Archive for August, 2008

What is that black tattoo on Kerri Walsh’s right shoulder? It is called Kinesio Tex Taping which is an elastic taping used in chiropractic, rehabilitation and sports medicine. Developed 25 years ago by Dr. Kenzo Kase, it is now getting recognition and being used by top athletes such as Lance ArmstrongSerena WilliamsDavid BeckamRobby Ginepri and Justine Henin. Kinesio Tape works by giving support like a flexible brace and facilitates weak muscles with neurological awareness or proprioception. Kerri Walsh had a recent rotator cuff surgery last November. NBC reported that she uses the black shoulder tape for better circulation and her shoulder pain.

Many people watching the olympics and ive received several questions regarding kinesio taping.

As the paragraph reports its been around for a long time.  It has just come to the publics attention from the exposure it got on the olympics.  While it can be beneficial it is not the miracle cure for all (even though it was in the olympics).  It is just another good tool to assist in the rehabilitation and healing of the body.

Hope you enjoyed the olympics as much as my family and I did.  U. S. A. !!

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Shoulder pain can range from nagging to debilitating depending on the problem and severity.  Generally, in the under 40 crowd shoulder problems usuually consist of impingement and instability.  Impingement occurs when the “ball” of the ball and socket joint “rides” up during shoulder movement and pinches the rotator cuff and bursae.  This can result from trauma or fatigue from repetitive movement.  Instability is from a laxity in the capsule (fibrous tissue.  Like the wrapper of a lollipop) that holds the ball and socket joint together.  This can occur from repetitive motion or trauma.  Some people are born with more laxity in their joints that predisposes them to these typess of problems.  These are the people that are “double jointed.”  They don’t actually have 2 joints they are just very flexible in their joint tissue.  This can range from mild to severe.  This creates “extra” movement in the joint that can irritate the tissue, rotator cuff and/or injure the cartilage of the socket (the labrum).  The over 40 crowd usually suffers from rotator cuff tears, although they can also have impingement and tendonitis.  Aging of tissue and the longevity of activity makes the older individual more prone to rotator cuff tears.  This can happen through gradual wear and tear leading to the cuff tear or from trauma such as a fall or heavy pulling movement.

Many factors can lead to shoulder problems and multiple steps can be taken to prevent or at least reduce your risk of shoulder injury.  Posture is a big problem for many people.  The rounded shoulders compromise the shoulder joint space and contribute to muscle imbalance and impingement.  Tight hip flexors can also contribute to shoulder pain.  The tightness in the hip flexor can “pull” the pelvis forward which can pull the shoulders forward leading to pec tightness which further pulls the shoulder forward.  Taken further this shortens the abdominal muscles (shutting them off) and contributes to an unstable back.  When looking at movement through a functional eye you would see that overhead activity requires extension and rotation through the spine and the same side hip.  So for example, if your hip flexor is tight and/or your shoulders or upper back was rounded and you were trying to change a light bulb, even if your shoulder motion was normal, your ability to work overhead would be limited and your chances of developing shoulder pain would be high.  The moral of the story is that it is all connected and that to successfully correct shoulder problems you must try to find and address the cause.  This requires understanding the functional relationships of the body.  Many times easier said than done.

In general, make sure your exercise programs are balanced and you are not just working the “mirror muscles,” stretch your hip flexors, watch your posture especially when sitting, drink plenty of water (most of your tissue is water) and eat a balanced, nutritious diet (give your body the nutrients it needs to be healthy and support the growth and repair processes).

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What an incredible kid with an incredible heart.

My good friend Scott Goodpaster trains Dustin.  Scott is an awesome and genuine guy as you can see in the video. 

I hope you enjoy this clip and Dustins amazing work ethic!

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                      Y’s                                                            T’s


                         L’s                                                       W’s

These are four staple exercise for our posture and shoulder patients.

Keep the thumbs pointed towards the ceiling with the Y, T and W’s.

Don’t force the motion at the top.  Keep it comfortable.  Keep neck in neutral position.

We initially start with 12-15 reps with no weight and progress to 3 sets.  Then we add 1 pound weights and progress.  If you experience pain (not the burning pain assoc. w/ effort) stop and consult a qualified practitioner.  

These are deceiving little exercises that are guaranteed to get your postural and rotator cuff muscles fired up!  Enjoy.

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Great, but challenging workout.  If your beginning modify the workout by decreasing the reps and progressively work up to the desired reps.  This is sure to get you looking great and feeling great!

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Posterior Tibialis: Attaches proximally to post aspect of tibia and distally attaches to almost everything under the foot (cuboid, navicular, cuneiforms).  During pronation (loading phase) it eccentrically controls tibial advancement in the sagittal plane(SP), tibial internal rotation in the transverse plane(TP) and eccentrically controls lateral to medial loading of the foot in the frontal plane(FP).

Soleus: Attaches proximally to post surface of tibia and distally forms achilles tendon to attach slightly medial on the calcaneus.  During the loading phase it eccentrically controls tibial advancement in the sagittal plane, tibial internal rotation in the transverse plane and calcaneal eversion in the frontal plane.

In most anatomy classes it is taught that the function of the posterior tibialis. is to plantar flex (point) and invert the foot and the soleus plantar flexes the foot.  Unfortunately, when your foot is on the ground this does not and cannot happen as was explained above.  After an injury or surgery many people walk on a bent knee.  Assuming they have full passive extension, the problem is a posterior tibialis and soleus that are not functioning properly.  When the foot hits the ground and begins to pronate, the soleus is ecc. controlling calcaneal eversion (FP), the post. tib. and soleus are ecc. controlling tibial advancement(SP) and internal rotation(TP) and the tib. post. is controlling the lateral to medial loading of the foot.  This all occurs through late mid stance of gait (normal pronation).  Then the foot/leg begin to supinate (unload) in order to lock up the joints to push off on a rigid lever.  The soleus inverts the calcaneus while the post. tib. and soleus concentrically “pull” back on the tibia and externally rotate it.  Meanwhile momentum is carrying the rest of the body “over the top” and thats what creates knee extension during gait.  It really has nothing to do with the quad, which is taught in school to extend the knee.  School anatomy really didnt prepare me or others to treat movement dysfunction and injury in the real world.  Thank goodness I was fortunate to meet Gary Gray early in my career.  He really opened my eyes to true “functional anatomy.”  For that I am grateful.

It is truly a never ending journey.

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When the foot hits the ground:

     The calcaneus everts

     The talus drops down and in

     The tibia advances forward, internally rotates and abducts

     The knee (unlocks) flexes due to the tibia moving a little faster than the femur

     The femur internally rotates

     The hip internally rotates, flexes and adducts 

     The lumbar spine extends and sidebends/rotates to the same side

     The shoulders rotate in the opposite direction of the pelvis (loads trunk)

     The cervical spine rotates in the same direction of the pelvis. (rotates from the bottom up)

Once you understand the biomechanics of function you can better design exercises for rehab and function.

After mastering what each bone is doing in each plane of motion then start to put the muscles on the bones and see what each muscle does in each plane to see what its true function is.

It is a never ending study to understand the complexities of human movement but one that never ceases to amaze and challenge me

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1.  Bent knee bridge (butt lifts)



2.  Hamstring curls in bridge position


3.  Straight leg bridge (balls of foot on ball)


Begin by doing 10 reps of each successively and build to 15-20 reps.  Work up to 3 sets and then start over  using one leg.  Feel the burn baby!  

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In my last post I provided a quick and easy way to determine your caloric needs.  One of the biggest mistakes most people make when trying to lose weight is to cut their calories when actually you probably need to eat more.  The “more” refers to the right amount of calories to permanantly lose weight and the right type of food to support your goals.  Remember if you restrict calories your body will go into survival mode and stor fat for the energy it needs that you are not giving it to survive.  Also, as you go from diet to diet, as many people do, you will ultimately gain more fat and have a harder and harder time losing weight.  This results because over time your fat to lean muscle ratio increases.  The key is to utilize a reasonable and correct nutritional strategy.  Research has also shown significantly better results when nutrition is coupled with an exercise program. (P.S. aerobics is not the most efficient way to lose fat!)

So, the first thing you need to do is to eat 5-6 times per day.  Especially breakfast.  Your body has been fasting all night long and if you do not supply it with nutrients it will rob your lean muscle mass and bones to get the nutrient it needs to survive and keep your body running.  Not 5-6 full meals.  Take the caloric needs you calculated (see previous post) and simply divide this number by five and you have the amount of calories needed in each meal.  For example, if you need to consume 2500 calories per day then you would want to eat 5 meals each consisting of 500 calories.  You would want to make sure your carbs are complex and your protein is a lean source.  Remember a calorie is not a calorie.  What composes your meals is important. (A topic for another post)

           1. calculate your caloric needs

           2. Eat 5-6 meals per day

Keep it simple and just begin by eating 5 meals.  This stabilizes blood sugar and regulates energy.

Once this habit is adopted then focus on the quality of your food.

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Whether it is a desire to lose or gain weight (lean muscle) the first thing you need to do is to figure out how many calories you should consume in a day.  While there a few methods to do this the one prsented here is quick and easy.

           1.   Add a “0” to your current weight.      eg   143lbs = 1430

                           This is an approximation of Basal Metabolic Rate.

                           BMR is basically calories needed to sustain life.

           2.  Add 1000 to that number.           eg.   1430 + 1000 = 2430 (kcals)

                          This represents calories needed to maintain current weight

           3.  Add 500 to above number for weight gain and subtract 500 for weight loss.

Stay tuned for next post to discuss what to do with those calories and a secret tip for weight loss.

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