Recent articles written for Physio Network: Highlighting cutting and running biomechancs.

Here is the current list of the summaries I have written on research articles for Physio Network.  If you are interested in them, or other authors comments on similar topics, please visit the Physio Network website for more information on how to easily translate current research into practice.

 

  • Dimensional Changes of the Tibial Nerve and Tarsal Tunnel in Different Ankle Joint Positions in Asymptomatic Subjects

  • Rearfoot strikes more frequently apply combined knee valgus and tibial internal rotation moments than forefoot strikes in females during the early phase of cutting maneuvers.

  • Change of Direction Assessment Following Anterior Cruciate Ligament Reconstruction: A Review of Current Practice and Considerations to Enhance Practical Application

  • Ankle kinematics, center of pressure progression, and lower extremity muscle activity during a side-cutting task in participants with and without chronic ankle instability

  • Upper limb neurodynamic testing with radial and ulnar nerve biases: An analysis of cervical spinal nerve mechanics

  • Fascia or Muscle Stretching?  A Narrative Review

  • Biomechanical Determinants of Performance and Injury Risk During Cutting: A Performance Injury Conflict?

  • Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes

  • The Iliotibial Band: A Complex Structure with Versatile Functions

  • Effects of and Response to Mechanical Loading on the Knee

  • Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi‑Directional Sports

  • Alternatives to common approaches for training change of direction performance: a scoping review


To access these articles and many more, please click on the link below.

Grand Opening of NEW Biomechanics Laboratory

Research demonstrates that altered biomechanics can be the root cause of movement related pain. Faulty movement patterns can create muscle overuse as well as increased strain on joints, tendons and nerves. SOP has recently added state-of-the-art technology to perform biomechanical analysis in order to determine the cause for recalcitrant pain.


In addition to our regular physiotherapy services, we are now able to obtain objective measurements of

Force

Motion

Pressure

Muscle Performance

Muscle Activation Patterns

to develop more effective clinical interventions that are capable of yielding better long-term outcomes.

The biomechanics lab is specifically engineered for

  • Gait Analysis

  • Running Analysis

  • Cycling Analysis

  • Return to Sport Evaluation

  • Injury Risk Screening

  • Return to Sport / Injury Prevention Training

Although a primary focus of SOP is dedicated to the evaluation of people who are injured or having difficulty moving, we also perform biomechanical assessments to enhance athletic performance or prevent injury.  

Our assessments include return to sport evaluations for those who completed their rehabilitation following injury/surgery and are striving to return to better than previous levels of competition as quickly and safely as possible.

Dr. Wood received his bachelor's and master's degree in Physical Therapy from Fresno State University as well as a second master's in Sports and Musculoskeletal Physiotherapy from the University of South Australia. He received his PhD from the Pathology Department at Loma Linda University's Medical School in Anatomy with a focus on joint and nerve pathology.  He was also an Orthopedic Resident, Movement Science Fellow and Proprioceptive Neuromuscular Facilitation Resident in the Kaiser Permanente system. 

Through this training, he was granted Fellowship standing with the American Academy of Orthopedic Manual Physical Therapists and is an Orthopedic Clinical Specialist with the American Physical Therapy Association.  He also holds specialties in Sports and Musculoskeletal Physiotherapy with the Australian Physiotherapy Association. He has further training with the Prague School of Rehabilitation where he became a Dynamic Neuromuscular Stabilization Practitioner. 

Dr. Wood remains an international instructor for Neurodynamic Solutions and author for Physio Network. He also continues his training in the biomechanics of movement related impairments of gait, running and return to sport with the Movement Performance Institute.


If you are having difficulty with walking, running or returning to sport, contact SOP for your biomechanical examination.

SOP is now hiring.

Sports & Orthopaedic Physiotherapy is currently looking for a part time physiotherapist.  This position has the potential to become a fellowship opportunity where participants will become proficient in

Clinical Reasoning and Manual Therapy based on the Maitland Concept and the University of South Australia’s Musculoskeletal and Sports Physiotherapy program.  

Neurodynamics based on Neurodynamic Solutions curriculum. 

Dynamic Neuromuscular Stabilization based on the Prague School of Rehabilitation. 

Proprioceptive Neuromuscular Facilitation based on Kaiser Permanente’s Vallejo program. 

Movement System Impairment Syndromes based on Shirley Sahrmann’s model. 

Lower Quarter Biomechanics curriculum based on the Movement Performance Institute. 

These concepts are integrated into a new state-of-the-art biomechanics lab to analyze gait, running and return to sport. 

Guest speakers and mentors include Mary Magarey, Michael Shacklock, DNS faculty, PNF faculty, and Chris Powers. 

Interested parties should send a resume to Carlo Wood at sportsandorthophysio@gmail.com

Recent Podcast With Physio Explained On Iliotibial Band Syndrome And How the SOP Biomechanics Lab Can Assist With The Condition.

I recently wrote a review of the research article titled, The Iliotibial Band: A Complex Structure with Versatile Functions by Hutchinson et. al. for Physio Network.  The paper summarized our current understanding of the ITB’s anatomy, biomechanics, etiology, examination and treatment of ITB Syndrome. 

The current research supports the use of interventions that directly target the running biomechanics suspected to cause ITB Syndrome.  

Physio Explained asked me to discuss the articles highlights and how the biomechanics lab at SOP is able to assist in treating this condition.  Physio Explained hosts the biggest names in physiotherapy discussing the most clinically relevant topics. 

To listen to my podcast on the ITB and the biomechanics lab, please click on the link below. 

Carlo Wood has been voted Best Physical Therapist for the 2nd year in a row by the readers of the North Bay Bohemian.

Sports & Orthopaedic Physiotherapy is proud to announce that Carlo Wood has been voted Best Physical Therapists for the 2nd year in a row by the readers of the North Bay Bohemian. 

The Bohemian is an award-winning weekly newspaper which serves Sonoma & Napa counties and provides a direct connection to the dynamic North Bay lifestyle.  It is regarded as the locals’ resource for insightful coverage of local news, arts, dining and entertainment. 

If you are having difficulty walking, running or returning to sport, Carlo will be opening a Biomechanics Lab to analyze these activities with state-of-the-art technology in the next few weeks. 

We would also like to thank the readers of the North Bay Bohemian for their continued support as it is an honor to continue to serve the Valley.

For a complete list of all the winners, please click on the link below. 

Running Biomechanics after ACL Reconstruction

“Normal running biomechanics are not restored in the surgical leg at 12-months post surgery” (Knurr et al 2021)

This is quite scary considering most athletes have returned to sport by the 12-month mark.

If you want to know how these running biomechanics differ in the surgical leg, and what this should mean for your ACL rehab…

I have reviewed this paper for Physio Network and they have made it FREELY available in audio format. 

Listen to it now. Audio Reviews - Physio Network (physio-network.com)

Free Access to my summary of Biomechanical Determinants of Performance and Injury Risk During Cutting: a Performance-Injury Conflict?

Physio Network has allowed free access for my October write up on cutting biomechanics. Find out key information like how knee valgus is linked with greater knee joint loads with no associated performance benefits, while penultimate foot contact braking dominant strategies and minimizing lateral trunk flexion are factors associated with better performance and safer change of direction mechanics. Teaching penultimate foot contact dominant braking strategies and minimizing knee valgus and lateral trunk flexion should facilitate effective performance and reduce knee joint loading and ACL injury. Also learn what is associated with faster cutting ability and see what creates a larger peak knee abduction moment. To read the write up in its entirety, click on the image below.

Recent Publication in Frontiers in Immunology on Arthritis.

I am proud to announce that my PhD research titled:

Driving β2-while suppressing α-adrenergic receptor activity suppresses joint pathology in inflammatory arthritis

is being published in Frontiers In Immunology.  Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology.  Frontiers In Immunology is the official Journal of the International Union of Immunological Societies (IUIS).

This study was performed in collaboration with incredible scientists at the Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University, Banner Sun Health Research Institute,  the Musculoskeletal Disease Center, VA Loma Linda Healthcare System, and Division of Biochemistry, Department of Basic Sciences, School of Medicine, Loma Linda University. 

Objective: Hypersympathetic activity is prominent in rheumatoid arthritis, and major life stressors precede onset in ~80% of patients, supporting a link between stress and disease onset and progression. Here, we extend previous research by evaluating how selective peripherally-acting adrenergic drugs effect joint destruction and influence immune mediation of adjuvant-induced arthritis (AA).

Methods: Inflammatory arthritis was induced by complete Freund’s adjuvant in male Lewis rats. These rats then received vehicle or twice daily treatment with the α-adrenergic antagonist, phentolamine (500 µg/kg) and the β2‐adrenergic agonist, terbutaline (1200 µg/kg, collectively named SH1293) from day (D) of disease onset (D12) through acute (D21) and severe disease (D28). Disease progression was assessed in the hindlimbs using dorsoplantar widths, X-ray analysis, micro-computed tomography, and routine histology on D14, D21, and D28 post-immunization.

Results: On D21, SH1293 significantly attenuated arthritis in the hindlimbs, based on reduced lymphocytic infiltration, preservation of cartilage, and bone volume. Pannus formation and sympathetic nerve loss were not affected by SH1293. Bone area and osteoclast number revealed high- and low-treatment-responding groups. In high-responding rats, treatment with SH1293 significantly preserved bone area and decreased osteoclast number, data that correlated with drug-mediated joint preservation. SH1293 suppressed abnormal bone formation based on reduced production of osteophytes. On D28, the arthritic sparing effects of SH1293 on lymphocytic infiltration, and cartilage and bone sparing were maintained. However, sympathetic nerves were retracted from the talocrural joint.

Conclusion and Significance: Our findings support a significant delay in early arthritis progression by treatment with SH1293. These findings support that targeting sympathetic nerve activity may provide a strategy to slow disease progression.

To read article in its entirely, please click here:

Frontiers | Driving β2- While Suppressing α-Adrenergic Receptor Activity Suppresses Joint Pathology in Inflammatory Arthritis | Immunology (frontiersin.org)

Study Design

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Micro CT Imaging to Quantify Bone Destruction in the Ankle Joint.

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Toluidine Blue Histological Staining for Cartilage Loss

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Trichrome Histological Staining for Pannus Development.

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Immunocytochemistry Histological Staining for Nerve Cells.

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Hematoxylin and Eosin Histological Staining for Lymphocyte Infiltration.

Tartrate Resistant Acid Phosphotase Histological Staining for Osteoclast Activity.

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Best of the North Bay 2021: Carlo Wood awarded Best Physical Therapist

Sports & Orthopaedic Physiotherapy is proud to announce that Carlo Wood has been voted Best Physical Therapist in Napa for 2021 in an online poll by the readers of the North Bay Bohemian.  The Bohemian is an award-winning alternative weekly newspaper serving California’s Sonoma & Napa counties that traces its roots back to 1979.  Sports & Orthopaedic Physiotherapy is honored to be valued by the people of Napa and Sonoma and look forward to serving the community for years to come.  Please click on the image below to see a complete list of local winners. 

Completion of the Movement Performance Institute’s Long-Term Course on Advanced Functional Biomechanics of the Lower Quarter

Movement impairments often predispose sports and orthopaedic patients to musculoskeletal injuries.  These situations often become chronic because many movement impairments are unable to be examined without the use of special technology.  Understanding how to utilize data collected from such technology and relate it to clinical biomechanics and pathomechanics in the lower extremity is imperative for the clinical reasoning process. This is needed to develop patient-specific interventions aimed at correcting dysfunctional movement patterns.

This long-term course taught by world renown gait expert Chris Powers at the Movement Performance Institute assists physiotherapists in learning a thorough evaluation of movement dysfunction which is critical for the development of successful treatment strategies. This evidence-based course series focused on the diagnosis of movement-related impairments and emphasized the examination of walking, running, cycling and common sport movements using technology not commonly found in a typical clinic. 

The technology that assists in clarifying movement impairments include  

EMG biofeedback: for assessing and facilitating motor unit recruitment

EMG image II close up.PNG

High-speed motion capture: for arthrokinematic analysis and motor control training

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Force plates: for ground reaction force observation and manipulation of shock attenuation

GRF vector.gif

Dynamometry: for muscle strength testing to determine a percent loss from norms or improvements:

 

Pressure plates embedded in a treadmill: for foot pressure analysis and spatio-temporal characteristics

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Zebris pressur plate image.jpg
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zebris foot pressure II.PNG

Understanding how to assimilate the data generated from this technology with a patient’s history and physical examination advances the physiotherapists knowledge in the area of clinical biomechanics and improves their ability to systematically identify movement impairments that underlie various lower extremity diagnoses.  This in turn develops targeted interventions to optimize biomechanical function and performance.

Stay tuned to this space as Sports & Orthopaedic Physiotherapy is looking forward to continue to implement this technology in the near future to assist the athletes and orthopaedic patients of Napa Valley. 

For more information on The Movement Performance Institute, Chris Powers, or the courses offered please visit http://movementpi.com

Residency in Proprioceptive Neuromuscular Facilitation

I have recently finished a 3-month residency in Proprioceptive Neuromuscular Facilitation (PNF) at Kaiser Permanente in Vallejo to further assist the neuromusculoskeletal needs of patients in Napa Valley. 

Well-established basic principles of PNF like the utilization of joint receptors, appropriate tactile input and resistance, stretch stimulation, normal timing, and irradiation of muscle chains in appropriate developmental positions and patterns play a large part in the link between tissue level changes and person-level performance. 

PNF has been proven to be an effective component of treatment for various orthopedic and neurological dysfunctions since the 1940’s.  It was originally based on neurophysiological principles and translated into practice by Maggy Knott PT and Herman Kabat MD.  Strategic demands placed on the individual, elicits their potential which is specific, purposeful and directed toward a functional goal.  Each component contributes to recruitment of efficient motor performance.

PNF maintains focus on what an individual can do, instead of what they can’t do while assisting with movements that are specific, purposeful and meaningful to the patient.  It uses stronger components to strengthen weaker components to promote motor learning, decrease pain and improve function.  It facilitates a maximal response of optimal quality which has been found to be the most effective way of increasing motor and sensory awareness.  Repetition of this response is varied in context in order to retrain motor learning with alternating activity to reduce fatigue.  

Research has shown that intensive rehabilitation produces more effective outcomes than less intensive approaches.  Well-integrated sensory input creates the ability to sustain asymptomatic exertion during training. In turn, this provides the greatest opportunity to improve power, endurance, coordination, balance and optimal function of the neuromuscular mechanism for optimal recovery. 

For more information regarding PNF and the International Proprioceptive Neuromuscular Facilitation Association, please click on the link below. 

Physio Network Articles to Date

Here is a list of the summaries I have written on some current research articles for Physio Network. If you are interested in them, or other authors comments on similar topics, please visit the Physio Network website for more information on how to easily translate current research into practice.

  • The effect of spinal position on sciatic nerve excursion during seated neural mobilisation exercises: an in vivo study using ultrasound imaging

  • Cervical Sagittal Balance: a biomechanical perspective can help clinical practice

  • Sciatic nerve stiffness is not changed immediately after a slump neurodynamics technique

  • Noninvasive measurement of sciatic nerve stiffness in patients with chronic low back related leg pain using shear wave elastography

  • Probing multi-scale mechanics of peripheral nerve collagen and myelin by X-ray diffraction

  • Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics. Consensus Statement·        

  • Medial elbow anatomy: a paradigm shift for UCL injury prevention and management

  • Decoupled epineurial and axonal deformation in mouse median and ulnar nerves

  • Response of the popliteal artery to treadmill exercise and stress positioning in patients with and without exertional lower extremity symptoms

  • Please click on the link below for more information.

  • More articles to come!

NDS and the Movement Performance Institute host the 1st Advanced Neurodynamic Courses in the US!

Neurodynamic Solutions is proud to announce the long awaited Advanced Neurodynamic Solutions Courses for the Upper and Lower Quarter.  Michael Shacklock held the first advanced 4-day series at Chris Powers clinic, the Movement Performance Institute in March.  It was well worth the wait.  If you are interested in hosting or taking a NDS class please see the link below. 

Recertified as a Clinical Specialist in Orthopedics by APTA and ABPTS

After becoming a Clinical Specialist in Orthopedics after my residency in 2007, I have been granted my recertification as a Clinical Specialist in Orthopedics by the American Physical Therapy Association and the American Board of Physical Therapy Specialties this year. 

The American Physical Therapy Association (APTA), a national professional organization representing more than 100,000 members throughout the United States, established the specialist certification program in 1978. Specialization is the process by which a physical therapist builds on a broad base of professional education and practice to develop a greater depth of knowledge and skills related to a particular area of practice. Clinical specialization in physical therapy responds to a specific area of patient need and requires knowledge, skill, and experience exceeding that of the physical therapist at entry to the profession and unique to the specialized area of practice.

The specialist certification program was established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice and to assist consumers and the health care community in identifying these physical therapists.

 

January Commentary in Physio Network!

To read my clinical commentary in this month's issue of Physio Network on

THE EFFECT OF SPINAL POSITION ON SCIATIC NERVE EXCURSION DURING SEATED NEURAL MOBILISATION EXERCISES: AN IN VIVO STUDY USING ULTRASOUND IMAGING

click on the image.  

“ If the goal is to maximize excursion, it is important to take up the slack at one end (ankle) while creating slack in another end (cervical spine) as nerves move down the tension gradient ’’

Returning to the Olympic Training Center in Colorado Springs 2018.

I will be heading back to the Olympic Training Center to assist our resident athletes which include:   

Boxing
Cycling (Olympic and Paralympic)
Figure skating
Gymnastics
Paralympic Judo
Pentathlon
Shooting (Olympic and Paralympic)
Paralympic Swimming
Wrestling

I am looking forward to the trip prior to the Olympic Games in PyeongChang.  To learn more about Team USA as well as the 2018 Olympic Games in PyeongChang, click on the images.   

 

New Affiliation as an Author with Physio Network.

Physio network is an organisation created to help practitioners keep up to date with the latest research in physiotherapy and its clinical implications.

With new studies coming out every single day, we help provide you with the research that matters by selecting the most clinically relevant articles, and having industry experts summarize and appraise the articles for you.

From the creators of

OUR MISION: “To improve physiotherapy standards worldwide by helping practitioners not only keep up to date with, but understand the clinical implications of, the latest research in physiotherapy.”