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When initiating sessions with special populations, many of them will come to you with an extensive past medical history. They may be on medication for heart problems, diabetes, high blood pressure, cancer, etc... Although you should give each of your clients your undivided attention, you must pay particular attention to what these more "medically compromised" clients report to you. Here are some "Red Flags" you must be aware of in order to maintain the safety of your clients. If a client complains of any of the following, do not tell them to "brush it off!" Refer him/her back to their physician before continuing your sessions.
RED FLAGS:
1)Complains of intense, unremitting pain
2)Pain is unaffected by medication or change in position
3)Complains of intense night pain
4)Complains of intense pain with no history of prior injury
5)Complains of intense spasms
Sunday, October 16, 2011
Friday, October 7, 2011
Detailed Pain Assessment
When a new client begins working with you, he or she may come to you experiencing pain in one or more areas. During your initial assessment, an easy way to formulate a detailed pain assessment is as simple as remembering O-P-Q-R-S-T. If you know your alphabet, you can do this assessment.
"O" stands for onset of symptoms - when did the symptoms start? Is it an acute, subacute or chronic condition? Was it a slow or sudden onset?
"P" stands for properties of symptoms - What makes your symptoms better or worse?
"Q" stands for quality of symptoms - Type of pain...dull ache, sharp stabbing, shooting, etc...
"R" stands for radiating - Is it local or diffuse?
"S" stands for score - How does the pain rate on a scale from 0-10 where 0 is nothing and 10 is "get me to the emergency room!"
"T" stands for timing of symptoms - Is it constant or intermittent?
Answering these questions during an initial assessment and on subsequent sessions will provide you with a guidance system on whether your client is improving or not. It will also help you to advise your client on what activities may be beneficial and which are detrimental.
"O" stands for onset of symptoms - when did the symptoms start? Is it an acute, subacute or chronic condition? Was it a slow or sudden onset?
"P" stands for properties of symptoms - What makes your symptoms better or worse?
"Q" stands for quality of symptoms - Type of pain...dull ache, sharp stabbing, shooting, etc...
"R" stands for radiating - Is it local or diffuse?
"S" stands for score - How does the pain rate on a scale from 0-10 where 0 is nothing and 10 is "get me to the emergency room!"
"T" stands for timing of symptoms - Is it constant or intermittent?
Answering these questions during an initial assessment and on subsequent sessions will provide you with a guidance system on whether your client is improving or not. It will also help you to advise your client on what activities may be beneficial and which are detrimental.
Saturday, October 1, 2011
P.R.F.C.T. Techniques: Mil Squat Overhead Tap
Today's P.R.F.C.T. Technique can be incorporated into any fitness or post rehab fitness routine.
The benefits are as follows:
1. Grip Strength: Controlling the uneven weight distribution of the Mil Device taxes your grip and forearm strength especially upon changing the grip position from a lateral bias to medial bias
2. Shoulder/Scapula Strength: The lateral raise itself focuses on the lateral deltoid muscle. Controlling the "awkward" Mil device challenges your scapular stabilizers as you perform the lateral raise
3. Lower Extremities: The squat portion strengthens your legs in order to assist in any squatting motion. The squat is a functional every day movement required by everyone, so you want to maintain strength and efficiency
4. Core: Elevating your arms while descending/ascending from a squat requires a strong foundation or core to maintain control and stability of your trunk
5. Coordination: Some people can not chew gum and walk at the same time. Squatting, while moving your arms with bilaterally weighted objects will definitely help with your coordination
Who will benefit from this:
Any client who needs to strengthen his forearm/hand, knee, hip, ankle, shoulder and/or requires strengthening in the overhead reaching/lifting actions due to his occupation or recreation
The benefits are as follows:
1. Grip Strength: Controlling the uneven weight distribution of the Mil Device taxes your grip and forearm strength especially upon changing the grip position from a lateral bias to medial bias
2. Shoulder/Scapula Strength: The lateral raise itself focuses on the lateral deltoid muscle. Controlling the "awkward" Mil device challenges your scapular stabilizers as you perform the lateral raise
3. Lower Extremities: The squat portion strengthens your legs in order to assist in any squatting motion. The squat is a functional every day movement required by everyone, so you want to maintain strength and efficiency
4. Core: Elevating your arms while descending/ascending from a squat requires a strong foundation or core to maintain control and stability of your trunk
5. Coordination: Some people can not chew gum and walk at the same time. Squatting, while moving your arms with bilaterally weighted objects will definitely help with your coordination
Who will benefit from this:
Any client who needs to strengthen his forearm/hand, knee, hip, ankle, shoulder and/or requires strengthening in the overhead reaching/lifting actions due to his occupation or recreation
Thursday, September 15, 2011
P.R.F.C.T. Techniques: Mil Drumming - Upper Extremity Bias
Click below to watch today's
P.R.F.C.T. (PERFECT) Technique: Persian Mil Drumming
P.R.F.C.T. stands for Post Rehab Fitness Circuit Training. Today's exercise has the following benefits...
Grip Strength: You must use your grip and forearm strength to control the device as it accelerates/decelerates. You should not "flick" the wrist as this may cause tendinitis. Your wrist moves in slight radial and ulnar deviation throughout, while maintaining a firm grip
Scapula Stability: You have the option of holding the device with your arms at shoulder/chest height, angled overhead or diagonally toward the ground. In either of the modifications, you must minimize shoulder movement, thereby maintaining scapulae stability (No shoulder blade protraction/retraction). Working this at different angles just strengthens these muscles throughout a larger range of motion
Posture: As scapular retractors/stabilizers play a large role in posture, this exercise helps build muscle endurance, in order to maintain proper posture for extended time frames (like the entire day).
Core Stability: As your upper extremities are applying a force to move the devices, you will be moving one device at a time. This unilateral movement applies rotational forces on the trunk. It is your job to stabilize your trunk and not allow these forces to rotate your torso. This develops core stability. Perform the exercise with outstretched elbows for more challenge. Bend the elbows slightly to decrease the challenge
Modification: Incorporate a squat or lunge while performing the drumming. This will work total body coordination, burn more calories, and will increase the challenge on your stabilizers, as there is more movement applied to the entire body while you focus on maintaining proper technique/form
Type of Clients Who Benefit: Anyone in the later stages of recovering from hand/wrist issues, Lateral Epicondylitis (Tennis Elbow), Medial Epicondylitis, Bicep or Shoulder/Rotator Cuff Tendinitis, Shoulder Impingement, those in the later stages of Rotator Cuff Repair, and those who are trying to improve their posture
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For Nabard equipment, check out www.nabardfitness.com
Saturday, September 3, 2011
P.R.F.C.T. ("PERFECT") TECHNIQUES: UPPER EXTREMITY BIAS
KB FITNESS or Knowledge Based Fitness presents P.R.F.C.T. (PERFECT) Techniques, which stands for Post Rehab Fitness Circuit Training Techniques. These explanatory videos offer information for trainers and their clients on the how-to and functional benefits of many exercises, in order to guide their progression and prevent and/or recover from injuries.
The following video is the Nabard Long Device Lateral Thrust.
http://youtu.be/_5tghrO5bQA
There are many benefits of this exercise, as it is a full body technique. However, it is especially good for the upper extremity, including strengthening the shoulder, forearm, wrist and hand (grip). This exercise provides:
1) Scapula Stabilization: You must maintain isometrically retracted scapula when performing this, or else you risk causing shoulder injuries. Scapular retraction is a major posture component. So this technique will benefit posture and those clients recovering from shoulder injuries.
2) Grip strength: With the offset handle of the device, you are forced to grip it tightly in order to control it. Read the prior blog post on grip strength, irradiation and the homunculus for more details. This movement also works on hand coordination and speed, as you transition from gripping the device to releasing the device frequently.
3)Core/Trunk rotation: As you increase speed of trunk rotation, you demand more from your core to control the rotation. You should not allow the device to create rotation of your trunk. Your trunk is what propels the device. Maintaining core recruitment throughout the entire motion will protect your spine.
4) Dynamic stretch of the psoas: The psoas muscle is a hip flexor and is commonly tight in people with lower back issues. When performing this exercise, the leg you are pushing off (the trailing leg) finishes in full hip extension with a gluteal contraction. This maintains flexibility of the psoas. If someone has a tight, symptomatic psoas/lower back, they may stop short of full hip extension and even hyperextend their lower back in order to complete the movement. Watch for these compensations and correct them. The hip drive you perform with this "trailing" leg during trunk rotation is a common motion in many sports. As you become accustomed to the movement, increase the amount of hip drive. This is a great technique to include in a athletes training program.
5) Foot speed: You must be able to adjust your weight distribution from 1 leg to the other frequently, rapidly, and safely to perform this technique. As the demand on the upper body changes, the weight distribution on the lower extremities must also adjust in order to maintain balance and efficiency.
So, give it a try. Keep the upper points in mind throughout, and always move with P.E.R.F.E.C.T. Technique.
Please help me provide you with valuable information:
1. For those reading this blog, what type of information would be of interest to you in a rehab/fitness blog or website?
2. What would you like to learn as a fitness/rehab professional or as someone recovering from an injury?
Questions, comments or requests, please contact me at: nicparm7777@aol.com
Join this blog to continue receiving fitness and rehab educational information
The following video is the Nabard Long Device Lateral Thrust.
http://youtu.be/_5tghrO5bQA
There are many benefits of this exercise, as it is a full body technique. However, it is especially good for the upper extremity, including strengthening the shoulder, forearm, wrist and hand (grip). This exercise provides:
1) Scapula Stabilization: You must maintain isometrically retracted scapula when performing this, or else you risk causing shoulder injuries. Scapular retraction is a major posture component. So this technique will benefit posture and those clients recovering from shoulder injuries.
2) Grip strength: With the offset handle of the device, you are forced to grip it tightly in order to control it. Read the prior blog post on grip strength, irradiation and the homunculus for more details. This movement also works on hand coordination and speed, as you transition from gripping the device to releasing the device frequently.
3)Core/Trunk rotation: As you increase speed of trunk rotation, you demand more from your core to control the rotation. You should not allow the device to create rotation of your trunk. Your trunk is what propels the device. Maintaining core recruitment throughout the entire motion will protect your spine.
4) Dynamic stretch of the psoas: The psoas muscle is a hip flexor and is commonly tight in people with lower back issues. When performing this exercise, the leg you are pushing off (the trailing leg) finishes in full hip extension with a gluteal contraction. This maintains flexibility of the psoas. If someone has a tight, symptomatic psoas/lower back, they may stop short of full hip extension and even hyperextend their lower back in order to complete the movement. Watch for these compensations and correct them. The hip drive you perform with this "trailing" leg during trunk rotation is a common motion in many sports. As you become accustomed to the movement, increase the amount of hip drive. This is a great technique to include in a athletes training program.
5) Foot speed: You must be able to adjust your weight distribution from 1 leg to the other frequently, rapidly, and safely to perform this technique. As the demand on the upper body changes, the weight distribution on the lower extremities must also adjust in order to maintain balance and efficiency.
So, give it a try. Keep the upper points in mind throughout, and always move with P.E.R.F.E.C.T. Technique.
Please help me provide you with valuable information:
1. For those reading this blog, what type of information would be of interest to you in a rehab/fitness blog or website?
2. What would you like to learn as a fitness/rehab professional or as someone recovering from an injury?
Questions, comments or requests, please contact me at: nicparm7777@aol.com
Join this blog to continue receiving fitness and rehab educational information
Friday, August 26, 2011
Grip and the Homunculus
Does anyone know who or what the Homunculus is?
It is a "pictorial representation of the anatomical divisions of the primary motor cortex and the primary somatosensory cortex, i.e., the portion of the human brain directly responsible for the movement and exchange of sense and motor information (namely touch: sensitivity, cold, heat, pain etc.) of the rest of the body. There are two types of homunculus: sensory and motor. Each one shows a representation of how much of its respective cortex innervates certain body parts." (Wikipedia)
In short, it is a caricature of a "little man" whose body parts are drawn in size to represent the area of the sensory/motor cortex of the brain that innervates each respective body part. There are larger portions of the brain processing information received from some body parts compared to other body parts. One example of this is the hands, which have a very large representation on the brain's sensory/motor cortex.
With this in mind, will training grip engage a larger portion of your brain/Central Nervous System? Will grip strengthening assist with neural plasticity in patients or clients who have suffered a stroke and want to regain function? Will it enhance the development of motor/movement patterns for athletes? As a Physical Therapist and Personal Trainer, I have incorporated grip strengthening into all of my client's sessions. When working with someone who is in the initial recovery stages of a rotator cuff repair, usually the protocol begins with 6 weeks of passive range of motion, meaning, the client lays down while I move their shoulder. He/she is not allowed to actively move the shoulder on his/her own. But, he is allowed to move the elbow, wrist and hand. That is to maintain mobility/strength in the peripheral joints. But will incorporating grip strengthening also assist in shoulder rehab by stimulating a large portion of the motor cortex? Does working grip make neighboring joints, such as the shoulder stronger?
Try this: Next time you are performing a 1 arm shoulder press, as you approach fatigue, make a tight grip on both the working and the non-working hand. Does it make it easier to press the weight? Better yet, as you approach fatigue, tighten the grip on both hands, as well as clench your glutes and tighten your thighs. Even easier now, right? This "irradiation" technique can also be used with less functional clients who have difficulty transferring from a seated position to standing. Ask them to move from sit to stand. If they have difficulty, have them try again, this time while making 2 very tight fists. This has amazed many of my patients, as at first they barely are able to stand, and then magically the second time they practically shoot out of their seat. My advice is to incorporate grip techniques into every training session.
It is a "pictorial representation of the anatomical divisions of the primary motor cortex and the primary somatosensory cortex, i.e., the portion of the human brain directly responsible for the movement and exchange of sense and motor information (namely touch: sensitivity, cold, heat, pain etc.) of the rest of the body. There are two types of homunculus: sensory and motor. Each one shows a representation of how much of its respective cortex innervates certain body parts." (Wikipedia)
In short, it is a caricature of a "little man" whose body parts are drawn in size to represent the area of the sensory/motor cortex of the brain that innervates each respective body part. There are larger portions of the brain processing information received from some body parts compared to other body parts. One example of this is the hands, which have a very large representation on the brain's sensory/motor cortex.
With this in mind, will training grip engage a larger portion of your brain/Central Nervous System? Will grip strengthening assist with neural plasticity in patients or clients who have suffered a stroke and want to regain function? Will it enhance the development of motor/movement patterns for athletes? As a Physical Therapist and Personal Trainer, I have incorporated grip strengthening into all of my client's sessions. When working with someone who is in the initial recovery stages of a rotator cuff repair, usually the protocol begins with 6 weeks of passive range of motion, meaning, the client lays down while I move their shoulder. He/she is not allowed to actively move the shoulder on his/her own. But, he is allowed to move the elbow, wrist and hand. That is to maintain mobility/strength in the peripheral joints. But will incorporating grip strengthening also assist in shoulder rehab by stimulating a large portion of the motor cortex? Does working grip make neighboring joints, such as the shoulder stronger?
Try this: Next time you are performing a 1 arm shoulder press, as you approach fatigue, make a tight grip on both the working and the non-working hand. Does it make it easier to press the weight? Better yet, as you approach fatigue, tighten the grip on both hands, as well as clench your glutes and tighten your thighs. Even easier now, right? This "irradiation" technique can also be used with less functional clients who have difficulty transferring from a seated position to standing. Ask them to move from sit to stand. If they have difficulty, have them try again, this time while making 2 very tight fists. This has amazed many of my patients, as at first they barely are able to stand, and then magically the second time they practically shoot out of their seat. My advice is to incorporate grip techniques into every training session.
Thursday, July 14, 2011
Nabard Combat Training For Post Rehab Fitness
Nabard Combat Training is a great way to incorporate multi-joint movement patterns into a client's fitness routine. Mastering these diagonal patterns may assist in maximizing both functional and athletic skill performance. In addition, the exercise techniques help in developing proprioception of the joints (joint awareness) as well as stabilization and grip strength. Check out these videos.....After watching, you will see this style of training is much more than just combat training. It can be incorporated into any post rehab fitness program as well for people of all ages.
http://youtu.be/tCo30lBPIHU
http://youtu.be/-DD96ukM1bo
http://youtu.be/9mNxq5VJKxQ
http://youtu.be/PfYv5quhbWU
http://youtu.be/tCo30lBPIHU
http://youtu.be/-DD96ukM1bo
http://youtu.be/9mNxq5VJKxQ
http://youtu.be/PfYv5quhbWU
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