Brian Schiff’s Blog

Running is in full force as Spring has sprung.  If you have ever experienced shin pain during or after your training runs, you know firsthand how aggravating this condition can be.  I treat many runners with overuse injuries.  Common issues include anterior knee pain, IT band pain, plantar fasciitis and of course shin splints.

Click here to read an earlier post on the link between poor ankle mobility and overuse injuries.  Unfortunately, shin splints can progress to a more serious stress fracture if not diagnosed and treated properly.  Recently, I was interviewed for a series of articles on thew topic of shin splints by Fitness Magazine.  You can read those articles below:

What are shin splints?

How to prevent, treat and heal shin splints

So, I just returned from the Combined Sections Meeting for the APTA that was held in Indianapolis.  There was lots of great networking and presentations to be sure.   I attended sessions on ACL rehab/prevention, femoroacetabular impingement, elbow injuries in throwers, running gait analysis, and shoulder plyometric training with the legendary George Davies.  I thought I would give you my top 10 list of helpful nuggets I picked up over the weekend in no particular order of importance.

1. Performing upper body plyometrics has no effect on untrained subjects so don’t waste time putting it into the rehab program, where as it does benefit trained overhead athletes.  The one caveat is it also increases passive horizontal external rotation so keep this in mind when working with athletes who have shoulder instability.

2. A new study  coming out in 2015 in AJSM revealed no major differences in throwing kinematics between those following UCL reconstruction (Tommy John) and age-matched controls.  This is good news for those worried about pitching mechanics after the procedure.

3.  According to Dr. Reiman at Duke, the orthopedic hip exam does a better job of telling us they do not have a labral tear than it does telling us they do have an intra-articular problem.  The tests have poor specificity.  In fact, he goes on to say that the “special tests are not that special.”  That brought a chuckle from the crowd including me.  Bottom line – we are not really able to conclusively say “yes you have a labral tear based on my exam today.

4. Reiman also feels we must consider look for mechanical symptoms during the lowering portion of the Thomas test, while considering the fact that fat pad impingement may cause anterior hip pain as opposed to joint pain.  Again, things are not always as they appear in the “FAI” crowd so we need to take a great history, look at the classic tests and also see how squatting and loading affects the hip.

5. More experienced pitchers do not drop the glove side arm, but instead tend to move their body toward the glove to conserve angular momentum and overcome small moments of inertia.  Less experienced pitchers rotate their trunk sooner in pitching cycles whereas pitchers who threw at higher levels rotated later and produced less torque at the shoulder.  Consequently, many players with higher elbow valgus torque and distraction force at the shoulder rotate too early.

Continue reading…

I hope you and your families had a wonderful Thanksgiving holiday! Starting today and running all week you can save 30% on any and all of my DVDs. Take advantage of this offer on any of my Fit Knee series (osteoarthritis, running, or ACL) as well as my Ultimate Rotator Cuff Training one. The sale will end on Sunday Dec. 7.

Please share this offer with friends, colleagues and family who may benefit from any of these products.  Simply enter code DVD30 at the checkout and hit apply coupon to save 30% today.  Click here to order.

This exercise is an excellent way to increase hip disassociation and more specifically hamstring flexibility.  Foam rolling and/or myofascial compression therapy prior to stretching may further enhance range of motion.  This exercise can be used with runners and clients struggling with tendonitis, IT band issues and patellofemoral pain.  It is also helpful in eliminating asymmetry that appears on the active straight leg raise on the FMS.

This exercise can be used as part of a mobility workout, warm-up, regeneration day or at the end of a workout. Remember that maximally dorsiflexing the foot will increase dural tension and place more stretch across the back of the knee.  So, relaxing the foot (or placing the rope more along the mid foot) will reduce this tension and allow for a more concentrated stretch in the hamstring.  For clients with a history of sciatica, I would suggest avoiding the stretch with the foot in full dorsiflexion as a general precaution.

Increasing hip strength and stability is a common focus in training and injury prevention programs. Current research indicates hip and knee strengthening is more effective than knee strengthening alone in those suffering from anterior knee pain. I routinely use mini-bands to strengthen the hips and maximize proximal stability.

Many clients struggle with poor proximal hip stability that shows up as excessive frontal plane adduction and compensatory trunk lean. This exercise targets the hips and closed chain control needed for those participating in jumping, running, cutting and pivoting activities. It is an excellent way to warm-up and activate the hips as well as reduce patellofemoral overload and prevent knee injuries.