Friday, February 20, 2009

To brace or not to brace...the back/spine?

Here's where I get I little fuzzy on the idea of bracing.
Bracing is essentially a co-contracting of the "core" musculature correct? If that is true, in movement, especially of the spine, their must be an agonist/antogonist relationship between the contractors (shortening) and noncontractors (lengthening) muscles. In terms of athletics the spine moves. In the industrial setting where I work, we see the interspinalis muscles become (in my humble opinion) de-conditioned especially in transverse movement. As a result, we still deal with back pain even though their "core" muscles are strong as can be. I also don't know that I buy the idea that our spines only have so many
"flexes" in them before they break. The analogy used was that of a wire bending which will eventually break. Unlike a wire, the body has the potential to actually become better with use. So for me the search continues to find that balance between bracing (protecting the back) and moving (using the back) to perform functional activities in a wide variety of settings.

Friday, February 13, 2009

Rest and Recovery

I will remember the first time it hit me. The time when I realized how important rest is. Vern Gambetta pointed out that it's not during the conditioning that we get better but during the rest after the conditioning where the adaptation takes place. This truth was HUGE for me to understand.

This week I've had to address the issue of rest and recovery in 2 completely different environments. The first environment is at the industrial facility where I work my full time job providing rehab and fitness programming. the individual is being seen post op shoulder debridement. Well on their own they have managed to turn a relatively simple rehab process into a much more complicated situation than it needed to be merely because they over worked the effected shoulder on the outside of rehab. I had to explain the reason why his RC is rebelling via spasm. Now that he has listened to me, the pain and spasm has decreased. Why? because of the appropriate rest.

In the second situation the DIII coach that I've been working with asked me, "My team looks like they are tired during practice and in games. What should I do?" My response, "Rest". I've made this mistake as an athlete myself. During the seaons isn't the time to get the players into game or tournament shape. This is why the off season is crucially important in developing those basic biomotor qualities of an athlete.

Tuesday, February 10, 2009

Athlete vs Athleticism part 2...

In a comment the question was basically why are we trying to redefine a word that seems pretty clear by its definition. Athlete or athleticism basically refers to an individual who participates in a game or sport requiring physical components of strength, stamina, etc. The comment was correct in pointing out that the word needs no new definition.

However what wasn't asked is why was the topic presented in this manner to begin with?

The reason I asked the question for a definition of athleticism was to break up the confines of rehabilitation and therapy. Too often we see an individual in our clinic or ATR and we immediately go to work on the area in question. The mantra train movements not muscles comes to mind (Gary Gray). So is the idea that we should train/rehab the whole person not just the 1 muscle that may have tendonitis. In the industrial setting where I work the production workers could all benefit from improved physical function as to prevent injury during their jobs. If I only rehab their 1 joint or muscle that has pain I've really not done my job. However if I can improve there overall function then I may have prevented them from becoming the next recordable. Perhaps I can even convince them to become the next fitness user at our facility.

So instead of looking at your next patient in terms of Range of motion, goniometer measurements, and 4+/5 during a manual muscle test try seeing them in terms of agility, balance, coordination, functional strength, functional endurance, functional reaction time.

Do we need to drop the swelling measurements? Maybe not but look and rehab the next patient as a whole and not as an injury.

Monday, February 2, 2009

Coaching, Teaching, Mentoring

No doubt I could find countless blogs about how to play this sport or that sport. And no doubt that I could hire someone to train me to become as good as i can in one of those sports. Personally my sport was baseball. Then one day when I was coaching a little league 13 year old team my perspective on coaching/teaching/mentoring changed.

One day during practice a 13 year old boy came up to me and told me what his father had said to him. His father told him that he threw like a girl and he would never be able to throw. The way the boy said this to me was not what you would expect. He said it so matter of fact, as if he actually believed his dad. Why wouldn't he, after all he was his father? So it was my mission to teach this 13 yo boy how to throw. I didn't want to teach him to be the best on thea team or to be the next Nolan Ryan. I wanted to teach him how to throw to prove the dad wrong. His father never came to the games by the way.

As the season went on the boy kept getting better and better. Then one day it happened. His dad actually came to a game. His son was playing right field when a sharp ball was hit in the gap all the way to the fence just under the 360 ft sign. His son picked up the ball and threw it on a line drive all the way to second base. No he didn't throw anyone out, or help us get out of the inning. But with that throw a relationship was restored, improved or whatever you want to call it. From that day on his dad didn't miss a game.

The kid learned from me only how to throw a baseball. I leanred from the kid that sports are a great avenue to reach someone deep in their soul. That day a boy began to walk with confidence, and a father was proud of his son and I walked away able to see the bigger picture.