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This entry was posted in Ankle, Fitness Training, Hip, Injury prevention, Knee, Low-Back, Resistance Training, Weight Training and tagged kinematics, kinetics, Knee, low back, mechanics, Olympic lift, shear force, shin angle, Squat, squat depth, Weight training on January 27, 2016 by Joshua Stone. AMI is a neuromuscular dysfunction that limits the ability to strengthen muscle and is common following ACL surgery.
Vibration training employs a low-amplitude, low-frequency mechanical stimulation that exercises musculoskeletal structures.
A recent article by UNC’s EXSS Impact site found that vibration training (local or whole-body) improves quadriceps function by improving central nervous system function. Individuals with anterior cruciate ligament (ACL) injuries are at greater risk of developing osteoarthritis (OA). Given the implication for future OA development, the restoration of proper quadriceps function is extremely important in rehabilitation. Previous work in our laboratory indicates that muscle vibration provided directly (local muscle vibration – LMV) and indirectly (whole body vibration – WBV) may improve quadriceps function. We found that both WBV and LMV acutely improved quadriceps function (strength and activation) relative to the control treatment, and that this improvement was likely due to greater cortical neuron excitability. These findings indicate that vibratory stimuli acutely improve quadriceps function, and could be useful in addressing deficits in central nervous system function such as AMI. A comprehensive rehabilitation program is vital for an athlete’s return to competitive sport. This entry was posted in Injury prevention, Knee, Neurological, Rehabilitation, Sports Medicine, Sports Performance and tagged ACL, AMI, Anterior Cruciate Ligament, Arthrogenic muscle inhibition, CNS, knee osteoarthritis, mechanobiology, OA, Power Plate, vibration training on April 13, 2015 by Joshua Stone. Ask any client I have trained, and they will tell you that I will destroy your glutes – in a good way. This entry was posted in Fitness Training, Injury prevention, Rehabilitation, Resistance Training, Weight Training and tagged core stability, exercise, fitness, glute exercise, glutes, gluteus maximus, gluteus medius, Injury Prevention, posterior chain, resistance training, Weight training on March 28, 2015 by Joshua Stone. This entry was posted in Injury prevention, Rehabilitation, Sports Medicine and tagged Anti-inflammatory, Cryotherapy, Ice, icing, mechanobiology, mechanotransduction, NSAIDs on February 8, 2015 by Joshua Stone.
Runners are a very particular type of athlete and will try almost anything to run longer, faster, and remain injury free. MYTH: A study done a few years ago demonstrated static stretching reduced power output and performance. MYTH: Foam rolling or self myofascial release is one of the most effective tools to improve motion and prevent muscle injury. MYTH: Inflammation is REQUIRED for the body to bring supplies to worked areas, clean up any debris and help rebuild tissue. MYTH: It’s long been held as fact that losing more than 2 percent of bodyweight to dehydration will hurt performance.
FACT: But don’t be fooled: Energy chews do work to prevent fatigue during long distance running events, but so do raisins! MYTH: While bananas are a great source of nutrition and do contain many electrolyte replacing nutrients, they alone do not prevent cramping. FACT: Running strengthens your muscles, but it only strengthens certain muscle fibers to a certain degree. FACT: There are many things that can cause injury, but one of the biggest determinants of injury is doing too much too fast. If you are a runner and look to increase performance or prevent injury, please feel free to contact me for a free consultation. This entry was posted in Fitness Training, Injury prevention, Mechanics, Running, Sports Medicine, Sports Performance and tagged barefoot running, dehydration, distance running, high arch, hydration, low arch, marathon, minimalist shoe, running, shin splints, shoe type on January 11, 2015 by Joshua Stone.
In time everything we do to treat injuries, prevent disease, or reverse disease will eventually change. This entry was posted in Injury prevention, Nutrition, Rehabilitation, Sports Medicine and tagged DNA, epigenetics, genes, genetics, injury, nutragenetics, nutragenomics on January 8, 2015 by Joshua Stone.
This entry was posted in Fitness Training, Injury prevention, Rehabilitation, Running, Sports Medicine and tagged distance running, injury, Marathon training, running, running injury, shin splints, tendonitis on January 4, 2015 by Joshua Stone. When you think of the most common lower body injuries, you think ankle sprains, shin splints, runner’s knee, jumper’s knee, fasciitis, or Achilles tendinitis. Normal range of motion of the big toe is 40° flexion, 80-90° extension, and 10-20° abduction and adduction.
This entry was posted in Injury prevention, Low-Back, Rehabilitation, Running, Sports Medicine and tagged Achilles tendinopathy, arthritis, dysfunction, hallux, jumper's knee, knee pain, mechanics, Range of Motion, runners knee, running mechanics on November 12, 2014 by Joshua Stone.
An athletic trainer working a Division 1 women’s volleyball tournament with elite Top-25 teams sent me a text: “You should do a study on the average number of ice bags used by volleyball teams after a match… Entire teams are getting ice on both knees and the hitting shoulder. This entry was posted in Injury prevention, Rehabilitation, Research Review, Sports Medicine and tagged Cryotherapy, Ice, jumper's knee, load, mechanotransduction, patellar tendon, tendinopathy on September 20, 2014 by Joshua Stone. This entry was posted in Hamstring, Hip, Injury prevention, Knee, Low-Back, Manual Therapy, Mechanics, Rehabilitation, Sports Medicine and tagged Anatomy trains, dysfunction, fascial lines, gluteus maximus, hamstring, Latissimus dorsi, mechanics, NASM, POS, Posterior Obliques Subsystem on August 7, 2014 by Joshua Stone. This entry was posted in Injury prevention, Knee, Rehabilitation, Soccer, Sports Medicine, Women and tagged ACL, ACL Prevention, Anterior Cruciate Ligament, Female, Injury Prevention, Knee injury, knee sprain, Neuromuscular, Soccer, Sprain, World cup on June 12, 2014 by Joshua Stone.
For several years now rehabilitation journals have published articles linking a myriad of lower extremity injuries to poor gluteal control. This entry was posted in Fitness Training, Hip, Injury prevention, Mechanics, Rehabilitation, Sports Medicine and tagged biceps femoris, glute, gluteus maximus, gluteus medius, hip rotation, rehabilitation, Tensor Fascia Latae, TFL, tibial rotation on May 29, 2014 by Joshua Stone. Pop quiz: What musculoskeletal issue could result in chronic low back pain, chronic  muscle strains, lower extremity tendinopathies, periscapular pain and tightness, glenohumeral and shoulder girdle pain, or tension headaches?
This entry was posted in Hip, Injury prevention, Low-Back, Rehabilitation, Sports Medicine and tagged Anterior innominate, anterior pelvic til, ASIS, low back pain, Muscle energy, Myofascial Release, pelvic rotation, Pelvic upslip, posterior iliac subluxation, Sacroiliac Joint, SIJD, tension headaches, trigger point on May 15, 2014 by Joshua Stone.
This entry was posted in Fitness Training, Injury prevention, Rehabilitation, Sports Medicine, Sports Performance and tagged clinical management, compliance, consistency, corrective exercise, correctness, goals, Outcomes, performance, rehabilitation, training on February 24, 2014 by Joshua Stone.
When we think of running injuries we immediately think lower extremity, IT Band syndrome, Patellofemoral Pain Syndrome, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Plantar Fasciitis, and the like.  However, one of the most common and debilitating injuries in runners is low back pain.  So why are runners so at risk of developing low back pain? Vladamir Janda (1928-2002) revolutionized human movement dysfunction and rehabilitation in 1979 when he described three compensatory movement syndromes.
Now, if you go on an all day hike or four-hour bike ride, you will burn a significant amount of body fat (that is, if you don't sustain an overuse injury in the process). Proper nutrition addresses blood glucose control, macronutrient proportion (the amount of fat to carbohydrates to protein), and caloric restrictions based on your goals of maintaining lean body mass, building lean body mass, or reducing body fat. The zone diet is recommended as a base guide that addresses these issues, specifically the issue of quantity: including portion control and daily caloric intake, as well as a macronutrient ratio of 40% carbohydrates, 30% protein, 30% Fat.
This next pdf, entitled 'Myth of the Fat Burning Zone', describes the long standing misconception that low intensity workouts can lead to greater fat loss. With AMI, neurological signals from the quadriceps muscle to the brain and spinal cord are interrupted or slowed. Vibration training provides strength gains without joint loading and stimulates osteoblast activity through mechanobiology, which improves bone density. Following vibration training, brain activity was altered in such a way that it became easier for these subjects to activate and use their quadriceps muscles. As such, muscle vibration can be an effective method to improve quadriceps strength and reduce the risk of developing knee OA. OA is a considerable burden on the US healthcare system and contributes to physical disability and comorbidities such as obesity and diabetes. However, quadriceps dysfunction is caused by a neuromuscular phenomenon called arthrogenic muscle inhibition (AM), which presents a substantial limitation to muscle strengthening. However, what remains unclear is the mechanism by which these vibratory stimuli actually work to enhance muscle function.
In other words, muscle contraction can either be voluntary (the brain tells the muscle to contract) or involuntary (spinal reflex loops). As such, muscle vibration could be an effective method to improve quadriceps strengthening protocols following ACL injury, and in turn reduce the risk of developing knee OA. Failure to normalize range or motion, strength, and neuromuscular control can result in performance loss, reinjury, or long-term disabilities. Unfortunately, there is a lot anecdotal and pseudoscience being pulled from the internet that leads runners astray.
Suddenly, performance experts started saying “Static stretching is the worst thing you can do.” This is not true!

When we ice that sore knee, aching Achilles, or painful plantar fascia after a run or workout we are delaying our body’s innate ability to repair that tissue.
But several recent studies, as well as anecdotal evidence from the world’s top runners, suggest it’s possible to lose more than 2 percent with little to no detriment to performance. Cramping can be caused by a large number of reasons, including over hydration (see above) or poor conditioning.
A study published in Medicine and Science in Sports and Exercise found that rear-foot strikers are up to 9.3 percent more economical than midfoot strikers (6).
A study in the Journal of Sports Physical Therapy evaluated progression of running distance and its relation to injury. Injury-reduction effectiveness of prescribing running shoes on the basis of foot arch height: summary of military investigations. Whether it is 5k or a Marathon, from April to October running enthusiasts have no trouble finding a running event to participate in. Walking down the street, at the mall, or at the bar, there is bound to be a butt that catches your eye. While the glute max – that which makes our heads turn – and the glute minimus are both important, the glute medius is the real problem. Most musculoskeletal injuries are multifactorial, but more often than not many chronic injuries result from underlying movement dysfunction. The people you see who religiously do 30-60 minutes on the elliptical machine look about the same as they did months ago, don't they? After finishing an intense (but short) workout, your metabolism may be higher for up to 14 hours afterward. If you have limited time to workout, interval training will help you reach your goals faster. Simply stated, world class nutrition can be summed up as: "Eat meat and vegetables, nuts and seeds, some fruit, little starch and no sugar. The Whole 9 Resources cover more in depth look at Primal & Paleo Diets, Why Grains are bad, as well as discussions on Dairy, Legumes, Peanuts, and more.
Send me an email to post to the water polo blog, water polo wiki, or NorCal water Polo website! Range of motion, neuromuscular control, or strength deficits that go unaddressed, negatively influence return to play and can also lead to other long-term consequences. Essentially, sensory signals from the knee joint inform the central nervous system – the brain and spinal cord – that the ACL as been injured.
Given that AMI involves alterations in central nervous system function, it is imperative to understand how muscle vibration influences characteristics of spinal cord and brain function.
What we found was that following WBV and LMV, brain activity was altered in such a way that it became easier for these subjects to activate and use their quadriceps muscles. Overall, knee OA is a major economic burden on the US healthcare system, and these findings could have important relevance for alleviating healthcare costs and physical disability. As peer-reviewed data continues to pour in, the evidence for the use of ice to treat musculoskeletal injury still lacks. It is a protective mechanism that when over stretched sends a signal to the brain and spinal cord telling the muscle to contract and protect itself, thus making the muscle tighter.
Dehydration and heat illness have very similar symptoms and often we use the two interchangeably, but they are not the same.
A study in the British Journal of Sports Medicine found that current hydration guidelines are erroneous and that dehydration does not impair performance (3).
Tim Noakes, MD, in Lore of Running, 4th Edition, suggests muscle cramps are caused by muscle fatigue and that cramping has more to do with not training properly than nutritional or hydration deficits. Strength and stability of the core and shoulder help translate to lower body power and efficiency. In fact, those who jump from a normal shoe to a minimalist shoe without proper training or adaptation are at an increased risk for injury. Lead author Ana Ogueta-Alday believes the reason for the improved efficiency stems from the increased ground contact time the study observed in rearfoot strikers. The authors found novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10% (7).
Current hydration guidelines are erroneous: dehydration does not impair exercise performance in the heat.
Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury. Here in my town of Champaign, some 20,000 participate in one of the Illinois Marathon events.
Common big toe issues such as, hallux valgus (bunion), hallux rigidus, turf toe, sesamoiditis, and gout will limit toe mobility. Most potential clients I interview complain of one or more of the following: sacroiliac joint (SIJ) pain and instability, non-specific low back pain (LBP), chronic hamstring strains or tightness, and peri-scapular and thoracic tightness or pain. Non-contact ACL injuries stem from a complex interaction of anatomical, hormonal and neuromuscular factors.
Like a kitten following a piece of yarn, there is the occasional butt that walks by and causes heads to turn, leaving onlookers with a severe neck strain and mouths agape. We have learned the important role the glute medius has on controlling lower extremity mechanics. Often, when a patient reports to our care with one of the aforementioned we immediately think locally. How do we have all of this evidence and knowledge at our disposal, yet individuals do not respond as anticipated? A smaller percentage of a bigger total can be better than a larger percentage of a smaller total. But if you don't have 4-8 hours every day to work out, high intensity is the way to go (assuming a level of intensity that is safe for you).
But at the end of a slow, steady jog, your body will be back to it's steady state within an hour and you will be right back where you started.
The Whole 9 resource page includes even more web sites and discussions including Mark's Daily Apple, which is another great site full of information.
With proper rehabilitation and adequate strengthening of the quadriceps, OA can be prevented. Sounds simple, but clinicians must also deal with arthrogenic muscle inhibition (AMI). Quadriceps dysfunction is ubiquitous following ACL injury and reconstruction, and is a major contributor to the development of OA.
In response, our central nervous system responds by inhibiting the quadriceps to prevent further damage of the injured joint. Therefore, the purpose of this study was to understand how both WBV and LMV influence characteristics of central nervous system function. Following baseline measurements, subjects received an intervention of WBV, LMV, or control (no vibration) treatment.
If your glutes function at an optimal level you will have better athletic performance and prevent injury. I’ve written about ice many times, but many of my anti-ice articles are science-y and focused around one topic. Even the physician who coined the term RICE (Rest, Ice, Compression and Elevation) has said that icing is wrong. If someone is suffering from heat illness, giving them water is not the answer, cooling their body temperature is.
If you need a kick to climb a hill faster or sprint to beat an opponent to the line, strength training is imperative. Five separate studies presented at the annual meeting of the American College of Sports Medicine “found no significant benefits, in terms of economy, from switching to minimalist, barefoot-style footwear.” Minimalist shoes also do not magically improve your running mechanics. The cause of shin splints is multifactorial and correcting musculoskeletal dysfunction through a structured program prevents shin splints.
More contact time with the ground allows for more force to be applied, while also decreasing the metabolic cost of running.

Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Below is an image of a client who demonstrates normal range or motion on the right and limited toe extension on the left. Some athletic trainers and strength and conditioning coaches are too ignorant and too lazy to provide proper warm-up and cool-down protocols to address mobility.” This is not shocking to me. Whether these complaints are isolated to one body part or involve many, the pain can typically be resolved by treating dysfunction of the Posterior Oblique Subsystem.
Recent studies suggest that ACL injuries are caused by both neuromuscular fatigue and unanticipated movements commonly found in athletics, such as evasive maneuvers that involve some form of deceleration, change of direction, or landing. Glute medius inhibition precipitates many lower extremity injuries such as ACL tears, Patellofemoral pain, Iliotibial band syndrome, Achilles tendinopathy, plantar fasciitis, MTSS (shin splints), the list goes on.
Unfortunately, the real problem could be pelvic upslip, anterior pelvic innominate, or both. And why are we, CrossFitters, getting such amazing results while our workouts last a mere 20 minutes? A higher metabolism post workout means you are burning more calories, even if you're sitting at a desk most of the day.
The quadriceps are responsible for absorbing impact forces during everyday tasks like walking and stair climbing, and also athletic tasks like running and jumping. While this mechanism may protect the joint in short term, AMI persists for many years following the initial injury and is thought to contribute to excessive cartilage loading and the development of OA. We repeated the same measurements of quadriceps function and central nervous system function following the treatment.
Over the years, I have worked with a variety of clients and the glutes are a focus for all of my clients. These exercises are designed to give you optimal gluteal function and they might even make you look good in a pair of jeans.
So, when you stretch a muscle that already has over active muscle spindle, the tightness can increase.
Due to the repetitive nature of running, runners are very susceptible to developing hyper-active muscle spindles. I’ve written many articles about this, but the most recent, explains why RICE is no longer accepted as the cure-all.  If you want to recover, cool down with foam rolling and stretching, and have a few days of light exercise or rest. Giving excessive water to a person suffering from heat illness can cause a serious or fatal event called exercise-associated hyponatremia encephalopathy (EAHE).   Marathoners and distance runners who drink at every aid station or drink excessively before a run put themselves at risk for this condition.
In addition, the raisin group showed a lower insulin spike when compared to the gummy group, a win for the raisin.
If you’re a heel striker and haven’t been chronically injured, there’s no need to change your ways.
Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period.
Ultimately, it can be a direct result in many of the aforementioned common lower body injuries.
The coupling of these movements with modifiable risk factors (see graphic) is what leads to non-contact ACL injury. Rehabilitation specialists must pay special attention in strengthening the glute med., but how? Despite being oft-overlooked, these malalignments are not hard to identify if you know what to look for. He continually investigated these movement syndromes and later learned that the muscle imbalances were systematic, predictable, involved the entire body, and a common cause of injury.
My grandmother's high intensity will be drastically different from a college athlete's high intensity; it's all relative.
Don’t believe urban legends or follow sports med sacred cows!” I couldn’t have said this any better!
When the quadriceps fail to act appropriately, their ability to attenuate these forces is reduced, and cartilage within the knee joint experiences greater loading. Therefore, strengthening the quadriceps is important in rehabilitation, but traditional exercises do not address AMI. It does not matter what your current fitness level is; if you want to prevent injury, boost performance, or become more fitter, the butt is key. This study found that the threshold of continuous static stretching in which muscular power output decreased was 60 seconds. I wrote an article about this phenomena, if you want to read more about that.  I understand this can be confusing, but when you read #3 you will see how all of this comes together. Foam rolling or self myofascial release targets the muscle spindle and inhibits it (hence the term release in myofascial release). Plus, the raisin group demonstrated higher free fatty acid content in the blood post activity, demonstrating more fat metabolism.
John Martinez, the assistant head doctor for the Ironman World Championships says “You can run five days a week and you’ll finish a marathon, but if you want to PR or qualify for Boston you need to have some kind of strength training in there.
In order to improve mechanics, you need a quality strengthening and flexibility program that encourages appropriate muscles firing. A systematic literature, published in the Journal of Sports Physical Therapy found that selecting running shoes based on arch height had little influence on injury risk. If you have dysfunction (pain, instability, or hypomobility) at the first big toe joint (MTP joint), it could wreak havoc on the entire kinetic chain.
With approximately a quarter-million ACL injuries per year, it is safe to say the injury is common in sport. The good news is that non-contact ACL injury can be prevented by addressing these modifiable risk factors.
Your body will need time to adapt to the stimulus, as it is vastly different from watching tv on a stairclimber.
Subtle increases in joint loading are amplified through repetitive activities like walking, and over time, greater loading contributes to a gradual breakdown of articular cartilage. Novel rehabilitation modalities are needed to combat AMI prior to the implementation of strengthening exercises. Static stretching for a short-duration (30 seconds) had a negligible influence on performance.
Foam rolling overloads the muscle spindle and the nervous system and gets it to relax and turn off.
So, for the same performance gains, you can gain additional benefits from raisins over energy gummies.
It’s about improving our performance.” Always add a strength training component to your training program.
Higher intensity requires more oxygen demand and thus a greater oxygen debt.  High intensity training has a caloric after burn that lasts for 12-24 hours.
In fact, Jack Daniels says that when training for long running events, train for time, not mileage. Though most common in female athletes, ACL injuries happen to anyone anywhere, with soccer, basketball, and gymnastics athletes being at most risk.
However, we are not looking to see if “Baby Got Back” or how that plump bump fills a pair of Wranglers, Levis, Seven, or True Religion jeans. The purpose of this blog is to shed some light on the debate and provide the rationale for proper squat technique.
You can burn more calories in a 20 minute high intensity interval training program than you can running for 60 minutes at a steady pace.

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