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.

What are the differences between Fascial and Muscle Stretching?

Physio Network has created a free audio version of my latest review on Dr. Stecco’s recent work titled Fascial or Muscle Stretching? A Narrative Review. Click on the link to listen. Please explore other great audio reviews from world experts like Alison Grimaldi on hip pathology as well.

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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

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

Toluidine Blue Histological Staining for Cartilage Loss

Trichrome Histological Staining for Pannus Development.

Immunocytochemistry Histological Staining for Nerve Cells.

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

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

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

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

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

New Speed and Agility Coaching Certification allows Multidirectional Athletes to gain an edge.

A Certified Speed & Agility Coach is a uniquely qualified individual that assists athletes improve explosiveness which translates into more multi-directional speed.

We are able to systematically breakdown speed development.

We regularly work specifically with multi-directional speed and power athletes, athletes who need to get more explosive and faster, and athletes that need to develop specific components of speed that they need to excel at their sport. 

Our goal is to make individual athletes, or whole teams, develop speed in the most efficient and effective ways possible.

If you are looking for assistance with:

Linear Acceleration

·Lateral Acceleration

·Linear Change of Direction (Decelerating and Reaccelerating)

·Lateral Change of Direction

·Cross Over Step

Retreating Acceleration

Cutting (Change of Direction)

Jumping (Leaping, Hopping, Landing)

·Sprinting

Mistake Recovery

Please schedule an appointment to begin training.  Slow motion video analysis can be used to observe deficits which can be integrated with Dynamic Neuromuscular Stabilization, Proprioceptive Neuromuscular Facilitation and Lower Quarter Advanced Biomechanical retraining with EMG biofeedback to improve these deficits in order to gain an edge on your competition. 

SOP is now offering Noraxon’s Ultium Electromyography (EMG) as part of our examination and treatment to assist in movement impairments.

EMG is a recording of the electrical activity associated with muscle contractions.  EMG does not measure muscular force or strength.  It measures how much motor unit activity or muscular fiber recruitment occurs during a given task.   

EMG biofeedback training allows patients/athletes to see which muscles are or aren’t being recruited appropriately.  This valuable skill is unable to be detected with a human eye and requires technology to determine. 

With the assistance of the physiotherapist, it allows patients/athletes to learn how to prevent unwanted muscle activation and develop proper muscular recruitment patterns. 

In combination with Dynamic Neuromuscular Stabilization, Proprioceptive Neuromuscular Facilitation or Movement System Impairment training EMG assists in learning appropriate timing of muscular recruitment for neuromuscular control.

Addressing the cause of a movement impairment in this particular manner, enables the patient/athlete to learn how to move more efficiently, avoid injury and impart more power which sets them up for success over the long term.   

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Partial Reopening of Sports & Orthopaedic Physiotherapy

Sports & Orthopaedic Physiotherapy is happy to announce that we are implementing a partial reopening as the state of California is nearing a reopening itself.  Dynamic Neuromuscular Stabilization training will still be offered via telehealth visits if that is an avenue you feel is more appropriate for you.  However, for those continuing to struggle with old problems or have developed new issues, and would like an in-office visit, I will be reopening between the hours of 1-5 PM Monday through Friday.  This partial reopening is likely to remain in effect until mid June in order to continue to somewhat slow exposure.  The new guidelines, as previously discussed, will now be in effect for your protection.  Health Spa Napa Valley will be remaining closed until further notice from the Governor.    

Thank you for all your concerns regarding myself, my family and the clinic during these trying times.  I hope that we can all get back on track relatively soon.  If you have any questions or concerns, please feel free to contact me. 

Warm regards,

Carlo Wood MPT, OCS, PhD, APA Sports and MSK Physio, DNSP, FAAOMPT

SOP is now offering telehealth visits for Dynamic Neuromuscular Stabilization training.

One of the many lessons it seems we are all learning through this time in history is that necessity is the mother of invention.  As patients still need healthcare, physiotherapists are challenged to come up with new and effective ways of delivering it safely. 

Like many other providers, I have found it has been very effective to continue to deliver Dynamic Neuromuscular Stabilization training to my current patients via telehealth visits. 

Therefore, I am now offering this as a regular service with Sports & Orrhopaedic Physiotherapy.  If you are local or live across the world, we can help. 

If you are continuing to have difficulty in your activities of daily living or want to improve your sport performance for when the time comes to return to full participation, improving the motor control and strength of your integrated spinal stabilization system with a certified DNS Practitioner is an effective way to meet those challenges. 

Please scroll down and read my former posts on DNS for more information on how DNS training may be right for you.

Update: Continued closure of SOP until 5/1.

Greetings all,

I hope this message finds you and your loved ones healthy during this challenging time.  What we are facing now with COVID-19 is an unprecedented challenge.  We have all had our lives altered to varying degrees, but hopefully, life will resume back to normal soon.  I wanted to continue to update you on the status of Sports & Orthopaedic Physiotherapy.  As of now, the Napa County Health Department has non-essential businesses closed down until May 1st.  I would like to fully reopen at that time to provide you with support, but I am skeptical. 

Quality of life is important to all of us. Physiotherapy undoubtedly assists in attaining that quality of life.  What makes the need for physiotherapy essential for this quality of life is subjective to each of us.  In order to assist you with this, on the 1st of May, I am considering a partial reopening to those of you who feel their quality of life is significantly diminishing. In particular, patients who have undergone a recent surgery, or anyone who continues to struggle through their activities of daily living. 

I have been seeing a few patients over Facetime to provide non-direct support, mostly in the form of Dynamic Neuromuscular Stabilization (DNS).  If you feel this may be a good option for your situation, please let me know. 

HOW SPORTS & ORTHOPAEDIC PHYSIOTHERAPY WILL BE PROTECTING YOU 

STAY AT HOME IF YOU ARE SICK

A key point is keeping people who are ill away from other people.  Therefore, I ask any patients who are feeling ill to stay home.

MINIMIZING GUESTS INTO THE CLINIC

This should minimize any unnecessary exposure to non-essential individuals. 

SCREENING TEMPERATURE

One of the signs of infection is fever, this will be monitored regularly for your safety. 

PRACTICE PROPER HAND & WRIST HYGIENE

Wash your hands – and your wrists often.  I regularly wash my hands between patients, but I will be placing extra emphasis on this.  I will ask patients to wash their hands, before and after treatment.

WEAR A MASK

Masks will be provided for each patient (if you do not have one) in order to keep exposure to a minimum. 

AVOID TOUCHING YOUR EYES, NOSE OR MOUTH

People frequently touch their eyes, nose or mouth without even realizing it.  Try and eliminate this behavior, particularly after touching objects or being around someone who is coughing or sneezing.

CLEANING & DISINFECTING THE CLINIC

We have always practiced good cleaning and disinfecting protocols, but have increased the frequency and depth of those efforts.  Rest assured that we are paying extra attention to items that are frequently touched.  

I know you have many choices in the valley for your musculoskeletal care and I would like to thank you for valuing Sports & Orthopaedic Physiotherapy.  I would also like to reiterate how honored I am to be able to serve you on your road back to full function.  I look forward to seeing you soon.  Please contact me with any questions.

Kind regards,

Carlo Wood MPT, PhD, OCS, APA MSK & Sports Physio., DNSP, FAAOMPT

Sportsandorthophysio@gmail.com

(707) 812-5066

Temporary closure of Sports & Orthopaedic Physiotherapy

Dear patients of Sports & Orthopaedic Physiotherapy,

I hope you are all doing well during this unique time of navigating the coronavirus. After careful consideration of the CDC, state and federal guidelines for limiting transmission to the community, I have decided to temporarily close the Health Spa Napa Valley location of Sports & Orthopaedic Physiotherapy beginning Friday, March 20 through Tuesday, April 7. This temporary closure is intended to protect you, your family, and mine. 

For those of you who have been doing Dynamic Neuromuscular Stabilization (DNS) for motor control and strength training, you may continue this line of care utilizing virtual visits and technology if you wish. Please contact me if you would like to schedule or switch an existing appointment to a virtual appointment or if you have concerns. 

This temporary closure will be in effect through Tuesday, April 7th.  I plan to reopen the clinic on April 8th unless there is a reason to change that date. I will send another email as that date approaches with an update.

While it appears that this virus will be circulating potentially for months, it is important for us all to do our part to slow its transmission to allow for adequate treatment resources to those who most need them. I know some of you have had a recent surgery and physiotherapy is crucial after those procedures.  Please continue to work on your home exercise program diligently. For those of you who have had your surgery postponed, please feel free to stay in touch with me for any recommendations that can be afforded to you until you get your procedure. 

As you probably know, Napa County is currently under a “Shelter in Place” order, restricting activities outside of the home to only essential needs.  For some, this includes health care visits like physiotherapy. Health Spa Napa Valley will be closed during the same dates, adhering to the recommendation from the Napa County Health Department mandate. While physiotherapy is allowed under the health care guidelines, I chose to close temporarily to help flatten the curve.  

When I reopen the clinic, I will be implementing several changes to meet standards set by the CDC for practitioners exposed to patients who have had contact with the virus. By meeting this standard, I will be able to meet your needs for physiotherapy and support the broader public health goal of preventing community transmission. 

With that end in mind, when I re-open, please avoid bringing guests or family into the office.  I will continue to clean between patients and ask that you wash your hands as soon as you enter the treatment room.  I will also take a screening temperature reading before we start our appointment.  Most importantly, please do not come into the office if you have even mild viral symptoms, and instead isolate yourself at home and call your primary care provider. It is also my intent to remain in the treatment room as much as possible and limit exposure to the other patrons and areas of Health Spa Napa Valley which are also being cleaned on a regular basis. 

Please follow CDC guidelines to self-isolate in the event that you have traveled internationally or had contact with a test-confirmed case of COVID-19, the disease caused by the coronavirus.  The above are determined to be best practice given the current information available. 

As a health care worker, I will self-monitor with temperature checks, be alert for the symptoms of cough, sore throat, or shortness of breath.  If those symptoms become noticeable or I learn I have been exposed to the virus, I will comply with the CDC recommendation for self-isolation. 

Data suggest that the current recommendations for minimizing transmission are effective. These include frequent hand-washing, avoiding exposure to symptomatic patients, covering your cough, and social distancing. While it may seem challenging in this unprecedented situation, it is essential that we maintain healthy immunity by caring for ourselves with adequate rest, exercise, and good nutrition.

It is a true pleasure to work with each and every one of you on a regular basis and assist you in your return to full function. If you have questions or would like to schedule a virtual appointment or consultation please contact me. During this down time, I will be working on related projects to improve the quality and services offered by Sports & Orthopaedic Physiotherapy as well as spending more quality time with my family.  I hope you are able to make use of this time as well to improve the quality of your life.  I believe we will be able to weather this societal challenge with grace, responsibility, and good health. 

Warm Regards,
Carlo Wood MPT, PhD, OCS, APA Sports & MSK Physio, DNSP, FAAOMPT

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!

Recent Certification with the Prague School of Rehabilitation as a Dynamic Neuromuscular Stabilization Practitioner

I recently traveled to Prague in the Czech Republic to finalize my training as a Dynamic Neuromuscular Stabilization (DNS) Certified Practitioner.  There are only a few of these specially trained individuals in the nation.  The trip was very enjoyable, I had a chance experience Europe for the first time, meet new people, make new friends and catch up with old ones.  This last course in the training series concentrated on current concepts in DNS, transitional movements of ipsilateral and contralateral patterns in active exercise, diagnosis, stretching, mobilization, and sport performance enhancement.  

DNS is based on the principle of developmental kinesiology.  This is the study of the maturation of the human locomotor system after birth and enables the biomechanics of dynamic movement to be linked with stabilization.  It enables efficient and ideal movement patterns to be acquired via the central nervous system's regulation of respiration and abdominal pressure with precise muscle coordination which is essential for optimal function and sport performance. 

DNS Practitioners are clinicians who have satisfactorily completed extensive DNS coursework, have at least 3 years of clinical DNS training, passed all tests associated with their training, and demonstrated competency in both knowledge and skill execution in the application of the diagnostic & therapeutic principles of DNS. They have earned the title "Certificate of DNS Practitioner" (DNSP) issued by the Prague School of Rehabilitation, Prague, Czech Republic.

Through skill acquisition of posture and locomotion, mature movement patterns are established by developmental kinesiology where the function of the brain and musculoskeletal system become integrated in order to move against gravity.  This occurs by transferring weight over a newly established zone of support that allows for optimal dynamic stability and mobility.  This skill acquisition protects joint structures by balancing internal and external joint reaction forces. 

DNS is manually facilitated exercise that improves movement system impairments.  Based on a patient’s impairments and goals, training begins by choosing a position from development that reestablishes the proper centration of a joint.  Centration is what assists in protecting a joint’s intraarticular and periarticular tissues. 

Joint centration reinforces optimal movement strategies based on preprogrammed and ideal movement patterns.  Once certain skills are achieved, movement patterns are progressed to higher developmental positions which places more demand on support and stability.  These can be integrated into any functional activity or sporting demand.  Acquisition of these higher tasks allows for improved performance, joint protection and longer athletic careers.      

The superiority of the DNS concept lies in its ability to bring about the most optimal movement strategies that match functional demand.       

DNS reestablishes developmental motor function.  Sports that create muscle imbalance can lead to impaired movement that diminishes performance and eventually cause injury.  DNS helps restore ideal movement patterns and retrains the movement system to function as it was designed.   

For movement to be efficient, it requires the transfer of body weight while maintaining dynamic stability.  Without this ability, strain on supporting tissues like discs, ligaments or tendons manifests as degenerative conditions. 

DNS has proven effective for treating patients with orthopedic conditions as well as improve sport performance.

When traditional approaches have not yielded optimal outcomes, DNS can be integrated into the impaired movement pattern with proven results.