Below are Tensioner videos for your irritated and sensitive peripheral nerves.
Warning: please only do this if your knowledgeable health care provider has taught these and specifically said that you should do these exercises.
Gentler “Slider” movements can be seen at a previous post here: Slider Videos
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.
Below are a number of exercises that are typically called stability exercises. While this might be true they are really movements to me. These movements can make you stronger, can calm down your pissed off nervous system and can increase your capacity to withstand stress. We typically say that they increase your stability but I think it is more complicated. They are many reasons to do these exercises and if you are unsure please ask. The body is smarter than we are. If our spine could talk I bet it would be pretty condescending discussing how we try to explain its function.
Audience: Patients
Purpose: Exercise videos for patients wishing to train their trunk and hips
This article is just a video series for runners to do some basic strength work. Stop worrying about the core. Just get strong during all movements. We try to build capacity to withstand load. We might also improve running efficiency with strength work. There could probably be thirty different exercises below. This is not a program just a few suggestions for what can be easily done. You will notice that there are no exercises that are specifically “core” exercises. I am of the opinion that this is over rated for running and that any benefits to training the core can be gleaned from the appropriate choice of compound exercises. (more…)
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.
Audience: Runners and therapists
Purpose: A reference to compare running technique
Limitations: Many of us assume that there is one right and better way to run. Deviations from that ideal are assumed to lead to injuries and decreased economy. This is still a debatable concept. Everything I write can be questioned so please do so.
Below is a video of Nicole Stevenson (www.nicolestevenson.com). Nicole is Canada’s former number 1 in the Marathon with a personal best below 2:33. Nicole is also a running coach
I wanted to highlight some probably beneficial components of her running gait. Future posts will look a deviations from this gait and how they might relate to injury. (more…)
Audience: Patients
Purpose: to provide some information about the pain experience
Why?: Understanding pain can help modify it
I don’t pretend to understand everything about pain. It is incredible complex and what we know is certainly involving. However, there is a lot of misinformation out there even from people that should know better. This article will link to a number of information sites that help explain pain. This is important because it helps you understand why things hurt. Understanding why something hurts can decrease pain but can also help you function better. Some basic concepts:
1. Pain is a perception. Signals (e.g. nociception or even pressure) come from the body and the brain creates an output that we perceive as pain. Ever heard of a soldier being shot and not feeling any pain until they were safe and out of harms way? If pain was some absolute thing that the brain has no choice to recognize than you would have no way but to feel pain any time a tissue was injured. We’ve all heard stories of people being injured but feeling nothing.
2. Your body does not have to be injured to feel pain. In fact you can lose a limb and later feel pain in that limb that no longer exists.
3. Tissue injuries (e.g. disc bulges, rotator cuff tears, tendinopathy) do not have to hurt. The body can have lots of so called “dysfunction” but this does not mean that you will feel pain. For example, 50% of people over fifty may have a rotator cuff tear but they experience no pain.
4. Emotions, beliefs, stress, past experiences etc can influence the pain that you feel. Pain is more than a punch in the arm.
5. The perception of pain can move around in your body and this does not mean that you are crazy. This is a normal finding when we experience persistent pain.
6. Pain changes how we move and how we function. Movement is often the key to resolving pain.
There is so much more than this but I will let the resources below provide better information.
Books
1. The sensitive nervous system (D Butler): a great academic reference
2. Explain Pain (Butler and Moseley): a patient’s guide to pain
3. Painful Yarns: stories from people with pain
Websites
1. Neurotopian: Pain for Dummies a great site, you can read this an ignore everything I say.
Youtube
1. Persistent pain described with pictures
2. Lorimer Moseley: Tedx Talks
All the best,
Greg
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