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The question about tennis elbow pain is simple.
Then answer is simple, I put it in a video for you:
Now if you, one of your clients or if you know someone that has tennis elbow pain, this will help:
CLICK HERE to get more details on the Tennis Elbow Pain Solution
Rick Kaselj, MS
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I was in Las Vegas a few weeks back and did a training and nutrition video with someone that was at the fitness conference.
The person that I did the interview with is John Romaniello. John is a personal trainer based in New York and does a lot of online training. One thing that he is heavily involved in with his online clients is their nutrition.
As you know, I have been exploring more when it comes to the nutrition side of things. If you read EFI, you know I focus on the exercise side of things when it relates to injuries. After doing more reading, taking with my clients and talking with more fitness professionals, I am keeping myself open to nutritional concepts and how nutrition relates to aches, pains and injuries. This is one more interview from that journey.
Now back to John.
I asked John if he could share some reasons why a fitness professionals must be involved in their client’s nutrition.
In the above interview, John shares with you:
Thanks John or as his friends call him, “Roman”.
Remember, earlier this week, I did another nutritional interview with Brian St. Pierre that may also my interest you.
Rick Kaselj, MS
P.S. – Here is an interview that I did in the past with Dan Go on Intermittent Fasting, that may interest you as well:
One last thing:
Okay, nothing more to say.
Have a great day and talk to you soon.
Rick Kaselj, MS
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One thing I have not done a good job about talking about on EFI is nutrition.
That all stop today.
Today, I start the day off with an amazing interview with Brian St. Pierre. In the content packed interview Brain brings the research and practical experience of many popular nutritional topics.
CLICK HERE to listen to the interview.
In the Nutritional Interrogation with Brian St. Pierre we share with you:
CLICK HERE to listen to the interview.
Brian St. Pierre is a nutritionist, coach, blogger, dad and the creator of the Nutrition Guide for Show and Go.
Rick Kaselj, MS
Here are some other articles that may interest you:
Got some answers on knee pain when you lunge plus checking in with a few answers from EFI readers.
Over the week, I get a bunch of questions and I wanted to take some time to answer some of questions that I got. I can’t answer them all but I will do my best to get back to everyone. If you don’t hear back from me after a few days, just send me a reminder email.
Rick,
I purchased your muscle imbalances revealed package on the weekend and I
just wanted to say I love it so far!! Extremely very informative.Just one question. I have a client right now whose left knee is really
bothering her. It makes cracking noises every time she flexes her knee. She
is alright for hip flexion exercises like squats but for lunges she cannot
perform anymore because of her knee.I just watched the Maximizing Strength and Stability of the Knee and I am
curious if those exercises will work for her condition.The doctor gave her exercises like the Bulgarian lunge on the bench but
that is putting too much pressure on her knee. I do not agree with that
exercise choice and I was wondering if you could help me.My client is overweight so I’m thinking there is too much pressure on her
knee joints but how do I get around this? I have her do squats on the Bosu
ball and Leg extensions on the TRX, to really focus on her knees to make
them stronger but are there other exercises that I could be doing?Thank you for your time!
–
SB
SB,
I am so glad that Muscle Imbalances Revealed has been such a benefit to you. It is a bit of a labour of love. Glad it is helping you out.
Yes, a lot of the exercises in the knee component will help out. Many of the exercises are in my Knee Injury Solution program. There are all kinds of levels of exericses plus videos and descriptions of the exercise in Knee Injury Solution.
Here are some videos that I have done that may help you. You can see more on you YouTube channel.
The Bulgarian Squat is a good exercise but I would call it an advance exericse that the average person can not do. It puts a lot of load on one leg. Often times the weakest point in the leg will give way and with most clients it will be their knees. With the client being overweight, this makes the situation even worse.
I am a big fan of regressions. The more you can modifiy an exercise, the happier the client will be. The more regression exercises you have the more you can change things up to challenge them, keep them guessing, doing new things and keeping them pain free.
One quick thing you can do for knee pain when lunging is decrease the distance between the feet with the lunge and also move the trunk in a forward position. This decrease the range of motion of the lunge which make the knees happy plus the forward trunk activates the gluteus maximus more which decreases the stress on the knee extensors.
When it comes to other exercises. Try the modified lunge that I talked about above. You can also try bilateral ball squats against the wall or unilateral ball squats. This decreases the stress on the knees. You can also try lunging onto a risor or a back lunge.
Let me know how this goes.
If you got something else to add, just leave a comment in the comment box below.
Here are details on my Knee Injury Solution program:
Thanks for the question, SB
Hi Rick,
Great article on minimalist shoes. I’ve seen them around but had no information as to their benefits. I just simply thought it was another fad shoe.
On that note, I was wondering if minimalist vs traditional shoes are good walking or work shoes (for nurses and/or massage therapists who work on their feet often).
Your insight is appreciated,
CI
I headed off to ask Curb, and this was his reply.
Take it away Curb:
I’d look at a couple of things for shoes that you use for standing in for long periods of time:
hope that helps!
Curb Ivanic, MS, CSCS
Thank you CI and Curb.
When the spring comes, I always get asked about tips for new grads. I will be doing an interview in the future about this. I just got in touch with an old colleague of mine and he has agreed to do an interview on tips for those going through a human movement or exercise science degree. Watch for it.
Hi Rick,
Do you have anything for clients returning to exercise after abdominal
hysterectomy?Best regards,
JE
Janice,
I does not have anything for that specific condition.
I often times start people off with the exercises in Core Stability of the Back ebook. You can check it out here.
Make sure the person has medical clearance to start an exercise program and the medical team supervising has provided you with exercise guidelines.
I am working on a bunch of live presentations and an internship. I will have more details on them soon.
I will put them up here.
That is it for this week.
Have a great weekend and stay injury free.
Rick Kaselj, MS
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If you read EFI (ExercisesForInjuries.com), you know I am a huge fan of self massage.
It is best to have a massage therapist or body worker doing the massage but if you can’t afford to see one, don’t have time to see one or do not have one living in your house, the second best thing is self massage.
I am going to go over some of what I do in this 2 hour workshop.
Rest and stretching are the recommended methods of preventing injuries or getting our client’s bodies ready for their next session. In this practical and hands-on workshop you will learn new, safe techniques and exercises for yourself and your client when it comes to fending off injury and to help the body get ready for the next session. You will be shown ways of using common and inexpensive equipment found in a fitness centre to add to your client’s or your programs. We will be using tennis balls, medicine balls, foam rollers and a few other gym tools to help in injury prevention and recovery for the neck, hip, shoulder, back, knee and foot. If you have nagging tight muscles or have a tough time recovering between workouts, you should make sure to attend this workshop.
Location: Live2Play Fitness Studio – Unit #200, 5858 176th Street, Surrey, BC V3S 4E2
Date: Saturday, February 18, 2012 from 2 pm to 4 pm
Continuing Education Credits: 2.0 BCRPA (Pending)
To Register: Call Live2Playf Fitness Studio at 604-579-0169
Due to equipment, this workshop is limited to 10 participants.
Please note, this will be the only time this workshop will be offered.
In this article, I wanted to highlight a few Tennis Elbow Exercise Mistakes.
If you have been reading my writing over the last 6 years, you know that I love looking to the research for answers and today is no different. Looking at the research allows me to challenge myself to see if what I am doing is right and safe.
I have been beating this drum for a while and it has been highlighted in the Muscle Imbalances Revealed series, fascia is something we need to think about.
I wanted to talk about fascia and tennis elbow.
There has not been much talk about fascia and tennis elbow but it is something that I have been doing for years. For my client’s, they may end up getting some hands-on work done by a therapist or bodyworker but between visits it is important for them to do what they can to continue the work that the therapist or bodyworker has been doing. Very much like flossing between dentist visits. What I encourage my clients to do is self massage. I know self massage may not follow the text book guidelines or follow what is taught in a fascia course but it has benefited my clients.
Lets look at some research that shows the benefit of addressing fascia and tennis elbow.
The investigators wanted to see if myofascial release reduced pain and functional disability in a group of computer professionals while the control group received sham ultrasound therapy.
The myofascial release techniques were performed by a certified practitioner where the test group had 12 sessions over 4 weeks.
The group that got myofascial release done had a 78% decrease in pain and functional disability while the control group had a 7% improvement.
At a 12 week follow up the treatment group had a 63.1% improvement in pain and function.
I mentioned it above, if you are a computer worker and have lateral epicondylitis, myofascial treatment maybe of benefit to you.
If you can not get myofascial treatment, try some self massage as I am sure it will help out with your pain and arm function.
Where to get more information – Ajimsha MS, Chithra S, Thulasyammal RP. (2012). Effectiveness of Myofascial Release in the Management of Lateral Epicondylitis in Computer Professionals. Arch Phys Med Rehabil. 2012 Jan 9. [Epub ahead of print]
I am working on this month’s Injury of the Month. It is on tennis elbow. At this time I am digging in the research to see what is new. This was the 15th article that I looked at and I thought it was a good fit for the article I chatted about, above.
They wanted to see the factors that lead to successful conservative management of tennis elbow.
They looked at 60 patients with tennis elbow and followed them for 6 months.
Not sure what more I can add.
The treatment and exercises are important but what is equally important is what you do to help yourself recovery from the injury. This includes looking at what you are doing, looking at your environment and minimizing things that slow down your injury recovery.
Where to get more information - Waugh EJ, Jaglal SB, Davis AM. (2004). Computer use associated with poor long-term prognosis of conservatively managed lateral epicondylalgia. J Orthop Sports Phys Ther. 2004 Dec;34(12):770-80.
I know, this is going to anger a few people.
I know you were taught in a course or your instructor at college/university said that you should stretch if you have a client with tennis elbow but the reality is, there is little evidence supporting just doing stretching as the primary activity for tennis elbow.
Looking at the research, there is more research that supports strengthening for tennis elbow than just stretching.
My approach is I use both.
My first preference is to use self massage in the forearm. Then I will use stretching with a focus on addressing the tension in the forearm and the focus on the stretch is very very light. Then I will work on concentric, isometric and eccentric strengthening .
There was one article that looked stretching and strengthening.
They had 94 subjects (50 men) with chronic epicondylitis were randomly put into three groups: stretching only, concentric strengthening with stretching and eccentric strengthening with stretching.
Each group performed their set of exercises for 6 weeks. Each group were given instructions on icing, stretching and avoiding aggravating activities. Two of the groups got education on their strengthening protocol.
There was no significant difference in the outcome of any one of the groups when it related to pain-free grips strength and function.
The focus of the paper was on exercise but as we saw in the paper above, the activities that someone does has an effect on the long term outcome of tennis elbow. This probably had a bigger factor in the result than they highlighted in their research.
From personal experience, I find people that manage inflammation of their injury have a better recovery result as well. If you keep doing what hurts, your hurt won’t go away.
If you spend some time on PubMed, you come across a number of articles that just focused on strength and this lead to an improvement in tennis elbow. I talked about one of those papers and tennis elbow exercises a few articles back.
Where to get more information: Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. (2005). Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther. 2005 Oct-Dec;18(4):411-9, quiz 420.
Hey, I hope this helps you out if you have a client that has tennis elbow or if you have tennis elbow.
Watch for this, it will be coming out next week.
That is it, have a great day.
Rick Kaselj, MS
I got a little lost with this interview.
The interview was with Elliott Hulse.
CLICK HERE to listen to the interview.
(To listen to the interview, scroll down to the bottom of this page and click the play button. If you do not have time to listen to it right now, just click the “download” button and download it to your computer. Then you can listen to it on your computer when you like or subscribe to the itunes podcast. Enjoy!)
CLICK HERE to listen to the interview.
Elliott Hulse is a strength coach and personal trainer in Florida that does a lot of unique things when it relates to helping people get stronger.
Here is a photo of Elliott and I at a conference in California last year.
Rick Kaselj, MS
Here are some other articles that may interest you:
If you are looking for a live course when I go through shoulder injuries, you can check this out:
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Getting ready for another presentation in Las Vegas. I was here in October and I am back again.
Today’s presentation should be fun. It is a little more of a business talk on what were the things that I did with my blog and social media that have helped my fitness business over the last few months.
Now usually, I put a nice photo of something here, but to be honest, I have been in the hotel room working. Working on my presentation, writing, planning for 2012 and this month’s Injury of the Month (IOTM) which is tennis elbow.
The year has started off hot in 2012.
Training has picked up with fitness professionals and the questions on injuries is through the roof.
This great to see because it is important for fitness professionals to know how to assess an injury, know what to do if your client has an injury and what exercises to do or not to do.
Let me give you an example.
A lady contacted me that wants to do some online training with me. She has seen 3 personal trainers but fired all of them because they did not know what to do for patellofemoral pain syndrome.
She contacted me and asked if I could help and I said, “yes.”
The second question she asked was, “Do I have any experience with injuries?” I sent her a link to EFI and that answered her question quickly (Your blog/website is the best business card you can have so spend some time on it.)
Lets get on with the mash-up.
I got emailed a few questions on neck pain and posture from an online magazine. As usual, I can’t say anything until it is in print but I am sure you have used one of their search engines of late.
The online magazine emailed me and asked me about neck pain and posture. I thought the question was good and my reply may interest you.
If these neck muscles are not addressed, this puts great stress on the neck and the shoulder. When these two areas are stressed, it has an effect on the rest of the body. If these small muscles lack the activation, endurance and strength to keep the head in good alignment, this will force upper trapezius and levator scapulae to work harder in order to keep the neck in good alignment. As these muscles contract for a long period of time, tension builds in these muscle which leads to pain. Very much like holding your fist tight for a long period of time.
If you want more info on Exercise Considerations for Neck Pain, you can check out an article I did for Mike Reinold, here.
Here is an intermediate level exercise for a neck injury:
I am a Personal Trainer who has previously ordered your programs which have been very beneficial in dealing with my clients.
Beginning in January, I will be working with a client who is in need of neck rehabilitation. The gentleman has disk herniation and bone spurs have formed causing him a degree of pain with neck/shoulder movement.
Do you have a rehabilitation exercise program designed to deal with such problems. If so what is the cost?
Thanks for your time and any info you have to offer!
Happy Holidays!
KG
I have been very very slow at replying back to this one.
Let me say it right now, I am working on a neck pain book. I am about half way done. I just need to work on the exercise side of things. It will be out in the next few weeks. I will let you know when the release date is.
KG, check out the article that I mention above, this will give you some ideas.
Plus check out Muscle Imbalances Revealed – Upper Body 2.0 Edition (MIRU). I have a section in there where I go through designing a program for the neck and go through a stack of exercises. Here is a clip from my presentation:
Hi Rick.
In June of 2011 I downloaded your How Exercise Can Help Beat Cancer. I would like to use this for BCRPA credits for my renewal. Can you tell me how I do this.
Thanks
D
It is really simple.
When you ordered you were send download instructions.
In those download instructions were details on how to access the CEC exam. Download the CEC exam and print it out.
Now watch the video presentation and while you are watching the video presentation, fill in the CEC exam.
When you are done the video presentation and exam, send me the filled in exam by mail, fax or email.
I will mark it and send you the results.
An editor from a UK magazine (Sorry, can’t reveal the name.) said this about the stuff that I have done:
“All of them would be good to investigate / feature in an article as in this day and age alot of the worlds population have / will suffer from one of these conditions.”
Very cool.
I know the world needs more information on exercise and injuries because there is a huge need but I also know, in your area were you train clients, there is an even bigger need.
“Muscle Imbalances Revealed is the most comprehensive educational tool a coach could ask for. The amount of information contained in the DVDs and online is enormous. I would highly recommend MIR to any serious coach or trainer.”
Josh Koenig CSCS
I very much appreciate the feedback, Josh.
I got a lot of exciting new stuff coming up with MIR (both upper and lower).
Hello Rick,
As I am listening to the second video of your on line course “muscles imbalance, the one on mobility”, I am wondering if and where I can get access of the cec exam and get started on it as I move along. I find this method easier on me and my memory.
Could you pls guide me on where to find it in your program and download it.
Thanks,
v
My answer is very similar to above.
With the Muscle Imbalance Revealed Series, things are a lot more comprehensive.
Lot into the membership area of MIR.
In there will be the CEC exam. Download it and print it out.
As you are going through the presentation and fill in the exam.
After you are done the presentation and exam, send them to me.
I will mark it and then send you your CEC certificate.
It should be an interesting night.
If not, I will probably be in my hotel room working on my article for Monday which is fun for me.
Thanks for reading and had a great weekend.
Rick Kaselj, MS
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There has been more talk about doing pull ups of late and I have been seeing more people give them a go in the gym.
What I have seen has kind of scared me. People jumping off stability balls, using other people’s backs or just crashing to the floor when trying one.
I asked my friend, Shawna Kaminski, who has created a very cool pull up program to give us some tips on how to do a pull up injury free. Take it away Shawna.
You can’t deny the power of the pull up; a beautiful physique can be sculpted with the simple pull up. It broadens and strengthens the back, while sculpting the waist in one fluid easy to understand (but difficult to do) maneuver.
The prime mover for the pull up is the latissimus dorsi. Surprisingly, the pull up engages the core a great deal. The secondary movers and stabilizers for the pull up include the trapezius, rhomboids, biceps, serratus anterior, transverse abdominus and the obliques. You can see how the pull up is a compound movement and can effectively train the core.
As with any movement, it’s imperative to ensure that proper form is used to prevent injury.
I once made the mistake of overzealous training when training to do the human flag and my elbows and I weren’t on speaking terms for several weeks.
(Shawna asked me about her sore elbows and this is what I suggested to her:)
The pull up is no different. There are a few things that can be done to prevent injury, specifically overuse injury when doing the pull up.
First of all, you need to get your mind focused on the correct muscles in order to get your first pull up. Rather than using the back muscles, many people will try to lift with their arms, chest, shoulders, anything to get their body to move. This will get you NOWHERE FAST.
When doing an assisted pull up, you need to be in the correct position.
You need to get your body UNDER the bar like this:
You need to position yourself so that you’re looking up and you’re ready to engage the BACK muscles, NOT just the muscles of the arms. Your legs will be used to help you but they need to be directly UNDER your hips, not in front of you. If you’re legs are in front too much, it will cause you to lay back and get out from under the bar.
Place the legs directly under your hips for the assisted pull like this:
Using a bench or box directly under you is the most helpful.
It may seem like I’m splitting hairs with the correct position for the assisted pull up. I am.
This is the KEY in order to be successful.
A simple exercise that anyone can do in order for you to FIND the back muscles is to do a simple hang from a suspended bar.
As you hang, look up and think about inwardly rotating your scapula, or squeezing your shoulder blades together. This will cause you to press the chest forward. You should start to feel a slight elevation of your body, even if you can’t move your entire body up to the bar yet.
This improved body position will address the common error of inwardly rotating the shoulders to pull the body up. The back is much stronger and everyone will be more successful when they engage the muscles of the back when doing a pull up.
Another area to be concerned with is the grip. Your grip can lead to some elbow pain and strain. Even though you’re actually ‘hanging on for dear life’ when doing a pull up, try not to use this ‘power grip’ as it actually radiates up the arm and can effect the elbow. Hold the pull up bar more loosely and this will alleviate or prevent elbow pain.
In addition, when you come to a full hang position, you will put strain on the elbow joint. If you’re going to be doing a copious amount of pull ups, it’s best to not fully extend the arm in the hanging position. By keeping a slight bend at the elbow in the extended position, you will work the bicep more and strain the joint less.
One of the best things about the pull up is the variety of ways you can do them. You can constantly change your grip from shoulder width, to narrow grip, palms facing each other or parallel. Every workout you do can be different just by changing up the grip. This helps with overuse injuries as you’ll put stress on different areas of the shoulder/back as well as the elbow/arm.
The key to learning how to do a pull up is to work the ‘eccentric’ contraction. The eccentric, or lengthening portion of any movement, is the strengthening phase; this is opposite to what most think. There are a variety of ways that you can work the eccentric contraction when doing a pull up. You can do assisted pull ups, jump pull ups, suspended pull ups, inverted rows, weighted pull ups (all of these are discussed in my program, by the way).
A caution when training eccentrically: the lengthening phase is the portion of the movement that causes the most muscle soreness. You need to be careful when doing eccentric contractions as you will cause more delayed onset muscle soreness and due to fatigue, there is a greater incident of injury where you strain the muscle excessively. While eccentric training is a great way to start to build up the strength to be able to do a pull up or increase the number of pull ups you can do, caution is necessary to prevent injury.
The pull up is clearly one of the most impressive bodyweight movements that can be done. With proper training with a mind towards injury prevention, you’ll be more likely to succeed at increasing your pull up power and not your aches and pains. You can check out Shawna’s pull up program here.
About Shawna
Shawna Kaminski is in her late 40′s but she can kick most 20 year old’s butt when it comes to pull ups, push ups and human flag. In order to help people improve their pull ups, she put together a program that helps improve your pull up, gets you to perform your first pull up and improve your push up. You can check out her Challenge Workouts here.
Shawna is a retired schoolteacher of 20 years who’s found her passion in the fitness industry. She’s been a competitive athlete all her life and has competed nationally in three sports. She’s parlayed her ability to teach and her love of training into programs that you can directly benefit from. Shawna is in her late forties, is a mother of two teenagers and understands how busy life can be. Her workouts are short and intense and often can be done anywhere. She’s always up for a challenge and shares her fitness challenges with you. Currently she runs her own fitness boot camps and coaches clients in person and online with her amazing result getting programs.
Rick Kaselj, MS
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Another interview for you today and it is on posture.
The interview is with Dr. Natalie Cordova.
Click Here to listen to the posture exercise interview.
In the interview Dr. Natalie Cordova shares with you:
Click Here to listen to the posture exercise interview.
Dr. Natalie Cordova is a posture expert, chiropractor and health educator in Houston, Texas.
Rick Kaselj, MS
Here are some other articles on posture that might interest you:
If you are interested in a course on posture and exercise, this is one that I put on:
In the last few years there has been an ongoing debate in the running industry regarding footwear. At one extreme are the barefoot and minimalist running shoe proponents who argue that no shoes or at most, shoes with minimal structure, are best. On the other end are experts who hold that the traditional thick soled, cushioned shoes are optimal for injury prevention.
Until the 1970’s running shoes were manufactured with flat, thin-soles. Indeed the current growth in popularity of minimalist shoes can be seen as a case of old becoming new again.
In the late 70’s and early 80’s running shoe construction began incorporating thicker soles with elevated heels. The rationale for adding cushioning in the midsole and motion control features in running shoes was to absorb impact forces and control movement, specifically pronation, of the foot.
This rationale however was probably misguided. Cushioning materials in shoes actually increases overall leg stiffness (Bishop et al. 2006). Some leg stiffness is beneficial to running well but excessive leg stiffness may be a factor for increased risk of injury (Hewett et al. 2004).
A review study by Richards et al in 2008 concluded that the prescription of “pronation control, elevated cushioned heel (PCECH) running shoes to distance runners is not evidence-based.”
Additionally, a study by Ryan et al in 2010 showed that motion control shoes had the highest incidence of injury in their research group, regardless if the wearer had highly pronated feet or not.
There is good evidence that the shoe construction of the last thirty years or so has not accomplished what it was originally intended to do. Injury rates in runners today remain as high as ever.
Since Christopher MacDougall published Born to Run in 2009, there has been tremendous growth in the number and styles of so-called minimalist shoes. Virtually every major shoe manufacturer and a number of smaller upstarts now have minimalist shoes.
These shoes were designed to mimic how the foot functions barefoot. Generally, running barefoot will cause a runner to land with a flatter foot (De Wit et al 2000).
In addition, Lieberman et al. (2010) found that if a barefoot runner lands with a forefoot landing there is no impact transient (a very rapid rise in impact forces) as compared to landing heel first in shoes. It should be noted however that Lieberman and his group do not claim that heel striking in and of itself causes injury.
Minimalist shoes share the following characteristics:
Traditional Shoe
Heel Drop
Minimalist Shoe Heel Drop
Within the minimalist shoe category are three main sub-categories:
Currently, neither the minimalist side nor the traditional side can conclusively say their method of shoe construction is superior in regards to injury prevention. More and more studies are being done with minimalist shoes and it will be interesting to see the data.
In my opinion as a coach I think most runners could benefit from some amount of running in minimalist shoes. However caution must be taken in how quickly and how much a runner transitions away from a regular, traditional running shoe.
There will be a wide range of individual variability in adapting to a more minimalist style of running. A runner’s experience, ability, strengths, weaknesses, injury history and psychology are all factors to consider.
The choice of running shoe style needs to be part of a well-thought out training program. If a runner has been relatively injury-free and is content with their performance in traditional shoes I see no reason to push them into minimalist shoes.
On the other hand, if a runner has had repeated injuries and setbacks with traditional shoes it may be time to transition to a more minimalist shoe.
My advice would be to first look for a shoe with a wide toe-box to accommodate splaying of the toes during running. This will facilitate proper function of the big toe. Less cushioning and more flexibility are other characteristics to look for. Lighter shoes will help improve running economy.
I would be more cautious in regards to heel drop. Going to a zero-drop shoe for many runners will be put too much strain on the Achilles tendon and lower posterior chain. Look for a 4 – 8 mm heel drop initially.
Use the shoes indoors during strength training sessions first and then try them for short runs and running drills. Build the mileage gradually. Some runners may adapt to where they can run with minimalist shoes all the time. Others may only be able to progress to using them for shorter runs.
But keep in mind that shoes, whether traditional or minimalist, are not a solution by themselves. Runners need to incorporate strength training, multi-planar mobility drills and technique exercises into an individualized conditioning program that includes adequate recovery and sound nutrition.
If you’re interested to learn more about this topic and are in the Vancouver area on January 26, I invite you to attend the Vancouver Running Symposium.
An expert panel consisting of a sports medicine doctor, physiotherapist, pedorthist, coach, shoe designer and a podiatrist will be debating the role of traditional shoes vs. minimalist shoes.
Full details and the RSVP form can be found at Vancouver Running Symposium.
Curb Ivanic, MS, CSCS is a Vancouver based trainer, running coach and experienced ultrarunner. He is the creator of the Core Running system and has coached hundreds of runners from beginner to elite over the last 12 years. You can contact him through CoreRunning.com .
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Big thanks to Curb, that was great.
I very much recommend that you do what you can to make the Vancouver Running Symposium. It looks great.
If you are looking for a fitness education course focused on working with the recreational runner, you can check out:
If you are looking for resources to help you run injury free, you can check out:
Here are a few other articles on running that may interest you:
I know when I talk about core stability, some people will roll their eyes.
There is always a discussion in the fitness world on what the core is and if we should be focusing in on it.
Well when it comes to injuries, I focus on the core.
It is looking like core stability is playing more of a role when it comes to injuries.
I know in previous Injuries of the Month (patellofemoral pain syndrome, sacroiliac joint pain and piriformis syndrome), core stability has been a component of the exercise program that I have recommended.
I wanted to highlight some research that talked about injuries and core stability.
They looked at 80 female and 60 male intercollegiate basketball and track athletes.
This was very interesting. They measured core stability by testing:
These were the main results from the study:
Often times when we focus on working on the core we think of crunches or bridge variations. It is interesting how this research expands on things further and looks at core function in different planes of movement and different movements. I like the fact that it highlights the importance of looking at hip abduction and hip external rotation strength. Many times this is not mentioned or covered in an exercise program.
Here is an exercise that I give to work on hip movement and strength:
A few comments on the exercise. The exercise can be used for:
The directions given and the cueing can change the function of the exercise.
Where to get more information – Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34.
If you are looking for exercises to strengthen the external rotators of the hip, these are what I use:
I am working on this month’s Injury of the Month. It is Tennis Elbow.
I was doing my research on the injury and came across this article, which was interesting. It talks about isometrics for an injury and really highlights the new trend in exercise rehabilitation.
They wanted to see if isometric exercises were as effective as medication for pain relief in those with lateral epicondylitis (tennis elbow).
They had two groups:
The researchers only gave one exercise. Here are the details of the exercise:
Interesting to see the benefits of isometric strengthening on an injury, specifically with lateral epicondylitis. Isometric exercises are not exciting but effective when it is comes to an injury and the safest of the three types of contractions.
A lot of the research out there focuses on eccentric exercises for tennis elbow. This article highlighted the benefits of an isometric exercise which is less stressful on an injured area.
The number of repetitions was a surprise to me. Over a day performing 200 repetitions or about 33 minutes of exercise sounds like a lot. This is a trend that is occurring in exercise rehabilitation. The standard used to be 1 set of 10 repetition but this is fading away and does not correlate well with what many people do during the day (number of movement cycles performed in a day). Performing low load (isometrics) more frequently transfers more over to what one does on a daily basis and assists in recovery.
Just so you know, the tennis elbow exercise program will be coming out at the end of the month.
Where to get more details – Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. (2011). Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3.
That is it for another edition of the research review. I hope this helps you out when it comes to core stability and injuries, plus a great little tennis elbow exercise.
Rick Kaselj, MS
Another great interview for you on medical referrals.
Specifically, how a fitness professional can get medical referrals.
I interviewed Cabel McElderry, who shares how he works with the medical community in order to help them with their clients.
(To listen to the interview, scroll down to the bottom of this page and click the play button. If you do not have time to listen to it right now, just click the “download” button and download it to your computer. Then you can listen to it on your computer when you like or subscribe to the itunes podcast. Enjoy!)
In the interview, Cabel shares with you:
Thank you, Cabel McElderry.
Rick Kaselj, MS
P.S. – If you liked this fitness business interview, here are some other posts that may interest you:
Plus here is a video presentation that I put together when it comes to using social media to get medical referrals:
This is a little video on how to download the interview to your computer:
CLICK HERE to listen to the interview
Another year has passed, wow.
They just keep truck’n on by.
It is always nice to stop and take a look at the year that is just about to pass. Before I look at the year, I wanted to see how far this little blog has come.
I started this Exercises For Injuries thing on February 26, 2009. My first post was Keeping Up with the Bones . It was a bad post. I had no idea of what I was doing, but I just started writing. Nearly 3 years later, I am well past my 400th post. Things have improved drastically but there is still a lot more that I can do.
One other way that I have been helping getting the word out when it comes to injuries and exercise has been my YouTube channel. I started it on December 25, 2008. Looking at the channel, I am getting very close to 250 videos. Not sure what I was doing starting a YouTube channel on Christmas Day but I am happy how it has progressed over the last 3 years.
I might as well finish off with the last place that I spend my time when it comes to getting the word out on exercises and injuries. It is Facebook. I started my fan page this year and I am still figuring it out. Just like my blog and YouTube, I will:
If you plan on doing this blog/YouTube/Facebook thing, remember those four things as I think they are very important and have helped me out a lot.
Okay, lets get to the list.
As you know, we are hitting the end of the month and that means time for the Injury of the Month.
This month’s injury is Jumper’s Knee.
In this video I talk about the equipment you will need to perform exercises targeting jumper’s knee.
I hope the video helps you.
It is good if you get Jumper’s Knee or to help one of your clients.
If you are interested in the Jumper’s Knee Program, this is what is what you will get.
That is it.
If you want the full details on the Jumper’s Knee Program, click here.
Rick Kaselj, MS
Back with part two of Nick’s injury story. In part 1, Nick talked about how he used corrective exercise to overcome an injury.
Now in part 2, he talks specifically how he used corrective exercise to help him with the deadlift.
Thanks so much, Nick.
Enjoy the story and info.
One day, I was doing sets of five on front squats w/chains. On the fifth rep of one of those sets, I felt something “give” on the left side of my low back. My entire low back was in pain and I couldn’t complete another set. I finished with some glute ham raises, cable chops, step ups, and a couple of other things just fine; however, the next few days my back hurt like crazy and I was definitely worried. I trained upper body fine and took the rest of that week off. The following week I felt a little better and was able to train decently. I got some tissue work done, got an adjustment and I felt like I was good to go; thus, I continued with my training for the meet and was actually hitting some PR’s for about a month or two after the “injury.” I decided against doing the meet but was still training pretty well.
Now, what I should’ve done was taken a decent amount of time off from any type of intense training but when I’m in the zone, I’m in the zone. Anybody who’s competitive with anything can understand that. Well, the pain came back and I ended up making things worse as I tried coming back too soon a couple of more times. I had a grade 2 strain (at least) near the 12th rib attachment site of quadratus lumborum and actually had some bruising on the rib. This might not sound like much and there are plenty of worse injuries but it was terrible because it affected pretty much everything I did. Too much stress would cause spasms here and in many surrounding areas and it was real easy to restrain the area. The pain was nagging, sharp, annoying and sometimes extreme.
QL is technically a deep low back muscle though it can really be thought of as a very deep abdominal muscle. It attaches to the 12th rib, lumbar vertebrae and the posterior iliac crest and is a very important spine and hip stabilizer for almost any activity you can think of; thus, it was hard to give it the rest that it needed since its active so often. Since my left glute wasn’t doing its job for who knows how long, my left QL was working overtime and eventually gave. This was definitely a cumulative injury as the overload that occurred in this area from the rotation and shift that I had probably created a large number of microtraumas over time.
I had neglected soft tissue work for too long and hadn’t addressed imbalances appropriately for long enough. Needless to say, I had to back off from heavy powerlifting for a little while and I have eventually come to realize that the entire experience was a blessing in disguise. It forced me to take a step back to figure out the answers to some questions.
What caused this to happen and what held back my lifts?
What do I need to do to fix things so that I can come back stronger and healthier?
I took some time off and then had to figure out ways to improve my body and strength without straining this area and making things worse. It took some time and it took some effort but I pulled it off. I focused on hammering out gluteus maximus exercises and gluteus medius exercises, with an emphasis on catching my left glute up to my right.
I hammered out lots of oblique work to help stabilize my spine and pelvis better. I worked on biomechanics and technique until my shifts were almost eliminated. I invested in a sled so that I could strengthen my legs without straining my back. I got massage, ART and chiropractic care. I did everything I could to make myself better and heal the injury at the same time.
When it had healed enough to allow it, I began to focus on getting my single leg lifts significantly stronger. I found that single leg variations didn’t aggravate anything while bilateral lifts seemed to aggravate it once I got to a certain weight. Single leg variations were something that I had done but had never really focused on getting strong with. Pushing these lifts up would help to iron out hip and trunk imbalances and increase strength and stability at the same time. I would rotate in 2-3 week cycles of barbell reverse lunges, front split squats, barbell step ups, yoke bar reverse lunges, one leg squats and bulgarian split squats while sometimes adding chains to keep things interesting. I ended up working in the mid to high 200 pound range for most of these, which was a good increase from where I had been before.
For glute work, I put myself on a steady diet of one leg hip thrusts, one leg rdl’s, reverse hypers, clam shells, side leg raises, bird dog variations, cable chops, sled dragging, prowler pushing, kettlebell swings and other exercises that I’m probably not thinking of at the moment. I pushed these up consistently and am now doing one leg hip thrusts w/ a 135lb bar or lots of chains on my lap, one leg rdl’s with around 150lbs for reps, clams and slr’s with heavy bands and have gotten strong on all of these exercises. I’ve probably put on an inch or two on my glutes over the course of the past two years. I also did some psoas and adductor strengthening as my hips all over were not as strong or as stable as they needed to be. My back has always been a strong point for me while my hips lagged behind. For lower traps, I have done lots of Y’s, I’s, high to low rows and face pull variations. Since lower traps attach on T-12, which is close to that 12th rib, gaining strength, stability and endurance here has helped to provide added support around the area and also helped to rehab the area.
For direct oblique and QL work, I got on a diet of side bridges, rotating side bridges, cable hold variations (split stance, tall kneeling, squatting, etc.), cable chops, side holds and offset farmers carries. All of the single leg work obviously hit obliques and glutes as well.
One great corrective exercise that I had used previously as well is the offset step up. You can either put more weight on one side of a barbell or hold a dumbbell in one hand, and do step ups. The offset weight will force appropriate oblique and hip muscles to fire in order to keep your body square. I have seen these work not only for myself, but many others as well.
The added oblique and glute strength is a big help to QL since it now has the appropriate support from its friends. While I know that there are varying view points on reverse hypers, I absolutely love them and they were a big help in rehabbing my back and keeping strength up. The fact that I could train glute function along with trunk stabilization via low back muscle activity combined with the traction and decompression that the exercise provides helped me tenfold. If you do them correctly and with control, they are an amazing exercise for both posterior chain strength and recovery.
For biomechanics, I had a great colleague and friend of mine watch my movement to help me find where neutral was while eliminating my shift. I did this with the use of lighter squatting and pulling with either a barbell or kettlebell. I did plenty of mobility work for hips and spine as well as some stretching for left TFL (part of the shift) and psoas.
Previously, if I missed a deadlift, it was because of my hips. Getting my front or back squat up almost always meant that my deadlift would go up with it. So by now you are probably wondering, what happened with the old weak points now being stronger points and the biomechanics improving? Well, over the course of the past few months, I’ve dived back into some heavier bilateral squatting and pulling and I feel great. I’ve hit 30 pound PR’s on squatting variations after only a couple of workouts back at it and am gradually working my way back up on the deadlifts but pulled around 500 pretty fast and easy recently, and should be able to hit a PR when I really push it. I feel more stable and have more pop out of the hole with my new found glute strength that I never had before. I plan on hitting some big numbers over the course of the next year and I truly believe that had this injury not happened, I might still be guessing what it was I needed to work on.
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One more part to come. The above was part 2 and you can check out part 1.
Thanks to Nick Rosencutter for the great information above.
Rick Kaselj, MS
Something to get you thinking when it comes to explosive training.
Think about how you should be training your clients.
Sam Leahey gets you thinking about training your clients like they are athletes.
Enjoy the read.
Let’s get right to it.
The reality is that as we age we lose muscular power at a much faster rate than muscular strength.
Would it not make sense therefore that we train aged populations for explosiveness?
Too many associate the word “explosive” only with athletes. In order to stave off daily functional decline, explosive training is unequivocally necessary for all human beings regardless of age.
Personal trainers and strength and conditioning coaches have taken a simpleton’s view on the topic with the approach – “training for strength is safer than training for explosiveness. Therefore I’ll train my older clients for strength and let ‘explosiveness’ take care of itself.”
This seems logical but the current of literature is showing that “Activities of Daily Living” in the aged are not affected as much by simple muscle strengthening activities (low-velocity contractions).
One of the highest ranked factors for independent living in elderly is fall prevention – the ability to stop themselves from falling down.
Consider the middle aged person who jumps over a puddle at the last second during their walk to work or the elderly person who grabs the hand rail quickly to stop himself from falling down the stairs.
What if an older person finds themselves in an emergency and sprinting is the only way to get away from danger into a safe area? Are not all these situations examples of “explosiveness” or muscular power?
What kind of muscular contractions are involved in these kinds of activities?
Yup, high-velocity contractions, also known as “explosiveness.”
This is one major reason why slow-velocity training can be much less effective than high-velocity training in fall prevention. It provides a more specific transfer of training. Granted, having both low-velocity and high-velocity contractions in the training program is optimal.
Now, I’m not suggesting every middle aged or elderly person we train be prescribed a heavy dosage of Olympic lifts or depth jumps. As with anything else, a progression is needed and there are plenty of safe and fully appropriate exercises for older populations to use and reap the longevity benefits that come along with enhancing one’s explosiveness. Fortunately, some older populations have remained active for the majority of their life, unlike others who stopped moving fast after college. Each person will have a different starting and/or ending level in your training progressions. As Coach Mike Boyle has said in the past – “what is a warm up for an athlete might be a power exercise for the elderly client.”
The Application of Explosive Training
As mentioned, the optimal approach for enhancing explosiveness in older populations includes utilizing both slow and fast-velocity contractions in the program. However, most reading this are probably adept with the former so I’ll focus the elaboration on the latter while simply noting the following guidelines for strength training (slow-velocity contractions) with older populations:
Sets: 2-4sets
Repetitions: 6-12
Intensity: never train to failure but you can absolutely progress to only leaving 2 reps left in the tank (2 reps before failure is reached)
Frequency: 2-4 sessions per week
Understand the above is simply a guideline and certainly not written in stone. As for the high-velocity training initiatives, there are a number of appropriate methods including:
With explosive exercise loading parameters you’ll want to keep the repetitions and sets rather low and allow as much rest as needed between sets to ensure high quality efforts each repetition. I would worry less about explosive endurance (high reps, short rest) and more absolute capacity and quality of effort (low reps, high rest). As for intensity of effort with each repetition, if the older client is just starting out, progress from 50% effort, to 75%, to 95%, and then finally as fast as possible. If the client has done high-velocity training in the past you can certainly start closer to 100% effort. In terms of frequency, there aren’t too many wrong solutions. Whether you have an “explosive session” on its own training day or whether you incorporate explosive exercises into the weekly routine is absolutely fine. I would just caution against doing high-velocity training every single session with older clients. Limiting the exposures to 1-3/week should be plenty.
For illustration here is a collection of videos from colleagues using the methods listed above:
A great article for you today.
It is a guest blog post from Nick Rosencutter.
Enjoy.
Take it away, Nick.
They are a pain, literally.
They can stop you from doing something you love.
They can cause nagging aches and pains.
They can affect you mentally.
They can ruin your day.
They are something that most people try to avoid.
On the other hand, they can also be a blessing in disguise. This is something that I have realized first hand.
I absolutely love training, especially powerlifting. I love the thrill and rush of stepping on the platform to compete. I love pushing my body past limits and growing stronger both physically and mentally when I push past barriers with my training. I love being in great shape and moving weights that most people can only wish to move. I’ve loved training (notice I said training and not “working out”) for over 12 years without a break (which really isn’t that much and I still have a long way to go).
When I’m not training, I’m helping others train, reading about training or dreaming about training. The deadlift happens to be my ace and pretty much my favorite thing to do in the world. In my opinion, there is absolutely no better feeling than locking out a heavy deadlift as you feel every muscle in your body tighten up to make it happen.
The hip drive, grip strain, the glutes coming through, the back locking out, the traps stabilizing, the intrinsic foot muscles gripping the floor, the blood rushing through the veins and the rush that flows through the body and mind; just an amazing feeling that only certain people will understand. Not being able to do this for a period of time was devastating.
Great little video from Nick on Gluteus Medius Exercises:
Flash back to November of 2008. I had just done my fifth meet in about seven months, which was probably a little too frequently. I was on pace to pull my first 600lb deadlift at a bodyweight around 178-180. Training had gone well as I had pulled 610 with band tension, tripled 540 and had made good progress on most of my assistance work. Well, I ended up missing 570ish at the meet when I had nearly locked out 585 a few months earlier. Part of the problem was just training stupidity. I had gone too intense for too many weeks before the meet and had competed too many times. But I knew that couldn’t be the only issue at hand because when I made that attempt, the weight was coming up smoothly; I thought for sure that I had it locked. Then as I approached lockout, I just couldn’t finish it. I was upset to say the least.
So at this time, I was in my last semester in the exercise science and strength & conditioning program at UW-La Crosse. Luckily, I was surrounded by some very knowledgeable people who knew their stuff. I spoke with one of my mentors, an amazing strength coach who knows a thing or two about the iron game. I showed him a video from my missed deadlift. He immediately pointed something out that I hadn’t noticed or really even thought of. My left leg began to shake as I approached lockout. He looked at another video of a 560 pull I had made easily a few months earlier. I had some rotation occurring through my hips and trunk as I pulled the deadlift. It was subtle, but you could sure see it.
He evaluated me and found out that:
If you have ever read any of Thomas Myers’ stuff on fascia and exercise, this should make you think of the spiral line: opposite hip and shoulder.
I’m assuming that many who read this page know about the book, Anatomy Trains
This had implications with the rotation that was occurring with my movement. So he did some ART on my hip and shoulder (left TFL and right subscap among other things) and gave me a few corrective exercises to fix this imbalance that I had. This was probably my first real personal experience/encounter with the world of muscle imbalances and corrective exercise.
I had been decently well versed in every strength and conditioning modality imaginable but had apparently slacked on this whole other department. I was determined to fix my imbalance and get better. I decided to take some time off of competing and hammer these things out for a little while. The January following this encounter, I would embark on my full time internship in order to finish up my degree, which would turn out to be one of the best experiences of my entire life.
Enter Indianapolis Fitness and Sports Training with a couple of guys named Mike Robertson and Bill Hartman. I learned a tremendous amount about training during my amazing time there and was totally immersed into the world of analyzing and addressing postural faults and muscular imbalances. I had no choice but to get better.
They discovered some of the same that my mentor at La Crosse had plus more:
Those were some of the main problems for me. So I hammered out lots of special exercises to help balance things out and get my lifts up. I did however, make one mistake. I still trained too intensely, too often. I picked a meet that I wanted to do that May and trained for it.
Little clip from Bill Hartman’s Presentation in Muscle Imbalances Revealed – Lower Body Edition:
Now, these issues that I had were things that were probably going on for a long time. In my early days of training back in high school, I really had no true idea what I was doing (though I sure thought I did) as I pretty much just taught myself and learned from random gym rats and magazines back then.
The shifts and rotation that I had with my squat and pull were subtle enough that an average eye would never notice them, so who knows how long that had been going on. While I had gotten along fine and had built up to a respectable strength level and build, fixing some of these things earlier could have saved me lots of trouble and probably helped me to hit bigger weights easier. I mean, locking out a max deadlift with one glute firing versus two glutes firing is kind of a big deal. So anyhow, I was training hard and lifts were going up, etc. until…..
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That is the end of part 1. I got part 2 coming up very soon. Big thanks to Nick. We all have an in jury story.
About the Author
Nick Rosencutter, CSCS, NSCA-CPT, LMT – Nick is a Certified Strength and Conditioning Specialist and Certified Personal Trainer through the National Strength and Conditioning Association and is also a Nationally Certified and Licensed Massage Therapist. He received his Bachelor’s degree in Exercise and Sports Science with a Fitness emphasis and Strength and Conditioning Concentration from the University of Wisconsin La Crosse, and received his diploma in Massage Therapy from Lakeside School of Massage Therapy in Milwaukee. He has worked with all varieties of clients ranging from fat loss to various levels of athletes and is also a competitive powerlifter. He currently trains clients at Southridge Athletic Club in Milwaukee and offers corrective exercise and movement training at Miller Sports and Wellness Chiropractic in West Allis. You can learn more at his website www.rosencutterultrafitness.com
Rick Kaselj, MS
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It is that time of year to look back and see how things have gone.
One thing that I have been working hard at on EFI are videos. I have well over 200 videos on YouTube and I keep adding more.
Looking back at the year, I wanted to highlight the most popular videos from the EFI YouTube channel.
Here they are in order of most views.
Back to doing research reviews. This is fun. It is great to go into the research to see what is new when it comes to exercise and injuries. In this round of research reviews I found some great research on scapular stabilization exercises, jumper’s knee and osteoarthritis.
Let’s get into the research.
The effectiveness of an exercise program on the shoulder with people who have subacromial impingement syndrome.
They divided 40 subjects into two groups.
Group 1 did stretching and strengthening exercises while group 2 did stretching, strengthening and scapular stabilization exercises.
Both groups showed improvement but the second group had greater improvement in muscle strength, joint position sense and scapular dyskinesis.
If you or your client has subacromial impingement, make sure to add scapular stabilization exercises to your program, along with stretching and strengthening.
Let me take a minute to explain a little more on why you should do this.
The results above all make sense because in shoulder impingement clients you often see:
To get more information, check out: Başkurt Z, Başkurt F, Gelecek N, Özkan MH. (2011). The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. J Back Musculoskelet Rehabil. 2011;24(3):173-9.
Also have a look at this one: Phadke V, Camargo P, Ludewig P. (2009). Scapular and rotator cuff muscle activity during arm elevation: A review of normal function and alterations with shoulder impingement. Rev Bras Fisioter. 2009 Feb 1;13(1):1-9.
For the program that I use for scapular stabilization exercises, click here.
They looked at 111 obese adults. The researchers performed a baseline MRI and a 12-month follow up MRI to look at cartilage thickness.
Neat Stuff in the Introduction:
The average age was 52 years old, a BMI of 37 and average weight loss was 9%.
A decrease in weight led to an improvement in quality and quantity of medial articular cartilage but this was not observed in the lateral compartment.
This improvement in cartilage could lead to a reduction in the need for total joint replacements and decreased the impact on the health system.
We don’t talk about it often but with so many conditions in the lower body, an emphasis on decreasing weight will help overweight and obese clients recover from some injuries and prevent future ones.
Thinking beyond just exercise to lifestyle, nutrition and activity – even when injured – is key.
To get more information, check out: Anandacoomarasamy A, Leibman S, Smith G, Caterson I, Giuffre B, Fransen M, Sambrook PN, March L. (2012). Weight loss in obese people has structure-modifying effects on medial but not on lateral knee articular cartilage. Ann Rheum Dis. 2012 Jan;71(1):26-32.
I go through more stuff on knee osteoarthritis in the course:
The effectiveness of an exercise program, ultrasound and transverse friction for the treatment of chronic patellar tendinopathy.
They had 30 subjects with chronic patellar tendinopathy and divided them up into three groups (exercise, ultrasound and friction). Each group received treatment three times a week for four weeks.
Then they looked at the pain level of each of the subjects at 4, 8 and 16 weeks.
They found the exercise program had better results than the ultrasound and friction.
Yay, exercise.
If you do get treatment for jumper’s knee and have ultrasound and friction performed, don’t discount the exercise. It may be the missing piece that will help you out the most with your jumper’s knee.
What the focus needs to be on is an eccentric exercise program. I go through that in Achilles Tendinitis Exercise Solution for the Achilles tendon. In a few weeks, I will be finishing up this month’s, Injury of the Month, which will be Jumper’s Knee. Watch for it before the end of December.
To get more information, check out: Stasinopoulos D, Stasinopoulos I. (2004). Comparison of effects of exercise programme, pulsed ultrasound and transverse friction in the treatment of chronic patellar tendinopathy. Clin Rehabil. 2004 Jun;18(4):347-52.
Hope you enjoyed the research review.
Let me know what you think. Please feel free to share a recent article that you have read in the comment area.
Rick Kaselj, MS
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