Month: May 2018

Drive your woes away

Ladies and gentlemen

Got a long drive ahead of you that you are dreading? Feel stiff and achy sitting all day. Below I present to you some simple exercises, stretches and strategies that you should try and incorporate if you know you would be behind the wheel for a few hours. Make them a non negotiable part of your drive (safety permitting) and more likely than not, your body will thank you for it.

Here you go-

1. While driving

(Disclaimer- do not take your hands of the wheel for more then 2-3 seconds and never both together, driving safety comes first. Do not let these exercises distract you from the primary activity of driving, I do these often and they are like second nature to me. Only perform them if you feel comfortable to do so safely depending upon your traffic conditions. Practice them at home or work first and then incorporate them carefully while driving. If you still feel unforgettable, avoid this and try the strategies in step two).

2. Take breaks often and move

Try holding the stretches in the above videos for about 30 seconds and repeat 2-3 times. For neck, wrist, back exercises that are not stretches, try about 10 repetitions. Although you ‘might’ feel some discomfort due to staying in one place for some a few hours, none of these exercises should cause pain. If they progressively increase pain and/or discomfort every time you do it, STOP. DO WHAT YOU CAN.

Always remember, the body is not meant to sit in one position all day and ‘motion is lotion’ for your body. Consult your physio if you have pre existing conditions as some of these exercises might not be right for you.

Pursue excellence

Abhijit Minhas PT

(BPT, MS, CMP, FMT)

Navicular Drop Test

Greetings

This is going to be a short one. As indicated before on my social media, this one is on the feet. Foot examination is a big part of my assessment with patients presenting with lower extremity pain and often back pain. Of the many dysfunctions of the feet that could cause pain anywhere along the lower extremity, a pronated foot often steals the lime light. While there are definitely problems that can be associated with  excessively pronated feet and has been well established in the literature, I must point out that the word ‘excessive’ is important here. When I first started looking at the body  not just as individual parts but as a unit together, the idea of regional interdependence was a game changer.

However, I was quick to jump on the bandwagon of blaming pronation for everything- shin splints, tibial stress fractures, ACL injuries, hip issues, global warming, oil crises (a bit too much, I know. Just my attempt to keep this as light reading). Remember that pronation is a regular part of the gait cycle during the suspension phase and also is a normal physiogical movement of the body. It is really the ‘excessive’ pronation and medial arch collapse that we should be worried about without demonizing foot pronation.

Apart from generally eyeballing movements for foot positioning during different movements like running, walking, squatting etc I like the Navicular drop test to assess ‘over pronation’/ medial arch collapse. Here’s a video of how I perform it.

 

If the difference between the two points is >10mm then the test is considered positive.

I’m keen to read  your thought on this subject. Do you often use this test? Any other tests you like to use in your assessment? Would you like that featured on this blog? Feel free to share your thoughts.

For those of you who are wondering what an excessively pronated foot has got to do with other lower leg problems (not you of course, you know this all to well), its might be useful to understand how problems at the feet might cause problems upstream at other joints, its called ‘regional interdependence’ and this is just one example. Understanding this is paramount. More on this in the next blog. Until next time

Pursue excellence

Abhijit Minhas PT

(BPT, MS, CMP, FMT)

Reference-

  1. Vinicombe A, Raspovic A, Menz HB. reliability of navicular displacement measurement as a clinical indicator of foot posture. J Am Podiat Med Assn 2001;91:262-8\
  2.  Flynn, Timothy. User’s Guide to the Musculoskeletal Examination. Evidence in Motion, 2008. Print.