Analisi degli schemi motori errati e

Transcript

Analisi degli schemi motori errati e
PART A – SPINE
PARTE A - COLONNA
“La Stabilità prossimale per la mobilità distale”
Analisi degli schemi motori errati e Allenamento integrato del core
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Analisi degli schemi motori essati
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Determinazione del confine tra Rehab/Training
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Processo di Revisone Clinica: Analizza-Correggi-Ri-analizza per
decidere come progredire o regredire su un binario oppure
scegliere una via tangenziale (lateralizzazione)
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Interdipendenza regionale/ Layer Syndrome/Joint by Joint
Approach
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Il ruolo del diaframma, del pavimento pelvico e il sistema di
stabilizzazione in una funzione simil cilindro
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Esercizi fondamentali di stabilità del core da una prospettiva
biomeccanica e seguendo lo sviluppo neurologico
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L’allenamento Anti-flessione e Anti-rotazione
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D4, mobilizzazione della caviglia e dell’anca (foam roll, yoga, Lewit’s
PIR, etc)
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Okinawan strength – eliminare le parti molli del “core”
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Gripping, la funzione di radicamento del piede nelle arti marziali
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L’importanza clinica delle funzioni umane – stazione eretta,
appoggio monopodalico e respirazione
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La relazione tra dolore e inabilità (bandiere gialle, eliminazione del
pericolo, sensibilizzazione centrale)
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Il ruolo della cinesiologia dello sviluppo e dei reset neurologici,
adattamento neurologico e determinazione dell’intensità
PARTE B – ESTREMITA’
Reabilitazione dell’Atleta: From the Ground Up &
The Continuum of Care: From the Head to the Toe
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Allenamento Funzionale Integrato del Core con le estremità
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Prevenire il collasso mediale del ginocchio Posterior Chain
activation
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Potenza/stabilità sul Piano Frontale
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La “zona morta” D4
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Disfunzioni oro -facciali
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Disfunzioni Cervico-craniali
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Disfuznioni del quadrante superiore e dischinesi scapolare
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Come raggiungere l’adattabilità residua ed il trasferimento delle
abilità
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Il Continuum della Potenza/Stabilità ed il ritorno sicuro
all’Attività/Sport (tripla flessione per tripla estensione,
riscaldamento di movimento)
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Indicazioni per ogni esercizio correttivo
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Allenamento reattivo, indicazioni esterne al posto delle interne ,
strategie in soglia o sotto soglia, Programmare i giorni al alta
intensità e a bassa intensità
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The Core Slings: Sagittal, Frontal & Transverse Plane
Questa serie di 36 ore viene tipicamente insegnata in due weekend da 3
giorni l’uno. E’ un workshop interattivo, basato sul problem-solving.
Puoi iniziare in qualsiasi punto del programma (siccome è diviso per
regioni corporee) ma se non inizi dall Parte A, pianifica di seguirlo al più
presto perché include una grande enfasi sull’analisi funzionale che è il
fondamento di ogni programma.
Tecniche imparate nel Programma di 6 giorni
I) ASSESSMENT:
A) History:
• Activity intolerances
• Fears, Worries, Concerns
• Goals
• Chief Complaint
• Onset (traumatic vs repetitive strain)
• Demands (Sports/activities)
B) Examination (Identify 0’s & 1’s):
• Finger tip to floor
• Deep Squat
• Calf Mobility
• Mag 7 (OH Squat, Wall Angel, 1 Leg Balance, 1 Leg Squat, 1 Leg Bridge,
IAP/Respiration)
• Side Plank Endruance (Goal symmetry w/in 5% AND > 40s)
• Janda’s Perturbation test
• Vele’s Transverse Arch Stability Test
• Open question – “Can you reproduce your symptoms?”
II) EXERCISE TRAINING (Rx 2’s only):
Goals –
• Corrective for Painless Dysfunctions
• AFTER 1’s turn into 2’s then Audit Markers – 0’s
• Hardest thing they do well
• Don’t police perfection (should be 2’s NOT 3’s unless adding LOAD)
• At or near threshold (overload principle to promote neural adaptation)
• Residual Adaptation (should continue next day)
• Skill Transferability (should be functional – the SAID Principle – Specific
Adaptation to Imposed Demands)
A) Stability Training:
1) Competency/Motor Control 1st –
• Pneumo-muscular reflex – active exhalation to create Okinawan core
strength/stability (no soft spots w/out holding breath in)
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functional brace (w/ B Dog, D Bug, Janda Perturbation Test)
• Cat/Camel
• McGill’s Big 3
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Bird Dog
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Side Bridge
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Curl Ups
• Boyle’s Bird Dog (regression)
• Lewit – 3.5 month position (IAP)
• Bug off Wall
• Pelvic Floor
• Barrel Roll
• Foam Roller (vertical) – marching, bicycle, arms OH w/ ribs in exhalation
position
• Developmental Sequence from 3.5 to 13 months
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Baby Get-Up Rolling from 3.5 to 7.5 month position on forearm
(“Kyla”)
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Diagonal Sit (Vojta) variation w/ top leg behind. leaning forward to
activate downside adductor’s differntiaion (pull) function
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8.5 month position starting point of Turkish Get-up on
outstretched arm & hand
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Bear – low and high (w/ reducing points of support & crawling)
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Sumo
• Bridges
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w/ band
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Single leg Bridge
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Cook 1 leg Bridge
• Vele
2) Capacity/Strength/Endurance after Competency assured –
• Quad RNT
• Plank (hard style, 2/1 Saw, Plank Roll)
• Stir the Pot
• Anti-Flexion Training for Trunk Extensors- (Superman w/ Ball, Vermeil
prone superman, Good Morning, Bent over Row)
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Note: remember extension sensitivity is common. Esp in patients w/
Fear-Avoidance Beliefs. Find Most sensitive extensor load &
Mark it. Train less sensitive Anti-Flexion exercises while giving
ROF of the dangers of flexion & benefits of building
endurance/ROM of postural extensor system. Then Re-assess
most sensitive extensor movement that was left un-trained.
B) Spine Sparing:
• Micro-Break –
Brugger
McGill Arm OH
• Hip Hinge –
Waiter’s Bow
Short Stop
• Dead Lifts
2 Leg Romanian Dead Lift
1 leg Romanian Dead Lift
Teeter
• Squats
Goblet Squat
Sumo Squat
Prone Rocking for hip width in squat
Hip Hinge (Squat) w/ arm rest, box squat assist
C) Mobilizations:
• Posterior Hip Capsule/Piriformis (Pigeon Pose, figure 4 supine, Supported
Piriformis Stretch)
• T4 Extension (Jerzey/Aniela’s T-spine mobility – flap the wings,; Foam
Roller (vertical) – chest press, arms overhead;
• Foam Roller (horizontal) – upper back cat & extension over foam roll
• T-spine rotation from Child’s Pose
• Halo (standing, tall kneeling, kneeling, inline kneeling)
• T4 Sphinx (Jiri) on hands & forearms
• Kolar’s T4-T8 active extension
• Ant Hip Capsule Mob – Thomas’ test, Valslide assist standing, kneeling
psoas stretch
• Leg Swings for supination
D) Functional Training:
• Lateral Squats
• Paloff Press – standing, half kneeling, tall kneeling, supine
• Cable Chop
• Balance reach (6:00Running man, 5:00/7:00 Bowler)
• Star Matrix Angle lunges w/ ipsi or contralateral reach for “driving”
supination in foot w/ arm
Plyo’s – up/down into athletic position, scissors into lunge, transverse
plane
Additional Skills Learned:
• Nordic Hamstring
• 1 Leg Hop
• Hip Abduction/Hip Extension/Active SLR Screens
• Lumbar Stability Shear Test
• Seated SLR with Slump
• Push-Up Test
• Scapulo-Humeral Rhythm
• Empty Can & Speeds Test
• Janda’s Neck Flexion Test
• Mouth Opening
• Posterior Shoulder Capsule Mobilizations
• Ball Bridges
• Monster Walk
• Lateral Band Walk
• Dead Lifts (RDL)
• Squats (Windowpane, Overhead, 2 X 4, sumo, Potato Sack, Goblet)
• Box Squat (2/1)
• Supported Functional Reach
• Reverse Lunge (step/slide)
• Janda Lunge
• Angle Lunge
• Qua
• Kettle Bell Carry
• Turkish Get-Up
• Med Ball Routine
• Push-Up with Plus
• Serratus Punch
• Horizontal Row
• Shoulder packing
• Rear Foot Elevated Split Squat (Bulgarian)
• Lateral squat
• Quick feet athletic position
• Plyometrics (stretch-shortening cycle)
• Pillar Running
• X-Hop
• High Pull
Kettle Bell Swing