Want to be faster?

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Take this simple test. 

If you want to be faster, you had better incorporate some proprioceptive training into your plan. It is the 1st part of our mantra: Skill, Endurance, and Strength (in that order). Proprioceptive training appears to be more important that strength or endurance training from an injury rehabilitation perspective injury rehabilitation perspective as well part of an injury prevention program

 What is proprioception? It is body position awareness; ie: knowing what your limbs are doing without having to look at them.

Take this simple test:

  • Stand in a doorway with your shoes off. Keep your arms up at your sides so that you can brace yourself in case you start to fall. Lift your toes slightly so that only your foot tripod remains on the ground (ie the base of the big toe, the base of the little toe and the center of the heel.). Are you able to balance without difficulty? Good, all 3 systems (vision, vestibular and proprioceptive) are go.
  • Now close your eyes, taking away vision from the 3 systems that keep us upright in the gravitational plane. Are you able to balance for 30 seconds? If so, your vestibular and proprioceptive systems are intact.
  • Now open your eyes and look up at the ceiling. Provided you can balance without falling, now close your eyes. Extending your neck 60 degrees just took out the lateral semicircular canals of the vestibular system (see here for more info). Are you still able to balance for 30 seconds? If so, congrats; your proprioceptive system (the receptors in the joints, ligaments and muscles) is working great. If not, looks like you have some work to do. You can begin with exercises we use every day by clicking here.

Proprioception should be the 1st part of any training and/or rehabilitation program. If you don’t have a good framework to hang the rest of your training on, then you are asking for trouble. 

 

 

Timothy E. Hewett, PhD, , Kevin R. Ford, MS, Gregory D. Myer, MS, CSCS Anterior Cruciate Ligament Injuries in Female Athletes: Part 2, A Meta-analysis of Neuromuscular Interventions Aimed at Injury Prevention The American Journal of Sports Medicine Vol 34, Issue 3, pp. 490 - 498   link to free full text: http://journals.sagepub.com/doi/abs/10.1177/0363546505282619

Lephart SM1, Pincivero DM, Giraldo JL, Fu FH. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med. 1997 Jan-Feb;25(1):130-7.

 

Cerebellar impairment = Gait Changes = Happy Patient

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This is a fairly info dense post with many links. please take the time to explore each one to get the most out of it. 

If you have been with us here on TGG long enough, you know the importance of the cerebellum and gait. Mechanoreceptor information travels north to the cortex via the dorsal (and ventral) spinocerebellar pathways to be interpreted (and interpolated, in the case of the ventral pathway), with the information relaying back to the motor cortex and vestibular nucleii and eventually back down to the alpha (and gamma) motor neurons that proved the thing you call movement and thus gait. (Cool video on spinocerebellar pathways here and here).

This FREE FULL TEXT paper has some cool charts, like this one, that show the parameters of gait that change with cerebellar dysfunction (in this case, disease, although idiopathic means they really don't know. Anatomical or physiological lesions will behave the same, no? Doesn't the end result of a functional short leg look the same as an anatomical one?)

Looking tat this chart, what do we really see? People with cerebellar dysfunction:

  • a shorter step length
  • a wider base of gait
  • decreased velocity
  • increased lateral sway
  • slower overall gait cycle

Hmmmm...Beginning to sound like a move toward more primitive gait. Just like we talked about in this post on the 5 factors and proprioception here several years ago. We like to call this decomposition of gait. 

They go on to talk about specific anatomic regions of the cerebellum and potential correlation to specific gait abnormalities, like the intermediate zone and interposed nucleii controlling limb dynamics and rhythmic coordination like hypermetria (overshooting a target), especially when walking in uneven surfaces or when gait is perturbed, like walking into something or changes in surface topography, or the lateral zone of the cerebellum, for voluntary limb control, such as where you place your foot. Definitely gait nerd material.

There aren't any direct tips on rehab, but it would stand to reason that activities that activate the cerebellum and collateral pathways would give you the most clinical gains. Lots of propriosensory exercises like here, here, here and here for a start.

Happy cerebellum = Happy patient

The Gait Guys

 

 

 

 

Winfried Ilg, Heidrun Golla, Peter Thier, Martin A. Giese; Specific influences of cerebellar dysfunctions on gait. Brain 2007; 130 (3): 786-798. doi: 10.1093/brain/awl376  FREE FULL TEXT

Acupuncture/Dry Needling and Proprioception. A Winning combination.

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What a great combination of therapies for folks with chronic ankle instability, or almost any injury for that matter! Taking 2 modalities that emphasize afferent input from the peripheral mechanoreceptor system, which has such a large influence on the cerebellum as well as the segmental and descending pain inhibition pathways.

Did you notice they used the trigger points in the peroneus longs muscle to needle? Though they didn't say it, did you remember that that the point correlates to a great point: Gallbladder 34, which is an empirical point for musculoskeletal pain? Interesting how this muscle influences both frontal and saggital plan stability. 

Though the techniques of exercise could use some refinement (check out the gents posture in the photo, sure looks like he could use some gluteus medius work!), this is a good overview that provides evidence that utilizing spacial summation (combining multiple techniques that provide afferent input to more than one modality to cause an effect) has better outcomes than one alone. Put this one on your reading list : )

Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, Sánchez-Milá Z, Fernández-de-Las-Peñas C, Alburquerque-Sendín F.Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial. Evid Based Complement Alternat Med. 2015;2015:790209. doi: 10.1155/2015/790209. Epub 2015 Apr 30.

link to FREE FULL TEXT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430654/

Rock Your Rehab Process with these simple Proprioceptive Exercises

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In this capsule, excerpted from a recent Dry Needling Seminar, Dr Ivo talks about one of his proprioceptive sequences and the neurological reasoning behind it

Today we give away some of the farm with a great proprioceptive exercise sequence that we use ALL THE TIME.

Skill (proprioception), Endurance, Strength. In that order.

Try incorporating this simple and effective sequence into your rehab program and watch your results get even better!

 

Comparative effects of proprioceptive and isometric exercises on pain and difficulty in patients with knee osteoarthritis: A randomised control study. Ojoawo AO, Matthew O, Mariam HA.Technol Health Care. 2016 Jul 8. [Epub ahead of print]

Efficacity of exercise training on multiple sclerosis patients with cognitive impairments. Chenet A, Gosseaume A, Wiertlewski S, Perrouin-Verbe B. Ann Phys Rehabil Med. 2016 Sep;59S:e42. doi: 10.1016/j.rehab.2016.07.097.

Exercise strategies to protect against the impact of short-term reduced physical activity on muscle function and markers of health in older men: study protocol for a randomised controlled trial. Perkin OJ, Travers RL, Gonzalez JT, Turner JE, Gillison F, Wilson C, McGuigan PM, Thompson D, Stokes KA. Trials. 2016 Aug 2;17:381. doi: 10.1186/s13063-016-1440-z.

Leg and trunk muscle coordination and postural sway during increasingly difficult standing balancetasks in young and older adults. Donath L, Kurz E, Roth R, Zahner L, Faude O.Maturitas. 2016 Sep;91:60-8. doi: 10.1016/j.maturitas.2016.05.010. Epub 2016 May 27.

Hip proprioceptive feedback influences the control of mediolateral stability during human walking. Roden-Reynolds DC, Walker MH, Wasserman CR, Dean JC. J Neurophysiol. 2015 Oct;114(4):2220-9. doi: 10.1152/jn.00551.2015. Epub 2015 Aug 19.

Proprioceptive Training and Injury Prevention in a Professional Men's Basketball Team: A Six-Year Prospective Study. Riva D, Bianchi R, Rocca F, Mamo C.J Strength Cond Res. 2016 Feb;30(2):461-75. doi: 10.1519/JSC.0000000000001097.

Proprioceptive feedback contributes to the adaptation toward an economical gait pattern. Hubbuch JE, Bennett BW, Dean JC. J Biomech. 2015 Aug 20;48(11):2925-31. doi: 10.1016/j.jbiomech.2015.04.024. Epub 2015 Apr 23.