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Catching up on the latest from Rehab HQ

Tendon Compression (Achilles) by Chris Mallac



Biomechanically the main issue that will affect Achilles is “eccentrically loaded end of range dorsiflexion”. If its inflamed you even have to limit stretching of the Achilles as it will compress it onto the calcaneus (heel). Ohhh you know what?
 



Tendon Compression (Adductor) by Chris Mallac



Adductor tendons. The compression zone for this tendon is the attachment onto the adductor tubercle of the pelvis. When the leg is adducted (as it would be with a follow through after kicking a ball) the tendon can be pushed up against the adductor tubercle and a pathology may develop. Hence why this problem is common in footballers.
 


Tendon Compression (Upper Hamstring)

Let’s dive around the back of the lower limb to look at what may happen (especially for athletes) at the upper hamstring.

  

Tendon Compression (Patella) by Chris Mallac



Patella tendon: This is the classic "jumpers knee". The spot of maximum tenderness is usually the tendon as it attaches onto the distal pole of the patella. When the knee flexes (bends) the change in angle of the tendon to the patella causes the pointy inferior pole to push into the uppermost portion on the patella tendon. Again, this compression area corresponds very closely to the site of pathology.
 


Gym Junkie's Elbow: Tendon Compression



We know that tendons can be subjected to compression zones and these tend to correlate very well to the site of tendon pathology. The simplest way to explain this is...
 


Gym Junkie's Elbow Supinator Retraining


The Supinator muscle: A little-known lateral elbow muscle that seems critical in the control of the Head of Radius, especially as the forearm is in more pronation it does the important job of eccentrically controlling it.


Gym Junkie's Elbow Bicep Retraining


Check out the video to help you retrain Bicep Curls via three progressions of loading. Low loads, slow tempo, and thoughtfulness are key. And minimal pain levels, of course ;)


Gym Junkie's MFR for Lateral Elbow

I have a treat for you today as I beat up on my friend Brad’s tight and grumpy (there’s that word again..) elbow musculature! Don’t forget MFR = “Myo-Fascial Release" which includes quite a few different techniques from firm rolling, to light rubbing, to deep pressure point release, to active movements.

  


Gym Junkie's Elbow Neural Risk Assessment

Get clients to gently try these movements to rule out any nerve component to their injury. If they are clear, then you are safer with that Low Risk injury! Simple.

  


Gym Junkie's "Tennis Elbow" Self-Assessment

These assessments I’m giving you are actually quite functional rather than clinical, and can be done by anyone safely - just take note of pain levels so as not to aggravate any injuries of course.. 

Kicking off 2018 Rehab Fridays

Hi again - wow didn’t that break go quick! 

2018 is upon us. Chinese NYr is soon upon us too.

I was very busy doing "holiday time rehab" because in December I tore my shoulder A/C joint doing handstands (and falling over on to the point of my shoulder)….silly season it is ;)

I’m back to overhead press and chin ups again so we’re getting there.. really helps focus the mind when you have strong pain doesn’t it?

 
 

Holiday time Rehab

My gift to you is a bit of Elbow Pain reading. Enjoy it when you get a quiet or a motivated moment over the next few weeks. 


Case Study #1: The Climber's Elbow

Climbing flexes the elbow repeatedly with a fully pronated forearm, overloading Brachioradialis and Pronator Teres muscles and irritating the superior radio-ulnar joint for many weekend warriors. Here's how to rehab and strengthen these.
 




GYM AND THE GYM JUNKIE'S ELBOW

Here is my small list of key things to look for in Gym-related Elbow Pain.
 




The Gym Junkie's Elbow begins


Let’s do a little series entitled “Gym Junkie’s Elbow” and see what we can all learn. I’ll also get small opinion articles from our other Educators to help us learn, and send you little videos on what you can do to help clients along towards improved function and less pain.


Grumpy Knees Reflection

Have you found some useful tips in this series that have moved you down the scale towards the 0/10 of pain? I truly hope so! - that makes it all worthwhile for me.


Deactivating Hamstrings Part VI

Today - myofascial and trigger point releasing for Gluteus Medius / Maximus and Piriformis.

  


Anterior tilt and Grumpy Knees

How can you break the hold of excessive anterior tilt on the pelvis? It's tricky but this exercise will slowly but surely create muscle balance around that pelvis.

  

Deactivating Hamstrings Part IV

Our drill today is a brilliant assessment tool for seeing which direction of pelvic tilt you are weak in. In other words are you too posteriorly tilted (like last week), or too anteriorly tilted? Most of us are one way or the other inclined and that affects our Hamstrings and Knees in different ways. 



Deactivating Hamstrings Part III

Overactive Hamstrings really mess with human biomechanics, and need to be deactivated via as many different channels as possible. Today we focus on those who have excessive or uncontrolled Posterior Tilt. 

Deactivating Hamstrings Part II


Do you struggle to grow your Glute Max? Perhaps you have some of what I affectionately called 'No Ass Syndrome'? It is a fun way to descriAbe the end result of when you (probably) have too much posterior tilt in your pelvis movement, and of course also (probably) have Hamstring Dominance.



Deactivating Hamstrings for Grumpy Knees #1



Today - a quick video with some Rehab Training ideas for deactivating your Client’s and your own Hamstrings. This is great for clients with hyperextending knees - turn down those whammies before turning up their quads and glutes!
 


Why Dominant Hammies suck for Knees



Grumpy Knees are STRONGLY connected to tight and over-active Hamstrings. Here's why.
 

Decline Board for Dominant Hammies

If you haven’t seen it before let me introduce you to the decline board for patellar tendon pain - an idea developed specifically for the purpose of eccentrically loading degenerative patellar tendons, in order to create positive changes in the tendon and 'rebuild' it from the inside out.




Dominant Hammies with Grumpy Knees

I’m sure you agree that we have spent a good amount of energy trying to improve our Quadricep Quality? Quad tightness, increased VL tone (neural tension), tightness, VMO inhibition and atrophy, etc are all critical. But what if there's one more major ingredient that keeps Quads under-active?



Taping for Grumpy Knees in Masterclass

Grumpy Knees need a lot of attention to rebuild them, partly for all the 4 reasons we alluded early in our series (see below for a refresher - if your knee is still struggling, then can you name which is still your greatest challenge of the four?)




How Are Your Grumpy Knees after 4 months?

Today we launch into Australia 'Rehab Elite' - our newest 3-day course written fully by Chris Mallac, our very own world acclaimed Sports Injury Doctor!




Medial Tubing Pull for Grumpy Quads

Today's video from 2011 in Iceland trials different techniques that cause up to 25% increase in VMO activation by applying tubing in a medial direction. See how.

Ball Squeezing for Grumpy Quads? GQ12

Uh ohhh look out... this one might mess with a few heads because a "sacred cow" is being threatened ….and this one is controversial! Friends, we are talking about whether or not to squeeze a ball together between the knees during squat to help with knee pain. 




Rehab Friday 115: Early Fx Integration for Grumpy Confused Quads 11

In all my Physiotherapy days treating knee pain, I was never more grateful for any piece of equipment than for the Leg Press they had in the massive gym next door to our Sports Medicine Clinic at Lutwyche in Brisbane. It was perfect! - the kind that moves your body away from the platform, not the platform moving (less functional I think). 

Though I use a wall instead of the machine, today’s video brings together many critical elements that need to be taught to clients with Grumpy Knees (and therefore Grumpy Quads!)

  

Firing UP Grumpy Quads 10

It all starts with firing Up your quads every day if you are in pain, before sports or fitness in your warm-ups, and adding a very determined approach that may involve a bit of slapping as in the video!

  


Switching ON Grumpy Quads 9

Let’s just pause for a deep breath in this series on Grumpy Knees…we have spent a good few newsletters now on Quad releasing, trigger points, R1/R2, and stretching, and how have you found this? Anything new for you? What do you find hardest to do if you have Grumpy Knees?

No video today, instead just want to intro a new direction for us: activation and strengthening of Quads. 

The challenging reality we face and discussed earlier was that "Stubborn Quadriceps are surprisingly vulnerable to inhibition and atrophy, and doesn’t like operating when pain and swelling is present. It’s a real Catch-22…weak quads result in knee problems, which result in weak quads. Chicken and egg.”! 

  

Passive Stretching R2 Mobility for Grumpy Quads 8



Straight after myofascial release, use that window of freedom to lock in some longer term changes. These two passive Quad stretches should be absolutely taught to every client with knee, hip, and low back issues.
 



Myofascial R2 Mobility for Grumpy Quads 7

Sounds like a technique on a certain Star Wars character ;) Seriously though, watch today's video and reduce Myofascial “knots”!


VMO Trigger Activation for Grumpy Quads 6

Watch me tackle my VMO Trigger Points in the video in order to activate it!


Hypersensitive Fascia Grumpy Knee 5

To assess for tight fascia on your client I recommend the simple method in today's video.  If it's tight, there will be areas of hypersensitivity in the fascia preventing easy expansion and movement of the local tissues down to the knee.


Triggered Quads Grumpy Knee: GQ4 R1 MFR Side Sit

If your Quadricep R1 has subtle tension that kicks in due to neuromuscular tension rather than tightness, now it’s time to get out your favourite myofascial release tools and have some fun! 

We are searching for “landmines” (or Trigger Points)! 



GRUMPY QUADS GRUMPY KNEE 3: R1 ITB & MFR



Grumpy Knees have Grumpy Quads that are tense and tight every time. Do your homework to release the triggers and fascial tightness - and today’s video shows me doing it to myself with the Rehab Dowel. Mark my words it’s a good pain!
 


Grumpy Quads Grumpy Knee 2

If you have knee pain, it ultimately will come down to this, and if you don’t then this is the ultimate knee injury prevention strategy! 



Grumpy Quads Grumpy Knee 1

If you have a Grumpy Knee, you MOST DEFINITELY HAVE Grumpy Quads. Guaranteed. So how can we break the cycle for ourselves and our clients?

  

Grumpy Knee Diagnosis

What’s the Diagnosis of your Grumpy Knee? 

Well, I’m going out on a limb here when I make the call that INSTEAD of focusing on structures and diagnosis, we SHOULD focus on these three things to improve knee function. Read on!

  


4 Realities for Grumpy Knees

Knees have lots of bits to get Grumpy. Here are 4 realities you need to know.

  


A Summary of Serratus

Let’s take stock of Serratus Anterior - a muscle surprisingly misunderstood and undervalued in the exercise and even allied health industries. Its the powerhouse of the active shoulder, and absolutely critical for overhead shoulder health.

  


Integrating Serratus Part II

Learn this complex integration exercise, guaranteed to increase whole body synergy, warm-up and a multitude of secondary benefits! 



Serratus Conductor

Train the brain to automatically include Serratus in movement. That’s the goal. Train the BRAIN. Here's how!



Serratus Seatbelt work: a peek from Practitioner

Enjoy using the Rehab Belt to activate and empower Serratus Anterior! 



Serratus Taping: a peek from Masterclass

Anyone can try this on clients. Who says you have to be a Physiotherapist to do this? Go ahead!


Serratus Q-mark Drill

Presenting the famous “Q-mark Drill” from Chris (actually it’s an upside-down Q-mark hahaha!) Use a towel or a swiss ball for this cute drill, teach your clients and make sure if they have any shoulder niggles they are doing 30-40 reps / day. NO compromise! ;


Iso-integrating Serratus II

Fire-up Serratus during elevation in the forward plane! Iso-integrating Serratus II is a “selfie” (a drill you do yourself)…so watch the video to learn!


Iso-integrating Serratus in Scaption - WTF??

If you can even understand what "Iso-integrating Serratus in Scaption” means, then boy oh boy! - you are no average Personal Trainer. Let’s unpack it to make sure this simple powerful concept doesn’t get lost in translation shall we?