Angela is the physical therapist for the Washington Nationals, and in this interview talks about her 'go to' treatments and the influence of the SFMA, NAIOMPT, DNS, and other systems on her treatment approach. She also discusses some of the 'links' in the system that have made a big impact on the way she looks at movement dysfunction in baseball athletes, teaming up with the S&C staff for injury prevention, plus some recommendations for those looking to get more involved in collegiate or professional sports.

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The Ultimate Guide To Resolve Hip Impingement - https://www.sportsrehabexpert.com/public/The-Ultimate-Guide-to-Recovering-from-Hip-Impingement-Without-Surgery.cfm

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Many people walk around feeling like their hips are out of alignment. However, changes in hip alignment is a NORMAL part of life. In fact, every step you take your hips will change alignment. Therefore there is no "perfect" hip alignment that is better than the rest.

Instead you pelvis and hips should be very adaptable and be able to achieve a variety of different positions under control. Its only when we lack movement options or have too many that we cannot control does our body default to a movement tendency which can become problematic over an extended period of time.

Many physical therapists and rehab specialists will constantly adjust the hips. Forcing you into weekly adjustments to help "keep you aligned" when in fact its either you need to ACTIVELY through exercise teach your body how to either achieve MORE positions or CONTROL the variety of positions/flexibility you already have.

https://youtu.be/S02LM-QQixY

Recently was asked a couple questions from another student PT that I help mentor on occasion. We discussed PRI methodology strengths and weakness to their approach. Which led to a discussion on the obers test and what I get out of it as compared to what PRI gets from it (PRI terms it the adduction drop test). Finally we wrap up our discussion with talking about how to better critically think and establish a "Needs Analysis" for your patients as far as what qualities they are lacking and making treatment determinations on whether or not to focus on strength, variability, capacity, manual therapy, etc...

If you would like to find out ways that Sports Rehab Expert can help you we have a couple options that you will find in the link below:

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Email me directly [email protected] if you are interested in any of these options :)

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

Full Article - https://www.sportsrehabexpert.com/public/Hamstring-Injuries-Proximal-Hamstring-Tendinopathy-Should-You-Stretch-The-Area.cfm

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

Physical Therapy in Ann Arbor, MI: https://www.annarbor.physio/

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Sports Rehab Success Show - Hamstring Pain - Proximal Hamstring Tendinopathy {Stop Stretching It!!!}

In this episode we discuss why stretching a proximal hamstring injury can be one of the worst things you can do for treatment. Especially early on in the recovery process!

Compression and the insertion of the hamstring tendon being at the hip is the biggest reason why.

Most of these clients will report a significant amount of pain in sitting due to the location of the pain. The increased discomfort comes from compression to the sensitive tendon attachment it gets while sitting.

So when a tendon is currently sensitive that it limits a significant amount of activities, placing the tendon in a state of compression can lead to increased symptoms or at best no relief from the problem.

It just so happens that greater degree of hip flexion or torso flexion will place the tendon in a compressed position. If you perform an activity that involves both trunk and hip flexion this will create the most compression (this would be the standard standing hamstring stretch).

So instead of stretching, it would make more sense to place the muscle and tendon in positions where it feels semi comfortable to perform some type of resistance based contraction. That contraction can be an isometric, isotonic, or eccentric. All 3 types will have benefits for restoring capacity in the hamstring tendon.

The biggest takeaway is that you want to restore strengthening of the tendon in ranges of motion that are comfortable and gradually work up to a flexed position as the injuries and symptoms allow for it.

https://youtu.be/axyqwQlW8Wo

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In this episode I share my 3 (technically 4) favorite ankle mobility drills:

But to provide some more context I made this video discussing some other considerations:
🦶Careful of always staying with low load exercises.

🦶Why not train other qualities WITH ankle mobility such as strength?

🦶If you are going to do a low load exercise, I personally recommend it being a VERY simple activity that allows the person to get to it frequently (I feel the volume of low load is what will create the lasting change). Combine that with loaded training you probably have a nice recipe!

🦶I realize I left out loaded gastroc and soleus raises. Definitely don't forget those!

🧐What about those who have good ankle mobility with single leg tasks such as anterior tap down or knee to wall, but struggle with bilateral tasks such as a true knee forward squat. Is there a point ankle mobility has been maximized and pelvic/thorax structure or adaptability is what limits further improvement in bilateral movements such as a squat?

Your #1 Educational Platform to LEARN Sports Rehab, Orthopedic Rehab, and Sports Performance: https://www.sportsrehabexpert.com/

Knee Pain is one of the most common diagnosis in the world that results in millions of dollars spent on surgery, rehabilitation, and disability.  It is wildly misunderstood and often times over complicated! 

As a result, many people suffer from poor outcomes to treatment and continued suffering from knee pain.   While this post is by no means trying to solve everyone's problems. It is trying to show how treating the knee CAN be simple. It does not have to be complicated. And you can still being effective!  Perhaps the biggest misconception in orthopedic rehabilitation circles is that every exercise HAS to be functional or it is a "bad" exercise as it does not relate to life...  

I would like to challenge that myth by saying that ANY exercise the helps develop greater tissue capacity, tissue resiliency, and overall movement confidence will be EXTREMELY helpful in removing someones pain and functional disabilities.  Furthermore, a simple knee exercise such as the knee extensions shown in this video can be very useful to overcome knee pain and keep it away for good! So long as you know why, when, and how to use the exercise.  

It was once thought that knee extensions were a "bad" exercise because the were not functional and it put to much compression to the knee joint...  Unfortunately this opinion was short sighted as obviously they did not consider that people with healthy knees are able to run, jump, change direction or simply go down stairs. All these activities will put compressive forces on the knee which the body NEEDS to be prepared to handle.  We need to think more deeply before we call an exercise "bad".  

The knee extension (through full range of motion in the open chain) can be a useful way of building quad strength and capacity. As well as patellar tendon strength, capacity, and tissue resiliency.  Again, running, jumping, change of direction, and simply going down the stairs will put as much if not more compressive force on the knee. So this exercise is perfectly fine to do from a safety perspective.  That being said, when someone is dealing with pain our approach has to change slightly until they are out of pain.  When in pain and dealing with patellar tendinitis or patellar tendinosis issues (also known as jumpers knee). The point of tendon highest sensitivity will be at bottom position where the tendon is on most stretch. So in some instances we may want to avoid this position until pain and sensitivity levels have decreased. In this instance an isometric at ~45 degree knee bend can be useful. 

Isometrics are also a great way to continue training the tendon and quad muscle safely while sporting or workout intensity/workload is high.  If someone is dealing with a patellar or knee joint issue. Commonly referred to as patelofemoral pain syndrome. Then the entire movement can be irritating as opposed to just the starting position. Also in this case, the last 30 degrees of open knee extension tend to be the most painful.  So again, we can still train the muscles around the knee in a NON-PAINFUL way by performing an isometric at 45 degrees. Essentially avoiding the repetitive movement and irritating range of motion. Until the pain and sensitivity levels have decreased and you can gradually return to a full range of motion with the exercise as tolerated.

Sports Rehab Success Show Episode #28 - Foot Pain After Running | Tarsal Tunnel Syndrome & Morton's Neuroma Treatment

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

Physical Therapy in Ann Arbor, MI: https://www.annarbor.physio/

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Foot pain is very common in both the running population and general population for that matter. But runners tend to get frustrated when foot pain starts to reduce their mileage or stop them from hitting a new personal best.

There are many different types of foot pain. The two types we are focusing on today are Tarsal Tunnel Syndrome and Morton's Neuroma. 

We are talking about these two diagnosis together because the pain is often similar, just in different locations. 

Tarsal Tunnel will experience pain on the medial side of the ankle that could radiate into the arch or foot. Morton's Neuroma is pain in the toes or forefoot that radiates. 

Both are nerve related pain symptoms. As such we know that nerves like 3 things:

1) Movement

2) Blood Flow

3) Space

Many people are quick to go to a new shoe or orthotics. Which can certainly be helpful to control symptoms. But it's just an assist to the bigger problem. Which is lack of adaptability at the foot/ankle complex. 

Our foot should be able to achieve 2 shapes actively on their own as well as controlled dynamically when walking, running, jumping, etc. In order to do this the foot must know how to control itself against gravity!

Limited pronation will decrease the bodies ability to attenuate forces. Likewise a pronated foot is a expanded foot where all the joints are gaping. This foot shape can be very relieving or irritating for Tarsal Tunnel and mostly relieving for Morton's Neuroma. 

A high arch sapped foot is a rigid foot and useful for propulsion. This foot shape can be relieving or irritating to both Tarsal Tunnel and tends to be irritating for Morton's Neuroma. 

Again, its the bodies ability to alternate between the two foot shapes effectively that will reduce pressure and force accumulation.

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

https://youtu.be/zLqNhKvc9uI

Sports Rehab Success Show Episode #27: Do You Get Back Pain While Running or Exercising??

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

Physical Therapy in Ann Arbor, MI: https://www.annarbor.physio/

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Why you get back pain when running or exercising

✅Really this concept holds true for the vast majority of back pain issues!

Sure you can try to stretch or strengthen. Both are useful to many and could be helpful for you....But you are still leaving out a major consideration!

How pressure will accumulate if a particular tendency is not managed. 

🔑Control over your center of mass = control over pressure accumulation.

🔵Comment below if you've tried to stretch and strengthen but have inconsistent results

Sports Rehab Success Show Episode #25: Common Running Injury - Fix IT Band Pain and Outside Knee Pain

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

Physical Therapy in Ann Arbor, MI: https://www.annarbor.physio/

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One of the most common injuries in runners is IT band syndrome or lateral knee pain. 

Many people try endlessly stretching and foam rolling this area in hopes to get relief. Instead what they get is sometimes temporary relief. But always feel the need to stretch or foam roll the area because the problem keeps returning.

Instead, find the source of the problem to fix it for good!

Building medial (inside) strength of the hamstrings and quads to limit the over activity of the lateral musculature of vastus lateralis, bicep femoris, and the famous IT band pain syndrome. 

Balancing the workload of these muscles can be a game changer to change pain and improve your running pain free.

Sports Rehab Success Show Episode 24 - 7 Rehab & Workout Programming Considerations

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As a personal trainer, athletic trainer, physical therapist or chiropractor you should be very aware of the 7 Trainable Qualities you can impact as a clinician or coach!

If you do not know what your intervention is doing to positively impact a patient, you cannot make educated recommendations for their problem. 

Knowing these 7 trainable qualities will allow you to take aim at the patients problem. Otherwise you are essentially shooting in the dark or with your eyes closed and hoping/praying that something works.

Your ability to recognize which quality needs improvement and how to improve it, as well as the order in importance you address it becomes very influential in making a difference in someones pain and function.

The 7 Main Trainable Qualities that you must consider for any rehab or workout program are:

1) Cardiovascular

2) Respiratory

3) Motor Learning

4) Tissue Capacity

5) Strength

6) Gait - Alternating activity

7) Sensory

Bonus #8) Mindset

Your #1 site for all things sports rehab, sports performance, and orthopedic rehabilitation is: https://www.sportsrehabexpert.com/

My Clinic: https://www.annarbor.physio/

Instagram: https://www.instagram.com/sportsrehabexpert/

With the "Last Dance" documentary recently airing, I thought it would be cool to take a look at some athletic movements that I have seen great athletes consistently be able to do throughout their career that I feel helps them express their full athletic potential as well as stay relatively injury free.

When watching Jordan play, we all know his athleticism is off the charts compared to just about anyone! However, there are some key concepts to his first step quickness and change of direction that allows him to display his full athletic potential.

#1) First step quickness - MJ was great at using a "plyo step". Some coaches unfortunately think this is a band thing and will call it a "miss step". But we must understand what this step allows him to do in order to be effective and why we see him use it all the time.

The plyo step is a way of lowering your center of mass, creating a better shin angle, and utilizing the stretch shortening cycle of the tendon to accelerate faster. Without this step you will lose all 3 of those key components!

Now with the plyo step, I will see some athletes perform this wrong...They will triple extend as they apply the impulse into the ground. Meaning, they will extend their knee at the same time DF their foot. Which would not be so bad if this was done on acceleration or moving forward. However, on the initial impulse and ground reaction forces it places a lot of stress on the achilles. Instead a bent knee should be utilized to apply that initial impulse so the gastroc is shortened on one end and allowed to lengthen on the opposite. Furthermore, this position will allow you to access you soleus more too. Which bringing more muscles to the party to help out is not a bad thing!

#2) Knee Valgus - Jordan and many athletes know how to use knee valgus to their advantage to allow themselves to display athleticism while still resisting injury.

In the video, I show how MJ (a lot of other great athletes do this as well) is able to use his off leg to unload and move into valgus so he can drop his center of mass. This creates an opportunity for him to get the plant foot re-positioned and rotate the body in the direction he wants to move. Creating better angles for changing direction.

His unloaded leg goes into valgus so he can drop his center of mass. His plant leg and body rotate 90 degrees to create a lateral force (not valgus force) into the ground with his foot and mid line of pelvis facing the same direction. As well as his plant leg shin and torso moving in the same direction as well. Allowing him to effectively change direction and use knee valgus to position his body advantageously for the movement.