WEEK 19 Iliopsoas, on the ground training and tweaking for success

This week was full of new information and concepts. We had been trained as therapists to “train the way you play” i.e. if you perform in an upright position, you should train in an upright position. The Gray Institute has looked closer at on the ground training, and thinks we are missing a key to using  the bodies natural developmental stages, in the first year of life, to assist in upright function.

We can look at the Transformation Zone of  upright function and decide what would assist with on the ground function. We can use  a variety of start positions such as prone, supine, side ly, and kneeling, with manipulations of these positions. Then use drivers of the head, trunk, hands, pelvis, and feet to move the body for greater mostablity.

The muscle discussed this week was the Iliopsoas. It is the muscle called on in emergencies and is responsible for swinging the leg and body through from toe off to heel strike in gait. It has connection to the transverse processes of L1-L5 and vetebral bodies of T12-L4. This muscle is loaded significanlty with transverse plane motion (internal hip rotation), but also extension, Abduction (Psoas muscle) and Adduction (Iliacus muscle) of the hip. Even if the hip is flexed it’s transverse and fontal plane loading has an important part to play in function.

At the spinal level, rotation of the spine can load the Iliopsoas, depending where the spine is relative to neutral. In the front leg of gait it is unclear of the Iliopsoas decelerates lumbar rotation or rotates it in the same direction as the pelvis. The iliopsoas will decelerate contralateral Lumbar lateral flexion.

Remember AFS is.. encourage transformation in others through the creation of personalised environments, using drivers, to create normal chain reaction through the body. If we can choose the correct drivers to load the Iliopsoas, we can create the explosive power we need it to produce for function.

Finally we looked more at tweaking the body for success. If we can choose the degree of tweaks (subtle to dramatic) which encourage the desired change reaction in the body, we can become more effective at attaining success. We looked at using bilateral symmetrical and assymetrical hand drivers, and then whether to use them in an alternating fashion. We looked at the power of the pelvis as a driver and how this is often the key driver in function.

We are starting to learn more about the spine and the muscles influencing the spine. I look forward to enhancing my knowledge of chain reaction biomechanics through spine and then the shoulder girdle.

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Week 18 Thoracic spine

This week we started assessment of the spine, in particular, the Thoracic spine. The Thoracic spine is an area of the body which can create problems in many other areas, such as the Low back, Cervical spine, Shoulders, Knees, Hips and Feet. The abdominal muscles require full 3D motion of the Thoracic spine if they are to be loaded to explode. The power transfer from the movements of the pelvis and hips are will maximised through full Thoracic spine motion.

The Thoracic spine can create pain in other areas of the body, but not have pain itself or have less pain. The Lumbar Spine acts as a force transmitter, passing forces between the upper and lower halves of the body. If there is low back pain, the Thoracic Spine must be assessed. 

The Thoracic spine is a region of mobility in all three planes. Some planes will have more movement depending on the level of the Thoracic spine. The rib cage makes it a stable region and the rib articulations must be assessed.

I can see the Thoracic spine assessment and treatment will use top- down and bottom- up drivers and is best done in gravity influenced positions.

Week 18 also looked at the value of tweaking the environment on the Chain Reaction. It was interesting to see how increasing the pronation of a foot (not to end range) can create greater load to the lower limb muscles and therefore be a valuable tweak in exercise progression. We also looked at diagonal lunges and how the foot position can be altered to change the load through the chain reaction.

This week was an introduction to work on the Spine. It will be great to see how we connect the shoulders to the spine and use 3D motion to rehabilitate the shoulders.

Week 12: JOPing and 1st Ray biomechanics

This week has been a further progression on understanding the foot, and its important role in helping the rest of the body move. The three key areas of body which must funciton correctly are the Big toe, Bog Butt and Big Belly.

The big toe must Dorsiflex in the push off phase of gait to optimise the chain reaction up the rest of the body, and proper Butt and Abdominal activation. To Dorsiflex well the Ist Ray must position itself in Plantarflexion. This requires the subtler joint, ankle, hip and the opposite leg all to move load and explode correctly. The upper body is also involved.

The treatment approach could start with therapist mobilisation of the foot to improve DF of the 1st ray. It could then progress to client mobilisation, and weight bearing mobilistaion.

Included in this weeks Chain Reaction Biomechanics is the knee. What happens to the knee in when the foot hits the ground and when the foot is about to leave the ground. The knee is wedged between the foot and the hip. To understand how the knee moves is to understand how the hip and knee influence the femur and the tibia.

Functional exercises reviewed this week was the JOP (Jump-Hop). This means jump off two feet and land on one foot. There was progression to JOPing along a 3D plane and then Joping along a plane whilst maintaining the JOP in a different plane. There are amazing progressions for movements and all challenge the body to load and explode in different planes. The skill is to choose which one is the best for the client in front of you.

Finally, we were asked to identify which lunges would load the Medial collateral ligament of the knee the most and least. We placed the lunge matrices in order of least load to most load. It was a great exercise to understand how to choose the most approprate lunge for a pathology of the knee. This skill does require and understanding of Chain Reaction Biomechanics of the knee.

I look forward to improving my skill in assessment and exercise selection next week.

Week 8: TZ1 and subtalar and midfoot joint motion

This week we covered the techniques to mobilise the subtalar joint and mid tarsal joint on the treatment table. These joints were mobilised by understanding how these joints connect and influence each other in weight bearing. These techniques were easy to use, and performed in as close to the normal hip and knee position as possible.

Using techniques on the treatment table fail to include the forces of gravity, ground reaction forces, mass and momentum when in weight bearing positions.  We can use environmental aids and in standing positons to best replicate normal funciton, and then mobilise the joints of the foot.

 

To be able to select the best position to place the body and then drive the body to get the desired chain reaction we can use TRAZMA analysis. In this analysis we look at what the bones are doing and what the relative joint motion will be. This is a key analysis to help confirm the correct drivers and body positions are used to get the desired chain reaction.

 

This week we covered balance and how we can mobilise the joints to get better stability with motion. There are many positions to use to test balance and they all involve movement, instead of standing still on one leg. 

 

We are one week away from Gift Gathering 1. There is a good build up of skill before the gathering. Time to test it out. 

Week 6: Front and back hip in gait

Week 6 has completed and it was great to learn more about  the hip joints and muscles. This region has some of the biggest muscles in the body and is the powerhouse for movement. The way the body moves from the feet to head, or the head to the feet, loads the hip joints (eccentric) in preparation for an explosive (concentric) unload. The triplane motion of this joint and, in particular the transverse plane internal rotation in gait, enables the buttock muscles to perform ecocentrically. This means the muscle uses its eccentric lengthening to perform concentric shortening, both at the same time.

 

The primary movement assessed this week was gait. We looked at the front hip and back hip in gait. We took our knowledge of what happens at the foot in gait and learnt the chain reaction up to the pelvis. It was clear that the movements through the chain reaction prepare the buttock muscles to load and then unload powerfully. We also looked at golf and how both hips are loaded in the back swing, in preparation for an unloading powerful stroke.

 

The webcasts on 3D squat looked at the various combinations of bilateral squat movements using combinations of saggital, frontal and transverse plane positions. (There are 27 possible combinations).

We also added in arm motions and also did triplane motion using single leg balance positions.

 

We grew our understanding of nomenclature using the SaFTey syntax. The key to assessment is to make the tweaks small at the start and see the clients response and then make the tweaks bigger later. We know the most powerful tweaks can be those planes of motion which are not the primary plane of motion of the joint.

We increased out understanding of nomenclature by learning how to describe exercise movements and how movements are done in reference to a common point called a Tripost.

 

In AFS Strategies we learnt about the desire of the body for success, to have fun, to be avoid pain. If we can have all these elements in our approach the body will unconsciously want to do the movement.

 

We finished the Sign language alphabet. It was not that difficult to learn and I look forward to learning some great new phrases.

 

Overall this week took the concepts of AFS and put it into the function of gait. Great week to consolidate some key principles in tweaking for success

 

 

 

 

 

 

 

Physical Edge starts training with the Gray Institute

This blog will follow the Journey of Rhys Chong, from Physical Edge, through his 10 month training in GIFT, with Gary Gray and the Gray Institute. GIFT is a course designed to encourage the transformation of others, through unique environments, using drivers to create biomechanical chain reactions. The course will achieve faster and functional results in Physical Therapy.
 
There will be a weekly update for those clinicians or clients interested in following the journey.
 
Week 0-3
 
In the first three weeks of GIFT we were introduced to the concept of Principles, Strategies and Techniques. There was an emphasis on the Scientific truths from Physical Sciences, Biological Sciences and Behavioural Sciences. From these Principles (Truths), Strategies were formed and then Techniques created. 
 
GIFT involved an understanding of the Mind, Body and Spirit. When one was altered, the other two would also be altered. This 3 Dimensional relationship was taken into treatment to create an encouraging transformational environment.
 
We were shown Lunge Matrices (logical 3D sequencing of movements) which opened up the possibility of assessing two sides of the body at once in a weight bearing position. To understand what to was happening at each joint in the body we were taught about bone motion and relative joint motion. 
 
There were some European clinicians on the course, but mainly American clinicians. The team at the Gray Institute pride themselves on giving the best possible course and service. They are all very approachable and easily contacted. They respond to emails quickly. 
 
The training is on webcasts with three trips to the USA to study. The webcasts had issues initially, but now a working with Vimeo.
So far the training is excellent and I look forward to the weekly training which starts each Thursday of the week.

 

Triathlon gear for your first Ironman

Making a decision to do your first Ironman must be taken seriously. It requires 12-6 months of training, through 3-4 different seasons. One of the first choices to make, before you start training, is what Triathlon gear you choose to use.
Be ready to be shocked, as there is more than you might first imagine. The ideal is to have good quality Triathlon gear, which will last you 12 months of training. If you choose to continue racing Ironman you can upgrade. There is a noticeable difference in performance, comfort and longevity of more expensive Triathlon gear.
What do you need? In summary, you need triathlon gear for the Swim, Bike and Run. The most expensive items will be your Triathlon bike and Triathlon wetsuit. You will need additional gear for colder climates for each sport. There is also nutritional supplementation, transitional and race day kit e.g race belt, transition box, and bike box.
There are several websites which can provide Triathlon Gear at better prices (www.eurekacyclesports.co.uk and www.wiggle.co.uk). These are useful if buying simple items like bike computer, googles etc. For items which require correct fitting e.g. wetsuits, bike, and bike shoes, it is best to go to a reputable Triathlon Store.
Most athletes who take on Ironman have trained in one or more of the triathlon sports. In this case there will be less Triathlon gear to buy. If you are starting from scratch, you could spend the following amounts in each area of triathlon (estimates for good quality Triathlon Gear for 12 months of training) Swim £500 including wetsuit, Bike £2500 including bike and bike computer, Run £200, nutritional supplementation £200, Race day £300 including bike box. Additional expenses would be flights and accommodation costs on race day, entry fee for the race (£500) and coaching.
Physical Edge (www.physical-edge.com)  hopes this information is useful. We specialising in helping athletes race Ironman for the first time. If you want to know more about coaching costs and training,  do get in touch with us and we look forward to talking Ironman with you.
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