Correcting Joint Dysfunction regardless of symptoms is the right thing to do for coaches? Who is doing the coaching while the coaches are doing the therapy? What would you do if the PT is trying to help with the olympic lifts and sprinting while people are doing joint actions such as mulligan therapy? I like Daniel’s simple solution. Call therapist if one can’t finish his warm up, and if one can it’s likely they are functioning well from head to toes. I don’t fault him for not doing myofacial release at the neck to fix nerve entrapments like some of the gurus are saying they are.
I will share a case study of former track athlete that is no longer competing after doing soccer her junior year in HS. She was a great multi event athlete but with ankle sprains she was having problems in the joint itself and starting to get knee issues as well. Now, I get an email from a mutual friend of the family as they went to a “performance enhancement” facility where they worked on ankle mobility with two exercises.
(1) Knee bends on an olympic lifting platform for 3 x 15 between sets
(2) Dorsiflexion Self Mobilizations- against a wall 3 x 10 reps in circuit fashion
Note: No mulligan technique, Z-health or similar exercises.
after 12 weeks (we all know that after 12 weeks everything is magically fine) she was having night pain and when long jumping and hurdling she was in a lot of pain.
Long story short imaging and evaluations by a very good PT showed evidence of ankle pathology related to the altered alignment and had signs of wear at the specific locations that were caused by repeated actions of the joint mob exercises. She has spent months during her senior year rehabbing and I have yet to work with her and will likely not be able to help.
Now you want me to cite a collection of evidence (120 gigs of pdfs) of the above in a JOPT pdf? I have plenty of rehab articles that show that the joint will have altered articular geometry and surface friction because of poor alignment. You can read the biomechanics and come to the same conclusions or you can continue to have faith that you are the chosen one after decades of rehabbing feet. You are not going to see wall drills and direct damage only research that shows poor alignment causing friction to the surfaces that are not designed for those actions. Those that are trying to enhance a joint restriction by using forces and motions not native to common biomechanics of everyday actions without the proper knowledge to tell the kid in the group of 8-10 doing the same cookie cutter program that the pinch they feel is not something to push through is the problem.
Most of the time a youtube exercise such as even the one I posted will be taken out of context by newbie coaches and those not doing their homework. If you are interested in learning more I would start (not finish) with this information.
Wainner RS, Flynn T, Whitman J. Spinal & Extremity Manipulation: The Basic Skill Set for Physical Therapists. 2001; Manipulations, Inc. ISBN: 0-9714792-1(an evidence-based electronic text in multimedia CD-ROM format)
I learn so I can shop for good therapists. I also learn so I can see the etiology of injury. I am not a rehab person but I don’t need to be a world class therapist to trust a doc that says don’t do rehab we are not trained for. Mobility is about joints and unless you know what you are doing you can cause problems. Repair capacities of those structures are not easy and when you play with fire…..
I don’t care if you are 21 or 61 but any intervention you have better be right or you are liable. If you are doing any joint actions manually you are breaking the law. When one places hands on an athlete things can get to be a problem.