PART A – SPINE PARTE A - COLONNA “La Stabilità prossimale per
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PART A – SPINE PARTE A - COLONNA “La Stabilità prossimale per
PART A – SPINE PARTE A - COLONNA “La Stabilità prossimale per la mobilità distale” Analisi degli schemi motori errati e Allenamento integrato del core • Analisi degli schemi motori essati • Determinazione del confine tra Rehab/Training • Processo di Revisone Clinica: Analizza-Correggi-Ri-analizza per decidere come progredire o regredire su un binario oppure scegliere una via tangenziale (lateralizzazione) • Interdipendenza regionale/ Layer Syndrome/Joint by Joint Approach • Il ruolo del diaframma, del pavimento pelvico e il sistema di stabilizzazione in una funzione simil cilindro • Esercizi fondamentali di stabilità del core da una prospettiva biomeccanica e seguendo lo sviluppo neurologico • L’allenamento Anti-flessione e Anti-rotazione • D4, mobilizzazione della caviglia e dell’anca (foam roll, yoga, Lewit’s PIR, etc) • Okinawan strength – eliminare le parti molli del “core” • Gripping, la funzione di radicamento del piede nelle arti marziali • L’importanza clinica delle funzioni umane – stazione eretta, appoggio monopodalico e respirazione • La relazione tra dolore e inabilità (bandiere gialle, eliminazione del pericolo, sensibilizzazione centrale) • Il ruolo della cinesiologia dello sviluppo e dei reset neurologici, adattamento neurologico e determinazione dell’intensità PARTE B – ESTREMITA’ Reabilitazione dell’Atleta: From the Ground Up & The Continuum of Care: From the Head to the Toe • Allenamento Funzionale Integrato del Core con le estremità • Prevenire il collasso mediale del ginocchio Posterior Chain activation • Potenza/stabilità sul Piano Frontale • La “zona morta” D4 • Disfunzioni oro -facciali • Disfunzioni Cervico-craniali • Disfuznioni del quadrante superiore e dischinesi scapolare • Come raggiungere l’adattabilità residua ed il trasferimento delle abilità • Il Continuum della Potenza/Stabilità ed il ritorno sicuro all’Attività/Sport (tripla flessione per tripla estensione, riscaldamento di movimento) • Indicazioni per ogni esercizio correttivo • Allenamento reattivo, indicazioni esterne al posto delle interne , strategie in soglia o sotto soglia, Programmare i giorni al alta intensità e a bassa intensità • The Core Slings: Sagittal, Frontal & Transverse Plane Questa serie di 36 ore viene tipicamente insegnata in due weekend da 3 giorni l’uno. E’ un workshop interattivo, basato sul problem-solving. Puoi iniziare in qualsiasi punto del programma (siccome è diviso per regioni corporee) ma se non inizi dall Parte A, pianifica di seguirlo al più presto perché include una grande enfasi sull’analisi funzionale che è il fondamento di ogni programma. Tecniche imparate nel Programma di 6 giorni I) ASSESSMENT: A) History: • Activity intolerances • Fears, Worries, Concerns • Goals • Chief Complaint • Onset (traumatic vs repetitive strain) • Demands (Sports/activities) B) Examination (Identify 0’s & 1’s): • Finger tip to floor • Deep Squat • Calf Mobility • Mag 7 (OH Squat, Wall Angel, 1 Leg Balance, 1 Leg Squat, 1 Leg Bridge, IAP/Respiration) • Side Plank Endruance (Goal symmetry w/in 5% AND > 40s) • Janda’s Perturbation test • Vele’s Transverse Arch Stability Test • Open question – “Can you reproduce your symptoms?” II) EXERCISE TRAINING (Rx 2’s only): Goals – • Corrective for Painless Dysfunctions • AFTER 1’s turn into 2’s then Audit Markers – 0’s • Hardest thing they do well • Don’t police perfection (should be 2’s NOT 3’s unless adding LOAD) • At or near threshold (overload principle to promote neural adaptation) • Residual Adaptation (should continue next day) • Skill Transferability (should be functional – the SAID Principle – Specific Adaptation to Imposed Demands) A) Stability Training: 1) Competency/Motor Control 1st – • Pneumo-muscular reflex – active exhalation to create Okinawan core strength/stability (no soft spots w/out holding breath in) • functional brace (w/ B Dog, D Bug, Janda Perturbation Test) • Cat/Camel • McGill’s Big 3 • Bird Dog • Side Bridge • Curl Ups • Boyle’s Bird Dog (regression) • Lewit – 3.5 month position (IAP) • Bug off Wall • Pelvic Floor • Barrel Roll • Foam Roller (vertical) – marching, bicycle, arms OH w/ ribs in exhalation position • Developmental Sequence from 3.5 to 13 months • Baby Get-Up Rolling from 3.5 to 7.5 month position on forearm (“Kyla”) • Diagonal Sit (Vojta) variation w/ top leg behind. leaning forward to activate downside adductor’s differntiaion (pull) function • 8.5 month position starting point of Turkish Get-up on outstretched arm & hand • Bear – low and high (w/ reducing points of support & crawling) • Sumo • Bridges • w/ band • Single leg Bridge • Cook 1 leg Bridge • Vele 2) Capacity/Strength/Endurance after Competency assured – • Quad RNT • Plank (hard style, 2/1 Saw, Plank Roll) • Stir the Pot • Anti-Flexion Training for Trunk Extensors- (Superman w/ Ball, Vermeil prone superman, Good Morning, Bent over Row) • Note: remember extension sensitivity is common. Esp in patients w/ Fear-Avoidance Beliefs. Find Most sensitive extensor load & Mark it. Train less sensitive Anti-Flexion exercises while giving ROF of the dangers of flexion & benefits of building endurance/ROM of postural extensor system. Then Re-assess most sensitive extensor movement that was left un-trained. B) Spine Sparing: • Micro-Break – Brugger McGill Arm OH • Hip Hinge – Waiter’s Bow Short Stop • Dead Lifts 2 Leg Romanian Dead Lift 1 leg Romanian Dead Lift Teeter • Squats Goblet Squat Sumo Squat Prone Rocking for hip width in squat Hip Hinge (Squat) w/ arm rest, box squat assist C) Mobilizations: • Posterior Hip Capsule/Piriformis (Pigeon Pose, figure 4 supine, Supported Piriformis Stretch) • T4 Extension (Jerzey/Aniela’s T-spine mobility – flap the wings,; Foam Roller (vertical) – chest press, arms overhead; • Foam Roller (horizontal) – upper back cat & extension over foam roll • T-spine rotation from Child’s Pose • Halo (standing, tall kneeling, kneeling, inline kneeling) • T4 Sphinx (Jiri) on hands & forearms • Kolar’s T4-T8 active extension • Ant Hip Capsule Mob – Thomas’ test, Valslide assist standing, kneeling psoas stretch • Leg Swings for supination D) Functional Training: • Lateral Squats • Paloff Press – standing, half kneeling, tall kneeling, supine • Cable Chop • Balance reach (6:00Running man, 5:00/7:00 Bowler) • Star Matrix Angle lunges w/ ipsi or contralateral reach for “driving” supination in foot w/ arm Plyo’s – up/down into athletic position, scissors into lunge, transverse plane Additional Skills Learned: • Nordic Hamstring • 1 Leg Hop • Hip Abduction/Hip Extension/Active SLR Screens • Lumbar Stability Shear Test • Seated SLR with Slump • Push-Up Test • Scapulo-Humeral Rhythm • Empty Can & Speeds Test • Janda’s Neck Flexion Test • Mouth Opening • Posterior Shoulder Capsule Mobilizations • Ball Bridges • Monster Walk • Lateral Band Walk • Dead Lifts (RDL) • Squats (Windowpane, Overhead, 2 X 4, sumo, Potato Sack, Goblet) • Box Squat (2/1) • Supported Functional Reach • Reverse Lunge (step/slide) • Janda Lunge • Angle Lunge • Qua • Kettle Bell Carry • Turkish Get-Up • Med Ball Routine • Push-Up with Plus • Serratus Punch • Horizontal Row • Shoulder packing • Rear Foot Elevated Split Squat (Bulgarian) • Lateral squat • Quick feet athletic position • Plyometrics (stretch-shortening cycle) • Pillar Running • X-Hop • High Pull Kettle Bell Swing