Foundations Of The ProSport Academy Therapist System Dave O’Sullivan Updated June 2016
My Main Past Experiences/Influences Gray Institute - Certificate in Applied • Meirion Jones / Martin Higgins Functional Science (ProSport Physiotherapy) Anatomy In Motion • Mulligan MWM’s Neurokinetic Therapy / Applied • Butler’s NOI Kinesiology Online Courses • Shacklock’s Neurodynamics Proprioceptive Deep Tendon Reflex • Shirley Sahrmann - Movement Integrative Diagnosis Impairment Syndromes Postural Restoration Institute • Functional Movement Screen / SFMA Active Release Techniques • VOILA - Structural Joint Active Isolated Stretching / Fascial Stretch Balancing Therapy • Club Physio - Dry Needling Frans Bosch | Louis Gifford
Your Journey Over The Next 12 Months...
The Bigger Picture -MY Current Thought Process • A PB Run Free Athlete is a durable, sustainable, robust athlete
• BUT FIRST
The BIG ProSport Academy Secret • PAIN IS AN OUTPUT OF THE BRAIN
It’s all About The Brain! (Kind Of) • Your client’s movement strategies are a result of the output of their brain. Change how their brain interprets information and we change their symptoms, and how they move.
Autonomic Nervous System - 2 Main Divisions: Parasympathetic & Sympathetic Nervous System ‘Fight or Flight’ & ‘Rest and Digest’ - Shift between the two daily depending on the perceived stressors - Can be analysed using Heart Rate Variability - Can be influenced with conscious command via the respiratory system
Chronic Pain Patient...
Chronic Pain Patient...
Our body loves variability... - Heart Rate - Diaphragm - Movement
IMPORTANT • We don’t provide interventions/rehab to pass specific tests, we provide interventions/rehab programs primarily to decrease the ‘perceived threat’ SPECIFIC to the PERSON in front of us. • => Only this will lead to LONG LASTING changes
How Your Athletes Nervous System Interprets Information? • Visual *(Eyes Down Or Out?) • Vestibular • Kinesthetic • Attention / Meaning • Past Experiences / Pain? https://bodymindandbrain.com.au
Performing Movement • Initial Intent To Move • Receiving And Analysing Neural Input From Sensory Inputs From Within The Body & Externally From Environment • Decision To Move -> Process Of Planning • Plan Influenced By Previous Experiences With The Movements, Movement Situation, Initial Evaluation, Choices Of Movements And Task Involved • Once General Plan Executed, Add Various Movement Parameters (Force, Velocity) To Achieve Movement Within The Environment (On Grass or 3G or Gym)
Movement Brain Controls The Intention Cerebellum Makes It Fluent Spinal Relays Make It Rhythmical Synergies Absorb Errors Co-Contractions Influence ROM Adapted From Frans Bosch, 2011
What Do We Already Know? • Previous Recurrent Injury • Previous Surgery • Asymmetrical Dorsiflexion • Pain On FMS Clearing Tests
Where Can The Threats Come From? • Movement Technique • Training Loads Spike • Not Strong Enough To Handle The Load • Anxiety • Fear of Failure • Home Issues / Contract Issues / Self Perception
Key points... • Perceived threat -> Altered Movement Strategy short term -> Altered force DIRECTION and motor output • Ok initially but long term whats the consequences?
• BUT SECOND
Self Limiting Beliefs...
- If your beginning to doubt your ability to help a patient, then you’re probably focusing on the pathological tissue and not the person and their nervous system... -It’s not your job to tell the patient there’s no hope for them and their nervous system... - Believe 100% you can help them, the answer is right there, between the two of you...
Ask Yourself Questions • ALL THE TIME WHEN ASSESSING, WHEN TREATING • Focus Your Mind And Get Answers From Your Subconscious...
Ask yourself better questions, get better answers...
• The quality of our lives will be determined by the quality of questions we ask ourselves... • Karl Morris 2015, Mind Coach.
Stress precedes pain… • Replace the Word STRESS with PAIN…
Stress… Physical Stressors Emotional (Including Previous Injuries)
We have all been lied to! Textbook healing times are obsolete and old school thinking
Welcome to the
So how Do We Do It? - What Does The Brain really Want?
Homeostasis - On A Cellular Level
But I’m a Therapist Not a Microbiologist
What Do We Require For This First And Foremost? • “All chronic pain, suffering and diseases are caused from a lack of oxygen at the cell level” – Prof. A.C Guyton, MC, The Textbook Of Medical Physiology
What Else Can We Help The Brain With To Achieve Homeostasis? - Achieve A Neutrality That The Nervous System Is Content With And Keep It
But what is neutrality? • - A mid point between one extreme to another
sethoberst.com
Look at the relationship between the lungs and diaphragms ability to lengthen…
The most important thing to your brain is the very next breath...
If you can’t control your inhalation, you can’t control your anterior tilt
If we lose the lengthening ability of the diaphragm, we lose movement variability...
sethoberst.com
Practically... • Our Brain Wants Homeostasis • I.e Our Nervous System Wants Full Range Of Motion Within Every Joint In The Body To Access If Required • Our Nervous System Will Be Able To Access Both ‘Parasympathetic’ and ‘Sympathetic’ Nervous Systems • => Full Range Of Motion Requires All The Soft Tissues To Lengthen And Shorten Around An Instantaneous Axis Of Rotation Of One Or More Joints
How Do We Assess Homeostasis of the body? • Subjective: Sensory Objective Range of Motion Feedback From * Joints Client *Joint Capsule • Behaviour of the * Muscle client * Ligaments • *Pain / Stiffness * Nerves • *Ease of Movement * Vascular/Arterial • *Others? * Skin • Sleep/Breathing? * Fascial *Other Mobile Connective Tissue
How does the brain keep homeostasis? • Feedback controls - corrective response after sensory detection • Feedforward controls - Anticipatory actions occurring before sensory detection Somatosensory, Visual and Vestibular input provides the information necessary for both forms of control during motor activities
Movement Control Central Control Preflexes
We Can Effect Somatosensory Input With Manual Therapy
(Pay Attention Here)
Superficial and Deep Adipose Tissue & Retinacula Cutis
Sensory Input To The Brain • Superficial and Deep Fascia + Joint Capsule Fascia have 9 times more sensory innervation than muscles • When you FEEL a stretch, you are FEELING 9 times more fascial receptors than muscle receptors... • Your client is feeding back 9 times more fascial receptors than muscle receptors, REMEMBER THIS
Motor Perception • determined by neuro-receptors such as ruffini corpuscles, pacini corpuscles, golgi corpuscles and free nerve endings • these neuroreceptors are activated by stretch and can only function correctly if they are embedded in a tissue that is capable of lengthening • when we side-bend we feel the stretch in the trunk wall rather than the vertebrae • 90% more receptors in fascia than muscle
Motor Coordination • Muscle spindles and golgi tendon organs are nerve terminations that regulate muscular contraction • Muscle Spindles embedded in the deep fascia parallel with the muscle fibres • Golgi tendon organs embedded in the myotendinous junctions in series with the muscle fibres • Continuity of the endomysium with the connective tissue skeleton ensures transmission of spindle contraction of the entire facscia • These mechanisms can only be activated correctly if the fascia maintains its physiological elasticity. • If fascia is too rigid it cannot adapt to the stretch of a single muscle spindle and the enlargement of the of the central part of the annulospiral fibres does not take place. • Golgi tendon organs also have a web of collagen fibres surrounding their axons; these fibres wind up or unwind according to the DIRECTION of stretch to which they are subjected to, such that the inhibitory nerve impulse may or may not be activated.
Deep Fascia Unable To Slide
We are constantly moving...
Practically What Does This Mean? • Full Range Of Motion In EVERY Joint In The Body • Ability To Access Full Range Of Motion • If The Tissues Can Slide In EVERY DIRECTION and provide adequate TENSION then the motor output of the PARTICULAR muscle fibres will take care of themselves if no excessive nociceptive input is present
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