Welcome the 21st Century Physio Podcast.
I’m your host Stephen King and I'm really passionate about the Physiotherapy and manual therapy industry and this podcast is a way of helping therapists all over the world improve the standard of care we provide. The aim of the podcast is to provide therapists with simple, easily implementable and actionable strategies to help improve and revitalise their own practices, careers and lives.
Tune in and listen to our bi-weekly sessions discussing the latest research and technology influencing your practice as a 21st century Physiotherapist.
Join leading experts from around the world as they share their experiences, research and thoughts on the future of Physiotherapy in the 21st century and provide you with simple, actionable and easy to implement tips to help you help more patients in your practice.
Well, it's been an amazing two weeks at the winter Olympics games in Pyeongchang, hasn't it?
Filled with amazing record-breaking feats, it's been must-watch viewing. If you're like us at MAT, you've been glued to screen to see how far the human body can be pushed. Often just a little too far as the injury list of hundreds of major injuries over the past two weeks proves.
This blog post isn't about how many injuries occurred though, or how they could have used the MAT to help identify those who may have been at a higher risk of injury during the games. They could have, but that's another post altogether. It's not even about the biomechanics of the sports and common risk factors that need to be assessed or improved.
We can learn a lot more about assessing our patients and athletes from the games by looking at how they determine the outcome.
So, what can we learn from?
Every profession uses objective data to help determine their...
The agility T-Test is a test that is commonly used to assess an athletes/individuals to move forwards, backwards and side to side. It is performed on a safe and consistent surface to ensure that test-retest reliability is high. Besides testing an individual's ability to move in all directions as quickly as possible it also tests a “combination of leg speed, leg power, and agility for performance” (Pauole. K, Madole. K, Garhammer. J, Lacourse. M and Rozenek. R, 2000).
Males that achieve less than 9.5 seconds and Females that achieve less than 10.5 seconds are ranked as excellent showing that they can coordinate lower limb strength, power and speed whilst changing multiple directions.
Having the ability to produce a muscle contraction that is quick and powerful in a sporting situation and the stronger and more efficient this contraction is the lower the likelihood of injury (Hübscher M , Zech A , Pfeifer K , Hänsel F , Vogt L , Banzer W , 2010). The...
Hip abduction is a movement where our leg moves away from the midline of body or the opposing leg, this movement is produced by our Gluteal muscles (Maximus, Medius and Minimus).
This movement is extremely important in a sporting or dynamic context as knee adduction “associated with increased knee valgus angles during athletic movements” (Cronin. B, Johnson. S, Chang.E, Pollard. C and Norcross. M, 2016).
Decreased Hip Abduction strength or excessive hip adduction has been a cause of issue for people with patellofemoral pain (PFP). With research being perfromed by Ramskov. D et al (2015) they found that “eccentric hip abduction strength that is higher than normal may reduce the risk of PFP” (Ramskov. D, Barton.C, Neilsen. R and Rasmussen. S, 2015).
The single leg abduction exercise when used correctly in a clinical setting can decrease our risk of associated lower limb injuries to the hip, knee or ankle. By performing the activity in a controlled way we...
Hip Adduction is the movement of where we bring our leg closer to the midline of the body or closer to the other leg. It is largely performed by our adductor group (adductor magnus, longus and brevis). Hip adductor weakness has been related to pain in through the groin in sports that require repetitive change of direction (i.e.soccer) “Large eccentric hip adduction strength deficits were found in soccer players with adductor-related groin pain compared with asymptomatic soccer players” (Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB and Hölmich P, 2014). Another article found that “decreased hip adduction strength is a risk factor for developing groin injuries” (Harøy.J, Thorborg. K, Serner. A, Bjørkheim. A,Rolstad.L, Hölmich.P, Bahr. R and Andersen.T, 2017).
The single leg adduction exercise when used correctly in a clinical setting can decrease our risk of associated groin injuries and performance detriments. The Copenhagen...
Our spine is made up of 3 sections (Cervical, Thoracic and Lumbar vertebrae) with the sacrum and coccyx forming part of the tailbone. Each area is individualised in the way it moves, for example, the Lumbars prefer to flex and Extend, whereas the Thoracics prefer to rotate.
Each segment throughout all 3 areas rotates/flexes/extends and laterally flexes a few degrees, but as a total, there is a great deal of range of motion available through the spine. Along with these movements occurring at the spine, we also have rotational movements below and above the spine that directly affect the range of motion available, an example of this is the hips.
“Range-of-motion deficits in the lead hip rotation and lumbar spine extension correlated with a history of low back pain in golfers” (Vad. V, Bhat. A, Basrai. D, Gebeh. A, Aspergren. D and Andrews. J, 2004). Along with golfers having lower back pain we also see athletes involved in throwing sports needing to...
The single leg hip extension (also commonly referred to as a hip thruster) exercise is performed with the foot placed on a bench/chair. The role of this exercise it to emphasis the use of our Gluteus Maximus “Gluteal muscle in the human body is one of the largest and strongest muscles” (Raj. S, 2016).
The gluteus Muscles are also apart of posterior chain (muscles that run along the back of our legs and back). “explosive hip extensor strength may be crucial in the primary prevention and rehabilitation of a variety of lower extremity injuries” (Cronin. B, Johnson. S and Chang.E, 2016).
The single leg hip extension is a very beneficial exercise to perform in a clinical setting because by having the leg at 90 degrees it shortens the hamstrings and places more emphasis on the contraction of the glutes (which is what we are aiming for). Along with that we also see that “hip thrust activates the gluteus maximus and biceps femoris to a greater degree than...
A single leg wall hold is a functional performance test that looks at the capacity of our knee’s to bear load as well as the strength of the surrounding musculature (quadriceps/hamstrings/glutes).
They are very similar to a single leg squat but the main difference is that you’re leaning against the wall and that your knee/hip is bent to 90 deg and maintaining this position for as long as possible. “One leg squat and wall squat exercises are used in both athletic training and during knee rehabilitation programs” (Escamilla. R , Zheng. N , Hreljac. A ,Imamura. R , MacLeod. T , Edwards. W , Fleisig. G and Wilk. K, 2009).
The Single Leg wall hold/squat is a very useful clinical exercise and along with other weight-bearing exercises that are similar because it has been shown in patients suffering from Patellofemoral pain syndrome (PFPS) that is has helped “patients to recover faster and return to function earlier” (Escamilla. R , Zheng. N ,...
The Single Leg Plank is an intermediate core exercise which is a progression from the basic plank. By having a single leg in the air we lose a point of contact with the ground which increases instability and makes the drill more challenging.
The ability to recruit our core muscles is really important with multiple research papers showing that evidence exists that “core muscle recruitment alterations in low back pain (LBP) patients compared with healthy controls” (Bliven.K and Anderson. B, 2013). Along with improving outcomes for patients with back pain, research has also shown that “preexisting core deficiency may increase the risk of lower extremity injury” (Wilson. J, Dougherty. C, Ireland. M and Davis. I, 2015).
This test is important to perform in a clinical setting because it can demonstrate (with minimal equipment) to us as clinicians how well someone’s trunk musculature is working. Doing this test as an assessment aids in the following:
The Single Leg Hop Test (SLHT) is a series of tests that are done at a high intensity to determine if you as an individual are ready to return to sport. They are commonly used in the later stages of ACL rehabilitation and the test results will determine if you are ready to return to play or not. The types of single leg hops we can do to assess:
Single leg hop test
Single leg triple hop test
Single diagonal hop test (crossing over a line with every jump).
Timed single leg hop over 6m
In a clinical setting hop tests are extremely useful for identifying “isokinetic flexion strength deficits and flexion-to-extension ratios” ( Sueyoshi T, Nakahata A, Emoto G, Yuasa T, 2017) for individuals looking to return to their chosen sport. They also found that “hop tests are useful tools for a bilateral comparison of knee strength and function when returning athletes to their sport” (Sueyoshi et al.).
The Hop tests are used in conjunction with the Limb Symmetry Index (LSI)...