My first experiences with reading about performance enhancing drugs were in the muscle mags and the Russian strength training literature. In university I read Speed Trap by Charlie Francis, which seemed to imply that everyone was using drugs and, in fact, you had to use drugs to compete at the Olympic level. It seems that the hunt is on for those taking performance enhancing drugs and even those prescribing performance enhancing drugs. The Tour de France has had a rough go of it for a while now. Since the Balco incident baseball has gotten a bad rap. Is it the fact that people take it or that they lie about taking it?
http://www.telegraph.co.uk/sport/othersports/cycling/lancearmstrong/8063187/Lance-Armstrong-investigation-could-be-as-significant-as-BALCO-says-WADA-director.html
http://www.huffingtonpost.com/2010/09/30/alberto-contador-tests-po_n_744711.html
http://www.citytv.com/toronto/citynews/news/international/article/96807--toronto-sports-doctor-indicted-in-buffalo
Thoughts? Comments?
Monday, October 25, 2010
EXSTORE - Functional Assessment and Treatment
In my 2nd blog I spoke about Dr. Lombardi from the Hamilton Back Clinic. I just spent the past 3 days at his clinic learning the Functional Musculoskeletal Assessment approach - EXSTORE. Fantastic! The EXSTORE approach allows me to specifically identify the underlying dysfunction, which I treat using a combination of medical acupuncture and soft tissue/myofascial release work. During my time there I was able to treat a variety of clinical conditions using these techniques. For example, in 2 cases of frozen shoulder we were able to increase range of motion and stability by treating the wrist and in a case of neck pain we were able to change function by treating the ankle!
If you're a health professional Dr. Lombardi is offering an Advanced MSK workshop in January.
http://www.hamiltonbackclinic.com/workshop1.htm
Feel free to post comments or drop a line if you have questions.
If you're a health professional Dr. Lombardi is offering an Advanced MSK workshop in January.
http://www.hamiltonbackclinic.com/workshop1.htm
Feel free to post comments or drop a line if you have questions.
Saturday, October 16, 2010
Is a specific amount of time required to manipulate fascia?
According to the link below it would seem so!
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WHF-5046W41-1&_user=10&_coverDate=10%2F31%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1fa688bff76d8ed265aec482551c0b61&searchtype=a
The study used a qualitative measure to identify the length of time required to modify fascia in patients with low back pain. Interestingly the average time was almost 3 and 1/2 minutes at one location! The technique used in the study was based on a technique called Fascia Manipulation. It was developed by an Italian PT by the name of Luigi Stecco. If you remember a few posts back I mentioned the technique in relation to the kinetic chain. That's because Stecco has developed his concept around lines of fascia throughout the body similar to the concept of Anatomy Trains. However there are some distinct differences. Stecco treats specific points using a friction type maneuver away from where the patient feels the pain. It's probably the most evidence based technique available given that he has published several peer reviewed articles on its efficacy.
I have both of his books. Both are of excellent quality and require dedicated reading time. The first book, Fascial Manipulation for Musculoskeletal Pain, is heavy with the technical aspects of fascia whereas the second book, Fascial Manipulation Practical Part, is as the title states. It describes the chains and points within the chains. Interesting side bar is that Stecco notes that many points correspond to acupuncture points.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WHF-5046W41-1&_user=10&_coverDate=10%2F31%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1fa688bff76d8ed265aec482551c0b61&searchtype=a
The study used a qualitative measure to identify the length of time required to modify fascia in patients with low back pain. Interestingly the average time was almost 3 and 1/2 minutes at one location! The technique used in the study was based on a technique called Fascia Manipulation. It was developed by an Italian PT by the name of Luigi Stecco. If you remember a few posts back I mentioned the technique in relation to the kinetic chain. That's because Stecco has developed his concept around lines of fascia throughout the body similar to the concept of Anatomy Trains. However there are some distinct differences. Stecco treats specific points using a friction type maneuver away from where the patient feels the pain. It's probably the most evidence based technique available given that he has published several peer reviewed articles on its efficacy.
I have both of his books. Both are of excellent quality and require dedicated reading time. The first book, Fascial Manipulation for Musculoskeletal Pain, is heavy with the technical aspects of fascia whereas the second book, Fascial Manipulation Practical Part, is as the title states. It describes the chains and points within the chains. Interesting side bar is that Stecco notes that many points correspond to acupuncture points.
Friday, October 15, 2010
A dynamic assessment!
The image below is from the PEO Model by Law, M et al. (1996). It illustrates an assessment approach that I like to use regardless of the area of practice. I also use it as an education tool for clients when I provide educaion on where performance is breaking down.
The model illustrates the interaction between the person, in a given environment, completing a particular activity or occupation. The interaction between the 3 areas lead to a person's occupational performance (or functioning) in their chosen activity. Person factors include the physical, the emotional/cognition or spiritual beliefs. The environment includes things like the physical, cultural and socio-economic factors, among others. And, of course, occupation is the task or activity that the individual is engaged in.
As an assessment approach it's useful because it illustrates the dynamic nature of functioning and moves away from the cause-effect mentality. It may also help identify whether it's best to use a remediative approach or a compensatory approach* (or both). For example, a client experiences a physical injury, which means the person circle moves away from the mid line thereby reducing the likelihood of successful performance in the desired activity. Now we have a several options
- use a remediative approach to treat the MSK injury to increase performance and/or
- change the demands of the activity to make it easier and/or
- change the environment to compensate for the injury.
The choice of strategy, of course, will be influenced by medical history, client goals/expectations, flexibility to make changes, etc.
For the same reasons above I use the PEO Model as an education tool. In my experience clients find it useful to see how the environment and the activity are potential sources to enable or constrain performance as opposed to just focusing on a remediative approach.
I hope you give it a try and find it a useful tool.
* To clarify a remediative approach would focus on fixing the underlying impairment (i.e. repairing a broken leg). A compensatory approach provides an alternative method of accomplishing a goal (i.e. change the activity).
The model illustrates the interaction between the person, in a given environment, completing a particular activity or occupation. The interaction between the 3 areas lead to a person's occupational performance (or functioning) in their chosen activity. Person factors include the physical, the emotional/cognition or spiritual beliefs. The environment includes things like the physical, cultural and socio-economic factors, among others. And, of course, occupation is the task or activity that the individual is engaged in.
As an assessment approach it's useful because it illustrates the dynamic nature of functioning and moves away from the cause-effect mentality. It may also help identify whether it's best to use a remediative approach or a compensatory approach* (or both). For example, a client experiences a physical injury, which means the person circle moves away from the mid line thereby reducing the likelihood of successful performance in the desired activity. Now we have a several options
- use a remediative approach to treat the MSK injury to increase performance and/or
- change the demands of the activity to make it easier and/or
- change the environment to compensate for the injury.
The choice of strategy, of course, will be influenced by medical history, client goals/expectations, flexibility to make changes, etc.
For the same reasons above I use the PEO Model as an education tool. In my experience clients find it useful to see how the environment and the activity are potential sources to enable or constrain performance as opposed to just focusing on a remediative approach.
I hope you give it a try and find it a useful tool.
* To clarify a remediative approach would focus on fixing the underlying impairment (i.e. repairing a broken leg). A compensatory approach provides an alternative method of accomplishing a goal (i.e. change the activity).
Thursday, October 14, 2010
Are you afraid of the dark?
I make a point of stopping by http://www.optimumperformancetraining.blogspot.com/ to see what is going on. In addition to great workouts he usually has a link to something health and lifestyle related. The blog is developed by James Fitzgerald (aka OPT). I'm lucky enough to count James as a good friend. Anyway the other day he had a link to this study
http://www.pnas.org/content/early/2010/09/30/1008734107.abstract
The summary is "These results suggest that low levels of light at night disrupt the timing of food intake and other metabolic signals, leading to excess weight gain. These data are relevant to the coincidence between increasing use of light at night and obesity in humans."
The study links the use of some light while sleeping to disrupting circadian regulation of homeostasis. This study reinforces the importance of sleeping in complete darkness as opposed to allowing any light in the room. From a lifestyle perspective it also demonstrates the importance of keeping a regular sleep routine. In addition to the latest research examining sleep in relation to obesity, other research is examing the role of sleep in concentration and memory. For instance, sleep deprivation has been linked to driving accidents and memory consolidation has been linked to different phases of the sleep cycle.
No doubt about it we need sleep to perform at our best! How many hours of sleep do you get per night? And are you afraid of the dark? Do you have trouble sleeping?
http://www.pnas.org/content/early/2010/09/30/1008734107.abstract
The summary is "These results suggest that low levels of light at night disrupt the timing of food intake and other metabolic signals, leading to excess weight gain. These data are relevant to the coincidence between increasing use of light at night and obesity in humans."
The study links the use of some light while sleeping to disrupting circadian regulation of homeostasis. This study reinforces the importance of sleeping in complete darkness as opposed to allowing any light in the room. From a lifestyle perspective it also demonstrates the importance of keeping a regular sleep routine. In addition to the latest research examining sleep in relation to obesity, other research is examing the role of sleep in concentration and memory. For instance, sleep deprivation has been linked to driving accidents and memory consolidation has been linked to different phases of the sleep cycle.
No doubt about it we need sleep to perform at our best! How many hours of sleep do you get per night? And are you afraid of the dark? Do you have trouble sleeping?
Tuesday, October 5, 2010
October is National Occupational Therapy Month - What is Occupational Therapy?
If this question was posed to most the answer would logically be "you help people with work?". Well yes and no. Occupation includes work or a productive role but it also includes activities related to taking care of yourself and leisure activities. Our national body, the Canadian Association of Occupational Therapists (http://www.caot.ca/) defines occupation as "everything that people do during the course of everyday life. And the primary goal of occupational therapy is to enable people to participate in the occupations which give meaning and purpose to their lives." So in summary an OT helps you do what you want to do whether it's a sport, doing an activity with your family or being productive at work.
How do we help? Well it varies depending upon the problem and the factors involved. Occupational Therapists are university-trained, regulated health professionals with a broad education background, which allows them to assess not only the medical and physical impairments but also the psycho-social factors that affect your ability to do the activities that you want to do (http://www.caot.ca/). With the end goal of helping you achieve your goals an OT examines the activity that you want to do, your ability to complete that activity and where that activity is taking place. From that process we are able to identify where performance breaks down and work with you to develop a plan.
So if you're not able to complete an activity that you want to do or if you feel as if you're not reaching your potential in some aspect of life find an OT in your area. Remember that health is more than the absence of disease and your performance in everyday activities affects your well-being!
Next time I will discuss a general assessment approach that you will be able to apply to a problem that you may be having whether it's a mobility issue or your child getting out of hand.
How do we help? Well it varies depending upon the problem and the factors involved. Occupational Therapists are university-trained, regulated health professionals with a broad education background, which allows them to assess not only the medical and physical impairments but also the psycho-social factors that affect your ability to do the activities that you want to do (http://www.caot.ca/). With the end goal of helping you achieve your goals an OT examines the activity that you want to do, your ability to complete that activity and where that activity is taking place. From that process we are able to identify where performance breaks down and work with you to develop a plan.
So if you're not able to complete an activity that you want to do or if you feel as if you're not reaching your potential in some aspect of life find an OT in your area. Remember that health is more than the absence of disease and your performance in everyday activities affects your well-being!
Next time I will discuss a general assessment approach that you will be able to apply to a problem that you may be having whether it's a mobility issue or your child getting out of hand.
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