Posted 05/16/2012
Happy Running!
Lori
Posted May 16, 2012 at 7:24am by Lori Thomsen.
Tagged With: biomechanics, Diaphragm, Hip position, Mediastinum, PRI Concepts, Respiration, Running • 0 Comments
Posted 05/04/2012
Have you or your child been diagnosed with spondylolisthesis (spon-dy-low-liss-thesis)? If so, do you understand what it is or what can be done about it? If not, hopefully you’ll find this information helpful. First, spondylolisthesis is a condition related to the integrity of the spine where one vertebrae of the spine is shifting or sliding forward on the next vertebrae below it (see the illustration below). Normally this should not happen because the design of the spine is such that there are partially interlocking members of each vertebrae that prevent such shifting, while simultaneously allowing us freedom of movement through the spine. A normal, healthy spine should allow for all of the following movements: rotation through your trunk (turning left and right), flexion and extension of the spine (i.e. bending forward and arching backward), and side bending left and right.
One of the reasons it is important not to take a diagnosis of spondylolisthesis lightly is because there are a network of nerves that travel from your brain downward through a canal in your spine to their various destinations. Therefore, if the integrity of your spine is compromised because of spondylolisthesis, there is risk of damage to some of those nerves depending on the degree or grade of slippage. When people who’ve received a diagnosis of spondylolisthesis hear this, they begin to think they have to be super cautious for the rest of their lives and give up many of their preferred activities. Although you want to make intelligent choices, life as you’ve known it, usually isn’t over.
Our backs have a natural lordotic curve in the lumbar region (this means there should be some depth to your lower back); A person can have excessive lumbar lordosis, (i.e. too much depth in the low back; compare the photos of the two girls below), which, by nature of the structure of our vertebrae, can be one contributing factor for a person developing spondylolisthesis. You don’t have to have excessive lumbar lordosis to develop spondylolisthesis, but a combination of excessive lumbar lordosis with spondylolisthesis is bad because not only have you lost the natural prevention from forward translation of one vertebrae on another (when you have spondylolisthesis), but now also have increased forces that promote forward movement of one vertebrae on the one below it because of the position you’re in. Therefore, a key component of a physical therapy program for a person with spondylolisthesis is to make sure that you have an appropriate amount (not excessive) of lumbar lordosis. In conjunction with proper spinal positioning, you need to have stabilizing abdominal activity. Frequently, people with excessive lumbar lordosis have tight and/or overactive hip flexor muscles (muscles on the front of the pelvis that, among other things, affects the position of your pelvis, legs and spine), and therefore, these muscles should not be ignored when you have spondylolisthesis. At the Hruska Clinic, your program will focus strongly on your posture with a repositioning program to help reduce the harmful forces on your spine if you have spondylolisthesis. This is a very brief synopsis of spondylolisthesis, but I hope you’ve found it informative and helpful.
Posted May 4, 2012 at 2:19pm by David Drummer.
Tagged With: biomechanics, Hip position, knee position, Lordosis, PRI Concepts, Spondylolisthesis • 0 Comments
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 April 9, 2012 at 11:11am by Torin Berge.
Tagged With: biomechanics, Breathing, knee position, Pelvis position, PRI Concepts • 1 Comment
Posted 04/04/2012
What is a tilted pelvis? A pelvic tilt is actually a fairly common postural problem. A pelvic tilt occurs when the pelvis tilts in one direction. There is an anterior pelvic tilt in which the pelvis tilts towards the front of the body and there is a posterior pelvic tilt in which the pelvis tilts towards the back of the body. The anterior pelvic tilt is generally the most common. Pelvic tilts are owed to muscle imbalances. In other words, certain muscles may not be working properly and other muscles may be working too much. Structurally, an anterior pelvic tilt can cause some muscles to become tight and others to be lengthened.
The back muscles and hip flexors become shortened in length when the body has an anterior pelvic tilt. Furthermore, when the back muscles and hip flexors shorten, the abdominal and hamstring muscles become lengthened. A common misconception is that the hamstrings appear to be short and tight and need to be stretched. On the contrary, the hamstrings are actually lengthened and tense secondary to the pelvis falling forward and need to be activated to return the pelvis to a more neutral position. Often times patients with low back pain are often told to stretch their hamstrings to relieve their discomfort. In response to stretching of the hamstrings, the pelvis may tilt even further forward and the lower back muscles may become tighter to keep the body upright.
Today I looked at the anterior pelvic tilt and how this position may affect your body. An anterior pelvic tilt can not only be an impairment to your posture but it can place undue stress on muscles, joints and your breathing to name a few. Your problems may range from a constant achy lower back to countless debilitating symptoms throughout your body. With a few exercises from a PRI therapist you can help correct your tilt and have a more balanced pelvis.
Questions or thoughts on this blog? Leave a comment!!
Posted April 4, 2012 at 12:42pm by Jason Masek.
Tagged With: Abdominals, biomechanics, Breathing, Hamstring, Low Back Pain, Neutral, Pelvis position • 2 Comments
Posted 03/29/2012
Happy Running!
Lori
Leave a comment for Lori, or to send her an email!
Posted March 29, 2012 at 1:41pm by Lori Thomsen.
Tagged With: biomechanics, Glute Max, Hamstring, Hip Shift, optimal stride, PRI Concepts, Running • 1 Comment
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 March 5, 2012 at 1:20pm by Torin Berge.
Tagged With: biomechanics, Glute Max, Hip position, Pelvis position, PRI Concepts • 1 Comment
Posted 02/28/2012
Have you ever tried to close a door and find that the door wouldn’t close? Why is it that we always slam the door hoping that doing so will solve the problem? All of us have had a door that doesn’t shut right, where the door runs into the door frame. Individually, a door and a doorframe can be proficiently put together but if they are not made to match each other in size, the two will never work together. To understand how a door functions, it is important to know what pieces go into a typical door system and the role that each plays.
The door jambs are the vertical sections of the door frame, which acts as a support for the remainder of the frame, as well as the door itself. Each door frame has two jambs used to mount the frame to the surrounding wall. The hinge jamb is the side where the hinges are installed, and the strike jamb is the where the door latches into the strike plate. Hinges are the metal plates mounted on the door frame that anchors the door to the frame and allows the door to open and close freely. The strike plate is the metal plate installed in the door jamb that receives the latch or lock when door is closed. The top horizontal member of the frame that connects the two vertical jambs is called the header. The lower horizontal member of the frame that supports the entire door system is called the sill.
The structures that make it possible to open and close a door are very similar to opening and closing one’s mouth. Indeed there is a mechanical relationship between the upper and lower jaw bones, the teeth, and the temporomandibular joints. To understand how a mouth opens, it is important to know the anatomy of the mouth and the role that each plays.
TMJ stands for “temporomandibular joint” otherwise known as the jaw joint. The joint is formed by the temporal bone of the skull (temporo) with the lower jaw (mandible) hence temporomandibular. There is one temporomandibular joint on each side of the skull located in front of each ear. The upper and lower halves of this joint are separated by an articular disc. The temporomandibular joint is the most unique joint in the human body as it is two joints in one. It is unique in that one joint directly influences the function of the other joint. The two joints function as one unit since they both move one single bone, the mandible. Each side cannot operate independently as both joints are joined to the same bone.
Think of your jaw as a door that is on hinges. If your door is crooked, it is going to add excessive stress to the hinges and it is not going to shut correctly. If you modify the door to make it look less crooked it is still going to have stress on the door and possibly not shut all the way causing further wear and tear to the door itself. On the contrary, if you have a door that is straight and a door frame that is bent you may still have a door that does not shut correctly. The next few blogs will discuss the various relationships that may be encountered when attempting to open and close one’s mouth using the door analogy.
Leave a comment for Jason! Or to send him an email.
Posted February 28, 2012 at 4:17pm by Jason Masek.
Tagged With: biomechanics, PRI Concepts, temporomandibular • 1 Comment
Posted 02/22/2012
Ron just wrote a blog for the Postural Restoration Institute’s website. Click here to read his latest thoughts on rail road beams, city block markers, ribs and doorways…
Posted February 22, 2012 at 10:46am by Ron Hruska.
Tagged With: Abdominals, biomechanics, Diaphragm, Hip position, PRI Concepts, Ribcage • 0 Comments
Posted 02/21/2012
What is it about people that make us love extremes? I’m not sure that I know the answer to that question but I’ve come to realize it is why we’re in business here at the Hruska Clinic. (If you’ve been reading some of the other blogs on our website, you’ve come to realize that we’re all right side dominant people, and when we’re too far out of balance-often to an extreme, you have a problem). I was recently discussing the topic (of extremes) briefly with one of my patients and we both wondered what drives people to participate in extreme training regimens that are beyond their ability to perform correctly. Often, patients come into the clinic after starting any number of these extreme programs, yet they don’t necessarily see a correlation between their new extreme activity and their pain. It’s not that participating in challenging activities has to be a bad thing, but where you may get into trouble with some of these activities is when your muscular balance is so far off, that you can’t do those activities without compensating. Another reason people may compensate in a way that will lead to pain is by trying to do an activity that is generally too challenging for you, or trying to lift more weight than you can handle.
For example, maybe you can normally handle doing dumbbell curls with a pair of twenty five pound weights, but if you go through an aggressive cardiovascular and/or resistance training routine and finish it up with dumbbell curls, you may only be able to handle ten or fifteen pounds at that time without cheating. The next thing you know you’re jerking your shoulders up and back and trying to get momentum to curl up those weights. Guess what? You’re compensating and putting yourself at risk of injury. Also, you’re not even getting the intended benefit from the activity. Can you believe this is coming from a guy who used to participate in competitions to see how much weight I could lift? Realize that I always worked out with people who wouldn’t let me lift a weight if I couldn’t do it right. I’ve never experienced a training injury because of this attitude.
So what’s the message today? I think being active and doing challenging activities can be a very good thing, but be sure if you do any activity, especially one of the many extreme workout options that are available today, that you do so with control over your body and the activity, or you’ll likely find yourself needing our services.
Posted February 21, 2012 at 11:50am by David Drummer.
Tagged With: biomechanics, compensatory activity, Cross Training, Hip position, PRI Concepts, Squat, Weightlifting • 0 Comments
Posted 02/15/2012
We all know how important the position of your LEFT leg and pelvis is - but what about the position of your RIGHT leg and pelvis? My newest video blog addresses this topic…
Happy Running!
Lori
Leave a comment for Lori, or to send her an email!
Posted February 15, 2012 at 1:12pm by Lori Thomsen.
Tagged With: biomechanics, Hip position, Hip Shift, knee position, Pelvis position, posterior capsule (hip joint), PRI Concepts, Running • 0 Comments
Hruska Clinic Restorative Physical Therapy Services
5241 R Street, Lincoln, Nebraska 68504
Phone: (402) 467-4545 | Contact Us
