Author: dedwardsmith

The Music of Movement

by dedwardsmith, posted in Movement Training

I have been a musician since I was introduced to a musical instrument way back in 6th grade.  Of course, I’m drawn to the analogy of music to movement.  All musicians know that learning an instrument takes persistence, repetition, strength and the ability to listen.  Take guitar for example. The more disciplined the practice and the cleaner technique results in a clean tone.

I see movement as a symphony.  This is well illustrated by the beauty of professional dancers or the powerful grace of gymnasts.  These athletes exemplify powerful stability and elegant mobility.  A swimmers flip-turn, an overhead squat, a turkish getup, and a dismount from the gymnast’s beam are movements are magnificent when symphony is masterfully conducted and the instruments in tune.

We all know that we can’t just pickup a guitar for the first time and shred a blues solo or pick up an Olympic bar and expect to squat our own body weight.  We earn those triumphs.  To play the music means we must first learn the instrument.  We must first learn how to move and learn what movements are available to our body.  Learning the instrument means listening to the notes as their being played.

I see movement patterns such as upper and lower body rolling, dead bugs, toe touches, bird dogs and half kneel chops and lifts as the “Mary Had A Little Lamb” fundamentals of movement.  If we cannot play a three-note song than why are we trying to play “Free Bird”.   If you want to overhead squat maybe you should be able to hip hinge and deadlift a kettlebell correctly first.  Or better yet hip hinge in a quadraped position.  Rushing to hurry up and play the instrument doesn’t usually make for good music.

And yes, sometimes the notes go out of tune.  In that case get the shoulder, knee or hip checked out if it doesn’t sound right.  It’s hard to play decent music on a broken instrument.  All instruments eventually require the time with the instrument tech or Luther.

You have fitness goals.  Take your time.  It’s worth the effort to own fundamental movement.  Learn to play the three-note song before the Beethoven’s 5th symphony. You want a long life of fitness.  Don’t just learn how to lift.   Don’t just learn how to run.  Learn how to move.  Make the music of movement.

A Golfer’s Elbow Diagnosis

by dedwardsmith, posted in Case Studies

There are many reasons for wrist pain.  These cases are common to most health care providers and often fall through cracks.   Ulnar nerve entrapment is effectively detected with a manual soft tissue specialization like Active Release Techniques.  X-Rays, or MRI’s and nerve conduction studies don’t reveal the nature of the problem.  Finding the site where the ulnar nerve does not move freely relative to it’s surrounding tissue requires a therapist to feel the movement.   You cannot treat want you can’t feel and you cannot feel what you don’t understand.  You cannot understand without a logical sequence of assessment.

A 42-year-old heavy equipment operator reports chronic elbow and wrist pain.  The onset of pain began after long hours working on a new machine that had a new layout of the hand controls.  He has been dealing with this issue for approximately three months.  He sought an orthopedic and medical evaluation for the condition.  A golfer’s elbow diagnosis was made and several weeks of physical therapy and an elbow strap was recommended to alleviate symptoms.

Where does it hurt?
He draws his finger along the ulnar side of his proximal elbow and wrist.

Do any motions make it worse or better?
He identifies that it is uncomfortable for him to straighten his arm.

Do you every have any type of numbness, if so where?
He indicates that his 3rd and 4th fingers is currently numb which is worsened with leaning on a chair armrest

Benchmarks Identified for Treatment
Immediate reduction in symptoms of numbness.
Decrease in symptom onset with leaning on armrest of a chair.

The Checklist

  • Palpation of passive qualities of elbow extension, flexion pronation and supination.
  • Palpation f passive qualities of wrist, extension, flexion, pronation and supination.
  • Observation of active qualities such as grip in elbow flexion and extension, pronation and supination.

Assessment
Palpation of relative motion of tissue.  Noted restricted relative motion of multiple structures including medial septum, brachialis, tricep, fcu, pronator teres, pronator quadratus.  Multiple sites of ulnar nerve entrapment most distinctive at the pronator quadratus and distal FCU.

The Treatment
Protocols to decrease tissue texture and tension consistent with adhesion to restore tissue relative motion.

Ulnar long tract protocols at the site of restricted relative motion of soft tissues.

Treatment Results

Immediate reduction in symptoms of numbness.
10 minutes after treatment fingers were no longer numb.

Next Visit

  • Expect report in follow-up visit on the benchmark of leaning on a chair armrest.
  • Reassess