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Goblet Squat as a Gluteus Maximus Exercise

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Filed Under (Corrective Exercise, Elbow Pain, Fitness) by Rick Kaselj on 24-08-2012

It has been a great week.

Lots of questions have come in from email and Facebook.

Goblet Squat and Gluteus Maximus

Here is one that was asked about Tyler Bramlett’s article on Importance of Movement Progressions for Post Surgery Knee Recovery

So, why is the goblet squat a good exercise for gluteus maximus activation?

– Tim D

First of all, any squat when done correctly is an excellent glute activation exercise. The goblet squat is simply the best way to go when rehabbing injuries or teaching a beginner how to squat.

With regular barbell squats, people tend to have a hard time getting into the right position. Back squats can hurt where the bar goes and often times people can’t keep their torso upright enough, putting too much stress on the back. Front squats hurt most people’s wrists and tend to emphasize the quads.

With the goblet squat, the weight is centered right in front of your chest, which gives you a counterbalance that allows you to go deeper, safely. And since you are holding the weight in front of you with your elbows facing down, you can maintain your natural spine curve throughout the exercise and even use your elbows to open up your hips.

Simply put, the goblet squat is the safest way to teach someone to squat correctly and, provided you have the ability to fire your glutes, squats are one of the best ways to teach your body how to apply force through your glutes.

Make sure to take a look at Tyler’s Warrior Warm Up. Great stuff that will help prevent injuries.

 

If I have Elbow Pain, Do I have to Stop My Training?

Jedd Johnson and I just finished up our coaching call for Fixing Elbow Pain customers.  It was great to have people on the line (Hugh, Scott, and others) and to have questions sent in.  We answered questions for about 70 minutes.

Here are some of our notes from the call:

Does your training have to be completely pain free or is it OK to still have some pain (but not so much)?

Returning to training for me usually involves changing the exercises to those that do not produce the pain response.

You can accomplish this by changing the implement being used, or by changing the positioning of your body– kind of like ergonomics.

These two methods have enabled me to keep training without losing strength and without making the injury worse.

A good example is, instead of doing barbell curls (which for me creates a lot of stress in the elbow) I will use an EZ Curl Bar, the kind with the wavy angles in the middle. This allows me to train the arms without aggravating the elbows.

Another thing to keep in mind is I follow the guideline of “attack the weakness” or “attack the injury”, meaning I will stimulate the area using specialized tools like SMR balls, foam rollers, etc, as well as other implements that enable me to focus in on the area that is hurt. This helps me to keep the healing process going and keep blood flowing into the area.

For example: I’m currently doing some grip specific exercises like 2hp, Fatdumbbell lifts, some gripperwork and I’m doing those with (semi) maximum weights.

This sounds like a good mix. If you keep experimenting, you may be able to find variations of these lifts that cause you no aggravation at all and you can train even more intensely. If not, feel free to stick with the lighter weights and always keep in mind warm-up, stretching post training, and increasing blood flow into the area.

If you have Fixing Elbow Pain, we will be sending out the recording of the call next week.  If you don’t have Fixing Elbow Pain, you can get it here.

 

 

I have Hip Dysplasia, what exercises should I do?

I had a friend, Shawna Kaminski, send me a question about hip dysplasia, as she has a client that has it and is wondering what to do and not to do when it comes to exercise.

Hip dyspasia is where bones of the hip are not aligning well with the hip joint.  This can occur as a infant, child, or adult.

The first thing to do is to get guidelines and recommendations from the doctor who diagnosed you. They will have the best idea of how severe it is and what you are able to to.

After this I would focus on minimizing pain.  Avoid positions and activities that lead to pain.  Pain will inhibit the recovery process.

When it comes to exercise, be cautious of single leg exercises, single leg jumping, and running.  These activities put a lot of stress on the hip joint.  In time you can build up to them but monitor how your hip feels.

I would work on performing:

  • bilateral squats
  • unilateral squats – starting off with balance and then progressing
  • lunges – starting off with static and moving to dynamic
  • glutueus medius exercises
  • gluteus maximus exercises

I hope this gives you a start.

What is Coming Up: Gluteus Medius Exercises

I have a preliminary graphic for next week’s Injury of the Month gluteus medius exercises.

It looks great:

I know it is not a specific injury but I use gluteus medius exercises for so many injuries, especially lower body injuries, so I thought it would be a great idea to put together research backed exercises that target the gluteus medius.

I know this will help with lower body injury recovery and prevention.

I am also doing one on gluteus maximus exercises.

With the theme being glutes, I will also have an interview for you on gluteal amnesia.  Watch for it.

That is it for today.

I will be working on this month’s Injury of the Month over the weekend and we will chat next week.

Rick Kaselj, MS

 

Email

Fixing Medial and Lateral Elbow Pain

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Filed Under (Elbow Pain, Fitness) by Rick Kaselj on 25-04-2012

Today I have a test for you when it comes to medial and lateral elbow pain.

It is an easy test that you can do, to get an idea of what kind of elbow pain you have.

You can also get your clients to perform the test in order to get a better idea of what kind of elbow pain they have, in order to get an idea of what exercises to give them and avoid.

Enjoy!

Simple Test for Medial or Lateral Elbow Pain

CLICK HERE to go directly to the video above.

The above is called a Polk’s test.  I always chuckle when people name a test after themselves.  I should name a test after me.  Need to think of that that would be.

If you want more information on the Polk’s test, you can check this out – Polkinghorn BS. (2002). A novel method for assessing elbow pain resulting from epicondylitis. J Chiropr Med. 2002 Summer;1(3):117-21.

Something that I have released this week is Fixing Elbow Pain with Jedd Johnson.

Let me answer a few questions that have come in about the product.

Questions about Fixing Elbow Pain Program

 

What is the difference between Tennis Elbow Pain Solution and Fixing Elbow Pain?

 

Tennis Elbow Pain Solution is a specific program targeted just to tennis elbow.

Fixing Elbow Pain is targeted to athletes and those that work out (lifters).  It helps the athlete and lifter when it comes to elbow and forearm pain.

I go through exercises for lateral and medial elbow pain that an athlete and lifter can add to his program to help overcome lateral and medial elbow pain.

I have teamed up with Jedd Johnson and he brings in the perspective of an athlete and lifter for preventive techniques and pre-habilitation exercises.

So to sum it up, if you have tennis elbow pain and you want to rehabilitate it, Tennis Elbow Pain Solution is what you should get.

If you are an athlete or lifter and you have medial and lateral elbow pain from what you do and you want to know what exercises you can to do in order to make it better and training techniques to keep it away, then Fixing Elbow Pain is what you should get.

I hope this makes sense.

How Did “Fixing Elbow Pain” Get Started?

Jedd Johnson saw my stuff on my blog and on other blogs.  He saw that I had a Tennis Elbow Pain program and let me know that he has had it.  He also let me know he does all kinds of strength training, grip sports, strong man, etc., and that there were a lot of things he did for pre-hab (exercises to prevent injury) and preventive techniques that he used after he overcame his tennis elbow.

We got chatting and thought it would be great if we combined forces.  I could be the rehabilitation side of things and Jedd could bring in the pre-hab and prevenative techniques.  What we came up with was Fixing Elbow Pain.

The program is a big help for athletes and lifters with medial and lateral elbow pain.

Fixing Elbow Pain Main Program

Let’s look at the program a little more, and see how it can help you:


In the main program, there are four components:

  • Component #1 & 2 – This is where I give you the exercises, progressions, exercise order and correct reps/sets for medial and lateral elbow pain.
  • Component #3 & 4 – Jedd puts together an 80 plus page manual on pre-hab and preventive techniques for elbow and forearm pain from stuff that has worked for him.  It is great.  I got a lot of great ideas from it and I know it will help people that are taking my Exercise Rehabilitation of the Wrist and Hand course.
  • Bonus – Ultimate Upper Body Workout Finisher with Travis Stoetzel is great.  It is for the person that is looking for ideas and workouts that are hard and challenging.

The main program has everything you need to fixing your elbow and forearm pain.

Fixing Elbow Pain Accelerator Program

We also set up an Accelerator Program for those people who are looking for videos of the exercises and techniques that we use in the program.  There is over 1 hour and 30 minutes of video.  Here is a list of the videos you will get:

  • 1 Warm-up Methods Part I – 6:49
  • 2 Warm-up Methods Part 2 – 3:19
  • 3 Hazard Awareness for Preventing Injuries – 2:01
  • 4 Elbow Sleeves for Injury Prevention – 2:29
  • 5 Tendon Wrapping Technique – 2:56
  • 6 Stretches for Injury Prevention Part I – 4:16
  • 7 Stretches for Injury Prevention Part II – 1:42
  • 8 Power Ball Massager Tool – 4:07
  • 9 Traction for Improved Recovery – 3:28
  • 10 Contrast Bathing for Improved Recovery – 5:55
  • 11 Compression Band Therapy – 6:22
  • 12 Self Myofascial Release Techniques – 2:06
  • 13 Professional Services for Recovery and Injury Prevention – 4:03
  • 14 Rice and Sand Bucket Training – 3:30
  • 15 Rubber Band Extensor Work – 3:58
  • 16 Leverage Bar Rotations – 3:52
  • 17 Shot Training for Lower Arm Health – 4:29
  • 18 Hammer Grip Band Exercises for Forearm Pre-hab
  • 19 Rehabilitation of Medial and Lateral Elbow Pain Exercise Program Video – 14:17
  • 20 What to Do and Not Do for Elbow Pain – 17:13

After this explanation, I hope you can see how Fixing Elbow Pain can help you with your elbow and forearm pain.  Especially if you are an athlete or lifter.

Lateral Elbow Pain Test

Also, in the past, I had done a video on a self assessment for lateral elbow pain.  Here it is again; it goes through four levels of lateral elbow pain tests.

Self Assessment for Lateral Elbow Pain

CLICK HERE to go directly to the video above.

That is it, have a great day.

Rick Kaselj, MS
.

How to do the Human Flag

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Filed Under (Elbow Pain, Fitness) by Rick Kaselj on 06-04-2012

Hey, I’m Shawna Kaminski. I just turned 49 on April 1st and I decided that it’d be cool if I could learn how to do the human flag.  It’s a pretty impressive strength move. I was never a gymnast or anything, so I knew I had a learning curve in front of me.

You may or may not know of me. Some people call me the ‘Pull Up Queen’ since I’ve mastered the pull up. I have to say that push ups are another strength of mine too. Mostly, I like to create challenging workouts and then just try them. It’s intriguing for others, they try them, tell me about their challenge, I feel another challenge come on and so the circle goes. It’s all in the spirit of fun and as a way to motivate to push for personal bests as opposed to full on competition as far as I’m concerned. (But if you throw down a challenge, I’m sometimes too competitive for my own good and will take it up…)

Taking On the Human Flag

 

So I set out to learn the human flag…

What I like about the human flag is that the ‘potential’ for injury seemed minimal when I set out to learn it. Having said this, it turned out the human flag (or efforts to learn one) proved too much for my elbow, leading to tennis elbow pain. I suffered some pain I’d blame on overuse so I’ll give you some tips to avoid the same mistakes.

But first, I’ll give you some tips and exercises I used to help me learn the human flag.http://challengeworkouts.com/wp-includes/js/tinymce/plugins/wordpress/img/trans.gif

First of all, I had to figure out how to do a flag. There’s some technique involved that makes it a little easier, more on that later…

Helpful Exercises for the Human Flag

 

Seriously, aren’t pull ups pretty much the answer to everything? 😉 Of course I’ll tell you pull ups are your ticket to a successful human flag. However, if you’re still working on getting your first pull up, you’ll unlikely be able to do the flag successfully. Work on the pull up first.

This free guide will help you with that.  Click here to get it or the image below.

When doing the human flag, your core stabilizers are the foundation and so I found hanging leg raises and oblique work to be helpful strengthening exercises. You need super strong obliques in order to brace and hold the position. Here are my favorite exercises for this:

Human Flag Exercise #1 – Hanging Leg Raise

 

When you do hanging leg raises, be sure to rock the hips. Bring the pelvis to the ribs and don’t just raise the knees up, which will just strengthen the hip flexors.

Human Flag Exercise #2 – Hanging Oblique Lift

 

Human Flag Exercise #3 – Barbell Windshield Wiper

 


Human Flag Exercise #4 – Hanging Windshield Wiper

 

The hanging windshield wiper is the motherload of core/oblique work. You’ll also feel your lats while you blast the core.

(Sorry for the bum shots!)

Of course upper body strengthening movements like rows and push ups are the core of your training for the human flag.

A strong back, biceps and triceps are necessary. The bottom arm on the flag needs to have tricep strength to hold the position, while the top arm relies on bicep strength.

To be honest, I concentrate more on compound pulling and pushing exercises to strengthen the arms as opposed to doing single joint movements. If you stick with the multi-joint movements for upper body, you’ll have more functional strength when it comes to things like the human flag. In other words, I can’t be bothered much with doing bicep curls or tricep extensions alone, that sort of thing.

These exercises helped me succeed at learning the human flag. The flag is a tough move; it’s so empowering once you start to be able to do it for even a few seconds.

Learning the proper technique is obviously helpful.

Here are a few pointers on How to do the Human Flag right:
• The right pole is hard to find. It’s tough to find one that’s just the right diameter that’s easy to grip. I’m still on the look out for one in my gym to practice on since I live in a cold climate.

• If you live in a weather friendly environment, I’ve found traffic poles (bus stops, stop signs, no parking signs) are good.

• Your grip needs to be greater than shoulder width apart. I’ve found it easiest to have the bottom elbow locked with the fingers pointing downward. The top hand also has the thumb pointing to the ground.

• While bracing the bottom arm, you need to stack shoulder over shoulder, pinch the shoulder blades together and pull away from the pole with the top arm.

• Keeping the shoulders stacked on top of each other is imperative. This puts some pressure on the bottom elbow since it pretty much takes all the weight.

• To avoid injury of the elbow: don’t practice too much at first. Give the elbow a rest, roll the elbow with a foam roller and don’t allow the elbow to hyperextend.

• Once the arms are in place, get ready to kick the legs up while bracing through the abs.

• Keep the legs tucked in at first, by keeping the lever shorter (bent legs) it will make things easier at first.

• If you’re able to hold it for any length of time, work on extending the legs.

• You’ll have a stronger, smarter side that you’ll want to favor. Don’t forget to work the weak and dumb side too.

The human flag is a worthy goal, but one that takes time, effort and patience. I’m getting so that on a good day I can hold it for 5 seconds or longer. It’s no Cirque de Soleil feat, but it’s a work in progress. A great challenge for me and anyone else that’s looking for something out of the ordinary.

If you liked this challenge, then make sure to check out my other Challenge Workouts:

Shawna Kaminski

 

Filtering Out My Spam Box

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Filed Under (Corrective Exercise, Elbow Pain, Fitness, Rotator Cuff Exercises, Shoulder Injury) by Rick Kaselj on 15-03-2012

I was not really filtering out my spam box. These are a few things that were in my inbox and on Facebook. Let’s get to it.

Cure My Elbow Pain

This was a question that came up for the Muscle Imbalances Revealed – Upper Body (MIRU) coaching call.  I thought the answer would be of interest to you.

Can you tell me how to cure elbow pain? Basically it hurts if I do chin ups, lying dumbell skull crushers (I think that’s where I hurt it and a little on bench press). Also, can you tell me the other types of elbow pain there is (if any other) and if the treatment for curing would be different for each one?

Of the MIRU crew, Dr. Jeff Cubos took on the question.  Just a reminder that the MIRU crew will be holding a seminar this June on Spinal Health & Core Training.  We hope to see you there.

“Unfortunately, it is quite difficult to answer clinical conditions online.

There are many components to the elbow proper and far more components to pain itself.

I will say this, unless there was an acute trauma or structural deformity, the tissues surrounding the elbow may likely be overloaded. Aside from training that progresses too quickly or with too much load, I’d look to the thoracic and shoulder girdle regions.

Often the scapulothiracic joint complex lacks requisite dynamic or static control causing the muscles that cross the elbow to do more work. I’ll often start by addressing mobility issues, then go after control.

I really like quadruped both on elbows and hands for scapulothoracic control ensuring that the scapula is properly positioned or centrated throughout the movement. The hand should also have good contact with the floor in a slightly external rotated position with load being put at the 1st and 5th mcp and base of the palm. The fingers should be spread out.

It may also be worthwhile to seek the help of a clinician who does soft tissue therapy to address the quality of the local tissues and mobility of the distal tissues.

I hope that helps. Sorry I couldn’t be specific but you are more than welcome to email me.”

– Dr. Jeff Cubos

It is back to Rick.  I would say, get it looked at and get an accurate diagnosis and approval to start an exercise program.  If what you have is lateral epicondylitis or tennis elbow, I will suggest this program:

What to do about Osteochondritis?

Tom, I would check out the interview with I did with Zach Moore on Exercise and Osteochondritis. I know this will help you out.

 

Funny Stuff

Since I do this injury stuff, I have been getting all kinds of nicknames, here is another one to add to the list:

I am Very Weak in the Push-up?

A question from Quebec:

Harold, I know you have both the Upper Body and Lower Body of Muscle Imbalances Revealed.

I would take the time to work on the scapular stabilizers.  You can do this in a plank position – Dr. Jeff Cubos talks about above or you can do this in an open chain fashion with exercises targeting the middle fibers of trapezius, lower fibers of trapezius and serratus anterior as I go through in the Scapular Stabilization Exercise Program.

I would also check out Tony Gentilcore’s Component #1 – Corrective Exercise Strategies for Athletes (and Meatheads, too) with Tony Gentilcore that is in MIRU.  He goes through some great exercises that you can do to help with upper body strength exercises.

My Shoulder Cracked?

A question from Brazil:

Sergio, I want to help you out but there is not enough to go on. My advice would be to get it looked at.  Get an accurate diagnosis, clearance to start an exercise program and written guidelines on what you can and can’t do.  Then we can go from there. My big advice: take the time to rehab your shoulder or you will get injured again.

Nice Stuff on Facebook

I am so glad to help fitness professionals and people with injuries.  Very motivating to get comments like this:

Kind Words

More amazing words for the Scapular Stabilization Exercise Program:

“I would describe the Scapular Stabilization Exercise program as very comprehensive, foundational and exceptionally accessible for clients, with a wonderful explanation for the “why” behind all exercises / approaches.

Exceptionally well laid out, with a great background review of the scapular, shoulder movement, and involved muscles to provide a holistic approach.

The exercises are very well described, LOVE the “errors” section to assist with improving accuracy of each exercise. Love the handouts and the E-book. Overall, the best thing is the ease of lay out/presentation of material, so all is easy to understand and implement immediately.”

Catherine Holden

Baltimore, MD

Occupational Therapist, Registered, Licensed

Nice that People Like EFI

 Ahhh, thanks:


Shoulder Injury Guide

Little feedback on the free shoulder injury guide that I give away at EFI:

“I think the gifts are wonderful.

I’m looking to take my knowledge in this direction (corrective exercise).

Where I am in Atlanta, (Roswell GA) there are a lot of tennis moms with the issues, back issues, plantar fasciitis and shoulder pain.

I want to be the go-to guy in this region”.

Thank you in advance,

Andre Coman

Roswell, GA

Personal Trainer

Effective Rotator Cuff Exercises

Feedback on the program:

“I currently work with clients who have past or present shoulder injuries due to overuse or athletically related. Because of Effective Rotator Cuff Exercises, I have a more in depth knowledge of the functions of the rotator cuff and it’s vulnerability to injury.”

Brian Bobo

That is it.

Have a great weekend.

Rick Kaselj, MS

.

How Do I Know if I have Tennis Elbow Pain?

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Filed Under (Elbow Pain, Fitness) by Rick Kaselj on 27-01-2012

The question about tennis elbow pain is simple.

How do I know if I have Tennis Elbow Pain?

Then answer is simple. I put it in a video for you:

4 Tests to Check if You Have Tennis Elbow Pain

CLICK HERE to watch the YouTube video.

If you, one of your clients or if you know someone who has tennis elbow pain, this will help:

CLICK HERE to get more details on the Tennis Elbow Pain Solution

Rick Kaselj, MS

Tennis Elbow Exercise Mistakes

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Filed Under (Elbow Pain, Fitness) by Rick Kaselj on 17-01-2012

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.

Tennis Elbow Exercise Mistake #1 – Ignoring Fascia

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.

What they Looked at:

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.

What the Result was:

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.

Comments from Rick:

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]

Tennis Elbow Exercise Mistake #2 – Your Computer Could Be Holding You Back From Recovering

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.

What They Looked at:

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.

What They Found:

  • Repetitive work tasks affected arm function and pain level.
  • Neck issues affected the outcome of tennis elbow and lead to lower arm function and greater pain.
  • They suggest those with tennis elbow look at their work station, posture and behavior.

Comments from Rick

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.

Tennis Elbow Exercise Mistake #3 – Little Evidence Supporting Stretching

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.

What they Looked At:

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.

What they Found:

There was no significant difference in the outcome of any one of the groups when it related to pain-free grips strength and function.

Rick’s Comments:

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.

If you, one of your clients or if you know someone that has tennis elbow, this will help out:

CLICK HERE to check out the Tennis Elbow Pain Solution Program

That is it, have a great day.

Rick Kaselj, MS

 

 

 

Core Stability and Injuries Plus a Tennis Elbow Exercise

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Filed Under (Core Stability, Corrective Exercise, Elbow Pain, Exercise Rehabilitation, Fitness) by Rick Kaselj on 03-01-2012

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.

What They Looked At

They looked at 80 female and 60 male intercollegiate basketball and track athletes.

This was very interesting. They measured core stability by testing:

  • Isometric hip abduction strength
  • Isometric hip external rotation strength
  • Back extensor endurance (modified Beiring-Sorensen test)
  • Quadratus lumborum endurance (side bridge test)

Interesting Points in the Introduction

What They Found

These were the main results from the study:

  • Males produced greater hip abduction, hip external rotation and quadratus lumborum measures
  • Athletes who did not sustain an injury were significantly stronger in hip abduction and external rotation
  • Hip external rotation strength was the only useful predictor of injury status

Rick’s Comments

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:

  • Educating the movement of hip movement from the rest of the body.
  • A dynamic stretching of the hip rotators.
  • A body weight active hip rotator exercise.

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:

Easy and Effective Exercises for Tennis Elbow

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.

What They Looked At

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:

  • Group 1 – Were shown the exercise and then they did it at home
  • Group 2 – Began the exercise after 4 weeks of medication

Interesting Points in the Introduction

  • An increase in symptoms from exercise will decrease the compliance rate to the exercise program
  • Performing the exercises too aggressively can increase the risk of irritation or injury
  • The above two points are obvious but nice to see them highlighted in an article

Tennis Elbow Exercise Performed

The researchers only gave one exercise.  Here are the details of the exercise:

  • The subjects did the exercise in a sitting or standing position with the arms flexed to just below shoulder height.  Then the wrists were moved in a slow controlled manner into extension with the fingers relaxed. The focus was on moving the middle finger towards the elbow in order to target extensor carpi radialis brevis.
  • The exercise was performed without pain and in a controlled manner.
  • Four sets of 50 repetitions with each repetition being held for 10 seconds, done daily.

What they Found

  • After one month, group 1 had a greater decrease in their pain levels compared to group 2
  • At 3, 6 and 12 month follow up there was no difference between the groups
  • Those that did not feel any benefit from the exercise program after one month were referred on to shock wave therapy

Rick’s Comment

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

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Exercise Rehabilitation of the Elbow and Wrist

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Filed Under (Elbow Pain, Exercise Rehabilitation, Fitness, Fitness Education, Shoulder Injury, Shoulder Pain) by Rick Kaselj on 27-08-2010

Exercise Rehabilitation of the Elbow & Wrist

 

DESCRIPTION:

 

The elbow and wrist are common site of repetitive injury and trauma.  With the increase in computer use there has been an increase in carpal tunnel syndrome.  As people increase their activity with racquet sports, golf and strength training there has been greater reporting of tennis and golfer’s elbow.  In this practical and hands on course you will learn the key anatomy, assessment and exercise rehabilitation programs for tennis elbow, golfers elbow, carpal tunnel syndrome and wrist fusion.

 

OBJECTIVES:

 

– The key structures involved in elbow and wrist
– Assessing the elbow and wrist to determine exercise readiness and progressions
– The four most common elbow and wrist injuries – tennis elbow, golfer’s elbow, carpal tunnel syndrome and wrist fusion
– Rehabilitation exercises and contraindications for the four most common elbow and wrist injuries will be discussed, demonstrated and practiced