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Thursday, October 27, 2016

Sports Injury Management/Prevention 'Pearls'

The conclusion...
how to treat,manage and prevent
part 2 of 2

 Compliance. That's key to executing any prevention and management program especially when you THINK you don't need to until you NEED to!However, my techniques are SO easy  and simple to do, it would be hard NOT to comply! Not only that, they work, IF you work them! My years of treating knee issues has proven this to be true time and time again.

PREVENTION & MANAGEMENT. At 30 deg. of knee flexion [non weight bearing ie sitting in chair] knee capsular pressure is low. However, full flexion(bending) or extension(straightening) increases pressure.
 That's why with most knee injuries the 'sweet' spot' most comfortable is 30 deg. I mention this because the following technique requires that sweet spot. Let us begin...

The leg extension machine [fig. 1] is one of my fave in my arsenal of treating and preventing PT. Even better if you can set the moving arm of the machine at 30 deg. [fig.2]
Fig 1

 [Fig 2] arm set at 30 deg.
Next, place both legs onto arm of extension[Fig 3a & 3b] Set the weight moderate, no more than 40#. If this causes discomfort, decrease weight. It is not uncommon to feel some MILD discomfort; in fact, its very normal.  

Fig 3a

 Fig 3b

Next, extend legs fully [fig 3b] then lower weight with ONE leg[Fig 4]. Extend again, but lower with other leg. Before you lower leg, though, be sure you are able to sustain extension with that one leg for at least 2 seconds before lowering it. Do 10 per leg. 1 set is all that is needed. Calibrate weight according to comfort level. This is NOT a quadriceps strength training program, but a tendon strength training program!

 Fig 4
WHY THIS TECHNIQUE WORKS: I learned some time ago during my studies that when a tissue inflames it scares. When it 
scares, the scaring is laid down on the tissue in a 'random' fashion like a box of spilled match sticks. This causes restrictions in the tendon that increases discomfort. Also, almost forgot to mention, there is a bursa (fluid filled sac) that rest between the tibia and tendon [fig 5.].
This can be a secondary symptom of PT which can be just as painful. It used to be, and still is called 'jumpers knee' because it was common in basketball players.

But now, ANY athlete can get it except swimmers because they don't have to deal with the same forces in water that exists when playing on land. 
What this technique is is an eccentric technique we use in therapy to get the scare tissue to align with the direction of the injured tissue! thus, allowing healing to take place. 

The tendon is inflamed from an offending activity of excessive loading.  These loads surpass the tensile capacity of the tendon, thus inflammation, combined with little restoration and recovery time, and NO prevention,is a perfect storm for tendonitis.
Fig 5

 'Old school is STILL the BEST school!'

Lastly, one of the most popular modalities for treating injuries is ice. However, when it comes to PT even the application of the ice is important! The idea of this technique is to put the tendon in a 'stretched' position. When you sit, the tendon is elongated. This is the best position for icing(see below). You only need to move the ice in a circular pattern for no more than 2-5 minutes. 'Thats all?' you say? 'What about the 20 minutes'? This is true if the tissue you are icing is deep under layer layers of fat and other tissue; it takes time, 20 or more minutes for the cold to have its affect. The patella tendon is very near the surface, thus less ice time

Sunday, October 23, 2016

Sports Injury/Prevention 'Pearls'

What REALLY is patella tendonitis?
The definition, prevention, treatment and management
PART 1 of  2

Patella tendonitis ('itis' means inflammation) is a very common injury that can ruin just about, well, EVERYTHING!:running, stairs, squatting, kneeling on a floor. The patella [fig. 1], is covered with a fibrous connective tissue which is an extension of the patella tendon, above the knee cap. [fig.2]. Attached to it are the powerful quadriceps muscle group. Combined, they provide a very powerful mechanism that helps in 'deceleration' of knee flexion e.g. when the foot fits the ground. The patella is actually vibrating very fast due to the intense contraction of the quadriceps  to keep the patella in place. Awesome.
Fig 1
 Fig 2
THE PROBLEM: However, over a short time, without preventive strategies, the tendon[fig. 3] can suffer minor tears. The tendon does have a blood supply. When the tendon tears, it inflames and at first seems somewhat innocuous until you start reaching for ice packs, knee straps, knee braces, topical agents, limping etc.
Fig 3
WHY: Remember when I mentioned the quadriceps muscle and its powerful contraction that exerts this awesome force, technically 'limp torque', through the patella? Well every time you take a step this exerts an eccentric load on the patella. Think of this moment as 'putting on the brakes'. Well brakes do wear out. In this case, the patella tendon is the brake! Now add hundreds of cycles of running, squatting, jumping{really the landing] the tendon ultimately suffers classic overuse symptoms.

CAUTION: The scope of this topic is confined to the patella tendon and one of many conditions that can exists with overuse. There are multitudes of differential diagnosis that should be ruled out or you risk implementing a treatment protocol that is contract-indicated(shouldn't do!). So unless you have been properly diagnosed, whether its through WEB MD or an actual health care professional! don't perform the strategies I will be outlining in the coming blogs on this topic. The good news though that if you live in the area I would be glad to perform an assessment to determine if you have 'true' patella tendonitis.

COMING UP later in the week!..
 A few simple methods to prevent and manage patella tendonitis that will surprise you!
Don't miss it!

Monday, October 17, 2016


Ladies and gentleman, introducing 'your' feet. I just wanted to shift gears and address the hygiene of ...the feet. Yes. The feet. I 'm always giving out training and stretching advice, yet, I didn't want to talk about that stuff today. When I was getting out of the shower yesterday, and I began my post shower ritual of feet maintenance, I was contemplating what to blog about. Boom! Now before you go off and call me a diva or metro-sexual let me explain: Feet are sensitive and are prone to not only structural(ligament, tendon and bone) wear and tear, but skin wear and tear. So I thought I'd share my strategy on taking better care of your 'dogs'!:

  • TEA TREE OIL: this has several other herbal oils in it that provide anti-fungal properties. Great for preventing toe fungus and athletes foot. I use after every shower. Works great!
  • SPT PAIN RELIEF: This is an 'outlier' and has NOTHING to do with foot maintenance. However, anyone involved in sports, or weight training should have this. In my, almost 3 decades in the treatment, prevention and management of sport related injuries SPT hs proven to be  the most effective topical for acute and chronic 'itis'es ie. tendonitis, joint capsulitis , and bursitis I've come across, and there have been many. But the results are quite impressive, so impressive I had to share it with you!
  • CALLOUS CREAM & FILE: after a shower or bath I file my hard callouses,( which can get uncomfortable and at times form blisters) then apply cream. Magical!
  • NAIL CLIPPERS: self explanatory, but if you clip the big toe nail to short you risk getting   'paronychia' which is the inflammation of the cuticle where the nail grows into the cuticle. Ouch! Sometimes this has to be treated with antibiotics.
That's it. Hope you found these feet tips helpful!

Thursday, October 6, 2016

Learn by watching

I will be showcasing my years(almost 30) of creating training circuits and combinations called MFC, 'my fave combo'.Very effective and challenging.
I hope you enjoy them as much as I enjoyed teaching them. 
NOTE: ALL footage is unedited and are recorded during actual training sessions.