How to Increase Hip Mobility for Golf

The PGA season has begun and, if you’re anything like me, those golf juices are flowing! It has been at least two months since I have swung a golf club (thanks polar vortex). The off season is great for recovery but it’s also a great excuse to get lazy with your fitness program. It’s very easy to get stiff over the colder months because we don’t move as much. This stiffness can rob your golf swing of consistency and power. The biggest area of your body that is responsible for power in your golf swing is your hips. So let’s get those joints moving and get this season rolling!

When you swing a golf club your hips/pelvis to internally and externally rotate about 60 degrees in each direction. As a golfer, when you go to the top of your backswing you need internal rotation of your trail hip, and external rotation of your lead hip. In your downswing you reverse those movements. A restriction in either hip, in either movement, can lead to swing faults. No matter what the fault may be, it will definitely lead to inconsistencies in your golf swing.

Another problem with poor hip mobility is a guaranteed loss of power and distance. If you want to be able to hit the ball a far way you have to be able to spin fast. When we start our downswing we actually push down into the ground with our feet. The earth is just a little bit larger and stronger than us so it pushes back and creates what is called ground reaction force (hello physics!). Now before I lose you in all my golf swing dork talk let me simplify things. For 99% of the world, our legs are the strongest part of our body (not this guy, do you even leg day bro?).

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When we push into the ground, all that energy that is created gets pushed up the legs towards our abdominals. The pelvis turns that energy into torque. The more torque that is created, the faster we spin, and the harder we hit the ball. If we have a restriction in how much our hips and pelvis can twist we can’t create as much torque and we don’t hit the ball as far as we possibly can. Make sense?

Now that I have completely confused you with talk of physics, torque, power, blah, blah, blah let me just tell you what to do about it. Here is my favorite hip mobility exercise for golf. You can perform this stretch multiple times a day. Just be careful if you have any pain in your hips and/or in your knees. If you are consistent with performing this stretch, your mobility will increase, and you will be hitting that ball farther down the fairways before you know it.

If you have any questions please don’t hesitate to contact us here at OrthoCore. Enjoy the last month of the off season and use it to get your body ready for the upcoming season.



Retiring From Powerlifting By Adam Davis (OR: How I learned to Stop Lifting Heavy and Love the Lunge)

I’ve rewritten this blog multiple times now. Originally I was just going to talk about lunges. A client of mine who’s a former trainer herself sent me an article regarding the common mistakes when both practicing and coaching lunges. This article upset me because it challenged how I’ve been coaching this movement for 6 years professionally. It was written by one of our favorite professionals in the industry to boot (Dr. John Rusin). I was forced to open my mind and accept new information. And for the first time since joining the OrthoCore Physical Therapy team, I told my clients I was teaching something wrong (well more like less efficient, we’ll say).

Now where am I going with all of this? Well first off, as a coach I have a policy that I never teach something that I don’t practice on my own, unless a client really needs something unique in their programming. I begrudgingly started to practice these new lunges. I’ve had a long love hate relationship with lunges since the first day I worked out my legs. I know their importance and the importance of unilateral work in general. But lunges suck. Or rather I sucked at lunges. So I avoided doing them for a long time during my powerlifting career. I wanted to focus on competition lifts like squats and deadlifts. Those were fun, short, and heavy sets that felt impressive. Lunges were long, grueling, and boring exercises that burned and used light weight. Not something a 23 year old powerlifter was excited to do.

Well now I’m 30 and have 3 notable prior sports injuries, arthritis of varying degrees in many joints, and a stability issue in my right hip. That issue is likely from years of ignoring lunges I’d wager. Well upon practicing these new lunges that better utilize the mechanics of the hip, I became more aware of this instability, as well as generally had better feedback from it. I had more control than ever before in this exercise when working on that right leg, and despite the muscles being stronger, it felt harder. My rotator cuff was working in ways it wasn’t before (yes your hips have a rotator cuff too).

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This newfound sensation with an old exercise blew my mind. How had I not come across this information on how to perform lunges in 6 years of training and 5 years of competitive lifting? My lower body program shifted to primarily focus on lunges first, and I began to go from heavy weight to lighter weight/higher reps. Now I perform them with unevenly loaded dumbbells to both challenge stability and engage the glutes even more than the original modification did. Compound movements like squats and deadlifts became ancillary lifts in my routine.

Ok so let’s get to the real point here. Ever since my shoulder injury 4 years ago, I’ve been out of the competitive lifting scene. It’s been somewhat of a rough journey as I was just months away from my first major competition (everything I had done before were unofficial amatuer meets that were a bit more loosely regulated). That really messed with me. I went through ups and downs trying to get back to the numbers I used to put up before that injury, never quite making it in any of the competition lifts. I even went through a period of depression because of it and gained a lot of weight.

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The last 2 or so years I’ve been getting back into consistent training and leaned out to a nice healthy level again. But I’ve still always been training for strength overall. So “going heavy” was my priority in a lot of lifts, even if I was sure to do things like care for my shoulder health and isolate where needed. I even got my bench press up to 235 lbs after rehabbing my left shoulder from an impingement! But even though I’m mechanically stronger than I used to be in my powerlifting days (I move weight more efficiently), the fact that the actual amount of weight I was lifting was so much lower continued to nag at me. That was until the last few months.

I’ve recently come to terms with the fact that I will never compete again, at least not in any ranked league, and even if I compete in an amateur meet again I know I will be far outclassed. I had instead been focusing on my clients’ programs, and exploring new avenues like yoga. I specialize in corrective exercise and movement after all, why not broaden my own training to include more avenues regarding it? And although I was initially hesitant to admit there was information that contradicted what I coached, these lunges were my final step to finding where I really need to be training wise for my body at my age.

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Let’s wrap this up as I tend to ramble when talking about my own experiences. Focusing on these lunges first basically meant a lot of my strength and energy would be sapped for the big lifts. So I did what powerlifters swear never to do. I lifted lighter weight. My squats were endurance and mobility focused sets of 10-15 reps. My deadlifts stayed at low rep sets of 3-5 (I personally believe the conventional deadlift is risky for high reps), but the weight I used was relegated to weight that was normally not a 3-5 rep max. I also started to superset multiple types of deadlifts, so it was more like one set of 6-10 when combined, again helping my muscular endurance more than my usual training used to.

And you know what? I’m seeing tons of progress. My hip feels stronger every week. I’m still adding weight to my lifts even if I use less weight overall compared to even a couple of years ago, nevermind my powerlifting days. My shoulder mobility is more consistent, and my core imbalance is improving faster. To top it off, despite lifting so much lighter, I have more muscle mass on my body now than ever before, which helps keep my metabolism well regulated so I stay leaner easier, and cushions my poor arthritic joints.

So after 4 years of frustratingly chasing the dragon of reaching my former glory days. I’ve finally accepted that I’m not living those days anymore. I’ve retired from heavy weight you could say. I still challenge myself, but in ways that are more appropriate for my body given my history and needs. And you know what? I’m happy with my programming, performance, and body for the first time in nearly 5 years. The new year just started, so I guess this is my “new me”. Perhaps something as simple as reexamining your training programming needs is all you need for a “new you” as well. If you’d like to try and don’t know where to start you can always contact me. Otherwise I wish you all luck in your endeavours in health and wellness in this new year. And remember, it’s ok to be a different kind of athlete than you were last year.

~Adam




Hip PNF Kicks

Outside of your core muscles, the hips are probably the most important muscle group in the golf swing. They help your hips to twist and also transfer all of your leg strength up into the trunk muscles. It’s that energy transfer that helps to send that little white ball farther down the fairway. Most golfers who workout do work on their hip strength. The unfortunate part is that most are going about it all the wrong way.

The hip joint is a very dynamic joint. It is a ball and socket joint just like the shoulder.

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The great thing about the hip joint is that it can move in almost any plane due to its kinematics (scrabble word, 800pts). That allows for all the movements that happen during the golf swing. Most people think there is just a twist at the hip. The truth is there is a natural twist, squat, and lateral shift happening at the same time in the golf swing. If it happens during the golf swing why wouldn’t you train that way?

When most golfers hit the gym they might do squats/deadlifts, and some lateral walk or side lunge. Awesome! I’m not saying those are bad to do. I certainly do them when I go to the gym. What I think is important is to incorporate all the movements of the hip joint into one exercise. That way when you make a golf swing your body has been trained to moving through all those planes of movement and can transfer that energy more efficiently. That will equal more power into the golf ball, and hopefully a lot more distance.

So I’ve teased you enough. You are probably saying at this point “what exercise does all this at once? That sounds like an infomercial.” PNF (Proprioceptive Neuromuscular Facilitation) patterns are the way to go. They are simple patterns that move the hip through all the ranges of movement in one movement. Here is a quick video that will show you how to go through the patterns on your own.


I prefer that clients do it without holding on if they can. That way you are working on balance as well which is also very important in the golf swing. I also will have people start with moving slow so you have to own the movement. Once that gets easy add some speed to it. Just don’t move so fast that you start to lose your balance and fall over. If you can’t do it with the resistance band at first that is okay. Just work on the patterns without resistance until it gets easy.  

You will definitely feel the burn in your hips when you do these exercises (take that Jane Fonda). Work on this over the off season and see how much farther you hit that golf ball once winter is over.

OrthoCore Physical Therapy has convenient locations in Westerly and North Kingstown, RI. For more information on our services please call (401) 667-0131






Facet Joint Back Pain

I treat a lot of people with back pain. The hard part about treating patients with back pain is getting the work we do on the table, to translate to standing and walking. Patients who are older (I’m talking 35+) will usually have pain due to a facet issue, degeneration in the back, or both. Lying down is a great position for those issues because it doesn’t put pressure on the back. Once you stand up, the back compresses, puts pressure on the joints, and the pain returns. If this sounds like you, let me give you a simple solution to provide you with some relief for your back pain with standing.

What’s a Facet Joint?

Unless you went to PT school, or some form of medical school, you have no clue what a facet is or what degeneration looks like in your back. Well...that is what I’m here for. Let me school you on some anatomy. Facet joints are the joints of the spine. Just like any other joint in the body, the spine moves. It requires joints to allow that to happen. In your spine you have facet joints on each side of every vertebrae from your head to your hips.

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Like all your other joints, the facet joint can get inflamed. When you compress an inflamed joint, it hurts. Facet joints get compressed when you are standing and when you extend. Hence the reason why lying down feels better, and standing hurts.

What do I do for Standing?

Since most of us can’t lie around all day, what do we do when we’re standing to help alleviate back pain? The key to having less pain with standing is understanding the position of your pelvis. Most of us have what is called an anterior tilt at our pelvis. That means that the front of our pelvis sits lower than the back part of our pelvis.

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Speaking in generalities, this usually happens because our hip flexors are tight and our abdominals are weak. In the game of tug-of-war, a tight muscle always beats a weak muscle. In therapy we will try to stretch the hip flexors, and strengthen the abdominals to correct the imbalance. That doesn’t always carry over to a standing position though. Sometimes, you have learned to stand like that so you need to retrain the brain to stand in a neutral pelvis. What is the best way to do that? Train your hips in a standing position. Here is a simple exercise that I like to give my patients that have back pain with standing.

Give this a try to help alleviate your back pain with standing. You can perform as many of these as you want. The exercise is meant to help you retrain your brains standing pattern. There is no resistance involved so you don’t have to worry about overdoing it.

I hope this helps correct your back pain you are getting with standing. If you have any questions please contact us. If you want a free session to review how to perform the exercise properly just mention this post and OrthoCore will give you a free 15 min session at any of our clinics. Thank you for reading!







Knee Arthritis vs. Meniscus Tear

I’ve had a lot of patients throughout the years with knee pain (I know, earth shattering beginning to a blog post). The biggest thing that we do as Physical Therapists is figure out what is the cause of your pain. I feel like I’ve had a group of patients recently, that have knee pain and their MRI shows they have a meniscus tear…and arthritis. The problem with having both is it makes it hard to discern where the pain is coming from because they are so closely related. The other problem with having both is that surgeons are usually shy about performing a meniscectomy (remove the torn meniscus) because it may not relieve your pain symptoms. That being said, let’s talk about the differences between the two so you can make an educated decision if this is what you are dealing with.

What is a Meniscus Tear?

The meniscus is the shock absorber of your knee. You have one on the inside (medial) and outside (lateral) of your knee. If you were looking down from the top of your knee they look like two lima beans. If you look at them from a straight on view they look like a race car track meaning the peripheral portions are thicker and it slopes down towards the middle of the knee from there.

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Typically a torn meniscus will hurt right over the joint line and will be sore at end ranges of knee movement. It will also usually hurt with activity, especially loading and twisting. Remember, its your shock absorber, so the more bumps you take the more strain you are putting on it. Think of it like driving a car. If you go over a lot of bumps you will feel it more.

When you have a torn meniscus the surgeon will usually just cut out the torn portion, which is usually on the inner portion. That way they can take the torn tissue, while still leaving a lot of meniscus for you to play with.

Recovery is usually quick (if you have a good PT) and you are usually back to your normal activities in a couple months time.

What is Knee Arthritis?

Arthritis is a loss of cartilage. Cartilage is like the shiny end of a chicken bone. When cartilage slides on cartilage, no problem, when it starts to wear down is when bone gets exposed and can lead to inflammation and pain.

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Arthritis is usually worse in the morning and at night. During the day, if you keep your knee moving without much impact, it usually makes the joint feel better. Activities like biking, swimming, non-impact weight lifting are good.

Arthritic pain is usually more global, meaning it’s hard to pinpoint with your finger. Sometimes it hurts in one area. The next day it could hurt in a completely different area. It depends on how much arthritis you have and what types of activities you are doing.

The surgical solution for arthritis is a knee replacement which isn’t as easy to recover from as a meniscectomy obviously. Recovery from a knee replacement is 3-6 months (back to activity with some pain) with full recovery usually by a year.

How do I know what to do?

So what do you do if you go see a doctor only to find out that you have a meniscus tear AND knee arthritis? The best thing to do is start to write down where you have pain in your knee and when. If you start to see that it is more over the joint line, and more with jumping/twisting activities, it’s probably coming from your meniscus. If you find that it is more painful in the morning, but gets better as the day goes along, and not in a consistent spot, it’s probably arthritis.

I would always recommend trying a course of PT first. In both cases there have been plenty of studies that show that PT can be effective without requiring surgical intervention. If PT doesn’t help and it appears to be more meniscus, if it were my knee, I would have the surgery. If PT doesn’t help and it appears to be more arthritis, it depends on what I would recommend. A knee replacement is a much bigger surgery, but is also really effective for relieving knee pain. It is really age related but I will say this … most patients that I have, that have had knee replacement surgery, say they wish they had done it sooner.

I hope this helps to give you an idea of why your knee hurts and what you can do about it. If you have any questions please comment below. If you would like to schedule an evaluation to see what might be causing your knee pain, please contact us at OrthoCore Physical Therapy  401-667-0131 to make an appointment at our Westerly or North Kingstown locations.




Running with Knee and Back Pain

So, I’ve been running more lately. To anyone reading this that knows me, knows that comes as an enormous surprise. I used to be a huge runner (3-4 times/wk) but, running and I fell out of love when I started to get injured. My knees and my back were always bothering me. I was getting tired of showing up to work and feeling worse off than my patients. Instead of working on the flexibility and strength deficits that I had, I decided to just stop running. Not exactly what I would recommend to any of my patients but, effective at eliminating my pain nonetheless.

Well I’m back on the team! I credit my return to three things. 1. Like most other people who run, it’s easy to just get out of the house and run. It doesn’t require driving anywhere, or signing up with any gyms, etc to participate. 2. I can do it with my kids in a stroller. I get to spend more time with them, and it gives my wife a little break (double bonus). 3. I was intrigued when I saw that “Headspace” had a running packet. To those of you who don’t know, Headspace is a meditation app. I’ve been using it for a while now and the running specific pack piqued my interest. I was pleasantly surprised it actually made it really enjoyable to run. It didn’t feel like the mental struggle that I remember from the past.

Unfortunately, with my renewed love of running, my knee and back pain returned as well. It’s like when you get back together with an old girlfriend and realize part of the reason why you broke up was her annoying best friend. Well this time the friend isn’t going to break us up again. Instead of running from my problems (see what I did there), I’m going to address them and make sure that I can keep my feet on the road.

My main issue (as is the case with many runners) is that I have very tight hip flexors and IT bands. Those muscles run in the front of the hip and can restrict your hip extension and stride length.

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The problem with the hip flexors, and the reason why I get back pain, is that they anchor at the lumbar spine. When they are tight, your spine will flex with every stride and put excess pressure on your spine causing pain. The IT Bands run all the way down to your knee. When they are tight they will pull your knee out of alignment. That misalignment with every step will eventually lead to pain. Hence, the reason why I get knee and back pain when I run.

The good news for me (and anyone reading this with similar problems) is that it’s really easy to fix. All I have to do is stretch those muscles regularly to keep my body aligned and moving properly. Here is my favorite hip flexor and IT band stretch. If you are stretching pre-run then perform 15 repetitions holding the stretch for just a couple of seconds. If you are stretching post-run then hold for 30 seconds to a minute and perform the stretch a couple of times.

I hope this helps you stay flexible and keeps your feet on the pavement. If you have any questions please contact me here at OrthoCore Physical Therapy. Otherwise, HAPPY RUNNING!

Foot Pain Due to Flat Feet

I know this comes as no surprise but I’ve been treating a lot of feet lately. Apparently when you open a second office with a Podiatrist that is bound to happen. A majority of feet problems that I see are due to flat feet. About 12% of the population have flat feet. That might not seem like a lot but when you consider the amount of people in the world, that’s a lot of fallen arches.

Most foot problems, that are due to flat feet, stem from weakness in the arches of the feet. There are a group of 9 small muscles in the foot that help to create and maintain the shape of the arch.

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Just like any other muscle in the body, if you don’t use it you lose it. The hard part about people with flat feet is that the muscles are constantly on stretch. A muscles that is constantly stretched, is going to be weak. So you are really fighting an uphill battle. The other difficult part for most people is they don’t know how to strengthen their feet. What do you do? Put a tiny dumbbell around your toes and do curls? As much as I would love to see people try that, it wouldn’t be effective. Here is one of my favorite exercises to do to strengthen the intrinsic muscles of the foot (crazy socks not required, but recommended).

If you perform this exercise regularly it will help to strengthen the foot muscles and start to build up your arch. If you have a really flat foot, I also recommend wearing a foot orthotic to give a little extra support and bring the arch up to where it belongs.

I hope this helps to keep your piggies from aching and get you up and on those feet pain free. If you have any questions please contact us . Thanks for reading!

 

When it Comes to Swing Length Size Really Does Matter, and Shorter is Better

Something that always comes up when I’m working with my golfers is their backswing length. Many golfers, and teachers, think that it’s vital to get to the top of their backswing, and get the golf club parallel to the ground. While I don’t disagree that players need to get to a good position at the top of the backswing, I do think that everyone has a unique backswing point. That point is very dependent upon how much flexibility you have.

How Many Degrees Do You Need?

Most professional golfers have 60 degrees of rotation in their shoulders, and 60 degrees of rotation in their hips. If you add those up it’s 120 degrees of rotation that is available (I know, difficult math). Now, you don’t need 120 degrees of rotation to get to the top of a “normal” backswing (lets just use parallel to the ground as a point of reference). You only need about 90 degrees of rotation to get there. There are two problems that most amateur golfers are faced with though. 1: They don’t have even close to 90 degrees of rotation. 2: If they do, that still isn’t enough.

Some of you are probably saying “what the heck! You just said I only need 90 degrees to get to the top of my backswing.” Let’s look back at those numbers though. Pro’s have 120 degrees and you only need 90 degrees to get to the top. That gives us a 30 degree difference (I know, hard math again). The pro golfer will get to the top of their backswing and then start the swing with their hips without moving their shoulders. That gives a greater stretch through the trunk and shoulders, and requires those extra degrees of rotation to prevent the shoulders from coming along for the ride. This gives them power and consistency with their swing.

So What Does an Amateur Do?

If you don’t have 120 degrees of rotation all is not lost. You should certainly do some stretching to improve your rotation if you don’t. What I do with my golfers is find the spot in their swing where they can still move their hips in the downswing. From there we use the K-vest system for biofeedback to memorize where that point is and prevent their swing from getting too long. It also helps them to coordinate the start of the downswing with their hips vs. their arms like most do. Once they do the flexibility exercises and improve their rotation we can continue to lengthen the swing without affecting the power and consistency they have created.

If you don’t have a fancy K-vest system but still want to find the correct length of your backswing watch this video.

The biggest thing to look for is the ability to start your hips without your arms. I always err on the side of short. You will be surprised how short you can make your swing and still hit the ball a far distance.

I hope this helps to improve your power and consistency with your golf swing. If you have any questions please contact me. Visit OrthoCore and learn more or make an appointment. Enjoy your new shorter, more powerful, swing.

Balance with Pitching

Balance and posture were the first two mechanical flaws I was taught to look for when I became certified through the National Pitching Association (NPA). The NPA is a group that was founded by Tom House who is the throwing coach for the G.O.A.T. (Tom Brady for those who live outside of New England), Drew Brees, Randy Johnson, Nolan Ryan, and so many other top athletes that this blog post would be 18 pages in just names alone. Their mission is to focus on strength and conditioning techniques that enhance a players skills and reduce their risk of injuries. In short, they look at the body first and performance second. You can’t be a division 1 pitcher if you can’t stay on the mound. Balance and posture is so important to this group that they don’t even look at anything else until this mechanic is fixed.

When we talk about balance we aren’t talking about a pitchers ability to stand on their drive leg for a long period of time. Quite honestly that doesn’t even matter that much. What we’re looking for is the pitchers ability to keep their shoulders level, through their stride, and delivery of the baseball to home plate. Any deviation from this level position will lead to a compensation which can lead to arm injury and break down over time.

Here are a couple of examples of good posture through delivery.

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Here are some examples of bad posture through delivery. They most common coaching mistake we see is telling a player to “get on top” of the ball.

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Now some of you reading at this point might be thinking, “Hey Matt Harvey was a dominant pitcher and Okajima was an World Series winning All Star.” That is all true but how long were they dominant and, at what cost.

A players inability to maintain their balance and posture through the delivery can be caused by a multitude of reasons. Literally any restriction in anything from the ankle up to the trunk can cause a loss of posture in the players delivery. I always recommend that a player get screened by a qualified movement specialist to be sure you are attacking the correct strength and flexibility deficits that are causing the problem. That being said here are some of the most common causes of loss of posture that I see with my pitchers.

Flexibility:

If a players hips and trunk are tight it will limit their ability to rotate which can lead to a loss of posture while throwing. Here are two simple stretches that you can do to help improve your hip and trunk mobility. If you try to do these exercises, and its really easy, then flexibility probably isn’t the reason behind why you are losing posture. It’s still a good idea to perform them regularly to maintain the flexibility that you have. Try doing 15 repetitions holding each repetition for about 3 seconds

Hip IR/ER with Twist:

Sit on the ground with a bat. Rotate one leg in and the other leg out keeping a 90deg bend in the knees. Once your legs are touching the ground rotate your arms towards the leg that is rotating in.

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Open Book:

Lie on your side with both legs bent up to 90deg. Rotate your arms open like a book.

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Core Strength:

Your core muscles are what keep your trunk upright while you are twisting as you throw. They also help to transfer the energy from your legs up to your arm. That means that by doing this exercise not only will you be able to better maintain your posture, you will also be able to throw harder (and who doesn’t like that). Perform 15 repetitions on each side and hold this reach/kick position for 3 seconds.

Plank with Reach:

Get into a tall plank position focusing on squeezing your glutes and keeping your core tight. Stay stiff and alternate reaching with your hands out in front of you. It’s important to prevent your hips from twisting while you reach.

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Plank with Kick:

Get into the same tall plank position. Alternate kicking a leg up in the air. Make sure that your hips don’t twist. Also make sure that your back doesn’t arch as you kick up.

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Balance:

Well it’s what we’ve been talking about the whole time. Didn’t you think I was going to give you an exercise to work on? Balance is important in your trail leg but also your landing leg so be sure to work on this on both legs. You may notice a difference between your legs which is completely normal. The more you work on it, the more your legs will equal out. Try to do 15-20 repetitions on each leg.

Single Leg RDL:

Stand on one leg. Keeping your back straight, balance on one leg and kick the other leg back. The goal is to get your body parallel to the ground without rounding you back. This is a really challenging exercise so don’t get frustrated if you have trouble with it. Just keep practicing and eventually you will master it.

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I hope this helps you improve your strength and flexibility to limit any loss of balance and posture that you might have in your delivery. If you haven any questions or problems please don’t hesitate to contact me on our website, www.orthocorept.com , or via email, IanM@orthocorept.com.

Golfers Elbow vs. Nerve Traction Injury

Specializing in treating golfers allows me to treat a lot of elbows. “Golfers elbow” is one of the most common injuries in golf (I know, shocking). What I find most interesting though is that pain in your elbow with golf isn’t always a true “golfers elbow.” Sometimes that persistent pain in your elbow could actually be a nerve problem coming from your neck. Please allow me to drop some knowledge.

Golfers elbow (or medial epicondylitis as the medical folk like to call it) is an inflammation of the medial epicondyle. It is the bony prominence on the inside part of your elbow.

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Golfers elbow usually happens because a golfer flips the club through the hitting zone. This over activity of the wrist flexor and pronator muscles pulls on the tendon attachment and causes pain and inflammation. The pain is usually localized to the elbow area and can be reproduced when you poke at it, or resist the wrist flexor and pronator muscle groups.

I have found on numerous occasions though that pain on the inside of the elbow for golfers is frequently NOT golfers elbow. Most golfers that I treat are not professional golfers (even though most think they are). By that I mean that most are working at a desk job during the week and maybe get out and play once to twice a week. That amount of volume is not usually enough to create a true golfers elbow.

Take a look at this road map for the median and ulnar nerves in the arm. The nerves run right around the medial epicondyle.

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That is why a nerve traction injury, or cervical spine radiculopathy, can feel like a golfers elbow but it’s actually a neurological injury. The nerve usually gets irritated up at the nerve root in the cervical spine. Although that is where the injury occurs, the pain usually presents down in the elbow and forearm.

Now let’s talk about how that nerve root gets irritated. Like I said before, my usual patient is the golfer that works all week and then golfs on the weekend. Most people have a sedentary job and really crappy posture. Does this picture look familiar?

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The common rounded forward position leads to a hyperextension at the cervical spine. That hyperextension leads to compression of the cervical spine and compression of the nerve roots. This postural problem arises when you take that posture and try to swing a golf club.

A normal golf swing requires a lot of rotation out of the cervical spine. Everyone always focuses on their shoulder turn and the poor neck gets passed over and neglected. When you keep your eyes focused on the golf ball and turn your shoulders your cervical spine is still moving. That extra rotation puts even more compressive force on the cervical spine and those nerve roots. That is where the problem arises from and leads to the pain down the arm and into the elbow.

Here are some simple tests and fixes to see if your elbow pain is coming from your neck. Take your normal set up posture like you are hitting a 5 iron. Now, try and turn your head like you are trying to look at your shoulder. If you can’t easily turn your head without feeling a restriction in your neck you have a cervical spine problem that is probably due to poor posture.

 

If you want to test if your nerves are involved, try this. Hold your arm up like you are holding a waiters tray. Now keep your wrist extended and stretch your arm out as you turn your head away from your hand. If this reproduces any elbow pain, guess what, you have a nerve problem not an elbow problem. If this is you then try this exercise to get your nerves moving better. This will hopefully calm the nerve pain down and minimize the pain you are feeling with your golf swing.

OrthoCore if here to help! For more information or to make an appointment at either our North Kingstown or Westerly location, call us 401-667-0131 or Contact Us

Single Leg Romanian Deadlift for Golfers

If you read my last post you know I’m all about exercises that involve multiple body parts. I believe this is the best way to train. It helps to train movements rather than single muscle groups. It also helps you get in a great workout in a shorter period of time. The unfortunate thing for some golfers is they don’t have access to a gym. Well if that is you, nothing to worry about, I didn’t forget about you. Here is an exercise that anyone can perform to help improve your body’s stability, to improve your golf swing.

The exercise is a Single Leg Romanian DeadLift. Why Romanian? No clue, but they seem to have the best exercises going, so thank you Romania. Your glutes and abdominals are the most important groups of muscles in your golf swing. As a unit they help to keep you stable in your swing. They also help to transfer all the power from your big leg muscles into your arms and eventually into the golf ball. When you perform the deadlift on a single leg you are working on balance which will also help you stay more stable during your golf swing.

The glutes and abdominals are also the muscle groups that help you stay in posture during your golf swing. Most amateur golfers struggle with staying in posture during the swing. It can happen during your backswing, downswing, or both. Loss of posture is a power robber, it will also make your ball flight really inconsistent. When you struggle with a loss of posture you always have to use your hands to find the golf ball. When your timing is on, you can have a great day. When your timing is off, forget about it. Its lost ball city, population, you. The single leg RDL will help to keep your posture consistent and your scores low. We demonstrated this on our Facebook page recently.

You can start by using a golf club to help you get in the right position during the exercise. When that gets easier take the golf club away. Try to keep everything locked in like the golf club was still there. When that gets easy you can start to add weight to the movement. You can hold a weight in either hand or just use a band for resistance. That way you can start to build the strength in your glutes and abdominals to make your golf swing more powerful.

If you have any questions or comments please contact me here at OrthoCore Physical Therapy. Our office phone is 401-667-0131 or use the contact form on our website. Hopefully this will be the start to your best season ever!