Number One………….Round can generates more power.

Dr. Kobasova spoke how as infants mature and develop increased stability they utilize stability through their midsection by increasing intra-abdominal pressure. She made this very clear by talking about the difference between Roger Federer and Raphael Nadal besides their world tennis rankings. If you look at pictures of each of them while in action, you can see that Roger is more round through the mid-section while Nadal has the typical six pack abdominals. While Nadal appears to be in better shape physically, he suffers from chronic low back pain while Federer continues to be number one in the world and has a less impressive midsection, or does he? What if the reason why he is so resilient to dysfunction and can generate such power is due to not having a ripped midsection like Nedal’s?

As Dr. Kolar and Kobasova stated,  concavities, hinges or creases in the midsection is a sign of dysfunction and an inability to recruit core stability properly. A ripped core typically means that  you most likely can’t establish a full diaphragmatic breath necessary for creating intra-abdominal pressure to stabilize the spine.

Number Two……. Centrate those Joints!!!!

Optimal stability through joint centration sounds logical enough, until you understand why it is so necessary and how the effects of joint centration cause irradiation of increased stability through the entire body. Joint centration is actually the position of the joint where there is maximal joint congruency as well as ideal balance from the muscles that act upon that joint. It is from this optimal position where the body can most efficiently handle the largest load and where actual good form comes from. Don’t believe me, check out the perfect form!!

With a loss of joint centration, we increase the stress on the surrounding tissues and body in general. This leads to an overall loss of global stability and the imprinting of sub-optimal motor patterns.

Using the simple but brilliant concepts of DNS ,we are basically instructed to return to the development patterns and milestones of a child to improve  overall function. This is because we all have this encoded into our DNA, it is the product of being born with an immature central nervous system, and the process we utilized to achieve verticalization.  Its not about Joseph Pilates idea of correct posture or Bruggers, it was the steps we had to go through to gain the ability to be upright. And as Gray Cook states, we all had the mobility but we had to earn the stability.

Sometimes, we can over think a lot of things in rehabilitation and strength training. Address the transverse abdominus, draw in the belly button, buy this ab machine, etc. But sometimes the answer is simple and has been there all along, we just have to dust off that software to get it going again, like riding a bike.

I ask this question because as a practitioner, I have contemplated how well we as a profession address this question. What do I mean by this? Well, we have become excellent at relieving pain and increasing strength but I don’t see us addressing the computer that drives all of the systems as well as we should to achieve optimum results for our clients. Our brain is an amazing machine that continues to amaze the researchers who look at its function and the purpose of why we truly have a brain. Daniel Wolpert is a neuroscientist that addresses this question at a TED conference that you can see here.

If the primary purpose of our brain is to create adaptable and complex movements to relate to our environment, then why do we not focus more on rehabilitating the software (our motor patterns) through purposeful rehab rather than just fixing the hardware and hoping that the software will just follow suit. There have been at least seven prospective studies that have found that one or more motor control deficits are related to injury. Out of those studies, the most profound data is from a study looking at motor control during simply transitioning from double limb stance to single limb stance using EMG. During this low level task, significant delays in the onset of ankle, hip and hamstring musculature was noted when compared to controls. It appears that subjects adapt a substantially altered strategy of movement, which is retained by the motor control system (your Brain!!), even after the subject has returned to full activity. This adaptation serves as a profound example of motor control changes and altered motor control following injury. It is possible that standard rehabilitation programs do not get to the level where we can address these motor control changes.

Until now……..

At Evolution Physical Therapy we have addressed this through the use of advanced therapeutic techniques. our main purpose is to address compensation patterns that are present following injury at their core. We utilize an extensive health and history and exam utilizing the SFMA to determine the most dysfunctional and non-painful pattern that is associated with the patients dysfunction. This allows us to attack the problem at its epicenter and promotes objective changes every session to make sure that there is no wasted time and energy in your session. ARP wave therapy  is utilized to address the motor control deficiency that is the root cause of your pain or dysfunction. This means that we will not waste your time  performing exercises that you could be being  doing at home or at your gym and strengthening within a compensated motor pattern which research has shown to be one of the leading causes of future injury. We will also utilize the most advanced therapeutic technologies and corrective exercises to get you back in the game sooner and while correcting the actual cause of the dysfunction rather than just chasing the pain and eliciting temporary relief.

Give us a call if you have any questions at 480-767-2769 or visit us at www.evophysicaltherapy.com

Dr. Jeffrey Beran, PT, DPT, ATC

Evolution Physical  Therapy, LLC

The Evolution of Rehabilitation and Performance

With all of the recent news about the quality of food in America that we are ingesting like GMO corn, high levels of sugar and of course…. pink slime. Its time we take a look at how our ancestors did it and let nature assist our healing through the power of food.

Good eating,

Dr. Jeff Beran, PT, DPT, ATC

Evolution Physical Therapy

Below are some common conditions and injuries which may be treated by a physical therapist.

At Evolution Physical Therapy, our goal is to provide the best care to improve your condition. Soon, you will then be allowed the opportunity to obtain more information by clicking on the specific condition or injury which you would like to learn more about. Please remember that the information on this site is for informational purposes only and should in no way replace a conventional visit to an actual live physical therapist or medical professional.

General

• Stroke Rehab
• Multiple Sclerosis
• Parkinson’s
• Arthritis
• Balance dysfunction
• Deconditioning

All injury is the direct result of the muscle’s inability to absorb force. The muscles of the body are driven and controlled by electricity and when they are injured, it develops a type of “short-circuit” in the muscles electrical system. ARPwave technology can locate the actual origin of that short-circuit (often not where you think it would be) and then rapidly repair it. By understanding and working in harmony with the body’s muscular system, ARPwave can help your body heal itself, naturally. ARP uses a patented bio-electrical current, simultaneously with active range-of-motion and other exercise techniques, to significantly speed up the body’s natural recuperative ability.

ARP is an acronym for Accelerated Recovery Performance, a system comprised of proprietary technology and protocols created by Denis Thompson founder of ARPwave. ARP treatment is indicated for the treatment of all muscle related injuries and post-surgical rehabilitation. Treatment Protocols are usually 10 – 15 sessions over 2 – 4 weeks. The goal of these treatments are to return you to full function as quick as possible without a burdensome home exercise program.

ASTYM

ASTYM (A-stim) treatment is a rehabilitation program that stimulates the regenerative healing process of the body. This approach is a non-invasive therapy that works fast and consistently. The ASTYM system rejuvenates muscles, tendons and ligaments. It gets rid of scar tissue problems from old injuries in a fashion previously unimaginable. This method has been research tested and has the scientific background, data and experience that proves it. More information is available at www.astym.com.

We utilize this method as a stand alone treatment to augment your other therapies or integrated into our other advanced practices to help you get better, faster. With ASTYM and our other therapies such as ARPwave, Evolution Physical Therapy is unparalleled in utilizing the best physical therapy tools, techniques and technologies available anywhere.

Electro Therapeutic Point Stimulation (ETPS)

Electro Therapeutic Point Stimulation (ETPS) uses a non-invasive tool to apply concentrated low-frequency stimulation to acupuncture points, motor/trigger points and contracted motor bands.

This small unit has an enhanced point finder that makes it easy to use to treat chronic and acute soft tissue pain. This combination of modern electrotherapy technology and ancient philosophies can provide synergistic therapeutic results to those who suffer.

The therapy is based on four therapeutic concepts: Increasing circulation, stimulating “gateways” in the nervous system to the body, relaxing contracted muscles to relieve pressured nerves, and releasing endorphins, the body’s natural pain killers. Applying ETPS stimulation to a unique combination of acupoints will provide immediate pain relieve, decrease muscle tonicity and accelerate tissue repair for any form of muscular skeletal disorder, regardless of cause.

Although motor, trigger and acupuncture points have been used in therapy for many years, when they are combined in special patterns they greatly increase the therapeutic outcome of the treatment. Many acupoints often have a beneficial therapeutic effect for disorders far removed from their actual anatomical location. Some acupoints even have a special influence on special forms of body tissue (influential points), while other acupoints located on the extremities have a beneficial effect on proximal disorders (distal points).

ETPS therapy has proven successful in the treatment of back and neck pain, whiplash, TMJ, fibromyalgia, neuropathies, migraines, headaches, sports injuries, carpal tunnel, failed backs, post operative radiculopathy, plantar fasciitis, frozen shoulder and shoulder pain, tennis elbow and many other neuromyofascial pain syndromes.

FSM (Frequency Specific Microcurrent or Micro-current)

FSM (Frequency Specific Microcurrent or Micro-current) is the use of specific minute amounts of electrical current which appear to stimulate cells to create ATP or “cell energy.”

When this occurs your body becomes capable of using this self healing energy to speed up any necessary corrections in damaged tissues. When the body is injured, the cells are more resistant to electrical input. This is called reduced capacitance. Microcurrent therapy improves cell capacitance allowing the following to occur.

This energy healing therapy helps create a more favorable environment in the body’s cells for healing by regenerating cell function, reducing pain and inflammation, and restoring proper blood flow and self healing energy to the affected area.

FMS (Functional Movement Screen)

FMS (Functional Movement Screen) was designed by physical therapy and fitness professionals to help prevent injuries. This simple test can give you insight into limitations that can affect your performance or lead to injuries. We can then recommend strategies to overcome these limitations leading to improved fitness. This system is used in the NFL combine to screen for athletes that are predisposed to injuries. This information helps to guide multimillion dollar decisions during the NFL draft and can help prevent you from getting hurt at the gym.

K-Laser Therapy

Laser Therapy, or “photobiomodulation”, is the use of specific wavelengths of light (red and near-infrared) to create therapeutic effects. These effects include improved healing time, pain reduction, increased circulation and decreased swelling. Laser Therapy has been widely utilized in Europe by physical therapists, nurses and doctors as far back as the 1970’s. Now, after FDA clearance in 2002, Laser Therapy is being used extensively in the United States.

Laser Therapy is proven to biostimulate tissue repair and growth. The Laser accelerates wound healing and decreases inflammation, pain, and scar tissue formation. In the management of chronic pain Class IV Laser Therapy can provide dramatic results, is non-addictive and virtually free of side effects.

There are thousands of published studies demonstrating the clinical effectiveness of Laser Therapy. Among these, there are more than one hundred rigorously controlled, scientific studies that document the effectiveness of laser for many clinical conditions.

TDN Therapy (Trigger Point Dry Needling)

TDN Therapy (Trigger Point Dry Needling) involves the insertion of acupuncture-type needles into muscles in order to relieve pain and restricted range of motion. TDN Therapy is NOT acupuncture. Acupuncture is based on restoring flow of energy (“chi”) along meridians in the body. In TDN, we have no intention of affecting these energy meridians. TDN is based on modern Western scientific principles and our knowledge of anatomy and physiology. We needle muscles that harbor trigger points.

A myofascial trigger point (TrP) is a tender “knot” in the muscle tissue. Most of us have these tender areas in various places in our bodies. You might feel a tight band of tissue for example in the upper trapezius muscle in your upper shoulder. In the middle of that tight band, you might feel a small hard nodule. That’s a trigger point. The nodule will be painful when you press on it. The trigger point may cause referred pain. That upper trapezius TrP may cause pain in your head and feel like a headache (picture below.) Often, the trigger point that causes symptoms might be quite distant from the painful area. For instance, the gluteus minimus muscle in the hip can cause pain all the way down the leg.

Myofascial trigger point (TrP) usually it happens when there is some kind of stress on the muscle. This may be from a sudden overload in a traumatic injury like a fall, a car accident or lifting something improperly. Or, it may happen over a long period of time for example from chronic postural stresses such as sitting at a computer. Most of us have movement patterns, which are not as efficient as they could be. We tend to overuse certain muscles, and underuse others. Also, TrPs can be caused or perpetuate by a problem with the nerves that supply the muscle. This often happens near the spine where the nerves exit from the spinal column. There may be a degenerated or herniated disc, or some arthritis in the joints of the spine. If the spinal nerves become compressed or irritated, the muscles that the nerves supply become more irritable and are likely to develop TrPs. Also, muscles at the spine are likely to tighten and develop TrPs, which will compress the nerve further.

This leads to a “vicious cycle” of pain and dysfunction. For this reason, we usually treat the of even for extremity pain. If you have pain in your shoulder, elbow or hand there may also be a problem in your neck. If you have hip, knee or foot pain you will usually benefit from treatment your low back.

There is ongoing research about what’s actually happening physiologically at a trigger point. We know that there is a continued release of certain neurotransmitters at the junction where the nerve and muscle meet. This causes a self-sustaining contraction in part of the muscle It holds on, and doesn’t usually let go until it is treated. Also, there is a low level of spontaneous electrical activity at the trigger point site. Because of the muscle tension, there may be some pressure and irritation on the nerve fibers and blood vessels in the area. This causes pain and tenderness in the area, and the decreased circulation causes an “energy crisis” at the trigger point.

Trigger point dry needling (TDN) is an advanced therapeutic technique that involves placing a small needle into a muscle in order to cause a quick contraction that releases the trigger point. This release improves flexibility and circulation in the muscle and can lead to a decrease in pain and other symptoms. TDN can significantly improve range of motion in post surgical knees and shoulders, and is an effective treatment of low back pain and chronic conditions.

Trigger point dry needling is NOT acupuncture: it is not based on Eastern or Chinese medicine and diagnosis does not include evaluation of the meridians. It is based on Western medicine and muscle physiology, being orginally developed by a medical doctor.

Evolution Physical Therapy also utilizes a Real Time Ultrasound that provides pictures of structures below the skin. This gives our clinicians the ability see the depth of structures, and we believe this technology provides increased patient safety and efficacy and is included at no additional cost.

Tennant Biomodulator

The Tennant Biomodulator is an electrical stimulation device that is used to treat symptomatic relief of chronic intractable pain, post traumatic pain and post surgical pain. This device has four advanced frequency sets that are simple to use but are not available in any other electrical stimulation units. Unlike a normal TENS unit the Biomodulator changes the frequencies so the body can not tune out the signal. This means the body continues to get pain relieving input the whole time the device is in use. The Biomodulator is used by physical therapists and other medical professionals to decrease pain which improves patients functional abilities. This is important in breaking the inflammation, pain, spasm cycle which causes most chronic conditions. An injury leads to inflammation which causes pain and then triggers spasm. The spasm causes additional stress and does not allow the tissue to heal normally. This cycle must be interrupted for recovery to take place. The Tennant Biomodulator allows us to halt this cycle and to continue the bodies natural healing process.

We have found the Biomodulator an important part of our treatment tools. It has been effective in decreasing pain and relieving muscle spasms prior to manual techniques making them much more comfortable and effective for the patient. We have also seen this device decrease pain and spasm in difficult areas such as the Piriformis and Psoas which most other TENS devices have little to no effect. As we continue to add additional technologies to our advanced therapy model, we are pleased to offer the Tennant Biomodulator as an effective treatment for pain.

Selective Functional Movement Assessment (SFMA)

The Selective Functional Movement Assessment (SFMA) is a systematic way to look at movement patterns to determine which parts of the body are contributing to your symptoms.

All physical therapists look at movement as part of an examination process but only the SFMA classifies movement patterns according to consistent measures, which means you will see definitive changes when you improve. This is different than the old way of measuring your motion with a plastic device and telling you that you have gained 5 degrees. You will feel the difference in motion if you are squatting lower or can touch your toes with ease. The SFMA also looks for connections in movement patterns that can prevent future injuries and directs you on a specific exercise program to fix your problem areas. This means will you perform exercises that are directly related to correcting your condition instead of a bunch of general exercises that you could have found on the internet.

The SFMA also zooms in on the movements that are limited or cause pain so the therapist can treat those areas more effectively. This assessment helps us to focus our advanced treatments of Laser, Trigger Point Dry Needling and ARPwave to the correct areas so you do not waste any time or money. A lot of therapists “chase the pain” and only treat those spots where you feel the discomfort. The pain is the result and not the cause of problem. Only by treating the underlying cause of your problem will you see lasting results of physical therapy. Our skilled therapists who know how to use the SFMA correctly will find the source of your dysfunction and help you to improve your movement patterns. This means you will progress quickly and be able to get back to the activities that you enjoy.