• 3d Guy: Attempting to Lift Barbell

    Revisiting the spinal flexion debate: prepare for doubt

    Whether the spine should flex repeatedly and under load is an old debate that we are still having having and we should be having it because I don't think its settled.  I thought it was settled 20 years ago but I should have challenged my biases more.  The basic question is whether you are at less risk for pain/injury if you minimize the flexing movement of the lumbar spine during activities and if minimize the flexed position when lifting heavy. The case to minimize flexion is laid out in this article here detailing how the Canadian Military has removed the sit-up and trumpeted the death of the sit-up. Link here.  I have probably taught 1000s of people to hinge at their  hips and try to minimize spinal flexion during many activities...certainly activities that demand high loads on the spine...

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  • Janda’s lower crossed syndrome has not been validated

    Mike Reinold gets me thinking with much of his posts.  He is someone I like discussing areas that we don't always agree on because he does it respectfully.  He wrote about the lower crossed syndrome here about a recent study. Very briefly, the lower crossed syndrome suggests that tight hip flexors are associated with weak gluteus maximus muscles, weak abdominal muscles, tight erectors spine/hamstrings and lead to anterior pelvic tilt.  This study looked at the relationship between hip extension mobility and gluteus maximus activity. A related study is an old one that looked pelvic tilt, lordosis and abdominal performance.  Guess what? No relationship.  Kind of a knock against the idea that the anterior pelvic tilt of the lower cross syndrome is related to abdominal strength (paper here).  These findings were also repeated in a study here. That recent study looked at Gluteal activity during kettlebell swings.  They also looked at hip flexor "tightness" as measured during the Modified Thomas Test.  The authors did good work on this paper and  kept their conclusions reasonable.  But what will ultimately happen is that we will run a bit too far with what the study provides in our clinical interpretation.  For one, this paper does not prove or even support Janda's lower crossed syndrome where it is suggested that "tight" hip flexors inhibit the Gluteus Maximus muscle via reciprocal inhibition.  I'll try to lay out my reasoning for this below.  But first the paper...

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  • Stretching Tendons: What can we do and why we should challenge our biases. Part 2

    In a previous post we looked at how long term static stretching might influence the structural properties of the connective and muscular tissue that crosses joints.  The question was whether static stretching changes passive stiffness.  Interestingly, we saw good research showing different results.  One point of that post was to continually challenge our own biases […]

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  • long sitting knee bent

    What does stretching do to a joint? We really have no idea. Part I.

    How’s that title for a proclamation of ignorance? For someone who rarely stretches I sure love talking about it. I’ve been lecturing on stretching since the late 1990s and always loved to challenge my student’s beliefs about what they thought stretching did.  The problem was, I didn’t challenge my own biases for too long a […]

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  • Functional exercise is a poor term – how about some Comprehensive Capacity

    originally posted at thebodymechanic.ca many years ago Here is an old post slightly reworked. Please read Eric Meira’s post on functional exercise that is just fantastic. A few years ago found myself defending the lowly clamshell exercise for runners. I was discussing with other physios whether the clamshell exercise was less “functional” than a band […]

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  • Treatment Fundamentals: a simple framework to reconceptualize pain and injury treatment

    The following article was also published at Medbridge Education. During our roundtable discussion on Pain: Where Does Biomechanics Fit on MedBridge, a good question came up: “How do you keep up with the literature to guide your practice?” The daily volume of publications can make it difficult. My solution is to regularly refer to my […]

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  • Treatment manual workbook

    The following document is a 26 page treatment manual and workbook for therapists and patients.  It has a number of different features for treating pain and injuries and lays out the start of a simple but comprehensive approach to rehabilitation. treatment manual and therapy map greg lehman feb 2015 The treatment manual helps address: 1. Assessment Suggestions […]

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  • Courses Available

    Pain Fundamentals: Reconciling Biomechanics with Pain Science (2 day)  This course is geared toward the health care provider and fitness professional.  With emerging research there is often the feeling that a traditional approach needs to be wholly discarded.  Instead, this course helps the therapist to integrate the  pain science and biopsychosocial model of pain with traditional […]

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  • Course Schedule

    Interested in hosting a course? Please send me an email and we can talk  greglehmanphysio@gmail.com The following course schedule details the two courses I am currently teaching.  One is the Physiofundamentals: Reconciling Biomechanics with Pain Science and the 1-day Reconciling Biomechanics with Pain Science Running & Sport Stream  that is often delivered in conjunction with the […]

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  • Reconciling Biomechanics with Pain Science Course

    A comprehensive approach to using a traditional biomechanically based practice within a biopsychosocial approach. Course Schedule is here. Brief Overview A percentage of this course is based on the Pain Science Workbook and The Treatment Manual Workbook.  Please download if you are interested.   This course teaches the therapist how to teach patients about pain […]

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