Why Muscles Become Tight 

There seems to be a growing number of programs and trainers touting how they offer ‘pain-free training’ and that anything less than what they offer is simply inferior by design.

Any intelligent trainer, coach, or therapist will acknowledge the value of proper training to ensure no serious orthopedic issues develop. No one wants their clients becoming pain patients. Proper training is multi-faceted from proper form to proper exercise selection to proper volume and loading parameters. These are a given. These are essential to ensuring we minimize injury risk and improve tissue resilience.

However the reality is if you are going to push your body to new levels of performance, you are going to feel it. It’s going to be uncomfortable. It’s going to hurt at times. If you aren’t looking to better yourself, why are you even training in the first place? Essentially at the heart of training is pushing your body to a place it’s never been before. There aren’t many people out there who have pushed their bodies in training who haven’t ended up ‘feeling it’ in the form of soreness, physical discomfort, and yes - at times - pain.

By all means, yes, we shouldn’t train recklessly. We should be practical and intelligent in our execution of a training plan. But we also shouldn’t be alarmed and fear we are doing something terribly wrong when we deal with discomfort, aches and pains. It comes with the territory of pushing our bodies to new levels of fitness or performance. This is why recovery methods and seeking out qualified professional care from sports/rehab chiropractors, massage therapists, and physical therapists can do wonders for helping our bodies better manage the stress of training. ——

No one wants to be in pain, but push yourself hard enough for long enough, you’ll feel it. We need to understand better pain education, how to be more realistic with training expectations, and how to manage the stress of our bodies to avoid serious pain or orthopedic problems.

 
For more related reading:

https://gallagherperformance.com/the-site-of-pain-is-rarely-the-source-of-pain/

https://gallagherperformance.com/15-minutes-of-exercise-or-8-hours-of-pain/

https://gallagherperformance.com/groin-pain-rehabilitation/

https://gallagherperformance.com/pain-indicates-a-health-problem-not-a-fitness-problem/

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

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

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

Sign up for our ‘Episode Email’ and get all CP Episodes Delivered right to you.  Sign up at www.clinicallypressed.com

Podcast Notes:

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

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

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

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

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

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

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

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

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

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

What does that mean?

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

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

• Stabilization of the injury and reduction of pain by approaches that follow desensitization and healing.
• Development of strength and physical ability only begins when the first stage has been achieved.

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

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

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

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

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

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

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

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

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

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

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

 
For more related reading:

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

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

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

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

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

 
 

A 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/

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

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

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

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

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

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

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

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

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

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

 
More related reading:

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

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

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

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

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

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

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

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.

When it comes to health, fitness, or athletic goals, there is no secret. There is no special exercise class, no special equipment or supplement. There is no magic. Yet people keep looking for one.

The truth is there are no shortcuts and anyone promoting shortcuts is lying to you. And if you bought it, you were buying 'hope' only to discover you actually got a bunch of nonsense that left you disappointed and frustrated.

Chasing shortcuts is a mentality that is robbing people of not only achieving their goals, but the ability to maintain them. If you some how think that serious health and fitness goals are able to be achieved with anything less than 100% commitment, dedication, discipline, and will power to sacrifice for your goals - there is nothing anything or anyone can magically do for you.

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

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

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

[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).

[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.

[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.

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

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

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

Some key points discussed in this video:

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

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

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

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

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

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

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

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

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

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

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

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

https://gallagherperformance.com/commonmistakesindevelopingyoungathletes/

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

[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
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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.

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.

Scoliosis.

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

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

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

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

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

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

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

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

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

• Visible signs of lateral spine curvature along with asymmetries seen in the shoulders or hips, in which one side appears higher than the other.
• Adam's Forward Bending Test revealing either structural or nonstructural (aka functional) scoliosis. Adam's Test is consider the most sensitive test for scoliosis and the most common test used in the diagnosis of scoliosis.
• Radiographs or x-ray indicating positive findings for scoliosis. The curves are often measured for angles of the curves to determine severity.

• Functional tests to assess movement control and coordination of the musculature surrounding the shoulders, spine, and hips.
• The central role proper neuromuscular function plays in spinal stabilization and optimal spinal posture.
• Sensory-motor integration and cerebellar function in the patient's ability to sense their body awareness, posture, and joint position in space.
• Hypermobility and other present musculoskeletal compensations in response to poor function of the integrated stability stabilization system (ISSS).

1. Observation
2. Bracing
3. Surgery

1. Cerebellar function and hypermobility in patients with idiopathic scoliosis, Kobesova A, Drdakova L, Andel R, Kolar P. International Musculoskeletal Medicine. , 2013, 35(3): 99-105.