Blog Entries by Torin Berge
Posted 04/09/2012
Spring has come (and gone?) to Lincoln, NE and with that comes sporting events. Our oldest son, who is in Kindergarten, just started recreational soccer and I have volunteered to be the coach of his micro league soccer team. It’s great fun and I don’t know who is having more fun, the kids or myself. Micro soccer is basically 4 on 4 soccer with small goals and no goalie to give the kids all a chance to kick the ball and have fun. And it works. The kids all get involved and a chance to contribute and play and I think it is great. Back when I was younger I played soccer and even coached my younger brother’s teams when I was in high school so I don’t feel too lost… older but not too lost. If you have ever watched kindergarteners play soccer you will appreciate the game play as basically a mad, chaotic rush or amoeba-like conglomeration of 8 kids swarming after one ball until it finally gets kicked free and then they all run after it. This continues back and forth until either the ball goes out of bounds or into one of the goals. Usually if one kid gets free with the ball he can outrun everyone else and score an easy goal. At our first practice I gathered the kids in and asked them if they wanted to know the secret to scoring lots of goals in micro soccer. Of course since it was a secret they all desperately wanted to know. The secret is for all of the players to stay in their position and wait for the ball to get passed to them. Since the other team’s 4-headed amoeba will be chasing the ball, as soon as the ball comes loose our players should have a nice easy pass to an open teammate or path to the goal to score. If we keep one player to stay back and be defense if the other team should get loose there is always someone to be in the way to keep them from scoring. Easier said than done of course. It isn’t easy to get 5 and 6-year olds to do this, or just to refrain from grabbing the ball with their hands every time it comes to them for that matter, but it is a great goal to have. Of course the main goal is for everyone to play and have fun, but if we can keep everyone in the right position they will have a much better chance for scoring goals.
Every day with our patients here at the Hruska Clinic we are constantly trying to get our patients to get their muscles into the right position so they can be effective at doing their jobs which in turn allows our bodies successful at doing their jobs. This can be anything as simple as breathing properly or as complicated as playing volleyball or soccer. This focus on first making sure muscles are in the right position before progressing with a rehab program is one of the main things that makes our clinic different and successful. If any muscle is in the wrong position it will never be able to be as strong or effective as if it was in the right position. For example let’s look at the muscles that we use to squeeze our hand into a fist. If you bend your wrist back as far as you can and then try to make a fist and squeeze as hard as you can you will find your grip strength is fairly poor. Then bend your wrist all the way forward and try to make a fist. Even worse… you probably can’t even get your fingers to touch your palm. There is a certain position of your wrist that optimizes the strength of the muscles that give you grip strength. Occupational therapists that manufacture splints can tell you probably the exact specific angle or degree of what that position is to optimize grip function. It doesn’t matter how much or how long you try to strengthen your grip muscles if you do it in an improper position. Your grip will never get as strong as it could just by putting your wrist in the proper position. This holds true for every muscle in your body which is why we feel so strongly about making sure your body is in a neutral or optimal position for muscles to function the way they should. Just getting into a good position will have more benefit and results than months of training in a wrong position. We will seek to find whatever it takes to put your muscles in the proper position, whether that is using specific exercises, manual techniques, foot orthotics, intra-oral appliances, braces, glasses, or duct tape and chicken wire if it works (just kidding). We will do this because we know that if we don’t the rest of our program will ultimately not have the success we want. In my next blog I plan to describe some specific muscles that here at the clinic we are constantly challenged to get into the right position to function properly and how we might address that with our programs.
After 2 soccer practices and games we seem to have the defensive position figured out and already the kids saw what a difference that makes. My next goal is to get the other positions figured out and then… look out YMCA Kindergarten boys Micro Soccer league… we’ll be unbeatable. Ha! Wish me luck!
Comments or questions? Let me know…
Posted 03/05/2012
After my last blog I recently went back online and Googled “smunching” to see if we’ve made any difference in the world. And this is what I found. http://www.youtube.com/watch?v=pSdY91QgKvw
Not quite what I had hoped for, but if she feels better I guess at least it’s a start. If I am not making any sense check out my last blog on smunching for a little clarity. I was even hoping that we might see some smunching at the Super Bowl but all that came out of that was “Bradying.” Check it out here. http://sports.yahoo.com/blogs/nfl-shutdown-corner/bradying-sweeping-nation-next-48-hours-204736897.html No abs working with that one. Oh well.
So far in my last few blogs I have highlighted the importance of finding 3 specific muscles on the left side of your body (namely the left inner thigh, or adductor, the left gluteus medius, and the left abdominals). All of those muscles are important to help us move our pelvis and trunk into a position to allow us to shift our body weight to the left more efficiently during walking and other activities. We did not focus on those same muscles on the right side because they are already active and strong because we typically like to stand on our right legs and shift our weight to the right side more than to our left. Those muscles on the right side don’t need to get stronger. However, there is one muscle on the right side of our pelvis that can get weak and is important for us to feel and get stronger. That muscle is the focus of today’s blog, and it is the right gluteus maximus muscle.
To review, the way our bodies are designed structurally (the way we are built), habitually (the way we tend to move), and neurologically (the way we are wired with one side more dominant) leads us to have a common movement pattern where we can more easily shift our center of gravity to the right side than to our left. When this pattern becomes too dominant or overactive it leads to a shift in the position or posture of our pelvis, spine and ribcage. As a result of that shift it leads to a myriad of muscle activity to compensate and keep us going straight ahead while in the asymmetrical position. Think of it as if the alignment of your car was pointed more toward the ditch than straight ahead. As the driver of that car you would have to work harder or compensate to drive straight ahead because your cars alignment wants it to go into the ditch. Our pelvis position tends to shift forward and to the right orienting our pelvis and lower spine to the right (at the ditch) which in turns requires us to compensate with certain muscles on each side of our body to position our hips and upper back (ribcage) back to the left. If this pattern is too overactive and too much undesirable muscle activity is occurring (or not occurring) injury may result. Our focus of treatment here at the Hruska Clinic is to teach our patients how to perform specific activities, utilizing specific muscles, to put and keep our pelvis, hip and thorax (including rib cage, scapula and shoulder) in a more symmetrical (neutral) position, (pointed straight ahead), to allow movement and activity to occur more efficiently and with less restriction. So far we have highlighted three muscles on the left side of your body to pull the left pelvis, hip and lower spine into a more neutral position. Today we look at the right side.
The gluteus maximus is a muscle that’s job is to extend (push back) your thigh bone and outwardly rotate it. In our normal pattern of asymmetry the right pelvis bone, or innominate, is in a position where the hip is in a position of adduction, internal rotation and extension. This places the fibers of the right gluteus maximus in an improper position (long and weak) to function as an external rotator of the thigh bone in the hip socket (rotate right thigh bone to the right), and more importantly to rotate the pelvis to the left when the thigh bone is stable during push off with walking. This means that during upright activity such as walking we have a much more difficult time pushing our body to the left to achieve a full hip shift to the left and leads to continued function in our asymmetrical pattern. So it is important for us to be able to utilize the right gluteus maximus, with the help of the left inner thigh, left gluteus medius and left abdominal, to fully push and shift to the left with dynamic functional activity. So can you feel it?
Initially if you cannot position yourself with your left hip back and your right hip forward with your pelvis and spine pointing left it will be difficult to isolate or feel the right glute max work during your exercises. Therefore all the activities that we have discussed in the past to reposition your pelvis need to be addressed and maintained during right glute max exercises to feel it work correctly.
Here are some more specific hints. If your pelvis has tilted forward, not backward, and your back is tight or overactive this will limit your ability to feel the glute, especially in an upright position. So think about tucking your bottom or emphasizing a posterior pelvic tilt, to better engage the glute. If the right inner thigh is too overactive and the left inner thigh is too underactive you will not feel the right glute max as well as you could, so make sure you fully shift your pelvis to the left and turn on your left inner thigh before you try to engage your right glute max. This will often help. Another activity in standing that can help is really focusing on pushing your right arch and big toe into the ground or shoe and not letting your right foot roll to the outside. If your foot rolls out onto the outer part of your foot, this will allow your whole leg and therefore pelvis to rotate outward putting you back into the normal asymmetrical pattern pointing you toward the ditch. This will limit the ability for your right glute to help push your pelvis to the left. Sometimes we may even put a small wedge in the outer heel on the right shoe and a little arch pad on the right side to give you something to feel to push your arch into to shut off your right inner thigh, turn on your right glute and shift your weight more easily to the left with gait. Hopefully these hints help you feel your right glute max more effectively with your exercises. If not do not hesitate to contact your therapist and ask them for some more specific hints. For more good information also check out Lori Thompsen’s latest video blog on getting your right hip and leg in the proper position.
Is your right leg and pelvis in the correct position when you run?
Questions for Torin? to send him an email. Or write your comment below!
Posted 01/20/2012
As you may or may not know I am a fairly recent transplant here to Lincoln. I grew up in Colorado Springs, CO. Obviously here Big Red football dominates but as I was growing up John Elway and the Denver Broncos was where we invested our loyalties. I still have to root for the Broncos and this year has been fun. Whatever your opinions of their quarterback Tim Tebow are, he has been the big story in Denver and throughout the NFL. A new word has entered our culture because of Tim. Tebowing. It is the act of getting down on one knee and praying, usually with head bowed on a hand or fist as Tim frequently does on the football field. It is now an internet craze where people will have their picture taken in that position in random locations. Google Tebowing for some fun pictures.
Recently, I have come up with a word for an activity that we like to do in the clinic with our exercises. Smunching. Or smunch for short. I looked it up online to see if it has other meanings and apparently it is used by a group in Phoenix to describe eating a Saturday morning brunch. So I guess I can’t trademark it. I like it though. Smunching. It just rolls off the tongue. To me it is part smush and part crunch and describes a movement where you bend your trunk sideways bringing your ribs down toward your pelvis. As therapists we call it side-bending or thoracic abduction. It requires a contraction of your lateral abdominal oblique muscles and is something we encourage on the left side with PRI exercises. Left lateral abdominal muscles (including internal obliques and the transverse abdominis) are very important, wonderful, and yet too often underused muscles that can make or break someone’s success or recovery with a PRI program. They are the next muscle that I want you to be able to feel. Can you feel it? Smunch. How about now.
It is not exactly news that abdominal muscles are important for “core stability” or back stability. What is often missed in traditional exercise or rehab programs is the need to address and correct differences in the position, function and use of muscles on the right and left side. Our philosophy here at the Hruska Clinic identifies and describes a normal, asymmetrical pattern of function. If you have not read much about that I recommend reading some of our other blogs here or on the Postural Restoration Institute website. This pattern describes a tendency to stand and shift our weight more on our stronger, dominant, stable right leg than our left leading to a tendency for the pelvis to drop forward on the left and orient or point to the right. Imagine if there were headlights on the front of your hip bones. In this pattern our headlights tend to point more into the ditch than into oncoming traffic. However, in order to reach with our more dominant right arm and look at oncoming traffic with our eyes we will rotate our upper body back to the left to compensate. When this pattern becomes too active or strong we can run into trouble.
The last 2 blogs I have done described using the left inner thigh and left glute med to line the pelvis back up and get our headlights pointing straight ahead. Unfortunately what has happened above the pelvis in that pattern (the need to always rotate the spine left) has had some impact on function above the pelvis and needs to be addressed. As our spines rotate to the left to reach with our right hand to drive our car, or use the mouse of our computer, or realign our bodies with the direction we want to walk, the rib cage rotates into a position where the right ribs come down toward the pelvis and are anchored with right abdominals, while the left ribs are rotating up and away from the pelvis. The left abdominals are not working and being lengthened which decreases their advantage to work even if we wanted them to. These left abdominal muscles then become weak in their ability to do several important things for us. They lose their ability to stabilize the pelvis on the left side so it won’t drop more forward. They lose their ability to laterally bend the trunk to the left (smunching to the left if you are paying attention). And probably most importantly they lose the ability to pull the left lower rib cage down and stabilize it so the left diaphragm muscle has an advantage to contract and pull air efficiently into your lungs (maximize the ZOA on the left side for you therapists). The left abdominal obliques, and the ability to smunch or get into thoracic abduction to the left, is of utmost importance to make sure the hard work your left inner thigh and left glutes are doing for your pelvis continues to work, as well as to help correct the compensation your upper body has had to do because of the normal positional shift of the pelvis to the right. The abdominals are what is going to integrate or coordinate what your lower body and upper body are doing so they can work together to do things like walk, and run, and go up and down stairs, and breathe, or do any reciprocal activity without excess strain or falling back into old patterns. In our normal pattern the right ribs and muscles are already smunching so we need to really emphasize the left side to create a functional balance.
Many of our exercises emphasize smunching on the left side by either reaching the left hand down towards your feet, arching the left side up when lying on the left, or even passively just positioning you to bend your trunk to the left. You should be able to feel it. But what if you can’t. Probably the most common reason for not being able to feel it in any position is a tendency to use your left back extensor as the muscle to smunch. It will bend your spine to the left but will also extend your back. If you are smunching and you feel your back make sure you round your back a little more and keep it rounded as you smunch. As we talked about earlier the abdominal muscles pull your ribs down which is what happens when you exhale or breathe out. If you hold your breath or are in a state of inhalation your abdominal muscles will have a harder time contracting so another trick is to fully exhale and feel your ribs go down. We will even use balloons or straws to resist the exhalation to feel the abs work. The key is then to try and maintain that feeling as you use your diaphragm to breathe in. If you lose your smunch when you breathe in we are never going to get anywhere. Sometimes when lying on your left side it can help to roll up a towel and put it under your left side to give yourself a feeling of where to smunch. In standing or squatting if you let your back extend and your pelvis drop forward you will stop feeling your abs and the back will take over. Think about reaching your knees forward as you squat to keep the pelvis tucked and abs on.
I can only hope that smunching (to the left) will become as much a craze as Tebowing has. But until we get a polarizing athlete to do more smunching I think Tim will have a definite edge. I personally am still going to try and see if we can make it a craze one patient at a time. If you all get creative feel free to send or post some smunching pictures and maybe we can start this craze and help people all at the same time!
Smunching for exercise…
Smunching while reading…
Smunch-bowing???
Questions for Torin? to send him an email. Or write your comment below!
Posted 01/10/2012
In my last blog I wrote about feeling the love of the left inner thigh muscle with PRI exercises to help with our ability to shift our body weight to the left to achieve and keep a neutral position of our pelvis. If you missed it, feel free to read it here. Hopefully you were able to feel your left inner thigh while shifting your weight from side to side as you stood in line buying (or returning) those last minute Christmas gifts. I also hope that the abundance of holiday music like “I’m dreaming of a White Christmas” or “Jingle Bell Rock” on the radio and in the stores helped clear the chorus of “Can you feel the love tonight?” from your mind.
As we shift (get it?) into a new year I want to shift to a new muscle for this blog. One of the next muscles that we usually emphasize with our programs is the left gluteus medius, or glute med. This muscle has several important functions that are desirable in having success with a PRI program. These include turning the thigh bone (femur) in (internal rotation), and probably more importantly stabilizing the pelvis over the head of the femur once we have achieved the proper shift into the left hip with the left inner thigh (adductor) muscle. This is especially important in standing positions and walking to allow us to keep that proper weight shift to the left and not revert back to the overactive tendency to stay shifted to the right side. If the glute med is ineffective, due to improper position, or weak, your ability to maintain a neutral pelvis with upright activity or walking will be challenged. That is why our exercises will progress from just finding and feeling the left glute in a lying down position gradually to an upright position when your therapist feels you are strong enough. If this is progressed too quickly and the left glute is not felt or strong enough pelvic neutrality will be lost and our program will stall and so will your recovery. So let’s make sure you can feel it…
If the glute med is appropriately working, it should be felt on the side and back of your hip behind your hip bone (think of your left back pocket), not in front. If you do not feel that muscle work when we want it to there are a few hints that we give to help you feel it. First of all you need to be able to fully shift into your left hip with your left inner thigh, so if you cannot feel your left inner thigh you will be challenged to feel your left glute med work properly. Therefore, all of the issues that can prevent you from feeling your left inner thigh may prevent you from feeling your glute. This includes things like hip capsule flexibility, right inner thigh over use, and lack of right chest wall mobility. See my previous blog if you need reminders. There are a few other issues I want to high-light specific to the left glute med.
The muscle on the side of your hip in front of the hip bone (the tensor fascia lata, or TFL) will commonly try to help internally rotate your thigh bone instead of your glute if it (the glute) is in an improper position or weak. If the pelvis is forward, as is common on the left side, the TFL becomes better positioned than the glute to turn the thigh bone in and becomes overactive. It also will flex the hip and pull the pelvis further forward limiting the ability to keep the pelvis in a neutral position. This is not what we want, so the TFL is not a muscle we want to feel with any exercise that requires turning the left thigh bone in. So if you feel the front of your hip working when you turn your left thigh bone in we need to do something to stop that. First of all we need to make sure you are in the proper position (fully shifted into your left hip, left knee/hip back behind your right). Then, in order to shut off the TFL, we sometimes will cue an active isometric contraction or muscle squeeze into hip adduction and/or extension by either squeezing the left knee down into the right or pushing the left thigh back into a chair or door frame prior to rotating the thigh bone in. This should help.
Another important thing that may help is to make sure that your left ribs are fully pulled down with your left abdominal wall (full left ZOA for you therapists out there) to achieve full stability on your left side and maximize the proper position of the left pelvis and glute. This will be highlighted more in my next blog.
As we stated above the left glute med is important for hip stability in standing and walking positions. Once you have adequate strength in a lying down or seated position we need to get you to feel the left glute work in a standing position. The most important factor is to make sure that you have achieved a proper standing hip shift back into your left hip with your left hip back, your right hip forward (pelvis pointing to the left) with weight on your left leg (left AFIR position) and without extending your back. If you are not in that position your glute will not be in the proper position and you will not feel your left glute work as effectively as possible. One of the cues in stance that we use for this is similar to the left adductor in that we want you to feel your right shoe arch when standing and shifting to the left to inhibit the right adductor and allow the pelvis to fully shift to the left. This is one of the reasons why proper footwear and foot position is so important with upright activity. Don’t transition to a single leg activity on the left leg until you are fully engaged and into the proper position or your glute and program will be challenged.
If you are doing your exercises at home and cannot get your left glute to engage or your front hip to relax during exercises aimed for your left glute med be sure to let your therapist know so they can help you find a way to feel it. And hey, no corny song that will get stuck in your head this time. Besides, the only one I could come up with for the glute was Sir-Mix-A-Lot’s “Baby Got Back…” Oops… sorry.
Questions for Torin? to send him an email. Or write your comment below!
Posted 11/22/2011
This past spring my wife, Leslie, and I went to Las Vegas on a little get-away trip and left our kiddos home with Grandma and Grandpa. At that time we were coming out of a long winter in North Dakota and just needed some sunshine and warmth. We spent a LOT of time at the pool soaking up the sun and relaxing. We had been there before so didn’t feel the need to walk the strip too much and it was very relaxing. The highlight of our trip, however, was getting a chance to see ‘The Lion King’ musical before it left Vegas. Yes I know, we took a vacation to Vegas, without kids, and ended up seeing The Lion King. It might sound a little pathetic but it was great. If you have never seen the musical I highly recommend it. The sets were amazing, the costumes…amazing, the singing… amazing. Of course the song we all remember from the movie was Elton John’s “Can you feel the love, tonight?” I know you all can hear it in your heads now… sorry about that.
Can you feel it? If you have come to therapy here or with a PRI trained therapist this is one question that I am sure your therapist has asked many, many times. Probably to the point that you hear your therapist ask it every time you do your exercises at home. When we are doing an activity with our patients we are trying to turn specific muscles on and turn other specific muscles off to improve the way in which we move. If you cannot feel the specific muscles we want you to feel when doing your activities, or are feeling other muscles too much, you are not going to have the success with the activities that we would like you to have. So we ask: Can you feel this?… Can you feel that?… Are you feeling this?… Can you feel the love, tonight? (Just kidding). To underscore this importance of “can you feel it,“ over the next few blogs I want to highlight a few of the major muscles we want you to feel, and probably more importantly if you are not feeling them what we may need to work on to be able to feel the correct muscle work.
Usually one of the first muscles we want our patients to feel is the left inner thigh muscle, or adductor. In our normal pattern of asymmetry our body has a tendency to center our weight, or base of support, over our right leg. This weight shift is usually accomplished with activity of the right inner thigh muscle to pull the body to the right. In order to do this our brain, primarily with reflex activity, turns off the left inner thigh muscle to make this shift easier. This in and of itself is not a bad thing as long as we have the ability to turn on our left inner thigh, turn off our right inner thigh and shift our weight to the left side as easily as we can to the right. Think about slow dancing (I’m thinking of a certain Elton John song…) and you can picture how the inner thigh muscles can pull or sway you from side to side. In order to get this side to side (frontal plane) activity to occur equally we want our patients to feel their left inner thigh work more than their right inner thigh to overcome our normal asymmetrical tendencies.
So, can you feel it? If you can, Great! Keep feeling it because we want you to use that muscle to stabilize your pelvis and not let it sneak back to the right. If you can’t then we need to address some other issues so that you can feel it. The things that might keep someone from feeling their left inner thigh work are primarily things that prevent them from being able to get in a proper position that allows them to fully shift their center of gravity to their left side and shift their pelvis over the top of their left hip bone (known as AFIR to PRI trained PTs). There may be some restrictions in the hip joint itself (posterior capsule) that need to be stretched out to allow the normal joint mechanics to occur, and allow the pelvis to shift over the thigh bone. If someone cannot fully get their hip socket into that position it will be challenging at best to feel that inner thigh muscle work. This will probably be the first thing we will address with some stretching activities for your left hip. If the right inner thigh muscle is too strong, hyper active, or tight, it may be preventing the pelvis from shifting correctly to the left or the left inner thigh muscle from turning on. If this is the case we may need to do some activities to inhibit or shut off that hyperactive right inner thigh (right adductor inhibition). Sometimes our patients can feel their inner thigh great lying down, but then when we transition to standing activity all of a sudden it is impossible to feel it. We then usually cue those people to find and feel their right shoe arch. This is done for a few reasons. If the center of gravity is too far to the right (which is part of our normal asymmetrical pattern) the tendency is to roll onto the outer aspect of the right foot which will cause you to use your right inner thigh (as opposed to the left leg) more for stability. Again if the right inner thigh is working too much it will be difficult to find and feel the left inner thigh. If we cue a push into that right arch that will allow the center of gravity to shift back to the left, shut off the right inner thigh muscle and allow better feel of the left inner thigh. Sometimes we may need even to look into footwear or orthotics to assist this to happen. One last thing that may be affecting someone’s ability to shift their weight to the left appropriately is the inability to fill up the right lateral chest wall with air. Once again our normal asymmetrical bodies and patterns create difficulties for our left diaphragm to work efficiently and for our right lateral chest wall to open up or expand the way it should (right apical expansion). If this is significantly restricted it can limit the ability to shift to the left and to feel the left inner thigh. So we may need to even look into activities that stretch the right lateral (and sometimes posterior) chest wall to get the body in a position to allow the left inner thigh to work as well as we need it.
I guess the bottom line is that if you cannot feel your left inner thigh and we keep asking and asking “Can you feel the love tonight?” let us know so we can address all of the issues that may be holding you back from progressing the way we want you to. Oh, and if you get the chance to see The Lion King I highly recommend it, and maybe, just maybe, you’ll hear your therapist’s voice saying “Can you feel it?”
Questions or comments for Torin? to send him an email.
Posted 10/17/2011
A few weekends ago on a beautiful Saturday morning we took our 3 young boys to a pumpkin patch just south of Lincoln and had a great time. I will say Nebraska definitely knows how to do pumpkin patches. There were jumping castles and giant inflatable pillows to hop on, trike rides for the kids, spooky houses, games, and of course hayrack rides to pick out pumpkins. One of the games that was there was a maze made of a brick pathway in which you had to get from the start to the finish only taking right turns. It turned out to be tricky and the solution required about 15 turns in circles to get to the finish (kind of like driving downtown on one way streets trying to find a parking space on a Saturday afternoon). Our kindergartener, not reading the directions, saw the start and finish and said “This is easy!” and with 2 left turns made it through the maze. Life was much easier when we could go left. Most of us in a way are trying to negotiate life only being able to make right turns. Not literally of course but we are all constantly fighting the tendency to shift and move to the right more than the left. As you all know one of the main tenets of our theory and treatment centers on the belief that we are all asymmetrical and right side dominant creatures. We prefer and feel more comfortable standing on our right leg, reaching with our right arm, looking with our right eye, etc. We feel this creates imbalance within our body that can lead to dysfunction and pain. Our treatment focus will often then focus on ways to encourage your body to move and shift to the left.
This week in our staff meeting we discussed 4 things, that we call reference centers, which can help us to move our bodies to the left, or if not present can prevent you from moving to the left. The first is your left inner thigh muscle. That is often one of the first muscles we want our patients to feel as it can pull our pelvis or center of gravity to the left. There are of course specific things to make sure this happens in a correct manner but in general we want our patients to feel their left inner thigh. The second thing we discussed was the ability to feel your right arch when you walk. If you have a tendency to walk on the outside of your right foot you will never properly push yourself to the left side when you walk. We want you to be able to evert (foot turned out with little toes up) your right foot, and feel your right arch to propel your body to the left side when you walk. This can be done with proper shoes (see other posts in regards to proper shoe wear), orthotics, or other activities to encourage that motion. The third thing that can push you to the left is by looking with your eyes to the right. Our bodies subtly move the opposite direction our eyes are looking. In order to properly get our bodies to the left we need to be able to look to the right. Once on our left side, however we need to be able to then look to the left and have the ability to stay on our left side and not move back to the right. So if you have been asked to do some eye activities with your exercise program do not forget eye motion to the right as a way to assist you to get to your left side. The fourth reference center that we discussed today was your right wrist. If someone is very strongly pulled or oriented to the right side we will see the tendency to flex their right wrist or fist the right hand as if they were using a bar or something to literally pull their bodies to the right. The ability to relax and extend your right wrist with gait and during your exercises will assist you in getting to the left, or conversely if you do not relax your right wrist you will be more challenged in your ability to shift left. These are 4 things that as therapists and patients we can use or check to make sure our abilities to overcome our right dominance is maximized. Hopefully this information is helpful for you all and may even help us negotiate our life of mazes by being able to make left turns and right turns whenever we want. Unfortunately however it cannot help with parking downtown with all those one way streets.
Questions or comments for Torin? to send him an email.
Posted 08/31/2011
Questions or comments for Torin? to send him an email.
Posted 08/11/2011
I have now been here working at the Hruska Clinic for 1 month and am starting to get acclimated with Lincoln and the new job. We have explored the parks and pools with our kids, enjoyed the nice weather (heck, we are used to taking advantage of any nice day where we came from) and are starting to get our home comfortable and lived in. The question I have gotten the most from people since we moved is why did you move here? Just for a job? Why would you move your family to Lincoln, NE to work at the Hruska Clinic when you were so established where you were? Other than to try and get away from the North Dakota winters (yes I am actually looking forward to experiencing a Lincoln winter) the answer lies in what makes the Hruska Clinic different from any other clinic. As “the new guy” I feel I have a unique perspective on what makes this clinicdifferent. As I wrote before I spent the last 9 years working for a “traditional” physical therapy clinic in Minot, ND. I was blessed to have worked with some wonderful physical therapists and people. But I knew there was more out there. As a whole I feel physical therapists are caring professionals who truly want to help people feel and function better. Here at the Hruska Clinic we are not different in that respect at all. Everyone here is 1000% motivated to help people feel and function better. However, we have different, and I feel better, tools to get that job done. We utilize the science of Postural Restoration, developed and taught through the Postural Restoration Institute ™ to guide our treatment in order to address the cause of pain and dysfunction rather than trying to mask the symptoms of pain and dysfunction. The staff here is immersed in the science of Postural Restoration and dedicated to not only treating patients but taking it a step beyond that and getting our patients back to whatever their hopes and dreams may be. The first question we ask on our intake paperwork is what activities are you happiest doing, not what hurts. That frame of mind is what guides us. Those activities that make our patients happy become our goals as much as they are our patient’s goals. In addition to the people here, we have additional tools at our disposal to look beyond PT to address other needs that our patients may have. There are other influential factors that may be limiting what we can do as physical therapists that cannot be addressed anywhere other than at this clinic due to the resources we have available. For example, our patients may have needs for other specialties including dentists, optometrists, podiatrists, or other specialties that we recognize, understand, and can integrate with our treatments to allow us to achieve the amazing results that we see for people who have not had success anywhere else. This is what makes us different. Our attitude, our approach and our tools. They really are unmatched and not available anywhere else and that is why I moved here… oh and for the winters too… believe it or not.
Posted 08/03/2011
Questions or comments for Torin? to send him an email.
Posted 07/19/2011
As the “new guy” here at the Hruska Clinic I am not used to this blogging thing but hope to get accustomed to it. As you may or may not know I recently started here at the Hruska Clinic after working for the last 9 years for a hospital based clinic in Minot, ND which is my wife’s home town. The last month or 6 weeks has pretty much consisted of preparing and packing to move, moving, and unpacking once we got here. My family and I are enjoying the new experiences, and heat, that Lincoln has to offer. If you follow the news much you may have heard of the devastating flooding that hit our old town of Minot over the last month or two. This devastation only made our move more stressful as we left family and friends behind in the midst of the worst natural disaster that the area has ever dealt with. 12,000 of the almost 40,000 residents of the city were evacuated due to the flooding. 4100 homes had some water in them with upwards of 3000 having at least 5 feet on the main floor and several hundred with water above the roof line.
This weekend as we continued to do all those little projects that come with moving into a new house, like staining a deck and building a swing-set for our boys, we were able to see some pictures, via Facebook, of the devastation in Minot as the water has now receded enough to let the residents back into their neighborhoods and assess their homes. After being under water for nearly 3 weeks the amount of damage done is truly devastating and the pictures I know do not do it justice. Many homes including my mother and father-in-laws house were either moved off of their foundation or had the foundation cave in. These houses are now unsafe for living in and most likely will need to be demolished and destroyed. The power of water and mother-nature is truly amazing.
As I looked at pictures of these homes off their foundations, tilted, twisted, and caving in, and felt for the owners of them knowing that they may never be able to be restored, the PT in me could not keep from thinking about how our bodies are fighting that same stress all the time. We utilize the analogy of our pelvis being the foundation for our spine a lot here. We all put repetitive, asymmetrical, stress and strain on our pelvis with the asymmetrical demands of life and our tendencies to stand more on our right leg and reach more with our right arm, twisting our spine more to the left than to the right. This is caving in the foundation for the rest of our body. Our house, aka our thorax, is tilting, twisting and caving in just like those houses that need to be demolished in Minot. We therefore cannot breathe well. Our arms, like the decks on those houses than now sit at 45 degree angles from the ground, cannot work the way they should. Our necks and heads, like the chimneys on those houses, are tilted and starting to fall over.
What a dire picture I paint. The good news is that unlike those houses that will probably be destroyed, we can restore our foundations and untwist our houses. With the power of a left hamstring, a left adductor and a properly opposed left diaphragm we can rebuild our houses and straighten out chimneys and decks and make our houses happy and livable again. It’s also a lot less messy. Please keep the residents of Minot and other flooded areas in your thoughts and if you need help with your foundation or contact us here at the Hruska Clinic.
More blog entries can be found in the archives…
