With football season starting, let us remind ourselves of some of the most common injuries. While high ankle sprains may not be as common as inversion ankle sprains, high ankle sprains are much more complicated. Athletes are typically out for weeks and sometimes months if they do not balance rest and rehabilitation properly. All too often sports physical therapists are left with a lengthy rehab for these athletes.
Dan Lorenz is a Duke sports fellowship trained physical therapist and athletic trainer who owns a practice in Kansas City. He is also one of the best minds in the PT community in integrating strength and conditioning principles with physical therapy. In this blog post, Dan breaks down what high ankle sprains are, the causes, the recovery timetable, and his suggestions of what should be done during rehabilitation. Additionally, he reminds us of some of the newer research pertaining to implementing a screw into the distal tib-fib to help improve the healing process. Check it out!
For those of you who are unfamiliar with Kelly Starrett, he is a physical therapist/trainer you should get to know. He put out a book called "Becoming a Supple Leopard" and runs a business that works with a lot of crossfit athletes. His work is unique and good to get familiar with.
In this video, he explains how to teach better mechanics with a deadlift. While it may be on the side of strength and conditioning more, its very sports related as there are many people getting into crossfit that have been getting injured land want to return. Understanding how to teach movements based on what you see is vital. Kelly does a great job of this and has many more videos on his youtube page and/or website. Check it out!
Did any of you listen to Mike Reinold's free webinar on Thursday? For those of you who did not have the chance to, it was really good. The purpose of the webinar was to analyze the relationship between rehabilitation and performance. During the presentation Mike made the distinction between how rehabilitation specialists differ from performance specialists but more importantly, how they can WORK TOGETHER. He was 100% on target when he said both professions are missing a lot of opportunity by not working together.
Mike laid out three fundamental principles to think about before giving his five points. He said that our goals for our patients/clients are to: feel better, move better, and perform better- in that order. Furthermore, he showed the viewers how performance specialists overlap in the "move better" goal with rehabilitation specialists. And its true. There is currently a big kick right now in the fitness industry on self mobilizations while therapists like to use more hands on. Both are great and help the patient or clients toward better function.
Now, onto the 5 key points:
1. Understand the Kinetic Chain & Functional Anatomy
- We need to know the basic parts but more important is the INTERACTION between parts
- Don't forget muscles act in 3 planes (triplanar motion)
. Understanding the Kinetic Chain Ripple Effect
- Don't just think of this as a joint issue, consider soft tissue interaction as well
- Always think in 3D, we can't get stuck in 1D all the time
2. Understand how to assess movement
- This was one of the longer segments of the presentation and he felt that this is something we can continue to work on
- FMS gives us objective measurements for movements. Don't just let it tell you what your patient can't do, but what it CAN do as well.
3. Understand Alignment
- The body is not always supposed to be neutral and symmetrical, especially in athletes!
- Depends on your population
- Alignment becomes important in evaluation when for example you test out a SLR. If the pelvis is rotated you may get a false sense of the true length of the hamstrings with SLR
4. Understand Mobility
- While Mike believes mobility before stability, he emphasizes alignment before both mobility and stability
- Without adequate mobility, if we strength train, then we are putting "strength on top of dysfunction"
5. Understand Stability
- Important for motor control. For example: getting the glute max to fire
- Still okay to isolated muscle strengthening, when appropriate
He finishes the five key points with a take home message: None of this is rocket science and most of you know these things. However, learn to INTEGRATE them all together for most optimal results.