Back Injury – A Physio’s Experience

10519510_10152801588837889_6239433146789197033_nAs a Physio, I know what to do when I get an injury…theoretically… You see, we are taught how to listen and assess and work out what is wrong. We tell the patient what we have found, what we think is wrong and what needs to be done to make things better. We do our “manual magic”, we give appropriate advice and whatever things the patient needs to do at home.

What they don’t necessarily teach you is what it is like to be a patient. Even if I saw someone daily, it is still only 30-60mins in 24 hrs…I think too many physios and other health professionals need to think about that more.

I realised this quite a while ago when I had injuries. I have always been quite active so with that comes increased risk of injuries and I have had my fair share. What I want to write for you today is what happened when I strained my back quite badly and how I dealt with the issue. I will discuss what I was thinking and throw some commentary into why I chose what I did and how I made my decisions.

This is post is all about ME, NOT YOU. This is NOT what you should do. You should get assessed for any problems you have. This is about informing you what I was thinking and how I think as a patient and a physio.

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7 Reasons why women should train at the men’s weight – one Rx weight only!

Girls-RxDI have learned many things from Darren Coughlan, Brendon Walsh, Pip Malone and the coaches at Reebok CrossFit GCS and CrossFit Newcastle. The one thing I want to talk about today is what Rx is in the world of Give’m Cold Steel…and how it can change the way you think and change your results.

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How I broke through my front squat plateau…and got a 12% increase in 2 months

Antony Lo's Front Squat - much improved form over the last 2 months

Antony Lo’s Front Squat – much improved form over the last 2 months – there is a prowler next to me in the picture!

Those of you who know me or have read this blog long enough will know that I am a stickler for technique. I love getting the “mechanics, consistency, intensity” right. I love improving people’s mobility, flexibility, stability, strength, power/speed, etc etc. Being the human that I am, sometimes I find it hard to take my own medicine. Please remember that in the Crossfit world, I am just your average (or below average) CrossFitter who will never make it to Regionals or the Games nor ever grace the podium at a local comp. If I ever compete, it will be fun or charity only. But I do have a desire to get better. I do want to improve…and I HATE plateaus in my strength.

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Lifting to train vs rehab lifting – Is there a difference?

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I am going to try write more quick entries because I have a long list of long articles on the back burner… And people keep asking when I am going to write more.

So today’s post is about when I told a patient we are going to go lift now…during his initial assessment. Read more of this post

Hip pain? Trouble Squatting? Consider your ribs (aka Thoracic Rings)

During the recent seminar I ran, we met Nicole. Nicole has given me permission to write this blog because of the beautiful illustration of how various parts of the body interact and can cause pain.

Nicole has been chasing her pain around for a while. It started with some ankle soreness which became back pain which became right hip pain. Looking down the barrel of an MRI for a labral tear…but no incident or accident. She couldn’t squat or move well because of the pain. The standard hip tests seem to indicate pain in the anterior hip like a labral tear.

But what I do is a bit different. I look to see how she squats and what moves well and what doesn’t…and I discovered that her ribs aren’t working well…don’t know why yet, just that they aren’t working properly – we were in a seminar remember, not in a consultation 🙂

Anyway, I found where her movement first deviates from normal…and it was in the left side of her ribs…The term “Thoracic Ring” was coined by Linda-Joy Lee (www.ljlee.ca), probably in a similar way to how the pelvis is called the “Pelvic Ring” – if you think of the 2 ribs and 2 spinal bones and the breastbone or cartilage the ribs join onto, they form a ring…what you do to one side affects the other side. But most people know what ribs are so I still persist with that when speaking with the general public 😉

So back to Nicole…

When she squats, you will see that the first 2 squats show her shifting off her sore right side. When she “corrects” the rib on the left, she squats better and accepts weight onto the right side. There is a bit of a pause in the video because I am asking her to squat “evenly” – the fact that she can’t tells me that there is a bit more work to do to unravel why she is doing this.

What you don’t see in the video is that by **THINKING** about supporting that rib, she can take that pain in the right hip away. When she lay down to do some “quadrant testing”, her pain was there without the “correction” and when she or I “corrected” the rib, the pain went away. So to my way of thinking, is it really a torn cartilage? I didn’t even touch the hip itself!

There aren’t that many people who can assess this way…I was luck to be among the first in Australia back in around 2006/7…there are a few more now since then…but, as always, the proof is in the results…

I also like to show videos like this because quite simply, I expect results like this every day I am with my clients. I love the challenge and the pressure to “get it right”.

So the take-home message is this: Just because something hurts, it doesn’t have to be the REASON why it hurts. Nicole’s hip hurts but there isn’t something “wrong” with the hip…it seems like there is something wrong with the coordination in her ribs!

If you have an interesting story to tell, please let me know below.

Nicole’s Squat Correction

Strict Muscle Ups – Making It Look Easy!!

Kat Dalecki, Australian CrossFit Regional Athlete for Reebok CrossFit GCS, demonstrates how to do strict Muscle Ups.

Points to note:

1. From the dead hang, Kat is in complete control on the way up and down — no hinging or wasted movement, flexed/flat spine throughout — it doesn’t change angle very much at all.
2. Her shoulder control and stability means that she doesn’t jar her shoulders at the end of the Muscle Up. She also doesn’t lose control in the bottom of the ring dip which is where lots of athletes come unstuck

Progressions to Consider:
1. Strict pullups on rings

2. Reverse transitions — use a box, jump up or keep your feet on the floor and get to the top of the muscle up or the bottom of the ring dip. You then go from the bottom of the ring dip (with your thumbs on lateral chest wall) to tracing your thumbs where the underwire of a bra would be to the sternum. From there you can go back to the start or continue to practice.

3. Strict Ring Dips

4. Negatives — eccentric loading throughout the whole movement. Again, use a box or jump up into the final extended position. Then lower slowly to the bottom of the ring dip. Then slowly lower back down to the ground.

5. Strict Muscle Ups with a band

If you can avoid kipping for now and just work on your strength, technique, and positions, you will go further in the long run 😉

Please post your comments, questions or links to other examples below! Thanks!

Question – Why Do I Have A Tummy Full Of Air After Exercising?

Did you know we take requests and questions?

This question is from a lady who has been exercising a lot recently and looks simply magnificent now. She asked me this recently because her trainer wants her to breathe properly during her weights and cardio.

Gas in the stomach – why?

It is hard to know exactly why some people can get gas in the stomach and if it is painful or troublesome, you really should consult your medical practitioner.

 

However in Louise’s case, I figured she might be drinking a lot of fluid because she is working hard. Lots of water or saliva in the mouth will make you swallow because you don’t want to look like a dribbling idiot 🙂

 

I put it to Louise that perhaps her mouth is excessively moist and causing her to swallow a lot – since she is huffing and puffing, she is likely to be swallowing air as well – hence her tummy full of air.

 

Not a real physiotherapy problem…but it is a good thing we can think laterally!

Goal achieved for a happy patient – State Cup Grand Final!

I thought I would start by posting a nice message I got from JB yesterday…

Hi Antony,
Played State Cup over the weekend. Thanks for helping me reach my goal!
We made it all the way to the GF and lost which given our past was a great result for us. Even though I had a shocker in the GF I’m pretty happy because I scored the try that put us there, against my old team! around my old team mate. Gold!
I was pretty worried last week when they said you were interstate as my hip had started hurting again. I saw Colin and he sorted it.
My knee is sore and swollen but it seems I haven’t done anything major. You probably know the rest but anyway Mr Sensible Colin is getting me to do rehab again (sensible and Irish ??!!) Perhaps my skinny left leg betrays my lack of effort last time. I plan to do much better this time as I want to be completely normal (well my normal) for Oz titles in November.
Thanks again,
JB

JB had a knee reconstruction and with diligent rehab with physio and exercise, she was able to play Oztag again. We should have her freely running by November 🙂

If you want to reach sports specific goals, please let us know so we can tailor your treatment and exercises to reach those goals.

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