Baseline Testing for All Long Island Players
Programs across Long Island place the highest emphasis on safe technique, certified coaches, and state-of-the-art equipment. Many organizations are now suggesting baseline testing as one more tool to keep the kids safe. Baseline testing is not specific to football, it's happening in all sports. Soccer leagues are also implementing pre-season ACL risk assessments. Doctor Steven Macagnone, of Center Island Sports Performance is doing baseline screenings for all Long Island Football Players. Call his office to set up an appointment (516) 433-4242
What is baseline testing?
Baseline testing is a pre-season exam conducted by a trained health care professional. Baseline tests are used to assess an athlete’s balance and brain function (including learning and memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solve problems), as well as for the presence of any concussion symptoms. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a health care professional during the season if an athlete has a suspected concussion.
A Baseline test is a term for any test used before a treatment or activity. It is one tool in an effective concussion management program because it measures what we can’t see – cognitive (brain) function. Baseline testing is a best practice and is recommended by both the National Collegiate Athletic Association (NCAA) and the American Academy of Pediatrics (AAP).
Baseline testing should take place during the pre-season.
How is baseline testing information used if an athlete has a suspected concussion?
Results from baseline testing can be used if an athlete has a suspected concussion. Comparing post-injury test results to baseline test results can assist health care professionals in identifying the effects of the injury and making more informed return to school and play decisions.
What should be included as part of baseline testing?
Baseline testing should include a check for concussion symptoms, as well as balance and cognitive (such as concentration and memory) assessments. Computerized or paper-pencil neuropsychological tests may be included as a piece of an overall baseline test to assess an athlete’s concentration, memory, and reaction time.
During the baseline pre-season test, Dr. Macagnone also records prior history of concussion (including symptoms experienced and length of recovery from the injury). It is also important to record other medical conditions that could impact recovery after concussion, such as a history of migraines, depression, mood disorders, or anxiety, as well as learning disabilities and Attention Deficit/Hyperactivity Disorder.
Who should administer baseline tests?
Baseline tests should only be conducted by a trained health care professional.
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One of the unique aspects of ballet training is the requirement that one learns to stand correctly before
One should ‘feel energized’ in the standing position because ‘standing’ is an active position Not a resting one since all actions originate from here.
Posture is all about body awareness, which is interpreted as “being cognizant or conscious of personal postural habits” (Schloder, 2010). We often hear the phrase “Stand up or Sit straight!” Such comments refer to our posture during daily functions or exercise. ‘Proper’ is construed as ‘correct’ body alignment whereby the pull of gravity is evenly distributed over the base of support with undue stress on the body. Postural training is a major focus in ballet training whereby body alignment and core strength are continuously reinforced as part of all technical requirements. This aspect is one of the most beneficial contributions to the training of athletes in general.
Posture can be defined in several ways:
…The position of the body in any environment or mode such as standing, sitting, lying down, leaning forward/backward/sideward, walking, moving, or running. Posture is based on the position of the spine and all the joints in the musculoskeletal system, i.e., the relative arrangement of body parts…
…It refers to the physical carriage: The way somebody holds his/her body, especially when standing…
…It is a body position the body can assume (standing, sitting, kneeling, or lying down)…
…It is also an attitude or frame of mind…
Posture is linked to a combination of neurological factors such as vision, touch, balance, kinesthetic awareness (sense of the location of muscle and joint movement), and a well functioning vestibular (inner ear). Psychological and/or emotional states, low self-esteem, depression, lack of sleep, and burn out are contributing factors that affect body carriage.
Disease, physical defects, muscle imbalance, pain, injuries, and nutrition deficiency can also contribute to postural deviation. Children may experience postural problems during growth spurts but these may disappear without corrective treatment.
However, it is easy to develop ‘bad’ postural habits during that time since the body ‘learns’ to compensate for possible deviation. If the condition continues or deteriorates further medical treatment is essential.
According to the Posture Committee of the American Academy of Orthopedic Surgeons (1947), “good posture is the state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude in which these structures are working or resting” (Retrieved May 31, 2010, from: http:/www.pt.ntu.edu.tw/hmchai/Kines04/ KIN application/Standing Posture.htm).
So, we can propose that ‘ideal posture is maximum physiological and biomechanical efficiency with minimum stress and strain on the body.’ In contrast, poor posture is the ‘faulty relationship of various body parts, which increases tension or pulls on supporting body structures’ resulting in less efficient body balance over the base of support.
Three vital principles enable athletes to attain and maintain a neutral spine, and thereby ‘good’ posture:
a) stretching the front of the body;
b) extending the back; and
c) strengthening the back. Functional neuromuscular coordination exercises are relevant to maximize both future performance and injury prevention because balance is not purely about improving proprioception (joint position sense and detection of movement) but also about improving normal neuromuscular coordination.
This occurs when exercises are directly relevant to the functional and dynamic positions of the activity or sport.
Alex McKechnie, well-known athletic performance director of the Los Angeles Lakers (NBA Basketball) has treated several star basketball and soccer players for chronic injuries due to poor posture. According to him, “muscles do not work in isolation; they work collectively to produce strength, power, and coordination” because functional strength is the key.” Leg muscles (quads, hamstrings, and gluteus muscles, i.e., all muscles tied to the thighs) have pelvic control and any lack of such affects the knees as well.
He believes strongly in the re-education of movement and correction of posture through exercises in front of a mirror so athletes can experience and correct core balance. Subsequently, if coaches could incorporate more ballet-type exercises many such instances and conditions would be prevented (remedial as well as upper-lower body awareness and progressive leg exercises.
Postural Assessment and Tests
‘Good, normal, or ideal’ posture is identified as an ‘imaginary’ straight line which passes through the earlobe, the cervical vertebrae, acromion (tri-angular projection part of the scapula – shoulder blade that forms the point or tip of the shoulder), the lumbar vertebrae, the center of the hip, just in front of the mid-line of the knee, and slightly to the anterior of the ankle bone
Good Posture includes–
• Straight line from the ear through the shoulder, hip, knee, and ankle joint.
• The head is centered.
• Shoulders, hips, and knees are of equal height.
Most Common Postural Flaws–
• Forward protruding head
• Rounded shoulders
• Arched lower back
• Excessive anterior pelvic tilt (protruding backside)
• Excessive posterior protruding pelvic tilt (protruding abdomen/pelvis)
• Scoliosis– Spine curvature from side to side – may also be rotated.
The spine of the typical scoliosis on an X-ray looks more ‘S’- or ‘C- shaped rather than a straight line.
• Lordosis– The condition is commonly referred to as ‘swayback, saddle back’ or hyper-
lordosis. It is an inward curvature of a portion of the vertebral column.
• Rounded Shoulder or ‘Slouch’ syndrome– common in sports with dominant forward
motion.
It can be the result of excessive time spent in the forward ‘slouch’ position (video or computer games).
Side View: Incorrect posture along the ‘imaginary’ line
A number of tests are available for postural assessment. Testing, however, should be administered at the beginning of the season, in mid-season, and again at the end of the season because posture can change due to growth spurt in younger athletes, medical reasons, or injuries. Individual assessments are recorded on the so-called ‘posture grid’ database. If needed, remedial exercises are designed and incorporated immediately into each daily training session.
Saturday April 9, 7:00pm-8:00pm
Location: Ur Vitamin Store Conference Room
Address: 250 Larkfield Rd, East Northport, NY
Address: 250 Larkfield Rd, East Northport, NY
Learn a powerful secret to excelling in sports and how to apply it.
This technique has been around for ages, but often overlooked in our modern society laden with equipment and training innovations. Olympians and Professional athletes have devoted hours to it, and it is becoming more popular in competitive Youth sports.
Athletes and their families welcome to attend.This technique has been around for ages, but often overlooked in our modern society laden with equipment and training innovations. Olympians and Professional athletes have devoted hours to it, and it is becoming more popular in competitive Youth sports.
This venue has limited capacity RSVP now for tickets!
Complete the form below, give a headcount,
and we will email you your tickets.
and we will email you your tickets.
- Biomechanics is a tool to understand human movement that can be applied to enhance athletic performance and prevent injury.
- Performance of a skill can be broken down into multiple layers of components, ranging from muscle strength to joint trajectories.
- Tools to measure human movement include video, accelerometry, medical imaging, and 3-D motion capture.
- Optimal movement is affected by body size and shape. Elite athletes move optimally and this knowledge can be used to coach and train others.
Robotics, physics, mathematical analysis, imaging, and computer simulations are the some of the latest tools in the quest to improve athletic performance. Together they are used in the study of biomechanics-the physiological analysis of the interaction of forces and effects of forces on and within the human body. Biomechanics researchers are able to examine each aspect of a movement to enhance performance and to understand the mechanisms of injury.
Measuring Movement
Measuring movement can take place in a lab or on the playing field. Dr. Besier often uses simple video analysis to assess temporal-spatial relationships, steps, stride length, and other components of movement. From there, he uses more complex equipment to study the player’s kinematics (three-dimensional motion), kinetics (the forces of motion), and muscle activation.
One of the challenges of biomechanics is that elite athletes can perform at their highest level but have different techniques. Two tennis players can serve in completely different ways. But is any one way better? Is there an optimal way? Or one with less chance of causing an injury? We have to take into consideration that we all have different constraints, such as body sizes, range of motion, and strength. Applying robotic techniques can help determine whether an athlete is moving optimally by estimating muscle movement to calculate effort.
Preventing Injuries
Most musculoskeletal injuries have a mechanical etiology. The stress applied exceeds the strength of the tissue. The extent of the damage is related to the magnitude, rate, and frequency of loading, and recovery and rehabilitation must incorporate the body’s ability to adapt to these mechanical loads (including the body’s adaptations to over- and under-use). Tibial fatigue fractures, for example, are caused by stresses in the bone, which are influenced by loading factors, such as distance or frequency, along with bone mineral density and bone shape. In addition, the biological response of tissue to different loads can induce tissue to change.
An anterior cruciate ligament (ACL) injury, for example, occurs when the load exceeds the strength of the ligament, taking into consideration factors such as posture, muscle forces, and ligament strength. To prevent such an injury, an athlete needs to reduce external loads (by improving perception skills to anticipate movement), improve muscular support of the external loads (through appropriate training programs), and/or grow stronger ligaments. (Ligaments will adapt to their mechanical environment and potentially get stronger with loading.)
If you understand the mechanisms behind injury, then you can prevent it.
The lacrosse shot it an essential skill for each offensive player. The purpose of
this movement is to accelerate the ball as fast as possible while maintaining accuracy to
place the ball into the goal. The lacrosse shot may be broken down into the following
phases: approach, crank-back, stick acceleration, stick deceleration, follow through, and
recovery (See Table 1). Each of the mentioned phases has a beginning of the phase and
an ending of the phase. The lacrosse shot may be performed overhand, underhand, or side
arm, thus all shots may not fit into or encompass all of the phases listed. Events in which
players are shooting with a long stick as opposed to the typical short stick an offensive
player carries will also alter the typical movement pattern.
Approach. --- The approach phase of the lacrosse shot initiates with the player
taking several steps towards the goal with the intent to shot (See Figure 6A). These steps
are typically of high velocity and include stepping styles such as stepping forward,
sideways, backwards, cross-over, or hopping. The approach phase concludes when the
player decreases lower extremity velocity and the “drive leg” is planted into the ground.
The drive leg is the lower extremity that performs forceful hip extension, knee extension,
and ankle plantarflexion during the lacrosse shot to exert force upward through a rigid
level and push the player forward. The “lead leg” to be referenced later, is the other lower
extremity which is the leg planted in front of the player during the lacrosse shot. When
performing a right handed lacrosse shot the drive leg is the right leg and the lead leg is
the left leg; vice versa for a left handed lacrosse shot.
Crank back. --- The crank back phase, also called the wind-up or cocking phase,
consists of preparatory movements for the angular motion seen in the stick acceleration
phase. The crank back phase begins with the drive leg planting into the ground (See
Figure 6B). The crank back phase ends when the top arm, arm in between the bottom arm
and the head of the stick, attains maximum elbow flexion. During a right handed shot the
right arm is the top arm, while a left handed shot establishes the left arm as being the top
arm. The crank phase is subdivided into phase A and phase B.
Phase A deal with placement of the lower extremities, known as a drive step, in
preparation for stick acceleration. This phase of the crank back begins when the drive leg
contacts and is planted into the ground. Phase A ends when the foot of the lead leg
contacts the ground.
Phase B deals with placement of the upper extremities into a wind up position in
preparation for stick acceleration. The phase begins when the foot of the lead leg contacts
the ground. The phase ends when maximum flexion is demonstrated at the elbow of the
top arm. Placement of the stick is of upmost importance during this phase. Proper
placement is necessary for increased shot velocity and accuracy. Peak elbow flexion
velocity has also been hypothesized to elicit a stretch-shortening reflex and increase
elbow extension velocity during the stick acceleration phase.
Stick Acceleration. --- Stick acceleration phase is an extremely short and
dynamic phase. The phase begins when the elbow of the top arm reaches maximum
flexion (See Figure 6C). From this point of maximal flexion, rapid extension of the elbow
and forward propulsion of the stick occur. The trunk swiftly transitions from a backward
rotation and extension position to a forward rotation and flexion position based on the
stick handling side. The rapid change of position propels the head of the stick in the direction of the goal and releases the ball from the pocket of the crosse. The stick
acceleration phase concludes with the release of the ball.
Stick deceleration. --- The stick deceleration phase of the lacrosse shot begins once the
ball is released from the pocket of the crosse (See Figure 6D). This phase will vary based
on the shot technique performed, player skill level, stick type, and the general
acceleration arc of the head of the stick. During this phase shoulder musculature for
stability and elbow flexor eccentric strength for deceleration of the extending elbow are
tested. The phase ends when the elbow of the top arm reaches maximum extension.
Follow-through. --- The follow-through motion represents an essential phase of
movement to dissipate forces produced from the previous phases of the lacrosse shot and
to prevent injuries. The phase begins when the top arm reaches maximal elbow extension
(See Figure 6E). As the body continues to attempt to decelerate the upper extremity, the
trunk begins to rotate. This phase is comparable to the follow-through phase seen in a
baseball swing. The phase is ends with the completion of trunk rotation.
Recovery. --- Recovery phase is considered a transitional phase. The phase begins with
the termination of trunk rotation. Movements during this phase vary based on the next
task the player needs to perform. There is no specific movement which concludes this
phase. Players will often perform a lacrosse pass or checking maneuver while running
down field rather than immediately beginning another lacrosse shot.
Figure 6. Lacrosse Shot Sequence. A, Approach Phase. B, Crank Back Phase. C, Stick Acceleration Phase.
D, Stick Deceleration Phase. E, Follow-Through Phase
Prolonged slumped postures – the curse of modern day society – force the thoracic spine into structural hyper-kyphosis. Sportspeople are by no means immune. The vast majority are recreationally active and therefore as likely as their sedentary counterparts to be slumped and desk-bound for large parts of the working day. Even full-time elite athletes spend significant periods relaxing in the normal fashion: hunched over a computer game or the internet, or slouching in front of the TV.
Poor upper-back posture can set up an injury chain reaction
The thoracic spine and ribcage have extremely complex anatomy and articulations, and are commonly neglected in the injury management of spinal and peripheral sports injuries. Yet thoracic mobility and ideal posture are vital to injury prevention and recovery.
The thoracic spine has 12 vertebrae and is the most stable region of the spine, thanks to the limitations imposed by the structural elements of the ribcage and the vast array of ligamentous and muscular connections (1). The function of this relative immobility – and hence stability – is to protect our vital organs, such as the heart and lungs, but this has implications for the contribution of thoracic spine stiffness to sporting injuries.
The first to seventh ribs are classified as ‘true’ ribs, as they articulate directly with the sternum. The eighth to 10th are ‘false’ ribs, as they don’t articulate with the sternum but with costal cartilage, and the 11th an 12th are floating ribs as they have no sternal attachments at all (1). Use this classification only as a guide: there can be major anatomical variations between individuals.
Ribs 2 to 10 each articulate with the vertebrae above and below; and although variable, ribs one, 11 and 12 generally articulate with only one vertebra. Every rib articulates with its thoracic vertebra(e) via two joints, the lateral ‘costotransverse’ joint (which attaches to the transverse process) and the more medial ‘costovertebral’ joint (which attaches to the vertebral body).
The ligamentous connections between the ribs and the spine and sternum are extremely stable and provide for only limited motion. Because of this, movement in the thoracic spine, while possible in all directions, occurs only in small magnitudes.
Flexion/extension is more limited in the upper thoracic region; rotation/lateral flexion is more limited in the lower thoracic spine. Extension is limited by the ribs, anterior longitudinal ligament, contact of the spinous processes and articular facets and disc structure. Rotation is mainly limited by the ribcage (ribs plus cartilage plus articulations). The significance of these structural limitations increases with age.
There is a dearth of literature on links between the thoracic spine and sporting injuries but Harrison et al (2) showed that thoracic spine kyphosis (convex curve), which increases with posterior translation of the thoracic spine, may be linked with low back pain. Scapulo-thoracic crepitus and bursitis (pain and grinding underneath the shoulder blade) has also been linked with an increased thoracic spine kyphosis (3). Although there is no specific empirical evidence, anecdotally thoracic spine stiffness and kyphosis can be a common predisposing factor to upper-limb overhead injuries, as well as thoracic and low back pain.
Skeletal changes with age
A normal newborn has to have an extremely compliant chest wall, so that it can deform in order to exit the birth canal. It is mainly cartilaginous: ossification does not occur for several months after birth, and skeletal development does not cease until the 25th year with the growth of the rib tubercle.
With aging, the costal cartilages ossify and allow less movement, and as the ligamentous and joint capsules stiffen, the thoracic spine loses mobility. The thoracic vertebrae commonly become anteriorly wedge-shaped, as the result of postural issues and/or osteoporotic vertebral collapse. This contributes to an increasingly kyphotic spine. Bone mass starts to deteriorate after the third decade, and although certain kinds of weight- bearing activity have been shown to reduce the rate of bone loss, roughly 70% of over-75s have osteoporosis of the ribs and spine.
Case study
Impinged shoulder, stiff spine
Brian was a keen amateur triathlete with a sedentary day job. He had a five-year history of shoulder impingement, which had never become serious enough to be functionally limiting, but which he said gave him an achy shoulder that he was always aware of. He routinely protected his arm when doing sprint training in the pool.
Brian’s posture was very poor, with an obvious slouch in both standing and sitting. His thoracic spine was stiff through T3 to T10, with limited extension, and while his gleno-humeral range of movement was normal, his scapula was classically protracted, anteriorly tilted and downwardly rotated. Impingement tests were positive on his right (dominant) shoulder.
We tried taping, which had a minimal effect in reducing his pain symptoms. We mobilised the thoracic spine and the patient stretched over a Swiss ball for five minutes and then on a foam roller. This immediately produced a large improvement in thoracic extension and reduction in shoulder symptoms above the head.
We set Brian a daily exercise programme, using Swiss balls, foam roller and Bakballs. After six months his shoulder symptoms had all disappeared: thanks to his improved thoracic mobility his scapular positioning was now also corrected.
Effects of structural changes
The thoracic spine and chest wall have been shown unequivocally to become less compliant and mobile with age. The healthy thoracic spine has a natural kyphosis. This normal anatomical position is under threat as poor, prolonged slumped postures – the curse of modern day society – force the thoracic spine into further kyphosis, or structural hyper-kyphosis. Sportspeople are by no means immune. The vast majority are recreationally active and therefore as likely as their sedentary counterparts to be slumped and desk-bound for large parts of the working day. Even full-time elite athletes spend significant periods relaxing in the normal fashion: hunched over a computer game or the internet, or slouching in front of the TV. Pro cyclists and triathletes are particularly at risk as a direct result of their sporting posture.
A hyper-kyphotic thoracic spine rarely develops in isolation. As the curvature increases, there are accompanying anatomical consequences. In sitting, the cervical spine and head move forward. This causes excessive upper cervical extension and lower cervical anterior shearing, often creating neck pain and headaches (4). If treatment is only directed to the cervical spine and not at the thoracic stiffness causing the problem, symptoms may temporarily reduce but the pain will never go away.
Prolonged slumped sitting and thoracic hyper-kyphosis cause posterior pelvic tilting, which contributes to lumbar flexion or loss of lordosis. The prolonged positioning of the spine in thoracic kyphosis and lumbar flexion can contribute to permanent elongation of ligamentous and muscular tissue.
As time progresses, this hyper-kyphotic posture becomes chronic and the neural and connective tissue adaptations become difficult to remedy. Pain often accompanies chronic postural hyper-kyphosis because of micro-trauma inflicted on the posterior muscular, ligamentous and/or neural structures from prolonged stretching.
The spinal discs, especially in the thoracic and lumbar spines, may also be structurally affected: compressed anteriorly and stretched posteriorly, causing posterior annular degeneration and potentially disc bulges/prolapses, which can be devastating for the sportsperson. When standing, the hyper-kyphosis will remain and it is easy to observe the consequential pelvic, lumbar and cervical alterations. These, too, can predispose the individual to upper and lower limb conditions as they make adjustments to their biomechanics.
Upper limb biomechanics
If the thoracic spine is held in hyper-kyphosis, the scapulae (shoulder blades) must also move in a relatively anterior-tilted, downward rotated and protracted position – a position linked with gleno-humeral impingement (5). The hypothesis is that as the scapula and hence the acromium move forward and downwards, the head of the humerus has less room to move under the acromium, which leads to micro-trauma of the supraspinatus and other sub-acromial structures, causing pain.
In sitting, the therapist can demonstrate the effect to their client by getting them to compare their range of shoulder elevation and pain first in an ideal upright posture and then in a slumped hyper-kyphotic posture. It is more than likely that they will have considerably less movement and greater shoulder pain in the slumped position.
In terms of the sporting population of swimmers, tennis players and golfers, any thoracic mobility restrictions they have will predispose them to shoulder pathology. This has implications for the assessment of all shoulder patients: it should be mandatory to assess the client’s thoracic extension and rotation to ascertain if thoracic stiffness is contributing to their condition.
Thoracic hyper-kyphosis is likely, also, to be linked to spinal and upper-limb conditions such as thoracic outlet syndrome (neurovascular compression), T4 syndrome (nonneurological numbness in the hands and arms) and Scheuermann’s disease (hereditary juvenile kyphosis), because of the consequent structural changes in the thoracic spine and positional changes of the scapula.
Lower limb
If there is a loss of lumbar lordosis because of the hyper-kyphotic thoracic spine and posterior pelvic tilt, the lower limb will be prevented from moving in an ideal pattern, which may predispose the individual to a variety of lower limb conditions. Hypothetically the motor patterning of the muscles that cross the pelvis and hip, such as hamstring, rectus femoris and adductors, may be altered, risking muscle tearing.
Respiration
As the costal cartilages ossify and the kyphotic spine alters structurally and stiffens, reduced rib and spinal mobility will affect the normal movement of respiration, which is a rib ‘bucket handle’ effect. In older patients the result may be to cause or lead to worsening respiratory conditions. In athletes, it may lead to reduced tidal volume and VO2max, impacting on sporting performance.
Again, the therapist can readily demonstrate to their client the effect of poor posture. In sitting, compare their ability to take a deep breath in an ideal upright posture and then in a slumped hyper-kyphotic position. They should be able to breathe more deeply and freely with ideal posture.
Techniques to improve thoracic mobility
If the thoracic spine has lost extension, the therapist needs to take active measures to reverse permanent structural changes. If this altered posture is the result of a disease state such as Scheuermann’s disease or osteoporosis, it is going to be impossible to restore normal spinal alignment, so the emphasis should be on postural advice and exercises to maintain the client’s mobility levels.
Where there is no underlying condition, the therapist should aim not just to restore mobility but also to ensure the client maintains ideal posture in the future. The most important aspect of re-education will be when the patient is sitting. Strategies for this are:
Visual cues – posting a red dot above the computer screen acts as a reminder to the client that whenever the dot catches their eye they should sit up straight
Verbal cues – get the client to set their watch or programme their computer to produce an alarm/hourly reminder to sit up straight
Physical cues – tape the thoracic spine into extension using two strips, starting from each collar bone and crossing in the mid- thoracic region.
Simple home exercises to maintain and increase thoracic extension
Gentle extension exercises (see figs 1 and 2) can initially be performed once a day, in static lying, using:
rolled-up towel/rolling pin or
foam rollers or
easy-to-use and portable products such as Bakballs (see www.bakballs.com).
The support should be placed at each vertebral level in turn for 20 to 30 secs. As the client’s toleration improves, the exercises should be performed two to three times a day. An alternative would be to arch back over a chair or Swiss ball.
Conclusion
It is easy to overlook thoracic spinal stiffness when a client presents with shoulder problems (especially in athletes), but assessment of the thoracic spine should be an integral part of the sports therapist’s initial examination.
Aim always to restore mobility and provide the necessary exercises and long- term postural re-education to ensure that the client retains ideal posture in the future.
References
Norkin C, Levangie P (1992) Joint Structure and Function FA Davis Company, Philadelphia
Harrison D et al (2002) ‘How do anterior/posterior translations of the thoracic cage affect the sagittal lumbar spine, pelvic tilt, and thoracic kyphosis?’ Eur Spine J Jun;11(3): 287-93
Kuhn J et al (1998) ‘Symptomatic scapulothoracic crepitus and bursitis’ J Am Acad Orthop Surg Sep-Oct;6(5): 267-73
Hiskins B (2004) Thoracic Workshop Australian Institute of Sport
Lewis J et al (2005) ‘Subacromial impingement syndrome: the effect of changing posture on shoulder range of movement’ J Orthop Sports Phys Ther Feb;35(2):72-87
The Philosophy Behind Functional Biomechanics
To understand the concept of functional biomechanics it is important to know that all human movement is based upon the functioning of the neuromusculoskeletal system (NMS). Simply put any and all movement depends on the many nerves, muscles, and bones operating efficiently, in the way they were designed, to allow us to do everything from walking and running to daily household activities and sports. The different parts that make up the neuromuscular system rely upon one another to do their job as designed in order to be able to carry out their specific tasks. The science of how these systems interact and affect one another in a fluid relationship of kinetic chain reactions is the study of Functional Biomechanics.
What does Functional Biomechanics Have to Do With Chiropractic Care?
Understanding how something properly operates in the most optimal conditions allows for an easier determination of the cause of areas of breakdown.
For example, a football coach notices that his go to play doesn’t seem to be working out the way it normally does. He knows in detail where all of his players should be and the actions each of them should take. All of the players on the team are still there and playing, but the outcome is sloppy and the play isn’t a smooth as it once was. When the coach breaks down each player as a part of the play (or system) rather than on the whole, he is able to identify that the breakdown is with the initial pass. His quarterback that was once throwing 35 yards lately has only been able to throw half that distance. This has caused his receiver to adjust his location, which in turn has caused a whole set of changes amongst the other players resulting in the breakdown of the play on the whole.
It is the same concept with functional biomechanics. When all of the players in our NMS are operating smoothly we are pain free and able to carry out tasks as usual, but when just one player isn’t operating normally, the process can be affected. Both repetitive motion injuries from everyday life and traumatic injuries can easily alter the smooth functioning of our systems. Our bodies are made to adapt and it is this ability to adapt that can change the normal processes our bodies were designed to carry out. However, when part of our NMS undergoes a stressor it may adapt in a way that alters it’s ideal fundamental action negatively, which can often lead to dysfunction rather than function, in its attempt to compensate.
For instance a joint, muscle or tissue that has undergone injury may in its simplest effect cause pain and an inability to complete normal tasks because of restricted motion. In even more advanced scenarios, an injury or instability to one area may lead to dysfunction in another area. For example, a common cause for low back pain is simply a chronic habit of “sucking in” your stomach. You may think that having a six pack or tight core muscles is a sign of a stable spine, but the simple act of sucking in your belly deactivates the diaphragm. When the diaphragm isn’t active it creates a lack of sufficient pressure that is needed to stabilize the lower back and, inevitably, this lack of stability causes pain. Chronic instability of the lower back can lead to irritation of the joints, disc bulges, disc herniations, and nerve pain into the hips and or legs (sciatic pain).
An inability to properly function pain-free or an inability to move with the highest range of motion is just the starting point of the information we will assess and evaluate before we develop a treatment plan for your injury. Being able to provide cutting edge chiropractic care relies on an in-depth knowledge of the science of functional biomechanics. It is only with this knowledge that we can identify the cascade effect a seemingly isolated injury can have on the rest of your body. We are skilled at identifying the underlying cause of breakdown within the normal process of functional movement that is causing you pain and at developing treatment plans that will help you avoid further injury. These core fundamentals are what allow us to not only treat your pain, but also to revive performance, alignment, movement, and function. Redefining human performance by restoring the functional aspect of each body’s biomechanics is our primary goal.
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