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Learn how movement dysfunctions can hinder performance and how to improve functional movement for better results. Case studies and treatment techniques discussed.
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Welcome to Coaches Clinic 2019 Dr Michael J Matury
Biography • Graduate of Highland High School; Highland, Indiana • Bachelor of Science in Biology, Purdue University 1991 ( 3 years of Biomedical Engineering) • Doctor of Chiropractic, Palmer College of Chiropractic 1989
Biography ( cont) • 23rd year as a provider of Active Release Technique • Certified in SFMA and FMS • Board Certified Chiropractic Neurologist • Chiropractor for 2 former MR USA body building champs, National power lifting champion, several NCAA athletes • Treatment staff of several Ironman races
Biography (cont) • Finisher of 4 half marathons, Chicago Marathon, Ironman FL, and 2 half distance IM • Certified by the American Nutrition Association in Ketogenic Diet therapy- board exam pending
Improving Performance Through Improving Functional Movement • Movement dysfunctions can be the result of developmental issues, Trauma or they are simply “acquired”
Developmental • Developmental movement deficiencies arise when movement opportunities are denied or modified, or inappropriate activities are in introduced in an otherwise normal system.
Traumatic • Pain can alter movement, but this alteration might remain after the pain is resolved. • Movement compensation is a primitive survival behavior • These compensations cause stress to other regions and are FAR LESS efficient than authentic movement patterns
Acquired • Unilateral movements such as in golf, throwing sports, or maybe breathing out of one side while swimming • Habitual postures ( texting/gaming, sitting) we are predominately flexed though the spine and hips as compared to extension
Extension • Ankle- normal is 20 degrees closed chain ankle dorsiflexion. • Measure by getting into a single knee position with 1 foot placed 4 inches from the wall • Glide the knee towards the wall while keeping the heel on the floor and knee over the ankle ( demo)
Hip Extension • 10 degrees • More importantly from here lets look at “multi-segmental extension” • Feet together arms up overhead • Hips forward torso backwards • Hips must pass forward of the toes and scapula behind the heels • Equal contribution from all spinal segments
Problem • Sitting robs us of the 10 degrees hip extension and normal thoracic extension • Arms and shoulders go into flexion as well • This happens with gaming and texting • Results in….
Case Study • 17 year old female volleyball player • Has NOT finished in a season in 4 years due to back pain • Has had prior treatment : Chiropractic, PT, AT and medical doctors • Diagnosis: “ Your Hip is Out” • Her multi-Segmental extension looked like this…..
The REAL Diagnosis • So all of this dysfunctional movement is going to correct itself when the hip is “IN”? • She had only 50% normal ankle dorsiflexion and hip extension • Thoracic spine did not move at all nor did her lumbar spine. • Past ankle injury led to shortening of the posterior talofibular ligament prohibiting her from normal ankle dorsiflexion
Diagnosis (cont) • Tight hip flexors from sitting, compensation for the ankle problem or from the pain? • Locked in flexion Thoracic Spine from sitting, compensation or from pain? • Shoulder extension ditto
Treatment • Active Release Technique to treat the ankle ligaments • ART to treat psoas, rectus femoris, lats, multifidus, and pec major • Spinal manipulation • The magic moment was when I found the abdominal oblique to be tight on her left side.
Results • Back to Volleyball within 4 treatments and released from care in 7 • Normal ankle flexion, hip extension and multi-segmental extension • No pain • From across the room when she saw me in public a few months later “ Oh there is MY chiropractor. I am still pain free. Thanks”
Case Study #2 • 17 year old male basketball player • Non Traumatic fracture of his tibia • How in the heck does THAT happen • I have a theory…..
Observation • This is his multi-segmental extension • See a problem? • Gaming and Texting • Sitting
Theory • His arms during a rebound will find a way to get extended • Compensation • This at the expense of another body part • No shock absorption abilities • Stress fracture in tibia and eventually a break
Stress Fractures…. • Somehow I became the guy who runs into all the lumbar spine stress fractures in this town. • My rule of thumb- either the young athlete is progressively improving with tx or they have a stress fracture. • I have only been wrong 3 times in 15 years. One had a disc herniation, and the other 2 had advanced facet arthritis
The cause? • One can simply say it is repetitive stress • But is repetitive stress just the result of many reps? Or is it ABNORMAL stresses due to improper movement patterns?
“These Kids Are Ticking Time Bombs” ESPN article 7-11-19 • Julius Randle NBA debut w the Lakers collapse on the court with a broken leg 14 minutes into game 1. No trauma seen on replay • Conditioning coach LALakers- Tim DiFrancesco, PT • Experienced in evaluating athletes prior to drafts/combines etc
His Findings • “..he evaluated high-level athletes who consistently could NOT perform basic movements such as squats, lunges or balancing on one leg. “ • There so some who moved so poorly he expected them to suffer an injury • Shhhh… don’t ell anyone, but I have been talking about this here for the past 15 years
Don’t skip mobility • We are taking these kids straight to sprinting, lifting, squatting, hitting etc without making sure there is available mobility to do these tasks • Mobility first, stability second and strength third
Don’t Skip REST • Another important part of the ESPN article. • Athletes go from HS season, to AAU season, to college…. And in some from one sport to another • No time for rest • The trainer for the Bulls was also quoted in this article- Jordan did NOT play basketball in off season
Corrections • I am on a constant quest to find ways for people to self treat a lot of these chronic movement dysfunctions • I will typically have patients feeling “well” long before their ankle dorsiflexion, hip extension, or thoracic extension dysfunctions are corrected • The patient needs to continue this quest
Foam Rollers • Hamstrings • Hip Flexors • Thoracic Extension • Shoulder Extension • Many others
NEW IDEAS • Old World Squat • Kneeling toe extension • Core assisted hip flexor with much longer holds than I showed before • Hanging
Putting it All Together • Wouldn’t we like to have known then what we know NOW? • Would I have been bench pressing, shoulder pressing etc until I ached or would I have been correcting my movement dysfunctions then building from there? • We leave A LOT of explosiveness on the table when we can’t move correctly
Core assisted hip • Single knee • Toes flexed • Stay tall • Pad the knee • Lock elbows • See handout
Toes…. Extension of toes=important • Kneeling position • See handouts
Old World Squat • I look at this exercise as a mobility and stability exercise at same time. • Let’s break it down • With support • Without support • Accumulate time
Thoracic spine mobility • Foam Roller • Roll for keeping muscle soft and pliable • Melt your t spine over the foam roller for mobility of spinal joints and ligaments
Thoracic rotation • Set up is important • Going slow and breathing • Do no wrestle yourself with any of these exercises.
Consequences in Life • 90% of people who end up in my office in pain do not have a story to tell…. • Inevitably the question is “ what did I do to cause this?” • Your hip is out…. • My answer …. “ LIFE” • “Why today?” ME: “ Because it was not yesterday or tomorrow”
Consequences ( Cont) • Today’s back surgery patient, hip/knee replacement surgery or the patients I saw this past Sunday for Social Security Disability determination came from “somewhere” • Dysfunctional movement patterns resulting in inefficient compensation patterns= pain and degenerative changes at some point in one’s life
I am trying to introduce people to their older self one person at a time • Healthcare is estimated to be 5.7 trillion by 2016 • That is 16,500 dollars for every man, woman and child. Family of 4= 66k • Who is paying this bill? The Govt? Where is govt getting the $? Bill Gates? • We need to take care of ourselves
Learn to…. • Move correctly • Then move often • Get rid of addicting low nutrient foods in your diet • Food is also a repetitive strain disorder • It is accumulative and sneaks up on us slowly and quietly
Questions? • I thank you for your time today