PrehabFitness.TV
PrehabFitness.TV
An inside look to Mark Munoz's injury
In the video linked below, Mark states he will probably be out of the octagon until June 2012. Quite often in the sport of MMA, the elbow will have accumulated trauma from the contstant pounding to the joint from punches and strikes with the elbow. This not designed to be a consistent weight- bearing or impact joint. Therefore, constant forces to the area will eventually wear it down. Bone chips often break off into the joint space and impact the normal joint movement. 
This can become painful, and if not addressed, create even more damage to the joint itself.
So why the "long" wait to returning to the octagon? Anytime there is an injury to a joint, muscles shut down and strength and stability to the whole limb is lost. Having surgery to "fix" the problem actually creates another new injury to the site. There is soft tissue damage from the scalpel and arhtroscopic tools and often new tissue damage from scraping bone spurs away and smoothing out the joint surface.
Rehabilitation will first consist of restoring normal range of motion to the joint and decreasing swe
lling. As the pain subsides, then gentle strengthening can begin. Soft tissue healing for a normal, healthy adult takes 6-8 weeks regardless of what physical shape you are in. Scar tissue must be formed and stretched appropriately. As much as we humans would like to think we can decrease this time frame, it cannot be changed with any drug or modality.
Because of the multifaceted nature of MMA, total shoulder, core and arm strength must be addressed. Pain from the initial injury and surgery will limit how much the surrounding muscles turn on due to an immediately disruption of the brain's connection to the injured site. It is our natural way of protecting the injured site. Normal muscle response to training takes 6-8 weeks before the muscles fibers actually change and growth is seen. Any increase in strength before that time is cause by an improved connection from the brain to the muscles exercised, not from muscle growth itself.
Due to a high stiffening rate with elbow injuries, normal pain free movement can take up to 2-3 months, if not longer. Then you have to add time onto that for the high intensity full body training required for an octagon fight. Many times it takes up to 8-12 months to feel 100% and, therefore, while June may seem far away, for a fighter of this caliber, it is the necessary minimal time for healing and proper preparation.
As for the question as to whether this will drop him down in the rankings, well that is completely up to how well he rehabilitates and trains in preparation for his next fight. If history tells us anything about the future, I think the fans will not be dissapointed.
http://www.mmamania.com/2012/1/24/2729831/ufc-mark-munoz-surgery-rehab-video-inside-mma
This can become painful, and if not addressed, create even more damage to the joint itself.So why the "long" wait to returning to the octagon? Anytime there is an injury to a joint, muscles shut down and strength and stability to the whole limb is lost. Having surgery to "fix" the problem actually creates another new injury to the site. There is soft tissue damage from the scalpel and arhtroscopic tools and often new tissue damage from scraping bone spurs away and smoothing out the joint surface.
Rehabilitation will first consist of restoring normal range of motion to the joint and decreasing swe
lling. As the pain subsides, then gentle strengthening can begin. Soft tissue healing for a normal, healthy adult takes 6-8 weeks regardless of what physical shape you are in. Scar tissue must be formed and stretched appropriately. As much as we humans would like to think we can decrease this time frame, it cannot be changed with any drug or modality.Because of the multifaceted nature of MMA, total shoulder, core and arm strength must be addressed. Pain from the initial injury and surgery will limit how much the surrounding muscles turn on due to an immediately disruption of the brain's connection to the injured site. It is our natural way of protecting the injured site. Normal muscle response to training takes 6-8 weeks before the muscles fibers actually change and growth is seen. Any increase in strength before that time is cause by an improved connection from the brain to the muscles exercised, not from muscle growth itself.
Due to a high stiffening rate with elbow injuries, normal pain free movement can take up to 2-3 months, if not longer. Then you have to add time onto that for the high intensity full body training required for an octagon fight. Many times it takes up to 8-12 months to feel 100% and, therefore, while June may seem far away, for a fighter of this caliber, it is the necessary minimal time for healing and proper preparation.
As for the question as to whether this will drop him down in the rankings, well that is completely up to how well he rehabilitates and trains in preparation for his next fight. If history tells us anything about the future, I think the fans will not be dissapointed.
http://www.mmamania.com/2012/1/24/2729831/ufc-mark-munoz-surgery-rehab-video-inside-mma
Knee Pain- An Easy Fix
Which knee has pain?
A. 
B. 
The answer is BOTH! This is a picture of a woman in her sixties that came in with the complaint of right knee pain and swelling for the past year! But, as the evaluation continued she admitted the left knee had pain as well. It is easy to see from the pictures that her squat postion is extremely poor. In both pictures her knee caves inward in relation to her hip, which indicates foot and hip weakness. In photo A, her foot is turned out which also indicates a tight calf.
This knee position during a squat or landing from a jump is termed dynamic valgus. I see this in 90% of my knee pain patients. Dynamic valgus is also one of the leading causes of ACL tears. As you can see from the pictures above, over time it causes uneven wear on the back of the patella (kneecap) and strain on the medial (inside) ligaments of the knee. While the photo above demonstrates a woman in her sixties, I am seeing dynamic valgus in children as young as 6-8.
How do we fix this? While many people try and treat the problem with strengthening the thigh, the real answer lies above and below the knee in the foot and the hip. Asssigning core, hip and foot strengthening exercises is key. Teaching the proper squat position is also essential to decreasing stress on the joint.
Subscribe to this blog and check out my post in 6 weeks for an updated picture and post of how this patient is doing.
Youth Sports Injury Education
Youth and parental education on sports injuries and injury prevention is imperative in this day and age. There has been an explosion of year round youth sports and this has come with a huge price tag. The amount of youth sports injuries is on the rise and many of these injuries are non-contact and overuse in nature and, therefore, 100% avoidable. If you are a coach or a parent, seek out professionals in the area of sports medicine and strength and conditioning. Many of these individuals will put on a free seminar for the team or coaches and share their expertise. At Breakthrough Physical Therapy we offer free AIR (Athletic Injury Risk) screens for any young athlete that is interested. As therapists, we feel it is our job to help prevent some of the injuries that occur in youth sports and decrease a child's or adolescent's risk of missing out on a season or worse having surgery. If you are a professional, reach out to the community and offer your knowledge. Together, we can drastically decrease the amount of youth injuries.
Live in Orange County, CA? Check us out at www.breakthroughphysicaltherapy.com.
Live in Orange County, CA? Check us out at www.breakthroughphysicaltherapy.com.
The Dynamic Warm up = Improved Lower Body Explosiveness
The study:
New research looked at the comparison of the dynamic warm-up vs stretching and vs no warm-up. The dynamic warm-up is special because it uses active motion and momentum rather than stagnant, static positions. The subjects used in this study were a small group of 25 collegiate baseball players from a Midwestern University. The players were asked to do 2 weeks of dynamic warm-up (listed below), 2 weeks of static stretching (listed below) and no warm-up. The same group of players performed all three of the different warm up protocols over a total of 7 weeks once a week on a Wednesday. Each week they performed a different warm-up requirement, with week 4 being a rest week, and cycling through the three warm-up/no warm-up requirements twice. After the warm-up or no warm-up requirement was performed the subjects were asked to perform a standing vertical jump and standing long jump.
Dynamic Warm-up-
Forward lunge with forearm to opposite instep, backward lunge with rotation, inchworm, knee to chest, toe touch, straight leg march, straight leg march with skipping, lateral shuffle with countermovement (arms), lateral leg swings, straight leg swings, hip rockers, reverse hip rockers, inverted hamstring, lunge fast, carioca short, carioca long, falling starts, backpedal with a turn, and backpedal with two turns.
Static Stretch-
Static hamstring stretch (right, middle, left), standing quadriceps stretch (right and left), calf stretch (right and left), squatting butterfly stretch, straddle stretch to right, middle and left, deep lunge to right and left, sitting butterfly stretch, sitting figure 4 stretch, pririformis stretch to the right and left, and lying quadriceps stretch to the right and left.
The results:
Dynamic warm-up increased leg power as seen by the top vertical and long jump scores. The interesting finding was that the static stretching weeks were their worst performing weeks. While no warm-up prior to activity is not suggested it yielded better results than the static stretching group! This suggests that static stretching decreases performance which is why it should be done at the end of a work out or sporting event.
The conclusion:
Since the muscles used to perform the vertical and standing long jump are the same as those used in sprinting, one can assume that sprint times would be affected in the same way. Future studies are needed to support this theory as well as look at warm ups where static and dynamic stretching are combined. For now the dynamic warm up continues to be the best way to get ready for a sporting event or practice.
Reference
"Effects of Dynamic Warm up on Lower Body Explosiveness Among Collegiate Baseball Players", Travis L Franz and Matthew D. Ruiz; Journ of Strength and Cond Res; 25(11):2985-2990
Injury vs. Soreness
After speaking in front of the California Yard Dawgs (a youth baseball organization in Orange County) for Breakthrough Physical Therapy a couple of weeks ago, I was struck by one question..."Can you tell my players how to know when they are sore vs injured?"
This question is so overlooked when it comes to the strength and conditioning world. Understanding the concept is so simple, yet so vital to avoiding what may be a simple sprain or strain turning into a tear or fracture. So here a a few simple guidelines I suggest people should follow...
1. What is the type and level of pain?
Is the pain radiating, burning or sharp? A sore muscle isn't any of these things A sore muscle is usually tight and hurts at a 5/10 pain level or less when activated. A sore muscle decreases in pain after warming up and doesn't return until you cool down, usually at a decreasd pain level. A sprain or strain that needs to be treated is usually worse with activity or it decreases intitially with warm up and increases with fatigue at the end of a workout. If the pain radiates or is sharp, that is much more than just a simple muscle pain from a previous work outand needs to be addressed immediately.
2. Where is the pain located?
General muscle soreness is usually located in the muscle belly, not near the tendon/joint region. Pain near the joints should always be given more attention. Often they dpo not go away on their own.
3. Does the pain limit or decrease your activity?
When performance decreases from the pain the it is time to rest and/or have the area checked by a medical professional. Muscle pain from a previous workout may make you feel tired and a little weaker, but it shouldn't make you limp or inhibit your ability to throw a ball once warmed up.
4. How long does the pain persist?
Muscle soreness does not last more than a couple of days, therefore, if the pain worsens with each activity and doesn't decrease after two days then you should consider having a medical professional or athletic trainer take a look.
Working through these symptoms can be devastating. Choosing to ignore the symptoms can turn a mild irritation into a severe tendonitis or worse stress fracture or tear. Many who ignore the warning signs end up in my office and are deflated when they hear the healing time required for their injuries. Their choices turned required rest for a week into limited activity for months. Don't let this be you or your players/ clients. Educate them on the warning signs and their severe injury rate will surely decline.
This question is so overlooked when it comes to the strength and conditioning world. Understanding the concept is so simple, yet so vital to avoiding what may be a simple sprain or strain turning into a tear or fracture. So here a a few simple guidelines I suggest people should follow...
1. What is the type and level of pain?
Is the pain radiating, burning or sharp? A sore muscle isn't any of these things A sore muscle is usually tight and hurts at a 5/10 pain level or less when activated. A sore muscle decreases in pain after warming up and doesn't return until you cool down, usually at a decreasd pain level. A sprain or strain that needs to be treated is usually worse with activity or it decreases intitially with warm up and increases with fatigue at the end of a workout. If the pain radiates or is sharp, that is much more than just a simple muscle pain from a previous work outand needs to be addressed immediately.
2. Where is the pain located?
General muscle soreness is usually located in the muscle belly, not near the tendon/joint region. Pain near the joints should always be given more attention. Often they dpo not go away on their own.
3. Does the pain limit or decrease your activity?
When performance decreases from the pain the it is time to rest and/or have the area checked by a medical professional. Muscle pain from a previous workout may make you feel tired and a little weaker, but it shouldn't make you limp or inhibit your ability to throw a ball once warmed up.
4. How long does the pain persist?
Muscle soreness does not last more than a couple of days, therefore, if the pain worsens with each activity and doesn't decrease after two days then you should consider having a medical professional or athletic trainer take a look.
Working through these symptoms can be devastating. Choosing to ignore the symptoms can turn a mild irritation into a severe tendonitis or worse stress fracture or tear. Many who ignore the warning signs end up in my office and are deflated when they hear the healing time required for their injuries. Their choices turned required rest for a week into limited activity for months. Don't let this be you or your players/ clients. Educate them on the warning signs and their severe injury rate will surely decline.
The Dynamic Warm up- Decrease ACL tears by 70%
Despite all of the scientific research on ACL prevention, I am concerned that I still see teams warm up with jogging around the soccer field and then sitting down to stretch. By practicing switching to a dynamic warm up such as the 11+ on Fifa's website, noncontact ACL tears can be decreased by a whopping 70%. This type of information should be applied towards all sports and the static stretching should be sidelined until after the activity is finished. Check out the link below and a FREE downloadable form is available.
All players should be receiving a thorough medical screen prior to participating in their sport. At Breakthrough Physical Therapy in Orange County, CA we offer a FREE Athletic Injury Risk screen to anybody participating in sports. This includes functional position, strength and ROM testing. go to www.breakthroughphysicaltherapy to contact us. We have found even the highest level athletes have weaknesses that put them at risk for injury.
Take action, create a dynamic warm up or seek a professional that can create one for you that promotes flexibility and motor coordination in your athletes and the injury rate of your players is bound to decrease!
http://www.fifa.com/aboutfifa/footballdevelopment/medical/playershealth/the11/index.html
All players should be receiving a thorough medical screen prior to participating in their sport. At Breakthrough Physical Therapy in Orange County, CA we offer a FREE Athletic Injury Risk screen to anybody participating in sports. This includes functional position, strength and ROM testing. go to www.breakthroughphysicaltherapy to contact us. We have found even the highest level athletes have weaknesses that put them at risk for injury.
Take action, create a dynamic warm up or seek a professional that can create one for you that promotes flexibility and motor coordination in your athletes and the injury rate of your players is bound to decrease!
http://www.fifa.com/aboutfifa/footballdevelopment/medical/playershealth/the11/index.html
Muscle hypertrophy
When increased muscle hypertrophy (size) is the training goal, perform moderate-intensity sets with short rest intervals of 30-60 seconds in between to maximize acute growth hormone levels.
Core stabilization decreases lactic acid
Performing core stabilization exercises within 5 minutes of finishing high-intensity exercise has been shown to enhance lactate clearance! That means decreased muscle cramps!
Hip weakness associated with knee pain
Research continues to prove that individuals with patellofemoral pain usually have associated hip weakness. It is so important to train the muscles surrounding the hip in conjunction with the thigh. If you focus solely on the VMO you will totally mistreat the problem.
Top 4 Shoulder Exercises
The top 4 shoulder exercises that maximize shoulder stabilization are:
1. Seated Row
2. Seated Press
3. Push up with a plus
4. Full can
Check out my website in the future for pictures of these exercises.
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