The Upper Body Exercise to Stop Right Now

Injury, Pain, Uncategorized

In the history of weight training there have been numerous examples of exercises that are fantastic: the squat, deadlift, lunge, pull-up, push-up. However, there are also exercises that make any anatomical professional cringe to the point of white-knuckling. Here are some examples:

I mean, really there is no explanation needed.

I mean, really there is no explanation needed.

Isolation:  Yes, from everyone around you who can't stand listening to your knees crack

Isolation: Yes, from everyone around you who can’t stand listening to your knees crack

Just, no.

Just, no.

The exercise I want you to throw away today, forever…no I mean it, FOREVER is the upright row.

The anatomy is simple:  The exercise is designed to target the traps.  However, to get the traps you have to put yourself into the position of shoulder impingement and the repetitive position that can lead to tennis elbow.

 

Yep, that's the one

Yep, that’s the one

elbow

 

With each of these exercises I know the argument:  “It isolates blah, blah, blah muscle.”  Well, the upright row isolates alright, it isolates the supraspinatus rotator cuff tendon right up under the acromion.  The only pump you’ll get from this exercise is a pump of corticosteroid the ortho doc will be giving you, unless surgery is the better option:

 

 

So, please….don’t do this exercise.  Your body will thank you.

Is the SI Joint Overrated or Underated?

Uncategorized

One of the more controversial areas in the body is the sacroiliac joint. This area has either been identified as the key to back/lower extremity pain or called a non-factor. The literature points to a lack of specificity and sensitivity in diagnosing, treatment is mostly anecdotal, and the therapists who dare “treat” it are frauds.

However, did we throw the baby out with the bath water? Clinically, is there a correlation with symptom complaints, objective limitations, and the SI joint? In an attempt to “legitimize” our profession we have begun to scrutinize by yelling at the top of our lungs about the lack of research.

The question I ask is simple: Why do clients have unilateral pain at the SI area? Why does it limit their SLR? Why does an audible cavitation occur with a resisted hip adduction? Finally, why does this cavitation very often reduce the complaints of pain in the area?

80/20 Examination: Getting all of your objective information in just one movement

Uncategorized

If you chose one movement to give you the most information about a client what would it be?

Tim Ferriss advocates the 80/20 concept in his New York Times Bestseller books like The Four-Hour Work Week. The 80/20 concept is all about value. Can I get a large return in value from a small investment in time? While as therapists we crave time to find movement patterns to address, we don’t always have the time we desire. In the changing world of reimbursement (Sorry, Jerry Durham) payment where pay for performance is king, treatment resulting in change will be paramount to an extensive examination.  Therefore, it is important to gather as much information as possible in the least amount of movements.

Enter the ground up squat:

Now, the only change is that you would try without the stick first.  However, you get ankle, knee, shoulder, lumbar, thoracic, and cervical ROM.  You also get trunk stability, shoulder stability overhead, and both upper and lower extremity stability.

Pretty big bang for your buck.

Top 5, or Maybe 3 Best Physical Therapy Moments on TV/Movies

Uncategorized

Here is the follow-up to the Top 5 Worst Physical Therapy Moments on TV/Movies!

As you’ll see, I could only find 3 really positive TV/Movie moments that do not set our profession back.  We talk about “brand” all the time….this is at least part of the problem.

 

#3. Regarding Henry – Bradley

I told you he would be on both lists.  Whatever you think of his techniques (they certainly are not evidenced-based), he showed empathy and promoted functional improvement.

 

#2 -Tourniquet Training – Johnny Owens

Leave it to the Army to do something this cool.  It will be fun to watch this technique play out.  I don’t know that it will have much indication in most civilian therapy clinics, but it is interesting.

http://espn.go.com/nfl/story/_/id/11858977/tourniquet-training-change-way-athletes-recover-injuries

#1.  Kobe’s Secret Weapon – Jody Seto

A great story about PTs presence in sports and the ability to keep someone as demanding as Kobe at the top of his game for as long as he could be.

http://espn.go.com/video/clip?id=10873110

Top 5 Worst Physical Therapy Moments in TV/Movies

Uncategorized

Although not well represented, Physical Therapy has had its place in pop culture.  Generally, PTs are in the background watching someone exercise or walking with them, but a few exceptions show the compassion and excellence that PT can provide.  However, there are some funny moments that probably set our profession back a decade. Here are 5 of the worst offending moments:

Honorable Mention:  Mike Reinold & Erson Religioso Too Funny.

 

Drum Roll, Please

 

#5.  Seinfeld – “It Moved”

Although, technically a massage therapy moment, it did happen in the confines of a PT practice.  A funny look at how uncomfortable it can be and the need for proper communication.

#4.  Regarding Henry – Bradley

Bradley is a tough one, because he may be included on the top 5 best also.  However, walking through the hall saying “I got to get me some of that” about nurses is probably a bad representation.

#3  Hard to Kill – Danny

I mean, come on…Gut from Stone Cold ?  First, a fanny pack?  Second, “I’m going to make you feel alright?”  Yikes, I am sure the folks at somasimple cringe at that.  The worst part:  Not listening to your patient, throw subjective report right out the window.  Lesson to any therapist: listen to your patient, and you may not be shot by goons of corrupt politicians.  “You can take that to the bank.” Sorry for the language

#2 – Seinfeld Again – Delicate Genius

$150 for a missed appointment….man those were the good ol’ days.  “No one can disturb the delicate genius”  Seinfeld put PT in the popular culture….but not the best type.  “You do have insurance don’t you?”

#1 (With a Bullet) – According to Jim – Physical Therapy

I don’t think I need to explain.

 

Stay tuned for the Top 5 Best Physical Therapy Moments in TV/Movies