Friday, 29 November 2013

Patella Femoral Pain

I came across a video discussing some of the contributing facts in PFP, which was really interesting. The video can be found here. One of the key factors suggested was VMO activation along with quadricep strength.

Worth a watch if you're interested.

There's also a blog by the presenter of the talk here.

Friday, 15 November 2013

Anterolateral knee ligament

In case you've missed the anatomy news of the week, if not the year at the very least, researchers have apparently discovered a ligament in the knee that was described in 19th century but not noted since then.

Strange to think that a ligament like this could go unnoticed for so long, what with all the technology we've developed over the years and the number of dissections that must have taken place in the intervening years. What is interesting is whether there is a relationship between ACL damage for example and this ligament. One wonders what role it plays in stabilising the knee. Perhaps it works with the LCL given it's proximity, but we shall have to wait and see what the experts discover.

Tuesday, 12 November 2013

More on hip mobility and low back pain

I came across another interesting article about low back pain and hip mobility the other day. It came in an email about tennis coaching rather than a therapy newsletter. Written by Dr Josh Renkens, DC, MAT, ART, the article was titled "Is Your Limited Hip Mobility Causing Your Low Back Pain". Because it came in an email, there was no publication source, so I can't give you a reference to find it for yourself.

Anyway, he suggests that lack of internal (medial) hip rotation is a contributory factor in low back pain experienced by golfers and tennis players. Actually he refers to an imbalance in hip rotation rather than limited rotation in one direction. He says:

In one study, 48% of subjects with low back pain (LBP) had increased lateral rotation and a deficit in medial rotation of the hip (Ellison, JB).

Another interesting point he makes was that:

Researchers found that a statistically significant correlation was observed between a history of LBP and decreased lead hip internal rotation (Vad, Journal of Sports Medicine).

The obvious thing might be to assume that the limited medial rotation come from tight lateral rotators, and that can certainly be true. But don't ignore the possibility that it might be that the medial rotators are not engaging properly. I've certainly seen that with at least one recent client where medial rotation wasn't restricted, it just didn't happen readily.