Monthly Archives: April 2017

Femoral Biomechanics


A network of trabecular fibers run through the head and neck of the femur and are extremely important during function, especially during single-limb stance. These fibers allow the proximal femur to withstand both compression forces (blue regions) and tension (red regions) and undergo more deformation (change in shape) than the hard cortical bone found in the shaft of the femur.


Although this region is designed well from an architectural standpoint, it does demonstrate a zone of weakness where trabecular fibers cross at suboptimal angles leaving the bone vulnerable to injury in certain instances such as falls. When this type of fracture does occur it is usually in cases of high force collisions (motor vehicle accidents, sports, etc) or in situations where bone health has been compromised such as seen with osteoporosis. 


This is yet another example that illustrates the importance of a resistance training program and a sound nutritional plan in order to optimize bone health and reduce the risk of fracture. Populations that are most at risk of suffering this injury include older adults, especially females, athletes who spend large amounts of time exercising in environments that reduce bone stress (cycling and swimming) and females who fall in the ‘female athlete triad’ category (osteoporosis, absence of a menstrual cycle and disordered eating).

The Skin

The skin is one of the largest organs in the body in surface area and weight. The skin consists of two layers: the epidermis and the dermis. Beneath the dermis lies the hypodermis or fatty tissue. —

The skin has 3️⃣ main functions: 



3️⃣Sensation –

The skin is an organ of protection and its primary function is to act as a barrier.🥅 The skin provides protection from: mechanical impacts and pressure, variations in temperature, micro-organisms, radiation and chemicals.

The skin is an organ of regulation which regulates several aspects of physiology, including: body temperature 🤒 via sweat and hair, and changes in peripheral circulation and fluid balance via sweat. 💦 It also acts as a reservoir for the synthesis of Vitamin D. ☀️ –

The skin is an organ of sensation containing an extensive network of nerve cells that detect and relay changes in the environment. 🏜There are separate receptors for heat, cold, touch, and pain. Damage to these nerve cells is known as neuropathy, which results in a loss of sensation in the affected areas. Patients with neuropathy may not feel pain when they suffer injury, increasing the risk of severe wounding or the worsening of an existing wound.

Choosing exercises you enjoy will help promote adherence, which will help to reduce symptoms and promote health overall. In many cases, exercise for physical pain can be much less specific than we once thought. At the end of the day, focus your efforts on a level of movement that challenges your system without pushing it past it’s yield point. This basic principle will promote positive adaptation and robustness throughout the neuromusculoskeletal system.


Human movement consists of a number of subsystems to create performances. If one subsystem is not working optimally the rest can not function efficiently.

🔺The LATERAL SUBSYSTEM is one of the four subsystems that stabilise the pelvis. …

🔺This system is made up of:

– Gluteus medius (your butt)

– Tensor fascia latae (side butt)

– Hip adductors (groin) (adductor brevis, adductor longus, adductor magnus, pectenius and gracilis) – Contralateral (opposite side) Quadratus Lumborum (lower back)

🔺it’s ROLE is frontal plane stability. In other words, the subsystem is a major stabiliser of the pelvis and spine in single leg movements such as walking 🚶🏼, running 🏃🏼‍♀️,lunges, step ups, etc. In more words, that means EVERYONE is ALWAYS using this subsystem 👥👥.

🔺When the weight is transferred on one side (let’s say the right side), the right gluteus medius (butt) works with the QL (lower back) on the opposite side to provide stability.

🔺During single leg stance, the gluteus medius (butt) is responsible for keeping the hips level. 

A weak or inhibited right glute means a drop ⬇️ in the left hip. 

Tightness, spasms and compression at the lower back, increased pronation of the knee, hip or feet are all common dysfunctions due to compensation in this system 😫 

These dysfunctions can be seen in dynamic (running, walking) or static postures. …

🔺Pain 💉often presents itself through knee pain, tendonitis, chronic tightness in the ITB, hip pain, plantar fasciitis, pulled groin and adductor injuries, lower back pain, ankle injury and sacroiliac joint pain. …

Kneecap Pain Series

I have had a number of questions recently about pain around the kneecap (patellofemoral pain syndrome) and what can be done to help this condition.


First, a bit of background. Patellofemoral Pain Syndrome (PFPS) is a multi-faceted pain condition, like many pain problems, and can vary from person to person. In general though, PFPS presents as pain at the front of the knee that is aggravated with activities that compress the patellofemoral joint (joint between patella and femur) such as squatting, climbing stairs, running, kneeling, prolonged sitting and so on.


Now, contrary to what many providers will tell you, pain in this region does not necessarily mean something is wrong with the cartilage of your knee (termed chondromalacia) or any other tissue. In many cases, the pain is really just thought to be a result of the nervous system being overly protective. Additionally, even if you do have signs of degeneration to structures of the patellofemoral joint, this does not mean you will for sure have pain. Large percentages of painless individuals show signs of degeneration, so let’s not stress too much about what an imaging study might show us. Remember, YOU ARE NOT YOUR MRI. Imaging tools are useful, but they only tell part of the story.


So, what do you do for PFPS? Well, this obviously varies person to person, but there are a few general interventions that work for many people. These usually revolve around modifying stress on the joint, learning to move the leg differently with certain activities and strengthening the muscles (mainly glutes) that control alignment of the lower extremity.



This is an important post if you or someone you know has chronic pain and can’t figure things out. ⤵️

Hypermobility syndrome describes a connective tissue predisposition that allows joints to easily move beyond their normal range of motion. If you have done the splits at some point in your life, you are probably on this spectrum. Women are affected more than men. 🙋🏼 Hypermobility isn’t always a problem; only when there is pain and discomfort associated with it. If you are very flexible, but you feel tight and have pain, this might be you. 🤔


The Beighton Scale (shown above) consists of 5 tests: .

1️⃣ Do your elbows hyperextend? .

2️⃣ Do your fingers bend back past 90 degrees?

3️⃣ Can you bend your thumb to your arm? .

4️⃣ Do your knees hyperextend? .

5️⃣ Can you touch your palms to the floor?


If you answered “yes” to more than 2 of those, you are on the hypermobility scale. ⚠️The key focus of your “corrective” training should be stability and strengthening through a full range of motion. Mobility without stability is a problem. Despite some short term relief, stretching can actually be harmful in this scenario. Don’t let it fool you!


The typical painful hypermobile patient has had pain for a long time. ✔️ They have tried a few different things to improve, but all with minimal success. 😞 Their pain is usually bearable, but it can still have a profound impact on quality of life and athletic endeavors. .


One common complaint you might hear from the hypermobile patient is they “feel tight.” 🤔 This perceived tightness is a result of a neurological tone and drive attempting to stabilize. It will decrease with strengthening. In activities where mobility is advantageous, such as gymnastics or throwing, there is a careful interplay between mobility and stability.


The key takeaway here: know YOUR body and best know how to treat it. If you are extremely mobile, focus on strength and stability. As with all training and rehab, the approach should be individualized and tailor fitted. Fit the program to person, not the other way around. 👊🏼 

WHY KNEE PROBLEMS HAPPEN!![dislocation explained]

Did you know that the knee is the most commonly injured joint with an estimated 2.5 MILLION sports-related injuries every single year?!


Funny part is, most of the time, knee pain happens not because there is something wrong with the knee, but due to dysfunction in the joints ABOVE (hip) and BELOW (ankle) the knee


When patellar dislocations happen (left knee pictured) many therapists will WRONGLY emphasize the importance of taping the patella in place or strengthening the VMO muscle in order to “stabilize” the patella


Let’s use an analogy to explain why 👎🏼overstabilizing the patella is a dumb idea!


If we were to use the analogy of a 🚂train rolling on rails, most of the time when an accident or malfunction happens it’s because of the rails, not because of the train. (Especially in Bond Movies. Villains always ❤️ to blow up rails 😝)


Similarly, the patella is a train that just follows whatever myofascial “rails” you give it!! You don’t try to fix a train going off the rails by “stabilizing the train” or “adding strength/power to the engine of the train”. You do it by fixing the 🛤


If you look at the mechanics of a knee dislocation, they happen when the femur is excessively internally rotated in relation to the patella/tibia


If your leg bone (femur) is going inwards and you can’t control it’s deceleration, the patella will end up LATERAL to the knee and “derail”


Situations that can derail your patella

1️⃣you can’t control the speed at which your femur decelerates. Femur moves faster than patella = derail 😞

2️⃣you can’t externally rotate your femur fast enough when your extend your knee. Femur moves slower than patella = derail 😩

3️⃣you get hit and it causes your femur to go in a direction faster than your patella = Your ACL explodes and your patella…DERAILS!😵


Basically people fuck up their knees when the femur and the patella don’t travel at the speed required to keep the train glued to the moving rails


A better rehab protocol would involve neuromuscular drills to recondition the knee to move in a strong+coordinated fashion

Gluteus Medius

 (GM) is a hugely important muscle in terms of controlling the proximal lower quarter and, in many cases, preventing injury and/or pain.••••••••••

GM is described as being a hip abductor, but it is also intimately involved in controlling other aspects of the kinetic chain in the frontal plane of motion. For instance, a lack of GM control can contribute to not only medial knee collapse (hip adduction), but also to contralateral pelvic drop (shown in this image) and lateral bending of the trunk. A lack of control at the hip, pelvis or trunk could lead to pain in the knee, hip or lumbar region in instances where the lack of frontal plane control occurs frequently such as running.

Massage Therapist 

Having an underlying sense of history is important for massage therapists emerging as modern health and wellness professionals. Knowing where you came from, the core of your professional identity, provides a strong foundation from which you can move into the future with integrity. Recounting former times also spurs “aha moments” as the world of the past opens up and we understand for the first time how things we see today came to be. Our profession begins to make more sense—the diversity, the independent streak, the holistic viewpoint, the affinity for natural healing, and the singularity of our vocation as massage therapists.-

Tracing the professional lineage of massage therapists in America today takes us back to colonial times and continues from there through generations of practitioners advancing to the present day. Progress through the decades was impacted by national and world events, advances in science and medicine, and religious and social movements—the larger context in which massage therapists of the past lived and worked. 



99% of the time our body’s inflammatory process is viewed negatively when we need to remember how vital this process is to healing. Between special diets, medication, electrical and thermal modalities (TENS, ice, etc) and other strategies to limit inflammation, we often forget that the inflammatory process is our immune system’s initial response to musculoskeletal trauma and a necessary step in the repair and remodeling of tissue.


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