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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Archive for 'injury prevention'

In my last post, I spoke of lunging and the stress on the knee joint.  Today, I thought I would speak about muscle strains.  Keep in mind you strain muscles and sprain ligaments.  The most common muscle strains I see are hamstring, quadriceps and groin injuries.

They typically occur with a deceleration movement in sport or recreational activity.  In my experience, I notice that some athletes tend to be more prone to these than others.  This particular group of athletes seems to be those with a predominance of fast twitch fibers (more of your sprinters) and those lacking good flexibility and mobility (no surprise there).

Proper warm-up, strengthening, plyometrics and acceleration/deceleration training all play a role in preventing these injuries.  Recovering from such an injury is often a tricky thing.  Athletes often are fearful of pushing the injured tissue 100% (they fear re-injury) and coaches may not sufficiently gauge how long to hold the athlete out of full participation.  More importantly, the athlete often under reports the pain associated with the injury.  I have included a great recovery article HERE that gives you 3 R’s to go by. 

I also included a picture of one of my favorite rehab exercises for rehabbing high hamstring strains below.  It is the single leg Romanian dead lift and provides n excellent way to elongate the hamstrings functionally.  Pain or the absence thereof during full range of motion will indicate the relative healing of the injured tissue to date.  One should be able to do this equal to the non involved side without pain.

RDL - Descent

RDL - Descent

Ever have knee pain in the gym with lunges?  I work with so many clients who find their strength program limited by knee pain.  It is very common for women to suffer from Patello-femoral Pain Syndrome (PFPS) as they get older.  It commonly begins affecting them around age 30.

Essentially, the cartilage behind the kneecap may soften (often referred to as chondromalacia) or break down exposing the subchondral bone (below the cartilage) to excessive stress.  There are many pain receptors in the subchondral bone region that let you know quickly when the knee is unhappy.

Activities like stair climbing, kneeling, squatting and impact exercise often bring this pain on.  Therapists and trainers have long debated whether one should lunge or squat with the foot beyond the toes.  To date, little research has been done to support the notion that allowing the knee to extend beyond the toes dramatically increases PF joint stress.

That is until now.  In a recent study in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT November 2008), researchers compared a short and long step lunge both with and without a stride (stepping out and back).  The results in a nutshell confirmed that indeed a short lunge (allowing the knee to extend beyond the toes) produced more force and stress on the PF joint than a long step lunge (knee remains over the foot).  The stride with a short step and long step also produced more force than it did with a stationary lunge indicating a stationary lunge is less stressful, especially at lower knee flexion (bending) angles.

The angles where the forces really increased on descent were from 60-90 degrees.  This research would suggest that people with anterior knee pain would be better served to lunge less than 50 degrees with a  longer step length in a stationary position while rehabbing or until they build enough strength to move safely into a deeper lunge without pain.  The big takeaway here is to find the range of motion that works for you, but ultimately lengthen the step length to avoid increasing PF joint stress with lunges.

With all that said, I still believe we were designed to move in ways that the knee does extend beyond the toes.  It happens with step-over-step stair descension and sprinting/acclerating for sure.  Yet, doing 2-3 sets of weighted lunges 1-2x/week on a regular basis for strengthening in this fashion may lead to problems long term.  For those with documented PF problems, the safer route is to side with the research and listen to the body.  I hope this info serves you well in the gym moving forward!

Ever wonder why your fitness program does not work, or why that nagging pain in your back, shoulder or knee never goes away?  I will tell you WHY.  It’s because most people fail to listen to their body.  Stay with me here.

If your fitness program is not yielding results, I bet you are not working hard enough and likely doing the same old routine.  Your body knows this and tells you this as it is not ever sore, nor does it change.  Likewise, the body sends signals of injury or mechanical failure in the form of pain, swelling, stiffness and weakness.  If you blow it off, bad things are likely to follow in time.

Consider the stubborn client who has a small shoulder pain related to a new kettle bell class he has been taking.  The pain starts out as a minor irritation, but as time goes by it grows.  Now bench press and shoulder press is hard to even do.  Even getting dressed is uncomfortable.  You guessed it.  The rotator cuff is flat out mad and inflamed.  Continuing to ignore it may lead to a tear, chronic inflammation and certain activity restrictions.

Can this be avoided?  In many cases the answer is yes.  Recognizing changes or the lack thereof, should give all of us a call to action.  It is much easier to solve pain and inflammation with early detection.  Telling yourself you can work through it and it will get better in time is foolish.  Not true 9 times out of 10.  Look at my neck problem.  I tried to work through it for a week and then realized it was not going away.  In fact it got worse.  Then I started an anti-inflammatory medication (mostly beneficial early on) and cervical traction.  The result is my symtpoms are resolving within 5 days of beginning treatment.  Whew!  The surgeron can keep waiting for me because I have no plans to visit anytime soon.

Am I fortunate?  Absolutely.  No one likes a pinched nerve.  But, do NOT discount the value of early recognition and intervention.  It has and will continue to keep me healthy long term.  So, listen to your body.  It provides all the clues necessary for people like me to help you stay fit and healthy while overcoming the plateaus and physical injuries.  Check back as my next post will give you some guidelines to determine if and when you can safely ramp activities back up after injury.

Well, today is Thanksgiving.  It should be a relaxing time to get together with loved ones and reflect on all we have to be thankful for.  I know 2008 has been full of triumphs for me personally and professioanlly speaking.  It has also had its challenges.  I am thankful for both as I reflect back on the year.

Oddly enough, I believe the challenges often lead to the most growth even though they can be very painful.  I feel so blessed to get up every day and help make the lives of others better through my fitness programs and knowledge about injury prevention and rehab.  So, thanks ot all of my clients and customers for putting your faith in me.  You only have one body on this earth, and making it the best body should be a goal shared by all.

With that said, I promised an update about my new e book.  As advertised, you can grab a copy online at www.HealthyGolfShoulders.com for only $19.95 from now until Sunday November 30.  This is half price!  Take advantage of this special Holiday offer.  I think it has great content that will help anyone has shoulder issues and/or plays golf.  You can get a sample online prior to buying if you like.

I look forward to hearing what people think.  If you have questions or comments, please send them to info@thefitnessedge.cc.   I have included another photo from the manual below.  This exercise is one of my preferred core strengthening exercises.  Lots more fun ones in the manual too. 

 

3 Point Plank

3 Point Plank

 

Be sure to tell all your golfing friends and family about the site even if you do not golf so they can test drive the book risk free for 60 days.  Now go enjoy your Thanksgiving feast!

Well, I have to laugh to some degree when I experience an injury myself.  I spend so much time helping clients overcome and prevent injuries that when I experience one I simply have to take it in stride find some humor in it.

You see, I suddenly had sharp pain in my neck 3 days ago.  Keep in mind I suffered a high speed car accident about 4 years ago when I hit a concrete wall at 50 MPH on black ice.  Not fun!  Fortunately, I had no serious injuries, but did come away with chronic neck and back pain.  So, if you ever wondered why people in car accidents complain if this, I can attest that it is very REAL pain.  One massage a month usually keeps my symtpoms in check.

For the past 3 days I have had limited neck range of motion, throbbing pain in my neck that radiates down my right arm, as well as interrupted sleep.  But, the great thing is knowing exactly what is causing it.  No doubts – a bulging disc in the cervical spine.  Probably between C5 and C6.  Why I am telling you this?  Simple.  I wanted to let you know that it is really important to listen to your body and address problems right away.  Since this rather unexpected onset of pain, I have taken 2 days off from working out and even stopped running. 

The running part is especially tough as I am training for a 5K in 2 weeks as well as another half marathon in the Spring.  But, early intervention is the key to avoiding long term pain and the surgeon (yikes).  I am confident I will be back in action next week.  Now, on to the meat of today’s post.  As you know, I am releasing my new golf ebook soon (likely next week).  So, I wanted to share a cool exercise with you that I use to warm-up my golfers prior to play.  The warm-up is almost always ignored by golfers.  Most think hitting balls on the range is the only warm-up they need.  Wrong!  Preparatory movement is key to injury prevention and performance.

The following dynamic warm-up movement is effective for loosenig up the groin, shoulders and torso in preparation for effective weight transfer during the swing. 

      

You can do this exercise in an alternating fashion left and right for 10-15 repetitions as part of a comprehensive warm-up.  Stay tuned as I will be sharing more exercise from my book in the coming days as the launch nears.  Have a great weekend!