The Physio Room

Getting strong does not mean you need to get big

2017-08-29T21:37:00.001-07:00

Getting strong does not mean you need to get big! For many athletes, the idea of getting big outweighs the urge to get strong as the belief is the 2 go hand in hand. 1) lift heavy weight with fewer reps. You are more likely to get big lifting 4 sets of 8-12 then 3 sets of 5-8! 2) Muscle can only grow with a calorie surplus. Muscle needs energy and protein to grow! 3) Speed and power is a very good way to develop the efficiency of the muscles, allowing you to lift more with out putting on weight!

Beautiful illustration of the deep and superficial musculature of theback

2017-08-29T10:12:00.001-07:00

Beautiful illustration of the deep and superficial musculature of the back. This anatomical slide by Netter shows in high detail the intricate muscle layout of the upper back and neck

Are deep squats bad for your knees?

2017-08-29T09:37:00.001-07:00

Are deep squats bad for your knees? Provided that the technique is learned accurately, under expert supervision with progressive loading, the deep squat presents as an effective exercise for protection against injuries and strengthening the lower extremities.

Sports lower limb trauma

2017-08-29T08:20:00.001-07:00

Sports lower limb trauma. Xray: Spiral comminuted fracture of the distal diaphyseal region of the left fibula, 8cm above the lateral malleolus. Early management: cast 6 weeks, non-weight bearing.

Meniscal tears

2017-08-29T08:14:00.001-07:00

Meniscal tear. Although meniscus damage can lead to pain, dysfunction and a decrease in performance, this is not always the case. Many individuals have meniscal injuries which they are unaware of. Surgery may indeed be an appropriate mode to relieve any one of these symptoms but the simple fact that a meniscal injury is present does not necessarily indicate surgery. Other treatments can be highly effective in resolving associated issues without the need to resort to surgery.

The importance of muscular strength in athletic performance

2017-08-29T07:28:00.001-07:00

The importance of muscular strength in athletic performance: 1) Greater strength is associated with improved force\time characteristic (impulse) 2) Greater strength can improve jumping, sprinting and change of direction 3) stronger athletes performed better at sport specific tasks 4) Strength improves muscle potentiation and decreases injuries 5) Strength can be tested, trained and retested 6) Performance can be gaged based on an athletes strength classification 7) Strength could be the single most trainable ability to improve performance and reduce injuries 8) Strength training can be specific, long term to achieve improvement in sports related tasks.

Comparison between a healthy PCL and a torn PCL on MRI

2017-07-29T23:54:00.001-07:00

Instagram: nicjbrink55

Major ligaments of the knee

2017-07-29T23:51:00.001-07:00

Anatomy of the lateral ankle

2017-07-29T23:45:00.001-07:00

Heavy slow resistance vs Eccentric training as treatment for achilles Tendinopathy

2017-03-08T08:08:00.002-08:00

A nice infographic about rugby related injuries from Brink & Carleo Physiotherapy

2017-03-02T10:01:00.004-08:00

Mechanisms and Factors Associated With Tackle-Related Injuries in South African Youth Rugby Union Players

Background: The majority of injuries in rugby union occur during tackle events. The mechanisms and causes of these injuries are well established in senior rugby union.

Purpose: To use information from an injury database and assess video footage of tackle-related injuries in youth rugby union matches to identify environmental factors and mechanisms that are potentially confounding to these injuries.

Conclusion: The relative risk of tackle-related injury was higher toward the end of matches. Incorrect technique may contribute to increased injury risk. Implementing recovery strategies between matches, training safe and effective techniques, and improving levels of conditioning may counter the negative effects of fatigue. These findings may assist stakeholders in youth rugby to formulate injury prevention strategies and may improve the preparation of field-side medical staff for managing tackle-related injuries at these or similar tournaments.

Nike Zoom Superfly R4 Running Spike - 2016

2016-04-18T11:52:00.001-07:00

'I have no affiliation or personal relationship with Nike. All opinions are my own'.

The Nike Zoom Superfly R4 Track Spike is an ultralight spike made for the power sprinter. Typically the tool for the short sprints and hurdles the spike features controlled lockdown across its top and a powerful spiked plate for traction and propulsion.

The upper used Flywire cables to create a glove like fit by clamping down the foot creating a secure confident lock while a thin Phylon midsole wedge provides lightweight, low-profile impact cushioning. The rigid outer Pebax® plate provides feedback and delivers potential energy into every stride.

This shoe is for the elite sprinter. Updated from its predecessor for the experienced the Nike Zoom Superfly R4 Running Spike is designed for the athlete who wants a dynamic, locked down fit with an aggressive plate that offers stability without increasing bulk.

Adidas Spikes for 2016 (Adidas Adizero Prime SP Running Spikes)

2016-04-18T11:49:00.001-07:00

I have no affiliation or personal relationship with Adidas. All opinions are my own.

Adidas Adizero Prime SP Running Spikes

The Adidas Adizero Prime SP Spikes are one of the lightest track spikes available. They deliver superb returns from each stride while keeping the foot in place to generate greater forward propulsion.

Weighing just 96g, this spike facilitated optimal performance for the elite athlete. The synthetic upper works in conjunction with the Sprint plate to prevent lateral foot motion while allowing optimum forward propulsion on the straights and curves.

The adiZERO Nano Plate enhances the potential energy from each stride transferring the power through the foot while reducing the torque across the mid-foot. This provides a greater energy return, propelling you forwards.

This shoe is the elite sprinters choice. Developed for the experienced athletes who desire precise feedback while sprinting. For short sprints and hurdles

Acceleration vs Maximum Speed

2016-04-18T11:44:00.001-07:00

I was posed this question ‘ Which is more important to improve, acceleration or maximum speed in sprinting’? The original question was for the 200m but for the sake of this post I will keep it broad.

Well the answer, as you may well have figured is ‘it depends’. Certainly there is a plethora of factors that will influence all races and many intrinsic and extrinsic factors impacting each athlete but for the sake of argument lets assume that our athletes are in a vacuum with minimal influence from outside and our actions will have a direct effect on the outcome.

Before we start we need to discuss the math of speed and acceleration. Speed relates to how quickly the athlete moves. This is done by dividing ‘how quickly’ by ‘how far’. This is important to not to confuse this with velocity, which also includes the resultant direction. This is not important in the 100m as the speed and velocity would be the same but they would be significantly different over the 200m.

Speed = Distance/Time

Velocity = Displacement/Time

Acceleration is the rate of change of velocity. Velocity is measured in meters per second while acceleration is measured in metres per second per second. To determine actual rates of acceleration, instantaneous speed is required i.e. the speed at the 10m mark.

Acceleration = Velocity/Time

m/s to km/h is m per s/1000 x 3600

km/h to m/s is km per h x 1000/3600

But who will run the faster 200m?

These models are hypothetical and to be accurate a coach will need to insert their athlete’s times. But let us assume for a moment that the 200m is divided in to a acceleration phase (0 – 50m), a maximum speed phase (50 – 150m) and a deceleration phase (150 – 200m). We also have the average speed and the total time.

Race phase	Actual time (s)	Acceleration - 3%	Max speed - 3%	Deceleration - 3%
Acceleration (0-50m)	5.90	5.72	5.90	5.90
Max Speed (50-150m)	9.70	9.70	9.41	9.70
Deceleration (150-200m)	5.30	5.30	5.30	5.14
Average speed (m/s)	9.60	9.65	9.70	9.64
Total time (s)	20.90	20.72	20.61	20.74

Therefore if we improve each factor by a 3% margin there is a more profound effect on the average speed with the adjusted maximum speed and therefore the total time in this example. So the answer to this question: the athlete who improves their average speed the most will run faster and in this example this is achieved through improving maximum speed.

In reality this does not happen but it is a nice controlled experiment to see effect. The goal for any coach is to maximize their athletes potential and try to not waste valuable time and energy on inefficient gains. In this example the coach may choose to focus their athletes time on speed endurance and less time on pure speed training however if the distance were changed to 60m then the most likely way to effect average speed would be to improve on the acceleration. Conversely the 400m coach may heavily focus their attention on maximum speed as an improvement in the acceleration phase would have even less improvement than the 200m example.

High kick to sprinters lunge

2016-04-18T11:35:00.001-07:00

High Kick to Sprinter’s Lunge

The high kick to sprinters lunge is a dynamic multijoint exercise that can be used as part of a dynamic warmup, provide an active stretch for the lower extremities or to improve hip mobility. This exercise is ideal for sprinters as it activates the anterior muscles of the leg while providing a stretch for the posterior muscles during the kick phase. The reverse lunge provides a dynamic hip flexor, glutes and hamstring stretch.

Muscles

Iliopsoas, rectus femoris, sartorius, and tensor fasciae latae, hamstrings and gluteus maximus, rectus femoris, vastus intermedius, vastus lateralis, and vastus medialis

Benefits

Although both exercise are often used individually during a dynamic warmup by combining them a component of proprioceptive control is introduced. This coupled with similar movement patterns in sprinting may provide a higher level of specificity and dynamic muscle overload to effectively prepare for training, racing or weights.

Exercise initiation

Begin standing in a neutral position feet hip width apart. Remember in its simplest form sprinting is a sagittal movement. This exercise mimics this and requires the athlete to avoid any deviation laterally during the lunge. There is however some truck rotation to activate the internal and external obliques.

Start position

Action

Initial the exercise with a step forward to preload for the trail leg to come through. Kick the trail leg forward while reaching across with the opposite arm towards the foot. Following the high kick the athlete immediately drops into an exaggerated reverse lunge. The leg posterior has a hip Angle of at least 180'and 90' at the hip knee and ankle of the anterior leg. The athlete holds this position for a moment before returning to the start position.

Preloading

High Kick

Reverse Lunge

Sets and reps

Beginner: 1 set of 3 reps. The exercise can be broken down in to its components until balance and coordination has been improved.

Intermediate: 2sets of 3 - 5 reps

Advanced: 2 - 3 sets of 5 - 10 reps

My opinion

This exercise contained all the components needed in a good dynamic exercise. It could also be argued that it saves time by combining 2 exercises into one. My personal preference in my warm up, have tried it for a few days is that I prefer to perform the high kick and lunge separately. I like to focus on the individual actions of high kick and lunge and I feel that each one is important enough to warrant Its own exercises. In saying that I can't fault the exercise in any way and is useful to add to an extended programme.

Walker, M. Strength and conditioning. (2013). Volume 35, number 5.

The little I know about the warm-up

2016-04-18T11:31:00.001-07:00

The little I know about the warm-up

My earliest memories as an athlete are not of the stadiums or the races, the victories or the losses but the simple grass track where I trained. From those first days it was clear that there was a brotherhood which connects the training group. There was a sense of unity against the pain and affliction regularly distributed by the coach in copious and often excessive amounts. The warm-up was our antebellum. A moment to contemplate, to reflect and to ponder what lay in wait mere minutes in the future. But this time was ours, to laugh and joke and ‘warm-up’ in preparation for training.

Although this was my experience with the warm-up, I am convinced that this was not a unique set of events. Warm-ups have been part of sport for as long as people have realised that some form of preparation may provide an optimal starting block; a point at which the body is ready to undertake physical activity. The generic warm-up was often expressed as a period of time to do what was needed to prepare for whatever it was that needed to be prepare for. Though in many cases I can understand, if not sympathize with an athlete’s lack of enthusiasm for this event. In popular sports, football, rugby and distance running, the athlete competes in most cases at a submaximal level. This allows for more gradual build up and longer maintenance of capacity with less emphasis on an optimal moment.

This is not the case with sprinters. Earlier I spoke of maximal potential. This is an individual’s ability to perform at their optimal capacity over a period of time. Where sprinting differs from other sports is that the period for maximal potential is very small where minute deficiencies have huge effects, hundredths of a second in some cases. Preparation is a vital component in achieving this maximal potential. Every athlete has a unique make up and ultimately this needs to be tailored to suit their individual needs. What is certain is that a generic warm-up is not good enough in this day and age. Our current knowledge on muscle function and physiology is closely linked with our desire to perform at ever higher levels. The problem which we unfortunately create is which of these ideas of the current batch of forward thinkers is correct, as controversy is never far behind. The long and short of it is that it is hard to separate the wheat from the chaff. New ideas based on sound research are like a mirage; they come and disappear, leaving confusion and misperception, often for years after something better has been though into existence.

The following pages attempt to unravel the questions of the warm-up. Up to date research is used to discuss this question and determine the appropriate practice to develop a physical preparation to maximise potential prior to activity.

'The warm-up is not merely the time before, it is where focus and preparation optimize an athlete prior to training or competition'

The little I know about speed

2016-04-18T11:29:00.001-07:00

The little I know about speed

When I was 12 years old, I made a conscious decision to be a sprinter. The allure came from the 1992 Olympic Games in Barcelona and watching Linford Christie stride to victory followed by my personal favourite and perennial ‘bridesmaid’ Frankie Fredericks. I don’t believe it was the medals, the celebration or even the resulting and enduring fame that drew me to this event, but the simple and unequivocal purity of speed. It was clear that this was the truest test of man’s ability to compete not only against his opponents but also against every person who has competed in the event in the past and every person who will compete in the future. There is no place to hide, no team to rely on, no tricks or tactics or equipment to create an unfair advantage. Every man faces up to the rest with nothing more than himself and the will to be better than the past, the current and the future. The prize; the fastest human being ever to have lived! Now that’s a title.

Depending on your outlook, certain factors may be essential while other factors may be desirable in developing a sprinter. For me, the unwavering, never faltering drive to put every ounce of myself into becoming faster was a vital factor in achieving the small, possibly large amount of success I achieved as an athlete. Others may view what defines athletic potential differently. Certainly genetics play apart and in recent times this has become clearly obvious. The phrase ‘sprinters are born and not made’ has never been as true as it is today. The question however is, what is the perfect genetic code? I believe that we are slowly whittling down the variables required to create the world’s fastest men but experience tells us that there is always something remarkable just around the corner. This was never truer when a one, Usain Bolt smashed the mould created by all those men who have previously claimed the title of the ‘world’s greatest’.

It seems reasonable to assume that these factors, like genetics and self-drive are important in developing fast individuals but there certainly appears to be a need for some external influence to direct the potential. My experience has taught me that although at the start of the race all men start from the same position, it is the level of potential that decides who will be successful and who won’t and believe me when I tell you the margins are small! Anyone can train to be fast but it takes a true understanding of what speed is to extract the potential to be better than before. In the rarest cases this external influence does not matter and success is as simple as stepping on the track but in most instances the correct input can maximise the potential for success.

I want to change track for a bit and focus on the average athlete. Everybody competes for different reasons. Some do if for monetary gain while others simply enjoy participating, but success is bred from improvement. Whether doing something for the first time or improving a time or selection to a school, club or national team, the potential to improve is based on the correct input and initiation of a goal driven plan. If the plan is flawed then the probable of reaching maximal potential is significantly reduced and although success is not measured in potential, falling short of maximal potential may affect how much you can achieve. This may be the difference between making a final at an event, the difference between second and first or being selected for a team.

Maximum potential is an abstract concept and ultimately cannot be achieved. Maximal potential is a much tangible concept as this defines the potential that each individual can achieve provided the circumstances are correct. New ideas are being developed and processed all the time with new and exciting prospects for those willing to embrace them. It is the maximal potential at a specific moment that most athletes aspire to achieve. This comes down to rigorous planning and the correct implementation of a clearly defined, scientifically proven and experience driven programme with the sole indication of creating this maximal potential. This moment may produce the world’s fastest man or winner of a county championship but to each the success is their own and could be their life’s greatest achievement.

‘Maximum potential is impossible, maximal potential is achievable’

Quadriceps contusion

2016-04-18T03:52:00.001-07:00

Commonly referred to as a ‘dead leg’, a quadriceps contusion leg’ is very common in contact sports. An impact to the muscles can cause more damage than you might expect and should be treated with respect. The muscle is crushed against the bone. If not treated correctly or if treated too aggressively then Myositis Ossificans (calcification or bone growth in the muscle) or other secondary complication may result. Athletes often report a ‘knee’to the thigh and although just another word for a bruise, a contusion can be quite problematic, especially if they occur deep inside a muscle. Along with the pain and swelling, secondary complications can occur, leaving the player with a long rehabilitation process.

There are two types of contusions:

Intramuscular which is a tearing of the muscle within the sheath that surrounds it. This means that the initial bleeding may stop early (within hours) due to increased pressure within the muscle, however the fluid is unable to escape as the muscle sheath prevents it. The result is considerable loss of function and pain which can take days or weeks to recover. You are not likely to see any bruising with this type - especially in the early stages.

Intermuscular which is a tearing of the muscle and part of the sheath surrounding it. This means that the initial bleeding will take longer to stop especially if you do not ice it. However recovery is often faster than intramuscular as the blood and fluids can flow away from the site of injury. You are more likely to see bruising with this one.

Immediate treatment for any type of muscle injury is to commence three practical yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal between 3 to 6 weeks

Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce bleeding and pain

Compression–Compression assists in the prevention of swelling in the affected area help to reduce the recovery time

Returning from a quadriceps contusion

· Use compression shorts to keep the muscles warm and supported

· Always warm up before sporting activity

· Always cool down after sporting activity

· Stability exercises

· Seek the advice of a qualified sports injury specialist

Quadriceps muscle strain

2016-04-18T03:50:00.001-07:00

Injuries to this muscle group are common and can be painful, debilitating and can result in significant time away from training and competition.

Anatomy

The quadriceps is made up of four individual muscles each of which play a role in hip flexion and knee extension. These are all innervated by the femoral nerve.

· Rectus femoris

· Vastus lateralis

· Vastus intermedius

· Vastus medialus

Quadriceps Muscle Strain

Quadriceps strains are most commonly caused by a strong eccentric contraction during sporting activities such as sprinting, football and basketball. A quadriceps strain injury normally occurs when the extensor muscles are forced to stretch beyond their limitations, resulting damage to the muscle tissue commonly called a tear. The tear in the muscle is called the strain, and fall into one of three different degrees, depending on its severity.

Grade 1

Grade 1 quadriceps strains do not normally appear until a particular activity like running, jumping or kicking is done. This is often described as a sensation of tightness or feelings of pain when the muscles are contracted or stretched. Continuation of the activity is often report with the discomfort occurring after or the day after participation

Grade 2

Grade 2 quadriceps strains immediately have sensations of pain, far more painful than those of the grade 1 injuries. It also produces severe pain on walking. The grade 2 groin strains are usually confirmed by pains and weakness, especially when muscles are contracted or stretched. This type of strain is normally very sore to touch and may result in bruising at the anterior thigh.

Grade 3

Grade 3 quadriceps strains are described as a full rupture of one of the extensor muscles but are rare. These types keep the athlete from walking with individual normally requiring surgical intervention following this type of injury. For both the grade 2 and 3 strain injuries, a large bruise is normally formed below the injured area after a few days. The bruise is generally caused by bleeding of the damaged tissues.

Immediate treatment for any type of muscle injury is to commence three practical yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal between 3 to 6 weeks

Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce bleeding and pain

Compression– Compression assists in the prevention of swelling in the affected area help to reduce the recovery time

Preventing Groin Strain

· Use compression shorts to keep the muscles warm and supported

· Always warm up before sporting activity

· Always cool down after sporting activity

· Stability exercises

· Seek the advice of a qualified sports injury specialist

Groin Strain

2016-04-06T12:38:00.001-07:00

Groin strains are one of the most common injuries in sports, particularly in football, hockey and rugby where kicking and change of direction is common. A groin strain describes a strain on the Adductor muscles, of which there are five located at the inside of the thigh.

These are:

• Adductor Brevis

• Adductor Longus

• Adductor Magnus

• Gracilis

• Pectinous

A groin strain injury normally occurs when the adductor muscle is forced to stretch
beyond its limitations, resulting damage to the muscle tissue commonly called a
tear. The tear in the muscle is called the strain, and fall into one of three different
degrees, depending on its severity.

Grade 1

Grade 1 groin strains do not normally appear until a particular activity like running,
jumping or kicking is done. This is often described as a sensation of cramps or
tightness, or feelings of pain when the muscles are contracted or stretched.
Continuation of the activity is often report with the discomfort occur after or the day
after participation

Grade 2

Grade 2 groin strains immediately have sensations of pain, far more painful than
those of the grade 1 injuries. It also produces severe pain on walking. The grade
2 groin strains are usually confirmed by pains, especially when muscles are
contracted or stretched. This type of groin strain is normally very sore to touch and
may result in bruising at the inner thigh.

Grade 3

Grade 3 groin strains are described as a full rupture of the adductor muscle but
are rare. These types keep the athlete from walking without pain and he
immediately feels a stabbing pain or burning sensation. The individual with
normal require surgical intervention following this type of injury. For both the grade
2 and 3 groin strain injuries, a large bruise is normally formed below the injured
area after a few days. The bruise is generally caused by bleeding of the damaged
tissues.

Immediate treatment for any type of muscle injury is to commence three practical
yet helpful methods:

Rest– Avoid the aggravating activity until the pain has disappeared, normal
between 3 to 6 weeks

Ice– Use ice every couple of hours for 20 minutes over the affected area to reduce
bleeding and pain

Compression– Compression assists in the prevention of swelling in the affected
area help to reduce the recovery time

Preventing Groin Strain

Use compression shorts to keep the muscles warm and supported
Always warm up before sporting activity
Always cool down after sporting activity
Stability exercises
Seek the advice of a qualified sports injury specialist

Pull from the Knee

2016-04-06T12:29:00.001-07:00

'There is no doubt that track athletes require weight training to optimise their performance. However weight training can be a daunting playground especially with the plethora of information out there confusing the issue. Weight training is time consuming and many exercises are moderately effective or ineffective in improving a sprinters ability. The formula is simple; will this exercise make me faster? Of course this question is not that simple but for the sake of this argument lets assume this is true. What must an exercise be? Firstly it must be specific. It must mimic the movements of sprinting. Secondly, it must overload the active system and thirdly, it must be progressive'.

Pull from the Knee (PfK)

This exercise effectively breaks down the components of the clean and jerk (C&J) and snatch emphasizing the triple extension of the hips, knees and ankles. Weightlifting exercises such as the C&J and snatch are regarded as superior training methods for athletes in power-based sports. Due to the explosive nature of these exercises it is important for athletes follow clear guidelines of form and safety while performing such exercises to prevent injuries. The pull from the knee can acts as a teaching progression for these exercises as well as a useful exercise in its own right.

Muscles involved

Erector spinae, rectus abdominus and obliques, subscapularis, latissimus dorsi, brachioradialis, trapezius, splenius capitis, splenius cervicis, infraspinatus, serratus posterior inferior, rhomboid major, rhomboid minor, and the supraspinatus. Also active during the movement phase, levator scapulae, teresminor, teresmajor, rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius, gluteus maximus, biceps femurs, semimembranosus, and semitendinosus, gastrocnemius, soles, tibialis posterior, flexor digitorum, peroneus longus, and the peroneus brevis.

Benefits of the exercise

Maximum transference to sprinting through transition to peak power position and acceleration of an external load using triple extension.
The PfK reduces of stresses from moving the load from the floor to the second pull.
High rates of force and power production are required to accelerate the load from at static position.
The pull from the knee is less complex than the C&J and snatch thus effectively reducing the risk of injury.

Start position

The weight should be positioned on boxes or squat rack at the appropriate patella height. Feet hip width apart with hands (hook grip) placed in the C&J position. Flex forward at the hips while aiming to maintain a normal curve in the lower back. Slightly bend the knees positioning the shoulders ahead of the bar.

Start position

Transition

Inhale deeply while tightening the muscles in the torso. The athlete should initiate the exercise by engaging their hamstrings, glutes, and erector spinae muscles to begin to move to the bar upwards. The peak power position is accomplished by extending their back while forcing the hips and knees forward at the same time. The bar should be moving vertically as close to but not touching the body.

Transition Power position

Second pull

From the power position the athlete uses the momentum from the initial pull to initiate the triple extension. As the bar brushes the thighs the athletes explodes through the hips, knees and ankles while shrugging their shoulders to maximize the loads velocity. At this point the athlete can lower the bar to prepare for the next repetition.

Second pull

Dependent on the periodisation the PfK can be used with higher reps during strength endurance training block with light to moderate loads (2 – 5 reps at 80 -100% of Power clean) . During the strength-power training block use increased loads and reduced volume (1 – 3 reps at 120 – 140% of Power clean). Explosive speed and maintenance block use reduced volume and intensity to enhance power output (4- 6 reps at 40 – 60% of Power clean).

However, the loads prescribed should be based on the athlete’s ability and strength. Weaker or less technically proficient athletes should focus on improving peak power through lighter loads, whereas heavier loads may be prescribed for a stronger, more technically proficient athlete.

Pull from the knee: Proper Technique and Application, DeWeese, et al, (2016)

Strength and Conditioning Journal, Volume 38, Number 1.

Myotomes in Physiotherapy

2013-09-24T13:09:00.003-07:00

Myotomes in Physiotherapy

Upper Body

Root	Joint Action
C1	Upper cervical flexion
C2	Upper cervical extension
C3	Cervical side flexion
C4	Shoulder elevation
C5	Shoulder abduction
C6	Elbow flexion
C7	Elbow extension
C8	Thumb extension
T1	Finger abduction

Lower Body

Root	Joint Action
T2 – L1	No tests
L2	Hip flexion
L3	Knee extension
L4	Dorsiflexion
L5	Great toe extension
S1	Eversion, Hip extension, knee flexion
S2	Knee flexion, Toe standing

Closed Packed Positions and capsular Patterns for Joints - Physiotherapy

2013-09-24T12:39:00.004-07:00

Closed Packed Positions and capsular Patterns for Joints - Physiotherapy

Upper Body

Joint	Closed Packed Position	Capsular Pattern
Temporomandibular Joint	Clenched teeth	Opening mouth
Cervical spine	Extension also for Thoracic and Lumbar Spine	Side flexion and rotation equally limited; flexion is full but painful, extension is limited
Glenohumeral joint	Abduction and lateral rotation	Lateral rotation then abduction then medial rotation
Humeroulnar	Extension	Flexion then extension
Trapeziometacarpal joint	None	Abduction and extension, full flexion
Metacarpophalangeal joint	Flexion Opposition	Flexion then extension
Interphalangeal joint	Extension	Flexion then extension

Lower Body

Joint	Closed Packed Position	Capsular Pattern
Hip	Extension and medial rotation	Flexion, abduction and medial rotation. Extension maybe limited
Knee	Extension and lateral rotation of the tibia	Flexion the extension
Talocrural	Dorsiflexion	Plantarflexion the dorsiflexion
Subtalar	Inversion	Inversion
Mid-tarsal	Inversion	Dorsiflexion, plantarflexion, adduction and medial rotation
First metatarsalphalangeal joint	Extension	Extension then flexion

Physiotherapy Defined or Definition

2013-09-22T04:13:00.001-07:00

Physiotherapy Defined or Definition

Also see: Physiotherapy Abbreviations, Pain Definition and Joint Range of Motion

A Physiotherapist works with people to identify, optimise and maximise their potential to move and function. Physiotherapy plays a key role in enabling people to improve their functional movement and thus improve their health, wellbeing and quality of life.

Physiotherapists use a combination of analytical thinking and practical skills to identify, treat and resolve physical, psychological, social and environmental factors limiting movement and function. Physiotherapists use these skills to identify limitations in an individual's movement and performance and best decide how to address their needs.

Physiotherapy is underpinned by ethical and evidence based values which are constantly evolving as practitioners develop new knowledge and understanding through critical reflection, evaluation and research. Chartered physiotherapists have a broad scope of practice that includes manual therapy, exercise and movement, electrotherapy and other physical approaches.

A Physiotherapist is an autonomous practitioner which means that they can assess, diagnose and treat an individual without a referral from another source like a GP or consultant. Physiotherapy interventions include, advice, help maintaining and improving the body's movement and function by offering treatment when someone is acutely ill in hospital, improve someone's function and independence at home or at work and enhancing their performance and participation by challenging the environmental or social barriers that limit participation.

Physiotherapists are adaptable and can deliver a high quality innovative services that are accessible, effective and efficient. Physiotherapists maintain a strong link between clinical and academic practice ensuring they are always ready for purpose.

Pain Defined or Definition

2013-09-22T03:36:00.001-07:00

The International Association for the study of Pain (IASP) defines pain as:

“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.