Stay Strong and Injury Free all Ski Season Long

When thinking about exercises to improve lower extremity strength for skiing, quadriceps (quads), and dominant movements such as lunges and plyometrics, typically come to mind. While quad strength is important, you need to look beyond this if you want to stay strong and injury free all season long. 

Many athletes, especially skiers, are quad dominant. This means their knee extensors are much stronger than their knee flexors. Also, these athletes will often have imbalances, including weak glutes and overactive or tight hip flexors. A frequent mistake in strength training is to over-emphasize the exercises targeting the most commonly used muscles. To create more balance and stability, we need to strengthen the muscles and movements that oppose those primary muscles to keep from making an established imbalance worse.

Exercises that target the posterior chain (muscles that include the back extensors, glutes and hamstrings) can help offset some of the common imbalances. The hamstrings have a direct effect on stabilizing the knee by decelerating knee extension and reducing the shearing forces on the anterior cruciate ligament (ACL). This results in more stable knees and hips, stronger skiing and decreased injury potential. 

There are many exercises that address the posterior chain. Squats and lunges are exercises used in most ski conditioning classes, however depending on how they are performed, they are exercises that can be very quad dominant. Simply keeping a more erect posture and maintaining balance through the mid foot to heel will help shift the emphasis to the glutes and back extensor muscles. When performed correctly, other exercises such as dead lifts, glute-hamstring raises, hamstring curls and bridging can effectively target the muscles of the posterior chain.         
Some exercises, like hamstring curls, body weight side lunges (with attention to weight distribution) and bridging can be done with little or no equipment and still yield excellent results. Hamstring curls done on hardwood flooring while wearing socks or having a towel under your feet is a great way to increase resistance with your own body weight. Bridges, specifically single leg, can address both flexibility of the hip flexor and end range extension of the hip.   

To view these exercises and to learn more about how to address the posterior chain for keeping you skiing strong all season, visit www.vailhealth.com and click on the “Spine & Sport Health Tip” link. 

Mark Pitcher is a chiropractor, exercise physiologist and TRX instructor with Vail Integrative Medical Group at Vail Vitality Center located at Vail Mountain Lodge and Spa. He specializes in rehabilitative medicine. 


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The Benefits of Active Release Technique

Active Release Techniques® (ART) is a technique that is utilized in our office on a daily basis. There are many frequently asked questions regarding ART. I will try to answer some of these common questions and give a more clear understanding of what ART is, what it is used to treat and what kind of results you may expect.

            

ART is a patented, state of the art, soft tissue movement based system. It can effectively treat soft tissue injuries which do not respond to other traditional treatment methods. Soft tissues include muscles, tendons, ligaments, fascia and nerves. Some of the common conditions we treat using ART include headaches, low back pain, IT Band Syndrome, shin splints, plantar fasciitis, knee pain, and sciatica.

            

The goal of ART is to restore optimal texture, motion and function of the soft tissue. This is accomplished through the removal of adhesions or fibrotic tissue through specific protocols. These adhesions can occur as a result of an injury, repetitive movements and constant pressure or tension. Through the specific protocols our trained ART professionals have learned, we are able to eliminate the pain and dysfunction which is associated with these conditions.

            

Every treatment with ART is patient specific. It will consist of examination and treatment of the entire kinetic chain, not just the area of pain. Usually, it is also combined with various treatments of chiropractic and physical therapy. The ART provider will evaluate the tissue looking for any abnormalities in texture, tightness and movement. Any abnormal findings will be treated with varying degrees of directed pressure and tension on the tissues, as the tissues are taken through specific movement patterns. Often, patients will describe the treatment as a “hurt so good” feeling. Every patient responds differently to treatment. However, utilizing ART has given our patients tremendous results. Typically, results are seen in a few treatments and may include decreased pain, improved tissue quality, improved range of motion and better functional movement capabilities.

For an informational video on the benefits of this technique or how it is performed, please visit our website at www.vailhealth.com and click on the Spine and Sport Health Tip Link (on the left).  

Dr. Joel at the Parapan American Games

This past summer, I had the honor and privilege of being selected by the United States Olympic Committee (USOC) to be part of the medical staff with Team USA for the Parapan American Games in Guadalajara, Mexico which concluded last month.  The Games (the 4^th) are an international multi sport event for Olympic-caliber athletes with various physical disabilities and is a qualifier for the Paralympic games this upcoming summer, in London.

A total of 1300 athletes (200 athletes from the United States) from 24 different countries competed in 275 different events in 13 sports.  The national governing body (NGB) I worked with was track and field. Our sports medicine “team” consisted of a multidisciplinary group including a medical physician, physical therapist, athletic trainer, massage therapist and myself (sounds like VIMG!). 

A typical work day would average between 16-18 hours and include covering track and field practices, clinic treatment time, Team USA and medical staff briefings and hopefully (but not always) a quick bite to eat.  The days were long but incredibly rewarding. The opening and closing ceremonies were remarkable and Mexico put on a great show!  One of the highlights of my trip was meeting and speaking with Mexico’s first lady, Margarita Zavala.       

Each athlete (and their disability) is ‘classified’ early in their athletic career with a very specific process. This ensures the events and competitions are equally fair.  For example, you have similar athletes, with similar disabilities, competing against one another.  While Brazil beat us in the overall medal count, Team USA recorded 51 gold, 47 silver and 34 bronze over the 8 days of competition.       

If having an opportunity to work on some of the best US athletes wasn’t enough, watching them compete with their physical disabilities was a very moving experience (try to picture a blind athlete performing the long jump).  There were Iraqi veterans who had lost limbs, spinal cord injuries, traumatic brain injuries, cerebral palsy, stroke and blind/visually impaired athletes to name a few.  Not only have these individuals become world class athletes, they are the most positive and ‘can do’ people I have ever met. 

The only draw back to the entire experience was being away from my wife and children.  I learned how to Skype like a pro while I was gone!

To see more photos from my trip to Guadalajara, please visit our gallery 

Dr. Joel Dekanich

Miki Blanchard Helping Children in Uganda this January

“Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat”

~Mother Theresa

In January, I will be joining Visiting Orphans and Sixty Feet on a mission trip to Uganda.  I cannot begin to tell you the impact this is making on my life.  As a physical therapist, I will have the opportunity to work with some of the most severely disabled and handicapped children who are imprisoned there.  I will have the privilege to teach the  Sixty Feet staff,  who volunteer their time and go into remand centers every day, how best to facilitate any recovery or rehabilitation in these children.

Thousands of children in Uganda live behind bars, not knowing if someone will ever come for them.  They are there because of petty theft, or they were picked up off the street, or they were abused or unwanted by family, or simply abandoned at the Police Station.  Sixty Feet is working towards moving the most vulnerable children out of remand centers and into family style structure where they will have the opportunity to really live and maybe someday, lead.

Please visit the Sixty Feet website at www.SixtyFeet.org to read their story and the work they are doing for the imprisoned and forgotten children in Uganda.  If you are willing, you may donate to Sixty Feet (they have a list of items can donate), to our trip (Uganda Jan 2012) or donate a bottle of Gummy Vitamins at any of the VIMG offices.  If you donate money at one of our office locations, I will use it to purchase Gummy Vitamins, games, toys, pencils and other supplies the children need when I am there in Uganda.

Thank you, and have a blessed Holiday Season!   Miki Blanchard, MPT