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4 Things I Learned from the Active Release Techniques (ART) Spine Course

July 29, 2015 · by Garrett McLaughlin

| Article written on July 29th, 2015 at 9:35am | Follow Garrett on Facebook, Twitter, and Instagram |

Just last weekend, I had the opportunity to take my third Active Release Techniques (ART) course which focused specifically on the spine. As an Athletic Trainer, the spine has always been an area that I would recognize as a weak point. AT’s are typically very good at evaluating and treating injuries in the extremities, because this is what we see most within the younger (high school and collegiate), athletic population. With that being said, the spine is often overlooked while treating injuries at the extremity because issues can be traced not to where the pain is, but to the actual source of the dysfunction. The ART spine course allowed me to re-visit such an important inner working of anatomy and biomechanics that are easy to overlook in human function. But, to also recognize the connectedness and relationship of one structure to another.

Here are 4 things I learned from the ART spine course:

The superficial back line (SBL) can become problematic and often overlooked at the sacrotuberous and long dorsal sacral ligaments. Often we see poor posture and increased kyphosis at the thoracic spine, as well as increased tension and tightness in the hamstring musculature. Well, the sacrotuberous and long dorsal sacral ligaments are the soft-tissue structures that connect both of these problematic areas. Maybe they need more attention to improve their resiliency and function that can help improve issues commonly seen at the thoracic spine and hamstring.
Do you suffer from relenting headaches? Headaches can often be combated and resolved with soft-tissue intervention to several surrounding head and neck muscles. There are so many vital muscles that surround the head and cervical spine. When these tissues become tight and fibrotic from poor posture, staring at a computer screen, and constant abuse, headaches are often the result. Several muscles, including: temporalis, occipitalis, rectus capitus posterior major/minor, superior oblique, trapezius, splenius capitus, and semispinalis capitus need to be evaluated from a soft-tissue standpoint to determine their quality. More often than not, we quickly prescribed medication to treat persistent headache without investigating the possible root cause in the surrounding musculature.
Is spinal alignment off? Manipulation is a key component to restoring proper alignment and function within the musculoskeletal system. But, manipulation without addressing the restricted soft-tissue structures will ensure you need multiple visits to regain pain-free function. When we look at spinal alignment, we have deep soft-tissue structures that control vertebral position, such as: rotatores, multifidus, intertransversarii, quadratus lumborum, iliolumbar ligament, and more. Many of these structures need to be treated in conjunction with manipulation for full resolution. There is no one technique or solution to resolve pain or dysfunction, but a multi-faceted approach will provide the best results.
Referred pain patterns into the thigh, lower leg, and genitals are possible from nerve entrapment within the hip flexor area. We have several nerves including: femoral n., genitofemoral n., and lateral femoral cutaneous n., that can become entrapped at the psoas, iliacus, and anterior aspect of the quadratus lumborum. When this happens we can feel burning, tingling, aching, or shooting pain further down it’s distribution pattern. Don’t always be fooled when something hurts that the specific location is the problem. With referred patterns, like when dealing with nerves, we must investigate the entire pathway of that nerve to determine if there are any issues further up.

I hope you enjoyed this post. If you are suffering from any type of soft-tissue injury or interested in improving overall function of the body, contact me to learn more about ART. In conjunction with a structured exercise regime, ART can allow you to stay injury-free, recover from injury, or feel the best you have in years.

By; Garrett McLaughlin, MS, ATC, CSCS, ART

Random Thoughts on the Foot: Installment #1

April 14, 2015 · by Garrett McLaughlin

| Article written on April 13th, 2015 at 11:30am | Follow Garrett on Facebook, Twitter, and Instagram |

When we think about proper lower extremity function, many people look at the ankle, hip, and lower back, but fail to recognize the importance of proper foot function. Here are 4 thoughts to help you look at and improve function of the feet:

1. The great toe is important, hence why we call it the “Great” toe (I just made that up, sorry). The great toe should have adequate range of motion regardless of your activity because of it’s importance during propulsion in walking and running. Imagine if the last part of the body to push-off the ground was limited, how would that affect your gait cycle? You bet we would need to compensate in some way to make up for this. The required amount of range of motion is 70-80 degrees of metatarsophalangeal (MTP joint) extension. This is often more motion then most people have, so we need to put in some time to address the great toe and it’s musculature. Here’s how:

2. A typical dynamic flexibility exercise is leg swings across the body (start video below at 14 seconds). This helps mobilize the hip in the frontal plane and target the adductors and abductors. Pretty important from that end, but even more so is what’s going on down at the foot. I typically use this drill to mobilize the metatarsals. The metatarsals are the long bones in the foot that need to be able to glide to some degree. We don’t usually consider the motion between these bones, but it is important in proper foot mechanics, shock absorption, and function. As we swing the leg across and away from the body, we cause the foot to roll from a pronated to a supinated position. This loosens, the sometimes too rigid, ligamentous attachment binding the metatarsals together.

3. Doing self-myofascial release or getting soft-tissue work on your feet is essential. Typically we will foam roll the quads, iliotibial band, calfs, and thoracic spine, but fail to pay attention to the plantar surface of the feet. The calf does have an impact on the foot with it’s fascial connection in the superficial back line (SBL), but there are so many small intrinsic muscles and the plantar fascia that deserve attention. Using a lacrosse or golf ball are two very good ways to work on this area. Simply roll the bottom of the foot slowly across the ball and look for any tender or tight areas. Once you find a spot, you can hold the ball on it and add toe movements to release the tissue. Try incorporating this before you next workout or run.

4. Have you ever been fitted into the proper kind of footwear? Know what happens when we wear improper footwear, pretty much all of the areas mentioned above get jacked up. This is so common today with high heels, dress shoes, and poorly fitted sneakers. Let’s not even go into sandals! Everyone’s foot structure is different and that is why we can’t all wear the same type of footwear. Many running stores do a great job of fitting their customers with which type of sneaker is compatible with their foot. Often, the people who develop foot and lower leg issues, especially distance athletes, do so because they are altering their biomechanics with a sneaker that isn’t right for them. Take the time and spend a few extra bucks to be fitted into the correct shoe.

There’s my few random thoughts on the foot. Start paying more attention to the foot and see if you can uncover any issues before they become problematic. Don’t be afraid to show your feet some love!

By: Garrett McLaughlin, MS, ATC, CSCS, ART

Function Before Fitness: Why Does It Matter?

March 30, 2014 · by Garrett McLaughlin

Function before fitness is a topic that I am very passionate about. I really shy away from giving people exercises just to exercise. To me, that is unethical and missing the most important part. Proper bodily function should precede every fitness program. This means each person should complete a movement screen first to detect any underlying imbalances, asymmetries, faulty movement patterns, or pain. If you test acceptable on the movement screen, then by all means do whatever exercises you like. But, if there are red flags, it is essential to investigate and correct these issues before compounding the problem

One ex Squat - delaware ercise I often see people doing wrong is the squat. By far one of the best exercises and a fundamental movement pattern that everyone should be able to do. But, if you can’t squat properly with the chest up, knees out wide, and weight back on the heels, then you really shouldn’t be adding weight to it. Something here is wrong and continuing to add weight to a dysfunctional movement pattern will compound the problem a lot quicker then correcting and then building up from scratch.

Have you ever suffered from an injury? Did you properly rehabilitate to regain natural function? And, I’m not just talking about until the pain subsided. Following each injury and any stimulus of pain, it is common for our movement patterns to be altered. This matters because so often people endure injuries where they limp, compensate, or favor the affected side and changes occur which will increase the likelihood of future injury. This should be taken into consideration for any exercise goer who had/has pain and continues to exercise without properly addressing the issue.

So, what am I trying to get at? Function far outweighs fitness when comes to proper movement. If you haven’t had a chance to be assessed, it is well worth the money. And, if you are returning from an injury or currently have pain, make sure you go through a full rehabilitation program aimed not only at decreasing your pain and symptoms, but fixing the underlying cause and addressing any compensation which resulted. All of this is just like building a house. You’d obviously want a solid foundation laid down before adding all the extras. Contact myself if you are interested in completing a movement screen or would like to be directed to the appropriate professional in your area.

Garrett McLaughlin is an athletic trainer, personal trainer, and certified active release techniques provider. He is passionate about creating safe, and effective fitness and rehabilitation programs for the general population and athletes. ‘Like‘ Garrett’s Facebook page to stay up-to-date on related health, fitness, and nutrition information.

What I Learned in 2013…

December 19, 2013 · by Garrett McLaughlin

What I learned in 2013…

I’ll start off by saying that 2013 was a great year. Of course, like all years there were ups and downs, but I can look back and honestly say I am a better person and professional than I was in 2012. I saw a few posts from others reviewing what they learned and thought it would be a good idea to share my own thoughts since many of you were part of my 2013 and may even be a reason for me getting better. For those that helped me move forward, I thank you. Okay, here we go:

It’s not only the college education you get that matters, but what you continue to learn that is key. I received a bachelors and masters degree and thought I knew a lot. What I learned this past year was that I know nothing. I don’t mean that literally, but in terms of how much information is out there, and how quickly we are advancing, there is so much more to learn. It is honestly a shame when I see people who are satisfied with how much they know. Over time we start to forget things we learned, but also pick up new techniques and strategies to fill there place. I could honestly say I spent most of 2013 with my face in some kind of book, whether it be a textbook or a for fun reading book. The more I read, the more I realized I don’t know. I jotted down a list of books, but when I finished I probably added 2-3 books for every one that I read. Learning is a lifelong process, don’t be satisfied but continue to grow each and every day.
I have always worked in professions where you deal with people on a daily basis. Kind of similar to #1, but I thought if I could learn more about the human body I would become more well-known and in turn make more money. 2013 made me realize it isn’t knowledge that necessarily makes you successful, but how you deal with people. One recommendation to everyone is to read Dale Carnegie’s book How to Win Friends and Influence People. Once I read this book and started implementing the strategies into my daily routine, I was surprised at how much things changed for me. I learned to simplify what I was trying to tell people to just the basics, but most importantly just getting to know people for who they are. It made me realize we don’t smile enough or say hello to strangers. We are so focused on getting from point A to point B that we forget about the journey and those we pass along the way. Take a second, put down your cellphone and give the person who walks by you a smile and a hello, it’ll go a long way.
Fitness is always placed over function. Let me ask you this, how good will your fitness be if your injured? Pretty poor I can imagine. So why do we go into the gym trying to loss weight or get stronger, but pay no attention to how our body functions. Before you squat with heavy weight, you must learn to squat properly, unweighted, through the full range of motion. DO NOT SACRIFICE THE BASICS FOR FITNESS! I realized based on this I need to be more stringent with my clients. Oftentimes, I would let my clients dictate their programs based on what they like, and not what I believe is right. In the end I may lose clients over this but we should all have a philosophy that we are willing to stick by no matter what.
You do not gain range of motion through static stretching. This has been a big transformation in thinking for me in the past year. When I was at the college as an Athletic Trainer, players would come in everyday either before or after practice because their muscles were tight. I now realize I wasted countless hours passively stretching players that still came back everyday. If passive stretching actually did what I intended it to do, increase muscle length, why did these players need to come back every day? While attending the Perform Better Functional Training Summit this past summer in Chicago, I was turned on that flexibility may not necessarily be an issue with the muscles, but could be the brain. The brain has the emergency brake on certain motions and movements to prevent it from injury. My entire life I did the standard hamstring stretch by reaching down and touching my toes. This past year I added more single leg full range of motion exercises into my work and it drastically improved my flexibility. At what point during these exercises did my muscles relax and become stretched to their end point? Actually they never relaxed. But what it did was allow the muscle to stay contracted as it lengthened, which told the brain it was in control of the movement, and in turn increased motion. That is why I actually don’t say flexibility anymore but use the term mobility. I think this is a better depiction of everything that goes into motion such as stability, muscle length, and neural components. I believe if you are going to static stretch in order to gain motion, try adding it before you exercise while you are cold. While I’m cold? Won’t I get hurt? Not if you don’t push past your limits. But realize once muscles are warmed up they become more elastic. We all know what happens to elastics- stretch them out, release, and they return to their original length.
The joint by joint approach- this approach shows the alternating relationship between each joint throughout the body. If you look at the body each joint actually has an opposite role of the joint above and below it. Ankles should be mobile, knees stable, hips mobile, low back stable, thoracic spine mobile, cervical spine stable, shoulders mobile, etc. And, when one joint does not function as intended it may cause additional stress at the joints above and below itself. That is why with people with low back pain it is essential to look at mobility at the hips and thoracic spine. If either of those two joints lack there full range of motion, the low back has to compensate by going through additional motion which over time increases the chance of injury.
It’s good to be pushed outside of your comfort zone every so often. I really believe to become better at whatever it is you do, you need to be nervous and uncomfortable at times, and realize that it is okay. Shout out here goes to the Your Turn Women’s Group and the Fit 4-50 class. Man, did I hate being in the front of the room, all eyes focused on me, center of attention, with so many hecklers! When I started at the BAC I always hated public speaking and being in front of groups. I told myself I would jump into the lion’s den and work through it. If you are afraid of something face it head on. It’s important to look at stressful situations and ask yourself: what is the worst that can come from this? More often than not the worst situation really isn’t as bad as you expected. Try putting your fears and stressors into perspective.
Kettlebells aren’t only for athletes! I was new to KB’s over the past year and really had no knowledge of the exercises and benefits of using them. I now believe they are an extremely valuable tool. Much credit goes to Steve Lewis and Ian Papworth at the BAC who taught me tons on proper KB use and their benefits. Definitely try out a kettlebell class to learn how to use them properly, it will impact your exercise program significantly.
Exercise is important, but nutrition, sleep, and stress management even more so. Try developing a great exercise program but continuing with other poor lifestyle habits and see how far it gets you. I would almost guarantee you’d make some progress and then plateau quickly. There is so much more to wellness that I never completely dove into. I now see the values of getting a good night’s sleep, properly managing stress, eating a well-balanced diet, and finding what makes you happy.
Crunches. There is tons of research out there on crunches and it’s damaging effect on the lumbar spine. Why are we still doing these day after day in our exercise programs. This is an exercise that I have given up completely for myself and my clients, and it has been challenging. When you say abdominals, most people would reply with crunches. Just realize that there is solid evidence out there that demonstrates the damaging effect of repetitive crunching of the lumbar spine. Try exercises like planks, stir the pot, side planks, rollouts, etc. The lumbar spine never moves from a neutral position but you still target the abs/core significantly.
Everything works out in the end. Plain and simple. Keep an optimistic mind set, do your best, and things will work out. Maybe not always as planned, but you’ll get through it.