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/

Pain Indicates A Health Problem, Not A Fitness Problem




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

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

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

A sample scoring system would look something like this:

0 = pain

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

2 = performs movement with compensation

3 = performs movement without compensation

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

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

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


Got pain?

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

 
For more related reading:

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

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

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



Exercise Hacks Ep. 13 - Horizontal Pressing Alternatives for Painful Shoulders


[embed]https://www.youtube.com/watch?v=LNH6aIezqd0[/embed]

Outside of low back pain, shoulder pain is one of the most prevalent musculoskeletal complaints. For avid exercisers and athletes, shoulder pain is something most are familiar with, especially when it comes to horizontal pressing movements.

The most popular of the horizontal pressing movements being the barbell bench press. Bench press often enough, long enough, and heavy enough, you will likely experience some degree of limitation due to shoulder pain or injury.

This can be for a number of reasons that all should be considered. But there is one reason why the barbell bench press becomes unfriendly to the shoulders - the fixed position the scapula (shoulder blades) are placed into.

Creating a tight upper back and stapling the scapula to the bench is critical for a big press as this forms the foundation for pressing.

But let's consider healthy shoulder motion is dependent upon a freely moving scapula. Otherwise too much stress is placed at the glenohumeral joint (shoulder joint). Yes, accessory exercises should be programmed to maintain healthy shoulders but there is only so much that can be done to offset thousands of pounds of bench pressing volume. We absolutely should be proactive in our approach to avoiding shoulder pain and/or injury.

That's why it is important to incorporate horizontal pressing movements that allow the scapula to move more freely. Whether they are used as a primary movement, accessory movement or alternative while the shoulder is on the mend, the exercises seem in this video can offer increased shoulder stability and motor control while giving your joints and connective tissue a break from intense training. See in this video are:

1) Standing Horizontal Cable Press

2) Stability Ball Dumbbell Press

3) Stability Ball Alternating DB Press

4) Stability Ball Single-Arm DB Press

A great benefit to these exercises is the amount of core and hip engagement required which is awesome for teaching force transfer through the body and how to steer strength.

Note: if performing heavy presses on a stability ball be sure to use a properly rated ball.

 
 
 
For more related reading:

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

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

The Site of Pain Is Rarely The Source of Pain

A testimonial worth sharing:

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

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

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

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

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

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

-Zaid Alzaid

 
For more related reading:

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

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

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

The Essentials of Hamstring Rehab

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

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

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

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

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

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

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

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

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

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

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

 
For more related reading:

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

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

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

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

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

Are You Receiving Value in Your Treatment or Training?

The combination of chiropractic/manual therapy and massage therapy paired with smart training can make a profound impact on any musculoskeletal condition you may be dealing with. There's tremendous value in care and training that focuses on the goals and outcomes you care about. You place a value on your health or performance and you should receive services that deliver value.

The challenge is finding a chiropractor, therapist, or trainer who aligns with your values and the value that you place on your body and health. There's a spectrum on which these providers exist and it becomes your responsibility to do your homework. To make sure you find someone that can deliver the care, quality, results, and value that you're looking for.



You can go to 10 chiropractors and have 10 totally different experiences. You could see 10 personal trainers and have 10 totally different experiences. Yet all those experiences fall under the broad categories of 'chiropractic' or 'personal training'.

You don't know what you're getting into until you do some research and understand how someone practices or how they are going to approach your specific exercise program.

Some may argue one way may not be better than another way, but there are certainly more affective means of treatment and training that get better results.

There is a responsibility on the individual to find someone who will deliver that value. People often go through detailed vetting processes when it comes to a mechanic, electrician, plumber, doctor, etc. When it comes to your health, are you vetting the people you work with?

A big reason why we get a lot of athletes and individuals that prioritize their health is they do their homework. They want to understand how the body works and they are driven to optimize it. They search out the right person for the job. They want someone to deliver value in the care and the training that they are receiving because they realize they only have one body and they want to take care of it to the best of their ability.

Are you placing value on your health, fitness, or sport goals? Or are you just looking for the best price?

 
More related reading:

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

https://gallagherperformance.com/essentials-of-keeping-athletes-healthy/

 
https://gallagherperformance.com/options-dont-take-insurance/

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

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

3 Common Reasons for Low Back Pain

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

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

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

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

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


More related reading:

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

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

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

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

Exercise Hacks Ep. 7 - Core Stability for Shoulder Mobility

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

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

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

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

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

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

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

 
 
More related reading:

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

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

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

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

Dynamic Duo - Chiropractic and DNS

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

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

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

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

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

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

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

 
For more reading:

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

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

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

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

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

Exercise Hacks Ep. 5 - Shoulder External Rotation

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

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

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

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

Some key points discussed in this video:

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

More related reading:

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

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

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

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

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

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

Exercise Hacks Ep. 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/

 
 

Clinically Pressed Podcast Episode 38

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

Clinically Pressed Podcast Episode 38

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

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

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

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

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

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

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

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

Continue reading

What Makes a Sports Rehabilitation Chiropractor?

Chiropractors have traditionally been known for treating patients suffering from acute or chronic pain related to the neck and back. Chiropractic treatment that involves spinal manipulation is regarded as a standard for treatment of cervical spine (neck) pain and acute lower back pain. Not only is it safe, but it has also shown tremendous health benefits for improving range of motion and reducing pain in patients during the rehabilitation process.

However, chiropractors are also capable of helping patients rehab and recover from injuries suffered in an accident or sports. The role chiropractors play in rehabilitation and sports medicine has grown substantially in the last 10 years. Almost all professional sports teams in North America utilize chiropractic services because of the recognition chiropractors has received in their ability to help athletes perform at their highest possible level. Apart from this, many rehabilitation clinics include chiropractic care as part of the services offered to patients.

Consider for a moment that the Managing Director for Sports Medicine for the United States Olympic Committee is Dr. Bill Moreau....a chiropractor!

Holding a position as a sports rehabilitation chiropractor is growing in popularity and, just like an athlete, a sports rehabilitation chiropractor must possess many tools or skills to be both effective and efficient in treating patients who are active and athletic.

Below is a list out 5 critical elements you should find when looking for a chiropractor who will be capable of treating you from a rehabilitation or sports injury perspective. Consider that these are not simply just my opinion, but rather this list has been compiled based on the insight of several of my colleagues and mentors, their clinical experience, as well as my own clinical experience.

  1. Palpation & Adjusting Skills. The heart of chiropractic is the ability to assess, diagnose and treat (heal) with our hands. Our hands truly are the greatest diagnostic tool available to us. I've had people say to me that what I do as a chiropractor is "easy" and that "anyone can adjust". There is some truth to that. Adjusting is easy. You can make a joint "pop" real easy. The challenging part is palpation and finding exactly what joint needs corrected, what motions are limited, and determine exactly how you will adjust the dysfunctional joint(s). Palpation is a skill and takes years to refine. You would be wise to find a sports rehabilitation chiropractor who is very skilled with their hands and capable of determining appropriate application of chiropractic adjustments.
  2. Functional Approach to Evaluation and Treatment. The use of functional evaluations is another critical skill of the sports rehabilitation chiropractor. The ability to assess movement and identify hidden causes to injury and pain become invaluable to helping patients find relief and optimize performance. If your chiropractor isn't taking time to assess your movement and helping identify how it may be playing a role in your pain or injury, you may be miss reasons why your pain is recurrent or why you just can't seem to get better.
  3. Functional Rehabilitation. A sports rehabilitation chiropractor should incorporate rehabilitation and active care into your treatment plan. Almost every case involving muscle or joint pain requires some level of strengthening exercise progression and education. 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.
  4. Dynamic Neuromuscular Stabilization (DNS) and 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 sports rehabilitation chiropractors.
  5. Myofascial Release & Manual Therapy Techniques. 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. Sports rehabilitation chiropractors commonly use myofascial release & manual therapy techniques such as cross friction massage, active release, instrument assisted soft tissue mobilization, muscle activation, PIR, and PNF. 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.
 
More related reading:

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

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

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

2 Exercises for Groin and Knee Pain

Please watch: https://www.youtube.com/embed/xBOWKP4CO4Y

Above is a short video addressing common reasons why ground and/or knee pain develops and two exercises to get to the root of the problem. Addressing muscular dysfunction through therapeutic exercise continues to prove to be the most effective and evidence-based intervention for common musculoskeletal conditions such as tendinitis, bursitis, sprain/strains, joint pain and muscle tightness.

These exercises involve minimal equipment and are easy to perform at home, in a hotel room, or at the gym. All you need is:

  • Chair/bench or some form on a firm elevated surface
  • Your own bodyweight

Exercises covered in this video:

  1. The Adductor (Groin) Side Plank
  2. The Rear-foot Elevated Split Squat (Bulgarian Split Squat)

Also covered in the video are common reasons why groin and/or knee pain may develop and why these exercises can be very effective once a patient is out of pain.


More related reading:

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

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

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

The Most Effective Treatment for Shoulder Pain

Our approach to working with shoulder pain or injuries is very unique in that we really don’t work around shoulder injuries when properly indicated. The majority of the time, we don’t force someone to rest for several days while inflammation quiets down. Yes, it can be necessary in rare circumstances. However, rest and traditional methods of ice and anti-inflammatory meds are often over utilized when properly prescribed movement (i.e. exercise) is probably the better bet for improved recovery. At Gallagher Performance, we have a nasty habit of getting our athletes, clients and patients to work through pain and injuries by strategically incorporating exercise with specialized approaches tailored to find “the hardest thing they do well”. We want to find what they can be successful with while not posing any undue risk. And the best part? The system works.

When it comes to the shoulder, pain and injury is most commonly associated with poor shoulder function and faulty mechanics. And when I say most commonly, it’s not a stretch to say over 50% of shoulder injuries are due to these underlying problems. If muscles are unable to fire properly to provide ideal amounts of support (stability) and motion (mobility), then injury will occur regardless of how strong or flexible one is.
I have written extensively on the subject of the “hidden cause of injury” since the root cause of the overwhelming major of musculoskeletal injury is dysfunctional movement. Most doctors and trainers do not have the training or eye to look for dysfunctional movement and no amount of rest, ice, and Advil will ever provide the solution. No amount of passive modalities, taping, cupping, mobility drills, or stretching will correct dysfunctional movement. When it comes to shoulders, the solution to reducing shoulder pain and preventing injury is all about restoring proper rhythm and mechanics of the shoulder joint. This includes all it’s associated articulations – the glenohumeral and scapulothoracic. Basically we have to improve how both the “ball and socket” joint or “shoulder joint” (as most of us know it) and “shoulder blade” function together.

When it comes to improving the function of the shoulder, we’ll take an athlete or patient and have them perform variations of rows, pulls, presses, and ground-based movements with adequate loads to reinforce ideal body mechanics and correct dysfunctional movement or stability patterns. This is done through a combination of exercises, tempos, external stimuli, and progressions to essentially re-educate the nervous system. This is why it’s called neuromuscular re-education. We must teach the nervous system to do things better and break bad habits. Yes bad habits can be very challenging to break. Most people would rather pop a pill or rest until their pain disappears rather than break bad habits because breaking bad habits sounds like hard work. Popping pills and rest are great because they are easy and effective. But those who deal with chronic recurrences may want to think about a different strategy once their patience wears thin.
For example, some lifters have such poor thoracic spine posture and scapular dyskinesis that they may need 6 months+ of rehab and corrective work. But they have no interest in that. They have no interest in stepping back a little and refocusing their training for long-term development. They prefer to band-aid symptoms while they push their training and perpetuate the pain cycle.

The funny thing is breaking bad habits isn't as hard as most people think. If you work with the right person you’d be surprised what proper coaching, cueing, and exercise can do in a relatively short period of time. The reality is most people are highly resistant to breaking bad habits because of either ego or the unwillingness to take a step backward. Typically after a number of training or therapy sessions, the individual is able to perform any and all movements without pain and with improved shoulder mechanics. For those dealing with shoulder pain, improving their mechanics through sensory-motor training enables their nervous system to be re-educated. This re-education process is the most effective form of therapy and healing available. It cannot be understated that a critical component of this process is proper coaching and cueing. This is the responsibility of the coach or therapist. As much as proper coaching and cueing can be beneficial, improper coaching and cueing can prove to be very damaging. It is my opinion that many injuries occur because the athlete or patient had previously received very poor coaching or instruction.

This is exactly why performing exercise with proper technique is proving to be the single most effective form of therapy as it promotes almost immediate healing. If someone is having pain during a movement, they are doing something wrong. Correct them into the proper movement and watch their pain disappear. The key is re-educating the nervous system so movement becomes both therapeutic and performance-enhancing to one’s body rather than promoting pain and destroying joints. This is truth when it comes to the shoulder joint as well as any joint within the human body.

Tired of pain? Want to reach your full potential? Visit gallagherperf.wpengine.com
EXPERIENCE THE DIFFERENCE.

More related reading:

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

The Solution to Long Term Improvement of Back Pain

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/

Dynamic Neuromuscular Stabilization: Advancing Therapy & Performance

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/

Why Therapists Should Understand Strength

As a chiropractor that specializes in manual therapy and rehab protocols, I see patients dealing with a variety of problems. Now while the conditions can vary greatly, the common denominator that all my patients share is that they are either in pain or unable to perform a specific activity at a level they desire. Being able to provide a service to help people was exactly why I got into chiropractic and it is why I work to continually develop my craft and treatment philosophy. My treatment philosophy has helped to develop my system for how I go about evaluating and treating each patient that comes to me for help. As valuable as my education and residency has been to developing my treatment philosophy, the insight and knowledge I have gained on strength and conditioning as an athlete and coach has been equally valuable.

A great mentor of mine told me that with his background as a strength coach, he uses that background and mindset everyday with his patients. Some years later, I continually have a renewed appreciation for what he communicated in that statement because looking at my patients through the "lens of strength" can provide me with a refreshing perspective.

Why?

Simply put, strength matters. Strength has the ability to cover up dysfunction. Strength will directly impact movement quality. Strength will improve mobility or flexibility issues. Strength has tremendous ability to minimize or reduce overuse injuries. Strength becomes a focus in my treatment plans and the advice I provide my patients.

In my opinion, a major player in the outcomes of patient care is the quality of advice they receive. Much of the advice I provide is directed at my patient's current exercise routine. And, at times, the advice is very blunt. The type of advice that is often tough to swallow on their part because it means big changes

What does that advice look like?

Say you are dealing with low back pain that is worsened from repetitive flexion. You can’t tolerate bending forward to tie your shoes or get nervous just thinking about picking up something from the floor, yet you love your group exercise class that has you running through dozens of crunches, sit-ups, air squats, and wall-balls. Your back is not going to respond to any form of therapy until you remove the irritating factor (your group exercise class) and follow the advice of substituting in more appropriate exercises that promote a healthy back.

Say you can’t properly lift your arms overhead with ideal form and posture through the shoulders, spine, and hips. Now you want to participate in an exercise routine that includes Olympic lifts such as the snatch and overhead pressing. What you must understand is that you lack the prerequisites to perform loaded overhead exercises. This is why your shoulders or low back hurt after overhead pressing or performing a full snatch and you need to be advised accordingly.

Advice should be constructive, providing a solution. However, there is some advice that is simply unacceptable. The classic example of this is the runner who develops knee pain, decides to see a doctor and is told, "Stop running."

Unacceptable.

The solution is rarely that simple. Maybe that runner lacks movement control in joints in such as the ankles, hips, pelvis, and spine because they lack adequate strength in surrounding musculature. Maybe that should be addressed while their current running program is restructured according to their tolerances.

There are solutions and often those solutions involve strength development.

As a therapist, odds are in your favor that you are going to find a strength deficit that is playing into that runner's knee pain. Odds are in your favor that you are going to find that lack of strength is correlated with any number of common conditions.

Lack of strength is never solved by inactivity and prescribing rest. Strength requires the opposite. Strength requires focus, guided effort. Strength is a difficult pursuit and it requires that one knows what they are doing if you are going to coach the process.

On my end as a therapist, what becomes even more difficult to navigate is managing a patient who has his or her own personal trainer or strength coach. I always ask them what they are doing for "training," and most times my response is inwardly shaking my head. I don’t say anything, unless I’m asked. If I’m asked, then it is time to be brutally honest.

It is important to note that you shouldn’t just take exercises away, but substitute better ones. My job is to find the best exercise for the job. This is why developing a large exercise pool to draw from is invaluable as a strength coach and as a rehab specialist. Having a huge exercise pool will allow you to make progressions, regressions, and substitutions based on movement patterns, training goals, mechanical sensitivities, or movement limitations.

At GP, we have taken time to develop our exercise pools for lower body pushes/pulls, upper body pushes/pulls, hybrids, developmental stabilization, etc. This allows seamless transition between phases of rehabilitative care for my patients and continual development from a strength and performance perspective for my athletes because we have developed our plan for progressive development. This understanding of strength also allows me to provide the most appropriate advice when it comes to exercise selection.

As William Penn said, “Right is right even if everyone is against it, and wrong is wrong even if everyone is for it.” People are there for your expertise and knowledge as much as your skills. Remember to provide the care and treatment you would want to receive and provide them with the advice and direction you would want to understand.

More related reading:

https://gallagherperformance.com/interview-with-mike-odonnell-dc-ccsp-cscs/

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

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

Stay Strong and Heal Faster While Injured

Injuries are a part of sport and life. It is an unfortunate reality and a lesson some encounter with greater frequency than others. I have had my fair share of injuries as well. The reason why I am writing this post is because of my most recent injury.

Over the past 14 weeks, I have been prepping for a strongman competition in Iowa on May 16. The training cycle had been going smoothly and I was feeling good heading into the final days before my taper. Four days ago, I pulled my left bicep during tire flips. The tire flip is one event that is notorious for causing bicep injuries due to the large amount of mechanical stress it places on the biceps. Fortunately, I did not suffer a complete tear, no surgery needed. However, competing is out of the question. When you are self-employed and your job requires the uses of your hands, there is no need for any further set backs.

For some, injuries mean down time from training. They see injuries as an obstacle. Not in my mind. An obstacle is what you see when you take your eyes off the goal. There are still ways to train around injuries. Sure, I will not be able to do anything stressful with my left arm for 3-6 weeks, but I can still get a powerful training stimulus from a incorporating squat and single-leg variations for lower body strength, jumps/bounds/hops for more intensive CNS stimulus, and training my non-injured arm to help maintain strength and speed recovery of my injured arm.

Wait….what? Training your non-injured arm helps to keep your injured arm strong and heal faster?
There is truth to that statement. The phenomenon I am referring to is known as “cross-education”. It is well established that to minimize the effects of detraining, performing single-side training with the non-injured limb (upper or lower body) will allow you to maintain strength and accelerate healing in the injured limb.

Cross-education occurs when you strength train a limb on one side of the body. The result is an increase in strength in the opposite limb on the other side of the body due to neural adaptations. Cross-education appears to be effective for all muscles and joints of the body, from shoulders and hips to ankles and wrists.

A study published in the Journal of Exercise Science and Fitness demonstrated that strength gains in the untrained limb are typically in the range of 5 – 25% depending on if that limb dominance. Strength gains average around 35 – 60% increase in the trained limb. Additionally, it appears that less range of motion will be lost in the injured limb due to the cross-education effect – another major benefit.

There are other studies on the subject of cross-education, but still cross-education is not completely understood. Strength gains in the injured limb are most likely due to neuromuscular adaptations and increased neural drive to the untrained muscle. A similar hypothesis is improved motor control because training the healthy limb results in recruitment of high-threshold motor units in both limbs. Keep in mind, there is no evidence of hypertrophy (muscle growth) or changes in muscle fiber types in the injured limb following single-side training.

Cross-education highlights the importance of single-limb exercises during training and rehabilitation from injury. Helping clients or athletes understand cross-education may encourage them to continue an exercise routine during time of injury, as it can help maintain strength and speed recovery. Cross-education is a perfect illustration of how one can turn a weakness into a strength through focused training efforts.

 
Sources:
Lee, M., Carroll, T. Cross-Education: Possible Mechanisms for the Contralateral Effects of Unilateral Resistance Training. Sports Medicine. 2007. 37(1), 1-14.
Zhou, Shi. Cross-Education and Neuromuscular Adaptations During Early Stage of Strength Training. Journal of Exercise Science and Fitness. 2003. 1(1), 54-60.
 
More related reading:

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

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  • 4484 William Penn Highway

  • Murrysville, PA 15668

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