Medical & Rehabilitation

Pain Management & Isometrics

Posted on June 7, 2018 by BPSUniversity

From Ankle to Knee
- 1^st and foremost; Many ankle dysfunctions can lead to knee, low back, and shoulder pain/discomfort due to compensation patterns.
- Many times we can correct ankle dysfunction building stability, which will allow the knee, back, and shoulders to return to “normal” function without the body needing to compensate.
- Our support system prep exercise, specifically the back dorsiflexion series is great for increasing ankle dorsiflexion, strength, and mobility. When the exercise is progressed with more speed and more force put through the ankle join, the ankle adapts stronger. When the ankle is isometrically held in dorsiflexion the knee also flexes while the musculature surrounding the knee isometrically contracts during ground contact. This important isometric contraction at the end, controllable, range of motion at the ankle joint, is the fastest method to gain strength. Decreased pain and discomfort for the ankle, knee, low back, and shoulder/neck area can be achieved when this base of support for the body becomes strong and less dysfunctional.
From the pelvis to the low back
- Low back pain can stem from many factors such as anterior hip tightness and hamstring weakness. If hamstring weakness exists, the anterior hip musculature can “tighten up” and contract to prevent the hamstrings from entering a range of motion that the weak hamstrings cannot control. Also, we must consider that the spine flexes, extends, laterally bends, and rotates.
- Strengthen the hamstrings and posterior chain and allow the hips to relax and return the pelvis and low back area into “normal” alignment. This is our safe scientific reasoning to alleviate pain and discomfort.
- Perform the hip bridge exercise with both heels on the floor moving into hip and trunk extension. Isometrically contract the posterior chain (glutes, hamstrings, lower back, etc.).
- HINT – since we know the trunk and spine also rotates, modify the double leg hip bridge into a single hip bridge by raising one leg up during the time progressive isometric contraction. This creates a moment of rotation that the trunk and spine rotator muscles must isometrically resist.
From shoulders to neck
- Shoulder and neck pain/discomfort may seem common. Many times we alleviate neck and shoulder pain by strengthening the musculature surrounding the shoulder joint and cervical/thoracic regions. Strengthening these areas allows the neck and shoulder to regain support and “normal” alignment.
- Use the alphabet to strengthen this area
- Perform Y’s, T’s, M’s and W’s
  - Grab lightweight dumbbells or utilize one’s body weight and allow your arms to form these letters. The Y’s and T’s are typically performed in an upright position, whereas the M’s and W’s are performed in a prone position.
  - HINT – Maintain an isometric contraction of the scapular retractor muscles throughout the entire range of motion of your alphabet training

**For full video demonstrations of these abdominal exercises plus many more, sign up for our BPSU online university. There you can listen to and watch coaching cues videos as well as have access to our entire database to build programs and get the best out of any athlete.

HERES THE LINK: http://www.bommaritoperformance.com/workshops/bps-university/

LOW BACK PAIN?

Posted on June 7, 2018 by BPSUniversity

Many of the most common treatments are – spinal adjustments, modalities, increasing flexibility/mobility of the hips, strengthening, etc. Some of these can be very expensive – in addition to the degree of uncertainty that may arise when trying to choose a specialist that fits your situation.

In terms of treatment, some of the most basic and effective forms of correcting dysfunction are ISOMETRIC STRENGTHENING. This goes well above and beyond traditional strengthening of the trunk/spine (like crunches or planks). This can be a very systematic approach to providing great stability across the various spinal levels by ensuring that the muscles that attach to these levels are contracting properly. In the pictures below, 4 key exercises will be demonstrated that strengthen the muscles that are involved in the 4 key motions of the spine: FLEXION, EXTENSION, LATERAL FLEXION, and ROTATION.

Usually low back pain and the onset of any type of condition in the trunk/spine arises because the spine is inefficient at contracting muscles that are involved in one or more of these motions. If one side is inefficient, the spine becomes unstable at that level and many problems could arise. To combat this, it’s always a good idea to train the motions from an isometric standpoint in every motion:

FLEXION

EXTENSION

LATERAL FLEXION

ROTATION

Sets/Time: Depending on the severity of your pain and your fitness level – can be 2-5 sets of 15 to 60 second holds

Advanced: There are dozens of variation of these isometrics – standing, kneeling, split stance, squat stance, performing these band exercises while lifting, etc.

Also, different band tension and/or different force angles (how high or low your partner/trainer puts the band) will dictate the emphasis being placed on various muscles.

The great thing about these exercises is that they can be done with bands – which are inexpensive and don’t take up space. And, they can be done from anywhere, even at home. To be very specific about the cause of your low back pain – getting evaluated by a specialist can dictate which variations of these exercises should be assigned along with a progressive plan that can really aid in the reduction of common low back ailments – with a plan for the future to keep from reoccurring. Bommarito Performance Systems has an entire staff of Biomechanical Evaluation specialists that can setup an individualized, long-term plan for you. We can also implement and progress this plan in any one of our group fitness classes or boot camps!

Greg Roskoph’s Muscle Activation Techniques (MAT) – Article By: Kika Mela MATCS

Posted on November 16, 2015July 26, 2017 by BPSUniversity

By: Kika Mela MATCS, BPS Medical Team

5-12-15

GREG ROSKOPF’S

MUSCLE ACTIVATION TECHNIQUES ™

If you aien’t playin, they aien’t payin

For most of the professional athletes that train here at Bommarito Performance Systems (BPS), their financial and professional success depends upon what they can do physically.

Are they fast enough? Strong enough? Are they injury prone? Will they rehab in time to play?

At any level, the best player will be sitting at home if he can’t perform on the field. For the pros, the ability to play the sport that they love and their financial future depends on the health of their body. Playing at a high level and hopefully pain free drives many players to seek alternative ways to keep their body right. One of the options we offer our athletes is Greg Roskopf’s Muscle Activation Techniques™.

You are only as strong as your weakest link

Injury, poor muscle firing, scar tissue, overuse, disuse, improper mechanics, and poor nutrition are only a few things that can negatively affect your performance.

What happens when you have a weak link?

Slower recovery time
Decreased performance
Muscular Compensations
Potential Injury

Or:

A QB that can’t open up his hips and has to alter his throwing mechanics to accommodate
A soccer player a with tight ankle who can’t cut off of his outside edge and misses an opportunity
A pitcher with limited hip rotation which can affect his development of power and effects his shoulder
A runner who pulls his hamstring because his trunk muscles are not assisting as well as they should
A player who never fully recovers from a Turf Toe injury

Traditional methods to improve performance or rehabilitate from an injury include:

Physical Therapy/Training Room
Strength and Conditioning
Chiropractic
Acupuncture
Massage

These traditional treatments are very effective in rehabilitation and BPS is one of the few facilities which offer them all onsite. In partnership with Mela Therapeutics, Inc., BPS also offers an innovative approach to address the weak links: Greg Roskopf’s Muscle Activation Techniques™ (MAT).

What is MAT?

MAT is a systematic approach using ROM and muscle testing to identify inefficient muscular contractions. It looks at what you can’t do and asks if your muscles are firing properly. If you can’t go there, you may be weak there. This is a different view point to thinking about flexibility in terms of a muscle weakness instead of muscle tightness. The job of an MAT Specialist is to hunt down the weak link of poor muscle contraction, improve it, and therefore allow the muscle to contract further, improve motion, and increase stability. Adding MAT to traditional methods has shown us to complement and possibly enhance the outcomes of treatments and speed recovery. Most of our professional athletes utilize MAT to help them get the edge they need to stay on top of their game.

Adding MAT to a Strength and Conditioning plan or to a Rehabilitation process can potentially:

Reduce pain and dysfunction
Increase ROM
Increase performance
Reduce recovery time
Improve the body’s tolerance to stress

MAT is NOT like Massage or ART (Active Release Techniques):

Massage uses various massage strokes and techniques to releases tight tissues and reduce spasms or fluid while ART uses manual therapy with motion around a joint to reduce adhesions and fibrosis. MAT enhances the ability of the muscle to contract via low grade isometrics or stimulation of the musculotendinous junction. MAT also uses a thorough ROM exam and muscle testing to identify where the weak links are. This allows the tight tissues to relax reflexively, improves ROM, and can add stability to the joint.

How long does it last?

An effective MAT session can last days, weeks, or months. However, just like one workout doesn’t mean that you are forever fit, one MAT session does not mean that all your muscles are forever firing properly. It is a process and is most effective when used regularly. It also lasts longer when used in conjunction with:

Intelligent Strength Training
Some Soft Tissue Modalities
Good Nutrition
Proper Recovery

How often should you get treated?

Physical, emotional, or chemical stress can reduce muscular function and create weak links in the body. It is important to frequently re-check the system for breakdowns in order to catch an imbalance before it manifests into a bigger problem. Getting tackled by a 300lb lineman or throwing dozens of pitches can create a tremendous amount of stress on the body. For high level athletes, 1-2 times per week during season and heavy off-season workouts are ideal but for others the ideal frequency can be anywhere from weekly to monthly depending on their body.

What to do on your own:

Your MAT Specialist should provide you with guidelines regarding activities that will help or hinder your progress. Also, your Specialist might provide at home MAT-based exercises to complement your MAT sessions. At BPS, we incorporate your recommended MAT exercises into your daily training program to get the most out of your workouts!

MAT has become an integral part of many player’s path to a healthy career. Several professional teams have also started to offer it due to the high demand of the players. To learn more about MAT as a treatment option, make an appointment, or to learn how to apply it to your own athletes, contact our Master Level MAT Specialist Kika Mela at [email protected] or call her direct line at 954.295.8302. You can also visit the MAT website www.muscleactivation.com to learn more or find a Specialist in your area.

Lower Back Pain

Posted on November 16, 2015July 26, 2017 by BPSUniversity

One of the most common ailments of people of all ages (athletes or the general
population) is low back pain. It is so common and causes so many issues that there
is an entire specialty (Chiropractic) that is dedicated to this condition. The reasons
is because of the severity of what could happen if low back pain continues without
treatment – pinched nerves, degenerative discs, arthritis, ruptured discs, etc.
Many of the most common treatments are – spinal adjustments, modalities,
increasing flexibility/mobility of the hips, strengthening, etc. Some of these can be
very expensive – in addition to the degree of uncertainty that may arise when trying
to choose a specialist that fits your situation.
In terms of treatment, some of the most basic and effective forms of correcting
dysfunction are ISOMETRIC STRENGTHENING. This goes well above and beyond
traditional strengthening of the trunk/spine (like crunches or planks). This can be a
very systematic approach to providing great stability across the various spinal levels
by ensuring that the muscles that attach to these levels are contracting properly.
In the pictures below, 4 key exercises will be demonstrated that strengthen the
muscles that are involved in the 4 key motions of the spine: FLEXION, EXTENSION,
LATERAL FLEXION, and ROTATION.
Usually low back pain and the onset of any type of condition in the trunk/spine
arises because the spine is inefficient at contracting muscles that are involved in one
or more of these motions. If one side is inefficient, the spine becomes unstable at
that level and many problems could arise. To combat this, it’s always a good idea to
train the motions from an isometric standpoint in every motion:

FLEXION

LATERAL FLEXION

ROTATION

Sets/Time: Depending on the severity of your pain and your fitness level – can be
2-5 sets of 15 to 60 second holds
Advanced: There are dozens of variation of these isometrics – standing, kneeling,
split stance, squat stance, performing these band exercises while lifting, etc.
Also, different band tension and/or different force angles (how high or low your
partner/trainer puts the band) will dictate the emphasis being placed on various
muscles.
The great thing about these exercises is that they can be done with bands – which
are inexpensive and don’t take up space. And, they can be done from anywhere,
even at home. To be very specific about the cause of your low back pain – getting
evaluated by a specialist can dictate which variations of these exercises should
be assigned along with a progressive plan that can really aid in the reduction of
common low back ailments – with a plan for the future to keep from reoccurring.

Combating Knee Pain/Tendonitis

Posted on November 16, 2015July 26, 2017 by BPSUniversity

One of the most common areas of issues for adults is knee pain/tendonitits. The easiest way to combat these ailments – and build a program to supplement your current activity level – involves a 3-step process:

STABIILTY. The most efficient way to ensure the knee is stable, and the structure of the joint is supported properly by the muscles that cross it, is to perform isometrics. Isometrics involves contracting a muscle at a specific range without moving; as opposed to moving the joint like traditional exercise. Looking at the muscles of the thigh the cross the knee joint (and/or are involved in function of the knee), there is the 4 primary groups: muscles in the front (quads and hip flexors); in the back (hamstrings); on the inside (adductors); and outside (abductors). Progressions can begin at 3 seconds and progress up to 30 seconds for advanced adults.
1. Advanced tip: Having a fitness professional assess any asymmetries (an imbalance) in the ranges of motion at the knee joint can help make the stability isometric program even more specific to your body.
STRENGTH. Don’t be scared off by the term strength. This is not the typical term that people think of that means “how much weight can you lift.” This is simply just progressing the 4 main exercise listed above from isometrics to motion. Using the same 4 machines (or bands for advanced), a person can start to implement basic motions. The range of motion can start very small (just what a person can control), and start to increase as the knee becomes more stable through the isometrics. This style of progression can be specific to anyone. We’ve had a lot of success with this protocol from anyone like an older person that just needs to combat various levels of knee pain to get back to the active lifestyle that they enjoy; to the 25-year old advanced fitness enthusiast that wants to get the knee stronger in order to train more aggressively. The key to finding what will work for your goals is to control two major factors: the range of motion and the speed (tempo) of the motion.
1. Advanced tip: If you are experienced with training, and already implement exercise such as squats and lunges – these exercise can still be for you – and lead to a lot more success (and less pain!) during the advanced training you are performing. Just complex (superset) the single joint exercises listed above into your current routine.
ENDURANCE. This is the key to long term health! Once the joint is stable, and you have provide the necessary strength at all of the required ranges of motion – ensure the knee joint can now handle your chosen activity. Doing exercises like backward and forward marches at various speeds and distances can greatly enhance all of the necessary muscles from an endurance component. Note the key word MARCH. Endurance training can be simplified for joint integrity and reducing pain; as opposed to the typical form of “endurance” that people think is cardiovascular. The marching can just focus on local muscular endurance, which is necessary for continued pain management.
1. Advanced tip: the use of resisted devices such as sleds, and pulley machines (outside) and the Keiser (inside) can make these exercises a lot more beneficial.

By: Pete Bommarito