Thursday, November 16, 2017

Hip Hinge 101 Course

On November 12th, I had the opportunity to attend a Hip Hinge 101 Course presented by Matthew Ibrahim (@MatthewIbrahim_) from TD Athletes Edge (@TDAthletesEdge) and Zak Gabor (@SimpleStrengthPhysio from Boston PT and Wellness (@BostonPTWellness).  These fellas were kind enough to bring the East Coast to the West Coast!

How did they fill the day?  They started with a focus on pain science - vitally important in the physical therapy/rehabilitation world as well as to be considered for strength and conditioning coaches.  They followed up with discussions around the word selection we use with patients.  The conclusion was lifting some heavy stuff in various ways.

Pain Science:
Zak presented a thorough discussion of the basics of pain science a la Adriaan Louw and several others.  It was a great summary and he used some excellent analogies to help drive his points across.  My personal favorite was a slide with two photos of USA Soccer Player Clint Dempsey - in one he's got his arms up and he's screaming with joy from a big goal to win a game and in the other he's looking down at the ground following the ball bouncing off the post and losing the game... No World Cup for USA Soccer.  But let's say that Clint had broken his ankle taking both of those shots.  Would his pain be the same if he was in a moment of elation as if he was in a moment of sadness and disappointment?  Based on pain science - the likely outcome would differ based on the emotional overlay.

The definition of pain has been evolving.  Zak presented the 1994 definition of Pain by Merskey and Bogduk: "Pain is an unpleasant sensory and emotional experience which follows actual or potential tissue damage, or is described in such terms." which has been updated in 2016 by Williams and Craig to "Pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive, and social components."  Both of these definitions highlight that pain is an experience but the new definition opens the gates for the psychosocial components that impact pain.

Recently in the clinic I've been seeing more chronic pain patients.  My focus on learning with regard to chronic pain and pain science has been a new topic of focus for me - but without understanding pain, these patients cannot be properly educated sufficiently to get them back to full function.  I'm looking forward to reading more resources about chronic pain to include that information here, and I'm grateful that this course took the opportunity to begin their presentation with this lens.

As for the hip hinging and deadlifting - it was really great to see various ways to break down the hip hinge in differing positions and using different equipment.  I had never tried using TRX bands for the upper body as a component of a hip hinge.  I'd previously never seen the "Squat-Hinge Continuum" the spectrum of exercises that range from hip dominance to quad dominance.  There's certainly benefit to training the front and the back sides of the legs - and to properly learning the patterns.  But for me, the biggest take away of the program was the importance of the pain science.

Anybody else taking  any classes I should check out?

More soon...

1 comment:

  1. Yo! Love learning more about pain science. Louw's stuff is excellent, JOSPT had a nice commentary recently which could certainly lead you to many more articles http://www.jospt.org/doi/abs/10.2519/jospt.2017.0608?code=jospt-site and I personally read a ton from the NOI group! http://www.noigroup.com/en/Home

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