Training =Rehab, Rehab=Training
This weekend I had the opportunity to learn from some of the industry’s best as we discussed screening, correction, and principles of training and rehab. Charlie Weingroff as well as local wunderkinds Patrick Ward and Jimmy Yuan were on hand to work hands on through these principles. I learned a ton from this course. Especially useful was the hands-on section and the ability to consult with the instructor one on one. Charlie makes himself incredibly available and is willing to answer any and all questions regarding the topic. Even better is his approach to questions – this was our learning opportunity and we could shape it however we saw fit.
Day one was trying to define what the principles of Joint centration and developmental kinesiology were. Joint centration maximizes the input and distributes the most load for each specific joint – utilizing these positions can result in better stability, motor output and performance. Dysfunction in muscle tone, muscle strength or length, joint mobility, or the ability to sense the world around you can affect the centration of the joint leading to faulty or painful joint/muscle movement. Developmental kinesiology is the rehab process taken from a standpoint of how we develop as children. I will discuss this in depth in a later blog.
We also discussed the core – trying to define it, it’s function and to what extent it drives our performance. I really enjoyed the viewpoint taken here. We have motion available to us for a reason (specifically the lumbar spine) – we just don’t need to always use it. Stability, was defined as the ability to control a segment in the presence of change, not preventing change entirely.
Day 2 was all about assessment. Coming up with a consistent baseline to retest against. The FMS is it when no pain is involved. The SFMA is useful for when there is pain. These provide us useful baseline measurements with which we can retest through the session to ensure change is happening.
Once we assessed, we then corrected. This was what the course was all about. Hands on corrective exercises, principles and ‘tricks’ to elicit change. While the principles I was familiar with, seeing them performed, hearing the cueing, and seeing the hand positions made the course all worthwhile. The best part about this course is that you can walk away with things to change your practice on Monday.
Clinical Pearls I took away from this course:
- watch for high threshold response. Strong individual can force their way through pain, but it will burn out the nervous system and lead to crashing at some point.
- Take the patient into the least threatening position available and breath.
- Breathing is the gateway into the autonomic nervous system that we can control. It can be our reset button when used with the right facilitory methods as well as the right proprioceptive input.
- Once a new pattern/baseline is changed – this is where you can take advantage. Load the patient up.
- Use heavy weights. (this in particular is something I think we fail to do enough of in PT)
- address joint mobility before stability. Often, stability is already there, we just can’t use it due to joint limitations.
- Our joint centration positions are determined from our postural development as children. Supine -prone-sidelying-crawling-kneeling-standing-squatting-stepping. Each has it’s own demands. Lack of proper response in one position – regress until the patient is able to achieve these positions and breathe.
- Poor motor control leads to bracing. Bracing leads to high threshold stability which turns our primary muscles of movement into stabilizers, taking them away from us for day to day mobility demands.
- Watch out for primitive responses. This is the body’s way of unconsciously saying it’s overloaded and running in the red.
- The bony prominences in our body are like antenna. With proper input, significant change can be elicited.
- Crossing the midline is like candy to the brain.
- Muscles Drive the motion. Motion Drives the Joints. Joint positions drive the brain.
Given the opportunity, I would take this course again. As much as I learned, I’m sure I missed that much more. I look forward to implementing this into my practice and growing from it.