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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

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