Sports medicine experts are advocating a greater role for therapists who can help athletes or active individuals recover without incurring lasting damage or hampering their activities. Specialists such as chiropractors, physical therapists, and massage therapists who specialize in sports-related injury and rehabilitation are often the first line of defense in managing and treating overuse injuries. These licensed professional are best for identifying muscular or fascial adhesions as they related to overuse injuries and movement disorders. With specialized training, these professionals are able to detect and treat muscular adhesions, expediting the healing process and minimizing downtime due to overuse injuries.

This is exactly why at Gallagher Performance we have a team which includes a massage therapist and a board certified chiropractic rehabilitation specialist. We strive to offer our athletes and patients the latest treatments and evidence-based soft tissue and rehabilitation techniques. Helping our athletes and patients achieve and sustain their best level of health and performance is our goal.

More related reading:

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

https://gallagherperformance.com/why-stretching-wont-solve-your-tight-muscles/

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

This short video discusses the reality of overtraining as it relates to human performance when it matters most. Overtraining is not a myth. Learn more here.

https://www.youtube.com/watch?v=tyYQEVO7QOI

Muscle has a great importance to the body beyond being stronger and looking better. So what's the best way to build muscle? Learn more in this short video.

https://www.youtube.com/watch?v=O6UkKFDO0uU

 
 

Here at Gallagher Performance we not only strive to provide the best in chiropractic, rehabilitation and manual medicine treatments for our patients, but we also utilize comprehensive diagnostic methods and tools to help determine which treatment is best for you. This allows us to apply to most ideal therapeutic interventions. At GP, this could include any combination of the following: chiropractic manipulative therapy, manual therapy according to Lewit and Janda, Vojta Therapy, myofascial release, trigger point therapy, neuromobilizations, and dynamic neuromuscular stabilization (DNS).

Despite many of our patients having previous experience with chiropractic or physical therapy, they are unfamiliar with DNS. Gallagher Performance specializes in DNS therapy. Dr. Gallagher has been studying and utilizing DNS since 2007. His extensive training and background allows him to provide a level of care that is unique to the Pittsburgh area.

Since DNS has implications in both physical rehabilitation and training, we spend a great deal of time educating our patients and clients on DNS and answering some frequency asked questions. With that in mind, the goal of this article is to help educate our readers about DNS and the significance this intervention has as it relates to pain or sports performance.

What is DNS therapy?
DNS is a revolutionary European approach in the treatment of back pain and several neuromuscular conditions. DNS therapy is based on the neuroplasticity of the Central Nervous System and targets the cause of pain/dysfunction rather than its manifestations. DNS therapy evokes ideal movement patterns by manual stimulation of developmental reflex zones and utilizes specific exercises to improve neuromuscular control. The therapeutic benefits become significantly expanded from previous standards of rehabilitation. Any one from infants to adolescents, chronic pain patients to athletes can all benefit from DNS therapy.

How does DNS compliment chiropractic adjustments? 
DNS therapy favorably compliments traditional chiropractic adjustments in several ways. When patients may be apprehensive about receiving an aggressive or forceful chiropractic adjustment, DNS offers gentle, non-forceful, low velocity manipulation that is well tolerated and safe. For those that receive traditional chiropractic adjustments, DNS works in concert to normalize joint function and restore muscular balance, leading to more sustainable improvements in reduced pain and improved function.

Often times, symptom relief experienced from a chiropractic adjustment can be short-lived with symptoms returning rather quickly. In contrast, when DNS is applied in a chiropractic setting, the approach allows for longer-lasting symptom relief due to therapy’s ability to improve Central Nervous System (CNS) coordination and joint stability which is then maintained by performing prescribed home exercises.

DNS therapy simply enables a chiropractor to effectively treat and manage a broad range of musculoskeletal and neurological disorders. While traditional chiropractic may be limited in what can be done through chiropractic adjustments and passive modalities, DNS represents a powerful alternative to chiropractic care when dealing with pain syndromes and more complex structural pathologies where the effectiveness of traditional chiropractic is highly limited.

How is DNS therapy able to get me out of pain and moving better when other conservative therapies have failed?
The results achieved by DNS therapy are often difficult to achieve with traditional methods used by chiropractors and physical therapists due to the physiological phenomenon that occurs during treatment to minimize muscular imbalances, relieving painful protective muscle spasms, resulting in a more stable musculoskeletal system with improved spinal stability and postural awareness.

During DNS therapy, induced movements are controlled not locally, but by the higher levels of the Central Nervous System. This then results in faster and longer-lasting improvement in function and pain relief.  When combined with exercise, the promotion of joint stability and ideal movement becomes habitual and independent of conscious effort.

How are DNS exercises different from traditional physical therapy or physical training exercises?
In the majority of physical therapy and chiropractic clinics, as well as in personal training settings, exercises are performed that simply train muscles in isolation. The patient who has shoulder pain and is only prescribed shoulder exercises illustrates this concept. The fault in strengthening weakened muscles through isolation training is that isolation training will fail to unify the painful or problematic joint with the entire locomotor system. Sure you can perform all the isolation exercises you wish, but this does not guarantee that the strength or coordination gained will automatically transform into adequate performance.

DNS exercises are applied in accordance with development kinesiology or essentially how we develop motor function during childhood. As we develop, reflexive movements (primitive, postural, locomotor) become more refined and coordinated, ultimately leading to specific movements we produce later in life such as walking, running, jumping, reaching, throwing, etc.

However, developing these skills does not happen magically.  Learning to control the body and developing fundamental skills make up our motor milestones.  These milestones mark critical points in our development and there is a progression that these milestones follow.  This is known as developmental kinesiology. In simplistic terms, we need to be able to lift our head and support it, roll over, crawl, support ourselves upright, walk with assistance, and then walk without support.

The understanding of developmental kinesiology and critical motor milestones allows the provider to make exercise progressions and regressions during the course of therapy in order to appropriately address the underlying locomotor system dysfunction(s).

These exercises are applicable for patients with variety of acute and chronic conditions as well as for athletes who are trying to improve their performance and also prevent or rehabilitate injuries.

Often DNS exercises are conducted with active support from the clinician to insure that the patient maintains proper support and executes ideal movement. DNS exercises could include the use of stability balls or bands to further facilitate the desired response of the exercise.  These exercises are not only used to improve the stability of the spine, muscle coordination, balance and strength, but also to increase the body’s awareness and sensory integration.

Conclusion
All of a sudden, conservative management and treatment of patients and training of athletes looks a lot different than what is traditional accepted.

DNS is not only a magnificent approach for preventing and rehabilitating pain syndromes in the movement system it is also becoming extremely popular in sports performance circles. The same ideal patterns that keep an individual out of pain also maximize the efficiency of the movements, which not only reduces risk of injury but improves performance.

When you consider the principles of DNS, it truly is not about what exercises we prescribe or what exercises we perform, but rather what we are actually getting from those exercises when we perform them that is important. DNS provides a system of evaluation and treatment which follows motor development, thus providing an effective way to help our patients get the most out of therapy and our clients get the most out of training.

Sources:
Dynamic Neuromuscular Stabilization & Sports Rehabilitation, Frank C, Kobesova A, Kolar P. Int J Sports Phys Ther. , 2013 Feb;8(1):62-73.
A case study utilizing Vojta/Dynamic Neuromuscular Stabilization therapy to control symptoms of a chronic migraine sufferer, Juehring DD, Barber MR. J Bodyw Mov Ther, 2011 Oct;15(4):538-41.
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.
Effects of shoulder girdle dynamic stabilization exercise on hand muscle strength., Kobesova A, Dzvonik J, Kolar P, Sardina A, Andel R. Isokinetics and exercise Science. , 2015;23:21-32, 
Developmental Kinesiology: Three Levels of Motor Control i the Assessment and Treatment of the Motor System. Kobesova A, Kolar P. Journal of Bodywork and Movement Therapies., 2014;18(1):23-33.
The Prague School of Rehabilitation, Kobesova A, Osborne N. International Musculoskeletal Medicine, 2012;34(2):39-41.
Postural - Locomotion Function in the Diagnosis and Treatment of Movement Disorders, Kolar P, Kobesova A. Clinical Chiropractic, 2010;13(1):58-68.
Analysis of Diaphragm Movement during Tidal Breathing and during its Activation while Breath Holding Using MRI Synchronized with Spirometry. Kolar P, Neuwirth J, Sanda J, Suchanek V, Svata Z, Volejnik J, Pivec M. Physiol Res, 2009;58(3):383-92.
Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain. Kolar P, Sulc J, Kyncl M, Sanda J, Cakrt O, Andel R, Kumagai K, Kobesova A. J Orthop Sports Phys Ther, 2012;42:352-362.
Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment, Kolar P, Sulc J, Kyncl M, Sanda J, Neuwirth J, Bokarius AV, Kriz J, Kobesova A. J Appl Physiol. , 2012;42(4):352-62.
Importance of Developmental Kinesiology for Manual Medicine, Kolar P. translated from Czech Journal of Rehabilitation and Physical Therapy, 1996;4:139-143.
Surgical treatment and motor development in patients suffering from cerebral palsy, Kolar P. Translated from Czech Journal of Rehabilitation and Physical Therapy, 2001;8(4):165-168.
Long-Term Efficacy of Dynamic Neuromuscular Stabilization in Treatment of Chronic Musculoskeletal Pain, Bokarius AV, Bokarius V. 12th World Congress on Pain. Glasgow, Scotland. Aug 17-22, 2008. Presentation # PF225.
A case study utilizing spinal manipulation and dynamic neuromuscular stabilization care to enhance function of a post cerebrovascular accident patient, Oppelt M,Juehring D,Sorgenfrey G, Harvey PJ, Larkin-Thier SM. Journal of Bodywork and Movement Therapies., 2014;18:17-22.
More related reading:

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