BFR or blood flow restriction therapy has been around for a long time, but recently, the evidence for its use in the world that is rehabilitation has begun to emerge. The principle is very simple: that the circulation of blood flow is confined to the area of the human body that’s being trained or undergoing rehabilitation in a certain manner to boost the impacts of the training via lower load (less stress).
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Is Blood Flow Restriction Effective?
According to the American College of Sports Medicine, to achieve an increase in muscle size and strength, you want to do 8 to 10 repetitions of an exercise. A moderate to high intensity is deemed to be 65 to 80 percent of their patient’s one rep maximum (the maximum amount of weight a person can lift 1 time). However, the majority of patients that are injured can’t deal with this kind of load, consequently restricting their capacity.
So again we’re faced with the question: Just how can we achieve hypertrophy and gain muscle strength without using heavy loads? The solution involves using a tourniquet to restrict blood flow into a muscle. This technique is known as blood flow restriction training (BFR).
According to the most recent research in the event the appropriate blood flow restriction therapy protocols are utilized, the benefits of the training are equal to those found when using 70 percent of an individual’s maximal load, while using as little as 20 to 30 percent of somebody’s maximum load. The secret is that restricted blood flow training allows healthcare professionals, such as physical therapists, to make a localized region of exercise that is anaerobic.
BFR is a tool that uses a doppler and tourniquet system placed on either thigh or the upper arm to limit blood circulation. After this, it begins to create lactate and hydrogen ions and denies the muscle oxygen. This is what causes the “burning” feeling when we lift heavy weights. The burn is simply the response to being in an active environment of the body. During heavy lifting (65-85%), we create small microtraumas in the muscle that the body then repairs by building more muscle. Together with BFR, we are not generating microtraumas at the muscle, so our body does not have to devote the energy to repair the muscle; rather our bodies just focus on creating the muscle.
Second, soreness is not experienced by us as we would when we were lifting weights. This means we can now lift at low loads (15-30%) and basically gain more muscle strength and size, at a quicker manner, as if we were lifting a more heavier load.
As soon as we create lactate, we activate growth hormone release. The release of IGF-1 subsequently stimulates once growth hormone is released. Such enables your muscles ability to activate; this in turn increases muscle protein synthesis, or our stem cells to the muscle. As previously mentioned, if we were to have muscle breakdown, these stem cells could have to concentrate on repairing muscles building. With blood flow restriction therapy or training, we skip the muscle repair and focus on muscle building. This result is not concentrated throughout the exercise, but impacts the tissues and muscles to create the greater benefit of BFR. BFR has shown to have the ability to help in endurance training and coaching, tendon healing and bone recovery.
All of our muscles are produced from other kinds of fibers, including type 1 which are slow to twitch and rely on oxygen and type 2, which are those we’re currently attempting to build with BFR training and fast-twitch fibers. By limiting the blood flow, we create an environment at the muscle group that compels the increase of more fibers that are type 2. Higher strength gains are the outcome because these type 2 fibers normally can produce more force. Another effect of blood flow restriction is that is allows for a synthesis of proteins needed to build and repair muscles and tissues.
In a treatment setting, this helps us achieve the outcomes for patients faster, and in sports it enables the gains to be attained with less strength and less damage to the muscle. That is why pro and college teams are currently turning to BFR as a training principle. In sports, athletes are attempting to come back to the field quicker after suffering trauma or injury from an accident. Some athletes re-injure themselves by lifting. That is really where BFR can come by lifting loads that are lower and receiving the same, or even much better profits. Healthcare specialists will tend to eliminate strength immediately following a sports injury, but they can not exercise at elevated levels. In this manner, they can not only keep the power but build strength in the process although together with blood flow restriction training.
Is Blood Flow Restriction Safe?
You might be thinking that its effects sounds fantastic, but is it safe? The brief answer is yes, but as with any rehab technique, there are precautions which should be taken and it’s recommended to first seek medical attention from a healthcare professional to discuss the option of BFR therapy for you. We certainly don’t recommend that individuals do this by themselves and tie bands around their limbs. In the practice, specialists can track it as you train and use special devices to know exactly how much you need to train to experience its benefits.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
For many athletes following any major endurance event they will return to their houses, to recover, celebrate, reflect and rebuild to their next career step. Some, like the athlete in this case study will need to now focus attention on delayed decisions concerning whether to go under the knife to sort out a chronic injury.�El Paso, TX’s Injury scientist, Dr. Alexander Jimenez takes a look at the study.
My client has been competing in triathlon for 10 or more years, although his career has included a range of serious injuries which have kept him from races for months on end. In the previous two to three decades, however, he’s enjoyed a sustained period of injury-free training and racing, and has climbed to the peak of the world rankings. But the emergence of hip pain has seen him once more return to the physio’s table.
The triathlete’s accident history highlights a common pattern among sportspeople: 2 tibial stress fractures, a femoral neck stress fracture and a serious ankle sprain — every one of these on his right side. The significant contributing element to the bone stress injuries is a 1.5cm leg-length gap (his right leg is shorter).
He’d first experienced comparable hip pain in 2004; it kept him from running for three months. At that time, nothing was detected on a bone scan or MRI, or so the pain went paralyzed. An intra-articular cortisone injection (CSI) elicited no improvement. The athlete remembers that he chose to train on his painful hip, never allowing the symptoms to settle. The nearest he ever came into an investigation was a hypothesis that he could have a little, undetected, labral lesion.
The present episode of hip pain began initially at night after a hard three-hour bicycle ride. Earlier this, however, he hadn’t cycled for five times. He described his initial symptom as a profound hip tightness (lateral and lateral), together with slight pain in his groin. He was able to continue to train however, was feeling that the hip tightness and pain following both cycling and running (swimming was symptom-free).
A week later his symptoms dramatically worsened when he flew from Australia to Singapore, on his way to a French high- altitude camp. As he got off the airplane, he felt deep hip pain as well as the tightness. As elite athletes tend to do, he coached anyway, running a tricky track session, which made the hip much worse: he was unable to ride or run without pain. He instantly started a course of anti- inflammatories.
I met him in Singapore and evaluated him in the airport, initially ruling out any prospect of a disease or systemic matter. He explained he had been feeling an ache during the night, lying in bed; on waking, the hip would be OK, but got worse the longer he walked.
On assessment, he had the following physical signs:
� walking with obvious limp
� pain on hopping (6/10)
�painful right hip quadrant/impingement test (full hip flexion/adduction)
� reduced right hip flexion (-10 degrees compared to left)
� reduced right hip internal rotation (-10 degrees compared to left)
� increased tone on palpation of TFL, adductors, hip flexors, gluteal, piriformis and deep rotators
� lumbar spine and SIJ were OK
� femoral shaft bone stress test was OK � leg length discrepancy (right side 1.5cm shorter)
� right innominate (pelvis) anteriorly rotated
� weakness in right hip abductors/extensors
� reduced calf endurance on right side (-5 reps)
� ankle dorsiflexion range of movement was OK
� reduced proprioception on right (single leg stance, eyes closed).
I thought the differential diagnoses were:
� femoral neck stress fracture
� labral tear, possibly with hip synovitis
� FAI (femoro-acetabular impingement), possibly with hip synovitis.
I initially treated the triathlete with soft- tissue techniques to reduce the tone around the hip joint. Trigger-point releases were performed on his TFL, adductors, gluteals, piriformis, deep rotators and iliopsoas.�This reduced his jump pain into 3/10. Manual long-leg grip further decreased the strain on hopping (2/10). He still had pain and stiffness on walking but it sensed “simpler. As he prepared to embark on his long run flight to Europe, I counseled him to not sit for too long and maintain his stylish as straight as possible to decrease any potential impingement from hip flexion.
Luckily, the hip didn’t get worse throughout the flight. On arrival at the French high-altitude training centre, we initiated a strategy of two swims and two intensive treatments a day, aiming at reducing muscle tone, restoring his range of hip movement and normal muscle control and stamina. We had been expecting that the problem was not a stress fracture, but just minor hip synovitis that could settle quickly. Following a week of conservative treatment, though, we were just able to keep his hop pain in 2/10, and that he still could not run 20 meters without any pain and limping.
In collaboration with medics, we flew to London to see a sports doctor and get MRI scans. The scans revealed no bone stress reaction, fracture or labral ripping — which was a big relief; however, it did show signs consistent with FAI (femoro-acetabular impingement). He had hip synovitis with a rectal lesion on his femur.
Hip injuries aren’t much reported among triathletes — in fact they are notably absent from reports on Olympic and Ironman triathlons, which mention knee, back, H/ Achilles, lower leg, ankle and shoulder as the most common accidents (1-3).
In this state, when the hip is in maximum flexion and internal rotation, the labrum and cartilage abut and impinge; damage to the articular cartilage and acetabular labrum results from this pathologic bony contact. The contact generally results in a structural abnormality of the femur (“camera impingement”) along with the acetabulum (“pincer impingement”) or a combination of both (“mixed impingement”). Over time, via repetitive micro-trauma, the aggravating motion hurts the hip cartilage or labrum (or both) during normal joint motion. This happens along the anterior femoral neck and the anterior–superior acetabular rim. FAI is a possible trigger of early hip joint degeneration (4).
Arthroscopic surgery is the direction of choice for FAI if symptoms do not settle; however as his next Competition was only three and a half a year off, surgery was not an option. Instead, over a five-day interval, the athlete had two cortisone (CSI) and local anesthetic injections into the hip joint (under ultrasound guidance) to settle the indicators.
Our aim was to grow the hip range of motion and extend the capsule to reduce any additional impingement, slowly returning to regular training. Following the competition, the athlete would then should see a hip arthroscopic surgeon to acquire a surgical opinion to the best option for long-term direction.
Injection Relief
After both shots my customer felt sore for five days. The initial CSI settled his pain on hopping to 1/10 and after seven days he managed to operate without symptoms. But minor hip stiffness and aching at the end of the day prevented him from progressing to optimal training, so that he then underwent a second steroid injection. This settled the hop pain into 0/10 and decreased the aching; so after five times he returned to mild cycling and after seven days he started running again, also.
The athlete admitted that, following the first shot, he had done more and gone tougher in training than directed, as he had felt “good. This mistake of “too much too soon — all too common in elite athletes — had led to excessive inflammation and aching in the hip nightly after training. After the next injection he returned to normal intensity slower and more gradually.
My client built his training up to regular levels by four months following the final injection (swimming five times per week, cycling four days and running six to seven days). He began with very easy cycling on a wind trainer for 30 minutes, building slowly to 90 minutes before cycling on the street. He cycled two days on and one day away and avoided hills to the first two weeks. He started jogging on the apartment for 15 minutes and slowly built up to 90 minutes after three weeks. He did not run hills or about the track; and as he ran only on every single day, he would diligently concentrate on technique.
From week six to week 11, my client remained on anti inflammatory medication and underwent two treatments a day.
The hands-on treatment continued to:
� increase hip range of movement
� stretch the hip capsule
� normalise pelvic symmetry and hip muscle tone
� improve muscle control and strength � improve proprioception
� ensure optimal biomechanics via video assessment (cycling and running).
Eleven weeks after he first felt his hip pain, the triathlete returned to racing; however he failed to finish the first race, partially because of minor hip stiffness but mainly due to “fitness. Fortunately there were not any prolonged symptoms after the race and a week after he successfully returned to competition, coming second in a really strong field. His very minor ongoing symptoms were handled with anti-inflammatory drugs and hands-on treatments.
If this athlete wants to pursue a long- term triathlon career up to the London Olympics, then he will now require surgery. The arthroscopic surgical technique initially assesses the cartilage and labral surfaces, debrides any abnormalities of the hip joint cartilage and hip labrum, removes the non-spherical segments of the femoral head�and any prominent sections of the anterior femoral neck and bony growths on the acetabular rim that may continue to contribute to hip joint impingement.�The alternative is early joint degeneration and onset of osteoarthritis.
References:
1. Wilk B et al: �The incidence of musculoskeletal injuries in an amateur triathlete racing club�. J Orthop Sports Phys
Ther 1995 Sep;22(3):108-12.
2. Collins K et al: �Overuse injuries in triathletes. A study of the 1986 Seafair Triathlon�. Am J Sports Med 1989 SepOct;17(5):675-80.
3. Korkia PK et al: �An epidemiological investigation of training and injury patterns in British triathletes�. Br J Sports Med 1994 Sep;28(3):191-6.
4. Ganz R. et al (2003): �Femoroacetabular impingement: a cause for osteoarthritis of the hip�. Clin Orthop Relat Res. 417:112�120. For more information see: www.hipfai.com
Imagine you trained well for a significant race, got yourself into form and cruised through the first half of the course without any issues, and were on pace for a nice PR. All of a sudden, you started to notice tightness in one of your hamstrings. In the beginning, it was a hindrance that could be ignored, but the tightness got steadily worse until your hamstring was a stiff, painful mass of tissue which cried out to cease.
You slowed down, you ceased to stretch, massaged it, but nothing helped. Realizing that this was the conclusion of your race, you limped to the end, disappointed and frustrated that after six months of attentive, time-consuming preparations, some strips of muscular tissue in the back of your thigh had prevented you from attaining your goal. Does this situation sound familiar to someone or has this happened to someone you know?
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Hamstring Injury Issues
Hamstring difficulties are common among runners, with strains, pulls, tendinitis and tears being the most commonly reported damage or injury to the hamstring muscles. Are hamstring issues common? Most distance runners have developed a scenario called “quad dominance,” a scenario that takes place when the quad muscles overpower the action of the hamstrings at the movement of the leg through a running stride.
Logging a great deal of miles on the streets can put repetitive functional overload on the quadriceps, which makes them powerful, strong and dominant. When the quadriceps contract as you land, the hamstrings, the opposite muscles, act as brakes for your knee to stop against hyperextending in the conclusion motion of a stride.
The quad functions when the knee is locked out in expansion with motion happening in the hip (the forward swing of a stride). The quadriceps work along with the hip flexors to flex the hip as you run. In addition, once the hip is fixated with movement taking place in the knee (when the leg is planted on the floor), the quads function as extensors of the knee.
If your hamstrings are significantly weaker than your quads, due to a continuous loading of the anterior (frontal) chain from jogging or running, particularly seen in athletes, then one of two things will happen: first, your hamstrings will tear as a consequence of not being able to take the load created by the contracting quadriceps and momentum out of hip extension; and two, you will run slower as a consequence of diminished power from the hip flexors and knee extensors since the hamstrings have to contract earlier to have the ability to break the ensuing movement.
Regrettably, once you get yourself into this quad-dominating problem, it’s difficult to undo. Hamstring injuries are rather slow to cure, and athletes regularly spend plenty of time resting before they are able to train without much pain towards carrying out activities. However, like muscle injuries, distress tends to return again and again, particularly because most athletes fail to deal with the root cause of their problems.
When the quadriceps are concentrically contracting (as you land), the hamstrings need to be eccentrically contracting to check the movement. It has been proven for producing activities, that contractions will have limited gains in strength. For this reason, focusing upon loading is critical.
By executing a suitable strengthening program for those hamstrings using a series of specific, isolated, and abnormal exercises, such as those in which muscle fibers lengthen because they contract, you can remove the quad dominance, and keep yourself healthy, powerful and quick. It is possible to begin with the following three simple hamstring exercises below to help treat an athlete’s hamstring injuries, improving strength, flexibility and mobility.
Hamstring Exercises
The exercises here will strengthen the hamstrings while the muscles actively lengthen by mimicking the “grab” of a leg’s swing period whilst jogging. Each of these exercises 8 to 12 times for 3 to 4 sets. On moving from the center, focus, and remember that the emphasis is on the portion of the motion.
Good Morning
A) Start with your thighs locked, arms holding a weight bar on your shoulders with conflicting grasp, back in neutral position and center tight.
B) Slowly bend over at the waist, gently feeling the stretch on down the road. Keep your chest do not hesitate to droop your shoulders toward the floor in an attempt to seem like you are going . Constantly keep the core to support your back.
C) On down the road, maintain the barbell as close to your leg as possible to decrease the pressure on the lower spine. Maintain the back at the neutral position.
D) When you’ve gone as low as possible with your knees locked, start to return up slowly. (Avoid the tendency to jerk upwards or arch your spine. Should you feel inclined to either, use less weight on the bar.)
E) For a sophisticated version, try this exercise one leg at a time by putting the non-exercising leg up on a seat on your side.
Single-Leg Romanian Dead Lift
A) Stand holding a barbell in front of you on your right hand, putting your weight in your right foot. Lean forward 15 degrees or so.
B) Keeping a small bend in your right knee, your back flat and your chest out, lift your left leg straight out behind you as you reduce your body over your right leg. Slide the dumbbell to about mid-shin down your quad and lift your own body back up into an erect posture, keeping your weight onto your right leg. Repeat for 2 to 12 repetitions, then switch hands and legs.
C) To progress this exercise, stand on a barbell or Bosu with the exact same weight, or stay on the floor and increase your weight.
Eccentric Hamstring Curl (with a partner)
A) Kneel on a folded towel or a pile of exercise mats with your toes pulled toward your shins. Keep your hands in front of your chest. Your partner sits behind you, facing your spine, pressing down on your legs with his palms.
B) Keep your core tightup your torso and hips forward so your body forms a straight line from the ears to your knees. As you lower your chest whilst resisting gravity keep this posture. Control the range of motion as far as you can, grab yourself with your hands, then push off the floor in yanking you back up to assist your hamstrings and glutes. (In case you do not have a spouse, you can perform a similar workout on a hamstring washing machine)
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
Blood Flow Restriction training (BFR) is a style of resistance training that utilizes the custom of wrapping a kind of tourniquet around a limb and training with a relatively light load. It is a practice that has gained quite a bit of popularity in the resistance coaching realm over the last few decades and is something which can benefit training protocols.
If used properly, practical blood flow restriction training (BFR) could help you through hypertrophy plateaus, pack on additional mass and even aid in growth or maintenance of muscle mass during times in which lifting heavy weight is either laborious or impossible. Let’s understand what’s actually going on in the body when it is used by you.
As mentioned prior, BFR demands using some form of tourniquet around a limb so as to inhibit blood flow. However, not all of blood flow is restricted. The purpose of the tourniquet is to prevent what’s known as ‘venous return’ . When you contract a muscle, more blood than ordinary is shuttled to provide the muscle with a myriad of different nutrients, such as oxygen. Typically, if un-wrapped, the blood then returns to the heart through veins so as to rid the muscle of metabolic bi-products like carbon dioxide, lactate, and hydrogen ions (the acidity that makes your muscle “burn off”).
The role of using some form of tourniquet is to inhibit the ‘venous return’ of blood to the heart while still allowing arterial blood circulation to the muscle. By doing this, the blood continues to be shuttled to the muscle and pools without having the ability to escape. It’s believed that the accumulation of blood and bi-products contributes to activation of fast-twitch muscle fibers, which is typically thought to only happen after these are fatigues or due to using fairly heavy loads. By doing this, you increase the potential for the muscle t.
In fact, a recent analysis by suggested that when participants used the same load (40% of 1 RM) and either used a tourniquet or didn’t, the team using BFR observed the same gains in strength and muscle volume as the group that did not. The catch: the BFR team had finished significantly less repeats, and thus less quantity, in addition to less time under pressure. This implies the exact same advantage was observed by them, but achieved in time.
The research appears to indicate that you could complete less work in order to achieve the very same results. Utilizing blood flow restriction training is ideal for times that you are fatigued or simply too sore to execute resistance training that is significant or are just at a time crunch. Additionally, using BFR is a candidate for instances when usage of significant weight is apparently impossible or ill advised, for example post-injury or operation, or being elderly.
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Gear
Considering the nature of this kind of training, BFR requires using some form of tourniquet. The easiest and most convenient way to achieve this would be to use some form of strap like an ace bandage or weightlifting knee wraps. If you are able to discover a strap using a comparable elasticity diameter that is smaller, this would be more optimal. When wrapping your limbs, you want to prevent wrap ‘over’ the limb. Otherwise you can risk limiting the muscle’s capacity to contract and your range of movement.
Placement
You will want to put the wrap around the proximal portion of the muscle you’re working. This implies over the muscle and close to the torso. If you are thinking about training forearms and your biceps, you should set the wrap beneath the deltoid. Using this technique for the body requires some careful instructions. Some experts say that when practicing BFR for the body, your leg ought to be wrapped close to the groin area, over the quadriceps. If you’re training calves this would be included. When training BFR for calves, its wise to wrap over the calf and beneath the knee. This is because the common wraps are not really large enough to effectively wrap over the quadriceps.
Wrapping Pressure
When wrapping your muscle, remember to keep in mind that you aren’t attempting to completely restrict blood flow. You still require blood circulation to the muscle. As such, when you wrap, you should try to shoot for wrapping the arm at about a 7 out of 10, with ten being very painful and a complete loss of blood flow. If your arm is totally asleep before you even begin training, the wrap is too tight.�If you complete a set of exercises and your arm is not pumped or fatigued, then you’ve probably not wrapped the bands tight enough.
First and foremost, a majority of experts concur that this kind of training is in fact a safe practice provided that it’s executed properly. To be able to maintain proper safety, ensure that you have not completely restricted blood circulation. Further, as soon as you’ve finished your sets, be certain that you remove the wrap in order to give the muscle blood supply and permit the used blood to be recycled. Should you have them too tight or keep the wraps on too long, you run the danger of inducing tissue and cell death. This isn’t advised. Further, if you have higher blood pressure or heart problems BFR, or blood flow restriction, training is not suggested.
There’s also some evidence to indicate that musculature which isn’t directly occluded, for example chest and shoulders, can experience some benefit from BFR. That is interesting because there was a long belief that advantage would be seen by muscle below the tourniquet. A current meta-analysis indicated that despite evidence, the indirect muscle (chest and shoulders) may see increased benefit in comparison to the same training without a tourniquet. If you are feeling tired, yet still want to get a chest and shoulder pump, then it may help you to wrap your arms.
Finally, BFR shouldn’t be used only in place of different sorts of training. Outcomes like power, power output, hypertrophy and force production rely on coaching specificity and varying immunity (i.e to be able to maximize strength, you need to train with heavier loads to get lower repetitions). The study suggests that blood flow restriction training could be as good as other types of instruction, not exceptional. Therefore, blood flow restriction, or BFR, training may be a useful tool within a resistance-training schedule that is well-rounded.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
In order to comprehend how BFR, or blood flow restriction, functions, it is important to perform a quick debriefing on how your circulatory system, also called vascular or cardiovascular system, works. Your arteries are blood vessels that carry oxygenated blood away from your heart to your body. Your veins are blood vessels that carry blood from the body back to the heart.
The objective of blood flow restriction training would be to restrict venous return while still allowing arterial flow by strategically wrapping the lightest portion of your own limbs. Blood can keep pooling to a muscle by restricting the veins rather than the arteries and it remains trapped there. It is like filling a water balloon to max capacity (with no popping up, of course).
By gathering all of the blood to the working muscles without letting it leave, a couple key things happen:�One, you receive a crazy pump and your muscles become supersized. The concept is that this contributes to cellular swelling that shocks the muscles into growth. Second, it’s gonna burn tremendously. Your muscles become deprived of oxygen and can not eliminate accumulating waste materials and this creates a great deal of acidosis or strain. Metabolic stress is just one of the three major mechanisms of muscle development and shouldn’t be dismissed.
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The Science of BFR
Dr. Brad Schoenfeld is a regular contributor on hypertrophy (the scientific term for muscle growth). In his book Science and maturation of Muscle Hypertrophy, ” he states: “The prevailing body of literature shows that BFR training stimulates anabolic signaling and muscle protein synthesis and markedly increases muscle development despite using loads frequently considered too low to encourage substantial hypertrophy.” Brad goes on further, saying that “it has been speculated that metabolic stress would be the driving force behind BFR-induced muscle hypertrophy.”
Another interesting matter that occurs with blood flow restriction training is since your oxygen-dependent slow-twitch fibers fatigue way quicker than normal, you have to quickly begin tapping into the fast-twitch muscle fibers, which have the biggest potential for growth.
Interestingly enough, your fast-twitch fibers typically don’t get hit unless you’re using heavy loads or pretty hefty loads performed explosively. But BFR lets you really go fast-twitch with loads less than 50 percent of your own one-rep max. Actually, one study from the Journal of Applied Physiology revealed increased muscle cross-sectional area with BFR training using loads as light as 20 percent of one-rep maximum.
What this means for you is that with BFR training you can utilize lighter loads to construct muscle while sparing your muscles from heavy loading and without fatiguing your central nervous system. Additionally, it is important to note that research has proven the gains are not just for legs and the arms but also for muscle groups over the wraps.
How to Wrap For BFR Training
There are some high-end pressure cuffs which may be used to wrap your limbs for BFR, however any wraps will get the job done. Some people utilize knee/elbow or ace bandages wraps. Others use hospital tourniquets that are run-of-the-mill.
For your upper body, wrap it only beneath the shoulder at the top of upper arm so that the wrapping is nestling into your armpit.
For the lower body, wrap only below the gluteal fold from the back and just below the hip flexor in the front.
For both the upper and lower body, you want to wrap at about a 7 out of 10 on the tightness scale (10 being as tight as you can).
You shouldn’t feel any numbness or tingling sensations. That usually means you wrapped it tight, if you do. Wrapping it too tight will limit flow and prevent blood from pooling in the gut, so it defeats the purpose. When in doubt, wrap at first, particularly around the back side of the spectrum.
How can you know whether you wrapped it right? In the event you get your life’s muscular pump. Recall, if it feels sketchy just take off the wraps and re-wrap a tiny bit looser. There is a bit of a learning curve and thus don’t place too much stress to nail it on the first try.
How BFR Training Builds Muscle
The secret to effective BFR training is using light loads (40 to 50 percent of your one-rep maxor less), high repetitions (10 to 15 repetitions or longer), and short rest periods (30 minutes or less). In addition, it is important to note that BFR does not replace your regular training–it just enhances it. Here are my three favorite ways to execute BFR training:
BFR Finishers
After performing your main work out, hit a BFR finisher. If you completed an upper-body workout, hit an upper-body BFR finisher. If you finished a lower-body workout, hit on a BFR finisher. Hit on one for the upper and lower body if you do total-body sessions.
Extra Training Volume and Frequency
BFR is a excellent way to increase training volume (how much work you do) and coaching frequency (how often you train) without impairing your recovery. As an example, to bump up your training volume, if you did 3 routine sets of an exercise with heavier loads, try adding in an additional couple sets of BFR training to the same movement pattern or muscle group using a lighter load for higher reps and shorter rest periods between sets.
Active Recovery and Deloading
Since BFR training requires having lighter loads, it is considerably easier to recover from deeper training. This makes it a process to employ but still want to train. It’s also great to use if you integrate regular deloads–or intervals of decreased loading or training volume–into your training schedule.
It is worth mentioning that BFR is being used with remarkable success in rehabilitation settings, especially with wounded athletes. Being able to operate and develop muscles after an injury or operation with loads is a joint-sparing feature unique to BFR training. As always, consult your physician or physical therapist to find out if BFR training is right for you in such circumstances.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
Athletes face extreme pressure to return to play when they are hurt however, the true challenge for physicians is to get them back in the game safely. Athletes should be tough and maintain a positive attitude whilst regularly going through pain. When they’re made to sit out due to an accident, they should be focused and motivated to return to play as quickly as possible. They rehabilitate and rest as they trust that their bodies will ready after a full treatment plan.
This is the idealistic perspective of injury associated with athletes in their specific sport or physical activity. However, the reality is that accidents are an unavoidable by product of being an athlete and the transition from “active athlete” to “injured athlete” and back to “active athlete” does not always happen without complications.
Injured athletes fight with anxiety, frustration, anger and sometimes depression during their time away from play, which might also keep them from following their rehabilitation program effectively. Additionally, the return to the sport itself yields a fresh pair of adversities as athletes should browse through personal fears and a desire to come back to their pre-injury condition with the support of their family and healthcare physician.
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Importance of Support for Injured Athletes
Social support can come from various forms, ranging from emotional support to task challenge assistance. Some wounded athletes want a caring individual simply to listen to their anxieties while others might prefer a challenging drive to work harder during rehab. Studies looking at the supply of social support have found that athletes feel most satisfied with the support provided by professionals in comparison to support supplied by teammates or coaches.
It would appear obvious that athletes would need support to assist with the injury recovery process. Because teams have access to trainers in a school setting, this additional support is possible. However, injuries are not unique to the collegiate population, which makes it important to address that �and provide this service.
Researchers who immediately addressed athletes’ tastes from healthcare professionals found that the desire to learn more concerning the injury resulted in a clearer timeline for return to play along with an open environment where athletes felt comfortable asking questions. In respect to athletes not fully understanding their injuries, they noticed that they would have appreciated the use of models and more sophisticated explanations from their physicians. It’s essential for healthcare professionals to take the time to help these athletes that are injured throughout the rehabilitation and recovery process and return to play with expertise.
Even though a complete return to play could be potential in time, it won’t happen immediately and teammates, parents, the athletes and coaches need to understand this. Trainers who have missed those who have been inactive for any period of time or numerous practices will require a slow progression back to their previous degree. This is bothersome for coaches who may “need” that athlete and also for the athlete who wants to return so as not to let the team down, trainer or themselves. Additionally, while appeasing the team and coach, the athlete may want to listen to doctors to ensure a safe recovery.
Goal-Setting to Facilitate Confidence And Motivation
Throughout the rehabilitation process, athletes should set modest goals, adjust their mindset, surround themselves with supportive people and develop their patience. It is important for others such as doctors, parents and trainers to understand the process, and provide athletes with resources and support to help them construct in these areas. Like setting rehabilitation targets that are daily followed by exercise goals, simple strategies can help athletes experience modest successes and build their own confidence.
Every injured athlete would like to return to 100 percent but it is going to take some time to reach that degree. They’re very likely to eliminate the drive and motivation to continue, if they don’t see improvements over time. The athlete has to set goals based on their current status. The athlete will see little daily improvements leading them in the path of better performances in the future.
Building and/or maintaining confidence is vital, and it cannot be connected to results. Athletes need to realize that confidence keeps them trying even if scenarios aren’t going their way, and helps them push through failures. Confidence is a way of behaving and thinking that should be evident in everything one does regardless of the outcome.
In Conclusion
Given potential effects related to harm and the emotions, it’s clear that more education is essential to guarantee positive consequences for athletes who’ve experienced sports injuries. Injuries are unavoidable but they do not need to be devastating to well-being and one’s life if handled effectively. It’s apparent that athletes encounter adversity due to the injury and due to the change for their own lives and daily routines. The recovery is sometimes more easy than the yield to perform since the bone may heal and the tear could be mended, but the brain doesn’t change as easily.
It is necessary for everyone involved to understand that helping an athlete recovery in order to return to play as soon as possible demands attention to both the body and the brain. This can be accomplished by one with awareness, education and effort of coaches, doctors, athletes and parents alike.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
Injury is a common occurrence in sport participation. Ask any athlete and they’ll tell you that one of the drawbacks they can experience in their specific physical activity is injury.
Being hurt can mean a number of things to an athlete out of the pain they experience. Firstly, injury can bring a stop to training (i.e., coaching) and may indicate that what they’ve devoted lots of their time and energy and can too be removed quite suddenly (Crossman, 1997). Sport participation is a part of the identity of an athlete and so sports are a tremendous portion of their lives. When that is removed, albeit for a short time period, this can have a possible psychological effect on how an athlete views themselves.
Additionally, injury can take away the positive reinforcements sport provides where athletes undergo a feeling of mastery, autonomy and sense of control (Deutsch, 1985). Injury might be thought of as a setback because sport is used by athletes as a means of managing anxiety, stress and depression, among other things.
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Psychological Effects on Injured Athletes
Understandably then, it may be anticipated that athletes can undergo a number of psychological reactions and stress upon becoming injured. Athletes’ psychological experiences differ as no one person experiences injury precisely in the same manner. Yet some emotions are more commonly reported than others and include stress, fear, anger, tension, fatigue, doubt, lack of motivation, and aggravation (Ahern & Lohr, 1997; American College of Sports Medicine, 2001; Klenk, 2006).
Of course it is normal for athletes to experience these emotions in reaction to trauma or injury and it is therefore necessary to be aware that not all athletes encounter an observable psychological disturbance to being hurt. They are athletes who seem to take being injured in their stride and their emotional reactions appear to resolve. On the flip side, other athletes appear to fight emotionally and their responses become problematic when symptoms do not resolve.
Though there’s no predictable sequence of an athlete’s psychological responses to injury, athletes often exhibit three classes of reaction to their injury. To help come to terms with their injury, athletes often attempt to get and interpret as much injury-relevant information they can (i.e., “How bad is it?” , “How long?” , “What can/can’t I do”, “Just how can I fix it?”) . As previously discussed, athletes may experience reactive behavior and psychological upheaval . Often athletes may ask questions or have thoughts that are like the following: “I can’t believe this has happened today”, “I’ll never return to 100%”, and “I’m no good to the group today”. Athletes with apparent psychological effects can frequently display a range of signs suggesting poor adjustment to the injuries, including:
Feelings of anger & confusion
Obsession with �when can I return to play?�
Trying to do too much too soon in terms of rehabilitation program (pushing the limits)
Denial (e.g., �The injury is no big deal�)
Repeatedly returning to play too soon & experiencing re-injury
Exaggerated bragging about accomplishments
Dwelling on minor physical complaints
Sleep disturbances
Alterations in diet
Guilt about letting the team down
Withdrawal from significant others
Rapid mood swings
Statements like �no matter what is done, it will never get better�
The final category indicates that athletes come to terms with the injury and engage in successful coping. If there is anything they could do at home or may help out in training athletes voice that the injury is starting to appear good or often think so, and ask their service network if their responses resolves than becomes debatable. But if an athlete is exhibiting problematic signs of adverse effect as a consequence of their injury, it is very important for them to find help from a sport psychologist who can assist them manage and cope more effectively with their injury thus assisting their injury recovery procedure.
Research has shown that negative emotions experienced by injured athletes may affect athletes’ attitudes toward and subsequent recovery from trauma (Ahern & Lohr, 1997; Crossman, 1997). Using psychological strategies have been found to improve injury recovery, mood through healing, coping, confidence restoration, pain control, and adherence to treatment protocols (Brewer et al., 2000).
Improving Athlete’s Psychological Skills
Psychological skills like goal setting, imagery and relaxation helps athletes cope better with stress, reducing likelihood of harm and stress of harm should it occur. In addition, even athletes that deal with injury can benefit from studying these strategies as they are sometimes utilized to boost performance on a basis that is constant.
Other psychological skills utilized to cope effectively with trauma but can also be used to enhance operation after experiencing injury include self-talk to help athletes have a positive attitude to rehabilitation and build confidence as well as problem solving to help deal with setbacks and search for opportunities. In addition to abilities, it is essential for athletes to be more educated in the recovery procedure and their injury to help reduce uncertainty and provide them with clear expectations and also to keep them informed.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
Blood is responsible for the transportation of oxygen, nutrients, and other molecules crucial for life. Most bodybuilders may also tell you that blood is important for gaining muscle, blood flow to be more particular. A whole group of nutritional supplements has surfaced in the past ten years, concentrated on boosting anabolism and so increasing circulation.
However, what if I told you that the opposite could be true? If I told you that occluding blood flow to muscles could have an anabolic effect, what would you say? Blood flow restriction (BFR) training has years of research to support its effectiveness and in this article I will explain what it is and how to use it to augment your training.
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What is Blood Flow Restriction Training?
Quite simply, BFR training includes restricting the venous return of blood circulation from the muscle. The objective isn’t to restrict blood circulation to the muscle, but rather prevent blood flow from returning to the muscle, i.e. you don’t need to restrict the blood circulation to the muscle, only the venous return from the muscle, causing the blood to pool in the muscle. This is accomplished by use of a blood pressure cuff or perhaps more practically using knee wraps tightly fastened round the limb(s).
For instance, to utilize blood flow restriction therapy on arm muscles, you would tightly secure a cloth or barbell knee wraps close to the shoulder as possible. This will restrict blood flow return from the arms and cause the blood to pool.
Blood flow restriction training, when done correctly, allows one to utilize much lower weights than normal training protocols and still attain sizable anabolic training results. Actually, occlusion training can increase muscle size and strength using training heaps as mild as 20 percent of a 1 rep max. This is especially useful for trainers who are currently experiencing a deload phase in their training practice or for individuals that are hurt and can only use light weights. BFR training allows you to still make gains using light weights while giving your joints, ligaments, and tendon a rest from heavy lifting.
Blood Flow Restriction Training Effects
Blood flow restriction training induces an anabolic response through various pathways, perhaps the most crucial of which will be by preferentially targeting the big fast twitch muscle fibers. Fast twitch fibers are the muscle fibers that have the potential for growth. These fibers are recruited last during contractions and therefore are largely anaerobic (do not use oxygen) whereas the smaller slow twitch fibers are recruited first through contractions and are aerobic (use oxygen). Slow twitch fibers have a potential for growth compared to fast twitch fibers.
BFR training restricts blood flow to muscles, pre-fatiguing the slow twitch fibers and forcing the anaerobic fast twitch fibers to deal with the load even at low intensities. Metabolically, your muscle is getting an effect that is similar lifting heavy loads although they are using weights that are much lighter. Not only does occlusion training preferentially activate fast twitch muscle fibers, it has been shown to cause a fiber type shift from slow to fast, thus increasing the possibility of muscle growth dimensions.
Metabolic by-product accumulation is primary mechanism by which occlusion training produces hypertrophy. These metabolic by-products would normally be �washed out� by normal blood flow, but occlusion allows them to accumulate near the muscle. Lactate accumulation in particular seems to have an effect, presumably by raising growth hormone (GH) concentrations (4-5). In fact, one study found that BFR training triggered a GH increase 290 times above baseline. This really is a twofold greater increase in GH than what is generated by regular heavy resistance training.
Perhaps even more impressive, blood flow restriction training was demonstrated to reduce myostatin concentrations. Myostatin is a time inhibitor of muscle growth and is thought to limit the possibility of muscle gain. Occlusion training could be able to increase the potential of muscle increase through slow to quickly fiber shifts and reductions in myostatin.
As always, before starting any type of training routine, you should talk with a medical professional. BFR can be performed for the thighs, calves, upper arms, and forearms with a blood pressure cuff or tightly wrapped knee bends (more practical). To occlude the thighs and upper arms, wrap at approximately 70 percent of greatest tightness around the part of their muscles. To occlude forearms wrap or the calves at approximately 70 percent of maximum tightness below the knee or elbow.
Perform 3-5 sets to muscular failure with 20-50 percent of your 1 rep maximum on a particular exercise together with the muscle occluded the whole time. Periods should be 30-60 seconds between sets. After the last set restore blood flow to the muscle and then remove the wraps. Blood flow restriction training takes training to another dimension.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
El Paso, TX. science based chiropractor, Dr. Alexander Jimenez looks at this uncommon problem � and how it can be treated.
The true incidence of obturator externus accidents is unknown, as frequently they may be misdiagnosed as hip joint pathology and/ or groin pathology as the website of symptoms as well as also the presenting objective signals may mimic other pathologies such as hip joint labrum pathology, anterior femoral triangle issues and perhaps even gluteal pathology.
Injury for this muscle gifts as a deep obscure groin/hip pain and functionally the muscle may still hide direct involvement as a pain generator since it is primarily a equilibrium muscle rather than a force-producing hip muscle.
This case study presents an unusual case of hip-related pain in a professional baseball player which also shown itself as an injury to the contralateral adductor longus.
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The Player
As he was wrestled to the floor, his right hip was compelled at a rapid and loaded flexion/internal turning position. His first sensation was pain deep inside the anterior hip/groin area.
When he presented to the medical team with the accident, he complained of a profound catching sensation inside the hip joint location. It had been difficult to fully bend the hip and to also twist on the stationary limb (because he did whilst kicking a ball). His prior background consisted of a right-sided inguinal hernia repair five seasons before as well as a few gentle on again/off back osteitis pubis-type signs that would normally flare from the first period as his goal-kicking amounts have been increased. He was obviously a left- footed goal kicker.
On examination, he observed that the pain to become worse on passive flexion/internal rotation of the hip (hip walkway test). He was noticeably tight and irritated from the shallow TFL muscle, and also posteriorly across the greater trochanter around the insertion for the gluteals and deep hip rotators. He was also particularly high tone in the right iliopsoas muscle.
He was initially diagnosed clinically because of hip joint sprain due to the mechanism of harm being a pressured flexion/internal rotation type position that would always put pressure on the anterior hip joint capsule/labrum.
He was treated initially with deep iliopoas muscle sparks and hip joint mobilizations using a seat belt to gap the hip joint. He reacted reasonably well with the therapy and immediately felt more comfortable on a hip joint quadrant test. He was rested from coaching for 2 days and ran on the next day and played a match on the fourth day. But during the match, though his right hip did not create any pain, he’d notice pain on his left adductor source that was more pronounced during kicking.
Three days post-game he detected this ongoing left adductor origin pain and it was made worse by kicking again through training. An MRI was performed to Look at the left adductor origin and also the report noted:
Grade 1 left adductor longus strain deep in the
Grade 2 right obturator externus strain on its femoral attachment
Grade 1 right iliopsoas muscle strain in the MTJ.
The surprise finding on the MRI of a grade 2 obturator strain prompted the medical team to more formally assess the participant for ongoing hip joint disorder. The particular features to notice from this medical examination were:
Subjective
? A sensation of weakness and instability in the right hip whilst kicking with the left foot.
? No pain in the right hip with running, even with top-end speed. However, the left adductor longus was symptomatic on running and kicking.
Objective
? Pain on passive right hip internal rotation whilst in 90-degree hip flexion. This pain was deep anteriorly in the hip, almost presented as a groin problem.
? Some discomfort on resisted right hip flexion/external rotation deep inside the iliac fossa.
? Pain and weakness in the left adductor on adductor squeeze tests. These squeeze tests performed at 0/45/90 degrees of knee flexion with a pressure cuff between the knees. Usual pre-season scores measured 260/260/250. On current testing they measured 150/170/180. Pain was felt at the end of the squeeze.
? Discomfort with prone lie hip passive internal rotation. This pain was more focused around the right greater trochanter posteriorly.
Pathomechanics
It had been suspected that this player had endured a secondary injury to the left adductor longus (a muscle used a lot in goal-kicking) due to the inherent failure in bolstering the proper hip throughout the plant phase of the kick due to the inhibition of the right obturator externus, a muscle considered to be an important hip stabilizer and turning control muscle at the hip. With insufficient hip stabilization in kicking, the left hip was required to create more power to compensate for the unstable right hip to gain the length from the kick. Then the left adductor longus failed along with a strain injury led.
Management
The management of the matter initially centered on the two key features being the left-sided adductor strain and the right- sided obturator externus strain.
In the week following the accident, the player was sent to get a series of Actovegin shots to the left adductor longus. This was done according to protocol that was three injections every 48 hours — Monday/ Wednesday/Friday. In this five-day period the adductor longus was handled with deep tissue flush massage and gentle isometric adduction exercises at supine (chunk squeezes) in the three positions of examining — 0/45/90 levels of knee flexion — also as wall squat adductor squeezes in the same positions. The obturator externus was medicated with heavy tissue releases (obtained through the anterior groin region) and direct theraband strengthening of hip external rotation in sitting and in prone. Actovegin shots to the obturator externus are regarded as difficult because of problems with accessing this muscle through the superficial hip musculature.
The adductor exercises progressed into through array adduction with theraband resistance (equally with the left leg being the motion leg as well as the stability leg).
By 12 days post-injury it had been detected that the obturator externus strength had not improved and the player still had deep- seated right back pain pain. It was rationalised that perhaps the direct treatment to this muscle and also the direct open kinetic chain strengthening was possibly making the muscle texture worse. The choice was made to stop any direct hands-on therapy to the muscle and also to prevent any direct open kinetic chain strengthening. Instead the player lasted with bilateral theraband exercises of both hips into flexion and then abduction and expansion in addition to adduction. The avoidance of lead obturator externus soft tissue treatment and exercise appeared to improve the hip function immediately.
The participant started running 20 times post-injury and quickly progressed through running stages over a five-day period of conducting on alternate days. At this point the player’s adductor squeeze scores had improved to steps according to pre- season baselines. However, daily the player ran direct adductor strength operate using a Pilates reformer as a slider drill to immediately load into adduction in addition to hammering theraband adduction exercises in standing and in supine lying.
By 27 days post-injury the player managed to begin kicking, change in direction and rugby training. He played at 30 times post-injury with no ill effects.
Discussion
It arises immediately around the medial side of the obturator foramen, as well as the inferior ramus of the ischium; it also arises in the lateral two-thirds of this outer surface of the obturator membrane, and also in the tendinous arch which completes the canal to the passage of the obturator nerves and vessels.
The action of the muscle is to externally rotate the hip and also helps in hip adduction. It’s postulated to also work as a hip balance muscle in one legged stance along with the obturator internus, quadrutus femoris, piriformis and the gemelli muscles. In a practical activity such as kicking, the muscle acts to stabilize or hold the ball of the femur into the socket (acetabulum).
The incidence of harm to the obturator externus muscle is unknown because there are only a handful of case reports from the medical literature that highlight injuries for this muscle. Additionally, among the vexing issues is the difficulty in creating the correct clinical diagnosis based on the history and physical evaluation. MRI imaging is needed to correctly picture injuries to this muscle.
From the case study introduced, injury for the muscle was a direct result of forceful flexion/internal rotation mechanism to the hip joint. As the muscle primarily functions as a hip stabilizer during jogging, it is possible that a patient can mask symptoms during functioning as the muscle isn’t required to produce any hip skate for locomotion.
Nonetheless, in this event the muscle has a role in stability of the hip during kicking, and for that reason may have produced a poor pelvic/hip complicated during kicking that then led to an accident to the adductor longus on the other hand.
In addition, it seems that direct treatment to the muscle in the form of deep trigger point releases and also direct strengthening may actually delay healing in the muscle in case of injury. This may highlight the value of the muscle as a hip stabilizer instead of a legitimate torque manufacturer in hip rotation.
Blood flow restriction (BFR) training is a training strategy which involves the use of cuffs or pliers placed proximally around a limb, with the intent of maintaining arterial inflow while occluding lymph flow through exercise (According to Scott et al. 2015).
BFR, or blood flow restriction training, has been utilized throughout a range of exercise modes. These include cycling, walking and strength training. When doing resistance training with blood flow restriction therapy, tight cuffs or pliers are commonly utilized. Virtually, blood flow restriction training is most frequently employed when utilizing resistance training with low loads of around 20 to 30 percent of 1RM and with wraps that are wrapped at a perceived tightness of 7 out of 10.
When compression of the vasculature proximal to the muscles is achieved via other means, the expression blood flow restriction training is more commonly used. An alternative way of employing this pressure is through the usage of knee bends. This sort of blood flow restriction therapy can be termed blood flow restriction training that was sensible to distinguish it from the method in which inflated cuffs are utilized to produce a strain.
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Blood Flow Restriction Therapy Findings
Blood flow restricted (BFR) training is a safe and effective method of improving power and strength in healthy, active people. A relatively unexplored possibility of this modality lies in treating patients with musculoskeletal injury and hamstring weakness despite improvement during postoperative strengthening, and conventional therapy.
This case series describes patients with chronic quadriceps and hamstring weakness who received an intervention of BFR at low loads, 20 percent of 1 repetition max (1RM), to restore strength. There was a case series conducted of seven patients, all situated with traumatic injuries. The seven patients were treated in the same center and using the BFR protocol. All seven patients had dynamometer testing that demonstrated thigh muscle weakness despite 35 to 75 percent torque deficit in flexion or knee extension and rehab with therapy in comparison with the lower extremity. Patients underwent two weeks of BFR training therapy using a pneumatic tourniquet set at 110 mm Hg while performing leg extensions, leg presses, and leg presses.
All affected extremities were retested after two weeks (six therapy sessions). Dynamometer measurements were done with flexion and extension. The data recorded included peak torque normalized for moderate power, body weight, and work.
All seven patients showed improvements in peak torque, moderate power, and overall work for both knee flexion and extension, with power being the most improved overall. Peak torque improved an average of 13 to 37 percent, based on speed and contraction direction. Average electricity improved a mean of 42 to 81 percent, and workforce improved a mean of 35 to 55 percent.
Conclusion
Blood flow restriction (BFR) treatment at low loads can impact development in muscular strength in patients who are unable to perform high-resistance exercise or individuals who have persistent extremity weakness despite conventional treatment. Blood circulation limitation training seems to be effective and safe. But, specific caution ought to be expressed regarding its usage under particular conditions, and for prolonged amounts of time.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Sports Care
Athletes engage in a series of stretches and exercises on a daily basis in order to prevent damage or injury from their specific sports or physical activities as well as to promote and maintain strength, mobility and flexibility. However, when injuries or conditions occur as a result of an accident or due to repetitive degeneration, getting the proper care and treatment can change an athlete’s ability to return to play as soon as possible and restore their original health.
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