resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Leg Length and Pelvic Fixations
A common component of low back pain is sacroiliac joint dysfunction. Signs of SIJ dysfunction can include fixation with reduced range of motion, and localized pain or joint laxity and inflammation.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Online Efforts That Convert Traffic Into Patients
Most chiropractors are using "dinner with the doc," "refer a friend," customer appreciation days, grand openings, health fairs, chamber of commerce meetings, and other networking events to get new patients.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
A New Era of Injury Awareness Means a New Focus on Prevention
Despite a dramatic Super Bowl last month, the National Football League has taken quite a few hits lately concerning player injuries, particularly concussions.
Adjusting the Occiput on the Atlas
You may never see a particular set of patients in your office – the ones who are either afraid of neck adjustments or have had a bad experience. A vast majority of those who had a bad experience did not have a life-threatening vascular event.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
The Easy Way to Learn How to Document ICD-10
The 2015 Work Plan for the Office of the Inspector General (OIG) includes a focus on chiropractic services. This means chiropractors can expect to see more audits and reviews in the coming year because private payers pay attention to the OIG's focus as well.
Joint Supplements for Athletes (Part 1)
Maintaining joint health should be a daily focus for athletes. Joint health is a complex issue for everyone, but for athletes it poses a greater concern.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
What's Triggering That Point?
An orthopedic friend recently saw a patient of mine. He felt an injection of a trigger point (TP) at the upper trapezius and surrounding areas was necessary, since that was the patient's area of chief complaint and there was a tender, radiating nodule.
Connections Worth Making
"If most doctors are like me, [they are] isolated physically and professionally. I do not make the time to connect with other doctors and also a lot of doctors do not want to be connected for a lot of reasons. Dynamic Chiropractic keeps me grounded and connected.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
We Get Letters & E-Mail
We Have Come a Long Way – But There's a Long Way to Go; Grounded and Connected.
February, 2011, Vol. 11, Issue 02
The Bike Body
Working With Cyclists
By Erik Dalton, PhD
It's astonishing the money and time many elite and "weekend-warrior" cyclists devote to retrofitting racing bikes to conform to their bodies rather than first restoring function to the most critical piece of racing equipment: the rider's body.When muscle imbalances, faulty movement patterns and joint fixations distort the body's bony framework, the cyclist is led on a never-ending journey searching for that perfect bike fit. (Fig. 1)
My personal mantra: "Fit the body to the bike, stupid!"
Bodyworkers and functional movement trainers whose practices cater to amateur and elite cyclists are keenly aware of the clinical and performance advantages gained by restoring optimal mobility, flexibility and stability to the biker's muscle/joint complex. It makes sense to first get the kinks out before sending the client off for an expensive and sometimes useless bike retrofit. Without hands-on maintenance and functional fine-tuning, cyclists often unknowingly reinforce dysfunctional movement patterns ingrained from long-forgotten micro- or macro-traumatic injuries.
Confusion and controversy over this chicken-or-egg (bike-or-body) thing is primarily due to lack of understanding of the Law of Cause and Effect. For instance, let's say a bike shop performs a retrofit and Bob, the cyclist, smilingly pedals away on his newly reconstructed machine feeling secure and pain-free. Life is good... or is it?
Unfortunately, if Bob is one of many "flexion-addicted" Americans with a sedentary job that keeps him glued to the computer terminal day-after-day, gravitational exposure will gradually drag his body into a big "C" curve. (Fig. 2) In time, Bob's brain relearns this aberrant posture as normal and on weekend outings his "hip-flexed" desk posture morphs into a similarly distorted riding posture. (Fig. 3)
To make matters worse, stubborn pain-spasm-pain cycles often appear as the hip stiffens and the imposed stress destabilizes sacroiliac and low back structures. In the presence of lumbar spine instability, the brain may decide to lock down the low back and ribcage with protective muscle guarding. Thoracic cage rigidity not only inhibits proper diaphragmatic breathing but also sends shock waves through the thoracolumbar and pectoral fascia and into the upper extremity joints where reverberations are met with strong resistance from habitually locked hands, elbows and arms. (Fig. 4) Meantime, compensations from adhesive hip capsules also traverse down through Bob's knees, ankles and feet searching for a weak link in the lower kinetic chain.
Cyclists who opt for a bike retrofit prior to receiving manual therapy to release fibrotic hip capsules and hip flexors, soon notice a loss of endurance and may develop soft tissue or joint sprains associated with lumbopelvic imbalance. Oddly, many flexion-addicted cyclists attempt to work through the injury despite sensing a noticeable reduction of speed, power and efficiency. "No pain, no gain" is an unacceptable working model for those seeking longevity in the cycling sport.
Does decreased hip angle equal less power?
One of the most common bike positions used by "flexiholics" has the hip flexors locked short and the hams and glutes overstretched and weak. This imbalance pattern as described by Vladimir Janda in his lower crossed syndrome, forces the pelvic bowl to be drawn too far forward creating a decrease in hip angle. (Fig. 5)
Cyclists who consistently ride with an anteriorly rotated pelvis and decreased hip angle are subject to capsular and ligamentous adhesions and a subsequent loss of economy and power. To accommodate the loss of hip extension, many recreational and competitive racers compensate by posteriorly tilting their pelvic bowl and rounding their backs into a hyperkyphotic posture just to increase hip angle and power. The famed cyclist Andy Pruitt believes that changing the seat height by a mere inch alters mechanics and motor control patterns of every joint in the lower extremity. By decreasing seat height, excessive force is transferred to the patellofemoral joint, while raising the saddle too much strains the hamstrings, low back and hands.
Stand and try this: Lift one leg with the knee bent about 90 degrees as high as possible without straining or rounding the back and forcing hip flexion. Most people are able to comfortably hip-flex about 90 degrees. Try this maneuver again except this time forward-bend your trunk about 50 - 60 degrees, while raising the knee. Notice a dramatic reduction in the amount of hip flexion? Try both tests again and this time, measure available hip flexion by observing how high your foot raises off the ground. This test illustrates what can happen to hip-impaired cyclists: decreased hip flexion = greater effort = more work = poor performance.
Riding Postures and Rehab
The first order of business when treating adhesive (motion-restricted) hip flexors and capsules is to mobilize the hip in all three cardinal planes. (Fig. 6a) To restore myofascial balance, fast-paced "spindle-stim" maneuvers such as those shown in Fig. 6b help tonify weakened (neurologically inhibited) gluteal and hamstring muscles. Once the therapist manages to increase hip angle and establish proper functional balance and range of motion, the cyclist is free to decide which type of riding posture (he believes) suits him best.
Some cyclists prefer a high seat so they can posteriorly rotate the pelvis to increase hip angle. Other riders find greater mechanical advantage by putting a little curve in the low back, engaging the core, and then slightly backing off the curve to allow a neutral lumbar spine. Either way, both groups should avoid:
The Yin-Yang of Muscles and Joints
To perform well in such a challenging event, cyclists like Bob would greatly benefit from a well-constructed manual and movement therapy program that focuses on restoration and maintenance of proper intrinsic/extrinsic muscle balance and diaphragmatic breathing patterns. Fluid and dynamic body movement during cycling events is dependent on the ability of muscles and fascia to stay strong, yet flexible. A healthy lumbar spine is the driving engine in most athletic endeavors and length/strength balance between muscles, ligaments, joint capsules, and thoracolumbar fascia is essential for providing that stable platform. Any weakness or motor control issues are magnified by traumatic shocks from funky road conditions or recurring bike injuries. Eventually, excessive neurological input cannot be handled at the spinal cord level and the information is "fast-tracked" to the brain for interpretation via pain-signaling nociceptors. If the brain decides to "splint" the vulnerable area to prevent further insult, pain-spasm-pain cycles may ensue.
Ingrained muscle and motor imbalance patterns such as those discussed by Vladimir Janda, Gray Cook, Craig Liebenson and others, often require a concerted team effort to reestablish normal movement behavior. In most cases, the ideal treatment protocol is to first restore lost mobility to impaired structures and then address stability issues via functional movement training.
Like many of America's other popular, but abnormal, athletic endeavors such as golf, tennis, bowling, etc., cyclists bring with them a complex biomechanical downside that's often hard to completely fix. The "arched back" model is generally the most problematic. In an attempt to level the eyes, the rider must hyperextend occiput on atlas. The cervicothoracic junction is also forced to hyperextend (neck-on-shoulders) causing chronically locked intervertebral joints and rib jamming. This area is particularly affected by road vibrations due to the stationary position of arms, shoulders and hands. Additionally, ligamentous laxity may develop from excessive thoracolumbar and lumbosacral bowing which, in time, sets the stage for low back pain and disability.
The good news is that the human body is both adaptable and dynamic; the bad news is that our biker clients often bring along a lot of baggage including flexion-addicted sitting postures, old injuries, compensations, poor training habits, etc. Once the skilled manual and movement therapist makes necessary corrections, the bike can then be retrofitted to conform to the rider's optimally functioning body. A properly fitted bike combined with a revitalized and functionally balanced neuromuscular system allows muscles and joints to work at optimal levels of motor unit recruitment and synchronization. As endurance and performance improve, so does the natural love of cycling.
Click here for more information about Erik Dalton, PhD.
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