Digestion and Core Stability

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Great link on how digestion and stability are linked!

Digestion and Stability

Hope you enjoy

Dr. Justin Hildebrand

Knee Pain

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Do you have knee pain and do not like to squat? Your problem may not be the knee themselves but who you squat and how you move through the hips. Proper hip posterior/backwards translation can take pressure off the knees and allow you to squat and train your hip and gluts without pain. Try these ball squats and see if your pain while squatting goes away.

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Setup:

  1. Begin by standing feet shoulder width apart just far enough from the wall that the ball is sandwiched between your low back and the wall.
  2. Start your squat by sitting BACK and down.
  3. Go down until your knees reach a 90°, angle being sure that your knees do not extend past your toes.
  4. DO NOT LET YOUR BUTT AND LOW BACK COME OFF THE BALL!!
  5. Return to the standing.
  6. Perform 3 sets of 10 repetitions 2-3 times every day.

 

Progression:

  1. Begin with a band around your knees, standing feet shoulder width apart just far enough from the wall that the ball is sandwiched between your low back and the wall.
  2. Repeat setup above.

 

Notes:

  • You should be able to do 3 sets of 10 of the regular ball squats with little to no fatigue before beginning the advanced ball squats.
  • Make sure you are squatting back and down.

VMO Exercises

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I have only found one VMO exercise that consistently activates the VMO. Oh, and it does a number of the gluteus as well.

Diagonal Sit Backs

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Setup:

    1. Start with the patient on one knee and heel directly under opposite buttocks. (right knee on the ground with right heel in line with left buttocks)
    2. Now the leg should be at a 45 degree angle, slight hip external rotation.
    3. Instruct the patient to perform a brace & breathe and slow start to sit back onto their heel. Do not have them go into lumbar flexion.
    4. They may not be able to touch their heel.
    5. Return to the starting position and repeat.

Notes: 

 

  • No flexion or posterior pelvic tilting should be noted.
  • The arms can be raised for balance.
  • This should be felt in the VMO and gluts.

 

Setup

Trigger Finger and Thumb Pain

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Finger and Thmub Pain

Check out this great info on trigger finger and thumb pain.

Hallux Limitis

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Hallux Limitis literally means limited big to motion. Hallux Limitis is a degenerative or arthritic condition in which the big toe becomes progressively stiffer ad more painful. While motion still exist in the  big toe with Halux Limitis, Hallux Rigidus is an extreme version of  Limitis where little to no motion is present.

Many people have Hallux Limitis and do not realize it. Pain generally does not occur until toe range of motion is less an 35-40 degrees. Hallux Limitis occurs more commonly in runners, especially those whose big toe is longer than their second toe. With this condition a bone spur begins to grow directly on top of the big toe “knuckle.”

Hallux Limitis can cause many biomechanical problems and needs to treated correctly. Techniques like Active Release and Graston can restore motion by 30 degrees and home exercises can help prevent the recurrence of ROM loss. General ankle mobility should be addressed and over-the-counter orthotics can help lessen pain. Click here for ankle mobility exercises.

 

Yours in health,

 

Dr. Justin Hildebrand

IT Band Syndrome

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IT-BandIliotibial (IT) Band syndrome or Runner’s Knee frequently occurs in runners, especially those upping their mileage. ITB is described as a burning pain in the outside of the knee and the pain is increased with activity. If left untreated and activity continues pain can begin to move upward from the knee, into the IT Band.

The IT Band is a fibrous, extremely strong structure that begins in the hip as the gluteus medius, maximus and tensor fasciae latae. It travels down the outside of the leg and attaches just below the knee. The pain associated with ITB is due to tension in the band due to the muscle pull in the hip.

Studies have shown that individuals with ITB Syndrome have greater inward rotation at the knee and an increase in hip drop on the side of pain. Lack of hip muscle flexibility can increase the risk for ITB Syndrome by increasing the strain placed on the band. The foot, although commonly ignored, plays a significant role in IT Band pain. Having a high arched or rigid foot has shown to cause ITB Syndrome. This means that the foot and the hip need to be treated for resolution and preventative treatment for IT Band Syndrome.

Click here to see exercises for IT Band Pain.

 

Yours in health,

 

Dr. Justin Hildebrand

Patella Tendinopathy

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indexPatella tendinitis or jumper’s knee is more accurately called patella tendinopathy. Tendinitis mean inflammation of the tendon but patella tendinopathy is a degenerative condition of the patella tendon. This condition is described as local tenderness of the patella tendon at the attachment on the patella.

Patella tendon injuries occur more commonly in distance runners, sprinters, and athletes that freqently jump. The increase is knee flexion or bending predispose these individuals to the injury because knee flexion increases the force and stress on the tendon. Excessive quad tightness or dominance may increase the risk for injury as well.

Treatment for patella tendinopathy consist of Active Release and Graston on the quad muscles as well as the tendon to decrease tightness and built up adhesions. These myofascial release techniques also start the rebuilding of the tendon by starting a controlled inflammatory response. Rehab exercises to strengthen and lengthen the  quad muscles help decrease longevity and recurrence of the injury.Interestingly, research has shown that resistance quad strengthening such as knee extension exercises has a negative effect on recovery.

 

Yours in health

 

Dr. Justin Hildebrand