Myofascial Release and Active Release Techniques Research

The evidence supporting the use of ART (Active Release Techniques) and MR (Myofascial Release) is growing:

Scapular shoulder pain

Wannapong- Immediate and short term effect of modified active release technique (mART) in patients with scapulocostal syndrome Associated Medical Sciences, Chiang Mai University

The mART with usual care of physical therapy showed immediate and short term effects for pain reduction and improvement of cervical and shoulder range of motion in patients with scapulocostal syndrome

Tennis elbow

Harneet, K.M Efficacy of ART in Tennis Elbow-   Indian Journal of Physiotherapy & Therapy; Jul-Sep 2012, Vol. 6 Issue 3, p126 

ART is effective in reducing (Tennis Elbow) pain, improving strength and functional performance.

Trivedi, P. et al Comparison of ART and MR on Pain, Grip Strength, & Functional Performance in Patients with Chronic Lateral Epicondylitis.  International Journal of Physiotherapy and Research 2014, Vol 2(3):488-94  

ART and MR were effective in all three outcome measures when compared to a control group. MR was more effective in improving grip strength & reducing pain & disability when compared to ART. 

Hamstring flexibility

Kage, Vijay.  Immediate effect of ART versus Mulligan bent lag raise in subjects with hamstring tightness: RCT.  Int J Physiother Res 201, Vol 2(1):301-04

A single session of ART is better as compared to MBLR technique to improve hamstring flexibility and range of motion.

Shah, S and Kage, V.  Comparative Effectiveness of ART and Rolfing on hamstring tightness in normal subjects. RCT  IJPR 

ART showed better improvement as compared to Rolfing in terms of Popliteal angle.

George, JW et al   The effects of ART on hamstring flexibility  J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):224-7.

a single session of ART increased hamstring flexibility in a group of healthy males

Neck pain

Kim JW Effects of the ART on pain and range of motion of patients with chronic neck pain   J Phys Ther Sci. 2015 Aug; 27(8):

ART and joint mobilization are both effective for the treatment of patients with chronic neck pain, but ART demonstrated a trend toward greater effectiveness for patients with neck pain involving soft tissue injury. Therefore, ART appears to be a better option for treating patients with chronic neck pain in the clinical setting.

Overuse syndromes

Schiottz-Christensen, Vert Mooney, et al.  The Role of Active Release Manual Therapy for Upper Extremity Overuse Syndromes—A Preliminary Report  Journal of Occupational Rehabilitation , Volume 9, Issue 3, pp 201-211

Results at one month and three months demonstrated a 71% efficacy rate, which when compared to similar studies in literature was superior. As a result of this study, recommendation of further use of this innovative technique is justified.

Plantar fasciitis

Kage, V and Bindra, R.   Effect of ART v/s myofascial release(MR) on subjects with plantar fasciitis: a randomized clinical trial. —  Physiotherapy Journal May 2015

The Results concluded that MR and ART both were equally effective in reducing pain and improving the functional ability in subjects with Plantar Fasciitis.

Ajimsha MS et al 2014 Jun;24(2):66-71. Effectiveness of MR in the management of plantar heel pain: a RCT.  Foot
 This study provides evidence that MFR is more effective than a control intervention for plantar heel pain.

Kuhar S. et al  Effectiveness of Myofascial Release in Treatment of Plantar Fasciitis: A RCT Indian Journal of Physiotherapy and Occupational Therapy

It is concluded that myofascial release is an effective therapeutic option in the treatment of plantar fasciitis.

Gluteus medius

Tak S.  The effects of active release technique on the gluteus medius for pain relief in persons with chronic low back pain.  Korean Academy of Physical Therapy Rehabilitation Science.  2013

Our results suggest that the response to ART may be usable to treat low back pain. ART was presented to reduce pain level of low back in people with chronic low back pain. Further study is required to management for low back pain due to gluteus medius and more ART study

Follow me on Twitter

Full list of ART articles and research!

You may also some other articles I wrote or contributed to:

Telegraph  The ART of Active Release Techniques for Injuries

STACKNew Age of Golf Training is Creating Stronger and More Athletic Golfers

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  ART- How is it different from sports massage

Vigour Magazine  ART can release tight muscles to improve performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

TPI What Performance Therapy Looks Like For Top Golfers

Full List

 

 

  • Leahy P.M., Mock L.E. Myofascial release technique and mechanical compromise of peripheral nerves of the upper extremity. Chiropract Sports Med. 1992;6:139–150.
  • Pedrelli JBMT ’08. Study finds manual therapy helps patellar tendinopathy (itis) in the short and long term. “Treating patellar tendinopathy with Fascial Manipulation”
  • Leahy, Michael: Improved Treatments for Carpal Tunnel and Related Syndromes. Chiropractic Sports Medicine; Vol. 9, No. 1, 1995. –
  • Miners  Chronic Achilles Tendinopathy: ART, Graston, eccentric exercise, and ice. J Can Chiropr Assoc. Dec 2011; 55(4): 269–279.
  • Robb, A., Pajaczkowski, J. ‘Immediate effect on pain threshold using active release technique on adductor strains: pilot study’,  Journal of bodywork and movement therapies, 2011, volume 15, num. 1, pp. 57-63
  • Howitt SD.  Lateral epicondylosis: a case study of conservative care utilizing ART® and rehabilitation  J Can Chiropr Assoc. Sep 2006; 50(3): 182–189.
  • Pajaczkowski J.A. Mimicking turf-toe: myofascopathy of the first dorsal interosseous muscle treated with ART. J Can Chiropr Assoc. 2003;47:28–32.
  • Howitt, S., Wong, J., & Zabukovec, S. (2006). The conservative treatment of Trigger Thumb using Graston Techniques and Active Release Techniques. Journal of the Canadian Chiropractic Association, 50(4), 249-254.
  • Spina, A. External coax saltans (snapping hip) treated with Active Release Technique®: A case report. Journal Canadian Chiropr Assoc 2007; 51(1): 23-29.
  • Scott Howitt, Sarah Jung, Nicole Hammonds. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report: J Can Chiropr Assoc 2009; 53(1)23-31.
  • Buchberger DJ.  Use of ART in post-op shoulder (case report) J Sports Chiro Rehab ’99; 13:60-65
  • Buchberger D.J. Use of active release techniques in postoperative shoulder: a case report. J Sports Chiropr Rehabil. 1999;13:60–65.
  • Yuil, E.A, Macintyre, I.G., ‘Posterior tibialis tendinopathy in an adolescent soccer player: a case report’, The Journal of the Canadian Chiropractic Association, 2010 December, 54( 4) 293-300
  • Durante, JC.  Pudendal Nerve Entrapment in an Ironman Athlete.  J Can Chirop Assoc. Dec ’10 54(4) 276-281
  • Woodward, JS.  Non- surgical treatment of a professional ice hockey player with signs and symptoms of a sports hernia Int J Sports Phys Ther. 2012 Feb; 7(1): 85–100.

 

Posted in Active Release Techniques Tagged with:

Elbow pain in golfers, what to do!

Tendon pain at the elbow is common in golfers. When on the inside it is called Golfer’s Elbow and when on the outside it is called Tennis Elbow. Some tips:

A Patient Guide to Lateral Epicondylalgia (LE) aka Tennis Elbow.

  1. Research shows Myofascial Release is better than standard therapies.
  2. Exercises help- try isometric (no movement) and eccentric (negatives) exercises.
  3. There is some inflammation in some tendon problems, ice may help after heavy use.
  4. MRI may be better than diagnostic ultrasound in identifying LE.
  5. Steroid injections don’t provide long-term benefit.

Should I ice it? The inflammation debate!  There may  be some swelling but in most cases ice is not needed.

Over the last few decades, LE stopped being considered a tendinitis because little evidence of inflammatory markers were found.  Tendinopathy became the new term of choice, but recent research found convincing evidence that the inflammatory response is a key component of chronic tendinopathies like LE.   My take: some inflammation is there, but it may be an important part of healing.  Only ice after heavy use.

What causes the pain?

In a nutshell, tendinosis involves too much tendon breakdown and not enough repair. When repetitive micro trauma damages cells, they create new collagen which is structurally different.

Is exercise the answer?

Exercises helped relieve pain in the short-term compared to no intervention 2011 study.

Exercises should progress from isometrics to eccentrics-

Isometric exercises involve putting a muscle and tendon under tension, but no movement.  In some cases I give this exercise with the wrist and finger in varied positions.

Eccentric exercises with a band for LE are often helpful and easy to do.

Will it go away on its own?

2002 study found in 83% of cases of LE resolved at 52 weeks with no intervention

Does manual therapy help?

Researchers compared Active Release Techniques (ART) and Myofascial Release to a control  group receiving therapeutic ultrasound, 1 2 the release techniques were found to be much more effective. Two case reports  also found them effective 1 2.  A recent study found myofascial release effective in treating plantar fasciitis, which is similar to tennis elbow.

What about injections?

Steroid injections were found to provide worse outcomes than placebo in a 2013 study.  “There may be a short-term pain relief advantage found with the application of corticosteroids, but no demonstrable long-term pain relief” – 2014 review

Are MRIs or ultrasound scans needed?

2014 review concluded, “power doppler ultrasonography and real-time sonoelastography (is) expensive, and …this technology did not significantly add to the sensitivity and specificity of Gray-scale Ultrasonography”.

There is evidence of MRI signs of oedema on the asymptomatic side of many LE patients. Thickening or partial tearing was not found on the asymptomatic side. Therefore if the non-painful side shows swelling, it may not be important for an MRI to find the sore side has swelling!

Conclusion

Combine manual therapy with an exercise program, before getting an injection.

 

 

 

 

 

Posted in exercises, Lateral Epicondylalgia, Myofascial Release

Plantar Fasciopathy Workshop by Tom Feeney

Health care providers who use therapy and prescribe exercise, like Manual Therapy UK for more original content, and information on my workshops!

Plantar Fasciopathy (PF) and Achilles Tendinopathy (AT) workshops.

email me to book  tjfdc@hotmail.com

Thursday 28 Jan 6 PM to 9:30 £45 at North Yorkshire Physiotherapy in Stokesley

  • latest research on PF and AT
  • mobilization of the arch of the foot
  • manipulation of the talocrural joint
  • exercise progression for PF and AT
  • when and when not to give stretches
  • hands-on myofascial slide release (not ART)!

Presenter bio: Myofascial Release Sports Chiro since 1997, working in Montreal, Philadelphia, and Newcastle upon Tyne.  I’ve treated Olympic athletes, WWE wrestlers, NHL, NFL, and Premiership footballers.  I’ve taught seminars on core training, movement assessment, and soft tissue work to hundreds of health care providers. I’ve written or contributed to health articles in numerous publications (see links at the bottom of the page).

Testimonials:

“The plantar fasciitis seminar was rewarding, as it’s really hands on. I appreciated that it’s research based and practice based as well.” Anne Carbonnel DC, Heaton

“Tom is a patient teacher who really knows the research behind therapy and sports injuries. You can implement his stuff immediately.”  Russell Purchon DC, Hexham Family Chiropractic

Research- manual therapy for PF:
  • The 2014 American Physical Therapy Association Guidelines for Plantar Fasciitis – found strong evidence that manual therapy, exercises, taping, and night splints were effective.
  • Studies in 2014 and 2007  found myofascial release of the calf and plantar fascia more effective than just conventional therapy.
  • 2015 study – Myofascial Release effective in treating PF. 
  • 2015 study – mob / manips are effective in increasing ankle dorsiflexion
  • 2014 study compared deep calf massage plus stretching and neural mobilization to ultrasound therapy plus stretching.  Massage / neural mobilization yielded much better results.
  • 2011 study – trigger point therapy plus self-stretching resulted in superior short-term outcomes as compared to a self-stretching program alone.
Research- exercises and stretches:
  • Cheung 2015-

    Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis –

    “There was significant greater rearfoot intrinsic muscle volume in healthy runners than runners with chronic plantar fasciitis “

  • 2014 study –compared high load calf raise (video) (with Windlass mechanism -extended MTP joints) exercises to plantar specific stretching.  The high load group had better results, check out the study for pictures.   
  • 2014 study – eccentric training for Achilles tendon insertion pain no better than conventional therapy.
  • 2014 study -windlass stretch slightly more effective than myofascial release. 
  • Exercise should focus on the gastrocnemius in isolation and in combination with the soleus. A 2011 study found that the gastrocnemius is tight in 57% of PF cases, the gastroc /soleus in 26%, and 17% had normal ROM.  Take away message, don’t forget the gastroc!
  • A non-weight bearing plantar fascia stretching program may be more effective than standing calf stretches.  An at-home frequent seated stretch is worth trying for PF sufferers.
  • 2014 study  PNF stretching better than a control for increasing gastrocnemius flexibility. A recent study found foam rolling before static stretching to be better at increasing ROM, than foam rolling or stretching alone at the hip.  Give it a try at the ankle.
  • Where the flexor digitorum brevis attaches to the calcaneus is the most common site for heel spurs, not where the plantar fascia attaches.
  • Strengthening the flexor digitorum brevis (FDB) and / or the  flexor hallucis brevis may take some pressure off of the plantar fascia.   The paper grip test (fig 4) is a good way to see if the FDB is weak.
Does prolonged standing cause PF?

Maybe!

A 2015 review of the literature of the topic found,  “low-quality evidence of an association between PF and weight-bearing tasks such as walking and standing on hard surfaces”. 

Putting it all together:
  • evidence based myofascial slide release 
  • PNF stretching of the gastroc and soleus
  • non-weight bearing static stretching
  • high load isometric calf raises
  • bare foot exercises
  • calf lowering eccentrics (it may be better to do isotonics)
  • flexor digitorum and flexor hallucis tests /exercises
  • Foot tripod exercises are great to add when the patient is ready.

 

For more go to – Manual Therapy UK  

Articles on soft tissue therapy I wrote or contributed to:

Telegraph  Active Release Techniques for injuries

STACK  New Age of Golf Training is Creating Stronger and More Athletic Golfers

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  Sports massage and ART differences

Vigour Magazine  Sports Performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

Titleist Performance Institute  What Performance Therapy Looks Like For Top Golfers

Podcasts

Ben Coomber Radio 

Propane Fitness

Posted in exercises, Myofascial Release

How Technology Helps The World’s Best Golfers Train Smarter

Many of the world’s best golfers now work harder and just as importantly, smarter than ever on their fitness and strength training. High tech video analysis is employed to find swing faults that the naked eye can’t detect. The information gleaned by the tech experts is used by the health and fitness staff to develop a training and therapy regime. Patrick Reed might not be on board, but Jordan Spieth, Shane Lowry, and Rory McIlroy are.

“I started to work on my fitness and strength for injury prevention and biomechanical standpoint. I got biomechanically analyzed in 2011 and we saw my peak club head speed was 18 inches before impact, my club was slowing down before I hit the ball. That was because I basically had no stability in my hips, my glutes, and my legs, especially on my left side, so a lot of stability work on my legs and my core and legs. I’ve always been able to create speed, but haven’t always been able to hold onto it through impact. ..  I’m doing a lot of single leg work. I’ve always had the ability to turn my hips fast and to have that explosive power, but if I’m not able to hold on to it or control it then either the ball is going to go all over the place or I’m not going to be able to control it” Rory McIlroy from Me and My Golf

A new health and training paradigm

The new paradigm in golf training involves biomechanical analysis of the golf swing and much more. In addition to high tech swing analysis, players are given a full body movement screen which tests flexibility, balance, stability, and coordination. Biomechanical issues, imbalances, weaknesses, and negative tendencies are all assessed. One company that is at the forefront of this paradigm is Titleist Performance Institute (TPI). They put an emphasis on players improving movement fundamentals of mobility, coordination, and balance, and only when these fundamentals are mastered does strength, endurance, power, and skill acquisition become the focus of training. One player who uses a team full of TPI experts is world number one Jordan Spieth.

A key member of Spieth’s team is TPI Chiropractor Troy Van Biezen, the two have worked together since the days when Spieth was looking for a prom date. Van Biezen who also looks after Zach Johnson, Jason Dufner, and Rickie Fowler, must be doing something right. The advanced swing analysis can flag up biomechanical issues, but the golfer’s health and fitness team need the manual therapy and corrective exercise knowledge to address the issues. A good example of where Van Biezen and the rest of Team Spieth put the paradigm to use was when his coach Cameron McCormick, noticed a tendency for him to sway when swinging. Van Biezen and Spieth’s trainer Damon Goddard worked to increase his hip mobility.  “The soft tissue component is crucial, imbalances and dysfunctions need to be addressed.”  said Van Biezen who uses A.R.T. soft tissue therapy.

IMG_7583IMG_9783

Van Biezen with Jordan Spieth and Zach Johnson celebrating major victories!

“Troy Van Biezen has been an integral member of my team since high school, I trust him fully and he now tours with me. Chiropractic care with a goal of achieving better postural balance and injury prevention, has been invaluable to my health, performance, and success.” Jordan Spieth 

How can recreational golfers train smarter and prevent lower back pain?

One thing full body movement screening often detects is stiffness of the mid to upper back. Lower back pain in golfers is an example where addressing the problem is often best served by improving flexibility. “If the mid-back and hips are not rotating enough the lumbar spine may compensate and the lumbar spine is not designed for a great deal of rotation”, says TPI / ART Chiropractor Shane Lawlor who has spent many years on tour with the likes of Shane Lowry and Padraig Harrington. “Some of the mistakes that I see amateur & professional golfers make is a poor warm up routine and not investing enough in hands on therapy. The biggest downfall is that they neglect to build a team around them. All of these contribute heavily to the common injuries experienced in the sport.”

shanex2

Photo golffile.photoshelter.com

“Shane is an integral part of my performance team and he has definitely added to my game over the past 3 years. His combined skills of Chiropractic & ART ensure that I am prepared physically for each round I play. I believe working with Shane is helping me to prevent injuries and will hopefully lengthen my career.” Shane Lowry

Two versions of this post were published:

The New Age of Golf Training is Creating Stronger and More Athletic Golfers Than Ever Before

What Performance Therapy Looks Like For Top Golfers

You may also like:

High Hamstring Strain: Best Low Compression Exercises

Best Glute Medius Exercises for Runners

Articles:

Telegraph  The ART of Active Release Techniques for Injuries

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  ART- How is it different from sports massage

Vigour Magazine  ART can release tight muscles to improve performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

Posted in exercises

The Best Active Release Techniques Articles of 2015

Health care providers who use therapy and prescribe exercise, like Manual Therapy UK for more original content, and information on my workshops!

Articles

Telegraph  The ART of Active Release Techniques for Injuries

STACK  New Age of Golf Training is Creating Stronger and More Athletic Golfers

Athletics Weekly  Performance Therapy for Greg Rutherford

Austin Fitness Magazine  Q and A on ART 

Vigour Magazine  ART can release tight muscles to improve performance

Progenex  ART for CrossFitters

Health & Fit Magazine  Address Soft Tissue Problems to Help Heal Your Body

FIT Institute  Research based hamstring therapies

TPI  What Performance Therapy Looks Like For Top Golfers

TV Segments 

KXON

Best of 2014

220 Triathlon  What is ART and how is it different from sports massage?  

Scifighting  ART for MMA Fighters

Athletes Acceleration  ART: neuromuscular efficiency / stability / mobility 

Running Competitor  Injury Prevention is an ART

Nations Tri  ART- Your New Secret Weapon 

Bobdybuilding.com “I’ve written about the value of ART many times. I’ve seen it clear up a number of nagging injuries in a single session. It can restore function, reduce (and even eliminate) pain, significantly improve flexibility (i.e. range of motion) and strength in just one session.” John Paul Catanzaro

Product of Running  My Experience with ART

Bryan Kelly “USA’s Top Hip Surgeon” on why he uses ART 

“Hip injuries occur in the hip joint but often times result in secondary muscular injuries over time ( i.e. flexor tendonitis, trochanteric bursitis, lower back pain, hamstring pulls). ART has been very successful in decreasing pain associated to these muscular injuries. We have found that patients do much better post operatively if the muscular pathology is addressed prior to surgery.”

Grantland

“We recognize that the management of soft tissue is the critical component to a player’s health,” said Boston Red Sox GM Ben Cherington. ““If we can find people who are at the top of their field to be hands-on with our players and create, I don’t know, a 5 percent difference in how much [the players are] out there or their level of physical fitness when they’re out there, that can translate into greater performance.”

Teemu Selanne NHL ice hockey star who retired at 43 yo,

“ART has been huge for me. Unbelievable. Seriously, it’s the most important reason why my muscles are in such great shape. I go twice a week (in Anaheim) and go here when I’m on the road. And I hope the young guys will realize how important this is, but they’re younger and don’t get it – but they will. The older we get, the toughest challenge is recovery time. You have to be very disciplined with that and your diet and ART.”  ART has been Teemu Selanne’s MVP

Matt Connery Senior Physiotherapist Everton FC 

“ART is a superb soft-tissue, diagnostic, and treatment modality which has shown time and time again to be effective in both the elite sport setting and general MSK therapy.”

Wayne Diesel   Head of medical services Tottenham FC 

“ART challenges you as a practitioner to have exceptional knowledge of functional anatomy. It allows more specificity which I have found particularly useful for spinal issues, being able to target individual multifidi.  I would recommend ART for its ability to treat specific issues as part of your regular treatment regimen, this can at times reduce of overall  treatment times.  In an elite sports environment, having several therapists all trained in ART is a tremendous help in continuity of treatment.”

TV segments

My9NJ.com

Reno Nevada 2 News

Georgia WTOC

San Diego Fox 5 

Posted in Active Release Techniques Tagged with:

Active Release Techniques (ART) Tennis Elbow

For more fitness, rehab, and news about our Tennis Elbow Workshops, follow us on Facebook and Twitter.

A Patient Guide to Lateral Epicondylalgia (LE) aka Tennis Elbow.

  1. Research shows Myofascial Release is better than standard therapies.
  2. Exercises help- try isometric (no movement) and eccentric (negatives) exercises.
  3. There is some inflammation in some tendon problems, ice may help after heavy use.
  4. MRI may be better than diagnostic ultrasound in identifying LE.
  5. Steroid injections don’t provide long-term benefit.

Should I ice it? The inflammation debate!  There may be some swelling but in most cases ice is not needed.

Over the last few decades, LE stopped being considered a tendinitis because little evidence of inflammatory markers were found.  Tendinopathy became the new term of choice, but recent research found convincing evidence that the inflammatory response is a key component of chronic tendinopathies like LE.   My take: some inflammation is there, but it may be an important part of healing.  Only ice after heavy use.

What causes the pain?

In a nutshell, tendinosis involves too much tendon breakdown and not enough repair. When repetitive micro trauma damages cells, they create new collagen which is structurally different.

Is exercise the answer?

Exercises helped relieve pain in the short-term compared to no intervention 2011 study.

Exercise progression- isometrics before eccentrics

Isometric exercises involve putting a muscle and tendon under tension, but no movement.  In some cases I give this exercise with the wrist and finger in varied positions.

Eccentric exercises with a band for LE are often helpful and easy to do.

Will it go away on its own?

2002 study found in 83% of cases of LE resolved at 52 weeks with no intervention

Does manual therapy help?

Researchers compared Active Release Techniques (ART) and Myofascial Release to a control group receiving therapeutic ultrasound, 1 2 the release techniques were found to be much more effective. Two case reports  also found them effective 1 2.  A recent study found myofascial release effective in treating plantar fasciitis, which is similar to tennis elbow. Find an ART provider near you.

What about injections?

Steroid injections were found to provide worse outcomes than placebo in a 2013 study.  “There may be a short-term pain relief advantage found with the application of corticosteroids, but no demonstrable long-term pain relief” – 2014 review

A 2016 trial found- “Among patients with chronic unilateral LE, the use of corticosteroid injection vs placebo injection resulted in worse clinical outcomes after 1 year, and physiotherapy did not result in any significant differences.”

Are MRIs or ultrasound scans needed?

2014 review concluded, “power doppler ultrasonography and real-time sonoelastography (is) expensive, and …this technology did not significantly add to the sensitivity and specificity of Gray-scale Ultrasonography”.

There is evidence of MRI signs of oedema on the asymptomatic side of many LE patients. Thickening or partial tearing was not found on the asymptomatic side. Therefore if the non-painful side shows swelling, it may not be important for an MRI to find the sore side has swelling!

Conclusion

Combine manual therapy with an exercise program, before getting an injection.

Find an ART provider near you.

Make an appointment to see me at  Whitley Bay Chiropractic.

Follow me on Twitter  Manual Therapy UK

Articles on soft tissue therapy I wrote or contributed to:

Telegraph  Active Release Techniques for injuries

STACKNew Age of Golf Training is Creating Stronger and More Athletic Golfers

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  Sports massage and ART differences

Vigour Magazine  Sports Performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

Titleist Performance InstituteWhat Performance Therapy Looks Like For Top Golfers

Podcasts

Ben Coomber Radio 

Posted in Active Release Techniques, Lateral Epicondylalgia, Myofascial Release Tagged with:

Dean Somerset Q and A on Hip Mobility plus more.

Originally posted 2014 

Health care providers who use therapy and exercise like Manual Therapy UK for more great original content, and information on my workshops!

I have treated elite athletes, studied and lectured on motor control / core exercises for 18 years and I learn something from every article Dean Somerset writes. 

Dean is a personal trainer, author, writer at T-nation.com, and international public speaker whose main area of expertise is injury and medical dysfunction management through optimally designed exercise programs. 

Check out this video of Dean helping hip rotation with core work. (See question 4)

1. How do you balance deceleration exercises (fast twitch) with distraction / compression (slow twitch) exercises for the shoulder rotator cuff?

It depends on their stage of healing and what their training experience is, as well as what their overall goal is. When it comes to a surgical repair, initial training is more passive or low load range of motion training and light isometrics, which will be followed by some light loaded carries, positional stability and perturbation work, and then eventually moving into heavy loaded carries, pressing and pulling. Typically when people think balancing the program they think of pulling v pushing movements, in which most cases involve a 3:1 ratio of pull to push, especially with a previous history of injury to the cuff. When it comes to stability, I would say it’s something that can be worked on with other exercise, with demands that can run the continuum of force application and velocities. With throwers, Eric Cressey uses a really good protocol.

 2. Do you think tibia – fibula movement restrictions are important / detectable / treatable?

I would be more concerned with tibial rotation during a terminally extended knee, but everything can play a role. I honestly haven’t looked into the aspects of tib/fib movement too much so I can’t really comment on whether it’s something detectable through manual testing or movement analysis separate from ankle pronation/supination. 

3. What is your take on the “butterfly effect” theory that fascial restrictions impact distant structures?

I understand that it’s possible for distance structures to influence each other, but I prefer the ripple effect theory proposed by Mike Reinold, in which the areas of the body in closer proximity with the insult will show the biggest effects. There’s a lot of stop-overs to go from the ankle to the neck, and each segment will tend to adjust to the stressors placed on it, so it’s pretty difficult to go from one extreme to another without being buffered somewhere along the line. 

4. I’ve found your video on addressing hip mobility with planking activation (motor control) to be very useful, especially in lifters who don’t plank. The pain science crowd think threat response is under appreciated compared to motor control. Your thoughts?

They’re both important to understand, but it depends on which one is being presented at the time. In my experience, you can state anything you like as the causative factor, especially when it’s something that can’t readily be removed as a variable in order to test its’ effects. Threat response makes sense in a concept that we’re trying to prevent injury to ourselves, but we’re also notoriously able to shut up our better judgment and do stupid stuff all the time, as evident by college frat houses and dumb internet fail videos.

  Read more ›

Posted in exercises Tagged with:

Golf Training and Therapy

A behind the scenes look at how professional golfers like Jordan Spieth and Shane Lowry maximize their athleticism, and some tips for how average golfers can improve theirs.

Improving biomechanics with golf training!

The name of the game in modern golf training is improving athleticism. Tour players now work harder and very importantly smarter than ever on their fitness and strength training. They use the high tech video analysis to find swing faults that the naked eye can’t detect. Most of the top golfers in the world tour with a team of experts who use the information gleaned from this technology and other tests to develop a training and therapy regime to address any biomechanical issues found. Rory McIlroy is one of many players who have embraced this philosophy as the following quote clearly shows.

“I started to work on my fitness and strength for injury prevention and biomechanical standpoint. I got biomechanically analyzed in 2011 and we saw my peak club head speed was 18 inches before impact, my club was slowing down before I hit the ball. That was because I basically had no stability in my hips, my glutes, and my legs, especially on my left side, so a lot of stability work on my legs and my core and legs. I’ve always been able to create speed, but haven’t always been able to hold onto it through impact. .. I am always doing lower body work on a wobble cushion or BOSU ball, I’m doing a lot of single leg work. I’ve always had the ability to turn my hips fast and to have that explosive power, but if I’m not able to hold on to it or control it then either the ball is going to go all over the place or I’m not going to be able to control it” Rory McIlroy video from Me and My Golf

If you’re not assessing, you’re just guessing

A new paradigm has emerged in golf training, it involves biomechanical analysis of the golf swing and much more. In addition to high tech swing analysis, players are given a full body movement screen which tests flexibility, balance, stability, and coordination. A bespoke training and therapy regime is created using the findings to improve a player’s mechanical issues, weaknesses, and negative tendencies. One company that is at the forefront of this paradigm is Titleist Performance Institute (TPI). They put an emphasis on players improving movement fundamentals of mobility, coordination, and balance, and only when these fundamentals are mastered does strength, endurance, power, and skill acquisition become the focus of training. One player who uses a team full of TPI experts is world number one Jordan Spieth.

Spieth is under the care of TPI Chiropractor Troy Van Biezen on tour, who also looks after Zach Johnson, Jason Dufner, and Rickie Fowler. Van Biezen told me, “Each player has individual tendencies and imbalances that are checked every morning and addressed to stay on top of them. After the round, corrective based exercises are employed.” One example where Spieth’s team used swing analysis technology , therapy, and training together occurred when his coach, Cameron McCormick, noticed a tendency for him to sway when swinging. McCormick then asked Van Biezen and Spieth’s trainer to focus on increasing Spieth’s hip mobility. Van Biezen said, “The soft tissue component is crucial, imbalances and dysfunctions need to be addressed.” The system must be yielding results as the group of players he treats on tour are winning majors and are at the top of the world rankings.

The importance of reducing soft tissue restrictions

In many cases, tailored exercises can improve imbalances but some soft tissue and joint restrictions are harder to shift. Many of the best golfers in the world including Van Biezen use Active Release Techniques® (ART) providers it the market leading soft tissue therapy in the world. The technique involves a patient shortening a muscle, the ART provider applies tension to the muscle with his/her fingers. The patient then stretches the muscle, pulling the muscle under the provider’s contact. The manual tension combined with the movement of the muscle improves flexibility immediately. Golfers who aren’t naturally athletic often need to work on soft tissue and joint flexibility.

Prefer an at home solution? Try foam rolling!

Foam rolling has grown massively in popularity over the last few years, and now even researchers have backed up the word of mouth evidence. Researchers may not know why it works, or exactly how long to roll, but they’ve found it does reduce pain and increase flexibility. The areas were foam rolling is particularly effective in increase increasing flexibility are the mid-back, hamstrings, and calves. Researchers found a short session of static stretching followed by foam rolling to be more than doing only one or the other. Stay off bony bits, and away from the top lateral side of the calf (to avoid a superficial nerve there).

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Van Biezen with Jordan Spieth and Zach Johnson celebrating major victories!

“Troy Van Biezen has been an integral member of my team since high school, I trust him fully and he now tours with me. Chiropractic care with a goal of achieving better postural balance and injury prevention, has been invaluable to my health, performance, and success.” Jordan Spieth World #1

How to take the pressure off of the lower back

Lower back pain in golfers is an example where addressing the problem is often best served by improving flexibility. “If the mid-back and hips are not rotating enough the lumbar spine may compensate and the lumbar spine is not designed for a great deal of rotation”, says TPI / ART Chiropractor Shane Lawlor who has spent many years on tour with the likes of Shane Lowry and Padraig Harrington. “Some of the mistakes that I see amateur & professional golfers make is a poor warm up routine and not investing enough in hands on therapy. The biggest downfall is that they neglect to build a team around them. All of these contribute heavily to the common injuries experienced in the sport.”

shanex2

Photo golffile.photoshelter.com

“Shane is an integral part of my performance team and he has definitely added to my game over the past 3 years. His combined skills of Chiropractic & ART ensure that I am prepared physically for each round I play. I believe working with Shane is helping me to prevent injuries and will hopefully lengthen my career.” Shane Lowry

How can recreational golfers train smarter and prevent lower back pain?

The average hacker has the same flexibility problems as the professionals, only worse in most cases. If you feel your flexibility or balance is holding your golf training seek out a TPI professional who works with an ART soft tissue specialist. If that isn’t possible, here are some tips to find your imbalances so you can train them away. It is often wise to work the weaker side more often until both sides are even and then go back to more traditional exercises like deadlifts and squats. Always train at a level that is safe for you, these exercises should be mastered at an easier level before made more difficult.

Articles I wrote or contributed to:

Telegraph  The ART of Active Release Techniques for Injuries

STACK  New Age of Golf Training is Creating Stronger and More Athletic Golfers

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  ART- How is it different from sports massage

Vigour Magazine  ART can release tight muscles to improve performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

TPI  What Performance Therapy Looks Like For Top Golfers

Podcasts:

Ben Coomber Radio

Propane Fitness

Posted in Active Release Techniques, exercises Tagged with: , ,

Performance Therapy for Golfers

Health care providers who use therapy and prescribe exercise, like Manual Therapy UK for more original content, and information on my workshops!
Two versions of this article have been published – 

New Age of Golf Training is Creating Stronger and More Athletic Golfers – STACK.com

What Performance Therapy Looks Like For Top Golfers – TPI

Many of the world’s best golfers now work harder and just as importantly, smarter than ever on their fitness and strength training. High tech video analysis is employed to find swing faults that the naked eye can’t detect. The information gleaned by the tech experts is used by the health and fitness staff to develop a training and therapy regime. Patrick Reed might not be on board, but Jordan Spieth and Rory McIlroy are. 

“I really started to work on my fitness and strength in the end of 2010 and the start of 2011. It was really from an injury prevention standpoint, but also from a biomechanical standpoint. I got biomechanically analyzed and we saw that my peak club head speed was about 18 inches before I actually hit the ball. My club head was slowing down when I hit the ball. And that was because I basically had no stability in my hips, my glutes and my legs, especially in my left side. So a lot of stability work in my legs, a lot of core work. I’ve always been able to create the speed, but I didn’t have the strength and stability to hold onto that speed through impact. If you see me in the gym, I’m always on a wobble cushion or a BOSU Ball, and I’m doing a lot of single-leg work.” Rory McIlroy Me and My Golf, 

The game of golf is changing, athleticism and strength is more important than ever. The best golfers in the world use Active Release Techniques® (ART) providers who specialize in Titleist Performance Institute (TPI) exercise prescription.  Troy Van Biezen and Shane Lawlor are two ART / TPI experts who have been on tour for years with some of the biggest names in golf.  Van Biezen works with Jordan Spieth, Jason Dufner, Zach Johnson, Rickie Fowler, Nick Watney,.. while Lawlor has been on the european Tour for 6 years with the likes of Shane Lowry and Padraig Harrington.

The importance of expert soft tissue therapy

The focus of golf performance therapy is to ensure that the golfer has full range movement of the spine, shoulders, hips,knees, and ankles.  Imbalances or asymmetries of movement can cause other areas of the body to compensate. Often muscles and sometimes joint capsules restrict flexibility. Hands on manual therapy is the quickest way to address most flexibility issues. “The soft tissue component is crucial, imbalances and dysfunctions need to be addressed.” says Chiropractor Troy Van Biezen with two-time major winner Zach Johnson and Jordan Spieth world number one.

IMG_9783IMG_7583

 

“Troy Van Biezen has been an integral member of my team since high school, I trust him fully and he now tours with me. Chiropractic care with a goal of achieving better postural balance and injury prevention, has been invaluable to my health, performance, and success.” Jordan Spieth

Van Biezen uses a soft tissue therapy called, Active Release Techniques (ART).  It is the market leading soft tissue therapy in the world, almost every professional sports team in North America employs an ART provider. The technique involves a patient shortening a muscle, the ART provider applies tension to the muscle with his/her fingers.  The patient then stretches the muscle, pulling the muscle under the provider’s contact.  The manual tension combined with the movement of the muscle improves flexibility immediately. 

If you’re not assessing, you’re just guessing

During the week of a golf tournament, Van Biezen takes his athletes through an assessment every morning. Van Biezen describes the normal routine as, “Players get a functional assessment including muscle testing and joint range of motion testing two hours before tee-times, we follow it up with hands on treatment and a dynamic warm-up. Each player’s individual tendencies and imbalances are checked and addressed to stay on top of them. After the round, corrective based exercises are employed.” The system must be yielding results as the players he tours with are higher than ever in the world rankings.

Movement screening is used to find imbalances. Weaker muscles often over work, and as imbalances become worse the weaker muscle can break down and becomes painful. After applying the hands on therapy specific exercises are used to address the imbalances which the screening has flagged up. A couple of good example occurred recently, one with Nick Watney, “Nick was struggling with his swing one week, and he brought his coach in. The imbalances and weaknesses we found in the screening evaluation were evident in his golf swing. I was able to show his coach what we usually see, his typical patterns and how we correct it through soft tissue adjustments and corrective exercises”.  The other example occurred when Spieth’s TPI Certified coach Cameron McCormick  noticed a tendency for him to sway when swinging. McCormick asked Van Biezen and his trainer to focus on increasing Spieth’s hip mobility.

How to take the pressure off of the lower back

Lower back pain in golfers is an example where addressing the problem is often best served by getting better movement of the hips and mid-back.  “If the mid-back and hips are not rotating enough the lumbar spine may compensate and the lumbar spine is not designed for a great deal of rotation”, says Chiropractor Shane Lawlor who has spent many years on tour with the likes of Shane Lowry and Padraig Harrington. Lawlor who is also ART and TPI certified is an expert in providing his players tailored rehabilitation and training programs. The tour players need efficient and effective training due to time constraints. He told me, “Some of the mistakes that I see amateur & professional golfers make is that of a poor warm up routine and not investing enough in hands on therapy. The biggest downfall is that they neglect to build a team around them. All of these contribute heavily to the common injuries experienced in the sport. My advice would be to look at the TPI database and to search for golf, medical and fitness professionals in your local area. These experts can put you through a comprehensive assessment, coaching, treatment and rehabilitation based on your needs. This will allow you to play more consistent and pain free golf in the long term.”

shanex2

Photo golffile.photoshelter.com

“Shane is an integral part of my performance team and he has definitely added to my game over the past 3 years. His combined skills of Chiropractic & ART ensure that I am prepared physically for each round I play. I believe working with Shane is helping me to prevent injuries and will hopefully lengthen my career.” Shane Lowry

How can recreational golfers benefit?

The average hacker has the same flexibility problems as the professionals only worse in most cases. If you feel your flexibility or balance is holding your game back seek out a TPI professional who works with an ART soft tissue specialist.  Flexibility issues can occur in the neck, shoulder, mid-back, hips, hamstrings and/or the calves.  Getting them assessed properly by an expert is the starting point, get focused therapy, and then a tailored exercise program to maximize your athleticism, just like the professionals do.

 

Read more ›

Posted in Active Release Techniques, Chiropractic, exercises Tagged with: ,

Ankle Dorsiflexion and Active Release Techniques (ART)

Shannon Turley, the Stanford University Strength Coach, was profiled in New York Times and Bleacher Report articles recently. When asked what N.F.L. scouts should focus on, he said, “ankle mobility, the ankle begins the chain of movement“.  Ankle mobility is often limited in athletes without the athlete even being aware of it.  Dorsiflexion is the movement of the foot towards the shin.  If one side is particularly limited then it is vital to address this issue before the body starts to compensate, which can cause dysfunction elsewhere.

A 2014 study of infantry recruits doing intense training found a link between decreased ankle dorsiflexion (with knee bent) and Achilles tendinopathy.

In 2011, there was a study by Backman et al. which tested basketball players for decreased ankle dorsiflexion, the players with decreased dorsiflexion were much more likely to have knee pain within a year.

The basics:

  1. how to  check if normal
  2. self treatment using a foam roller
  3. mobilization drill
  4. PNF stretching which a recent study concluded was very effective after a 6 week program.
  5. prone scoop manipulation works every time

In my opinion, the best way to make a more lasting change in ankle dorsiflexion is by using Active Release Techniques (ART).  I use ART on elite athletes every day to improve dorsiflexion. What separates ART from other approaches is the ability to isolate and treat the ankle ligaments (and work between muscles) which are often the problem.  Of course the soleus often restricts dorsiflexion, but this study demonstrated why treating the gastrocnemius in isolation is wise.   It is important also to check and treat the tibialis posterior, flexor hallucis longus, and the flexor digitorum longus when needed  Each muscle can be tested to see if it is a limiting factor in dorsiflexion, and should always be ruled out.

Side note:  Limited dorsiflexion should not be the assumed cause of a squat that lacks depth, it is important to rule out a threat response, and/or a motor control issue. I will write another blog on that in the future  It is also important to make sure the big toe mobility is adequate, and therefore the foot is able to form a solid three point base.

For more fitness, rehab, and wellness news, follow on Facebook and Twitter.

You may also like:

High Hamstring Strain: Best Low Compression Exercises

Best Glute Medius Exercises for Runners

Research Based Hamstring Therapy – FIT Institute

The New Age of Golf Training is Creating Stronger and More Athletic Golfers Than Ever Before – STACK

Performance Therapy: Greg Rutherford’s StoryAthletics Weekly

The ART of Active Release Techniques Telegraph

How is ART different from Sports Massage  220 Triathlon

Golf Performance Therapy Titleist Performance Institute

Posted in Active Release Techniques, exercises Tagged with: ,

Dynamic Sports Chiropractors

Chiropractors have been treating top athletes back to the heydays of Rocky Marciano and Babe Ruth.  Many of the top athletes in the world have used Chiropractors ever since. While the spine remains the focus of DCs working in sports, many augment their work with other areas of expertise. The following Chiropractors have worked with the biggest names in sport.

Keith Pyne DC has been treating the Washington Nationals Baseball team since 2011, and was recently named chairman of their medical services advisory board. He has treated over 1300 professional athletes from treated over 1,300 professional athletes across all major sports (including: baseball, basketball, football, hockey, boxing, golf, and track & field). His treatment concentrates on the neuromuscular structural integration that resolves injuries and biomechanical discrepancies by addressing the problem in the body’s kinetic chain. 

Troy Van Biezen DC looks after a group of PGA golfers including three in the top ten in the world.  His group has won four majors in the last three years. Van Biezen is a certified Titleist Performance Institute (TPI) coach who relies heavily on movement analysis to augment his hands on work. He describes his approach, “Players get a functional assessment including muscle testing and joint range of motion testing two hours before tee-times, we follow it up with hands on treatment and a dynamic warm-up. Each player’s individual tendencies and imbalances are checked and addressed to stay on top of them. After the round, corrective based exercises are employed.”

 

“Troy Van Biezen has been an integral member of my team since high school, I trust him fully and he now tours with me. Chiropractic care with a goal of achieving better postural balance and injury prevention, has been invaluable to my health, performance, and success.” Jordan Spieth

Niagara Falls based Chiropractor Mark Scappaticci has travelled extensively with the biggest stars from track and field, ice hockey, and baseball.  He developed the Fascial Abrasion Techniques (FAT-Tool™) soft tissue treatment instrument, and had it put it to the test by researchers at the University of Zagreb, Croatia.  They  compared the effects of foam rolling and FAT-Tool therapy on the knee and hip range of motion of soccer players. In the study, both interventions improved thigh muscle flexibility, but only the FAT-Tool’s effect were seen 24 hours later.  Scappaticci combines Chiropractic with a acupuncture, taping, and shockwave therapy.

“My focus had been improving function and performance through understanding the repetitive strains and biomechanics of the individual sport, finding the specific restrictions that were limiting the athlete, and then removing these.” Mark Scappaticci

Gerry Ramogida DC has held the Lombardi trophy with Seahawks and struck Olympic gold working for UK Athletics. I wrote about his work helping chronically injured Greg Rutherford win long jump gold in London 2012.  Ramogida combines fascial work, Active Release Techniques® (ART), acupuncture and movement analysis to improve athlete performance and reduce injury. 

“I first met  at . He is the model for the provider of the future.” Supple Leopard author Kelly Starrett recently tweeted

Ramogida and athletics super coach Dan Pfaff work together at their facility in Phoenix, where they  combine training with therapy – they call it “Performance Therapy”. Ramogida explained performance therapy by saying: “What is required is an understanding of the mechanics required for an athlete to perform their skill or event most effectively. We call it the “athlete-coach-therapist trinity”. The formula is working- if the ALTIS group of 17 athletes were a nation at the 2015 World Athletics Championships, they would have ranked 11th in the medals table.

Posted in Chiropractic

How is ART therapy different from sports massage?

This article originally appeared in 220triathlon magazine. 

We ask a practitioner of Active Release Techniques about the injuries it can treat, what it involves and where to find a provider  

Do you have a niggle that stubbornly refuses to be fixed by traditional sports massage? Heard about the popularity of Active Release Techniques with elite athletes and wondering what’s the dealio? We asked ART practitioner Thomas Feeney for the lowdown…

220: What is active release and what does it involve? How does it differ from traditional massage?

Active Release Techniques (ART) is a hands-on treatment in which a muscle, ligament or capsule is held with a tension while the structure is moved from under the tension. ART differs from massage in the use of movement of the limb (or spine) under tension, and the attention to anatomical detail.

What type of injuries can be treated? Is it solely for muscular injuries? What are some of the most common injuries you deal with?

Most soft tissue injuries: ITB syndrome, hamstring pulls, shoulder rotator cuff issues, hip flexor strains, plantar fasciitis, shin splints, Achilles tendinosis. ART is also effective in treating many issues that cause back, neck, and knee pain.

Can it be used as part of an injury prevention program as well as for treatment?

ART has been used on a preventative basis by elite triathletes in North America for a couple of decades, as well as every NFL team. Injury prevention is best achieved by movement screening which detects mobility problems (ART fixes these) and stability problems (motor control exercises fix these).

Articles I wrote or contributed to:

Telegraph  Athletics Weekly  220 Triathlon  Vigour Magazine

Podcasts I was on:

Ben Coomber Radio    Propane Fitness

Posted in Active Release Techniques

Things I Learned From Paul Mort.

For more fitness, rehab, and wellness news, follow us on Facebook and Twitter.

I have always been interested in how two business people can have very similar skill sets and situations, and one is a huge success and the other is struggling to pay the bills.  I have been giving seminars to personal trainers and soft tissue therapists since 1998. I get asked all the time by those starting out or struggling what do I recommend to build a business. 

They say never meet your heroes.

Two years ago, a patient told me about the mad genius Paul Mort. Last year, I met Mr. Mort and I expected to meet a loud, fast talking, intense, potty mouthed one man dynamo.  I was surprised, when all he talked about was the Bible, positive thinking, the death of email, and the importance of “word of mouth”. Just kidding. He was just like he is on the podcast.

The meat and potatoes of marketing for trainers and therapists.

  1. Positioning your business as unique is vital! 
  2. Position your business to attract clients who want to invest in themselves (be it business, health,..), don’t market to time wasters who just want a bargain.
  3. Give away the what and the why, make them pay for how (soft teaching).
  4. Ask new clients for referrals, because a new client has you fresh in the mind. Long standing clients no longer blab about you as much.
  5. The best stories are about results, not technical details.
  6. Three ways to grow: A  more clients  B  clients spend more  C.  clients spend more often
  7. Marketing materials should mimic the client’s voice, not yours.
  8. Don’t be afraid to turn away clients that aren’t a good fit.  (Sort of different but GPs do this to me, they send me patients just to stop the patient from demanding an MRI.)
  9. Of course learning is important, but stop reading books and remembering 1% of it and implementing less.  If you are going to read books take notes and what you think you need to implement. You should learn it so well you could teach it.
  10. Segment your list because those who already paid need a different pitch.
  11. Marketing should be 80% story. Stories resonate.
  12. Quantifiable marketing is best. (Can you measure the worth of free FB posts).
  13. “Magic bullets” rarely happen, consistent low glamour marketing is the real deal
  14. Write to do list at night, not in the morning.
  15. Start website with mission statement.
  16. Get better at writing by writing more.
  17. Persistence is more common than genius. Nobody succeeds every time: test, tinker, discard what doesn’t work, identifying what does
  18. Target your ideal client, better than trying to target all kinds.
  19. Morty / Settle:  daily email marketing is king.
  20. The website should chiefly be a funnel to get emails.
  21. Cost / benefit your time on FB / Twitter. FB ads to build a list.
  22. One page squeeze pages to convert.
  23. Emails should build trust before going straight for the sale.
  24. INFOTAINMENT- Emails need to entertain.
  25. Segment your list because those who already paid need a different pitch.
  26. Hire a coach (invest) it creates accountability. Put some skin in the game.
  27. Don’t forget to market to your local area in person.
  28. Use mistakes from past marketing as lessons.
  29. Don’t try to hit homeruns, go for singles every day.
  30. Focus on creating a niche.
  31. Don’t ask to pick the brain of movers and shakers for free. Put some skin in the game by investing in yourself.
  32. Study some marketing / business not just your discipline.
  33. There is no finish line where you suddenly are content.
  34. Don’t give away free anything in most cases.
  35. Don’t ask for big favors from movers and shakes unless you have built a relationship, or bought their products. 
  36. People spend money to fix problems – to eliminate pain or create gain. 
  37. D’Souza suggests the following sequence that salespeople should follow:1. Identify The Problem
    2. Present A Solution
    3. Define The Target Profile
    4. Handle Objections
    5. Collect Testimonials
    6. The Risk Reversal
    7. Establish Your Uniqueness
  38. Testimonials that work tell a story.
    • They share the concerns and hesitation someone had before buying: “I was concerned about the technology or I wasn’t sure it would be worth the investment.”
    • They talk about what happened as a result of buying: “The return on investment was almost immediate.”
    • They highlight a specific feature or benefit: “The software helped identify new opportunities for growth.”
    • They list additional benefits: “I’m a more confident, more energized, more knowledgeable business owner.”

Morty:  Inner Circle and Email Marketing Courses

“Tom Feeney is my go to guy for A.R.T.” – Paul Mort

Read more ›

Posted in Marketing Tagged with:

Are Your Hamstrings Weak, Sore, or Tight?

The FIT Institute published this blog post recently.

There are a few different reasons why a hamstring can feel tight. Sometimes your hamstrings don’t stretch because your brain senses instability and it “tightens ” your hamstrings. This is easy to test for and fix. Researchers have found some new approaches which are quite effective for helping weak, tight, and/or sore hamstrings.

What should you do if you have a tight hamstring?

Three evidenced based interventions to try are Active Release Techniques® (ART), Fat-Tool™ instrument therapy, and foam rolling!

Two recent studies compared ART to two common interventions for hamstring tightness. The first study compared ART to the Mulligan Bent Leg Raise Technique (video) on increasing hamstring flexibility. While the Mulligan Technique was found to be effective in this study and a previous study, ART was even more effective.  The second study reached the same conclusion between ART and the Rolfing Soft Tissue Technique. 

Fascial Abrasion Techniques (FAT-Tool) therapy was put to the test by researchers on whether it could have a lasting effect on hamstring flexibility.  In the study the FAT-tool and foam rolling both improved thigh muscle flexibility, but only the FAT-Tool’s effect were seen 24 hours later.

Research into foam rolling has found it to be effective.  The best approach is to foam roll the hamstring first and then do some static stretching. It is probably best to stick to a quick routine of a couple of minutes only. Researches have yet to study how long to roll or how hard you should go.  So try a few different variables and see which works best for you.

What is the best exercise to prevent hamstring strains?

Try an eccentric exercise where you slowly lengthen the hamstring muscle while it is under tension like a Nordic hamstring curl. They have been found to prevent first time and recurrent hamstring strain injury. To do a Nordic curl you kneel with the ankles held down, then you lower the body from the knee up with the body fixed in a plank. A lack of eccentric strength has been linked to hamstring strains, therefore eccentric training is a great way to prevent hamstring tears.

What is the best way to rehab a high hamstring injury?

Low compression high hamstring exercises

For hamstring injuries near the top of the muscle try exercises where the hip isn’t flexed towards the chest. In some cases hamstring exercises where the hip is flexed will cause too much compression of the tendon against the bone it attaches to.

  • Glute Bridge
  • 30° Raised Glute Bridge
  • Shallow Hip Thrusts

You may also like:

High Hamstring Strain: Best Low Compression Exercises

Best Glute Medius Exercises for Runners

Articles:

Telegraph  The ART of Active Release Techniques for Injuries

Athletics Weekly  Performance Therapy for Greg Rutherford

220 Triathlon  ART- How is it different from sports massage

Vigour Magazine  ART can release tight muscles to improve performance

Progenex  ART for CrossFitters

FIT Institute  Research based hamstring therapies

Posted in Active Release Techniques, Chiropractic, exercises

Golf Performance Therapy

Secrets of the golf performance therapy behind Jordan Spieth’s and Shane Lowry’s success!

Put yourself in the shoes of a top professional golfer in his or her prime (many of us dream of it regularly). You do two things that are very tough on your spine and other major joints.  You travel loads and you swing a golf club repetitively subjecting your spine and other joints to absorb some serious force. The game is changing and maximizing your athletic ability through weight training is now the norm. You know of all the golfers who came before you whose bodies let them down, shortening their careers.  What would you do, and who would you hire to look after your body?

The best golfers in the world use Active Release Techniques® (ART) providers who specialize in Titleist Performance Institute (TPI) exercise prescription.  Troy Van Biezen and Shane Lawlor are two ART / TPI experts who have been on tour for years with some of the biggest names in golf.  Van Biezen works with Jordan Spieth, Jason Dufner, Zach Johnson, Rickie Fowler, Nick Watney,.. while Lawlor has been on the european Tour for 6 years with the likes of Shane Lowry and Padraig Harrington.

The importance of expert soft tissue therapy

The focus of golf performance therapy is to ensure that the golfer has full range movement of the spine, shoulders, hips,knees, and ankles.  Imbalances or asymmetries of movement can cause other areas of the body to compensate. Often soft tissues (muscles and sometimes joint capsules) are the restricting factor which does not allow “normal” full range movements. It is more efficient and effective to address soft tissue restrictions with hands on manual therapy, rather than stretching programs alone. A combination is always best, but when time is of the essence, expert soft tissue work like ART is utilized first.

“The soft tissue component is crucial, imbalances and dysfunctions need to be addressed.” Troy Van Biezen

IMG_7583

“Troy Van Biezen has been an integral member of my team since high school, I trust him fully and he now tours with me. Chiropractic care with a goal of achieving better postural balance and injury prevention, has been invaluable to my health, performance, and success.” Jordan Spieth

What is ART?

ART is a hands-on soft tissue treatment of ligaments, muscles, tendons, and nerves.  It is the market leading soft tissue therapy in the world, used by every NFL team. The technique involves a patient shortening a muscle, the ART provider applies tension to the muscle with his/her fingers.  The patient then lengthens the muscle forcing it under the provider’s contact.  The patient feels a “good hurt” which provides a stretch that you need, but you can’t do by yourself.

Getting the players ready

During the week of a golf tournament, Van Biezen takes his athletes through an assessment every morning. Van Biezen describes the normal routine as, “Players get a functional assessment including muscle testing and joint range of motion testing two hours before tee-times, we follow it up with hands on treatment and a dynamic warm-up. Each player’s individual tendencies and imbalances are checked and addressed to stay on top of them. After the round, corrective based exercises are employed.” The system must be yielding results as his players are higher than ever in the world rankings.

Movement screening is used to find imbalances. Weaker muscles often over work, and as imbalances become worse the weaker muscle can break down and becomes painful. Hands on therapy and specific exercises are used to address the imbalances which the screening has flagged up. A good example occurred recently with Nick Watney a player Van Biezen looks after, “Nick was struggling with his swing one week, and he brought his coach in. The imbalances and weaknesses we found in the screening evaluation were evident in his golf swing. I was able to show his coach what we usually see, his typical patterns and how we correct it through soft tissue adjustments and corrective exercises”.  Spieth’s coach TPI instructor Cameron McCormick,  noticed a tendency  for him to sway when swinging. McCormick asked Van Biezen and his trainer to focus on increasing Spieth’s hip mobility. The team approach has obviously working  for Spieth.

If you’re not assessing, you’re just guessing

The Titleist Performance Institute is a leading advocate of training golfers to become more athletic. This is achieved by testing and improving the movement fundamentals first: mobility, coordination, and balance. Only when adequate foundational movements are demonstrated does strength, endurance, power, and skill acquisition become the focus of training.  Corrective exercises are prescribed to address weaknesses / imbalances, often golfers develop tendencies which a well thought out training program can keep at bay.

How to take the pressure off of the lower back

Lower back pain in golfers is an example where addressing the problem is often best served by getting better movement of the hips and mid-back.  Lawlor explains, “If the mid-back and hips are not rotating enough the lumbar spine may compensate and the lumbar spine is not designed for a great deal of rotation”. Preventing lower back pain is what the golfer is hoping for when he or she hires a top TPI / ART expert to come on tour. Through daily screening followed by therapy and exercises, the hips and thoracic spine are kept mobile and stabile keeping the pressure off of the lower back.

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Photo golffile.photoshelter.com

“Shane is an integral part of my performance team and he has definitely added to my game over the past 3 years. His combined skills of Chiropractic & ART ensure that I am prepared physically for each round I play. I believe working with Shane is helping me to prevent injuries and will hopefully lengthen my career.” Shane Lowry

Exercising more effectively 

Lawlor’s time on the European tour brought home the importance of incorporating tailored rehab / training programs. The tour players need efficient and effective training due to time constraints.. “Some of the mistakes I see are overstretching, players often waste energy and time stretching an area that doesn’t need it. Another problem is spending too much time doing isolated strength work. Multi-joint exercises require more full body stability and flexibility and are therefore more effective for golfers. Lastly players need to build on a foundation of decent flexibility and stability, before strength and power work is added to the training.”

Help for recreational golfers

The average hacker has the same flexibility problems as the professionals only worse in most cases. If you feel your flexibility or balance is holding your game back seek out a TPI professional who works with an ART soft tissue specialist.

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