Shoulders

It seems that lately we've been seeing a lot more shoulders. The most intersting observation is that they seemed to be mostly related to scapular dysfunction as the problem where as their point of pain is just a symptom. How many protocols develop and emphasize the scapula in rehab either post operatively or not?

plyometrics

If you have been in fitness long enough you have heard of a plyometric or a plyo for short.  A plyo is a method used to gain muscle strength.  It utilizes the stretch-contract property of the muscle to produce greater force.  Such activities include jumping, bounding, hopping among others.  However I have recently asked the questions:
1. Is a plyometric basedon the range of motion?  In other words, is an activity a plyo if only 5 degrees of joint flexion os achieved prior to the contraction?
2. Does the strength of the contraction matter?  In other words, after the stretch, does the muscle have to fully contract in order for a plyometric effect to occur?
3. Does the movement have to be voluntary?  In other words, what if the stretch and/or the contraction is a reflex?

Just some things to consider when attempting to come up with strengthening techniques for someone who may not have full ROM.

Functional Hip Stretch

Lately it seems that I have had several hip/back issues to deal with. And in each case teh remedy has been a functional hips stretch.



Have the individual stand on the effected leg and with the other foot have them perform a toe tap in the transverse plane allowing the hip to "open and close". Think of them standing on the fact of a clock with there right leg let's say. The right foot will be placed with the toes facing 12. With the other leg they will see how far they can reach, for example, can they reach from 2 and then pivot backwards and toe touch the 6? Do not hold at either position for any length of time. This is a very effective way to lengthen the external rotators (ERs) and teh internal rotaors (IRs) of the hips while weightbearing and against gravity.



Try it and see what you think.

Shoulders

Seems like we've had a lot more shoudlers lately. The most interesting part is that the scapula seems to be the real problem despite the pain is located elsewhere. The other interesting think about the scap is that the LE feed into it and help to make it move more effectively. But how many protocols emphasize the scap in post op rehab or rehab in general?

Baby Fox

Just down from our house is a den with 3 baby foxes. I was fortunate enough to get a picture of one of them. Check it out!!

Mental Toughness Myth?

Vern Gambetta has a post on his blog today about mental toughness. His opinion is that mental toughness is a myth and a cliche'. Cliche' maybe but myth? Come-on! Mental toughness is the ability to ignore that little voice (internal or external) that says, "Ok it's time to quit. There's no need to keep going, that's good enough." Or it's the circumstance that threatens to break your spirit but you continue to press on. This character trait can and should be developed. In Vern's blog he also mentions mindfulness. There is a vast difference in my mind between bull headedness, which some would call mental toughness, and mindfulness. Mental toughness must be accompanied with a moral compass and the wisdom to know when you are being mentally tough and rightfully so or just bull headed and wrongfully so.

What is cusious to me is how Mr. Gambetta so highly relies on the facts of science in his training methods and principles but seems to be able to state his opinions as fact but appears to not have any scientific back support at all.

Is mental toughness a myth? No. Can it be developed? Yes Can it be mistaken for other less desireable character traits? Yes.

In the blog it was also suggested that one of the qualifications of mental toughness is "getting it done". I'm sorry but depending on the situation, not getting it done is not in direct coorelation to mental toughness. Someone can be extremely gifted with mental toughness but still falls short of "getting it done" whatever that means. However I would have to say that a certain amount of mental toughness is required when "getting it done" is achieved.

Feet

Right now I've got a female former DI cross country runner that still trains like she's gonna lose her scholarship. We are seeing her for a torn posterior tib. Interesting, during the eval, her arches were almost exactly the same on both feet. One side she's had multiple stress fxs, plantar fascitis multiple times, etc. The other side, she's never had an injury. However she has always had orthotics in her shoes since her early years in high school.
Oh did I mention that her navicular has migrated medially and her talus pronates extremely bad.
If the feet were the problem, and she ahd orthotics in both the left and right shoes? Then why is one side never injured while the other is frequently injured?