The Tripod Position

Left foot and right arm support. The right leg and left arm can support or move in to a stepping forward pattern.                   This position is the tripod is a variation of a static lunge taught as part of the Dynamic Neuromuscular Stabilisation programme according to Pavel Kolar, and correlates to the 8-9 month developmental age. The right arm and left foot are supporting and the left arm and right leg are stepping forward. The clinician can support the left knee and foot centration, trunk centration and uprighting of the spine. The most common...

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Psychology, The Limbic System And Chronic Musculoskeletal Pain

The limbic system is a key component of an individual’s psychology. Mood, personality and risk reward behaviour are all intimately related to limbic function. The amygdala plays a particularly important role in this regard. The “thought viruses” discussed by Butler and Moseley [1] highlight how the amygdala and hippocampus, in particular, interact to produce behaviours that may then increase the likelihood of musculoskeletal symptoms. These behaviours may become learned further influencing symptoms. Mood can directly alter the pain experience. In a study of 65 patients, pain tolerance but not...

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Hand Position And Over Active Upper Trapezius

When teaching exercises to patients the priority is often the patient’s key dysfunctional areas. In other cases spinal alignment and inner unit activation are top priorities. Further we can all be guilty of giving too many extrinsic cues to patients and we may want to focus on just one area of cueing too avoid confusing our patients. As a result the type of grip or hand position is often not considered. Nonetheless, how important is the hand position? Cogley et al (2005) found that a narrow base elicited greater triceps brachii activity compared to a wide base during the press up. But more specifically...

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Vastus Medialis Obliquus (VMO) Exercises

There remains controversy over whether the vastus medialis can be divided in to vastus medialis longus and vastus medialis obliquus (VMO) (Smith et al 2008). Nonetheless in rehabilitation we frequently attempt to bias our strengthening exercises towards the medial portion of the quadriceps over the lateral, with mixed success. Research in to exercises for the vastus medialis has in general been disappointing. For example, Kushion et al (2012) found that altering the foot position from neutral to external rotation had no effect on vastus lateralis to vastus medialis ratio in straight leg raise...

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Low Back Pain, Modic Changes and Bacterial Infections

Modic changes are edema in the vertebral body, which can only be detected on magnetic resonance imaging (MRI) and are closely associated with low back pain. There is growing evidence their formation may be related to bacterial infection. Herniated discs may be susceptible to bacterial infection and these infections may cause Modic changes. In patients with Modic changes antibiotic treatment appears to reduce symptom severity, although alternative methods of treatment could be considered. In alternative medicine fungal infections have been linked with everything from allergies to arthritis (Kauffman...

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