What is the difference between a disc bulge, disc herniation, disc protrusion, disc extrusion and a disc sequestration?
What about terms like focal, posterolateral, and circumferential?
Learn it all in this quick, simple video.
Read the quote from Joseph Pilates
Return To Life Through Contrology (Pilates, 1945, p34)
“Therefore, in the reclining exercises, be sure wherever indicated, to keep your back full length always pressed firmly against the mat or floor.”
Read the research
I did a whole blog on the research on spinal flexion versus neutral
Antony Lo is a Sydney based physiotherapist who specialises in female athletes, and in particular female Crossfit athletes.
Having successfully grown 2 private practices, Antony sold these to concentrate on his Specialisation Training Program and developing educational courses for health professionals and the general public. He still consults at 2 locations in Sydney seeing everyone from children to the elderly, as well as his sports-specific patients. He also travels around Australia to deliver seminar information for his course The Female Athlete, and to provide consultations for those interested in his approach.
I have been friends with Antony since 2006 when we worked together. Every time I talk with Antony I learn something valuable, he is one of the practitioners I admire the most, and who I have learned the most from.
In this conversation we talk about pelvic health, urinary incontinence, low back pain, making quick changes and Antony’s approach to evidence-based practice.
Read the Research:
Relaxin levels during pregnancy are not related to pelvic pain
- Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review (Aldabe et al., 2012)
- Association between the serum levels of relaxin and responses to the active straight leg raise test in pregnancy (Vøllestad et al., 2012)
The sacroiliac joint basically doesn’t move – even in people with diagnosed “pelvic instability”
- Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain (Kibsgård et al., 2017)
- A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test (Sturesson et al., 2000)
Pregnancy is characterised by widespread tissue hypersensitivity
You can’t palpate movement of the pelvic joints (even if you think you can)
- Manual palpation of lumbo-pelvic landmarks: a validity study (Kilby et al., 2012)
- Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction (Holmgren et al, 2008)
- Clinical tests of the sacroiliac joint: a systematic methodological review. Part 1: reliability (van der Wurff et al., 2000)(a)
- Clinical tests of the sacroiliac joint: a systematic methodological review. Part 2: validity (van der Wurff et al., 2000)(b)
The biggest predictor of recovery from pelvic pain is – belief that you will recover
Read the Research:
- Clinical outcomes of a scapular-focused treatment in patients with subacromial pain syndrome: a systematic review (Reijneveld et al., 2017)
- Exercise for rotator cuff tendinopathy: a systematic review (Littlewood et al., 2012)
- Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: randomised, placebo surgery controlled clinical trial (Paavola et al., 2018)
- A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study) (Littlewood, 2016)
- Effects of Scapular Stabilization Exercise Training on Scapular Kinematics, Disability, and Pain in Subacromial Impingement: A Randomized Controlled Trial (Turgut et al., 2017)
- Sham surgery versus labral repair or biceps tenodesis for type II SLAP lesions of the shoulder: a three-armed randomised clinical trial (Schrøder et al., 2017)
- Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis (Piper et al., 2017)
- Arthroscopic decompression not recommended in the treatment of rotator cuff tendinopathy: a final review of a randomised controlled trial at a minimum follow-up of ten years (Ketola et al., 2017)
Read the Research:
Read the Research:
- Kemp-2009: A randomized comparative trial of generalized vs targeted physiotherapy in the management of childhood hypermobility
- Pacey-2013: Exercise in children with joint hypermobility syndrome and knee pain: a randomised controlled trial comparing exercise into hypermobile versus neutral knee extension
- Palmer-2014: The effectiveness of therapeutic exercise for joint hypermobility syndrome: a systematic review
- Smith-2014: Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials
- Di Stefano-2016: Central sensitization as the mechanism underlying pain in joint hypermobility syndrome/Ehlers–Danlos syndrome, hypermobility type
Greg Lehman http://www.greglehman.ca/ is a Canadian physiotherapist, chiropractor and strength and conditioning specialist treating musculoskeletal disorders within a biopsychosocial model. He is incredibly well-read, a highly skilled educator. And he’s funny.
Before his clinical career, Greg received a Natural Sciences and Engineering Research Council MSc graduate scholarship and became one of only two students each year to train with Professor Stuart McGill in his Occupational Biomechanics Laboratory, subsequently published more than 20 peer-reviewed papers in the manual therapy and exercise biomechanics field. He was an assistant professor at the Canadian Memorial Chiropractic College teaching a graduate-level course in Spine Biomechanics and Instrumentation as well conducting more than 20 research experiments while supervising more than 50 students.
Greg has lectured on a number of topics on reconciling treatment biomechanics with pain science, running injuries, golf biomechanics, occupational low back injuries and therapeutic neuroscience. His courses Reconciling Biomechanics with Pain Science and Running Resiliency have been taught more than 60 times in more than 40 locations worldwide.
In this conversation, Greg and I talk about how the biomechanics research invalidates the idea of ‘dysfunction’ as a cause of pain or disability, why scapular dyskinesis (aka poor scapular positioning and movement) is not a thing, knee valgus during a squat is nothing to worry about and several other interesting topics.
Greg shares his approach of movement optimism, and his basic framework for working within a biopsychosocial model.
I was inspired to write this by Jenna Zaffino’s story in episode 52 of Pilates Unfiltered – I don’t want to put words in Jenna’s mouth so you should listen to the episode after reading this if you’re interested to understand her point of view.
As movement teachers – Pilates professionals, exercise physiologists, physiotherapists – for years we have operated on the assumption that understanding anatomy, physiology and biomechanics are foundational to being an effective practitioner and teacher.
I think this assumption is wrong. You don’t need to know anything about anatomy, physiology OR biomechanics to effectively teach Pilates or help people rehabilitate.
Yep. Anatomy is not important when teaching Pilates. In fact, I think it gets in the way of good teaching.
I will even go so far as to say, you don’t need to know ANY anatomy, physiology or biomechanics in order to be a great teacher and practitioner. The less the better.
