ACL Injuries and Prevention - Part 3

Here is video #3 in our series on box jumps to decrease the risk of ACL injuries and also to improve jumping performance. 

If you have not watched the previous two videos, you can do so below:

Part 1

Part 2

Remember these exercises alone are generally not the complete solution. This is just one piece of the puzzle and their are other aspects of training that should be addressed as well if you are looking complete recovery or do all you can to prevent an injury.

If you want more information on the topic, be sure click the image below to get your free tips report!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention - Part 2

Last week I talked about some of the main causes of ACL injuries and why they occur at a rate of 3-4x more often in female athletes.  You can find that article along with our first jump training video HERE:

This week I’m posting the second video in a series of three showing how we begin jump training to a box.  This type of training can be used for ACL injury prevention and to enhance sports performance.  It’s also what we do post-surgically to get the athlete used to jumping again and landing safely.

The great thing about box jumps is that the forces on the knee are quite low because you are not coming all the way back down to the floor.  It’s also much easier because of this for the athlete to work on proper landing technique.

Before I get to the video though I thought I’d post a picture of what you don’t want your athletes knees to look like.

Looks fairly simple but let me assure you it can be quite challenging for many athletes – boys included.  Learning to jump and land correctly has been proven to help prevent ACL injuries and it must also be a huge focus of any post-surgical ACL rehabilitation program.

If you would like to learn more about how to recover from an ACL injury or just better prevent one from occurring, click on the free guide below!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention

ACL injuries (anterior cruciate ligament) have been an epidemic in sports but even more so in women’s athletics.  Females are 3-4x more likely to tear their ACL than men.  There are several proposed theories on why this is so but for the purposes of this article and what we address here at On Track PT and Performance we will discuss the following:

  • Poor movement quality
  • Strength deficits
  • Landing mechanics

There certainly are other factors, but for brevity sake on this article these are what we tend to see most commonly. I’ll go more in depth in subsequent articles but for now here are the basics:

Poor movement quality

There are just certain joints in our bodies that need to be very mobile in order to get us through our daily activities and especially sporting activities like running, jumping, and cutting.  Don’t get me wrong – all of our joints need to move through their full range of motion for us to be efficient movers.  Some just need to be emphasized a bit more because of their tendency to become stiff while other areas of our body need a bit more stability/motor control.  Check out the picture below to get an idea of how this works – it’s called the Joint – by – Joint theory.

It’s a very simplified way of looking at things but it does often work out this way.  The knee joint needs to have a great deal of stability in all directions to prevent injury.  If the ankle and hip joints above and below are moving well then the knee joint will more likely stay within it’s accepted range of motion during athletic movements.  If the ankle and/or hip are stiff then the knee may just have to go outside of it’s normal boundaries to land from a jump or decelerate while cutting.  This is where things can go south in a hurry!

Strength deficits

There is plenty of research out there in the medical and physical therapy journals showing that strength deficits can lead to knee injuries, and in particular ACL tears. Years ago the main concern was the ration of strength between the quadriceps and hamstrings, which if it was below a certain level it could inhibit an athlete's ability to decelerate correctly leading to injury.

Lately the focus has been more on the hips and muscles of the ‘core’ and how weakness or lack of control in those areas can contribute to injury.  I’ll get more into the ‘how’ and ‘why’ in another article but it is a reality that needs to be addressed.

At On Track PT and Performance, we know that a comprehensive strength program must be implemented to assist in the prevention of ACL injuries.  Quality movement is critical for effective strength training as well.  Being able to combine these qualities is what we do best, and definitely one of my favorite things to talk about so more to come for sure!

Landing mechanics

It is also well documented that female athletes land and cut differently than the male athletes.  Women tend to land stiffer and higher than the men who typically land in deeper hip and knee flexion angles.  Stiffer and higher landings are more dangerous as far as the knee joint is concerned.

Strength and movement quality again play a large role in this.  Some athletes can’t even get into a good position to perform complex athletic movements.  Big problem!

Many don’t have the strength to get into the proper positions.  Another big problem.

As the athletic activities get faster, more complex, impose higher forces, etc it becomes more and more challenging to perform them using good technique.  Fortunately all of these qualities can be addressed through physical therapy and proper training techniques.

Check out the video below filmed by a good friend of mine Joe Heiler. We both use these methods to start teaching athletes to jump correctly using box jumps.  The nice thing about landing on a box is that you don’t really have to come all the way back down.  Much less strain on the knees and an easy way to work on jumping and landing technique.

If you would like to learn more about how to recover from an ACL injury or just better prevent one from occurring, click on the free guide below!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

Sciatica, Back Pain, and Associated Leg Pain

Sciatica, back pain, and associated leg pain can be really annoying to deal with. It can make simple tasks like sitting, sleeping, or walking a nightmare. Fortunately, we’ve had a lot of great success with these folks so thought I’d share a couple examples.

Often these issues can be difficult to treat (especially if you have been dealing with them for an extended period of time) but we like a challenge!  Always being mindful of how the location of the pain extending down your leg can be a dead give away as far as what area to target in treatment.

There are other ways to narrow down the location of the problem as well:

  • The muscles will be painful to palpation at a specific vertebral segment and may even refer pain down the leg when palpated with deeper pressure.
  • Reflexes may be diminished.  A slow or non-existent patellar tendon reflex corresponds with lumbar spinal nerve L4.
  • Muscles may test weaker on the affected side which may indicate an injury to a particular spinal level or nerve.  An example of this would be weakness in the calf muscles (can’t lift up on to the toes) which are controlled by the first two sacral nerves (S1 and S2 on the chart).

So below are a couple great examples of a number of these factors all lining up and how quickly the pain and loss of function can be addressed.

Case Study #1

The patient in this case had left sided low back pain and pain running down through the back of her hip and leg to the mid-calf.  She felt a ‘pop’ in her back and immediate leg pain as a result of pushing and twisting trying to put a heavy object in the back of her truck.  She is an avid runner but even standing and walking significantly increase her pain after 10 minutes.

Exam

So here is what I found:

  • Symptoms following the S1 and 2 dermatomes down the back of the left leg
  • Increased muscle tone/spasm at the S1 and S2 levels of the spine, and these muscles are tender to palpation.
  • ‘Springing’  or pushing down on the S1/S2 vertebrae reproduced the symptoms into the back of her hip/upper thigh.
  • She could do only 12 calf raises on her left leg while doing 25 on the right side (this muscle corresponds with S1 and S2 nerves).
  • Achilles reflexes normal (S1 reflex)

It’s nice when everything points back to a specific level or two like that.  Doesn’t always work that way but when it does it makes me much more confident that we can knock this out quickly.

Treatment

In this case I chose to use dry needling to address the muscles at the S1 and S2 spinal levels on both sides of the spine.  Once the needles were placed I attached an electrical stimulation unit and she just relaxed for 10 minutes.  Dry needling in conjunction with e-stim are shown in the research to decrease tone within the muscles as well as alleviate pain through a number of local and global factors.

The patient was instructed in two exercises that had multiple purposes:

  • decrease pain through relaxation of the over worked muscles of the back and anterior hip
  • facilitate improved stability through the lumbar spine and pelvis

Results

The patient had near full resolution of symptoms for two days after the first session.  Her exercises relieved her pain at home and she could walk as much as she wanted.  She tried to run on the third day but was unable due to pain.

We repeated the same dry needling + e-stim treatment during the second visit and followed it up by progressing her exercise program.

The patient cancelled her appointment the next week as she reported being completely pain free and back to running.

Case Study #2

The patient in this case presented to our clinic with pain shooting into the front of his hip and groin as well as down the front and side of his thigh.  He also reported minor back pain but it was nothing compared to the pain in his leg.  The patient reported having this pain on and off over the past couple years especially when exercising but recently it was much more constant and severe.  In the past he had been diagnosed with IT Band syndrome (pain laterally in the hip and thigh might make you think that), and more recently with a hip flexor strain (could also make sense now that he was having more pain into the front of the hip and groin).

Exam

  • Minimal tenderness to the ‘hip flexor’ muscles anteriorly, slight weakness with manual muscle testing but no pain (probably not a hip flexor strain).
  • Moderate tenderness and active trigger points in the lateral hip musculature that referred pain down the lateral thigh to the knee (could be part of IT Band syndrome).
  • Springing of the lumbar vertebrae at L2 and L3 reproduced the typical symptoms  he felt into his anterior hip/groin as well as lateral thigh (Bingo!)

Treatment

Dry needling was performed at the levels of L2 and L3 along with electric stimulation for 10 minutes, and followed up with IASTM to decrease tone and improve mobility of the superficial fascia and muscles of the mid and lower back.

A couple exercises were given to maintain, and hopefully even improve, the mobility gained through the spine and hips as a result of the dry needling and IASTM.

Results

The patient reported a significant decrease in the anterior hip and groin symptoms as well as a moderate improvement in lateral hip and thigh symptoms.

During the second treatment session I decided to treat the muscles of the lateral hip as well since they also referred pain into the lateral thigh.  This was done with by dry needling + e-stim just like we had done in the low back.

By the third treatment session a few days later the patient was reporting a significant reduction in lateral hip and thigh symptoms as well.

Final Thoughts

It took a few more treatments to completely resolve this patient’s symptoms but it’s nice to see an immediate decrease in symptoms to know that you are treating the right areas.  With a thorough evaluation process it wasn’t hard to figure out that the patient’s symptoms were primarily coming from his spine which was quite a different diagnosis than what was previously thought.

If this sounds similar to you or would like some assistance in your recovery, then click the link below to receive a FREE discovery session.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi.

Follow On Track PT and Performance on Facebook.

3 Acceleration Drills To Build Speed for Football Players

Speed is important for any athlete. The ability to accelerate quickly is what can set a good and great athlete apart. Being able to get up into top speed quickly takes technique, strength, and power. With these three drills we are assuming you have been addressing the strength component of your workouts. This video will show you 3 acceleration/sprint dills you can do on the field, court, or track in order to improve technique to better allow for the transfer of strength into power. 

Want to improve athleticism and start dominating your competition?! Check out my free tips report below, designed to show you exactly what  youth and high school athletes need to include in their workouts!

Ankle Sprain Answer

Ankle sprains are one of the most common injuries.  Some have estimated that ~2,328 people sprain their ankle a day. For some individuals it takes months to recover, others a couple days/weeks.  In either scenario, the treatment of choice most people would have you believe is to rest and ice.  However, very rarely is resting the treatment of choice for any injury, but for whatever reason this seems to be the common recommendations given to individuals with ankle sprains.  This could be one reason why your recovery from an ankle sprain is taking so long. The other problem is that it often leads to limited ankle mobility down the road even if the pain is gone. Limited ankle mobility has further implication such as knee pain, ACL injuries, hip pain, and low back pain.

Unfortunately some individuals will experience frequent ankle sprains. Which can be frustrating, as they seem to happen more and more often. Preventing you from playing, practicing or performing the activities you enjoy on a regular basis.

So what should be done?

First, start moving in a pain free or tolerable range of motion, no matter how small this may start out to be. Also, a very effective treatment to try is submaximal isometrics.

Tip: Do not discount the effectiveness of this simple exercise and its ability to get rid of your pain and start to improve you walking quickly. As an added benefit, this strategy can often be started immediately after spraining the ankle to facilitate the healing process.

Finally, retraining your foot and ankle positional awareness is important to prevent future ankle sprains from occurring. When individuals experience frequent ankle sprains, most commonly they have a reduced ability to react to situations and stabilize the ankle for protection. In many circumstances, this exercise can be started day 1 as well as better help prevent you from experiencing frequent ankle sprains in the future.

If you would like to recover faster from ankle sprains and prevent future sprains from happening so you can stay active or playing the sport you enjoy. Check out the Ankle Sprain Answer.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

5 Secrets for Decreasing Low Back Pain… Without Medication or Visiting the Doctor

Secret #1 – Don’t Focus Just on the Back

Low back pain is a very common problem, and is a topic that comes up often when people find out that I am a physical therapist. The problem with low back pain is that there are a number of different factors that could be contributing to the issue. Without a thorough evaluation, it is impossible to give a direct recommendation. Please don’t think that I am trying to weasel out of the question, but low back pain is probably the most complex area to treat and generalized recommendations get generalized results. With that being said, the purpose of this document is to give you useful information and take home points that can help give you some relief today! If you understand the functions of the segments above and below the low back, a solid correction program can be initiated.

jt by jt.jpg

The picture above provides a simple summary of the movement capabilities in different areas of the body. Front and center is the low back, which as you can see, the main function in this area is stability. Above and below the low back are your hips and thoracic (mid) spine. Both of these segments require a great deal of mobility. If you think about this for a minute, it makes perfect sense. The joints with the greatest natural range of motion and degrees of freedom are intended to be mobile, and those with limited ranges are intended to be stable. If areas that are supposed to be mobile do not function optimally, then the body is going to have to create the mobility somewhere else. Most of the time this happens at the expense of areas that are intended to be predominantly stable (in this case the back).

Secret #2 – Start Moving

One of the biggest mistakes some people make after getting back pain is they stop moving completely because they are afraid of making it worse. The problem with this is that if you want to get out of pain, you’re going to have to start moving at some point. Doing absolutely nothing will do absolutely nothing to give you relief. It may sound obvious, but find different movements and positions that don’t cause as much pain then repeatedly get into those positions and movements until things start to ease up a bit. When your back or hip pain is affecting the way you walk, sit, get out of a chair or drive, its definitely time to do something so this doesn’t last longer than it needs to for recovery. Below is a very simple example that often times many people can start doing early on in their recovery process.

Secret #3 – The Easiest Way to Start Moving

I realize point #2 and #3 are the same thing. This was done on purpose, because I like action takers and people who are proactive about getting better. Now as prefaced in this guide, back pain can manifest itself in a variety of ways and a variety of intensities. So if your back pain is severe, be sure to start this exercise out slowly in a small range of motion and move on from there. If you feel your pain is worsening, please use common sense and stop (it should go without saying, that this exercise may not be for everyone). With all that being said, here is one of the easiest exercises I have found to start easing back pain and get someone moving again after treating hundreds of people over the years with back pain.

Secret #4 – Ease Back Pain by Reducing Compression on the Back

You are probably asking “how can I do this?” Or “how do I know if this is a problem?”

The simplest way of telling if you are naturally too extended or compressed in the back more so than normal is to lay flat on your back and look at your ribcage. If you identify a large rib flare on one or both sides, this could be playing a role in your back and hip symptoms. Below is a picture of what I am talking about.

Here is a simple exercise that you can do to help combat this issue and relieve some compression at the back. Note: this exercise is only scratching the surface on how we can address this issue.

Secret #5 – Movement Assessment

Having a trained eye watch how you move through different ranges of motion and see where limitations might exist in hips, spine, among others. This will often direct which set of particular exercises and potentially manual therapy techniques would be most important for your particular set of limitations. Sometimes generalized exercise and soft tissue work will not do the trick. This is why we at On Track Physical Therapy will take you through a movement assessment every visit and multiple times per visit. It allows us to be very targeted in what we do as opposed to throwing things out and hoping something sticks. This allows us to help you get off painkillers, get some sleep, and continue to move as fast as possible. If that sounds like something you’d enjoy, then let us know by filling out this quick questionnaire below and inquire about a FREE Discovery Visit.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Sprint Training For Beginners (Part 3)

These exercises will build further upon the previous exercises listed below. So if you have not watched them, check them out first.
Part 1: https://youtu.be/ikGkgWFh4fA
Part 2: https://youtu.be/LONKdUZ6Mao

In part 3 we include two exercises that start to incorporate reactiveness into the exercise. The hop prior to starting will initiate the stretch shortening cycle upon landing to start working the elastic component of the achilles as well as up the chain to initiate a sprint. By performing this in both the forward and lateral start postures it teaches the athlete how to really push off and get into the drive phase of acceleration. Using the bounce is another way to facilitate proper angles while working on strength and power eventually needed later on from a 3 point start.

To learn more about how you can improve athleticism and start dominating your competition. Check out my free tips report for athletes below.

Stop Daily Annoying Knee Pain Without Taking Painkillers Or Having Surgery

Knee pain is one of the most commonly treated and surgically operated injuries in the world. It impacts you daily by making stairs or frequent lifting a nightmare. It might be stopping you from playing a sport with your child or going for a round of golf with your buddies.  Maybe you have had an x-ray performed, and been told you have degeneration or arthritis in your joint? While x-rays certainly do not lie, they also do not tell the entire story.

In fact, one study by Katz and fellow researchers showed that getting physical therapy first helped 60%-70% of knee osteoarthritis patients avoid surgery.  

Another study of 180 patients with osteoarthritis were separated into three groups: two different types of arthroscopic surgery, and a placebo (fake) arthroscopic surgery. Interestingly, the two arthroscopic surgeries were no more effective than the placebo (fake) surgery.

Staggering information isn’t it? That’s a lot of money to throw at a surgery with questionable outcomes. Not to mention you probably will have to go to therapy after surgery anyways. Fortunately to both you and me “arthritis” is a normal change in the body that happens over years of accumulated stress and as a result can often be improved through conservative measures.

Why Does My Knee Still Hurt?

The knee often takes the brunt of the force for lack of mobility or control in the hip or ankle. The degrees of freedom in the knee are much less than the ankle or the hip. If motion limitations exist in the hip or ankle, the knee will start creating wear patterns as a result. This wear pattern typically presents itself in some form of faulty orientation of the knee. The body will always take the path of least resistance. So if the hip and ankle orientation are not optimal due to restrictions, this creates a twisting mechanism at the knee as it tries to adapt and accommodate for other structures that are not functioning at optimal capacity.

As you can imagine, this makes the knee much less adaptable and resilient.

Maybe you have had a previous injury to the knee? If optimal function and adaptability was never restored in the knee afterwards, then the overall level of resiliency to injury of the knee will remain low as well.

So how do we reduce pain in the knee so you can squat, go up and down stairs, and walk without that annoying pain?

1) Perform exercises that will get the muscles around the hip strong. This program is often much trickier than going to the gym and working out. Remember we have adaptive changes to deal with that have occurred in the body as a result of dysfunctional or overused movement patterns (most likely both).

Because the body currently has a very low level of resiliency we need to be careful of the amount of load applied to the knee. This is one reason why a low impact endurance program can be very beneficial such as riding a bike 10-30 minutes a couple times per week at about 75% effort. In fact, a lot of research has actually shown that endurance training can increase pain tolerance.

But ultimately, we need to gradually start to load the knee again in a functional way to improve tolerance to activity. We can do this by improving hip function, this will help take some of the stress off of the knee. Here are a couple options that may be helpful. 

As part of a physical therapy treatment, we can perform different manual techniques such as dry needling that can help modulate pain. However, if we never address other limitations above and below the knee joint, the pain may remain or linger much longer than necessary. This is why a detailed assessment is required, so specific interventions can be given to restore optimal function and abolish pain.

Looking at the way you move through different ranges of motion and see where limitations might exist in both the hip and ankle. This will often direct which set of particular exercises and manual therapy techniques would be most important for your particular set of limitations. This is why we at On Track Physical Therapy will take you through a movement assessment every visit and multiple times per visit. It allows us to be very targeted in what we do as opposed to throwing things out and hoping something sticks, which unfortunately is what many other providers do. This allows us to help you get off painkillers, get some sleep, and keep an active lifestyle. If that sounds like something you’d enjoy, then schedule an appointment or a FREE discovery session to take things for a test drive.  

References

Katz, Jeffrey N., et al. "Surgery versus physical therapy for a meniscal tear and osteoarthritis." New England Journal of Medicine 368.18 (2013): 1675-1684.

Moseley, J. Bruce, et al. "A controlled trial of arthroscopic surgery for osteoarthritis of the knee." New England Journal of Medicine 347.2 (2002): 81-88.

Jones, Matthew D., et al. "Aerobic training increases pain tolerance in healthy individuals." Med Sci Sports Exerc 46.8 (2014): 1640-7.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Stop Achilles Tendinitis and Foot Pain BEFORE it causes another Problem

Have you ever heard someone say that after they hurt such and such body part that all of a sudden a whole slew of other injuries started?

I hear this all the time, and there is a lot of truth behind it. Especially when it comes to the foot and achilles tendon!

You see the foot is the body’s first line of defense to absorb and transmit force, your achilles tendon plays a major role in this. The foot hits the ground first thing in the morning and with every step you take during the day it must absorb and transmit force. However, when injured this capability becomes impaired.

So what happens when you have achilles pain? The body says “next man up”. Meaning your knee, hip, and back on either side start to take the brunt of the impact. If you do this repetitively, there is a pretty good chance something will start getting a little cranky.

I’ve treated a variety of Achilles injuries. Runners with chronic Achilles pain, partial tears, and post-surgical clients. I can tell you from firsthand experience that individuals who have been dealing with this for a prolonged period of time tend to have other issues as well. Most common tends to be the opposite hip from working overtime, but it could manifest itself in other forms as well.

Achilles Tendon Injury (bottom)

Achilles Tendon Injury (bottom)

Often times the problem with these individuals is that they have been performing the same stretches over and over again for months on end without much improvement in symptoms or overall ability because that is what their doctor, PT, or Chiropractor told them to do.

Stretching could be part of the solution. However, chances are if you have not made improvement by now, then that is not the answer. Remember how I said the Achilles tendon's job is to absorb and transmit forces? Well stretching does not necessarily accomplish this mechanism. Think about a rubber band. The more you stretch it, the more it becomes loose and decreases its ability to create force or tension. The same concept applies to your tendons. Don't get me wrong, they need a baseline level of flexibility, but more does not necessarily mean better.

The solution? Creating useful stiffness and strength in the tendon so that it has the resiliency to absorb force all day long when you are walking, going up/down stairs, jogging, or playing a sport.

You have probably seen a calf raise before. This exercise, especially done at particular tempos and angles proves to be effective for a lot of people. However, a lot of times people will have pain with this activity so it makes it really hard to progressively load the tendon.

At On Track Physical Therapy we also utilize a method called blood flow restriction training. This allows us to make strength gains with very low loads of resistance. Research has also shown how it can increase human growth hormone (this hormone has been known to improve tendon recovery).

Another method for pain reduction used is Dry Needling. Which has been shown to improve pain in the short term. Allowing us to effectively strength train the tendon in a more pain free environment.

Finally, if you are an athlete, you need to progressively start including dynamic exercises and drills that will ultimately translate to sport by improving your body’s ability to efficiently transmit forces. Such as the exercises below:

 

For free tips on how the pros recover faster from injury, click the picture on the left. If you'd like to get help AS SOON AS possible then enquire about a FREE discovery session below.

 

 

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Basketball Weight Training Workout | Athlete Workouts Episode 5

This was a workout that is designed specific for basketball players to improve the athletes ability apply a vertical force. Prior to performing this workout, the athlete should have already established a proper squatting pattern and have prerequisite levels of strength through a full squat. 

This workout demonstrates a partial squat because that is what is encountered more in a basketball environment, in particular when we talk about vertical jump. A box jump is added as well for a plyometric after the lift for post activation potential. We follow this up with some tempo squats with eccentric focus and sled drags.

Foundation Program - http://physicaltherapyontrack.com/athletes/

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Sprint Training For Beginners (Part 2)

Part 1: https://youtu.be/ikGkgWFh4fA

In part two we are working on a 2 point start and a lateral start. Neither of these exercises utilize momentum (like in part 1) to help the athlete obtain proper body positioning.

Coach the athlete to drive away from the line and punching their knee forward. Body should rise naturally and over a period of time such as an airplane rising for take off.

Foundation Program - http://physicaltherapyontrack.com/athletes/

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Sprint Training For Beginners

These are two sprint variations that I will use with my athletes when they are first learning how to sprint.

Often times coaches will have athletes start to low (or simulating like they are coming out of the blocks). However the problem with this is the athlete is often not strong enough to power out from this position to obtain the proper shin and torso angles for acceleration.

By using a momentum start or falling starts you can get the athletes into better positions for acceleration until their strength levels start to increase enough to go down into a 3 point or 4 point stance.

For FREE Training Tips click the picture below and sign up to download your report today!

How to Sprint Faster and 3 Exercises to Improve Your Forty Time

How to sprint faster and improve their forty time is a question a lot of athletes have and will ask me. Many athletes get confused by all the different exercises and advice that can be found online. Here is a simple grouping of exercises that I think pair well with each other. 

1. The speed prowler push - focus is on speed not the amount of weight pushed. Weight on sled should really only be about 10%-20% of what you could maximally push.


2. MB chest pass with broad jump - Explode out and jump as far as you can forward. Perform lower repetitions and higher sets.


3. Deadlift - depending on where you are on the strength continuum and competition season the sets and rep scheme will change. If you cannot perform 1.5x bodyweight your focus should be with a weight you can perform 3-5 sets of 7-10 reps. If you have met that strength prerequisite you can start loading the bar up more and performing 3-5 sets at 2-5 reps. 

Feel free to like, comment, share, tag video with friends who could use some more speed!

Reign Superior Athletics is the gold standard program developed for all athletes. A solid foundational program is necessary to build a rock solid foundation level of strength, movement, power, and athleticism. I highly encourage all athletes to start with this program no matter your experience level. It has over 10 different workouts, so you can pick the specific one based off of your training experience and skill level. If you ignore the foundation, you will compromise your durability and full potential as an athlete!

The #1 Box Jump You Are Not Doing

Whats going on everyone. In effort to try to provide more information to the public on specific training for athletes I am going to be starting to post 1-2 videos per week on the topic. On the video it says "Athlete Workout Wednesday". Decided to keep it short with "Athlete Workout, Episode 1". Be sure to subscribe to the youtube channel to get updates if you'd like, and hope you find these useful!

Today I wanted to share with you my #1 box jump variation that most athletes are not doing. I call this box jump variation the "drop step box jump". This is because it looks like a basketball player about to throw down a nasty dunk on somebody. 

The reason why I am such a fan of this exercises is because after mastering a simple box jump, the prerequisite level for performing this type of box jump or plyometric is fairly low. Now I will always say an athlete should establish a foundational level of strength before performing any type of box jump. But once that is accomplished, this exercise can be progressed to fairly quickly. 

Its a nice exercise because it gets that athlete to start utilizing momentum and the stretch shortening cycle by adding in the step. By making it a drop step it will add coordination to the mix. You may notice one side easier or more explosive than the other. Finally by opening the hip and rotating the leg it will bias more hip rotation and load the hip greater for a more explosive exercise.

Exercise of the Week - Foam Roller Assisted Single Leg RDL

The foam roller assisted single leg RDL is an excellent exercise to teach someone how to correctly perform a single leg deadlift. This is a beginning level exercise to teach someone the movement prior to loading the movement with weight. The reason why this exercise works so well is it keeps the foot in contact with the hand via the foam roller. This keeps the torso parallel to the ground as a common fault in this exercise is rotating the hips and thorax.

Simple Shoulder Pain Test and Solution

Today I have a simple test for shoulder pain and dysfunction with a potential solution that has helped others who have had similar issues.

Below is a simple test you can do at home to assess for shoulder pathology. This is called a horizontal impingement test, often used in physical therapy clinics. The test is assessing for healthy joint movement. If there is pain or pinching involved, this is a positive test and may warrant further examination from a trusted healthcare provider.

If this test is positive, chances are you have difficulty reaching overhead, across and behind your body.

Below is a simple solution that has often cleared up this test and improved people's shoulder on numerous occasions. The rotator cuff, in particular the backside (posterior) of the shoulder consists of three muscles that tend to hold a lot of tension and contribute to a lot of movement related issues of the shoulder. They are the supraspinatus, infraspinatus, and teres minor. In addition to these three, the long head of the triceps can at times be involved as well. Here is a simple activity you can do at home to start addressing these soft tissue limitations.

Give it a try and let me know what you think!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Dry Needling For Hip and Knee Pain

Ann Arbor, Mi - At On Track Physical Therapy and Sports Performance we strive to find new and innovative ways to treat pain and get you moving again.  Dry needling is one of those treatments and can potentially works wonders for hip and knee pain.

The Vastus Lateralis (VL) is one of the four muscles that make up your quadricep and is the most lateral.  Trigger points in this muscle will often refer pain to the lateral knee.  Check out the photo below of the VL and corresponding trigger point referral patterns.

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Even without active trigger points, the VL is often in a state of high tone which can significantly limit hip mobility in certain directions.  With it’s attachment all along the IT band, it can also create greater stress on the knee joint through that IT band.

In the video you’ll see the limitations in our patients hip adduction (her knee should hit the table when I try to lower the leg across midline).  Her right hip does this easily.  This is a fairly standard PT test, known as the Ober test in most circles.  In the video you’ll see how dramatically dry needling the Vastus Lateralis with a few minutes of muscle stimulation can change her hip mobility.

Just a quick note on the video.  This was originally created by my mentor Joe Heiler at Elite Physical Therapy in Traverse City for the website Sports Rehab Expert which is read by other PT’s, Athletic Trainers, Chiropractors, etc.  Sorry for all the medical talk but you’ll get the idea with the huge change in range of motion following the dry needling treatment.

Here are some of the common diagnoses you’ll hear from your doctor that will respond well to dry needling:

  • IT Band Syndrome
  • Runner’s Knee (distal IT band syndrome)
  • Patello-Femoral Pain Syndrome/Patellar Mal-Tracking
  • Hip Bursitis

There are many other ‘diagnoses’ that can benefit from improved hip mobility but those above are what we would see most frequently.  For those that are needle-phobic, we can get similar results using IASTM and other manual therapy techniques, it’s just often not quite as dramatic.

There are also a number of specialized motor control and strengthening exercises that need to be used following this treatment to maintain this new mobility.  Just because she can move her hip now on the table doesn’t necessarily mean its going to move that well when she is standing, walking, or running.  Strength must also be established in that new range.

Hope that was helpful to see plus you get a bit of a glimpse at what we do here at On Track Physical Therapy and Sports Performance.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Exercise of the Week

This exercise comes from the postural restoration institute (PRI). Its purpose is to help restore neutrality in the body to help offset our asymmetrical tendencies. It can be a very useful tool for someone with low back pain, hip pain, shoulder pain to name a few. When performed correctly you should feel both hamstrings engage (left > right), a left adductor, your left abs, and a right glute muscle. Hold this position as you focus on proper breathing mechanics. If able, a balloon can be added to the exercise to ensure proper breathing mechanics are being utilized. 

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

5 Ways to Defeat Neck Pain and Stiffness if you Work at a Computer All Day

Do you spend most of your day working in front of a computer?

If you answered yes, then you'd be like most other Americans. Chances are you are also spending a lot of time on your phone as well. 

As a result many people will encounter some sort of achy or stiff neck that may or may not become painful. Below are 5 solutions that one should consider when experiencing neck pain and stiffness. 

1) It's never to late to address the issue, but the sooner you start the better.

I can't tell you how many people I have seen that come to see me for neck pain which has been going on for months to years at a time. I'll then ask them what they have been doing to resolve their pain on their own. The answer I usually get is: "nothing", "medication", or "hope it just went away."

If you get one thing out of this, remember that it is never to late to start addressing the issue yourself. On the flip side, the sooner you start doing something for you pain, the sooner it will go away. The problem is that most individuals do not know where to start or a reliable system of addressing their issues so they fail to start in the first place.

The purpose of this post is to eliminate this fear.

2) Ice early, heat usually works better later

This is probably the question I get asked the most. Should I ice or should I use heat? The simple answer is that you are probably overthinking it and use whichever feels better. Ice tends to dull the pain the best from 0-48 hours after the injury. After that, heat or a topical cream such as icy-hot seems to do better. It is important to realize though that both of these provide temporary relief by altering sensation, it is not a permanent or long term solution. Some type of movement based activity is and will always be long term solution to getting you back to what you enjoy the most.

3) Early Movement 

Piggy backing off the last statement made in point #2, movement will be your long term solution. The trick is finding the point of entry that is least provocative to your symptoms and building upon that motion throughout the days and week/s.

Two very simple exercises which can often be used early on are:

4) Soft Tissue Work

A lot of tension is usually held in the muscles that surround the neck for a number of reasons such as work, posture, exercise, taxes, and the boogey-man. Point being is that life in general can at times be taxing for everyone. When gone undressed these muscles become overactive and facilitate further stress in an already stressed out environment. So some type of soft tissue technique can often be effective. At On Track Physical Therapy we perform various hands on massage and myofascial techniques. Some other unique techniques we offer that can be very useful at times are: Cupping and Dry Needling (click the links to learn more about these modalities). I want to reiterate the fact that movement will always be the long term solution. All of these techniques just mentioned are most useful when followed up by some sort of movement based activity such as the ones listed in #3.

5) Breathing

If every thing you have tried thus far has failed to work. MRIs, Injections, X-rays, manipulations, and all the things listed in #1-4 have not made a difference. This may be your missing link. However, it's not as simple as just breathing. Let me explain, I'll try not to get to sciency on you.

Very stressful environments tend to push us toward inhalation. Think about walking on a tightrope or near the edge of a cliff. You tend to tense up and hold your breath. Unfortunately many of us tend to do this throughout the day without even realizing it because of daily stressors.

The main muscle of breathing is the diaphragm. It attaches to your ribs and low back. You breathe around 22,000 times per day. If it's done repetitively in a state of inhalation (or stress). Then it can start to alter one's spinal alignment causing compensation patterns all the way up through the neck. Another way people compensate is to use muscles of their neck to help with breathing. Think about someone who just got done running. They have their hands on their head and you can see all their neck muscles helping them breathe. While this may be necessary at times when working out, it should not be the case at rest. However it is very common to see people compensate with their neck when they breathe at rest. This can be addressed through a series of various exercises specific to how the individual may present in the clinic. 

Would you like some help to recover faster? On Track Physical Therapy can help get you back to the things you enjoy most! 

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

On Track PT.jpg

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.