Independent Function
description
Transcript of Independent Function
The L.A. Sports & Spine Philosophy
Craig Liebenson, D.C.
www.lasportsandspine.com
(310) 470-2909
OUR PHILOSOPHY
• Finding the Source of Your Pain
• Functional Goals of Care
• Modern Approach to Fitness
• Functional Approach - Biomechanics
• What You Can Expect at L.A.S.S.
FINDING THE SOURCE OF YOUR PAIN
Injury
Repetitive Strain
Genetics/Anatomy
Injuries/TraumaRepetitive Strain/
Overuse
What leads to pain?
Repetitive Strain/Overuse
• If your ACTIVITY DEMANDS exceed your FUNCTIONAL CAPACITY this will cause repetitive strain
• Any GAP between your DEMANDS & CAPACITY must be erased by postural advice & core-stability training in order to address your “weak link”
Site vs Source of Pain
Site• Pain Generator• Structure
Source• Factors responsible for
pain• Overactivity• Poor posture• “Weak link”
Guarding after an injury is normal
• “after an injury tissues heal, but muscles learn, they readily develop habits of guarding that outlast the injury”
Janet Travell, MD
White House Physician,
President John F Kennedy
Hardware vs Software
Hardware• Orthopedic problem• Structural problem• Injury or Degeneration• Inflammatory
Software• Rehabilitation problem• Functional problem• Postural • Mechanical
Corrupted Motor Program
Pain/Injury orRepetitive Strain
Corrupted Program“emergency brake”
Disability -Activity Tolerance
The Corrupted Program:
• Faulty movement patterns
• Poor biomechanics
• Is a protective reaction to pain or injury
• Is memorized as a new motor program & becomes a habit!
Corrupted Motor Program - altered biomechanics
•
• Poor posture • Faulty movement patterns
GOALS OF CARE
Improve your biomechanics!• Postural Correction• Core Activation• Breathing Re-education & Flexibility Training• Independent Functioning
Goal: Correct your Posture• Poor posture strains your
joints and overloads your muscles
• Correcting your posture re-aligns you
• Correcting your posture is the first step in injury prevention, recovery & performance enhancement
Goal: Correct your PostureA Posture Test
• Can you reach your arms overhead so that the back of your hands touch the wall?
• Can you do this without your back arching away from the wall?
• Can you flatten your back?
• Is it painful?
Goal: Activate your core
• Your core muscles give you support & stability
• They help you prevent injury
• They aid your recovery & rehab
• And, they enhance your performance
Your core provides you with a 360º ring of support
Goal: Activate your core
A Core Test• Perform a plank• With only your toes &
forearms on the floor• Can you hold this position for
60 seconds?• Try a front plank• Try side planks• Is it painful?
Husk vs Core
Husk/Shell• Outer Superficial Muscles
(e.g. shoulder shruggers, chin pokers, jaw clenchers)
• Compensate• Guard/Protect• Emergency Brake• Limit Mobility• Increase
Stress/Tension/Pain
Deep Core• Inner Muscles (e.g.
shoulder depressors, pelvic floor, gluteals)
• Stabilize you• Guide movement
Goal: Re-educate Breathing
• Breathing with your chest & shoulders in a vertical direction is a common error ’es shoulder/neck
tension– Disables the core
Standing or Sitting Breathing Test
• When you breathe in do your shoulders rise up
• Ideally you would breathe horizontally not vertically
Goal: Re-educate Breathing
A Breathing Test:• Lie on your back &
see if when you breathe in your abdomen or chest rises more
• Ideally, your abdomen would rise more
Goal: Flexibility training• Tight muscles lead to muscle
imbalances & poorly compensated movement patterns
• If you have good flexibility then you can maintain an upright posture during normal activities such as:– Standing– Squats– Lunges
Goal: Flexibility trainingA Flexibility Test:
• Perform a squat
• Can you keep your chest arched up in front?
• Can you keep your head over your knees?
• Can you prevent your knees from passing in front of your toes?
Goal: Flexibility trainingA Flexibility Test (cont’d):
• Can you prevent your knees from collapsing inwards?
Goal: Flexibility trainingA Flexibility Test:
• Perform a kneeling lunge• Can you reach overhead with
your arms so they are vertical?
• Can you lean forward in your hip without your knee pressing forward of your knee?
• Can you feel the stretch in the front of your hip on the back leg?
INDEPENDENT
SEMI-SUPERVISED
SUPERVISED
Goal: Independent Functioning
• Our goal is to help you return to your activities as soon as possible
• We will guide you through this process
FITNESS FACTORS
Traditional• Strength• Flexibility• Cardio-vascular
Functional• Agility• Balance• Coordination• Speed• Endurance• Relaxation
Which is the athlete?
Bodybuilding (cosmetics) vs. Athletics
QuickTime™ and aTIFF (Uncompressed) decompressor
are needed to see this picture.
Big & Strong Quick & Powerful
COORDINATION
BALANCE
AGILITY
FUNdamental ABC’s of Fitness
Aristotle
• “Practice doesn’t make perfect, it makes permanent”
• Quality NOT Quantity is our goal
YOGA
TAI CHIPILATES
Core Fitness Philosophies
Functional Approach - Biomechanics
• Holistic approach
• Patient-centered care
• Return you to your recreational, home & work activities as soon & safely as possible
• Identify & train your “weak link”
Functional Approach - Biomechanics
Legs and FeetLegs and Feet
ScapulaScapula
Arm and ShoulderArm and Shoulder
Thoracic and LumbarThoracic and LumbarSpineSpine
Hips and PelvisHips and Pelvis
Faulty Biomechanical Movement Pattern - Running
Faulty Biomechanical Movement Pattern - Stepping
Faulty Biomechanical Movement Pattern - Reaching
• Ideal arm raising w/ shoulder relaxed
• Poor pattern due to shrugging the shoulder up
You will learn the ATHLETIC POSTURE
• Chin in• Chest up• Shoulders relaxed• Knees over toes• This posture protects
you against injury & enhances athletic performance
WHAT YOU CAN EXPECT
• Orthopedic & Functional Evaluation
• Individualized Self-Care Prescription
• Collaberation with MDs, Trainers, etc.
Evaluation
Orthopedic• Initial• Rule out Serious or
Sinister problem requiring medical/surgical intervention
Functional• After Ortho
assessment• Biomechanical
Predisposing or Perpetuating factors
Roadmap of Care - Your 1st Visit
• Orthopedic Dx – site of pain
• Functional Dx – source of pain
• Map of Problem – What makes you hurt
• Goal: find the Compass – Customize your program.
• Simple, light exercise to nourish tissue
Phase One of Care• PHASE 1 – Approx 1 month - 3X/week• GOAL: Increase Function/Reduce Pain/Increase
Activities
• SUCCESS: 80% of people are 50-80% improved
Phase Two of Care
• 1:1 Preventive & Functional Training
• Soft Tissue Work
• Diminishing frequency
• More self-care
• Return to activities
Synergy• MD – Medication/Tests• ORTHO – Medication/Tests/Injections/Surgery• ACUPUNCTURE• PSYCHOLOGICAL COUNSELING - Relaxation• OTHER – Massage/Personal Training• LASS – Physical therapy, manual therapy, fitness
training, soft tissue work, nutrition-supplements
What You Will Learn on Day 1
• Site of pain– Where it is coming from
• Source or cause of your problem– Why it happened
• What will we do
• What you should avoid
• What you can do• Prognosis/forecast
Dr Liebenson works with premier elite athletes
• Kobe Bryant, Sam Cassell, Corey Magette - NBA• Jayson Werth, Troy Glaus, Eric Byrnes - MLB• Christian van de Velde - Tour de France• Nathan Ramsey - Motocross• Julia Mancuso - Olympic Gold Medal Skier • Tara Dakidas - Snowboarder• Scott Walchek - Triathlete• Team Chiropractor - NBA, L.A. Clippers• Consultant - MLB, Arizona Diamondbacks• Chiropractor - Athlete’s Performance International