Tag Archives: physical therapy running

Elite PT Newsletter August 18′ – Running Injuries: Preventing Lower Back Pain

We’re continuing with our series on running injuries – this month focusing on how to prevent lower back pain.

But first:

I want to welcome our new PT student Charlie Crockatt

Charlie CrockattCharlie is in his third and final year of Grand Valley State University’s doctorate of physical therapy program, and is with us until October for hands-on clinical experience. He grew up in Livonia Michigan, playing football and baseball for the Stevenson Spartans. After high school he completed his undergraduate work at Central Michigan University, studying athletic training. After graduation from PT school, he is interested in working with athletic populations of all ages and hopes to travel outside of Michigan. In his free time, he enjoys the outdoors and also plays drums for an indie rock band called Birdie Country.

Charlie will be a great fit at Elite PT and will be here through October 5th.
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Running Injuries continued:  Preventing Lower Back Pain

Unfortunately lower back pain is a frequent problem for runners especially as distances increase.

As you’ve learned from our previous articles on running injuries, having good joint mobility and flexibility are very important for injury prevention.  When it comes to your lower back, the more mobile and flexible you are through the joints above and below – specifically ankles, hips, and thoracic spine – the better.

Another important consideration is core stability.  I prefer to use the term ‘stability’ over the more common term ‘strength’ because that’s really what we are after.  Stability, in this case, is the ability of the muscles of the trunk to maintain a safe position of the joints of the spine while you alternately swing your arms and legs to run.  In simpler terms:  to keep your lower back relatively still while the rest of you moves.

One of the best ways to train for stability is to use a variety of plank exercises to challenge the various muscle groups on the front, back, and sides of the trunk.  These are known as Bunke Planks and are pictured below:






Use a small box or chair approximately 12-18″ high (the higher it gets the easier it tends to get).

These exercises were introduced a few years back as a way of developing stability and endurance through the trunk muscles but also to compare how stable a runner was right to left.  Everything is done on one leg and compared to the opposite side.  Competitive runners should be able to hold each position 40 seconds at a minimum on each leg.  Asymmetries right to left (i.e. hold on left leg 40 seconds but only 25 seconds on the right) was thought to put runners at a substantially higher risk of injury.  Not being able to hold the full 40 seconds was not as big a deal but still thought to increase risk of injury.

So that’s the quick and dirty history of the Bunke Planks in one paragraph.  Competitive runners should be able to hold each plank 40 seconds on each leg in each position.  This can be very challenging, and very eye opening as some folks think they are quite ‘strong’ through their core until they try these!

For the rest of us, these planks can be very difficult and in some cases way to advanced.  Luckily there are a number of regressions possible that can be used to build up stability and endurance and maybe eventually work up to the full blown Bunke plank.

The easiest thing to do in some cases is just to do the plank in the pictures on both legs and work up to 40 seconds before trying to lift a leg.

From there alternate lifting legs up to 10 reps each leg.  You will only be holding a few seconds each leg before switching to the other.  If your on your side you would lift the top or bottom leg 10 time then switch sides.

The next step would be to start working in longer holds.

The shoulders can often be limiting factors in performing the Bunke planks – here are some regressions to take the shoulders out completely or at least to decrease the total amount of body weight you must hold up:

Hamstring Bridging

Single Leg Hamstring Bridge

Lift the tailbone but not the lower back!

 

 

 

 

 

 

Side Plank (from the knees)

Side Plank from knees

Hold the hips high and lift the top leg up and down

 

 

 

 

 

Front Planks (from the knees)

Kneeling Front Plank

Keep the hips high and back flat

 

 

 

 

If you have any questions at all or are suffering from lower back pain feel free to email me:  Joe@elitepttc.com

Keep running and stay healthy!

 

Joe Heiler

231 421-5805

Joe@elitepttc.com

Elite PT Newsletter May 2018 – Running Injuries Part 2 – Knee Pain

This month’s newsletter focus is on knee pain.  Things have been getting busier here with summer just around the corner and lots of runners prepping for races.

One thing we’ve definitely noticed with our runners is that prevention is key.  They’re coming in sooner, once they can tell something is not quite right, rather than waiting weeks or months for it to just go away on its own.  Because of that we’ve seen two trends:

1)  They are recovering much quicker than in the past
2)  They’re completing their races – most we’ve checked in on have run faster than in previous races.

So on that note let’s continue with our series on running injuries – this month focusing on knee injuries.

***Just a quick note for you non-runners out there – these injuries are very common in all sports and even in non-athletes so if you have knee pain you will still want to check this out!

The most common knee injuries in runners are:

1)  Patello Femoral Pain (front of the knee)
2)  Distal IT Band Syndrome, a.k.a. Runners Knee (outside of the knee)
3)  Patellar Tendinosis (just below the knee cap)

Last month we talked about improving mobility and stability of the foot and ankle – which will also help to relieve strain on the knee joints so if you have knee pain go back and read that article here:  http://www.elitepttc.com/elite-pt-newsletter-april-2018-common-running-injuries-part-i-foot-and-ankle/

This month I want to focus on a couple of the muscles that are notorious for causing knee pain, and what you can do about them. Check out the pictures below:

Rectus Femoris Trigger Points and Pain Referral Pattern

RF Trigger Point Knee Pain

Vastus Lateralis Trigger Points and Pain Referral Pattern
 

VL Trigger Points Knee Pain
The ‘X’ is the location of common trigger points (tight irritable bands of muscle) and the reddened area is that trigger point’s pain referral pattern.  From the pictures you can see how irritation within the big quadricep muscles can cause pain all the way down to the knee.

The quadricep group frequently gets overworked with running which can cause these hyper-irritable bands of tissue in the first place.  As a result the muscle tissues feel tighter and become less flexible.  This creates a vicious cycle over time and ultimately these tissues can refer pain down to the front or side of the knee mimicking the conditions I listed above.

Luckily these trigger points are usually easy to identify and treat with manual therapy techniques such as Graston Technique and Dry Needling.  Following up with corrective exercises can ensure that these irritable areas don’t flare back up after being treated.  On top of that, most of our clients can manage this in the future doing their own soft tissue work using foam rollers and massage sticks, and warming up properly.

Check out the video below if you’d like to see how we dry needle and treat that outer thigh muscle:

***This video was originally created for physical therapists and posted on SportsRehabExpert.com so there is quite a bit of medical lingo but you’ll get the drift.  Be sure to check out how much better Lydia’s leg moves after the treatment. 

Last year one of our Kingsley athletes was diagnosed with IT Band Syndrome and was experiencing significant pain on the outside of the knee.  His knee had actually buckled on a number of occasions while trying to sprint.

He presented with almost identical range of motion at the hip as Lydia in the video above.  One treatment of dry needling followed by a couple corrective exercises and he was able to return to running the next day without pain.

I can’t guarantee it will always work that fast but sometimes it does (helps to be 16 too!)

SPECIAL OFFER – if you’ve been struggling with knee pain and you’re not sure what to do about it then give us a call for a free screening.  We can quickly identify the cause of the problem and guide you down the right treatment path.  231 421-5805.

Until next time…

Joe Heiler PT
Joe@elitepttc.com
231 421-5805

Hip Flexor/Ankle Dorsiflexion March

Elite PT June 2017 Newsletter – Dry Needling for Ankle and Foot Pain, Athlete Updates, and more…

Welcome to this month’s issue of the Elite Physical Therapy and Sports Performance newsletter.  Check out the short article and demo videos on dry needling, see what some of our graduating athletes will be up to in the Fall, as well as our ‘Exercise Tip of the Month’:

I can’t believe it’s already June and school’s just about out!

Here’s what’s new at Elite Physical Therapy this month:


Kristy Ockert MSPT just completed her first Functional Dry Needling course down at Grand Valley State University a few weeks ago.  She had a great time and learned some cool new techniques.  Since then she’s been practicing on Lydia and myself to fine tune her skills.  Follow the link below to see how its going!

We’ve seen numerous clients lately with calf pain, Achilles tendonitis, and plantarfasciits who’ve had great results with the combination of dry needling, Graston Technique, and exercise.  Here is what one of our clients with Achilles tendonitis had to say:

“I had issues walking at work and limited mobility in the ankle before therapy.  I can now walk all day at work and have no pain or swelling in the ankle area.” – K.W. from Grayling

In this case, PT was the last option prior to surgery.  Thankfully we were able to avoid surgery and get her back to work without pain.

There are certainly plenty more conditions that can benefit from dry needling in addition to the other physical therapy techniques that we employ.  Relieving pain and improving muscle function are big benefits of this technique.  To see more on dry needling, how it works, and a demonstration for treating neck pain and headaches, click the link HERE to check out the video on our home page.

If you have any questions about the technique or if you’re wondering if dry needling may work for you, feel free to give us a call at 231 421-5805.  Ask for Joe or Kristy.
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Athlete News

I want to acknowledge some of our past and present clients that will be moving on at the end of this school year to further pursue their athletic dreams.  These guys are a hard working bunch and will be missed!

Chris Kolarevic from St. Francis High School – will be playing football at the University of Northern Iowa.
Michael Hegewald from St. Francis High School – will be playing football at the University of Dayton.
Alec Trautman from Elk Rapids High School – will be playing football at the University of Dayton.
Will Russell from Traverse City East Middle School – will be attending the Steamboat Mountain School in Colorado skiing on their U16 Alpine Team.

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Exercise Tip of the Month

We’ve been talking about treatments for the lower leg and foot the past couple months so I thought I’d stick with this commonly injured area one more time.  Last month I showed a great way to improve the way the foot and ankle move – if you missed it just let me know and I can re-send that to you.  This month we’ll look at an easy way to begin strengthening.

Ankle Marching with mini-band

Place the band around your feet with the feet just wide enough that there is a small amount of tension on the band.  Bring the knees up toward your chest and flex the ankles back as far as possible.  Kick one leg out straight but keep the opposite leg motionless.

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Start Position

 

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Finish Position

The leg that remains motionless will actually be the leg that is working the hardest.  Do not let this leg follow the other!  Not only will you feel the muscles in the front of the lower leg working hard but you’ll also feel your hip and stomach muscles.  This exercise is typically done after stretching out the calf muscles and is done for 2 sets of 10 on each side.
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Have a great month and talk to you again in July!

Joe Heiler PT

 

 

Back Pain and Sciatica – Physical Therapy Treatments

This month I figured I’d post on a couple case studies related to back pain and sciatica, and how we evaluate and treat cases like this at Elite Physical Therapy.  We’ve had a lot of great success with these folks so thought I’d share a couple examples.

Back pain, and associated leg pain, can be difficult to treat but we like a challenge!  Playing detective can be fun if you know what to look for.  Check out the pictures below that show the paths the spinal nerves take throughout the body.  Leg pain (or what many people like to call ‘sciatica’) can follow a number of paths down the leg and sometimes that can be a dead give away to identify exactly where the pain is coming from.

dermatomes

***The letter and numbers above correspond to a particular spinal nerve, i.e. L4 means lumbar spinal nerve #4 ***

There are other ways to narrow down the location of the problem as well:

  • the muscles will be painful to palpation at a specific vertebral segment and may even refer pain down the leg when palpated with deeper pressure.
  • reflexes may be diminished.  A slow or non-existent patellar tendon reflex corresponds with lumbar spinal nerve #4.
  • Muscles may test weaker on the affected side which may indicate an injury to a particular spinal level or nerve.  An example of this would be weakness in the calf muscles (can’t lift up on to the toes) which are controlled by the first two sacral nerves (S1 and S2 on the chart).

So here’s a great example of a number of these factors all lining up and how quickly the pain and loss of function can be addressed.

Case Study #1

The patient in this case had left sided low back pain and pain running down through the back of her hip and leg to the mid-calf.  She felt a ‘pop’ in her back and immediate leg pain as a result of pushing and twisting trying to put a heavy object in the back of her truck.  She is an avid runner but even standing and walking significantly increase her pain after 10 minutes.

Exam

So here is what I found:

  • Symptoms following the S1 and 2 dermatomes down the back of the left leg
  • Increased muscle tone/spasm at the S1 and S2 levels of the spine, and these muscles are tender to palpation.
  • ‘Springing’  or pushing down on the S1/S2 vertebrae reproduced the symptoms into the back of her hip/upper thigh.
  • She could do only 12 calf raises on her left leg while doing 25 on the right side (this muscle corresponds with S1 and S2 nerves).
  • Achilles reflexes normal (S1 reflex)

It’s nice when everything points back to a specific level or two like that.  Doesn’t always work that way but when it does it makes me much more confident that we can knock this out quickly.

Treatment

In this case I chose to use dry needling to address the muscles at the S1 and S2 spinal levels on both sides of the spine.  Once the needles were placed I attached an electrical stimulation unit and she just relaxed for 10 minutes.  Dry needling in conjunction with e-stim are shown in the research to decrease tone within the muscles as well as alleviate pain through a number of local and global factors.

The patient was instructed in two exercises that had multiple purposes:

  • decrease pain through relaxation of the over worked muscles of the back and anterior hip
  • facilitate improved stability through the lumbar spine and pelvis

Pretty simple exercises that are beyond the scope of this article but lots of bang for your buck when they only take 5 minutes 2-3 x per day.

Results

The patient had near full resolution of symptoms for two days after the first session.  Her exercises relieved her pain at home and she could walk as much as she wanted.  She tried to run on the third day but was unable due to pain.

We repeated the same dry needling + e-stim treatment during the second visit and followed it up by progressing her exercise program.

The patient cancelled her appointment the next week as she reported being completely pain free and back to running.

Final Thoughts

Sometimes it just works that well but I certainly won’t make that guarantee in every case!  Back pain and ‘sciatica’ cases can be quite complex but knowing how to put together all the puzzle pieces definitely helps.

That’s probably enough to wrap your head around for this time.  Next month I’ll post another case study but with a different symptom presentation.  In the meantime if you have any questions just shoot me an email:  joe@elitepttc.com or call 231 421-5805.

Dry Needling for Hip and Knee Pain

At Elite Physical Therapy and Sports Performance we strive to find new and innovative ways to treat pain and get you moving again.  Dry needling has been one on my go-to treatments for the past 3 years now, and the method I’m going to show you today works wonders for hip and knee pain.

The Vastus Lateralis (VL) is one of the four muscles that make up your quadricep and is the most lateral.  Trigger points in this muscle will often refer pain to the lateral knee.  Check out the photo below of the VL and corresponding trigger point referral patterns.

Vastus Lateralis Trigger Points

Even without active trigger points, the VL is often in a state of high tone which can significantly limit hip mobility in certain directions.  With it’s attachment all along the IT band, it can also create greater stress on the knee joint through that IT band.

In the video you’ll see the limitations in our patients hip adduction (her knee should hit the table when I try to lower the leg across midline).  Her right hip does this easily.  This is a fairly standard PT test, known as the Ober test in most circles.  In the video you’ll see how dramatically dry needling the Vastus Lateralis with a few minutes of muscle stimulation can change her hip mobility.

Just a quick note on the video.  This was originally created for my SportsRehabExpert.com website which is read by other PT’s, Athletic Trainers, Chiropractors, etc.  Sorry for all the medical talk but you’ll get the idea with the huge change in range of motion following the dry needling treatment.

Here are some of the common diagnoses you’ll hear from your doctor that will respond well to dry needling:

  • IT Band Syndrome
  • Runner’s Knee (distal IT band syndrome)
  • Patello-Femoral Pain Syndrome/Patellar Mal-Tracking
  • Hip Bursitis

There are many other ‘diagnoses’ that can benefit from improved hip mobility but those above are what we would see most frequently.  For those that are needle-phobic, we can get similar results using Graston Technique and other manual therapy techniques, it’s just often not quite as dramatic.

There are also a number of specialized motor control and strengthening exercises that need to be used following this treatment to maintain this new mobility.  Just because she can move her hip now on the table doesn’t necessarily mean its going to move that well when she is standing, walking, or running.  Strength must also be established in that new range.

Hope that was helpful to see plus you get a bit of a glimpse at what we do here at Elite Physical Therapy and Sports Performance.

Big thanks to our Athletic Trainer, Lydia Case, for being our ‘patient’!

Multi-Planar Single Leg Deadlift

The single leg deadlift is a staple exercise here at Elite Physical Therapy and can improve hip mobility, core and hip motor control, and also challenge balance.  Adding movement into other planes can also add value to an already excellent exercise.

Originally published on SportsRehabExpert.com by Greg Schaible
This is a great way to start exploring movement and introducing variability of motion once your typical single leg deadlift has been mastered. Start including these variations to develop better body awareness. It also can effectively be used as part of an athletes warmup.

  • Keep a soft knee and stay long through the torso
  • Torso should be in parallel with the ground

This doesn’t take the place of a progressive loading program with your standard single leg deadlift. Don’t forget the benefits that a progressive resistance program can have on tissue remodeling.

BIO

Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a Student Athlete. As an athlete he competed in both Indoor anGreg Schaibled Outdoor Track & Field where he earned honors as a 5x Division II All-American and a 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. In addition to his rehabilitation services, Greg has a passion for youth sports specific training. Follow On Track PT Performance on Facebook.

Vastus Medialis Obliquus Muscle (VMO) “Isolation” Exercises Fact or Myth?

At Elite Physical Therapy and Sports Performance we take pride in the fact the we are well ahead of the curve with out treatment techniques compared to the rest of the traditional PT world, but we also acknowledge that it is important to use evidence based treatment techniques.

Evidence based practice is the buzz word in PT circles but despite this strengthening/isolating the VMO continues to be utilized as a way to decrease knee pain and improve function.   PT’s and physicians alike continue to prescribe strengthening for the VMO muscle of the quadriceps group even though the research has proven this concept to be faulty and ineffective.

This short article was written by a couple PT friends of mine in New York (one of which is in the PT and Strength and Conditioning Halls of Fame!) showing once and for all that you can not isolate the VMO, nor should you bother trying when it comes to solving knee pain.

Enjoy!

Originally posted on SportsRehabExpert.com

Robert A. Panariello MS, PT, ATC, CSCS
Timothy J. Stump MS, PT, CSCS, USAW

Professional Physical Therapy
Professional Athletic Performance Center
New York, New York

Patellofemoral pathology is a fairly common condition observed in clinical setting. The treatment philosophy of some rehabilitation professionals to resolve this painful condition may include the prescription of exercises in the attempt to isolate the Vastus Medialis Obliquus muscle (VMO). Although this VMO exercise isolation “myth” has been negated at least 20 years ago (1, 2) it continues to presently endure.  During this attempt to isolate VMO activity, some designated exercises executed include but are not limited to the following:

  • Quad sets
  • Terminal open chain knee extension exercises
  • Straight leg raises (SLR) with external rotation of the lower extremity

These exercises may or may not be performed with the adjunct application of electric stimulation.

Although these exercises will enhance the strength of the quadriceps muscles, likely assisting in resolving the patient’s knee pathology, this is not due to isolation of the VMO. The case some clinicians formulate for the performance of SLR with external rotation is based on the false premise that by externally rotating the femur will result in further activation of the VMO.

The knee is a hinge joint and during the execution of a SLR, the force of gravity will act in a perpendicular manner between the knee and ground surface. The quadriceps mechanism will now be required to resist the resultant force attempting to flex the knee as this is the only contractile soft tissue structure that is capable of resisting that force.  The quadriceps mechanism like any other dynamic structure can only resist this external force via the neural activation of the muscle group.  The external rotation of the femur gives rise to the placement of stress on medial collateral ligament (MCL), a static stabilizer of the knee.  This treatment philosophy actually removes stress from the very muscle(s) the clinician is attempting to enhance.  As an example a patient with a diagnosis of polio, a condition affecting the anterior horn of the femoral nerve or a patient with a quadriceps tendon rupture can still perform a SLR when externally rotating their femur based on the static stabilizing properties of the MCL.  Therefore one may inquire why would a clinician who is attempting to activate and enhance the quadriceps muscle group perform the SLR exercise in external rotation.

The anatomy and neuroanatomy of the quadriceps muscle group

The quadriceps muscle group is comprised of the rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis. The vastus medialis (VM) is located at the medial aspect of this muscle group and has been reported to consist of two separate components, the proximal vastus medialis longus (VML) and the distal vastus medialis obliquus (VMO) (4). The neuroanatomy of the quadriceps muscle complex reveals an innervation from the femoral nerve.  The femoral nerve is comprised of large motor units that innervate all four heads of the quadriceps without individual fine motor unit innervation of the separate muscle heads.  Therefore, since the VMO does not have a distinct and separate nerve innervation, it is not possible to “isolate” this muscle from the other quadriceps muscles via a specific exercise performance. The most beneficial way to enhance the VMO is to incorporate the same exercise philosophy used to improve any other muscle or muscle group, the application of unaccustomed stress. The application of unaccustomed yet safe levels of stress is simply known as the “overload principle”. This may be accomplished in two ways; expose the patient to higher levels of unaccustomed resistance or overload them by increasing the velocity of the movement. Both methods will result in a positive adaption of the entire quadriceps muscle group.

Since stress transpires throughout the kinetic chain of the lower extremity during the performance of ADL’s as well as athletic endeavors, the activities prescribed for patellofemoral pathology should also include exercises for both the hip and ankle. “Critical thinking” is a requirement for the approach to the patient’s optimal exercise selection and treatment design. The health care professional’s obligation to provide optimal treatment does not include the application of myths during the patient’s plan of care.

References

1. Cerny K “Vastus medialis oblique/vastus lateralis muscle activity ratios for selected exercises in persons with and without patellofemoral pain syndrome”, Phys Ther (8):672-83, 1995
2. Malone T, Davies G, Walsh WM, “Muscular control of the patella” Clin Sports Med 21(3); 349-362, 2002.
3. Hubbard JK, Sampson HW, Elledge JR, “The Vastus Medialis Oblique Muscle and Its Relationship to Patellofemoral Joint Deterioration in Human Cadavers”, J Ortho Sports Phys Ther 28(6):384-391, 1998.
4. Weinstabl R, Scharf W, and Firbas W, “The extensor apparatus of the knee joint and its peripheral vasti: anatomic investigation and clinical relevance”, Surg and Radiological Anat  11(2): 17-22, 1989

Robert A. Panariello MS, PT, ATC, CSCS
Rob Panariello PicRob is a Founding Partner and Chief Clinical Officer with Professional Physical Therapy presently with 44 facilities in the New York and New Jersey Metro areas and the Professional Athletic Performance Center located in Garden City, New York. He has Bachelor Degrees in Physical Therapy and Physical Education/Athletic Training from Ithaca College in Ithaca, NY. He also holds his Master’s Degree in Exercise Physiology from Queens College in Queens, NY.

Rob has more than 30 years of experience in the related fields of Sports Physical Therapy, Athletic Training, and the Performance Training of Athletes. His experience includes the study of the Science of Strength and Conditioning of weightlifters and various sport athletes in Bulgaria, the former Soviet Union, and former East Germany. He previously held the positions as the Head Strength and Conditioning Coach at St. John’s University of New York (1986-1995), the World League of American Football NY/NJ Knights (1991), and the WUSA NY POWER Women’s Professional Soccer League (2001-2002). He continues to rehabilitate, athletic performance train, as well as serve as a consultant to many NFL, NBA, MLB, NHL, Collegiate and University teams, coaches, and players.

Rob has more than 60 peer reviewed Orthopedic and Sports Medicine Research, Sports Physical Therapy Research, and Strength and Conditioning Journal Articles and Book Chapter publications. He has also presented his research at the International World Confederation of Physical Therapy in Washington, D.C. He is nationally renowned and lectures throughout the country with regard to the related fields of Sports Physical Therapy and the Performance Training of Athletes.

Rob received the 2015 APTA Sports Physical Therapy Section Lynn Wallace Award for Excellence in Clinical Education, the prestigious National Strength and Conditioning Association’s Presidents Award in 1998 and was elected to the USA Strength and Conditioning Coaches Hall of Fame in 2003.

Tim StumpTimothy J. Stump is a partner with Professional Physical Therapy, and is also a founding partner with the Professional Athletic Performance Center. He  has more than 20 years of experience in the related fields of Orthopedic and Sports Physical Therapy, Strength & Conditioning, and Performance Training of Athletes of all levels of competition. Tim’s experience includes the successful participation as a nationally ranked competitive strength athlete in the sports of Powerlifting and Weightlifting from 1990-2010. He continues to actively participate in these sports as a coach and mentor to many athletes.

Tim has published several peer-reviewed original research articles and has presented his research at the APTA National Conference and at CSM. Tim was also awarded the Jacob & Valeria Langeloth Foundation research grant for studies on ACL functional outcomes while employed at the Hospital for Special Surgery. Tim was the 2012 recipient of Columbia University’s Award for “Leadership in Clinical Education” and co-chairs Professional’s Clinical Affiliation Program with over 64 school contracts providing PT, PTA, ATC and Exercise Physiology students with quality clinical affiliation experiences.

Bunke Plank Regressions

Joe Heiler PT

Originally posted on SportsRehabExpert.com

‘Core’ strengthening is always a popular topic so figured I’d highlight another set of exercises that we use here at Elite Physical Therapy and Sports Performance.

I’ve been playing around with the Bunke planks for awhile now as part of the discharge criteria for my runners and other select athletes.  It’s just one more way to gauge symmetry and in this case its looking at stability through the fascial lines of the body.  My only problem has been that the tests can be too difficult for larger athletes, older patients, and those with shoulder dysfunction so I needed to regress these planks a bit to allow all my athletes and patients a safer place to start and to give them a shot at being successful.

(Click the link below to check out the original Bunke plank series:  Bunkie Tests)

The goal of the Bunke Test is for the athlete to be able to hold each test position 40 seconds.  You’ll see in the videos below how I use some different positions to regress the planks, but you’ll also want to consider these other regressions within the positions:

–  hold the plank with both legs 40 seconds
–  perform leg lifts – either alternating or just with one leg depending on the type of plank
–  finally hold on one leg up to 40 seconds

Bunke Plank Variations – Knees

Bunke Plank Variations – Elevated

The hamstring planks can be modified by putting the forearms on a bench with the feet on the floor and then running through the progressions above.  If the shoulders are the problem, then we typically have to go to lying supine with feet up on a box or ball.

If you have any questions or want to get tested as part of our Annual Musculoskeletal Exam, just email joe@elitepttc.com or give us a call at 231 421-5805.

 

Ankle Mobility Drills for Runners

This is the last in our series of dynamic warm-up drills for runners that we use here at Elite Physical Therapy and Sports Performance.  In this video Scott McKeel demonstrates some of our favorite ankle mobility drills to get those ankles moving which will help with a number of common injuries like plantarfascitis, Achilles tendinopathy, IT band syndrome, knee pain, and low back pain.

 

We do small group, and even individual, training sessions for runners which includes the Functional Movement Screen plus other critical tests to find the weak links in mobility and flexibility, strength, and running technique.  If you’re interested contact us:  joe@elitepttc.com

Dynamic Warm-Up for Runners Part III

In this episode Scott McKeel continues with the dynamic warm-up series including drills for lower body warm up and running technique.  These drills are great for those who have been battling common running injuries like plantarfascitis, hip bursitis, IT band syndrome or low back pain.

 

We do small group, and even individual, training sessions for runners which includes the Functional Movement Screen plus other critical tests to find the weak links in mobility and flexibility, strength, and running technique.  If you’re interested contact us:  joe@elitepttc.com