Boston Sports Medicine and Performance Group, LLC Blog

Beyond Moneyball - Sports Medicine & Performance

Posted by Boston Sports Medicine and Performance Group on Fri, May 18, 2012 @ 07:05 AM

Topcoder

BSMPG

 

TopCoder's Clinton Bonner will be guiding an in-depth  panel discussion and presentation on sports performance and sports medicine today at 4pm-5:15 during our VIP Workshop. A revolution is coming in how not only do coaches and therapists approach performance and injury, but how technology is going to disrupt legacy approaches. Moneyball ten years go was a milestone for sport, but analytics and algorithms is still embryonic now in our profession. Attendees will leave with a blue print on getting started with data driven methodologies and how they are giving a competitive edge to the best teams in the world.  

During this session Jose Fernandez and Dr. Bruce Williams will do an assessment of an athlete, followed by group discussion on best practices with screening. A focus on gait and lower body mechanics is the highlight, supported by both biochemical and biomechanics monitoring. Evidence based medicine and the latest advancements of technology, therapy, and sports performance methods will be covered. With the advent of Moneyball, Jose and Bruce will show how they look at risk analysis with athletes in team sports from both a time management perspective and decision making process.

Catch up with Jose, Bruce, and the rest of the country's top sports medicine and performance professionals at the 2012 BSMPG Summer Seminar May 19-20th!!

 

Click me

 

 

Topics: Art Horne, Craig Liebenson, Charlie Weingroff, Andrea Hudy, Bruce Williams, Cal Dietz, Alan Grodin, Jeff Cubos

Interview with Victor Bergonzoli, CEO of Dartfish

Posted by Boston Sports Medicine and Performance Group on Wed, May 16, 2012 @ 07:05 AM

 

Dartfish

 

Victor, the mobile market is a very disruptive movement to many software companies. How has Dartfish continued to succeed with more and more competition?

 

Actually it helps the overall picture because many coaches had not realized before how important video was. An app is only once piece of a total solution and if you do not answer all the needs (or most of the needs) of an organization, you will not be successful. Dartfish has been serving this community for more than 10 years and we have listened to our client’s needs. This why we continue to be the driver in this market. We have developed apps as well and will continue with new ones to come, but always in a fully integrated and complementary approach (cloud, software and mobile).

 

Dartfish.tv allows users to monetize their skill sets with revenue streams similar to the iTunes store. How do you see coaches take advantage of this in the world of sports performance? Many private facilities are looking for both a competitive edge and a way to keep profits from dissolving to their competition. How does this help coaches on salary such as college and professional ranks as well?

 

There are many ways where coaches can create additional revenue or at least show a very professional image with great technologies. Coaches can sell video clips online (clips, drills, etc.,), they can start remote coaching services, they can post videos of camps and clinics, they can ask parents to subscribe to competitive events. We have clients with thousands of videos on their dartfish.tv platform today.

 

Many coaches want instant feedback or analysis live during training sessions. Most experienced coaches feel just the opposite that athletes should be viewing outside the field, court, pool, or track. Shouldn't analysis be more in the office and not in the field? What problems have you heard regarding this practice?

 

Actually there is a fine line between doing too much on the field and not doing enough with video. A quick visual feedback on the field is very beneficial to the muscle memory learning experience (seeing is believing). However, doing too much can be disruptive and you will lose the impact according to our best users. Deeper analysis should be done after the training session to find out additional facts and reinforce what was communicated on the field.

 

Fusion of data sets such as EMG and Force plates can be done with your system; can you share why this is going be a major and more common practice in the future?

 

What is essential here is to be able to have the full picture. Too many times, athletes and coaches are presented with data and it is very complex to really understand what is going on just by looking at the numbers. We say that your data needs video! As more and more data systems are available to larger audiences, the fusion with video will help the understanding and communication process. It is an additive process. A picture or video may worth a thousand words, and the data/words are worth a lot, but the combination is worth a million words.

 

Speaking of the future, without giving away too much can you identify the problems coaches and therapists have with video analysis with a busy team or clinical setting that will be alleviated with the innovations you are working on currently?

 

 

We are working on offering a product for every step of the process. 3 Key elements are important for therapists and coaches: Communicate, analyze, and then share. The key is to have the solutions that are fully integrated within their processes. It is always difficult to first embrace something new (people hate changes) but as soon as you have your workflow well established and you see that you can reap the benefits (patients doing better, medals won, increased revenue) there is no more doubt. When the first vehicles were introduced, many moving companies resisted and kept their horses and carts….we don’t see them on the roads anymore.

 

Interview courtesy of Carl Valle

 

A few seats still remain for the 2012 BSMPG Summer Seminar - sign up today to avoid disappointment this Sat!

 

Click me

 

 

 

Topics: Art Horne, Craig Liebenson, Brijesh Patel, Charlie Weingroff, Dartfish, Andrea Hudy, Bruce Williams, Cal Dietz, Alan Grodin, Barefoot in Boston

Join OptoSource at BSMPG Summer Seminar

Posted by Boston Sports Medicine and Performance Group on Mon, May 14, 2012 @ 08:05 AM

 

Optosource 

 

The Fusion Event Track at BSMPG

May 19th 2:30-3:30pm

The fusion of sports and medicine becomes a more potent mixture each day. Using tools that gauge performance with a high degree of accuracy allows us to quantify our results in almost any fashion imaginable. Tracking minute changes in the body such as heart rate, function, mobility and mechanics provides us information on our athletes that we can rely on to develop customized programs for each athlete. Real-time reporting functions provided by today’s latest technology make it simple and efficient to make evidenced based decisions in any setting.

 

Doctors, physicians and trainers are all working closely with one another to bring the most comprehensive care an athlete can hope for. Student athletes are among the top demographic to benefit from this union of sports and medicine where coaches and trainers regularly evaluate hundreds of students regularly. Coordinated care breeches team practices in addition to advising on lifestyle choices and curriculum.

 

Outside of institutions, merging is evident in private facilities where athletic development is the number one priority. Through the eyes of Dr. Thomas Lam, Director of Athletic Development at FITS Toronto, an environment focused on sports-science and coordinated care is a premier destination for training and therapy. Located in the hub of Canada, Dr. Lam’s two Toronto locations service every level of athlete, each equipped with a sports science lab. Tracking manipulations to the nervous system by evaluating the results in through changes to the biomechanical system, Evan Chait of Kinetic PT brings his discussion to OptoSource’s Fusion Track workshop.

For attendees of the Boston Sports Medicine & Performance Group, the Fusion Track will be the ideal chance to learn about incorporating data collection into sports performance planning and get a look at the best tools for managing all of the streams of information sports performance programs rely on today.

Speakers for this presentation include:

Dr. Thomas Lam of FITS Toronto on integrating objective analysis into an existing sports performance and medicine program.

Evan Chait of Kinetic PT will discuss The Chait Neuropathic Release Technique (CNRT), a multidisciplinary diagnostic and treatment process that focuses on 3 tiers of health. The 3 Tiers include the nervous system, biomechanical system, and the movement pattern system.

 

What to expect:

  • Using the cloud to safely and efficiently manage data.
  • Incorporating multiple streams of objective analysis into existing programs.
  • Tracking and trending change for coordinating care.

 

Visit OptoSource for more information!

See this track along with 22 other lectures to choose from during our 2 day event this May 19th and 20th.  A few seats remain - sign up before the last one goes!!!

 

 

 Click me

 

Topics: Art Horne, BSMPG, Craig Liebenson, Charlie Weingroff, Andrea Hudy, Bruce Williams, Cal Dietz, Bill Knowles, Alan Grodin, Dan Boothby, Chris Powers

Leopards or Turtles? by Jose Fernandez

Posted by Boston Sports Medicine and Performance Group on Fri, May 11, 2012 @ 07:05 AM

BSMPG

 

 

Basketball is a multifactorial sport where recovery, nutrition, training, technical & tactical aspects, mental preparation and innate conditions are involved. As S&C coaches, our ultimate goal is to enhance the team performance by optimising each player´s physical condition and helping them stay away from injuries.

Profiling athletes is an important part of the training process that helps me to decide what is the most appropriate strategy for each of the players I coach.

The image below represents the average results of 3 pre-season assessments to determine the % of Type I muscle fiber (Slow Twitch). It is an example of two different football players, both of them playing for the same team but with a different muscular profile.

The player on the left seems to have lower predominance of slow twitch as every muscle group except Semitendinosus (very postural muscle) is within 30-45% of slow muscle fibres.

The player on the right seems to have higher predominance of slow twitch, especially on key muscle groups like Biceps Fem (59,8%) and Gluteus Max (62%).

Click HERE to continue reading...

See Jose and other internationally known speakers at the 2012 BSMPG Summer Seminar May 19-20th.

Hurry - Seats are limited.

 

Click me

 

 

 

Topics: Art Horne, basketball performance, BSMPG, Craig Liebenson, boston hockey conference, Cal Dietz, Bill Knowles, Alan Grodin, Barefoot in Boston, Dan Boothby

BSMPG & Bruce Williams : Hit The Ground Running - Video and Interview

Posted by Boston Sports Medicine and Performance Group on Thu, May 10, 2012 @ 07:05 AM

Take a sneak peek into Bruce Williams' presentation, New Concepts in Foot Function & Gait Analysis Assessments & Treatments, at the 2012 BSMPG Summer Seminar.

Space is still available - Register today before the last seats are gone!

 

Click me

 

 

 

Most athletes and coaches think podiatrist means someone who makes orthotics, could you dispel that myth and talk about the holistic approach with foot care and how you even work with injuries in the low back? Many don't understand your profession deals with biomechanics, surgery, and even manual therapy.

Podiatry is a very interesting profession.  Surgery is really the highlight of what Podiatrists do and are trained to do at the present time.  All Podiatrists receive about a year of biomechanics while in school.  They are all trained to cast for orthotics and write prescriptions as well.  Some podiatrists utilize manual therapy in their practice, but probably less than 5%. 

In my practice I figured out very quickly my orthotic outcomes were not what I wanted them to be.  I set out to understand how I could do a better job for my patients and that lead me down a very interesting path of self- education.  I found a mentor to assist me in the use of in-shoe pressure and video capture technology.  He also happened to expose me to the use of manual therapy in the foot and ankle.  The use of the technology and the therapy really opened my eyes to what I was missing in practice.  The use of the quantitative data from the in-shoe pressure really exposed me to the way the foot will function and react to a shoe and to an OTC or custom foot orthosis.  This has helped me to realize my limitations in practice while also allowing me to move past most of my peers in the understanding of the foot’s importance in walking, and athletic gait. 

Most of my sports medicine podiatry peers are great collaborators with physical therapists, strength and conditioning coaches, athletic trainers and massage therapists.  We all realize that we are just a piece of the puzzle in the process of enabling our athletes to compete at their highest levels.

 

Barefoot training and minimalist shoes seem all the rage right now, can you share some objective pros and cons to what athletes may benefit and risk wise when diving into this territory?

Barefoot is the thing right now, just as toning / rocker bottom shoes were a few years back.  In moderation and in certain specific situations I see benefit for patients and athletes from both types of shoes.  The biggest problem I have with the minimalist / barefoot shoe debate is that there is very little proof that doing workouts barefoot will have the amazing results that so many people say they have had. 

I use a lot of technology to quantitate my outcomes, good or bad.  I would appreciate it if others would utilize similar technology to do the same.  Enthusiasm is wonderful, but there is a need to realize when something is not working the way we hoped it would and realize a different take is needed to get a successful outcome.  I have seen a lot of people chasing rainbows the last few years and it confuses me.  I appreciate the capacity of strength and conditioning to improve outcomes for athletes, but, there are limitations to what can be achieved and maintained.  I see the limitations daily with what I do and I try to refer to P.T. and strength coaches to assist my patients and athletes to achieve an overall better outcome.

I am regularly amazed that so many in the sports industry seem very anti-foot. I’m not really sure why this is, but my suspicion is that every podiatrist and many P.T.’s will put patients and athletes in an orthotic and often they do not work.  Podiatrists are very bad about this and often don’t have a specific reasoning or a plan for why they chose to use their devices.  I have a very specific reasoning pattern and evaluation process for doing what I do for my patients.  I really try to have a method to my madness.  I have a very good success rate, but not perfect by any means.  I am always looking for a new way to improve my outcomes whether it is through a new modification to a device, a new mobilization technique or through partnering with a better team of sports minded individuals so that we can all work together to benefit our athletes.

 

When the foot hits the ground a complex reaction of joints, muscles, and neurological responses happen. Could you share your approach with both technology and experience when working with athletes?

I use F-Scan in-shoe pressure and Dartfish as well as another older video capture technology.  I am starting to experiment with wireless emg and a nodular motion capture technology.  In-shoe pressure can give you a tremendous amount of insight into how an athlete’s foot and lower extremity functions.  There are however limitations to what the data can indicate.  This is why I use video capture and why I’m experimenting with the nodular motion capture.  It is important to know what the position of the hips, knees and lower extremity in general are doing for each step.  Relating this to the trunk position can give you insight as well. Once you have enough gait data from the trunk on down, then you can really start to incorporate a plan for the athlete from the ground up.  As you track going forward you should see what is working and what is not.

Wearable technology is being used now and will be utilized even more in the near future.  It is important to start to work with this technology or to partner with those who do use it regularly.  There are great benefits to quantifying evaluations and using wearable tech to validate plans of interventions is going to become the gold standard as we move forward.

 

You are familiar with different screens such as the FMS and traditional orthopedic assessments. Could you share your perspective on how some additional information from your methodology can help athletes reduce injuries?

FMS is a great screening tool and can give you quite a bit of information to help practitioners to formulate a plan for an athlete’s rehab or for their regular conditioning.

I have a basic screening tool that can assist or expand on the FMS as far as for evaluating the foot, ankle and lower extremity.  If you can gain a better understanding of how the foot is structured and functions then you can start to get a much better understanding of how your interventional plans will work and whether you can expect realistic improvement.

I like to use a basic scale to discern the structure and stiffness of the foot along the medial and lateral columns.  It is good to know the standing heel position of the foot, if there is any limb length difference left to right, and also the available range of motion of the big toe joints and the ankle joint.  Just having these few basic points of information can start to give insight to why an athlete may be prone to stress fractures of the metatarsals, chronic ankle sprains, and even if they may be prone to knee injuries.   Adding ranges of motion of the hips, and knees in static and walking gait can multiply your available knowledge base even more.

There are reasons and patterns for why some athletes get injured and why some do not.  Quantifying as much of the structural components of the foot and lower extremity function is the best way to start to identify those patterns.

** interview courtesy of Carl Valle

 

 

Topics: Craig Liebenson, Charlie Weingroff, Bruce Williams, Cal Dietz, Bill Knowles, Barefoot in Boston, Dan Boothby, Chris Powers

See Tomorrow's Training Technology Today

Posted by Boston Sports Medicine and Performance Group on Sat, May 5, 2012 @ 07:05 AM

Ever wonder why some Performance Coaches, Athletic Trainers, or Physical Therapists always seem to be ahead of the curve?

What do they see that you don't?

Sometimes having a little help from the sports science world and measuring progress can go a long way....

Be the first to see tomorrow's technology today at the 2012 BSMPG Summer Seminar - May 19th and 20th in Boston MA.

Click on each logo to learn more about each company and how they are changing the way we track and progress our athletes and patients.  

Stop chasing the pack, and start moving towards the front with the help from the leaders in advanced training technology from around the world!

 

TMG     visiblegains

 

ithlete          Polar

 

 

MyotestPRO          kinetic

Affectiva          BioSensics

Dartfish         zflo

 

Zeo            Free Lap

 


 

Tekscan      Optosource

 

 

 

Inside Tracker

 

 

Register for this event and for opportunities to win prizes from these sponsors today.

 

Seats are limited!

 

Click me

 

Topics: BSMPG, athletic training conference, boston hockey summit, Craig Liebenson, Charlie Weingroff, barefoot strength training, Andrea Hudy, Cal Dietz, Bill Knowles, Alan Grodin, Barefoot in Boston, Dan Boothby, Clare Frank

Q: Who Do The Top Athletes From Around The World Trust After Surgery?

Posted by Boston Sports Medicine and Performance Group on Wed, May 2, 2012 @ 08:05 AM

A: Bill Knowles

There is a reason why top athletes and clubs from around the world seek out Bill Knowles after surgery.  He is simply one of the best in the world at returning athletes to pre-surgery performance levels. 

Meet Bill Knowles at the 2012 BSMPG Summer Seminar, May 19-20th as he lectures about Reconditioning and Return to Competition Strategies for the Joint Compromised Athlete.

 

Bill Knowles

 

 

Notable Athletes

Notable Clubs/Teams  
(lectures-clinics-athletes)

  • Tiger Woods – Golf
  • Alex Rodriguez – Baseball/NY Yankees
  • Peyton Manning – Football/Indianapolis Colts
  • Jonny Wilkinson – Rugby/England
  • Dara Torres – Swimming/5x Olympian (12 medals)
  • Frank Lampard – Soccer/Chelsea-England
  • Tracy McGrady – Basketball
  • Shawn Horcoff – Ice Hockey/Edmonton Oilers-captain
  • England FA, Manchester United, Chelsea, Manchester City, Tottenham, Aston Villa, Bolton Wanderers, Middleborough, West Brom
  • England Rugby(RFU), Scotland Rugby(SRU), London Wasps, Leicester Tigers, London Irish, Harlequins, 
    Sale Sharks, Edinburgh
  • US Ski Team, Canadian Ski Team, Edmonton Oilers, Indianapolis Colts, San Jose Sharks

 

Athletic Development Coach and Sports Rehabilitation Specialist
Certified Athletic Trainer, Certified Strength and Conditioning Specialist


Experience:
• 21 years professional experience working with World-class, Olympic, Professional, Elite, & Nationally ranked athletes from around the world.
• Professional and World-Class sports include: Soccer (football), Rugby Union, Ice Hockey, Basketball, Football, Aussie Rules Football, Golf, Alpine and Freestyle Mogul Skiing, Snowboarding and Swimming
•Former Head Athletic Trainer and Director of Strength and Conditioning at Burke Mountain Academy (Vermont, USA) for 12 years. BMA is recognized historically as the best youth sports academy in the world for alpine ski racing. 
The list of Olympic, World Cup, and World Junior success is unparallel in the Unites States and worldwide.
• Author of numerous articles on injury prevention and performance training in ski publications, strength and conditioning magazines and health journals.
• Featured speaker dozens of times around the United States, Canada, England and Scotland on topics related to injury reduction programs, rehabilitation/reconditioning, and performance training for all types of athletes.

For the past 21 years Bill Knowles has been working with elite level athletes from around the world. As a sports rehabilitation specialist, Bill has helped Professional and Olympic level athletes recover from season ending and career threatening injuries. His energy and enthusiasm keeps every training session educational and fresh, while his unique experiences allows a creative approach to address any injury situation. Bill’s rehab philosophy allows each athlete the opportunity to express their inherent athletic ability quickly following injury or surgery. This mean the “down time” is minimal and the athlete stays very active and motivated.

After receiving his education at Cortland State College in New York, Bill began his career at the world renowned sports academy for Alpine and Nordic ski racing; Burke Mountain Academy. As the Head Athletic Trainer and Performance Director Bill took care of countless knee injuries and developed his skills that began to attract world-class ski racers from Europe and North America. Since then athletes from England, Scotland, Ireland, and Australia have visited Bill in Killington, Vermont. Bill has also traveled extensively working with and visiting many of the top sports clubs in the world.

This success has evolved to designing and implementing rehab and performance programs that have placed athletes back into the English Premiership and Championship Football Leagues, The Rugby World Cup and Premiership Squads, Baseball World Series, Winter Olympic podiums and X-Game podiums.

As a former collegiate soccer player, ski racer, and coach, Bill delivers his training programs they way an athlete understands and respects.

 

Register for the 2012 BSMPG Summer Seminar Today!

 

Click me

 

 

Topics: Craig Liebenson, Bruce Williams, Cal Dietz, Bill Knowles

Interview with Coach Schexnayder : 2012 BSMPG Seminar Keynote Speaker

Posted by Boston Sports Medicine and Performance Group on Mon, Apr 30, 2012 @ 07:04 AM

LSU jump

 

 

This is part 1 of the weekly “Friday Five” series where I ask 5 tough questions to world class elite coaches.

Irving "Boo" Schexnayder is regarded internationally as one of the leading authorities in training design, especially in the Jump events.  He coached triple jumper Walter Davis, long jumper John Moffitt, and 19 NCAA Champions.

Boo will be speaking at the Boston Sports Medicine and Performance Group (BSMPG) on May 19-20, 2012.

You can also see his complete jumps DVD package for the Long, Triple and High Jump (plus a weight training bonus).

Q1 – SpeedEndurance.com:  A lot of confusion and mystery lies with the true volumes of jump training that is sufficient for stimulating neuromuscular adaptions and teaching. While small doses are often looked at as the goal, teaching takes repetition. Could you expand on how important the sequence of the training year and the quality of foot strike?  Can you explain why it seems that some programs thrive off of higher volumes while some just lead to injury?

BOO:  As far as foot strike, the ability to properly dissipate impact forces through full-footed landings is obviously a huge help to staying injury free while jump training. I think there are two other, more subtle keys to successful progression and remaining injury free in jump training. The first lies in variety, specifically advancing training cycles in a timely fashion. The other is taking a purposeful approach to the process.

Just as athletes do, we as coaches tend to settle into comfort zones. You get your athletes doing particular forms of jump training. Then, as mastery is approached, it’s time to move on to something else, but our natural tendency is to breathe easy and admire our work for a while. Periodic shifts in exercise choice, volume and intensity are critical, even though they might make life for the coach tougher. Successful higher volume programs do this and show a bit of a pioneer spirit.

Also, everything done must have a very specific purpose. That purpose might be establishing initial volumes, technical development, high end or low end elastic strength development, or whatever. It’s easy to fall into a “this is my fallback workout” philosophy if you are not targeting something specific. This is the primary rationale behind the small volume programs, and I think this is the key with high training age athletes who have already accumulated injuries and other physical issues over the course of a career.

In either case, whether it is failure to progress or mindless repetition, at this point jump training quits being a stimulus and becomes simply another piece of baggage that must be carried around that increases injury risk.

Q2 – SpeedEndurance.com: You mention that Olympic lifts are great harmonizing agents to a program. With your experience could you address what mechanisms and systems such as posture and coordination enable the lifts to transfer to sprinting and jumping?

BOO:  The results I see in my program are the main reason I feel strongly about using Olympic lifts. I don’t want to give anyone the impression that I researched them first and then started to use them. My personal journey was more of a matter of seeing huge gains and then figuring out why.

I think the orders of joint firing and the mixing of absolute strength, power, and eccentric activity show huge transfer into sport specific skills. Also, the need to stabilize the core while performing something functional like an Olympic lift does more for the body’s core than all the crunches in the world. In short, they are highly functional.

I am a fan of functional training. But I have never gone completely that way, always keeping a base in more old school approaches. Maybe it’s because I started my career in football, but it’s also because I have watched too many great athletes train that way to scrap it.

I think a key variable in strength training is the amount of muscle tissue activated in the course of a repetition. That variable, more than any other, affects blood chemistry and endocrine responses. Many exercises are functional but don’t elicit enough muscle fiber activation to accomplish this. Olympics are where gross movements meet functional training and old school meets new school.

 

Continue reading on speedendurance.com   

 

See Coach Schexnayder at the 2012 BSMPG Summer Seminar as he talks, "Mulitjump Exercises: Applications for Teaching, Training, and Rehab"

 

Coach Schexnayder joins Chris Powers, Craig Liebenson, Bill Knowles, and Alan Grodin as Keynotes speaers.  See these world class speakers along with the best Sports Medicine, Hockey and Basketball therapists and performance coaches throughout the weekend - May 19-20.


Register today before seats fill up!

 


Click me

 

 

 

 

Topics: basketball conference, BSMPG, boston hockey summit, Craig Liebenson, boston hockey conference, athletic training books, Cal Dietz, Bill Knowles, Barefoot in Boston

Postural Function of the Diaphragm and Low Back Pain by Pavel Kolar et al.

Posted by Boston Sports Medicine and Performance Group on Wed, Apr 11, 2012 @ 07:04 AM

Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain

by Pavel Kolar et al.

Excerpt taken from JOSPT, April 2012, Vol 42, Number 4 p. 352.

 

 

Pavel Kolar

 

 

Despite the high prevalence of low back pain in the population, options regarding effective treatment strategies are still limited, possibly due to the lack of knowledge of the underlying mechanisms.9 Trunk stabilization and postural trunk control may play an important role in the etiology of low back pain.9 In turn, the function of the diaphragm may affect how the trunk is stabilized, especially during postural activity.11,15,22 Various studies have shown that the pelvic girdle and lumbar spine are reflexively stabilized and braced prior to the initiation of extremity movements.3,13,17,22 The central nervous system must be able to anticipate movement and stabilize the entire core musculature automatically to provide a stable base from which the muscles performing the movement can pull.

Trunk bracing maintains all spinal segments in a biomechanically neutral position during the course of any movement. Segmental movement (eg, hip joint movement) is therefore related to the synergistic activity of the spinal extensors and all the muscles modulating intra-abdominal pressure (ie, abdominal muscles, the diaphragm, and the pelvic floor). The diaphragm is the muscle that contributes the intra-abdominal pressure modulation and plays an important role in spinal stability.7,16,18,27,31

Insufficient function and poor coordination of postural, or stabilizing, muscles are considered to be important etiological factors in spinal disorders associated with low back pain, such as deformational spondyloarthrosis (with or without spinal disc herniation), spinal disc protrusion, and/or spondylolisthesis.5,12,21,25

Continue to read the remainder of this article by clicking HERE.

CONCLUSION

We found reduced diaphragm movement when isometric flexion against resistance of the upper or lower extremities was applied.  The combined, more cranial position in the anterior and middle portions of the diaphragm and, particularly, the steeper slope between the middle and crural portions of the diaphragm in patients with chronic low back pain may contribute to low back pain symptoms. However, given that the results are based on crosssectional analysis, we cannot exclude the possibility of reverse causation. Still, the results support the theory that patients with low back pain complaints present with compromised diaphragm function,
which may play an important role in postural stability.


KEY POINTS

FINDINGS: We found reduced diaphragm movement in patients with chronic low back pain compared to healthy controls when isometric flexion against resistance of the upper or lower extremity was applied, mainly in the anterior and middle portions. This pattern of diaphragmatic recruitment resulted in a steeper angle in the middle-posterior part of the diaphragm and likely a greater strain during activity on the ventral region of the spinal column.

Topics: Craig Liebenson, Pavel Kolar, Barefoot in Boston, Clare Frank, Core Stability Training

Jeff Cubos Talks Dynamic Neuromuscular Stabilization : Filling the Gaps

Posted by Boston Sports Medicine and Performance Group on Mon, Apr 9, 2012 @ 07:04 AM

by Jeff Cubos

 

It’s been over a year since I first began the Dynamic Neuromuscular Stabilization program. Since that initial “A” course, my clinical thought process has expanded exponentially through following up with the “B” and “C” courses, my privileged opportunity to visit Motol in Prague, and the day to day reflections of my current practice.

Well recently, I had the privilege of taking part in another DNS A course that was put forth by Michael Maxwell of Somatic Senses and taught by Alena Kobesova and Brett Winchester. This particular experience was quite special for me because not only was it local (hence no flight costs), but it provided me with the opportunity to share my experiences to date with many of my friends and colleagues who attended the course…including my wife.

I would say however, that the most beneficial aspect of being present was that it afforded me the opportunity to “fill in the gaps”.

 

 

Continue to read this article by Jeff Cubos by clicking HERE

Meet Jeff Cubos and other top therapists and strength coaches as attendees at the 2012 BSMPG Summer Seminar.

Register today before seats are filled!!

 

Click me

Topics: BSMPG, athletic training conference, Craig Liebenson, Charlie Weingroff, boston hockey conference, Cal Dietz, Jeff Cubos, Barefoot in Boston, Dan Boothby, Clare Frank, DNS course, barefoot training