Lateral Epicondylitis (aka Tennis Elbow)

Tennis elbow is a repetitive-motion injury that is caused when the wrist forearm muscles (extensors and supinators) are overloaded. When the tendons cannot handle the load, small micro tears begin to occur and eventually you feel pain and weakness. Common activities like the following can evoke your symptoms:

  • playing tennis
  • using tools (plumbers, painters, cooks, etc…)
  • holding a coffee mug
  • turning a door knob
  • shaking hands
  • gripping anything

Full-Body Dynamic Warmup

Get your body ready

The best way to get ready for your workout or sport is to incorporate a dynamic warmup.  The purpose of taking a few minutes beforehand is to stimulate the nervous system, increase body temperature, work on range of motion, flexibility and address any limitations. Getting your joints, muscles and ligaments ready to start taking load and speed is necessary for optimal performance and will also help decrease your risk of injury.

Perfecting the Hip Hinge

The Hip Hinge:

The hip hinge is a fundamental movement that all humans should know how to do. It is the backbone for all athletic movements as there is no way to jump, land, change directions or train power without being able to get in this position. Spinal bending (flexion) is fine for certain motions like tying your shoes, but not for movements that require a greater load or more explosion.

Pitcher’s warmup between innings

Keeping your arm fresh between innings

Throwing a baseball is one of the most demanding movements you can do with your shoulder. Making sure your arm is warmed up properly is important for safe throwing. Obviously, it’s a full body movement, but baseball throwing requires strength, mobility and stability at extreme end ranges of the gleno-humeral joint into external rotation. In addition, you must have good thoracic mobility and core control.

Throwing arm warmup

Warming up your throwing arm

Working on you shoulder and thoracic mobility and stability are key components for proper arm care. Start with spinal mobility, concentrating on thoracic extension and rotation. Scapular stability is key to throwing and safe over-head arm mechanics, so make sure to address the sequencing of these muscles routinely.

The video below has a few specific mobility and stability exercises designed to do just this. Keeping your full range of motion in your thoracic spine and shoulder joint is  important and needs daily attention particularly as your strength training and season progresses.

References:

Erickson, B. J., Thorsness, R. J., Hamamoto, J. T., & Verma, N. N. (2016). The biomechanics of throwing. Operative Techniques in Sports Medicine, 24(3), 156-161.

Faries, M. D., & Greenwood, M. (2007). Core training: Stabilizing the confusion. Strength and Conditioning Journal, 29(2), 10-25.

Hurd, Wendy J, PhD,P.T., S.C.S., & Kaufman, Kenton R,PhD., P.E. (2012). Glenohumeral rotational motion and strength and baseball pitching biomechanics. Journal of Athletic Training, 47(3), 247-56.

Jeran, J. J., & Chetlin, R. D. (2005). Training the shoulder complex in baseball pitchers: A sport-specific approach. Strength and Conditioning Journal, 24(4), 14-31.

Kibler, W. B., Ludewig, P. M., McClure, P. W., Michener, L. A., Bak, K., & Sciascia, A. D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the ‘scapular summit’. British Journal of Sports Medicine, 47(14), 877.

W, B. K. (1998). The role of the scapula in athletic shoulder function. The American Journal of Sports Medicine, 26(2), 325-37.

Wilk, K. E., Williams, R. A., Dugas, J. R., Cain, E. L., & Andrews, J. R. (2016). Current concepts in the assessment and rehabilitation of the thrower’s shoulder. Operative Techniques in Sports Medicine, 24(3), 170-180.

Yogic Breathing: How to get the most out of your breath

Why is Yogic Breathing so important?

Breathing is a simple, but powerful function. In recent years, the Polyvalgal theory has shown the vagus nerve has implications on everything from complex cardiac functions to more discrete aspects of attention, motivation, feeding, communication, emotion, vocalization, and the entire muscle array of the human face, head, throat and neck.  Since human primary emotions are directly related to various autonomic functions, right brain activity has shown how important breath is in regulating the body’s response to stress. Who doesn’t need a better way to control the stress in their life?

Marathon Mom: Relaxation tips from a 4 year old.

Here’s the latest Monterey Herald Article with a simple breathing exercise at the end. Proper breathing dynamics is so important. It balances the body, helps with alignment and proper muscle activation, and decreases stress levels. I focus more on proper breathing in preparation for exercises, and find it fundamental for pelvic issues, musculoskeletal issues, and chronic pain. I also love the stress relief and mindfulness it can offer with just a few minutes a day. I am liking the Headspace app for guided meditation for anyone interested.

What is “W sitting” and why is it bad for your children?

Recently I have been treating a lot of high school patients with hip and knee pain during sports activities, and in more than one case the underlying cause is probably a long history of “W sitting” which is demonstrated in the above photo. I would always correct my children when they got in this position because I know that it can have some serious long-term risks for their developing bodies like the following:

Hip and Psoas Mobility

There are so many great hip openers out there, but I wanted to share one of my favorites. It is my go- to exercise when I feel like my alignment is a little off, or my back or hips are feeling achy or just not as mobile as I know they should. It’s as close to WD40 you can get for your hips. The purpose of this exercise to get a gentle hip capsule stretch while you are pushing towards your feet, then a gentle gluteal and pirformis stretch as you pull your knee to opposite shoulder. To do this, take up the tissue slack and then breath out as you press down towards your feet. The movement is small- like maybe 1/2 inch. The breathing is really important, so make sure you first do this in a quiet place so you can concentrate. Remember, you are always breathing out on the mobilization or stretch part.

Aside from working the hip capsule, this is a very gently and effective psoas Muscle stretch. The Psoas muscle is one of the body’s main hip flexor muscles, or trunk flexor if your feet are stable. Since it inserts on the T12-L5 vertebrae, if can cause back pain if tight or in spasm. A tight psoas muscle also effects posture and alignment, so it’s one to stay on top of if you do a lot of hip flexing (runners, I’m talking to you.) Manual work is great for this muscle, but if that’s not an option, this will help.

Psoas Muscle – My favorite muscle FYI:)

The knee drop (second part of the video) is great for stretching your smaller external hip rotators that can effect your hip and sacral alignment. Again, let your leg fall in GENTLY to the center with gravity stretching it. Breath in as you come back up, and then repeat on the other side. Go back and forth 6x each leg.

As always, there should be no pain with any of this, so stop if you feel any. Though they feel great, 1-2 x times a day is plenty.  Again, I will stress, be GENTLE. Don’t over do it or you will have a sore back and hips.

Happy running…or what ever form of exercise you choose!

Blake Russell, PT

 

Rainbow Passes

Single-leg dynamic stability is important, as is core stability. This exercise challenges both and is great for almost any sport. Add it to your routine as a warm-up or routine. I am using a 10 pound medicine ball, but it’s best to start light and stay light as the focus of this drill is quality of movement; not strength. Balance is something I work on quite a bit to keep my feet intrinsic muscles and hips strong for the pounding of running. Keep your routine fun and add these rainbow passes to your gym routine. Enjoy!