Inside-Out Training in Brazil!!!

This has by far been the busiest trip for that I have been on for work related endeavors. I am making stops in Sao Paulo, Rio, Londrina, Florianopolis and back to Sao Paulo for work. While it has been exciting I feel like I need someone to help me with things like packing my suitcase correctly. I have got to be the worlds worst person for understanding what I need and more importantly what I DON'T NEED to take with me on a trip. 

This trip started out in Sao Paulo, Brazil teaching a few STOTT PILATES(R) courses for Pilates Studio Fit. I worked for this company for 3 years and am very happy they think highly enough of me to have me teach there again. Abracos and Obrigado to the entire staff. Everytime I come here though my schedule is full (this is a good thing). I had to teach 2 very intense courses (Injuries and Special Populations) in one day for 6 days straight in SP. That was taxing as I try and give it everything I can while I am in there teaching (as I am sure most do with these courses). 

1 hour after finishing the final day of the course I was off to Londrina, Brazil to teach a course that I co-created with Sally Belanger entitled Inside-Out Training. I shot a supplamental DVD with one of my employees prior to coming down here and then had a great voice over done in Porutugese thanks to Fernanda Misquevis. 

Since this was the first time I taught the course I was a bit nervous. It's a 20 hour course designed to help both movement professionals and manual therapists know how to reeducate movements. One of the things I think Joseph Pilates did a great job of was focusing so much on movement initiation. I love pilates though I believe it to be an unfinished work (I am sure he would have agreed if he was still living). This course seeks to take the post-rehabilitative approach of focusing on movement initiation to the next level. Sally and I developed a matrix that is not only designed to plug in correct exercises for clients but facilitate creating one's own exercises. 

The course was 3 days and 20 hours of non-stop lecture with application. At the end of the time I was exhausted but it was well worth it given the physical therapists excitement and desire to implement the matrix into their own practices. Sally and I believe that this course is a very common sense approach to facilitating movement strategies from basic movements to complex. It provides a system that allows the movement professional to think about how to properly progress a client without overwhelming them. While it was intense I have to say it was well worth it! Thank you so much to Vania and Vivian for helping make this happen. 

I'm currently in Rio right now waiting to start my next Inside-Out Training course. Let's see how it goes but I'm incredibly excited! From here I head to Florianopolis, Brazil to do manual work on the Ironman and then back to Sao Paulo to co-teach a CCB course with a Brazilian instructor. From there it's up to Toronto to attend the Community of Excellence for STOTT PILATES!

Hook 'em!

Well the decision has been made...I will be a graduate student working towards my Ph.D. Starting August 29th I will be working in Dr. Lisa Griffin's lab at the University of Texas. Dr. Griffin has been amazing to me during the entire application process. It's quite a long story but one worth sharing with those who have dreams. 

While I was living in Brazil I read an article on feed forward mechanisms and spinal cord injuries. It was an amazing article and I really believed in what it was trying to say. I decided right then I needed to study under the woman who wrote the article at the University of Texas. The problem was...well I had no prerequisite courses to show my passion for movement. I really didn't care at the time so I booked a flight from Brazil to Austin, Texas for a meeting with her. I slapped several books on her desk and articles that I had carried with me for her viewing. 

Dr. Griffin and I ended up getting along well and it was a very positive trip. Unfortunately for me while I was interested in LBP research she was still stuck on spinal cord injuries. However, last year I received a call from Texas asking me if I would be interested in coming there to do research. This was my dream so I was extremely happy to apply and work something out. 

I was hoping to research from Charlotte but that ended up not being an option for me, therefore I will be moving to Austin in August. This begs the question, WHAT WILL HAPPEN WITH MY INVOLVEMENT WITH ABSOLUTE PILATES in Charlotte? I'm happy to say I will maintain my equity in the company and travel back and forth to contribute to the business. 

We plan on using my work at UT-Austin to facilitate our business in Charlotte. Our vision at ABsolute Pilates is to make it an educational hub for instructors from all areas of functional movement. We also have the desire to heal people in pain. We want to contribute to the HOW and the WHY. One thing Monica (my business partner) and I believe in is that premium education facilitates good business solutions as it creates ideas for innovation (how is that for the business jargon that was a product of my undergrad years?).

I will be studying LBP at UT-Austin with an open ticket to research what I want. I could not turn this opportunity down as it doesn't get any more entrepreneurial than this. Dr. Griffin was the perfect match for me and I will be forever grateful to her for affording me this opportunity. I am going to be a teaching assistant for the graduate Motor Control class and working every minute outside of class in the neuromuscular research lab. I can't express how happy I am to do this. 

I have to be honest that I am excited to go to the football games as well. I'm still trying to work out being an ART Provider for the athletic department as well as a post competition massage therapist. Hopefully I will be able to contribute somehow to the LongHorns obvious victory over the Sooners this season ;-).

Get off the Sagittal Plane!

Last week over Easter break I went home to visit my family. I had been communicating with pilates studio in the area about how to work with some collegiate football players for a top tier football program. One of the players was having groin pain. After speaking about this problem with the instructor at length, I decided to visit the studio since it was so close to hometown in Virginia. I put the athlete through some movement tests and noticed that he first did not like to flex his hips much at all but rather tried to hinge his torso to compensate. In addition to this when I put him on his side to test his glut. med. strength he could not lift his leg against finger pressure. I'm not kidding when I say that. He was very hip flexor and TFL dominant in his coronal plane movements. We also found out that because of this he had an impinged hip that needed to be released.

As a defensive back (his position) he will have to "skate step" and cut very quickly so I have no doubt his sagittal plane movements are incredible but it appeared his lateral stabilization was coming from his TFL (hip flexor/medial rotator/abductor). Since the gluteals were relatively weak, he tended to like to use his hip flexors for everything. When an athlete starts to accelerate on a dime the adductors are working a lot in addition to the psoas/rec. fem to flex the hip. Since the lateral stabilizers were not there, the hip flexors/adductors had become overworked. 

What needed to happen for him was the following:

1. Release the impinged hip through traction technique.

2. Make sure adequate internal/external rotation is present.

3. Release adductors AND abductors as well as hip flexors.

4. Strengthen lateral chain on the coronal plane and then sagittal plane. 

On thing that I believe that pilates instructors need to draw more attention to is coronal plane stabilization. Pilates folk are very stable on the sagittal plane. You probably won't find an exercise group more stable on that plane. If you put a pilates person on their side (particularly if they are only mat pilates trained) they tend to struggle with spinal stabilization significantly. It's very easy to ignore the sagittal plane if you are just used to teaching starting with footwork (which I now argue against for some (not all) as the pelvic floor is least active in a supine position). 

This is why I created the Re:Thinking of the Reformer workout (shameless plug I know). The workshop is dominated by coronal plane stabilization. Remember to think outside the pilates recipe or functional training recipes and get those clients on different planes of motion. Exercise methods like gyrotonic and good pilates programming encourage this kind of work. 

Understanding the Foot/Ankle

This one will be a short one but I have been reading a lot about the ankle and knee recently. In particular I have been reading about pronation syndrome. The foot/ankle complex is amazing. It's the first place to where force is usually dramatically imposed on the body so it's positioning is vital concerning the dynamic stability. 

The way one moves his/her shoulder, spine, hip, knee could possibly determine how the foot hits the ground. Much has recently been made of the Newton shoes and the forefoot running craze. While I think the jury is still out I have a few initial thoughts.

1. Striking the heel allows for proper talocrural motion. While this does not necessarily mean proper supination and pronation will occur it is the best possibly scenario for proper motion at the ankle joint. If the midfoot and/or forefoot strikes first then there is possible risk for the talocrural joint to remain in fixed position and the mid-metatarsal joints may in fact take the brint of the "dorsiflexion load" and may be forced to dorsiflex.

2. Forefoot/Midfoot striking may inhibit anterior muscles from acting functionally. The gastronemius and soleus and the unsung hero, tibialis posterior may be stuck in a place where they are constantly shortened and cannot build enough elastic energy through the eccentric phase of a motion to allow for adequate "active" plantar flexion while the anterior tibialis/extensor digitorum may be inhibited as well by staying in a more "lengthened" position.

3. Lack of dorsiflexion = more inversion/eversion - One of the main things that I have learned about the foot/ankle complex  is that it is all about triplanar motion. I once asked a very respectable movement specialist, "what is the deal with eversion/inversion? where does it happen solely? where does it not happen?" The answer I got was, "eversion/inversion happen at the subtalar joint, while pronation and supination happen at the mid-metatarsal joint." I felt that was an adequate answer and given this gentlemans reputation I almost left it at that...but I couldn't. The subtalar joint allows for supination (combination of inversion + adduction +plantar flexion) and pronation (combination of eversion + abduction + dorsiflexion). When dorsiflexion is limited at the ankle then eversion and inversion will take over and often this leads to impairments.

4. Toe flexors meant to "relax" walking to the beach- The toe flexors were not meant to hang onto your thong flip flop. They were meant to regulate postural sway among other things. I used to think I had the strongest toe flexors in the world by wearing my flip flops in Brazil. I realized that they were just gripping and not getting strong by holding onto my flip flops. They were just stuck in a shortened position. Anyhow, let those puppies lengthen.

5. Ankle connected to the Knee bone...knee bone connected to the hip bone! - Make sure that you realize that medial rotation of the hip, femur or tibia can affect ankle mechanics. It's kind of a chicken or the egg situation if you don't know what you are looking for. I think it's important to address all of these parts together after isolation as they will all affect one another.

Anyhow, those are a few brief things to think about right now while addressing the foot/ankle. I know it's quick and not terribly specific but the more I learn about the foot/ankle the more I want to learn about the foot/ankle.

Shoulder issues not always what you think

Recently I have had many clients come into the studio with a lot of neck and shoulder pain. I will ask them what's wrong and for some reason 9 times out of 10 they say, "well I am recovering from an impinged shoulder." The first thing you are probably thinking is WORK ON THE SUPRASPINATUS. That would make sense at first as this would be the muscle that gets impinged, however rarely do I have go there. The supraspinatus gets a bad wrap and takes a lot of the blame for shoulder problems that really aren't it's fault. It's almost like the little brother that is going to have to take the blame for everyone else (Sorry of the poor figurative but I'm the third of five boys). Many times poor should mechanics that lead to an impinged shoulder start with muscles like the subscapularis. Most people think of the subscapularis as a medial rotator of the humerus (which it is) as well as a scapular stabilizer. I would argue it is as important as any muscle in the rotator cuff because it functionally keeps the humeral head back and down. This will allow for much easier freedom of motion of the entire complex. When this muscle becomes weak it will allow the humeral head to anteriorly deviate and rise which will cause poor mechanics in upward rotation and thus the supraspinatus takes on the brunt of this impairment. Another reason for the impingement is that the infraspinatus is not working properly. When the arm is lifted overhead the infraspinatus should work eccentrically. If it does not want to lengthen appropriately impingement of the supraspinatus tendon may occur. There are other muscles as well such as a dysfunctional serratus anterior, upper traps, fibrotic joint capsule, short pec minor, short pec major, short subclavius, etc. The point is that many times with an impairment the source of pain is often getting a blame for someone else, much like the little brother.