Monday, January 24, 2011
Graston Technique - A Case Study
Here is a guest post from Eric on the Graston Technique as a component of treatment for knee pain. (patellar tendonitis). The case study is posted on www.mikereinold.com. Mike was kind enough to let me submit a guest article for his ultra-successful blog. (covering areas of rehab., sports medicine, and performance). Mike is the Head Athletic Trainer and Assistant Director of Medical Services for the Boston Red Sox.
Sunday, October 10, 2010
Soft Tissue Work
In addition to the dynamic warm-up, it is crucial to not ignore the quality and condition of our muscles that we are training. Our muscles are surrounded by a dense, fibrous tissue known as fascia. This fascial tissue does not have elastic property like a muscle and therefore does not respond to stretching. These “knots” or restrictions that form in and around our muscles are best treated with some form of manual therapy or soft tissue work. Failure to treat the fascia will decrease the function of the muscle and dramatically increase injury risk.
As mentioned above, fascia is an extremely dense, fibrous connective tissue that is the common link between our skeleton and our muscular system. It is known as a “passive” structure in the body. In other words, it does not have the ability to contract and relax like a muscle and therefore cannot be strengthened or stretched. Fascia responds directly to the stress that we put on our body. For example, a common location for “knots” is the upper trapezius muscle (connecting our neck to our shoulder). This area is often restricted due to the forward head, rounded shoulder posture that we hold while sitting at a computer, driving, reading, etc.
In the athletic population, we often find soft tissue/fascial restrictions throughout the body based on overuse and decreased efficiency of movement (as discussed in our previous post and will be further examined in future posts.) If left untreated, these soft tissue restrictions will lead to further muscle imbalance, increased compensation, and increased risk of injury.
In the past, this presentation would result in a physician or trainer telling the patient that he/she is “tight” and “needs to stretch more”. What we have now learned is that this particular person needs more soft tissue work/manual therapy to correct the imbalances and restrictions and strive to establish proper movement without restriction. The combination of manual therapy and postural correction is essential to establish painfree movement and improved athletic activity.
There are many options to improve soft tissue mobility. The most common forms of SMR (or self-myofascial release) are the foam roller, the Tiger Tail, the “Stick”, and the use of a massage ball. There are many professional options available to the patient that can sometimes be confusing. (i.e. physical therapist, massage therapist, chiropractor, and some athletic and personal trainers). It is important to note here that massage alone is often effective in managing the patient’s symptoms, but often will not have the desired long lasting effect unless it is coupled with corrective exercise.
Lastly, the Graston Technique is a highly effective soft tissue treatment offered at Momentum Physical Therapy. It is a specialized form of instrument assisted soft tissue mobilization that has been proven to be extremely effective in treating a wide range of pain and injury. Graston is prominently featured on our website at www.momentumpt.com.
As mentioned above, fascia is an extremely dense, fibrous connective tissue that is the common link between our skeleton and our muscular system. It is known as a “passive” structure in the body. In other words, it does not have the ability to contract and relax like a muscle and therefore cannot be strengthened or stretched. Fascia responds directly to the stress that we put on our body. For example, a common location for “knots” is the upper trapezius muscle (connecting our neck to our shoulder). This area is often restricted due to the forward head, rounded shoulder posture that we hold while sitting at a computer, driving, reading, etc.
In the athletic population, we often find soft tissue/fascial restrictions throughout the body based on overuse and decreased efficiency of movement (as discussed in our previous post and will be further examined in future posts.) If left untreated, these soft tissue restrictions will lead to further muscle imbalance, increased compensation, and increased risk of injury.
In the past, this presentation would result in a physician or trainer telling the patient that he/she is “tight” and “needs to stretch more”. What we have now learned is that this particular person needs more soft tissue work/manual therapy to correct the imbalances and restrictions and strive to establish proper movement without restriction. The combination of manual therapy and postural correction is essential to establish painfree movement and improved athletic activity.
There are many options to improve soft tissue mobility. The most common forms of SMR (or self-myofascial release) are the foam roller, the Tiger Tail, the “Stick”, and the use of a massage ball. There are many professional options available to the patient that can sometimes be confusing. (i.e. physical therapist, massage therapist, chiropractor, and some athletic and personal trainers). It is important to note here that massage alone is often effective in managing the patient’s symptoms, but often will not have the desired long lasting effect unless it is coupled with corrective exercise.
Lastly, the Graston Technique is a highly effective soft tissue treatment offered at Momentum Physical Therapy. It is a specialized form of instrument assisted soft tissue mobilization that has been proven to be extremely effective in treating a wide range of pain and injury. Graston is prominently featured on our website at www.momentumpt.com.
Sunday, October 3, 2010
Expanding Role For Physical Therapists
Great article in the Wall Street Journal posted below.
http://online.wsj.com/article/SB10001424052748704654004575518010995537450.html?KEYWORDS=physical+therapy
It highlights the evolving role of the physical therapist - “more older people are starting to hire physical therapists before they get hurt to fill the role of personal trainer.”
Consider the experience and education level of the individual you hire to handle your fitness goals.
"A proactive visit to a physical therapist can reveal the muscle imbalances and inefficient movement patterns that cause injury. The therapist can provide a regime that corrects those problems while enhancing endurance, balance, strength and weight control."
See More
http://online.wsj.com/article/SB10001424052748704654004575518010995537450.html?KEYWORDS=physical+therapy
It highlights the evolving role of the physical therapist - “more older people are starting to hire physical therapists before they get hurt to fill the role of personal trainer.”
Consider the experience and education level of the individual you hire to handle your fitness goals.
"A proactive visit to a physical therapist can reveal the muscle imbalances and inefficient movement patterns that cause injury. The therapist can provide a regime that corrects those problems while enhancing endurance, balance, strength and weight control."
See More
Monday, September 27, 2010
Dynamic Warm-Up
We have all heard the phrase “practice like you play”. This has been found to be a requirement when speaking about a proper warm-up to prepare for sport/activity.
Most adults that we see in the clinic (if they stretch/warm-up at all) will prepare for a workout/activity the same way they their phys. ed. teacher taught them 20 years before. Thankfully, the physical therapy and fitness industries have evolved.
We are now armed with research and experience to develop specific warm-up programs to properly prepare the body for the movements it needs to encounter during their sport of choice.
Gone are the days of sitting and reaching for your toes to “stretch” your hamstrings or tucking a leg behind you in a seated position and reaching for your toes to “stretch” your quads. These outdated forms of static stretching are now being proven to decrease muscular productivity rather than enhance it! In these cases, it may actually be better to do nothing!
The good news is that a lot of youth coaches are slowly starting to catch on to the idea of a dynamic warm-up. However, most simply implement a series of high leg kicks, skips, lunges, hops, and jumps with very little instruction on the goals of the program and minimal correction of common mistakes that athletes will make.
This is often the part of practice that is run by the players and unfortunately for the majority turns into a time to talk and relax, rather than prepare the body for athletic activity.
The key to a proper dynamic warm-up is improving neuromuscular efficiency, or in other words, to effectively change the way an athlete moves, thus making the movement proper and automatic. A movement is efficient when the brain is trained to recruit the proper muscles with the proper timing to perform the desired movement. The nature of athletics is to overuse certain muscle groups based on the demand of the sport. For example, a hockey player tends to overuse their hip flexors and adductor (groin) muscles while skating, thus predisposing them to us muscle strain/tendonitis.
Our initiative at Momentum Physical Therapy is to educate the athlete, parents, and coaches on safe and effective techniques to help prevent injury. The dynamic warm-up is a key step in accomplishing this goal.
Most adults that we see in the clinic (if they stretch/warm-up at all) will prepare for a workout/activity the same way they their phys. ed. teacher taught them 20 years before. Thankfully, the physical therapy and fitness industries have evolved.
We are now armed with research and experience to develop specific warm-up programs to properly prepare the body for the movements it needs to encounter during their sport of choice.
Gone are the days of sitting and reaching for your toes to “stretch” your hamstrings or tucking a leg behind you in a seated position and reaching for your toes to “stretch” your quads. These outdated forms of static stretching are now being proven to decrease muscular productivity rather than enhance it! In these cases, it may actually be better to do nothing!
The good news is that a lot of youth coaches are slowly starting to catch on to the idea of a dynamic warm-up. However, most simply implement a series of high leg kicks, skips, lunges, hops, and jumps with very little instruction on the goals of the program and minimal correction of common mistakes that athletes will make.
This is often the part of practice that is run by the players and unfortunately for the majority turns into a time to talk and relax, rather than prepare the body for athletic activity.
The key to a proper dynamic warm-up is improving neuromuscular efficiency, or in other words, to effectively change the way an athlete moves, thus making the movement proper and automatic. A movement is efficient when the brain is trained to recruit the proper muscles with the proper timing to perform the desired movement. The nature of athletics is to overuse certain muscle groups based on the demand of the sport. For example, a hockey player tends to overuse their hip flexors and adductor (groin) muscles while skating, thus predisposing them to us muscle strain/tendonitis.
Our initiative at Momentum Physical Therapy is to educate the athlete, parents, and coaches on safe and effective techniques to help prevent injury. The dynamic warm-up is a key step in accomplishing this goal.
Wednesday, September 22, 2010
Top 5 Secrets to Prevent Injury
We will look at each of these topics individually in greater detail in future blog posts to help guide our readers in safe and effective exercise training principles.
Please note that we are not ignoring the value of proper nutrition, sleep, and recovery periods, but for the purpose of this article, we will focus on activities that involve the movement system.
1. Dynamic Warm-Up: A proper warm-up is essential. Preparing the body to exercise with dynamic movement-based activites (i.e. leg swings, walking toe touches) is far superior to the traditional static stretching routine that we learned in gym class. (i.e. sit and reach, seated butterfly stretch). In fact, there is research to support that conventional stretching with long hold times (30 seconds) actually makes us less prepared for the exercise/sport that we are preparing for.
2. Soft Tissue Work: In addition to the dynamic warm-up, it is crucial to not ignore the quality and condition of our muscles that we are training. Our muscles are surrounded by a dense, fibrous tissue known as fascia. This fascial tissue does not have elastic property like a muscle and therefore does not respond to stretching. These “knots” or restrictions that form in our muscles are best treated with use a foam roller. (or other options such as the Tiger Tail, Massage stick, or massage ball). Check out our website (www.momentumpt.com) to learn more about the cutting edge soft tissue technique that we are using to get incredible results with our patients! Failure to treat the fascia will decrease the function of the muscle and dramatically increase injury risk.
3. Strengthen the Weak Muscles: Most injuries that we see in the clinic are the result of muscle imbalance or asymmetry. This means the patient will present with areas of strength (which are often relied upon and overused in daily function) and areas of weakness (which are underused and become weaker). This imbalance results in overuse and eventual breakdown (i.e. tendonitis) of the stronger muscles. Unfortunately, most of the patients we see that are exercising, are strengthening their strong muscles (i.e. biceps, triceps, deltoids, chest, quadriceps) rather than addressing their weaker muscles (i.e. deep abdominals, gluteals, upper back, and rotater cuff).
4. Stand Up: Have you ever asked yourself why we sit all day (driving, computer, eating) and then we go to the gym to “exercise” and we continue to sit on machines or benches. The role and responsibility of our muscles drastically changes when we stand up. Our injuries commonly occur when we stand up and move, yet we train ourselves to prepare for these activities by sitting? It doesn’t make sense! We need to engage our muscles to support our posture against gravity and stabilize our joints through functional movements such as squatting and lunging.
5. It Starts in the Middle: Whether you are building a house or stacking children’s blocks, the key to its stability is a strong foundation. The human body is no different. The trendy term in fitness is “core strengthening”. This is often mentioned, but rarely understood. We view the “core” as everything besides your extremities (arms and legs). The role of the “core” is to be stable to allow your arms and legs to function efficiently. It is the base from which all of our postures and movements originate. As a result, it is crucial to understand because improper “core strengthening” (i.e. traditional situps and ab. machines) can actually increase your pain and injury risk.
Check back and learn more about each of these topics and see how adding them into your program can help reduce your risk of injury.
Please note that we are not ignoring the value of proper nutrition, sleep, and recovery periods, but for the purpose of this article, we will focus on activities that involve the movement system.
1. Dynamic Warm-Up: A proper warm-up is essential. Preparing the body to exercise with dynamic movement-based activites (i.e. leg swings, walking toe touches) is far superior to the traditional static stretching routine that we learned in gym class. (i.e. sit and reach, seated butterfly stretch). In fact, there is research to support that conventional stretching with long hold times (30 seconds) actually makes us less prepared for the exercise/sport that we are preparing for.
2. Soft Tissue Work: In addition to the dynamic warm-up, it is crucial to not ignore the quality and condition of our muscles that we are training. Our muscles are surrounded by a dense, fibrous tissue known as fascia. This fascial tissue does not have elastic property like a muscle and therefore does not respond to stretching. These “knots” or restrictions that form in our muscles are best treated with use a foam roller. (or other options such as the Tiger Tail, Massage stick, or massage ball). Check out our website (www.momentumpt.com) to learn more about the cutting edge soft tissue technique that we are using to get incredible results with our patients! Failure to treat the fascia will decrease the function of the muscle and dramatically increase injury risk.
3. Strengthen the Weak Muscles: Most injuries that we see in the clinic are the result of muscle imbalance or asymmetry. This means the patient will present with areas of strength (which are often relied upon and overused in daily function) and areas of weakness (which are underused and become weaker). This imbalance results in overuse and eventual breakdown (i.e. tendonitis) of the stronger muscles. Unfortunately, most of the patients we see that are exercising, are strengthening their strong muscles (i.e. biceps, triceps, deltoids, chest, quadriceps) rather than addressing their weaker muscles (i.e. deep abdominals, gluteals, upper back, and rotater cuff).
4. Stand Up: Have you ever asked yourself why we sit all day (driving, computer, eating) and then we go to the gym to “exercise” and we continue to sit on machines or benches. The role and responsibility of our muscles drastically changes when we stand up. Our injuries commonly occur when we stand up and move, yet we train ourselves to prepare for these activities by sitting? It doesn’t make sense! We need to engage our muscles to support our posture against gravity and stabilize our joints through functional movements such as squatting and lunging.
5. It Starts in the Middle: Whether you are building a house or stacking children’s blocks, the key to its stability is a strong foundation. The human body is no different. The trendy term in fitness is “core strengthening”. This is often mentioned, but rarely understood. We view the “core” as everything besides your extremities (arms and legs). The role of the “core” is to be stable to allow your arms and legs to function efficiently. It is the base from which all of our postures and movements originate. As a result, it is crucial to understand because improper “core strengthening” (i.e. traditional situps and ab. machines) can actually increase your pain and injury risk.
Check back and learn more about each of these topics and see how adding them into your program can help reduce your risk of injury.
Tuesday, September 21, 2010
Top 5 Secrets to Prevent Injury
The key to preventing injury is selecting the right professional to help you. We believe physical therapists, based on their expertise in human movement, are perfectly suited to help decrease pain and minimize risk of injury.
We often hire professionals to fix our car, cut our hair, and handle our taxes…. However, we decide to maintain our bodies based on information we read on the internet, a magazine article, or “something someone told me once”. I cannot count the number of patients that we have treated over the years that come in due to a preventable injury sustained at the gym. We recommend being proactive in preventing injury so that pain doesn’t become a “normal” part of your life.
Please check back in tomorrow when we reveal the top 5 "secrets" to prevent injury.
We often hire professionals to fix our car, cut our hair, and handle our taxes…. However, we decide to maintain our bodies based on information we read on the internet, a magazine article, or “something someone told me once”. I cannot count the number of patients that we have treated over the years that come in due to a preventable injury sustained at the gym. We recommend being proactive in preventing injury so that pain doesn’t become a “normal” part of your life.
Please check back in tomorrow when we reveal the top 5 "secrets" to prevent injury.
Thursday, September 9, 2010
Innovative Treatment for Muscular Injuries
Have you ever had a muscle injury that just would not heal? Frustrating isn't it? It's one of the facts of aging - injuries are more likely to occur.
One of the reasons why some muscle and tendon injuries don't heal properly, however, is due to excessive scar tissue build-up in the muscle. Scar tissue formation is the body's natural response to healing an injury. Unfortunately, some muscle injuries result in excessive scar tissue formation which will inhibit full healing and lead to chronic pain and decreased strength. Graston Technique® is a method used at Momentum Physical Therapy to address this excessive scar tissue formation, reduce pain, and foster faster recovery.
How Does It Work?
Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The Technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.
Common injuries treated with Graston Technique® are Tendonitis (i.e. tennis elbow, golfer's elbow, patellar tendonitis, Achilles tendonitis), plantarfasciitis, carpal tunnel, muscle strains/tightness, low back pain, headaches, TMJ and shoulder pain.
It is important to realize that Graston Technique® is most successful when used in combination with flexibility and strengthening activities tailored to your specific needs.
If you think you could benefit from Graston Technique®, feel free to contact Momentum Physical Therapy in Milford for additional information. Also, check out our website www.momentumpt.com for a slide show to learn more about Graston Technique.
One of the reasons why some muscle and tendon injuries don't heal properly, however, is due to excessive scar tissue build-up in the muscle. Scar tissue formation is the body's natural response to healing an injury. Unfortunately, some muscle injuries result in excessive scar tissue formation which will inhibit full healing and lead to chronic pain and decreased strength. Graston Technique® is a method used at Momentum Physical Therapy to address this excessive scar tissue formation, reduce pain, and foster faster recovery.
How Does It Work?
Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The Technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.
Common injuries treated with Graston Technique® are Tendonitis (i.e. tennis elbow, golfer's elbow, patellar tendonitis, Achilles tendonitis), plantarfasciitis, carpal tunnel, muscle strains/tightness, low back pain, headaches, TMJ and shoulder pain.
It is important to realize that Graston Technique® is most successful when used in combination with flexibility and strengthening activities tailored to your specific needs.
If you think you could benefit from Graston Technique®, feel free to contact Momentum Physical Therapy in Milford for additional information. Also, check out our website www.momentumpt.com for a slide show to learn more about Graston Technique.
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