Categories: exercise pictures

Hamstring Tendinopathy: Sample Rehabilitation Program Videos

by Greg Lehman
Categories: exercise biomechanics, exercise pictures, hamstring function, Patient Exercise Sheets, Tendinopathy, Videos
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Comments: 1 Comment
Published on: March 18, 2020

Audience: Therapists and Patients

Purpose: This post is video overview of the sample exercise progression I might advocate for patients (primarily runners) who present with persistent longstanding high hamstring pain.

Background

Runners, particularly faster runners, will often present with high hamstring tendon pain.  The pain is typically felt where the muscles insert into the bottom bone of the hip (the ischial tuberosity).  In addition to the hamstrings the adductor magnus can often be involved.

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Basic Shoulder Movement Videos

by Greg Lehman
Categories: exercise pictures, Patient Exercise Sheets, shoulder dysfunction, Videos
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Published on: March 17, 2020

Audience: Patients

Purpose: Exercise videos for those doing shoulder rehabilitation

Preamble

The same exercises or movements can be used with different intentions and to achieve a different goal.  Some possible intentions being:

1. Motion is Lotion - we are moving your shoulder in a manner just to calm down nerves, decrease pain and get that pissed off shoulder happy with moving again.  The amount of weight or resistance is not that important

2. Stress loading - for whatever reason we want to stress your shoulder and shoulder girdle musculature.  You might have some weakness (e.g. prolonged immobility, post surgical) or we wish to increase the capacity of your joint and muscles to withstand load.  Appropriate weight selection, speed of movement and technique is important

3. Motor control - certainly there is some overlap with the previous two intentions mentioned.  But with this intention we might look at trying to change how your muscles work together.  An example, is training both the internal and external rotator cuff during alternating movements.  We are trying to get the cuff to pull the humeral head away from the scapula or just get the muscles happy working together again.  Load or stress is important but so is learning the movement.

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Nerve Slider Videos: Calming down that irritated nervous system

by Greg Lehman
Categories: Chronic Pain, exercise pictures, Nerve Sliders, Pain Education, Patient Exercise Sheets, Videos
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Comments: 4 Comments
Published on: March 5, 2020

Audience: Patients

Purpose: Demonstrate simple movements to calm, move and make healthy some irritated nerves.
Disclaimer: Not to be done if painful. Do 5-6 to start. Always under health professional guidance.

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Running and hip strength - my response to the Toronto Star

by Greg Lehman
Categories: exercise pictures, running biomechanics, Running Injury
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Comments: 2 Comments
Published on: April 1, 2020

Audience: Runners and therapists

Purpose: advocate hip strengthening exercises

 

The “core” gets all the press.    But when it comes to running research and injury prevention I would sooner extol the virtues the butt.  The side of the butt to be most specific.

 

These muscles (gluteus medius/minimus and gluteus maximus) are huge in the relationship to injuries to the knee, hip and spine.  If you want to split hairs you can call them part of the core (you should, but most people don’t).

 

For a decade, I swear its been that long, researchers (and their readers like me) have advocated that runners should train these muscles and forgo stretching if they had to pick between the two exercise possibilities (I’ve softened my stance on stretching, more posts to follow).  The exercises are easy to do and can be fit in after a good run.

 

To support these views the Toronto Star just published a summary of a paper by Reed Ferber out of Calgary.  He runs a great lab and worked with Irene Davis (a superstar researcher in running biomechics), before starting his lab in Calgary.  His research publications are quite exceptional and if I were still a researcher they would make me envious.

See the Star article here: http://www.healthzone.ca/health/dietfitness/fitness/article/960175-researchers-get-hip-to-the-root-of-knee-pain-for-runners

 

For those interested in training their hips here are a slew of exercise programs (click on the links):

 

1. Patellofemoral pain treatment

2. Neuromuscular control of hip and knee function

3. Hip airplanes

4. Side Bridge variations - the best exercise to work the gluteus medius

One of my favorites is below.  The one leg squat with leg raise.  Most Toronto Physiotherapy places advise that you do the clamshell or side lying leg raise.  The problem (click here for a detailed review) is that the exercises only work the hip stabilizing muscles about 40% of their max.  This is not enough.  Muscles get stronger when you stress them. Unless you just had a hip replacement forget about these remedial exercises - unless maybe you truly are super weak here, then  you need them.

 

Otherwise, train harder.  You are an athlete and a runner.

 

 

 

 

 

 

 

 

 

Have fun,

 

Your Toronto Physiotherapy snob,

 

Greg Lehman

Shoulder Rehabilitation: Minimizing the Upper Trapezius to Serratus Anterior Ratio

by Greg Lehman
Categories: exercise pictures, shoulder dysfunction
Tags: , ,
Comments: 3 Comments
Published on: January 25, 2021

Audience: Therapists

Pushup plus protracted

Purpose: I like the idea of quantifying the “dosage” of an exercise.  We can do this with EMG and this post will be part of a larger theme that catalogues the EMG amplitude of various shoulder rehabilitation exercises.  Further, it will also try to justify a number of exercises for their ability to avoid negative loading on the shoulder and promote a possibly optimal way of working the shoulder.

Caveat:  This review only looks at a few papers addressing the Upper Traps (UT) to Serratus Anterior (SA) ratio.  Other exercises must obviously be incorporated into a rehab program.

Exercises to maximize the Serratus Anterior (SA) to Upper Trapezius (UT) Ratio

To simplify: SA = good, UT = bad.  Basically, activation of the SA moves the scapula out of the way of the humerus while too much or too early activation of the UT tends to

pushup plus retracted

anteriorly tilt the scapula and decrease the space for humeral movement.  Ann Cools has done extensive work in this area.  Here is a taste of her findings and recommendations.  You may want to consider using the exercises when you have a little scapular dyskinesis on your hands - you may see some medial border prominence of the scap, some winging during arm elevation and the scap can get a little jiggy with arm raising and lowering. (more…)

Hip Airplane Exercise Pictures

by Greg Lehman
Categories: exercise pictures
Tags: No Tags
Comments: No Comments
Published on: January 22, 2021

Purpose: I have found it difficult to find unlicensed exercise pictures of certain exercises.  One of the goals of this blog is to share exercise pictures with anyone that would like to use them.  Most pictures are in jpeg format so they can be inserted into documents that you create.  Below are pictures of a hard to find exercise - The Hip Airplane.  This exercise is ideal for training balance, a strong foot, posterior chain muscles and when you drop and rise from the open to shut position the hip external rotators (or is the piriformis now an internal rotator because of the hip flexion - I do not know), glut max/min/med.

All the best,

Greg Lehman, Physiotherapist/Chiropractor

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