"Train the Chain": Rehabilitation Methods Addressing Bio "Mis" chanics of the Kinetic Chain: Introduction (04:44)
Thomas G. Palmer recently completed his PhD at the University of Kentucky. The athletic trainer will define key concepts in the pelvic and lumbo-pelvic area and assessment considerations. Every evaluation incorporates some analysis on how the athlete moves.
Segmental Dependency (04:20)
Unrelated impairments in a remote region may be associated with a primary complaint. Movement dysfunction can occur while the trainer is unaware of it. The laws of conservation, momentum, the summation principal, the radius of rotation, and radius of gyration apply to segmental interdependence.
Functional Properties (03:01)
Every joint relies on three subsystems to move: active muscles, passive muscles, and a neural network. Function depends on inter-segmental dependency. Palmer compares linear versus rotational movements.
Kinetic Chain Approach (05:20)
Athletic trainers need to look at connecting the dots between the different joints. Most joints alternate between providing mobility and stability within the human body. The International Classification of Function (ICF) is a framework for measuring health and disability.
Exposure to Injury (04:20)
Palmer presents Bahr's 2005 framework to athlete's risk factors for injuries. Movement patterns become habitual and asymmetries increase the likelihood of injury. Address asymmetry first.
Movement Becomes Habitual (02:51)
People become less mobile when they are constricted in a certain position. Muscle characteristics begin to change after sitting for 15 minutes. Damage distributes throughout the kinetic chain.
Improvements in Functional Movements (04:18)
A study assessed a group of firefighters and provided an intervention to address movement deficits. The average cost of injuries reduced by 42%. Palmer advocates for ensuring the population is appropriate to a functional movement exercise.
Common Ailments (04:14)
Palmer sees many patients with tight hip flexors and weak abdominals in the lower cross. He will highlight three concepts of manual therapy to address issues in the lumbo-pelvic region. Incorporate trigger point and myofascial release when treating an athlete for upper cross syndrome.
Additional Treatments (02:18)
Palmer incorporates T-spine and paraspinal mobility exercises in patients with upper cross syndrome. Integrate muscle mechanics into a treatment and add pectoral elongation strategies.
Lower Cross Syndromes (03:43)
Palmer demonstrates the Iliopsoas release technique and advises not to use a finger or a prod. Incorporate anterior chain lengthening exercises.
General Guidelines for Training (05:41)
Release the muscle and then incorporate movement that enforces function specific to an activity. Palmer summarizes his lecture and emphasizes attacking asymmetries. Increase oxygen level and normal muscle contraction.
In the Laboratory (04:12)
Palmer identifies the locations of Dai Sugimoto, Stephanie More, Stephanie James, and Carrie Silkman-Baker. Using two participants, the athletic trainer demonstrates how different individuals incorporate different joints to touch their toes.
Pectoralis Minor Technique (04:21)
Locate the pectoralis minor and hold the trigger point. Palmer advocates also trying it on the bicep and the pectoralis major. Palmer demonstrates the technique on a participant and incorporates internal rotation.
Coracoid Process (05:10)
Palmer demonstrates how to find the structure. Hold the myofascial release point for 60 to 90 seconds and incorporate internal rotation. Use your treatment discretion to determine length and range of motion.
T-Spine: Paraspinal Release (04:03)
The exercise consists of the athlete performing an abdominal crunch then reaching behind and above while lying atop a ball near the scapula. Breathe through the pelvic floor to enlarge the thoracic cavity and provide stability to the abdominal muscles. Clinical discretion will dictate range of motion and intensity.
Practicing the T-Spine (06:15)
Palmer asks participants to try the exercise on the table and the floor. Athletic trainers do the movements while incorporating breathing through the pelvic floor. Palmer diagnoses one of the participants with an asymmetry that the exercise could help.
T-Spine Mobility (05:09)
The pelvis will lock more in place the further an individual sits back on his or her knees and ankles. Palmer demonstrates the exercise, which compliments the myofascial release. A component of contralateral compression relates to segmental compression.
T-Spine Butterfly (03:23)
The patient's wrists and arms should be flat against a wall. This exercise elongates the anterior muscle fibers. Palmer demonstrates the technique.
Participants demonstrate the t-spine butterfly exercise. Athletic trainers can help facilitate a greater range of motion with their patients. Modify movements based on a patient's pathology.
Hip/ T-Spine Rotation (04:00)
This exercise incorporates the lower body to help facilitate greater t-spine mobility. After triggering the release point, the movement will help elongate and relax the pectoral muscles.
Iliopsoas Release (03:42)
Find the umbilicus and the anterior superior iliac spine (ASIS) to determine the positional release point. Have the patient relax abdominal muscles. Palmer demonstrates the technique and explains it is uncomfortable.
Trying It on Others (02:39)
Participants attempt the iliopsoas release. Athletic trainers can incorporate additional muscles, oscillations, and rotation depending on the needs of the patient.
Psoas Release (03:11)
Find the ASIS and dig behind it. Palmer demonstrates how he incorporates resistance to find the muscle. A static lunge can help incorporate gluteal activity.
Exercises to Elongate (02:56)
Palmer demonstrates several exercises to promote anterior structural movement. Low impact activities can cause spinal injuries.
Credits: "Train the Chain": Rehabilitation Methods Addressing Bio "Mis" chanics of the Kinetic Chain (00:21)
Credits: "Train the Chain": Rehabilitation Methods Addressing Bio "Mis" chanics of the Kinetic Chain
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