This document discusses hip and core strengthening from an evidence-based perspective. It begins by outlining how posture is a symptom rather than a cause of dysfunction, which corresponds to compromised muscle activity. Typically stabilizers become inhibited while movers become overactive, driving faulty posture. The document then examines research on the transversus abdominis and its role in spinal stability. It analyzes various hip muscles like the gluteus maximus and medius and their functions. Single leg squats are discussed as a functional assessment tool. The document concludes by recommending specific corrective exercises to target muscle imbalances.
Posture and Movement. Better understanding to get clients from rehab to performance.
Do you feel that while you can see and assess your clients’ bad posture and movement you are unsure what to actually do about it? Has posture and movement assessment then gone in the ‘too hard basket’?
This session will equip you to understand ‘why’ you see the deviations you see, and give you a plan of action you can follow to correct them.
Function of the Hip and the lower limb: The relationship between injuries and...Max Martin
Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia.
Learn about the functional relationship between the hip, knee and foot, and how dysfunction in one typically affects injury patterns of the others.
Interestingly, a significant portion of chronic injuries below then hip are caused by hip dysfunction.
At the presentation you will learn why, what the research has to say about this, and how to prevent injuries to this complex of joints!
Posture and Movement. Better understanding to get clients from rehab to performance.
Do you feel that while you can see and assess your clients’ bad posture and movement you are unsure what to actually do about it? Has posture and movement assessment then gone in the ‘too hard basket’?
This session will equip you to understand ‘why’ you see the deviations you see, and give you a plan of action you can follow to correct them.
Function of the Hip and the lower limb: The relationship between injuries and...Max Martin
Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia.
Learn about the functional relationship between the hip, knee and foot, and how dysfunction in one typically affects injury patterns of the others.
Interestingly, a significant portion of chronic injuries below then hip are caused by hip dysfunction.
At the presentation you will learn why, what the research has to say about this, and how to prevent injuries to this complex of joints!
When someone experiences groin strain, they’ve experienced a tear to the adductor muscles of the hip. There are 5 groin muscles (adductor brevis, adductor longus, adductor magnus, gracilis and pectineus) and these muscles may be injured when they are in a stretched position, but also if they are forced to contract suddenly.
The semilunar cartilages are commonly called menisci and form an important shock-absorbing mechanism, which helps in the gliding movement of the tibia on the femur. Injuries to the meniscus are common in young adults and are often sustained by the football players.
A meniscus tear is usually caused by twisting or turning quickly. These tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.
An abduction external rotation violence, on a flexed weight-bearing knee, causes a tear in the medial meniscus. in football, it occurs when the player standing on one leg, which is slightly flexed at the knee, turns to tackle the ball with the other leg.
The lateral meniscus is damaged by the opposite violence, that is, internal rotation and abduction violence of the tibia or a semiflexed weight-bearing knee.
Management
Paracetamol
Anti-inflammatory medicalYou can also take medication such as ibuprofen, aspirin, or any other non-steroidal anti-inflammatory (NSAID) medication to reduce pain and swelling around your knee.
Hypertonicity is a upper motor neuron lesion basically found in cerebral palsy and hemiplegia. The orthosis help to reduce the tone are known as tone reducing orthosis follows the principles of Neurodevelopmental technique and neurophysiology.
Flexibiliy: Stretching vs Self-myofascial Release. From research to practice ...Max Martin
Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia.
This workshop will equip you as an exercise professional to understand the impact, relevance and correct application of flexibility, stretching and self myofascial release (SMFR) on musculoskeletal health, function and performance.
At the workshop you will establish a strategic approach to dealing with muscle tightness affecting injury, posture and movement, based on clinical evidence and current research, theories and practices.
Commonly used Manual therapy technique by Physiotherapists,Osteopaths .useful in treating many of the soft tissue ailments and also a very useful tool in Sports physiotherapy.This deals with the basic concept of mayofascial release technique and its types ,indications ,basic concept of fascia,its functions.
Locomotion which means gait is controlled by various systems. Janda described these systems in three different linkages; articular, muscular and neural. The slide show also, describes in the same the locomotion control as described by Janda in brief.
Suffering from knee pain? It is important to know you what is the cause of your knee pain and their physiotherapy treatment also. To know your types of pain and their various pain management treatment my slide will help you.
Groin discomfort as well as tenderness establishes from a selection of reasons including athletic and non-athletic injuries in addition to inner physiological elements.
Forgotten in the complexity of attempting to identify. Groin discomfort is tendon laxity. Damaged, torn ligaments that cause instability. Consequently, physicians experienced in ligament reference patterns should be gotten in touch with in cases of groin discomfort.
this PPT contain detailed kinetics & kinematics of ankle joint & all joints of foot complex, muscles of ankle & foot complex, plantar arches & weight distribution during standing.
When someone experiences groin strain, they’ve experienced a tear to the adductor muscles of the hip. There are 5 groin muscles (adductor brevis, adductor longus, adductor magnus, gracilis and pectineus) and these muscles may be injured when they are in a stretched position, but also if they are forced to contract suddenly.
The semilunar cartilages are commonly called menisci and form an important shock-absorbing mechanism, which helps in the gliding movement of the tibia on the femur. Injuries to the meniscus are common in young adults and are often sustained by the football players.
A meniscus tear is usually caused by twisting or turning quickly. These tears can occur when you lift something heavy or play sports. As you get older, your meniscus gets worn. This can make it tear more easily.
An abduction external rotation violence, on a flexed weight-bearing knee, causes a tear in the medial meniscus. in football, it occurs when the player standing on one leg, which is slightly flexed at the knee, turns to tackle the ball with the other leg.
The lateral meniscus is damaged by the opposite violence, that is, internal rotation and abduction violence of the tibia or a semiflexed weight-bearing knee.
Management
Paracetamol
Anti-inflammatory medicalYou can also take medication such as ibuprofen, aspirin, or any other non-steroidal anti-inflammatory (NSAID) medication to reduce pain and swelling around your knee.
Hypertonicity is a upper motor neuron lesion basically found in cerebral palsy and hemiplegia. The orthosis help to reduce the tone are known as tone reducing orthosis follows the principles of Neurodevelopmental technique and neurophysiology.
Flexibiliy: Stretching vs Self-myofascial Release. From research to practice ...Max Martin
Presentation for WAFIC 2011 by Max Martin AEP, Director of Corrective Exercise Australia.
This workshop will equip you as an exercise professional to understand the impact, relevance and correct application of flexibility, stretching and self myofascial release (SMFR) on musculoskeletal health, function and performance.
At the workshop you will establish a strategic approach to dealing with muscle tightness affecting injury, posture and movement, based on clinical evidence and current research, theories and practices.
Commonly used Manual therapy technique by Physiotherapists,Osteopaths .useful in treating many of the soft tissue ailments and also a very useful tool in Sports physiotherapy.This deals with the basic concept of mayofascial release technique and its types ,indications ,basic concept of fascia,its functions.
Locomotion which means gait is controlled by various systems. Janda described these systems in three different linkages; articular, muscular and neural. The slide show also, describes in the same the locomotion control as described by Janda in brief.
Suffering from knee pain? It is important to know you what is the cause of your knee pain and their physiotherapy treatment also. To know your types of pain and their various pain management treatment my slide will help you.
Groin discomfort as well as tenderness establishes from a selection of reasons including athletic and non-athletic injuries in addition to inner physiological elements.
Forgotten in the complexity of attempting to identify. Groin discomfort is tendon laxity. Damaged, torn ligaments that cause instability. Consequently, physicians experienced in ligament reference patterns should be gotten in touch with in cases of groin discomfort.
this PPT contain detailed kinetics & kinematics of ankle joint & all joints of foot complex, muscles of ankle & foot complex, plantar arches & weight distribution during standing.
anatomy of lumbar spine, biomechanics of lumbar spine, movements at lumbar region, muscles of lumbar region, lumbar vertebra, kinetics and kinematics of lumbar spine
What is structure of lumber disc? What is disc bulge/prolapse/herniation? What is difference between disc bulge, disc prolapse, disc herniation or disc extrusion? What is criteria to diagnose lumber disc prolapse? How lumber disc herniation is treated medically or surgically? How lumber disc herniation is treated by conservative method? How lumber disc herniation is treated through physical therapy? What is physiotherapy after various disc surgeries? What is radiological method to diagnose disc prolapse?
1. Core Hip and Slings -
Intelligent prescription
PRESENTED BY:
Max MARTIN BAppSc (Hons) AEP
2. Movement is a behaviour
Developmental and learned
Quality over quantity
Posture is a good baseline for movement
Posture is not the cause of dysfunction but a SYMPTOM
Such dysfunction corresponds to compromised activity of muscles
Stabilisers typically become hypotonic/inhibited – ‘allowing’ faulty
posture
Gross movers typically become hypertonic/facilitated – ‘driving’
faulty posture
Prescription Paradigms
4. Why weakness?
Muscle inhibition due to pain/injury
Muscle susceptibility – eg. VMO vs VL atrophy post surgery
Muscle inactivity in chronic postures – eg. Sedentary behaviours
CNS driven protection
5. Why tightness?
Joint ROM can be limited by the following factors
1. Joint constraints
2. connective tissue (40%) –
protective, inactivity, hypertonicity
3. Neurogenic constraints (voluntary and reflexive) -
protective
4. Myogenic constraints – overload protective
10. The research journey
1992: TrA found to exhibit anticipatory function (activation prior to activation of prime
movers in arm movements) in healthy subjects (Cresswell)
1996-97: TrA disrupted in multi-directional arm movements in LBP subjects
1998: TrA also disrupted in lower limb movements among LBP patients
2001: TrA latency in LBP patients shown to increase with increasing task demand
2001: Experimentally induced pain causes disruption (hypoactivity) in the TrA
2002: TrA contraction shown to increase stiffness of the sacro-illiac joint to a greater
extent than a more global abdominal contraction
2007: Pelvic floor shown to share the same pre-emptive quality as TrA and MU
2009: LBP patients shown to have greater lumbo-pelvic instability in simple open-chain
stability exercises (eg Leg Loads) compared to controls.
11. Lumbar Vertebrae
Largest and strongest due to compressive
load.
Cortical bone shell with cancellous bone
core (trabeculae). Vertical Column
alignment.
Aids shock absorption quality of L1-5.
Age and repetitious loading degenerate
horizontal trabeculae ‘struts’
12. Lumbar facet joints
Bony articulations between vertebrae.
Synovial Joints- articular surfaces covered in
hyaline cartilage.
Allow flexion and extension
Movement pumps fluid in and out of joint
space. Fixed postures lead to joint dehydration
and degeneration.
Constant compression caused by hypertonicity
of paraspinals can accelerate degeneration.
13. Sacroiliac Joints
Junction point between spine and pelvis.
Synovial Joint- innervated by pain
receptors.
Corrugated design to assist stability.
Allows forward and backward tilting of the
sacrum.
Sublaxation possible, resulting in dull ache
or sharp pain that may refer inferiorly.
14. Intervertebral Discs
Colloidal gel nucleus
Concentric rings of fibrocartilage (lamellae)
form the annulus.
Outer third ONLY innervated by pain and
mechanoreceptors.
Slight movement of the vertebrae helps
rehydrate discs.
Repetitious torsion forces can derange
annulus, allowing nucleus to seep out.
Late warning of this process due to lack of
pain receptors amongst inner 2/3 of annulus.
15. Intervertebral Discs Cont’d
Discs are poor shock absorbers
– Very little compressive potential
– Nucleus facilitates movement rather
than compression
16. Thoracolumbar Fascia
Dense multilayered sheet of
connective tissue.
Insertion point for many muscles
Overactive lats and/or glutes can
cause excess collagen
deposition, making TLF more stiff.
This can restrict the ability of TrA to
slide freely as it pulls on deep layer.
18. Transversus Abdominis
Intra-abdominal pressure, thus making this area more stiff (less bendable).
Increases the stiffness of thoraco-lumbar fascia and abdominal aponeurosis.
Line of pull helps to align the ribs and pelvis in anatomically correct
Fibres crossing the sacroiliac joints pull the Ilium and the sacrum closer
together, decreasing laxity in these joints.
19. Gluteus Maximus
Primary hip extensor and external rotator*
Important for maintaining upright posture
Stabiliser of SIJ via attachment to TLF
Supports hip and knee via ITB attachment
Functional role in stepping, running, climbing etc. and…
DECELERATION
20. Gluteus Medius
Primary abductor and controller of rotation of the hip*
Functionally supports pelvis during SL stance and gait
Plays rotator cuff-like role
Strongest in neutral or slight adduction
21. Tensor Fascia Latae
Primary functions are hip
flexion, internal rotation and abduction
(via ITB)
Works in synergy with glute max:
Tighten ITB to extend
knee joint
Control movements of pelvis on
femur and femur on tibia when
weight bearing
22. Iliotibial Band
Thick, lateral aspect of
fascia lata
Attachment point for glute
max, TFL (and glute med)
Indirect insertion onto
patella
Anatomically impossible to
stretch effectively
23. Piriformis & External Hip Rotators
Primarily lateral rotator of the hip
In hip flexion, will also abduct the hip
Secondary phasic stabiliser of the SIJ
Close relationship to sciatic nerve
Piriformis syndrome
24. Vastus Medialis & Lateralis
Primary action is knee extension in inner
range- 15-20deg of knee flexion
Provide medial and lateral stability
to patella respectively
Perform anticipatory role
Often dysfunctional (knee pain, pronation)
26. SLSq Research (performance and strength)
Wilson et al (2006) Frontal Plane Projection Angle measured
(FPPA)
Women > FPPA
Weakness in external rotators correlated most closely to
FPPA (predisposes to ACL injury & PFP)
Claiborne et al (2006)
Hip abductor strength most important for resisting
valgus alignment
Crossley, 2006
Glute med shown to be latent in poor SLQ
Abduction strength and Trendelenburg test shows
correlation to SLSq
31. Correctives!!
Core exercises:
Leg loads (ant oblique, ant superficial and Spiral)
hip extension (post oblique and posterior superficial)
Hip lifts/SL (post oblique and post superficial)
Hip exercises:
Squat (posterior superficial),
SL DL (Lateral), hitches (lateral) and Rots (posterior and
anterior oblique), SL SQ (lateral)
32. PRESENTED BY:
Max MARTIN BAppSc (Hons)AEP
@iNformMaxMartin
max@correctiveexerciseaustralia.com
Editor's Notes
Do visual black out after “CNS protection”
----- Meeting Notes (6/02/11 07:41) -----WHAT DOES IT DO??