SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > Welcome Guest > Welcome, Bienvenue...
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

Welcome, Bienvenue... This forum is intended for a brief presentation of our members.

Reply
 
Thread Tools Display Modes
Old 25-03-2011, 10:48 PM   #1
christopher
Junior Member
 
christopher's Avatar
 
Join Date: Mar 2011
Location: Pleasanton, CA
Posts: 2
Thanks: 0
Thanked 0 Times in 0 Posts
Default sprint coach

I am a high school sprint coach, speed trainer for a local soccer club, and distributor for the Freelap Timing System. You can probably guess why I'm here. Yes, it is the bane of speed training ... shin splints.

Best,
Christopher

Last edited by Diane; 25-03-2011 at 11:12 PM. Reason: live link removed
christopher is offline   Reply With Quote
Old 26-03-2011, 04:03 PM   #2
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Christopher!

Thanks for coming over from bearpowered!

If anyone can give us a different perspective of post-tib pain, the folks here are the ones whose views I would consider.

I used to believe all the traditional PT foot flexing, rotational, and strengthening stuff. That lasted until 1995 when Bryan Hoddle, World Paralympic Sprint champion Tony Volpentest's coach noted at a clinic here in Lisle, Illinois that Tony also experienced "shin splints" (post tib pain).

How was that at all possible since Tony didn't have feet? It had to involve something other than the way the foot was contacting the ground.
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 08:00 PM   #3
Linas
SomaSimpler
 
Join Date: Mar 2011
Location: Lithuania
Posts: 22
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Hi Ken,

Tony didn't have feet, but he had natural shins? I think even with artificial feet, shin muscles needed to withstand impact forces. Artificial feet might help to reduce impact forces but in this case it didn't help to avoid shin splints. For my girls pain of "shin splints" is reducing, but still there is pain when I press with finger. I still avoid running and they do strengthening exercises for shins. I'm not sure if these exercises will help to avoid these problems in the future, but I don't have what to loose. Next week they will move to run some hills on sand b/c impact forces are low. It's better than nothing and they will get into shape faster when moving to flat running.
Linas is offline   Reply With Quote
Old 26-03-2011, 08:07 PM   #4
christopher
Junior Member
 
christopher's Avatar
 
Join Date: Mar 2011
Location: Pleasanton, CA
Posts: 2
Thanks: 0
Thanked 0 Times in 0 Posts
Default

My younger daughter is a freshman in college and is on the soccer and track team. She runs the 4x100 relay and 100 meter sprint, and their "speed workouts" are 12 x 150 sprints with walk-back recovery. Sigh. I was her sprint coach for many years and I knew what this training would do to her, but there's not much a freshman athlete on a track team can do when they are trying to be a team player. They don't do any lifting at her school (soccer or track), but she knows how to lift and they do have a weight room, so I coach her strength training via Skype, but the other training is problematic.

So, here we are. She's home on spring break and won't go to the mall with her friends because walking is too painful. She's had MRI's in the past with no indication of stress fractures. Your thoughts?

Best,
Christopher
christopher is offline   Reply With Quote
Old 26-03-2011, 08:29 PM   #5
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Linas!

Quote:
shin muscles needed to withstand impact forces.
No disagreement here, but does "withstand" still imply, as many wholeheartedly believe, that there are muscle imbalances in the legs?

My concern is how conventional PT (at least the approaches to post tib pain I've seen with trainers at the high school level) always seems to come back to what you've mentioned: "strengthening exercises for the shins." And this then involves dorsiflexion resistance via such things as theraband, DARD, etc.

But is this really "all we've got" relative to prevention? Further, these protocols really aren't addressing pain.
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 08:40 PM   #6
Linas
SomaSimpler
 
Join Date: Mar 2011
Location: Lithuania
Posts: 22
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Hi Ken!

I don't think that imbalance is always the case. Don't you think that in many cases shin muscles are simply too weak to withstand impact forces? Stronger shin muscles = less chance to get "shin splints"? If these strengthening exercises don't help at all so what might help? Massage can help to treat that problem but it doesn't prevent.
Linas is offline   Reply With Quote
Old 26-03-2011, 08:50 PM   #7
gollygosh
Geralyn Giuffrida PT
 
Join Date: Nov 2010
Posts: 434
Thanks: 256
Thanked 179 Times in 96 Posts
Default

When people have "tight hip flexors", I like to have them walk backwards. One of the things that I think is going on is that I am asking glut max to contract concentrically, and hip flexors to contract eccentrically. I think this also "freshens up" the motor program people have been using. Frequently as they walk forward again, there hip flexor lengths appear to be improved.

If you were to use the same premise of having them walk/run backwards do you think it could help?

Geralyn
gollygosh is offline   Reply With Quote
Old 26-03-2011, 09:01 PM   #8
Linas
SomaSimpler
 
Join Date: Mar 2011
Location: Lithuania
Posts: 22
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Ken, do some of your athletes get "shin splints"? I'm asking b/c you use Gravity Constant before fast running and part of these exercises are done backwards?
Linas is offline   Reply With Quote
Old 26-03-2011, 09:23 PM   #9
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Linas!

Quote:
Ken, do some of your athletes get "shin splints"? I'm asking b/c you use Gravity Constant before fast running and part of these exercises are done backwards?
That is an excellent question!

As you know, we spend several weeks doing our Gravity Constant protocol. That involves complex movements that are done continuously, with runners eventually building up to 4.5 miles worth of movement.

We do this from February 22nd to March 15th--indoors and on a tile floor (concrete base). We had no incidents of medial tibial stress pain. And that involved thirty-three male athletes divided as follows: eight freshman, six sophomores, nine junior,and ten seniors. None of these guys reported to the trainer for "shin splint" pain. We had no athletes with any lower leg pain "down time."

Many of these complex activities involve backward, lateral, and rotational movement. If they do our variation of a protocol like the "carioca," they also do that backward. If they do skipping or galloping, they also do that sideways and backwards.

That's why I was very intrigued by gollygosh's insight.
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 09:32 PM   #10
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

One review of the literature on MTSS "Etiologic Factors in the Development of Medial Tibial Stress Syndrome" (Journal of the American Podiatric Medical Association
Volume 98 Number 2 107-111 2008) noted the following:

"Medial tibial stress syndrome is a type of exercise-induced leg pain that is common in recreational and competitive athletes. Although various studies have attempted to find the exact pathogenesis of this common condition, it remains unknown.

Until recently, inflammation of the periosteum due to excessive traction was thought to be the most likely cause of medial tibial stress syndrome. This periostitis has been hypothesized by some authors to be caused by the tearing away of the muscle fibers at the muscle-bone interface, although there are several suggestions as to which, if any, muscle is responsible."

The conclusion: "Recent studies have supported the view that medial tibial stress syndrome is not an inflammatory process of the periosteum but instead a stress reaction of bone that has become painful."

What appears to be the "take home" message?

"There have been few randomized controlled trials investigating treatment options for athletes with MTSS. Those that have been performed rendered no significant findings, leading researchers to conclude that rest is equal to or better than other treatment options."
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 09:43 PM   #11
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,730
Thanks: 3,046
Thanked 6,194 Times in 2,809 Posts
Default

Why does everyone avoid considering the most sensitive structures in the area, which would be macroscopic neural structures? How they might be feeling from too much mechanical stress?
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 26-03-2011, 09:59 PM   #12
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Diane!

Quote:
Why does everyone avoid considering the most sensitive structures in the area, which would be macroscopic neural structures? How they might be feeling from too much mechanical stress?
I think everyone in our realm (high speed running) avoids this because we know little about it! The problem for most of us in the coaching ranks: assuming the problem is indeed too much mechanical stress, how do we calm those neural structures?

This is something we seldom ever hear from PT's. Everything seems to come down to strengthening imbalances.
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 10:01 PM   #13
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,730
Thanks: 3,046
Thanked 6,194 Times in 2,809 Posts
Default

Man oh man...
Sure takes a long time to get more ectodermal/less meat&bone memes installed.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 26-03-2011, 10:14 PM   #14
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Diane!


Quote:
Man oh man...
Sure takes a long time to get more ectodermal/less meat&bone memes installed.
Yes! And we get pounded by these "meat and bone" memes to the point that we dread the trainer's wrath, and walk away with our tails between our legs because we are seen as dumb to the importance of correcting muscle imbalances.

That's why more of us our slowly coming over here!!

The more we learn, the more we wag our tails!
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 10:19 PM   #15
TexasOrtho
Arbiter
 
TexasOrtho's Avatar
 
Join Date: Feb 2008
Location: Huffman, TX
Age: 42
Posts: 1,659
Thanks: 926
Thanked 730 Times in 266 Posts
Default

Quote:
Originally Posted by Diane View Post
How they might be feeling from too much mechanical stress?
Would now be a good time to point out how difficult it is to avoid dualist language even among the most experienced ectodermalists on this forum?

If not, please ignore this post.

cough...aporia...cough
__________________
Rod Henderson, PT, ScD
It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift
TexasOrtho is offline   Reply With Quote
Old 26-03-2011, 10:19 PM   #16
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,730
Thanks: 3,046
Thanked 6,194 Times in 2,809 Posts
Default

Interactor models baby, we all need to construe more of those. Not just between individuals, but between ectodermal constituents and all that meat they have to slide through/around...
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 26-03-2011, 10:20 PM   #17
Karen L
Guest
 
Posts: n/a
Default

Quote:
Phys Sportsmed. 2009 Dec;37(4):39-44.

Current developments concerning medial tibial stress syndrome.
Craig DI.
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011-5094, USA. debbie.craig@nau.edu

Abstract
Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in athletes who run. Studies have reported MTSS to occur in 4% to 20% of this population. It can be defined as an overuse injury that creates pain over an area covering the distal to middle third of the posteriomedial tibial border, which occurs during exercise and creates cyclic loading. Differential diagnosis includes ischemic disorders and stress fractures. Although the pathology of this injury is understood, the etiology is less agreed upon. This makes it difficult for clinicians to diagnose and treat this common injury. The purpose of this article is to present health care practitioners with the most current information regarding MTSS so they can better diagnose and treat this common injury. To this end, a literature review was conducted, with the most current results presented. The areas of etiological theories, imaging techniques, and treatment options for MTSS were searched. Five of the most prevalent etiological theories are presented with supporting evidence. Of the imaging tools available to the clinician, magnetic resonance imaging (MRI) and bone scintigraphy have comparable specificity and sensitivity. Clinicians should first make the clinical diagnosis of MTSS, however, because of high percentages of positive MRI scans in asymptomatic patients. There have been few randomized controlled trials investigating treatment options for athletes with MTSS. Those that have been performed rendered no significant findings, leading researchers to conclude that rest is equal to or better than other treatment options. Given the evidence, treatment suggestions for practitioners caring for athletes with MTSS are provided.

PMID: 20048539 [PubMed - indexed for MEDLINE]

Conclusion sounds a lot like all the low back MRI studies where lots of defect and no pain is found.


Quote:
Gait Posture. 2011 Mar;33(3):361-5. Epub 2011 Jan 17.

Biomechanical and lifestyle risk factors for medial tibia stress syndrome in army recruits: A prospective study.
Sharma J, Golby J, Greeves J, Spears IR.
Physiotherapy Department, Infantry Training Centre Catterick Garrison, Ministry of Defence, DL9 3PS, UK; Sport and Exercise Subject Group, Teesside University, Middlesbrough TS1 3BA, UK.

Abstract
Medial tibial stress syndrome (MTSS) is a common injury in active populations and has been suggested to be a result of both biomechanical and lifestyle factors. The main aim of this study was to determine prospectively whether gait biomechanics and lifestyle factors can be used as a predictor of MTSS development. British infantry male recruits (n=468) were selected for the study. Plantar pressure variables, lifestyle factors comprising smoking habit and aerobic fitness as measured by a 1.5 mile timed-run were collected on the first day of training. Injury data were collected during the 26 week training period and incidence rate was 7.9% (n=37). A logistic regression model for membership of the MTSS and non-MTSS groups was developed. An imbalance in foot pressure with greater pressure on the medial side than on the lateral side was the primary risk factor. Low aerobic fitness, as deduced from a 1.5 mile timed-run and smoking habit were also important, but were additive risk factors for MTSS. In conclusion, "poor" biomechanics were the strongest predictors of MTSS development but lifestyle factors were also important. The logistic regression model combining all three risk factors was capable of predicting 96.9% of the non-injured group and 67.5% of the MTSS group with an overall accuracy of 87.7%. While the model has yet to be validated against an external sample and limitations exist with regards to the quality of the data collected, it is nonetheless suggested that the combined analysis of biomechanical and lifestyle factors has the potential to improve the prediction of MTSS.
Copyright © 2010 Elsevier B.V. All rights reserved.
PMID: 21247766 [PubMed - in process]

The bolds are interesting. It would be unusual if any of the athletes mentioned in this thread smoked or generally had a poor aerobic capacity. I agree with Diane that the next logical tissue to examine would be the peripheral nerves, and CNS contribution to the pain output. Diane had some great papers by Coderre that might help build an explanation regarding reduced collateral blood supply, tissue perfusion and danger signals from hypoxia.


Karen
  Reply With Quote
Old 26-03-2011, 10:20 PM   #18
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,730
Thanks: 3,046
Thanked 6,194 Times in 2,809 Posts
Default

Avoiding dualist language is a whole other issue.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 26-03-2011, 10:32 PM   #19
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Karen!

Thanks for that information!

Most DPM's would look to corrective orthotics to reduce excessive pronation, yet the exception would be someone like Volpentest--a very fast sprinter born without feet-- who suffered from MTSS. He ran on carbon fiber keel bars bolted to the back of his prostheses.

That's why considering peripheral nerves seems so intriguing. It perhaps explains these "exceptions."
Ken Jakalski is offline   Reply With Quote
Old 26-03-2011, 10:48 PM   #20
TexasOrtho
Arbiter
 
TexasOrtho's Avatar
 
Join Date: Feb 2008
Location: Huffman, TX
Age: 42
Posts: 1,659
Thanks: 926
Thanked 730 Times in 266 Posts
Default

I have never suffered from medial tibial pain, but the distance runners I've worked with seem to benefit by playing with pacing, foot strike pattern, and shoewear.
__________________
Rod Henderson, PT, ScD
It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift
TexasOrtho is offline   Reply With Quote
Old 26-03-2011, 10:55 PM   #21
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi Rod!

Quote:
I have never suffered from medial tibial pain, but the distance runners I've worked with seem to benefit by playing with pacing, foot strike pattern, and shoewear.
Yes. These are strategies that do resolve this for distance runners.

For the fast guys, it's a different story.
Ken Jakalski is offline   Reply With Quote
Old 27-03-2011, 08:03 AM   #22
Linas
SomaSimpler
 
Join Date: Mar 2011
Location: Lithuania
Posts: 22
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Quote:
Originally Posted by Diane View Post
Why does everyone avoid considering the most sensitive structures in the area, which would be macroscopic neural structures? How they might be feeling from too much mechanical stress?
Diane, even if the main problem lies at macroscopic neural structures then how this knowledge would help to avoid such injuries? I'm talking not about treatment, but about prevention.

Here might be the case that people are talking about different causes, (meat, bone, nerves) but conclusions about prevention and treatment could bring to very similar methods.

Like for example many at long distance community would say: "I trained VO2MAX, I trained lactate threshold, I trained certain muscle fibres or maybe even I trained my brain", however everybody could do the same workout.
Linas is offline   Reply With Quote
Old 27-03-2011, 08:10 AM   #23
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,730
Thanks: 3,046
Thanked 6,194 Times in 2,809 Posts
Default

You would help them desensitize, treat/tape them, wait for them to recover for a few days, then you would start training again a bit further back in intensity or length of time.

Quote:
how this knowledge would help to avoid such injuries?
You would progress but slower - wait for the neural system/nervous system to adapt to the physical stress. Whatever happened to "pain is a warning sign"? It should be a clue that there was too much irritation - too much too soon.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

Last edited by Diane; 27-03-2011 at 08:12 AM.
Diane is offline   Reply With Quote
Old 27-03-2011, 01:00 PM   #24
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 62
Posts: 16,414
Thanks: 1,687
Thanked 3,003 Times in 1,709 Posts
Default

I'm with Diane totally here. Surprised?

What happened to the concept of assisting adaptation with gradiation? Doesn't it make sense to work to create a system that is more likely to tolerate the stresses you plan on imposing upon it at a future date? Shouldn't this include the local, superficial nervous tissue? Would it be so hard to start taping and moving the superficial nerves in the region of the shin-splints in February in preparation for Spring track season?

By the same token, shouldn't someone facing a four hour sit on a plane next month begin preparing ASAP?

I've always liked the concept of "controlled burns" in forestry. Not doing this led to a conflagration in Yellowstone a few decades ago. To me, regular expression of ideomotion beyond cultural acceptance is a "controlled burn" of naturally required correction of mechanical stress on the nervous system.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com

Last edited by Barrett Dorko; 27-03-2011 at 02:30 PM.
Barrett Dorko is offline   Reply With Quote
Old 27-03-2011, 02:21 PM   #25
Bas Asselbergs
Physiotherapist
 
Bas Asselbergs's Avatar
 
Join Date: Jul 2004
Location: Canada
Age: 62
Posts: 4,554
Thanks: 1,903
Thanked 1,408 Times in 619 Posts
Default

This also points to the "one-size-fits-all" method of training, so often applied in clubs, teams and schools.

It has become abundantly clear to me over the years that it is often ineffective and potentially injurious.
Very rarely (only at the highest levels) is there room for truly individual training routines.
__________________
We don't see things as they are, we see things as WE are - Anais Nin
I suppose it's easier to believe something than it is to understand it.
Cmdr. Chris Hadfield on rise of poor / pseudo science

Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

We don't need a body to feel a body. Ronald Melzack
Bas Asselbergs is offline   Reply With Quote
Old 27-03-2011, 02:29 PM   #26
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 62
Posts: 16,414
Thanks: 1,687
Thanked 3,003 Times in 1,709 Posts
Default

Fungible. Rather like therapy is considered these days.

Perhaps this accounts for the popularity of personal trainers among the adults that can afford them.

How much help is that going to be when the personal trainer kows nothing of neuroscience?
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is offline   Reply With Quote
Old 27-03-2011, 03:09 PM   #27
norton
Senior Member
 
norton's Avatar
 
Join Date: Mar 2009
Age: 45
Posts: 368
Thanks: 24
Thanked 2 Times in 2 Posts
Default

Quote:
Originally Posted by Barrett Dorko View Post

What happened to the concept of assisting adaptation with gradiation? Doesn't it make sense to work to create a system that is more likely to tolerate the stresses you plan on imposing upon it at a future date?.
Went out the window with returning to work part-time after a work comp injury. We have a girl off at work from back injury from lifting bariatric patient. She is feeling better but isn't up to working 8 hours. she is not allowed by management to return to work to "get used to the job again" until she is 100%. This to me is stupid. Work hardening costs the company money via insurance utilization and really doesnt simulate her job. Also, we have 3 PT's in here, can't they voice warnings if they see her doing something wrong?

I like assisting adaptation with gradiation and will mention this to our supervisor tomorrow.
Thanks
Deb
norton is offline   Reply With Quote
Old 28-03-2011, 01:46 AM   #28
docjohn
Senior Member
 
Join Date: Jan 2011
Location: Boston, USA
Posts: 119
Thanks: 5
Thanked 43 Times in 18 Posts
Default

Unfortunately I feel that the rehabilitative world has become quite a bit like the primary care physician word where patients would rather have a prescription written than listen to what the doc has to say regarding rest, diet, exercise, etc. I deal every day with multiple strength and conditioning professionals referring their athletes over for some "soft tissue work" to clean up some "junky tissue". If they are not getting what they want, then they will go elsewhere and business goes down the hopper. My attempts at explaining the neural pathways, true sources of pain, and recommended treatments usually falls on deaf ears since they have their ears on pseudo-expert podcasts, seminar series, and "sports medicine conferences". All of which have presenters with big names and especially big name athlete clients. My own approach has been to explain what I believe to be the cause(s) of the problem from both a mechanical model and a neurological model, and treat them thusly.
Every journey begins with a 1st step and to get the coaches to realize that there is another cause out there besides the mechanical is difficult, but if they see their jobs reliant upon the performance of athletes who cannot return to play (can't make the club from the tub), then they may be open to inserting interventions prior to the season, in season and even post season as part of the s&c regimen to keep athletes on the field, track, etc.
As Roger Waters was keen on saying "the tide is turning..."
Concerted efforts on the part of all involved in sports medicine is not necessary, only a few to start and the contagious nature of the superior care will prevail. I am old enough to remember when the FMS was still in its infancy, and how it has grown in popularity regardless of its shortcomings. Neurological screening of athletes is usually only reserved for the recently concussed but soon it will be a part of the preseason s&c evaluation for the purpose of prevention, and/or management of injuries.
It can't be avoided, athletes enjoy actually participating, however they get there.
Quite rantish I know but I completely agree with Diane. Athletes are a great population to work with because they are highly motivated. If they get great results then that is all they care about. Educate them to the neurological approach and they will eat it up, however reluctantly at first...but results speak volumes.
John
docjohn is offline   Reply With Quote
Old 28-03-2011, 03:52 AM   #29
Ken Jakalski
Senior Member
 
Ken Jakalski's Avatar
 
Join Date: Oct 2007
Age: 63
Posts: 2,075
Thanks: 374
Thanked 1,295 Times in 559 Posts
Default

Hi John!

Part of the problem, at least from my perspective at the prep level, is that we've been so programmed by the "meat and bone" approach of high school trainers that athletes as well as coaches come to expect that more "advanced" PT simply comes down to an even greater focus on unique protocols to correct imbalances and instabilities.

You would also be surprised by the number of schools for whom the game day "sideline medical specialist" is a chiropracter. Often this is undertandable because post injury follow-ups at the chiros involve a great deal of moving and manipulating, and this, in the minds of athletes and their families, suggests "real" pain therapy.
Ken Jakalski is offline   Reply With Quote
Old 09-04-2011, 03:04 PM   #30
Mariette
Member
 
Mariette's Avatar
 
Join Date: May 2005
Location: South-Africa
Posts: 78
Thanks: 2
Thanked 0 Times in 0 Posts
Default

Hey there
I tried to post this yesterday but got logged off. So let's try again. I see a lot of young sprint athletes complaining about "shin splints". As I, just like some of you have tried to get them to modify the program, the intensity etc...and that did not work I now show them my answer to "shin splints". For some reason (there are a few very knowledgable writers on this forum that can explain WHY) it works. After knowing more about neural structures and pain science there is not much else they need as the tolerance of the structures improve...it takes a few days though.
Do a tibial nerve slide/neurodynamic SLR lying or in standing with the foot in dorsiflexion, eversion and pronation. Athletes do this as a warm - up exercise or as self - medication after I have seen them and perhaps modified with extension of the toes as necessary.
Hope it helps your athletes too.
Good luck Christopher (sprint coach)
Mariette is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
The relationship between the PT and the S&C Coach HstephenG The Performance Lab 12 16-02-2010 10:45 PM


All times are GMT +2. The time now is 05:33 AM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2014