In 1981, Robin McKenzie proposed a diagnostic classification system – MDT, or Mechanical Diagnosis And Therapy - in which patients would be classified according to the mechanical and symptomatic responses to mechanical loading strategies. Diagnostic classification would then establish the appropriate criteria for treatment.
McKenzie proposed three mechanical syndromes: postural, dysfunction, and derangement. Postural syndrome is characterized by end-range stress of normal structures, thereby producing pain with sustained end-range loading. Dysfunction is characterized by end-range stress of shortened structures (secondary to scarring, fibrosis, and/or nerve root adherence), thereby producing pain with repeated movements to end-range. These two syndromes fit neatly into a traditional pathoanatomical, tissue-based model.
It is the third syndrome – the derangement syndrome – which is perhaps the most intriguing and which garners the greatest debate amongst clinicians. The derangement syndrome is characterized by “anatomical disruption or displacement within the motion segment”. But does the derangement syndrome fit into a traditional pathoanatomical model? And if not, does it matter anyways?
The first Formula One race of 2012 – the Australian Grand Prix – was held this past Sunday. It was the first stop in the 20 race world championship that concludes in November in Brazil. On November 18, one week before the championship finale in Brazil, teams will compete in the United States Grand Prix in Austin.
I am looking forward to that day in November when we will hear the wail of Formula One engines emanating from metropolitan Elroy, Texas. The first day of practice will be a special day indeed.
As I look forward with great excitement, I look back with fondness as well. When I was growing up in Canada, Formula One was an integral part of my world – and my youth.
This is the 12th in a series of RunSmart videos. The series is on-going, with a new video released on a biweekly basis. These videos complement the material presented in the book “RunSmart: A Comprehensive Approach To Injury-Free Running”. The full series of videos can be found here. A compilation of the first 10 videos will be available on Vimeo as well.
For those of you that are interested in a more interactive learning environment, consider attending a Level One (half day), Level Two (one day), or Level Three (two day) RunSmart program. The Level One program is 4 hours and focuses on basic training principles and running mechanics. The Level Two program is 8.5 hours and focuses on injury prevention and performance optimization. The Level Three program is a two day, 15 hour program that includes a comprehensive approach to running injuries. The next Level One program will be offered in Austin on March 24, 2012. The next Level Three program will be offered in Reno, Nevada on May 5 – 6, 2012 at the University of Nevada.
In this video, I discuss the issue of training load and how it is measured. Training load should be quantified relative to the primary limiter of performance – the neuromuscular system – instead of the cardiovascular system.
The University of Texas Longhorns’ appearance in this year’s NCAA men’s basketball tournament was a microcosm of their season. It was as if someone had reduced their season – highlights and lowlights – to one 40 minute first round matchup against Cincinnati.
You didn’t need to watch the rest of the season, because lo and behold, it was all there in one game. The whole ugly roller coaster 2011-2012 season was on display.
Once again, the Longhorn Nation were left hanging in the balance, with far too many questions and very few answers.
It is a sport adage that is frequently uttered by many a pundit at this time of year: “The best offense is a good defense”. Follow that up with “defense wins championships”, and you would probably have two of the most oft-used phrases in sport. With the NCAA men’s basketball tournament upon us, I am sure we’ll be hearing these a lot in the next few weeks.
The same thinking also exists in health care these days. We hear the phrase “defensive medicine” far too frequently anymore. Defense may win championships in football and basketball, but it doesn’t appear to be winning any health care championships.
So is defensive medicine really “the best offense”?
March is, without question, the best month of the year. March Madness, the promised land of college hoops, is upon us again. The annual basketball madness is now in full swing, but it isn’t just a basketball phenomenon this year. We have plenty of other madness taking place in the world of politics, sport and music.
There is plenty of rhubarb for everyone. Dig into to another healthy dose – and keep the television remote close by for all those basketball games!
What started out as good research has morphed into a great way to sell gym memberships. Or something along those lines.
It all started when researchers established that there are varied percentages of fuels (carbohydrate and fat) that participate in energy metabolism during exercise. With increasing intensity of exercise, there is a proportionally greater share of energy derived from carbohydrate. The reverse is also true – as the intensity level decreases, a greater percentage of energy is derived from fat.
The fat-burning workout was born. Go longer, go slower, “burn more fat”, and lose more weight.
This was followed shortly thereafter by “get a gym membership”. You can come in and do more longer, slower workouts on our cardio equipment. Oh, make sure you get a heart rate monitor so we can establish that you are in that “fat burning zone”.
Allan Besselink, PT, DPT, Ph.D., Dip.MDT has a unique voice in the world of sports, education, and health care. Read more about Allan here.