Brian G. the therapist is in - JP Fitness Forums

Bill Hartman · 05-29-2003, 10:05 PM

Hey Brian,

Fill me in on your injury status. If you prefer send me an email, or perhaps you could share with the group. Either way maybe I can give you some leads.

Bill Hartman, rehabilitation genious since 1991
(Ouch! I just separated my shoulder patting myself on the back)

Brian Grasso · 05-31-2003, 10:24 AM

Thanks for the offer, Bill.

I will get started detailing my injury status tomorrow morning!

- Brian

Brian Grasso · 06-04-2003, 07:30 AM

O.K... Where do I start???

Let me first say that I have been in chronic pain since 1995. I have seen sports medicine physicians, therapists, chiropractors... you name it, no one can give me any great explanation.

All this has lead me to believe that it is at least partly somatic in nature.

I have had LBP since I was about 12 years old. I was RECENTLY diagnosed with a lumberlization (sp?) which means obviosuly that my spine is just a TOUCH unstable. I NEVER trained core as an athlete growing up (I just lifted) but have found as a professional coach that the more core I do the more stable my back feels (duh!).

O.K. Bill... Do you want me to keep going, or should I stop there for now?

A good friend of mine (and one of the best therapists I know recently had a quick look at me and mentioned that I had myofacial restrictions EVERYWHERE).

- Brian

Bill Hartman · 06-04-2003, 09:59 PM

With your history of athletics and combat sports there is no doubt you are full of soft-tissue scarring and adhesions. Over time, it can accumulate and cause a great deal of unnatural tension and of course pain. Muscles then become inhibited and weaker and the cycle continues (see the ART article on my site for more info on the cumulative injury cycle).

My first thought is to try to get the soft-tissues in some king of shape manually. This wouldn't be your typical ooooh and ahhhh kind of stuff the OUCH! and F*&#! kind. ART, Rolfing, and Augmented soft-tissue mobilizaton (ASTM) with tools works wonders. You'll feel like crap for about 2 weeks and then mobility starts to improve. (I've been working on it on myself and via a massage therapist here in Indy...it has done wonders for my chronic injuries!) Then you can start to work on stabilization exercises. McGill's Low back Disorders book is a great reference for starters.

Does typical stretching relieve or aggrevate symptoms?

Bill Hartman

Brian Grasso · 06-05-2003, 08:03 AM

Great answers so far!

My business partner is a clinical therapist and she takes a good poke at me on a regular basis. Basically she uses myofascial stripping and skin rolling - AND IT HURTS LIKE HELL!!

To answer you questions, when I engage in typical stretching, I feel MUCH better for about 5 minutes and then everything starts to hurt again (am I sounding like a wimp here??). I do stretch everyday though.

Off topic for a second Bill, could you suggest any scapular training exercises? My right scap is a mess and it's causing havoc on my traps, levator scap and SCM.

Also, where can I find that book - McGill's Low back Disorders? How often should I get some soft tissue work done before I start to incorporating stabilizing exercises? Everyday? I am going to start doing some pool training next week just so I can get myself unweighted yet moving. Good idea?

Boy I’ve asked you a lot!!

Thanks for the help, buddy!

- Brian

Bill Hartman · 06-05-2003, 09:21 AM

McGill is available a www.humankinetics.com

It's one of the best I've seen so far. It's based on direct evidence/research.

Are you familiar with PNF methodology (not just the stretching methods) such as alternating isometrics, slow reversals, slow reversal hold, etc. This will do wonders for your stability issues as well as your scapular complaints if applied correctly. See if your therapist can help you out with that. If not there is a great explanation in Mel Siff's Supertraining 6th edition.

Add. Scapular issues...the subscapularis tends to be problematic in most scapular problems. See if your therapist can release it. This may reduce some internal rotation of the humerus and downward rotation of the scapula which will alter your entire shoulder girdle resting position. Pec minor is also a big contributor. You may also have some neuro restriction which can cause weakness in the shoulder girdle. It could be something as simple as tight scalenes.

Depending on level of aggressiveness, you can usually tolerate soft-tissue work about every other day.

I would also have your therapist check your psoas for increased resting tone (decreased hip internal rotation is a dead give-away). That sucker usually tightens up in most chronic back situations. Once it releases, it's almost magical as far as mobility and pain relief are concerned.

Are you including some form of isometrics in your stretching? If you get relief from passive stretches, it sounds like your nervous system is keeping you in some form of protective posturing. The isos will help reset the nervous system and get you some prolonged relief. Also, performing isometrics with muscles in a lengthened position has been shown to increase strength throughout the full range of motion. That may add to your stability. Be sure to build up the intensity of contraction very slowly to avoid strain.

The pool may be a good idea to unload your spine although a freestyle stroke may be uncomfortable on your lumbar spine. Kicking with a kick board may be a good idea to work the deep rotators. I would still attend to how quickly you are moving (see the statute of fitness limitations post).

Hope this is helpful. I'm sure yor're already aware of some of this but I'm trying to give you as much info as possible.

Bill

Brian Grasso · 06-11-2003, 01:19 PM

Hey Bill,

Thanks again for the GREAT advice!

'Are you familiar with PNF methodology (not just the stretching methods) such as alternating isometrics, slow reversals, slow reversal hold, etc. This will do wonders for your stability issues as well as your scapular complaints if applied correctly. See if your therapist can help you out with that. If not there is a great explanation in Mel Siff's Supertraining 6th edition'...

I'm not familiar and neither was she. Is an on-line explanation possible?

The pool stuff has been going well.

Serious question...

I'd like to consider driving from Chicago to Indy for an appointment with you. Do you have time? Email and let me know a cost.

Thanks buddy,

- Brian

jax · 04-11-2006, 10:04 PM

Quote:

Originally Posted by Brian Grasso

'Are you familiar with PNF methodology (not just the stretching methods) such as alternating isometrics, slow reversals, slow reversal hold, etc. This will do wonders for your stability issues as well as your scapular complaints if applied correctly. See if your therapist can help you out with that. If not there is a great explanation in Mel Siff's Supertraining 6th edition'...

I'm not familiar and neither was she. Is an on-line explanation possible?

- Brian

Hey Bill... hope you don't mind me bumping/hijacking this OLD thread but (to echo Brian's question), do you know of any online source(s) I could check out to learn more about these techniques?

thanks.

Bill Hartman · 04-13-2006, 10:39 AM

There's just over 500,000 sites with PNF info on the net.

Search on pnf techniques, pnf patterns, pnf training, etc.

Mel Siff has a great deal of stuff all over the place and in his books.

Bill

DKing · 04-13-2006, 11:00 AM

Here is a Mel Siff article with a pretty good explaination: http://www.sportscience.org/SPORTSCI...ing_system.htm

I can't seem to find a good diagram of the movements like in Supertraining though. Although that one is hard as hell to follow too, the drawings kind of suck.

Danny

jax · 04-13-2006, 02:22 PM

thanks

Jean-Paul · 04-14-2006, 01:45 PM

Since we're talking about it I have a question for Bill on the subject. I seem to remember you mentioning that pnf was not necessarily a good method for increasing flexibility/mobility. Something about tests showing that it "did not activate the golgi tendon organ"... or something like that. Basically that it was not much different than static stretching, and potentially only increased the flexibility deficit. I am operating on an old memory so I may be waaaay off. I love the way I feel after getting some pnf, but if it is not helping me I don't want to waste my time.

Bill Hartman · 04-14-2006, 02:39 PM

Quote:

Originally Posted by Jean-Paul

Since we're talking about it I have a question for Bill on the subject. I seem to remember you mentioning that pnf was not necessarily a good method for increasing flexibility/mobility. Something about tests showing that it "did not activate the golgi tendon organ"... or something like that. Basically that it was not much different than static stretching, and potentially only increased the flexibility deficit. I am operating on an old memory so I may be waaaay off. I love the way I feel after getting some pnf, but if it is not helping me I don't want to waste my time.

Both forms of flexibility training increase stretch tolerance. The theory behind PNF forms of flexibility training was that you're activating the muscle spindle to neurologically "reset" the extensibility of the muscle. It just doesn't pan out in the research. In general, the gains from PNF are better in head to head comparison. Because of the active contractions with PNF techniques, you're more likely to see some transfer to active flexibility. There's no reason not to do PNF because it does work. It's just that the theory doesn't hold up.

Bill