Faulty Movement Patterns – Functional Assessment & Training in Phoenix, AZ.

Faulty Movement Patterns – Functional Assessment & Training with Dr. Craig Liebenson.  Phoenix, AZ. March 10-11, 2012 in Phoenix, AZ.  I just booked my flight out there.  Looking forward to a weekend of workshopping with Craig.  There are always some new clinical nuggets to pick up and bring home.

I was excited before, but found out from some Facebook friends that there is a water slide and some fun to be had at the resort.  Resort fun is a distant second, but a nice perk to what will be a fantastic seminar.

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Assessment/Training of Faulty Movement Patterns bridges the gap from acute care to injury prevention to skills training. This program is ideal for any musculoskeletal practitioner who works with patients or clients that want to enhance their results. Learn the art of functional assessment of the kinetic chain and how this relates to sports function as well as injury rehab. Particular emphasis will be on the groundbreaking work of Professors Janda & McGill, Gray Cook, Michael Boyle and other leaders in the athletic development.

Some of the Topics Covered:
• Subcortical Reprogramming of Movement Patterns
• The Frontal Plane and Knee Instability
• The Transverse Plane & Upper Quarter Syndromes
• Kolar-McGill: biomechanics & neuro-development
• Cortical Plasticity & the Neuro Matrix

Lateral Stabilizers and Transverse Plane Exercise

Quadratus Lumborum

Can you see the stabilizing, connecting architecture.

We know that no muscle works in isolation and the brain thinks in terms of movement, not muscles.  So I think the title of these videos (and articles) may be misleading for those who are not familiar with the paradigm and principles that support it.  Despite calling it QL training, you will notice very quickly that Dr. Liebenson & Chad Waterbury are training patterns and functional whole body exercises, not working to isolate an individual muscle.  Keep in mind our common movement patterns as you review this and realize how neglected that lateral direction or transverse plane can be.  So far today I’ve spent 95+% of my time moving forward on level surfaces.  My activation of the lateral stabilizers has been minimal.  Our modern society and common training exercises necessitate evaluation of this plane and likely incorporation of these exercises into most routines.

A great introduction, now see how it’s done.

Some addition reading: on Dr. Liebenson’s blog  & Chad Waterbury’s blog.
Also a previous post by Dr. Cubos on Gluteus Medius activation which includes the role of the QL.

We must assess all planes and all movements.  Treatment is the applied to the worst, pain-free pattern (treat the abnormal motor control that improves the mechanical sensitivity).

Quantity vs Quality – Past & Present

The age of electricity began in 1882 and fueled the second Industrial Revolution.  The ability to produce more goods faster, shaped the outcomes of major world events such as World War I & II.  Consider that only England, Germany, France and the U.S. has completed the industrial revolution at this time. Our ability to produce mass quantities of weapons, uniforms, supplies, and food was significant in this era.  History buffs know there are many examples of how German technology was superior to US/British technology at this time, however we all know the outcome. In short, during this period quantity trumped quality.

As this has carried forward we see widespread  examples of how this concept of quantity over quality has gone wrong.  Quantity over quality  has corrupted society.  We are saturated in low quality abundance.

  • Calories over nutritional content.
  • White bread everywhere vs. whole grains.
  • American cheese food vs. actual cheese.
  • Processed, packaged foods full of preservatives.
  • ALL LEAD TO: Obesity & disease

 

  • Exercise fads, the quick easy, this is for everyone approach.
  • 3 sets of 10 mentality.dysfunctional hypertrophy in bodybuilding
  • Lift more weight.
  • Add balance challenges to anything.
  • No pain, no gain mantra.
  • LEADS TO:  hypertrophy, compensatory pattern, accumulation of stress/strain, failure to meet goals, frustration, injury,…… inactivity.  (Stronger, but no healthier.)

 

We now know that quality of exercise is more important than quantity.  The same holds true in nutrition, quality foods (whole foods, organic foods) are more valuable than quantity.
Systems have been developed to access quality of movement.  Functional assessment or evaluation of movement quality have been around for some time and were championed by Vladamir Janda.

  • Janda & Prague School teachings including Dynamic Neuromuscular Stability.
  • FMS /SFMA
  • Liebenson’s Mag 7

These methods are not always used as we rely on traditional orthopedic testing (which has it’s place in examination, but also has it’s limitations) and diagnostic imaging.  Imaging such as x-ray, MRI, CT also has it’s utility, but is frequently over utilized and often muddles the clinical picture as it does not show function or pain.  Evaluation of structural change has poor correlation to pain and function, it can be misleading.  To combine the concepts, below are some examples of imaging (flouroscopy) during poor quality and then high quality movement patterns.  After watching them which is more important, the # of repetitions you do, or the quality of the repetitions?  Would you prefer 3 sets of 10 with bad form? Or one set of 4 with good form?

Abduction of the shoulder, first with a shrugged, decentrated, elevated scapula; then repeated with proper packing/stabilization.

original posting @ http://irontamerblog.com/packing-the-shoulder/

Which shoulder exercise would you like to see in your patients?  In your own exercise?

The days of quantity have passed.  The emphasis needs to return to QUALITY.   Once we achieve quality, quantities of quality exercise can be used to increase capacity.

Triathlete Imaging- Supporting active care.

To view the original, well referenced blog post look here, from Toronto physiotherapist Laura McIntyre.

So is active care and exercise important?  (Yes, this is rhetorical.)

  • Compared to the top image… which do you like the looks of better?
  • Image 2: Sedentarism?
  • Image 3: Active lifestyle?

You will see the active triathlete with significantly more muscle mass, less fatty (adipose) tissue, and denser bones.  More muscle, less fat, & stronger bones. Sound like something you might want to be part of?

I once heard Craig Liebenson, DC say that we need patients to ‘fear inactivity, more than they fear activity’.  To add context this includes having someone knowledgeable helping them choose appropriate movements, exercises, and activity.

With this being said, there is another side.  Elite athletes and extreme performance are not exactly the best examples of healthy living.  While there are clear benefits to remaining active, at the extremes there is some negative consequence as well.  These feats of athleticism place a toll on the body as well.  This was very clear to me after completing my first marathon. I was convinced by personal experience that there is another extreme.  Another example is the shortened average lifespan of the NFL player.

To summarize:

  • What happens as you age is partially (& significantly) your choice? (see images).
  • There’s a middle road between the couch and ultra-marathons.  Maybe the focus should be on long term athletic participation.

Holiday Pains

The holidays are a fabulous time for being with family and friends, sharing food and drink, and reflecting on the past year.  However, they’re also full of scheduling conflicts, shopping, wrapping, food prep, travel, and expectations.

Unmet Expectations.... Can Hurt.

 

For many people this time can be stressful.  As a clinician working around the holidays there is often a noticeable increase in the number of flare-ups, recurrences of old issues, and onsets of pain.  For those experiencing this unfortunate side of the holidays, understanding the reasons for it goes a long way in helping to deal with it.  Here is a collection of a few great videos on pain perception and why it may increase during this time of year.

You will find that chronic or recurrent pain is a function of the brain, is often unrelated to the amount or significance of tissue damage, and that ‘hurt does not equal harm’.

As you live or train, avoid the “no pain, no gain” mentality and realize that if you “know pain” you will “know gain” (Thanks to David Butler and Lorimer Moseley authors of Explain Pain for these words). The clips below should help you “know pain”. Final words regarding rehab, training, and reactivation for those living with pain, from Diane Jacobs (paraphrased) “If you want your body to feel better, you have to feel your body move better.”  Quality movement is essential to feeling good and living well.

Enjoyed the videos and want more? Information and products from the NOI Group: http://www.noigroup.com/en/Product/EPBE

A sample from the audio book:

Life University R2P Course

Rehab 2 Performance Presents:  FUNCTIONAL FOUNDATIONS with Drs. Jeff Cubos & Jason Brown on April 28-29, 2012.

This course is offered with support from the International Society of Clinical Rehab Specialists and Theraband® Academy.

"Learn the Skills. Master the Art"

Date: April 28-29, 2012

Time:
Saturday: 8:30-5:00
Sunday: 8:30 –1:00

Location:  DoubleTree Suites by Hilton Hotel Atlanta
2780 Windy Ridge Parkway, Atlanta, GA 30339
Phone: 770-980-1900
AtlantaGalleriaSuites.DoubleTree.com

View registration form or simply register below.

The future is near and you must choose your path. The shift in paradigm has begun, is your foundation strong enough for you to thrive?

 

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