Two combinations tonight built off the jab.
Combination 1: Jab, cross, hook, hop step right/switch left kick
Combination 2: Fake jab, Rear leg front kick, hook cross, hop step right/switch left kick
Pendulum Step: I'm much more aware of the pendulum step after the switch left kick when I think about it but still relapse from time to time. It's still a little clumsy and not as quick and light on my feet as it could be but it's getting there.
Relax: I'm tensing up before I throw a punch. I'll need to either tape or shadow box in front of a mirror and check it out myself. I need to relax and concentrate on snapping the punches out, not muscling them out and tensing up.
Lower body Punching: I'm punching with my upper body too much and not generating power from the ground and the lower body. I need to drop my weight into my cross and pivot more on my lead hook.
Thursday, October 21, 2010
Thursday, October 14, 2010
Physical Therapy: Martial Art Injuries
The morbidity of injury in martial arts is pretty high, higher than actually getting injured in a self defense situation (which many martial artists claim to train for). Soft tissue damage seems the most consistent injury in martial arts. At the beginner and amateur level, the most common injuries are sprains and strains, while at the veteran and professional level you see fractures and joint dysfunction. For today I'm going to discuss three common joint dysfunctions and the physical therapy stretches and exercises to treat them.
Rotator Cuff
What is it: The rotator cuff is a group of muscles, bones and tendons that make up the shoulder joint and rotate the arm inward or outwardly and stabilize the arm. The bones consist of the clavicle, scapula, and the humerus head. The muscles involved are the suprapinatus, infraspinatus, teres minor, and subscapularis (SITS).
The Injury: The most common injuries are bursitis, which is inflammation of the bursa (the gel sac that surrounds the head of the humerus at the glenohumeral joint), tendonitis, which is inflammation of the muscle tendons, and strains and tears. If tendonitis is left untreated, the muscle tendons weaken and become more susceptible to strain or tear. The most common muscle that strains is the suprapinatus, which runs under the acromium of the scapula and inserts on the greater tuberosity of the humerus. The injury I'll look at is a muscle strain or tear.
Diagnosis:
Stretches:
Walking Wall Stretch, Can stretch (external rotation), Towel stretch
Exercises:
Subscapularis
Infraspinatus
Supraspinatus
Patellar Tendinitis
What is it?: Commonly known as Jumper's knee or Sinding-Larsen-Johansen disease, is pain located on the anterior proximal origin of the patellar tendon on the patella.
The Injury: It is caused by overuse of the extensors muscles at the knee joint (the quadriceps femoris: rectus femoris, vastus medialis, vastus lateralis, vastus intermedius). Overuse leads to edema in the patellar tendon, which leads to further weakening of the tendon and increased tearing and degeneration of the tendon.
Diagnosis:
Stretches: Quadriceps stretches, standing, kneeling, prone variations
Exercises : The key is the strengthen the quadriceps muscle with a heavy emphasis on eccentric loading. Eccentric is when the muscle lengthens under tension, commonly known as the negative rep to many body builders. Studies suggest that eccentric exercise is the best tissue remodeling which is perfect for rehabilitation.
Eccentric squat on decline
Eccentric single leg raise
Step up
Achilles Tendinitis
What is it: The Achilles tendon is the joining of the gastrocnemius muscle and soleus muscle that attaches onto the calcaneus or the heel bone.
The injury: The tendon heals slowly as it is does not get very good blood supply, as such microtears in the the tendon can accumulate, inflammation occurs, scar tissue or cross fibers adhesion occurs, further increasing the likelihood of tears.
Diagnosis: An example of a test to check for a complete achilles tendon tear.
Stretches:
1. The gastrocnemius stretch; 2. The soleus strech, similar to 1. but with knees bent to deactivate the gastrocnemius.
Exercises:
Rotator Cuff
What is it: The rotator cuff is a group of muscles, bones and tendons that make up the shoulder joint and rotate the arm inward or outwardly and stabilize the arm. The bones consist of the clavicle, scapula, and the humerus head. The muscles involved are the suprapinatus, infraspinatus, teres minor, and subscapularis (SITS).
The Injury: The most common injuries are bursitis, which is inflammation of the bursa (the gel sac that surrounds the head of the humerus at the glenohumeral joint), tendonitis, which is inflammation of the muscle tendons, and strains and tears. If tendonitis is left untreated, the muscle tendons weaken and become more susceptible to strain or tear. The most common muscle that strains is the suprapinatus, which runs under the acromium of the scapula and inserts on the greater tuberosity of the humerus. The injury I'll look at is a muscle strain or tear.
Diagnosis:
Stretches:
Walking Wall Stretch, Can stretch (external rotation), Towel stretch
Exercises:
Subscapularis
Infraspinatus
Supraspinatus
Patellar Tendinitis
What is it?: Commonly known as Jumper's knee or Sinding-Larsen-Johansen disease, is pain located on the anterior proximal origin of the patellar tendon on the patella.
The Injury: It is caused by overuse of the extensors muscles at the knee joint (the quadriceps femoris: rectus femoris, vastus medialis, vastus lateralis, vastus intermedius). Overuse leads to edema in the patellar tendon, which leads to further weakening of the tendon and increased tearing and degeneration of the tendon.
Diagnosis:
Stretches: Quadriceps stretches, standing, kneeling, prone variations
Exercises : The key is the strengthen the quadriceps muscle with a heavy emphasis on eccentric loading. Eccentric is when the muscle lengthens under tension, commonly known as the negative rep to many body builders. Studies suggest that eccentric exercise is the best tissue remodeling which is perfect for rehabilitation.
Eccentric squat on decline
Eccentric single leg raise
Step up
Achilles Tendinitis
What is it: The Achilles tendon is the joining of the gastrocnemius muscle and soleus muscle that attaches onto the calcaneus or the heel bone.
The injury: The tendon heals slowly as it is does not get very good blood supply, as such microtears in the the tendon can accumulate, inflammation occurs, scar tissue or cross fibers adhesion occurs, further increasing the likelihood of tears.
Diagnosis: An example of a test to check for a complete achilles tendon tear.
Stretches:
Exercises:
Friday, October 1, 2010
Physical Therapy: Burning pain
I have a headache and can't sleep. Thought I would write a little about what I learned today in PT.
An older patient came into the clinic claiming she experienced a burning sensation in her knee when climbing the stairs. Burning sensations generally fall into three categories: Lactic acid buildup (technically not an acid but that's another story), bone on bone grinding, or nerve pain.
When diagnosing, you never rule in diagnoses, you can only rule out. So you work through what a problem isn't instead of what it is.
It was not lactic acid build up because the pain is too centralized. Generally lactic acid build up creates a burning sensation in the muscle. Since the burning pain occurred only at the knee joint, we can rule out this diagnosis.
It was not nerve pain because again the pain was too centralized. Nerve pain can take any form of sensation but generally if it's a burning sensation it would be a form of radicular nerve pain, which means it the pain radiates from the spinal cord all along the nerve pathway. So the pain would go all along the leg, which was not the case with the patient today. Now the pain could also be a referred pain, where the pain is experienced at one location but originates from another. However, because the ankle and hip joints of the patient would relatively stable, we could rule this diagnosis out as well. Referred pain generally appears most commonly in the glenohumoral (shoulder) joint and deltoid tuberosity of the arm.
We concluded that the burning pain was likely caused by joint on joint grinding, essentially hypercompression of the quadriceps on the patella. As the patient climbs up the stairs, because she has decreased motion in her right leg, she can't fully extend that leg out when climbing the stairs, so as she steps to push her self up onto the next step the quadriceps are compensating for the lack of motion and thus compressing the joint more so than natural.
An older patient came into the clinic claiming she experienced a burning sensation in her knee when climbing the stairs. Burning sensations generally fall into three categories: Lactic acid buildup (technically not an acid but that's another story), bone on bone grinding, or nerve pain.
When diagnosing, you never rule in diagnoses, you can only rule out. So you work through what a problem isn't instead of what it is.
It was not lactic acid build up because the pain is too centralized. Generally lactic acid build up creates a burning sensation in the muscle. Since the burning pain occurred only at the knee joint, we can rule out this diagnosis.
It was not nerve pain because again the pain was too centralized. Nerve pain can take any form of sensation but generally if it's a burning sensation it would be a form of radicular nerve pain, which means it the pain radiates from the spinal cord all along the nerve pathway. So the pain would go all along the leg, which was not the case with the patient today. Now the pain could also be a referred pain, where the pain is experienced at one location but originates from another. However, because the ankle and hip joints of the patient would relatively stable, we could rule this diagnosis out as well. Referred pain generally appears most commonly in the glenohumoral (shoulder) joint and deltoid tuberosity of the arm.
We concluded that the burning pain was likely caused by joint on joint grinding, essentially hypercompression of the quadriceps on the patella. As the patient climbs up the stairs, because she has decreased motion in her right leg, she can't fully extend that leg out when climbing the stairs, so as she steps to push her self up onto the next step the quadriceps are compensating for the lack of motion and thus compressing the joint more so than natural.
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