November Book Review

I hope everyone had a great Thanksgiving and is enjoying what hopefully turns out to be a great weekend. I am in for a long travel day, flying to Munich, meet back up with the bobsled team and driving another 7 hours to Torino, Italy, sight of the 2006 Olympics. The last few weeks have been hectic so haven't had as much time to read, but did manage do some light reading and finish AJ Jacobs, "The Guinne Pig Diaries." I really like Jacobs writing, it is fun and poignent. The premise of the book is that Jacobs does mini one month "life experiments" on himself and writes how it affects him and his view of the world. For instance, one chapter was devoted to outsourcing everything imaginable in his life to a virtual assistant in India. Another was he was forced to live by George Washingtons 110 rules for life. The big take home point throughout his book and that he realizes is this, Behavior shapes your thoughts. You want to change, force yourself to do the things first. In his month of absolutely no lying no matter what the circumstance, he found himself telling less white lies, exagerations ect. In a month where he was forced to buy his wife a gift a day, he found that the act of picking something out and up, reinforced his love for her. Behavior shapes your thoughts. It's a pretty powerful message in a really fun read.

High Speed Gait Analysis

This year I have access to a high speed film camera that we have been using with the system dartfish to film starts and loads for the bobsled team. I also starting playing around with it filming athletes sprinting, lifting and working out. It's been a pretty interesting to see some of the early results. Here is Bobsled athlete Jessie Beckom pulling a sled. He had been having problems with a right hip flexor/adductor. Under load it gets magnified a bit and you can see how high the left arm is driven to try to compensate for the problem.

World Cup Race #2

It was a great weekend for the US bobsled team this past weekend in Lake Placid, NY. The women put one sled in the top 6 and the men's team of John Napier won the two man event. The following day the mens four man team showed dominance as they took first and second. They were equally dominate at the start pushing the fastest and third fastest times of the day. The teams have a week off of competition as we head over to Europe for a race in Torino, Italy, sight of the 2006 Olympics.

Lake Placid Track Life

Here are a few pics of the top of the track at Lake Placid World Cup. The women and mens two man race tomorrow. The pic of the cleared parking lot is where the athletes warm up. The other is of the start looking up the track. The last one is of the work area where the sleds are kept before being brought to the line. Have a great weekend.

Is Rest Still Appropriate?

How many time have you heard the old adage, "Just rest it," after complaining of a sore hurting muscle. How many have heard it from their doctor? How many runners see a podiatrist and say "my calf has been really hurting me on long runs," only to be told, "well rest it for three weeks and try again."

Rest was the prescription for many things awhile back. Fast forward to the present. Rest isn't the answer, unless you have a tear. If the muscle is torn or severely strained, then yes rest is the answer. But persistent pain, will in fact persist.

Pain in a muscle is usually a warning that you have exceeded it's capacity for tolerance. In the above example, you may only have the strength in your calf to run 3 miles before your overpronation causes your tibialis anterior to give up, and yet your trying to run 4 miles on it, so your body sends pain to your calf to get you to quit. Sure you can rest your calf until it feels good enough to run again, but as soon as that 4 miles comes around again, here comes the pain again.

Rest will get rid of the pain, because you've gotten rid of the stimulus. But, bring the stimulus back, and back comes the pain. Understand that load and capacity are a seesaw, keep them in balance. More importantly realize that their is usually always a cause for pain and that rest very rarely is the answer.

Monday Quote

‘Between stimulus and response there is a space, and in that space lies all our freedom.’

Viktor Fankl, the Austrian psychiatrist and Holocaust survivor, wrote this in Man’s Search for Meaning. So the next time something happens that you feel you have no control over, think again.

World Cup Race #1

Today is the start of it all. Bobsled world cup race number 1 in Park City, UT. The women kick off at 3 and then men at 7pm central time. It's been a long time since the last race, but it's finally here. I believe there is 90 days till the 2010 games. On a side not the bobsled and skeleton federation (USBSF) has decided to support the following organizations this year.

American Cancer Society
Leukemia & Lymphomas Society
Make-A-Wish Foundation
National Breast Cancer Foundation
Autism Speaks
Seattle Childrens Hospital

If your interested in seeing how you can lend support or in just following the team as they compete up to the Olympic Games, visit, http://bobsled.teamusa.org/

Hip Internal Rotation Evaluation

Internal hip rotation is a crucial component when it comes to proper sprinting and athletic performance. It also plays a significant role with healthy backs. Normal internal rotation for the hip is around 45 degrees. In most really good sprinters, it tends to be a little more, in the athletes I've evaluated.

So when your checking for this one thing to keep in mind is what can inhibit this motion. The number one obvious culprit is tight or short external rotatores of the hip. These smaller muscles, that lie under the glute max can exert a strong pull on the hip, limiting the motion. Another less obvious soft tissue problem is tight psoas/adductors. These muscles when tight together, will have a combined vector pull to inhibit internal hip rotation.

The motion when lacking, will cause an increase demand on the glute medius eccentrically. So doing all the glute med rehab exercise will be like hitting your head against a wall, useless. Fix the problem, don't patch it. Not only will the glute med become overworked and inhibited, the piriformis will now take on a much larger roll and become hyperactive. This will place more stress on the sciatic nerve.

The most common predictable common factor in low back pain is lack of internal hip rotation. This is part of the biomechanical arsenal of things I always check on my patients in Grand Rapids. They have done many studies that have linked low back pain, SIJ problems with greater external rotation. So again, the importance of hip internal rotation, can not be stressed enough. Here is a link from Mike Reinhold, that lists several studies that have been done with hip rotation. http://www.mikereinold.com/2009/03/low-back-pain-and-hip-motion.html

Fascia, Fascia Release and Results

The last few days a couple of the bobsled athletes that are heavy squatters, had been having some TFL, IT band discomfort with some of there heavier sets. Upon inspection, I released a lot of adhesion's in the vastus lateralis. To my surprise, both experienced visual growth in the quad, with one experiencing new found "cuts" in the vastus medias, lateralis and rectus. I had heard that this can happen with the biceps with guys that work arms a lot and don't do much stretching or self care. It was pretty cool to visually see the quad flex harder and larger on completion of the releases.

Fascia interpenetrates and surrounds all organs, muscles, bones and nerve fibers, creating a unique environment for body systems functioning. Lately I've been reading about fascia may be considered an organ of support for the human body. In it's simplest example, it forms a support tube around the muscle. When the fascia gets to tight from adhesion's, the muscle has no where to go on contraction. So the contraction isn't as powerful or is painful. When you release the fascia the muscle is able to contract to its full capability, so the muscle didn't exactly grow, you're just taking away it's restriction so to speak. Interesting to see for the first time.

Monday Motivation

Pretty cool piece about San Diego State Football. Another clip that will definitely get you moving and into the gym!

Lunge Assessment pt2

Last week we looked at one of the things to look for in doing a lunge. These clues will show you or your patients and athletes what can be going wrong with their bodies. This week as you lunge, look at the front knee, does it stay stable and straight ahead, or does it deviate towards the midline. If it deviates towards the midline it may be because a decrease in force production from the external rotatores of the hip. These are the muscles that lie underneath the glute max. Often times the decrease in force production may be caused by tightness or adhesion's in these muscles.

Groin pain and the Femoral Sheath

Last week, one of the bobsled athletes I take care of complained of some pinching pain on hip flexion, with some sharper adductor pain as well. Checking the adductor group, I couldn't really find any tightness or adhesions in the muscles themselves that would make me think that it was a concern. While there was a feeling of pinching on hip flexion it wasn't sharp and alignment of the hip/pelvis was good. Thinking the sharp adductor pain could be referral pain, I started checking structures around the pinching site in inguinal triangle. I finally found that the femoral sheath wasn't sliding under the inguinal ligament. After several passes of Active Release Technique to free up the sheath under the ligament, hip flexion was now much less irritated and upon a few strides the adductor had no pain. This was the first time I had ever felt this. Thought this was an interesting case to share. Again this shows how the site of the pain is very rarely the site of the problem.

Monday Morning Motivation

Persistence is a powerful tool. Failure is never final. Cliche but true.