Archive for the ‘anatomy/biomechanics’ Category

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Santa is not the only one to use a sled!  The weighted sled can be used in rehab for lower extremity strength, endurance and makes a great core activator. Every patient suffering a significant injury to the lower extremity needs to restore integrated movement, strength, endurance and power. With the sled fastened around the waist and the sled towed behind leg drive and posterior chain strength can be developed for gait and transition into running. It simulates walking up hill without the hill. In addition it will get that heart rate jacked in a hurry!  Walking backward will really fire up the quads.  Now to use the sled for core strength and activation, I just put handles on the ends of the ropes where the waist band attaches. We can now repeat our walks holding the arms chest level or outstretched in front.




The resistance is now pulling back through the arms that have to be stabilized by the core as your legs are still driving forward, not to mention an even greater metabolic demand!  Walking forward activates more of the abdominals and walking backwards (holding the handles) will activate more of the posterior core muscles.  It also give you some additional bonus shoulder and arm work.  A shoulder harness is a great alternative to the handles although not as demanding.





I am a big fan of asymmetrical loading due to the increased demand for stability and its relation to “real life” activity/movement.  So, here are just a few of many tweaks to the sled I use.





1 arm push                                     1 arm pull                        over shld pull

So, as you can see (hopefully)  these exercises can be used in rehab for the upper extremity, core or lower extremity.

Get Strong! Stay Strong!


Great article I came across on Mike Mahlers website written by Sarah Cheatham

Nerve Glides mobilize and tension the nerves through a range of motion. Which can be thought of as joint mobility but for your nerves. Nerves are high-threat and thus high-priority for your CNS (central nervous system). This means that if something goes wrong with a nerve you know pretty quickly.

For example: Sciatica pain. The sciatica is a nerve that runs from your low back (lumbar plexus) down the back of your thigh, into your calf, and ends up in branches in your feet. You know when it has been compromised. Often the important nerve gets pinched from excessive compression via heavy squatting, bad lifting, poor rotation, a large gut, high heeled shoes, etc. Most often, the sciatica is pinched by lumbar stenosis. Lumbar stenosis is narrowing of the lumbar nerve canals and too often occurs because of shoe choice. Anything that elevates the heel forces everything up the chain to adjust.

So think about this: your heel is elevated (the point of initial impact of your body and the earth). To propel you forward, the energy transmits up to your knee, but with an elevated heel the knee is already pitched forward. In a barefoot step, the knee starts from extension, then flexes, then goes into full extension. In a heel-raised knee, the knee starts in flexion, goes to semi-extension (in other words: still in flexion) then finishes in flexion. There’s no good chance for the knee to go through its full range of motion. So you’re selling your mobility short here, at the first joint up from the ground. This means you have knee and low back pain…Your shoes are limiting your mobility and this is the reason you have knee and back pain. There is nothing wrong with your knee, it’s over-working because you chose some silly shoes.

We’ll move up to the pelvis from the knee and by-pass the hip for now. What happens in the pelvis with a raised-heel (because of your cute shoes …that were on sale)? The pelvis tilts forward. You see a great example of this in pregnant women and pot-bellied men. But it happens in your body when you wear high, or semi-high heels, Nike Shox (and the like) or even combat or cowboy boots. This means that lower belly you just can’t seem to get rid of with all those crunches is really a result of your shoes. When your pelvis tilts forward, all that is in it has to adjusts too. In other words, save for your skin & fascia, your guts would spill forward out of your low-belly. A graphic description, I know, but it proves a point. Are those shoes really that cute now? May I remind you they give you a belly “pooch,” the one ladies are forever complaining about not being able to get rid of despite countless “core” work. And it goes beyond high heels, to elevated heel tennis shoes.

With the pelvis pitched forward, the low back has an excessive curve in it: lordosis, technically. Meaning an exaggerated curvature of the low back. That curve is what’s putting the pinch on your sciatica, amongst other nerves that live in your low back. Remember, this is all because your heel is elevated up off the ground…even slightly. Our bodies are so smart, that they will adapt to a demand (walking in high heels or running in shox) without us asking. But you can see it comes at a price…and it’s all your fault.

What’s the significance of poor shoe choice, joint mobility, and what can you do to help yourself?

Often smaller branches of the sciatica down in the feet go unused and can even of die off due to the stenosis caused by poor shoe choice and the resulting poor posture and gait. This, in addition to chronic low back pain and decreased training performance. If you don’t mobilize the joints the nerves feed through, (in this case the lumbar & hip joints for the sciatica), we get disuses injuries (see: sprained and twisted ankles, muscular atrophy, weakness and imbalances). The answer to getting the most out of your body for a lifetime: Specific joint mobility and flat-soled shoes regardless of your chosen activity.

Specific joint mobility done with intention will gently mobilize the nerves that feed through the joints and therby significantly enhance your brain/body coordination!

Get Strong! Stay Strong!


Yes, I said dormant butt syndrome, DBS for short! I see it all the time in the clinic. In athletes and people of all ages. The cause of DBS is usually tight hip flexors, again, which most people have. This is due to repetitive hip flexion from walking, running, sitting, driving and sleeping in the fetal position.  Other causes include injury and inactivity.   If you remember back to previous posts the gluteus maximus generally attaches proximally to the sacruum, and illiac crest and wraps around the hip to distally attach to the greater trochanter (the big bony bump on side of hip).  Although we think of the gluteus maximus as a powerful hip extender it is actually built for rotation.  Just look at the fiber orientation (yes, you may have to crack open the old anatomy book).  So, functionally its main function is to eccentrically control internal rotation of the femur in the transverse plane during the loading phase of gait or running, eccentrically control hip flexion in the sagittal plane and assist the gluteus medius in stabilizing hip adduction in the frontal plane.  The ability to appropriately load enhances their ability to concentrically contract during the unloadong or propulsive phase.  If the gluteus maximus is inhibited (which V. Yanda taught us) from a tight hip flexor, then the hamstrings and erector spinae group  become overactive to compensate.  This leads to the possibility of hamstring strains, low back pain, knee pain and possibly even plantar fascia.  A simple way to check for DBS is to have patient lie prone and ask them to do a leg lift.  Palpate the gluteus and the hamstring and see which contracts first.  Many times I feel the hamstring contract then the gluteus.  It should be gluteus then hamstring.  Sometimes ive seen people have a 5/5 manual muscle test and not even fire the gluteus.  They used all their hamstring and erectors to lift/hold the leg up.  Some general strategies include a basic muscle re-education of laying prone over table or bed and actively squeezing butt then lifting leg.  Sequence can also be done with bridge exercise.  Stretching the tight hip flexor, of course, and functional hip dominant exercise like single leg balance w/ arm reaches, multi planar lunges, sled walks, various step up and downs.  So now get moving and wake that sleepy butt up!

Get Strong! Stay Strong!











No, I dont advocate high heels for squatting (just for a night on the town). After an ankle injury or surgery many times the ankle is limited in dorsiflexion either due to joint restriction, tightness of the achilles/calf or both. This often occurs as a result of the foot/ankle being immobilized (casted or boot) or just not walking normally due to pain, swelling and/or apprehension to fully weight bear. This restricted ankle movement often limits the ability to squat. The ankle, knee and hip all have to flex (as well as rotate and ab or adduct) simultaneously during the descent. Obviously if the ankle joint motion is limited the the depth of the squat will be effected. This should’nt stop you from squatting, it just requires a little creativity. Simply put a 2×4 under the heels. This places the ankle in a plantarflexed position which allows the ankle (and lower extremity) to go through more motion thereby creating a more normalized squat. Now the legs can be strengthened while the ankle is protected and everyone is happy! Dont forget to gradually lower the heel lift as their mobility returns until they are able to performa proper squat with their feet flat on the floor.
The other benefit to the heels up squat is that it moves your center of mass forward and the body automatically will sit back into the squat creating a more “normal” pattern. Most of the people I see cant squat to save their lives and the sad thing is I deal mostly with athletes! As a whole our society has lost their ability to squat. Why? Good question, probably because we utilize toilets instead of a hole in the floor. Think about it, many other cultures dont utilize toilets which forces them to move through the full range of motion and thereby maintain a normal squatting pattern. Relative to the U.S. these other societies have fewer cases of low back pain and knee pathology. See, I wasn’t kidding! Other causes of poor squat mechanics are inactivity, injury, and overuse / repetitive movements.
As I always say, there is always a way. It just might take a little creativity and of course understanding your functional anatomy and biomechanics.

Get Strong! Stay Strong!

Despite their name, the adductor muscles work primarily as strong sagittal plane hip flexor or extensors. For example, if you are walking (or running) and the right leg is forward, the right adductor works as an extensor and the left as a flexor and then they switch as you alternate legs in the cycle. Have you ever went out and ran or sprinted for the first time? Where did you feel sore? Right, in the groin and inner thighs (as well as the rest of your body if was your first time).
The adductors (generally) attach proximally to the pubic bone and distally attach to the posterior medial aspect of the femur, giving them their mechanical advantage in the sagittal plane. In single leg stance or the single leg phase of gait running or kicking they work with the gluteus medius and the quadratus lumborum to stabilize the pelvis and limb in the frontal plane on the stance side. Now, in activities such as gymnastics, ballet, and karate where the leg is lifted or rapidly “thrown” out to the side the adductors will actually adduct the leg to bring it back into position to hit the ground.

Due to its atachment to the pubic bone, the adductors when activated, can stimulate (turn on) the pelvic floor muscles.  So, squeezing something between the legs while doing a bridge or squat for example can increase pelvic floor activity, which is important for women who have had multiple childbirths and people with core stabilization issues.

Some examples of functional exercises that activate the adductors include:  lunges – forward, lateral and posterior lateral w/ rotation, step up w/ opp. leg hip flexion (w or w/out resistance from cuff or cable), single leg balance w/ opp. leg reaches, and resisted walk, jog or running (cable, bungie, sled).

Once you understand what the bones are doing in all 3 planes (against gravity, ground reaction forces and momentum) and you know where the muscle attaches proximally and distally, you can begin to figure out its true function and design exercises to actually improve the bodies abilitiy to move.  Unfortunately, school doesnt usually teach us that.  Think back to anatomy.  We are taught that the adductors adduct the leg.  Well, now we know that in function they rarely ever do that!  Good luck and have fun!  There is always more to learn!

Get Strong! Stay Strong!


By Doug Gray

Jumping is an action that has implications to everything we do. Squatting, walking, running, lunging, etc. has components of jumping involved. Therefore, jumping better will pave the way to functioning better. A common element of plyometrics and calisthenics is jumping. Jump training is a point of focus in sport, yet has extreme implications to life in general. The topic of jumping initiates many questions to consider, such as the following:

• Is your jump training directly carrying over to that which you are training for?

• Is your jump training better preparing you to execute activities more efficiently, whether in sport or active daily living?

• Is your jump training incorporating all three planes of motion (as the body is intended to function)?

• Is your jump training properly sequenced to be safe and guarantee progress / improvement?

• Is your jump training properly preventing future injury?

• Is your jump training dynamic and variable (i.e. – incorporating two feet to two feet, two feet to one foot, one foot to two feet, and one foot to the same foot)?

As the above questions trigger contemplation to the purpose, logic, and sequencing of one’s training regime, it sets the table for exploration on how to better train the body. A great starting point is identifying and discussing a functional threshold.  A functional threshold … the body’s ability to successfully perform the multiple tasks required for what one needs to do and what one wants to do in life. In essence, it leads to productively owning ones three‐dimensional space in completing the desired task at hand. The spectrum of “needs” and “wants” is long and variable, yet lends itself to the following point: it is in ones best interest to expand his / her functional threshold in order to enhance overall performance.

Jump‐Jop‐Hop Explosion, which is part of the Gray Institute’s 3D Matrix Performance Series, is a workout intended to increase one’s vertical, to protect one from injury, as well as to improve one’s strength, flexibility, cardiovascular endurance, coordination, agility, power, speed, reaction, etc. More importantly, it is designed to enhance one’s overall health, wellbeing, and longevity by creating an environment where one can expand his / her functional threshold. Jump‐Jop‐Hop Explosion, as all DVDs in the 3D Matrix Performance Series, consists of both instructional and follow‐along segments.

The terms jumping, jopping, and hopping all refer to the act of loading the lower body and trunk to efficiently and effectively (as well as explosively) unload the body to become airborne in defying gravity. Pure jumping is defined as leaving the surface (or ground) on one foot or both feet and landing on both feet. Pure jopping is defined as leaving the surface on both feet and landing on one foot. Pure hopping is defined as leaving the surface on one foot and landing on the same one foot.

The Chain Reaction™ biomechanics involved with jumping are very similar to that of the lead (or front) leg in gait (or walking). In understanding this better, it is valuable to identify what is known as a Transformational Zone (TZ). A TZ is defined as the period of time when motion changes direction. Moreover, a TZ is the point where eccentric lengthening (loading) of a muscle transforms into a concentric shortening (unloading). The TZ of jumping (when the body compresses before exploding upward or outward) calls for a three‐dimensional Chain Reaction™ throughout the entire body (feet / ankles, knees, hips, trunk, etc.). This load and explode sequencing is a common denominator for all forms of movement. For that reason, Jump‐Jop‐Hop Explosion is not strictly for jumping population, but for all walks of life.Jump‐Jop‐Hop Explosion is a workout that trains the body’s muscles and joints to load and explode in a variety of ways in performing jumps, jops, and hops. Embedded into the workout is a progression that gradually intensifies the workout from round to round (consist of three rounds) by beginning with jumps (two feet to two feet), then shifting to jops (two feet to one foot) and hops (one foot to same one foot). Also, very important to the topic of the DVD, a strategy of safety and progression is performing the workout in initial ranges of motion until the body is comfortable and strong enough to be challenged more (which would involve moving then into mid ranges of motion, and then moving into end ranges of motion).

Additionally, Jump‐Jop‐Hop Explosion positions the body from the top‐down to facilitate and different Chain Reaction™ to add variety and functionality to the workout. For example, both hands are positioned differently in certain portions of the workout to put parts of the body at a biomechanical advantage, while putting other parts of the body at a biomechanical disadvantage, in order to mimic sport and daily activities that the body needs to perform. Of course, these positions are logically organized into all three planes of motion (in front of, above and behind, to the right of, to the left of, rotationally to the right of, and rotationally to the left of the body). Placing the hands in front of the body (anterior at hip) recruits more of the back hip (glute muscles) to execute the task, whereas placing the hands above and behind the body (posterior at overhead) recruits more of the front hip to execute the task. Different positions of the body allow gravity to compress the body differently, as gravity is the competitor of jumping, yet also the best friend when it comes to loading the body to jump.

According to the Gray Institute’s Functional Video Digest Series v2.4, “Jumping: Unleashing the Load” CLICK HERE, jumping is a tri‐plane phenomenon. Also, to enhance jumping, it is imperative that new pathways of loading the body are established and existing pathways are deepened and enhanced. Jumping is not only vertical, but also horizontal and rotational. All these dimensions need to be exploited in any jumping program to better prepare and protect the body in all areas of performance, in which Jump‐Jop‐Hop Explosion successfully exhibits. This needs to be the goal for any athlete: to develop and enhance the gifts and talents that he / she has been given. Therefore, all dimensions need to be attended to in expanding one’s functional threshold. Jump‐Jop‐Hop Explosion is an integral step to this process.




By Michael Rizk, CPT, ART  


Have you ever witnessed a relationship gone sour? The telltale signs are significant, but many  

times the root cause stems from poor communication. There is one particular area of the body  

that seems to get more press than a short‐lived Hollywood hook‐up. You’ve got it – the lumbar  

spine (LS) is likely the most injured, dysfunctional, and (supposedly) weakest link of the body.    

  In relation to the rest of the body, the LS is active in nearly every functional task performed … it  

resides at the crossroads of the body. For that reason, it is important for the rest of the body to  

communicate with the low back to let it know how important it is, how much it is needed, and  

how much it is appreciated for all it does.    

  What is meant by communication with the LS? Great question! Communication refers to the  

ability of all our joints to feed triplane motion to the LS creating triplane stability. A lack of  

triplane  mostability  (mobility  plus  stability)  can  shut  down  the  phone  lines  feeding  

proprioceptively rich information to the LS, thus creating undesirable chain reactions.  

  By design, the LS facilitates flexion and extension, allows lateral flexion, and almost inhibits  

transverse plane motion. The small amount of transverse plane motion may in fact be the most  

important motion allowing the LS to be the transverse plane transmitter of forces between the  

upper and lower extremities.   

  To simplify motion, we consider two phases: loading and unloading. Loading is the preparation  

of the task and unloading is the performance of the task. Using the golf swing as an example,  

the backswing is the load and the downswing / follow through is the unload. The moment of  

time between the load and unload is what we call the transformational zone (TZ). The TZ is  

where  motion  is  decelerated  and  transformed  into  a  concentric  production  of  force.  

Understanding what happens just as we enter and exit the TZ will allow us to effectively assess  

our patients and clients.  

  I  recently  assessed  a  57‐year‐young  right‐handed  golfer  with  right  low  back  pain,  which  

occurred during the end range of his back swing just prior to transition. His approach to me was  

simple, “So I heard you can fix my back.” With a humble smile, I explained how the body works  

relative  to  the  intended  task.  I  shared  with  him  how  a  lack  of  three‐dimensional  motion  

(communication) at any segment will become excessive compensatory motion elsewhere.    

 While his assessment started with a gait evaluation, I kept in mind that gait and golf create very  

different chain reactions in the TZ.  During gait, the pelvis and trunk move opposite each other,  

and in golf, they move in the same direction. However, I immediately noticed an inability to  

load the left side of his body during gait, which was evident by a rough transition from his right  

to left foot, as well as an early heel rise on the left foot. After viewing this global glitch, I had to  

become a biomechanical detective and get more specific.  

 To  further  assess  his  left  ankle  and  left  hip,  I  had  him  perform  a  three‐dimensional  balance  

reach  matrix.  He  lacked  balance  when  I  asked  him  to  reach  in  the  frontal  and  transverse  planes  

from  his  left  foot.  To  create  stability,  I  placed  him  in  the  TRUEStretch™  in  a  backswing  posture  

and had him perform his balance reaches from this golf‐specific position. Lo and behold, he said  

“Wow,  it  feels  like  my  ankle  doesn’t  want  to  turn  that  way!”  He  continued  to  say,  “I  wonder  if  

the left ankle sprain I had playing college basketball has anything to do with this?”    

Next,  I  positioned  him  in  his  backswing  posture  to  his  threshold  of  success  (meaning  prior  to  

experiencing  any  pain  or  compensation)  and  used  my  hands  as  a  driver  to  facilitate  frontal  and  

transverse  plane  subtalar  joint  (STJ)  motions.  To  balance  his  new  mobility  with  stability,  we  

performed  lateral  and  rotational  lunges  with  three‐dimensional  arm  drivers  specific  to  the  golf  

TZ.  This  strategy  facilitates  proprioceptive  communication  between  his  left  STJ  and  right  LS.  

Within  one  week,  my  client  was  enjoying  a  pain  free  backswing  with  added  yardage  and  accuracy.  Needless‐to

say, we were both happy. Even though my client came to me with low back pain, I am led to believe his lack of frontal and  

transverse  plane  motions  at  his  left  STJ  was,  at  least,  in  part  the  CAUSE  of  his  LS  dysfunction.  If  

we  take  a  snapshot  of  the  backswing,  we  can  see  the  following:  right  trunk  rotation,  right  hip  

internal rotation, left hip external rotation, right ankle inversion, and left ankle eversion. Frontal  

plane  eversion  of  the  left  STJ  transforms  into  rotation  of  the  left  limb;  therefore,  a  lack  of  that  

motion  must  be  made  up  somewhere  else  in  the  kinetic  chain.  With  the  nominal  amount  of  LS 

rotation available there, is not much room to compensate at the LS before dysfunction and pain are experienced.  

With  an  understanding  of  Applied  Functional  Science  (AFS)  and  chain  reaction  biomechanics  we  

can  effectively  and  efficiently  keep  the  LS  healthy  and  functional  with  improved communication.  

Oh how I love function!

Get Strong! Stay Strong!























By David Westerman LMT, FAFS  

Are  we  utilizing  “authentic”  principles  of  Function  when  designing  our  strength  and  

power programs?  

Is  there  a  special  population  that  might  be  missing  two  of  the  most  important  bio‐ 

motor abilities in their training and rehabilitation programs?  

As  a  former  collegiate  and  professional  strength  and  conditioning  coach,  strength  

and power were (and are) the two most emphasized bio‐motor abilities.   

Take,  for  example,  the  “power  clean”  in  an  athletic  weight  room.  This  is  one  of  the  

most  utilized  exercises  in  “power”  training.  The  typical  strategy  is  to  put  as  much  

weight  on  the  bar  and  successfully  lift  it  one  to  four  times.  Let’s  see  if  we  can  use  

part  of  our  litmus  test  of  “authentic”  strength  and  power  principles  to  better  

understand its carryover to three‐dimensional Function.  

  Is  it  three­dimensional? 

  The  power  clean  is  a  sagittal  plane‐dominate  

movement.  Most  activities  require  three‐dimensional  movement  in  all  

muscles and joints. 

  Is  it  specific  to  activity?  

Considering  most  sports  and  activities  have  a  

horizontal component to load, the power clean is mostly a vertical load.  

  What  is  the  neural  input  and  range  involved?  

If  the  weight  is  too  heavy  

and  we  go  through  long  ranges,  we  may  actually  slow  down  the  neural  input  

which will inhibit our power and strength transfer to activity.  

  Are  we  taking  advantage  of  the  Transformation  Zone?  

The  fact  that  

most  of  our  power  is  utilized  at  the  zone  in  which  a  direction  is  reversed  in  a  

motion needs to be considered (i.e. – plyometrics).  

Above  are  a  few  key  questions  that  we  can  use  for  any  population  or  exercise  we  

choose to work with.     

Typically  we  associate  strength  and  power  with  athletes.    However,  the  population  

that  may  need  it  the  most  is  our  senior  population.  With  the  baby‐boom  explosion,  

more  and  more  of  this  growing  population  are  getting  injured  and  becoming  more  

sedentary.  Consider  the  following  scenario  and  proposed  training  /  treatment  



A  75‐year‐old  woman  has  balance  problems  when  walking.  

Through  functional  assessments,  the  practitioner  finds  abdominal  muscles  

are  weak  and  significantly  lack  the  ability  to  move  in  all  three  planes  of  


Potential  strategy 

:  Position  client  in  a  small  stride  position  with  the  left  leg  

forward  in  front  of  a  wall  for  support  and  as  a  target.  To  create  a  load  in  the 

abdominals  we  want  to  reach  with  the  left  shoulder  posterior  (backward)  at  

shoulder  (height)  towards  the  wall  in  a  short  range  of  motion  at  a  moderate  

to fast speed.  


  This  facilitates  tri‐plane  loading  of  the  abdominals  in  the  

Transformational  Zone  of  walking  with  an  exercise  that  replicates  the  

activity,  while  creating  more  power  that  will  transform  into  better  strength       

of the entire kinetic chain by using a short (safe) range and increased speed.     

Whether  you  seek  strength  or  power,  our  strategies  and  exercises  need  to  be  based  

on “authentic” principles of Function. 

Get Strong! Stay Strong! (and be functional)