CORE Strategies Physical Therapy Blog
Written by CORE Strategies PT Specialist on July 13, 2018
At CORE PT, we strive to empower individuals to optimize their overall health and physical wellbeing. That’s why we’re building a community space for you to connect with us and with each other. We’re calling this space CORE PT Power Tribe because we believe the first step in any physical transformation is to own the “POWER” that lies within you.
In our CORE PT Power Tribe Facebook community, you can connect with other CORE PT clients working at many levels of rehabilitation and clients who are out living the active life they envisioned for themselves. We will list events that you can participate in with your CORE PT Tribe and family. Our community board is always open for topics and discussions. We encourage you to connect with each other.
Interested in joining the CORE PT Power Tribe? Contact us! Let’s create active lives together.
Written by CORE Strategies PT Specilaist March 10, 2015
Think you have good form when working out? What if there’s more to good form than meets the eye? Popular belief suggests that good form means looking in the mirror or hav
ing a trainer watch you to ensure an exercise looks good. However, you can look good in the mirror yet be using all the wrong muscles to complete the task. A closer inspection of your movement strategies may reveal hidden cheats creating road blocks to reaching your full potential and setting you up for injury.
Let’s try a very simple movement test. Stand on one leg and then slightly bend your knee (see picture). Repeat this motion 5 times slowly on each leg. Now, let’s assess how you completed this task. Were you able to keep your trunk upright as if sliding down a wall and avoid tipping forward or to either side? Were you able to keep your toes pointing forward and prevent the knee from diving in? Were you able to keep your toes relaxed and the arch of the foot off the ground? Were you able to prevent your back from rounding or arching? Did you use your arms to maintain balance? Did you rely on speed or perform the task slow with control? If you’re like many, you either couldn't perform the exercise at all or initially thought you looked good in the mirror but nowrealize that your toes are scrunched up when you're on one leg or your trunk is leaning forward when you drop into the small knee bend. These are just a few of the cheats oftens een in the simple movement assessment to indicate that your body lacks efficient muscle function and coordination of the kinetic chain.
It’s not just CAN you complete the exercise but HOW you complete the exercise that matters most. Form is more than just how you look in space; it’s also the sequencing of movement and muscle strategies you use for a particular task. How you complete a task is directly linked to your risk of overuse injuries. Conditions like IT Band Syndrome, Plantarfacitis, Shin Splints, Achilles Tendonitis and Rotator Cuff Tendonitis are all linked to poorly controlled movement.
Don’t wait until you’ve reached a performance plateau or suffer from recurring overuse injuries to act. Find a movement specialist in your area to analyze “HOW” you move. Get more out of your exercise, get specific with your training, understand your body, and preventing your cheats during exercise. For most, improving how you move only takes weeks of dedicated training. Knowing what to do and how to do it is key. Take charge of your fitness in 2015 and change how you move. Doing so will save you hundreds of hours of wasted time at the gym and likely save hundreds to thousands of dollars in future medical bills. Don’t let limitations of your current workout programs deter you from reaching your goals! You can work smarter, not harder in 2015.  
Written by CORE Strategies PT Specialist on February 10, 2015
Would you get into a fast moving race car knowing it lacked brakes? Unless you’re a true dare devil the answer is no. So why do the same thing with your body? Race car drivers rely on their team to provide 3 distinct areas of performance: 1) acceleration mechanisms (i.e. engine and fuel injection systems); 2) deceleration and control mechanisms (i.e. brakes, steering mechanisms, and tires); and 3) driver skill (sport technique). During movement your body must also possess efficiency in all 3 areas to perform at its best.
In the body, the primary job of some muscles is to accelerate movement while others work to decelerate movement. Mobility muscles are those best suited to rapidly shorten, accelerating your body in space. They produce high speed and force. The deeper stability muscles are best suited to decelerate force and provide precise control. Given the prevalence of non-contact sport injuries, it’s evident that many sport programs over train mobility muscles and/or under train stability muscles. Optimum performance requires efficiency in both types of muscles.
Acceleration Mechanisms
Are you familiar with your biceps, triceps, hamstrings, quads, lats and rectus abdominus? These are examples of mobility muscles biased during traditional exercise programs to increase strength, speed and endurance. Training these muscles also helps maintain function as we age, increases bone density, and improves sleep patterns.
Deceleration Mechanisms
Are you familiar with your serratus anterior, gluteus medius or peroneus brevis muscles? These are a few important stability muscles best suited to decelerate and control forces on the body. These muscles work in the background of all movement. They play a key role in timing, coordinating multi joint movements, maintaining body alignment, and attenuating force to prevent tissue damage. Stability muscles specifically provide control during rotational movements such as pivoting, swinging a golf club or tennis racket, and kicking a soccer ball. A comprehensive movement assessment is the best way to identify deficits in this part of the system. By adding a movement specialist to your performance team you can improve sport outcomes and decrease injury risk.
Sport Specific Skill
Technique coaching is an important part of performance training. However, the ability of your coaches to advance sport skill is often limited by deficits in your movement system. If you want to ensure maximum benefit out of the time you spend on sport technique, be sure to simultaneously work on the efficiency of your stability and mobility muscles.
Optimum performance has many variables. Every program should include exercises to 1) maximize acceleration; 2) maximize deceleration and control; and 3) advance sport skill. No one program meets the needs of every athlete and comprehensive testing is required to identify your specific training priorities. Just as a winning racing team requires a combination of skilled professionals to compete on top, you too should assemble a team of professionals looking at your performance from all angles to help you reach your full potential. 
Written by CORE Strategies PT Specialist January 15, 2015
In the gym we expect free weights and machines to make our muscles tired, possibly even sore the next day. A common slogan to motivate people is “No Pain, No Gain.” Some form of the phrase can be traced back hundreds of years, but the phrase was largely popularized by Jane Fonda in her workout videos. What does the phrase really mean and can its interpretation get you into trouble?
The trick becomes defining the pain in “No Pain, No Gain.” Does pain refer to the initial training hurdles one must overcome to condition the body to a new task? For example, a novice runner must overcome the body’s urge to stop running in the first mile so that overtime the body adapts to the challenge. Does pain refer to the mental toughness one must possess to persevere or sacrifice to achieve goals? Does pain refer to the delayed onset muscle soreness (DOMS) experienced 24-48 hours post exercise? If that is how you define pain, then I agree “No Pain, No Gain.”
For many exercise enthusiasts however, the phrase “No Pain, No Gain” is so ingrained that they fail to listen to the body’s pain alarms. Systems designed to warn us of potential tissue damage. Is it taboo to show weakness when training or is it just the line between training effect and tissue damage are poorly defined? Frequently in the clinic I hear stories of people pushing into tissue pathology under the guise of “No Pain, No Gain.” Stories of people with back pain who state, “I needed to do sit ups to strengthen my core, only now my back is so sore I can’t stand up tall.” Stories of athletes like runners training for a race. They share stories of cocktails of anti-inflammatories, ice, massage, foam rollers and the like to manage hip, knee or foot pain. Many are convinced pain is “normal at these miles and I just have to toughen up” until the pain becomes so severe they can’t push through it anymore. These are stories of people with a musculoskeletal problem leading to tissue damage. Pain is your body’s alarm to notify you of a problem. Choosing to ignore these warning signs can lead to more serious pathology and increase recovery times.
Warning signs that require medical attention include pain lasting longer than 24-48 hours post exercise; pain associated with a specific movement direction or activity; recurring episodes of pain; and pain that requires medications like Ibuprofen for relief. If you experience one or more of these symptoms, call your physical therapist to see if you have a musculoskeletal problem that will benefit from treatment. The earlier you address pain the easier it is to alleviate symptoms and address the underlying cause. We encourage exercise enthusiasts to work smarter not harder. Learn your body, listen to your pain alarms and seek care when appropriate to ensure you lead a healthy and active lifestyle for years to come.   
Written by CORE Strategies PT Specilaist on December, 14, 2014 
You probably know someone who’s suffered an ACL tear. The ACL (anterior cruciate ligament) is 1 of 4 major knee ligaments. It prevents the lower leg (tibia) from sliding out in front of the thigh (femur) and provides rotational stability in the knee. Athletes who suffer an ACL tear lose time from sport due to surgery and rehabilitation. They’re likely to suffer joint arthritis later in life and this risk is compounded if other structures like knee cartilage (meniscus) are simultaneously injured. The American Orthopaedic Society of Sports Medicine (AOSSM) reports ACL tear rates exceed 150,000 annually and cost more than a half-billion dollars a year.
ACL injuries occur in all sports but most frequently in basketball, soccer, football, and skiing as they involve jumping, pivoting, and quick changes in direction. ACL tears can occur with a direct blow to the knee as is common in football; however the majority of ACL tears are non-contact, occurring when the athlete fails to control body alignment during landing or pivoting maneuvers. The good news is specific training can improve mechanics and decrease risk during these activities. ACL tears occur in both male and female athletes; however female athletes are at greater risk for non-contact ACL injuries. AOSSM reports female athletes participating in basketball and soccer have 8 times greater risk for ACL injury than their male peers. Preventative screening and training can successfully reduce the risk of ACL tears and other similar non-contact injuries.
Stop Sports Injuries, an injury prevention initiative, recognizes the importance of preseason screening programs to monitor important risk factors and identify “high risk” athletes who require targeted neuromuscular training. It’s important to realize that ACL injury risk is not just a knee problem. Rather, poor control at the hip, trunk, and lower leg are the primary causative factors for non-contact ACL injuries. Dynamic stability of the knee depends on accurate sensory input and appropriate neuromuscular responses throughout the body to adapt to rapid changes in body position during landing and cutting. Neuromuscular training is more than strengthening muscles; it involves creating new movement patterns in the brain. Quality prevention programs decrease one’s risk of non-contact ACL tears and re-tears.
ACL injury prevention programs are found in schools, healthcare facilities, and sports performance organizations. Many programs target females due to their increased risk for ACL injury. However, any athlete participating in a high risk activity such as basketball, soccer, or football should consider advanced training. Premium ACL prevention programs assess the whole person, identify the site and direction of uncontrolled movement(s), and develop an exercise program specific to the individual athlete. These programs emphasize cognitive retraining to change how the brain coordinates movement, improve body control, and then progress to traditional strength training. Educating athletes about their body is crucial in reducing the risk of many sports injuries. At CORE we screen our clients with The Performance Matrix. It provides the level of detail and specificity needed to reduce the risk of all non-contact injuries while also maximizing performance.       
Written by CORE Strategies PT Specialist on November 12, 2014
October is the best month for baseball fans and Physical Therapists. MLB postseason is here and it’s National Physical Therapy month. Physical therapists play a critical role rehabilitating and preventing injuries in all professional sports. In July 2013 Kansas passed Patient Self- Referral legislation allowing you to access a Kansas Physical Therapist without physician referral. You can now directly access care like the pros; early intervention speeds recovery time and prevention is better than a cure.

Healthcare costs are shifting to the consumer with higher deductibles, copays, and stricter therapy caps. It’s imperative that consumers get savvy and “Work Smarter Not Harder.” Here are 3 simple tips to get the most for your money and lead a healthy active life.
1) Don’t ignore symptoms. Symptoms such as shoulder pain with lifting, or tightness in a muscle when running cost more to treat the longer you ignore them. Muscle imbalances increase your risk for injury and can be present even in the absence of pain. Recognize early warning signs like aching, stiffness, a need to modify your activity, or a need for anti-inflammatories. Stop the cycle before it becomes serious.
2) Take control. Physical therapists are the provider of choice for treating and preventing injuries. We maximize your muscle control and we educate you on how to manage your long-term movement health without depending on passive strategies that only mask the problem. Our active approach puts you in the driver’s seat of your health. At CORE, we use The Performance Matrix to help our clients achieve ideal movement efficiency, decrease injury risk, and enhance performance.
3) The choice is yours. You aren’t tied to any one network when selecting a physical therapy provider. Ask friends and family for recommendations. Get savvy as everything from physical therapists with professional degrees to individuals with 6-week online certifications use exercise. Not all professions are equally qualified and even within one profession vast skill differences exist. The most convenient or cheapest services may not be the best. They could even do more harm than good. Passive interventions may not be the best long-term investment as they often fail to change how your brain and body move. It’s not simply “feeling the burn” as the intensity of your workout doesn’t determine its effectiveness at decreasing your injury risk. Choose a provider that understands your unique needs, your history, and your goals to help you make the best decisions. Expect results! If despite your efforts you’re experiencing recurring pain, activity limitations, or you’re stuck at a plateau, you may simply need to find a new provider.
We care about your long-term movement health. So whether you’re a youth pitcher with dreams of playing in the World Series or a weekend warrior looking to log a few more miles, we urge you to be a savvy consumer when it comes to your current and future health. Focus on how you can “Work Smarter Not Harder.”     
Written by CORE Strategies PT Specialist on October 9, 2014
Football season is just around the corner and concussions are a hot topic for athletes of all ages and competitive levels. Sports organizations are implementing baseline assessments for athletes and standardizing protocols for managing concussions. Just this year, the NCAA allocated $70 million dollars for concussion testing and diagnosis of NCAA players to settle several claims by current and previous athletes. Meanwhile, the NFL proposed a $765 million concussion settlement.
How did concussions become today’s hot topic? In the good ole’ days, we didn’t hear much about concussions even though athletes wore leather helmets and minimal padding. So, what’s changed? Is it that the medical community understands concussions better? Is it that our medical diagnostic processes have improved? Are we more aware of the short-term and long-term signs and symptoms of concussion? Is it that the athletes or game itself have changed? The answer is, all of the above.
Our understanding of concussion injuries has increased substantially due to the injury trends in sports and the volume of US soldiers returning from war with concussions. Legislative and research endeavors are improving our understanding of epidemiology, incidence, prevalence, prevention and management of concussions. Diagnostic testing allows athletes of all ages to get baseline assessments for comparison should an injury occur. Sport organizations are establishing guidelines to recognize symptoms and standardize the medical management of concussions. We now know how critical it is to rest the brain after concussion; that means not only avoiding play (physical rest) but also requires cognitive rest. Cognitive rest includes rest from reading, texting, computers, TV, and related activities to the extent prescribed by your physician.
Today’s athletes are stronger (mass) and faster; it’s simple physics to understand why their bodies are under excessive force during every tackle. After all, “Force = Mass x Acceleration.” Combine increased force with psychological factors like confidence in protective gear and/or a general belief that they, like so many athletes, could “come back from an injury” and you have a recipe for disaster. Strength training is the primary emphasis of most sport conditioning programs; however more attention should be paid to the other body control elements of optimum performance. Don’t get me wrong, strength training is important, but to what end? With increased mass under increased speed, it’s unlikely that advances in protective equipment can offset the forces these athletes experience with every snap of the ball. Concussions, unlike many joint or muscle injuries, cannot be “fixed” in the operating room. In contact sports, concussion prevention is crucial and could be as simple has training athletes at all levels to hit smarter not harder. Playing smarter with self-discipline will reduce the prevalence of injuries including concussions.
Ask a Physical Therapist or Movement Specialist how you can prevent injuries by diversifying your training regimens. These professionals are also at the forefront in educating parents, coaches and athletes about prevention and proper injury management. As an athlete, maximize your performance by working smarter both on and off the field.  
Written by CORE Strategies PT Specialist on September 9, 2014
Growing up in today’s sports world is tough on both kids and parents. Competition is fierce and sport specialization has become main stream. Pressure from coaches and scouts have parents fearing that their child may be left behind. Take baseball for example, pitchers as young as 14 are being scouted and even signing college scholarships. These immense pressures have health care providers worried about what the future looks like for these athletes.
Youth injury rates have increased under the current sporting trends. Kids are even sustaining “career ending injuries” that can have significant ramifications on their overall fitness and activity level throughout life. According to the June 2014 Bleacher Report, in April and May alone 28 professional pitchers underwent Tommy John surgery. Of those 28 pitchers, five were 21 and younger. Even worse, the American Sports Medicine Institute reports the rate of this surgery in youth athletes was 0% in 1994 and since then has dramatically increased each year reaching as much as 32%. Healthcare providers, parents and coaches must navigate the current trends to ensure kids stay healthy. Parents can impact the long-term movement health of their child by 1) encouraging movement diversity, 2) ensuring plenty of rest, and 3) collaborating with coaches and movement professionals that understand a balanced training approach.
Expand your child’s movement repertoire by encouraging variety and body awareness. Your child doesn’t have to be a multi-sport athlete to develop a diverse skill set. Make sure your kids have plenty of time for unstructured play, like a game of backyard tag or dodge ball. Sign your kids up for non-sport camps in the summer and take those adventurous family vacations. Well rounded athletes are more likely to be successful and less likely to sustain injury.
Rest is crucial for tissue recovery. In every sport some tissues are stressed more than others; over time those tissues are at risk of breaking down. Professional athletes get an off season to recuperate mentally and physically, yet many youth athletes are deprived this reprieve. Consider your child taking at least one sport season off every year and make sure they get ample sleep throughout the season. “Rest” doesn’t mean being a “couch potato” but is an opportunity to experience the movement diversity previously described.
Collaborate with coaches and movement specialists who recognize the impact today’s training methods have on your child’s future movement health. Youth programs should not be weighted too heavily on strength training. Successful athletes possess keen body awareness as well as strength, speed, power, flexibility and a strategic understanding of the game. Balance and coordination activities enhance body awareness allowing athletes to control the compressive and shear forces placed on the body during sport. Make time for injury prevention, recognize the early warning signs of overuse injuries, and by all means ensure you kids are having fun. These simple tips can keep your child successful in the game for life.

Written by CORE Strategies Specialist on August 5, 2014 
Hamstring injuries are becoming seemingly more frequent even for professional players. For example, the USA team in the World Cup in Brazil suffered hamstring injuries to Matt Besler, who plays for Sporting Kansas City, and Jozy Altidore, in the opening game, a victory over Ghana. They’re not the only ones struggling with hamstring injuries. At least nine players in the World Cup are suffering from the same including Portugal’s Cristiano Ronaldo and Brazil’s Givanildo Vieira de Souza (aka Hulk).
Why are recurring hamstring injuries so prevalent even at the elite sport level? Most hamstring injuries are driven by an underlying muscle imbalance. The body has multiple layers of muscles. Some layers like the hamstrings are power muscles ideal for producing explosive power, strength and speed. Other layers are stabilizer muscles that function to decelerate forces on the body, control posture and alignment.
Anytime the deeper stabilizer muscles aren’t sufficiently doing their job the power muscles attempt to do both jobs; however the job of “gluing you together” and “rapidly exploding through range” are in conflict with each other. The brain can only do both jobs by shortening the range of motion that it has to control (muscle stiffness). When the athlete challenges the system with a full range motion like sprinting, the knee rapidly accelerates into the stiffened range and a hamstring tear ensues.
Muscle imbalance can be a result of over emphasis on strength training with insufficient focus on tissue extensibility, inefficient stabilizer muscles due to a history of previous injury and/or a movement restriction. According to the National Institute of Health, athletes have a 63 percent recurrence rate of hamstring injury following the first episode. Traditionally hamstring rehabilitation includes rest and treatments to expedite tissue healing followed by progressive stretching, strengthening and gradual return to sport. Often rehabilitation fails to identify and resolve the underlying impairments driving the hamstring to stiffen up in the first place. It is crucial trainers identify the underlying muscle imbalance to stop the adaptive cycle leading to recurring hamstring injury and prevent these sometimes career ending injuries.
You can decrease your risk for hamstring injury and re-injury. Movement specialists can identify and fix muscle imbalance to restore maximum efficiency in all layers of your muscle system. Muscle retraining has to be specific to the identified impairment to decrease your risk. Movement specialists around the world, including those in Kansas City, are turning to technology like The Performance Matrix to prevent injuries and revolutionize training of elite athletes and people from all walks of life. Whether you’re an elite World Cup soccer player or a recreational athlete, preventing injury is the key to keeping you successfully in the game for life.
Written by CORE Strategies PT Specialist on July 14, 2014
After a long winter, it’s time to grab your clubs and hit the course. Golfers start the season with renewed enthusiasm; however over the next few months may become dissatisfied about their performance or plagued by recurring injuries. Many spend the off season on gym based training, completion of traditional golf programs, video analysis, lessons with your pro and/or purchasing new equipment. Despite these efforts, why do appreciable changes in your game elude you? It’s simple, you are moving wrong.
Your performance potential is only as good as your movement control and efficiency. In golf, timing and consistency are crucial for optimal performance. Traditional length and strength programs can only get you so far. Technique based training also encounters barriers of 1) sport specific muscle memory and 2) movement faults. Your body may lack the necessary movement assets to implement a desired technique. So, let’s investigate how movement faults can impact the accuracy and efficiency of your golf game.
Movement faults encompass anything that forces you to deviate from an ideal path of movement or compensate. This includes tissue restrictions you must work around, muscle inefficiencies that require you to switch to a less desirable muscle or “back-up strategy”, poor recruitment timing and inefficient braking mechanisms. Yikes, what does all of that mean? Basically, there are numerous strategies your brain can employ to swing the club; however not all strategies are desirable for efficient and effective ball strike whether teeing off or on the putting green. Anytime your brain encounters a limitation due to tissue restriction or muscle inefficiency it will choose the next best pattern available to complete the task; however, that “back-up strategy” sacrifices the ideal path of movement, changes recruitment timing and dramatically affects the accuracy of your game while also putting you at risk for injuries. If you want to get the most out of all of your golf game you need to fix your movement first.
Effective movement training requires thorough screening to identify the site, direction and threshold of your movement faults; specific muscle training for your impairments and the desired physiological change; and integration of your new assets into sport. Not all golf programs or trainers are created equal. Programs lacking detailed assessment and training specificity will not fix how you move; rather they mask or reinforce your limitations. Chose a skilled movement specialist to devise a program to resolve your movement faults and ensure you have the movement assets necessary to excel on and off the course. Don’t let movement faults you may not even know you have limit your potential. The definition of insanity is doing the same thing over and over and expecting a different result. Do something different. Change your game.  
Written by CORE Strategies PT Specialist on June 10, 2014
Did you know that there were 722 marathons scheduled in the U.S. and Canada in 2013 with almost half a million finishers (1)? Each year, there is an increasing number of people taking up running so now more than ever, we as movement specialists need to spread the message about not only injury recovery but more importantly injury prevention. The most common injuries runners experience include hamstring strains, ITB syndrome, ankle sprains, stress fractures and knee pain (2). Notice anything in common with these injuries? They are all overuse injuries. Runners are notorious for overworking muscles and joints because most feel the only way to train is to run and then run some more. Many runners believe the old adage “no pain, no gain” and accept the notion that runners have pain. There is no denying that runners must be mentally tough to push their bodies to accommodate; however the pain associated with mental toughness and that of tissue pathology are two different things. The increasing frequency of overuse injuries indicates runners are ignoring the body’s pain alarms and pushing into tissue pathology.
Let’s look at the hamstring strain as an example. The biggest risk factor for a hamstring injury is a previous injury. Other risk factors include age and fatigue (2). Most individuals with this type of injury manage their pain with rest, massage, chiropractic treatment, ice, or other passive strategies only to realize only temporary relief and improvements that are short lived (3). That’s because these passive treatments simply manage symptom irritability rather than treat the underlying problem driving symptoms. However, there is a solution to runners’ overuse injuries; you can take an active approach to find and fix the underlying problems driving your aches and pains.
New York University’s Langone Medical Center recognizes that proactively identifying underlying weakness and correcting movement can prevent injuries and eliminate the downtime required to rehabilitate injuries (3). At CORE, we couldn’t agree more! Injury prevention is our PASSION and that is why we teamed up with The Performance Matrix screening platform to identify underlying weakness and movement control problems within the musculoskeletal system. These underlying problems or “weak links” are the driving force behind the onset of overuse type injuries, are the key to stopping injury recurrence, and are also the reason so many athletes encounter performance barriers. So, stop managing your pain with passive strategies. Take the first step in actively fixing your problems by getting screened today.  
How can finding your “weak links” prevent injury? Let’s look back at the hamstring strain example. There are many factors that can contribute to hamstring strains, but a common factor is weak gluts (aka gluteals, the large muscle group that makes up your backside). If the gluts aren’t doing their job the hamstrings will try to pick up the slack by working double time to fill both power and stability roles. In this scenario it’s only a matter of time before sufficient speed or load results in a hamstring injury. Often, the underlying glut weakness is residual from a previous injury in which the pain resolved without regaining efficient glut function. The glut “weak link” kicks off a chain of events leading to hamstring injury. So you can see why the number one risk factor for a hamstring strain is a previous injury. It’s also easy to understand the importance of finding your “weak links” now before injury ensues.
Using The Performance Matrix screening platform CORE’s movement specialists will identify your “weak links” and design a specific training program to fix your underlying problems, decrease your injury risk and help you reach your full running potential. Training with our movement specialists will help you achieve superior results compared to programs you do on your own. Our team monitors your every move during training to ensure the desired physiological training effect occurs to fix your “weak link” and regain efficiency in your musculoskeletal system. By helping you avoid common exercise pitfalls, our specialists will maximize your results. In describing the most common training pitfalls Alison Peters, M.S., a clinical exercise physiologist at NYU put it best, “You can get strong doing something incorrectly” (3). Injury prevention is about more than strength, it’s about control. If during exercise you lack sufficient control, you merely reinforce the muscle imbalance or compensated movement pattern your body is already using. You may feel stronger, but failed to change how you move or decrease your risk for injury. At CORE, helping you regain movement control is our expertise. We will help you fix your underlying “weak links” and perform better. Take the first step in actively changing how you move by getting screened and leave other passive strategies behind. Your next PR is just around the corner and we can help you achieve it.
(2) Injury Prevention in Novice Runners: ACSM’s Health & Fitness Journal Vol. 18/NO.2
(3) The Whole Body Fix: Runner’s World Magazine March 2014
Written by CORE Strategies Specialist on April 9, 2014
When you’re pregnant, you envision this perfect, little baby that only sleeps, eats and poops. It can’t be that hard, right? Then the little one arrives and everything changes. He or she only sleeps for short stretches, eats ALL THE TIME and is the most demanding roommate that you’ve ever had. All this adjustment is hard enough when you feel somewhat normal, but if you’re in pain it can make the transition even more challenging. Pregnancy changes a lot of things, but it really takes a toll on your body. Everything is loose and stretched out, literally. While you’re pregnant, your body increases production of a hormone called relaxin. Among other things, it relaxes your pelvic ligaments and is believed to soften the pubis symphysis, which are important for delivery, but your body doesn’t just go back to normal after delivery. Relaxin stays at elevated levels for 5-6 months and even longer if you’re breastfeeding. This leaves you with a level of instability in your core. It is common a complaint to have back pain after pregnancy, but it doesn’t have to be the norm. Gentle stability training (no sit-ups for the new momma) can help to stabilize your spine and control your pain.
And you’ve never spent as much time on the floor as you will with a baby. All the time spent trying to get your little one to enjoy tummy time might have left you with low back pain. The amount of bending forward you do (changing diapers, changing clothes, lifting your baby, sitting on the floor) uses a lot of lumbar flexion and without the right form or muscle balance, it can eventually cause you pain.
Another common post-partum complaint is neck and shoulder pain. Those little babies are heavy, especially when you add the weight of your newest accessories, infant carriers and diaper bags. And now you’re spending multiple hours a day looking down at your little one (maybe to admire how precious they are when they’re sleeping or maybe to plead with them to take a bottle and stop crying). If you don’t have the proper shoulder positioning, it can really take a toll on the muscles of your neck and shoulders. The best tip is to RELAX. When things get stressful, try to keep your back relaxed (you’re probably arching it) and make sure your shoulder is resting in a good position (it’s probably tipped forward).
Life as a new mom is HARD, but it doesn’t have to be painful too. At CORE, we can help you safely get control of your aches and pains and allow you to enjoy the new little person in your life. 
Written by CORE Strategies PT Specialist on  associate on March 14, 2014
Growing up in today’s sports world can be tough on kids and parents. Competition is fierce and sport specialization has become main stream. Unlike professional athletes, many kids no longer have an off season. While we applaud kids for being active; we like our peers featured in the attached article worry about what this means for the masses. We're concerned about the long term implications of the current sporting trends on injury risk, movement health across the lifespan, and performance optimization.
At CORE we specialize in movement assessment and training. For us, it's not CAN you move but HOW you move that matters! You’d be surprised at the number of competitive athletes who can’t efficiently decelerate a jump, squat correctly or do a push-up without falling apart. Kids must learn to efficiently control their body weight and hone their proprioceptive awareness while their tissues are young and less susceptible to injury. Kids used to develop these skills in P.E. class and unstructured play activities but the push towards sport specialization has changed our perception of exercise, limited diversity of motor control development and increased repetitive use injuries in today’s youth.
In recent years, strength and power training have dominated sport development programs with little or no emphasis on the quality of control with which youth athletes decelerate body movements. These training practices in conjunction with the motor development limitations of sport specialization are a recipe for injury in the youth athlete. Body control is the foundation on which all future sport skills must build upon. Larry Meadors who is a strength and conditioning coach with the National Association of Strength & Fitness put it best in his article Yes Kids are Stars on the Playing Field, but Can They do a Push-Up? “We all learned the alphabet, and as we learned the alphabet we learned how to put two letters and then three and then four to form words, and pretty soon we had a word, a sentence, a paragraph, a chapter, a book. And you should apply the same things for athletics.” According to Meadors’ article, more than 3.5 million kids 14 and under are treated annually for sports injuries, and the numbers are increasing. More than half of all youth sports injuries are preventable. In about half the cases, the injuries are associated with overuse, often linked with the growing trend of children specializing in one sport and playing year-round.
At CORE our passion is helping consumers navigate the misconceptions out there. When it comes to your kids we recommend 1) variety to ensure development of a diverse movement repertoire, 2) rest to avoid overuse injuries in developing tissues and 3) a comprehensive and balanced training approach. Successful athletes not only possess strength, speed, power, flexibility and a strategic understanding of the game. They also possess keen body awareness and the ability to control the compressive and shear forces placed on the body during sport participation. Ensure your kids have adequate control so that they can be successful movers as youth athletes AND throughout their lifespan.
Written by CORE Strategies PT Specialist on February 20, 2014
Low back pain and obesity are both extremely common conditions in the United States. We are very aware of how excessive weight gain can put us at risk for many health conditions. . . but how many times have you heard someone say, “I just need to lose the extra weight and my muscles or joints will feel better”? Does weight gain cause musculoskeletal pain? Well, the answer isn’t that simple.
There is some research that indicates a correlation between obesity and musculoskeletal pain. However, this research is far from cut and dry when other variables are considered. In one study listed by the National Institute of Medicine, chronic pain conditions were analyzed in twins. The study initially found a correlation between chronic pain conditions and obesity. Overweight and obese twins were more likely to report conditions such as fibromyalgia, migraines, and low back pain. However, when factors such as familial influences and depression were evaluated, the correlations were reduced.
Studies show that depression can lead to more sedentary behaviors and social withdrawal which can facilitate weight gain in some people. However, chronic pain conditions such as low back pain and fibromyalgia may also limit one’s social engagements and activities, thus contributing to the obesity correlation. The important part to remember is that this correlation does not mean that obesity causes pain. Is there a relationship between obesity and pain? Yes. Is pain caused by obesity? No, not necessarily. The truth is pain is a complex and multi-faceted issue. Pain can be caused by many factors, including tissue pathology, biomechanical deficits and poor movement patterns.
The belief that losing the “extra pounds” will result in pain relief can set some individuals up for failure. In order to lose weight, people have to move more. If in doing so, they aggravate underlying musculoskeletal pathology or dysfunction their pain could actually increase and jeopardize their compliance with exercise and weight loss. Your movement specialist should not only encourage you to move but, also teach you how to move with adequate control. Understanding how quality of movement will impact your long-term success in weight loss and pain control is imperative. So, the next time you hear someone say that they just need to “lose a little weight” to get rid of their aches and pains, remind them that when it comes to musculoskeletal pain, our body weight is only one of many variables they can control. Encourage them to find a trained movement specialist who can help them understand their body, target their individual needs, manage and prevent pain episodes, and help facilitate their goals.
Stone AA, Broderick JE. Obesity and pain are associated in the United States. NAASO. 20; 7:1491-1495. doi: 10.1038/oby.2011.397
Wright LJ, Schur E, Noonan C, et al. Chronic pain, overweight, and obesity: findings from a community-based twin registry. J Pain. 2010; 11(7):628-635. doi: 10.1016/j.jpain.2009.10.004.
Written by CORE Strategies PT Specialist on January 23, 2014

Click Here for the original New York Times article

"Insanity: doing the same thing over and over again and expecting different results." - Albert Einstein
After reading the New York Times article about Olympic Slalom Skier Mikaela Shiffrin, you will understand why Albert Einstein’s definition of Insanity makes so much sense. This article talks about the upbringing of Mikaela and how at 17 years old, she became the youngest World Champion skier.
The burning question everyone wants to know is how Mikaela got to be so good so early. Was she pushed into the sport? Did she train 24/7 since the age of 2? The answer is no. Mikaela grew up just like everyone else. While of course, Mikaela has a lot of natural born talent for the sport, that isn’t the only thing that got her to the Olympics. There was another piece of the puzzle and that was diversifying her activities and not doing too much of one thing. Her parents insisted on “keeping a light race schedule for their children as they loaded up on practice days filled with deliberate, skills-based drills and exercises.” She also learned good work ethic through “shovel(ing) cow manure for weeks…when we were replacing our lawn one summer.” Mikaela also spent her free time playing soccer, tennis and even learned to ride a unicycle while juggling during her free time. “So she’s a good ski racer because she did all kinds of different developmental things.”
This is exactly what CORE believes in! While every athlete needs strength and technique coaching, they also need balance, stability and coordination training as well. By diversifying the activities that you do and bringing in exercises that challenge your core control under a variety of settings you can enhance your performance in a short amount of time. Fortunately, you don’t have to take up unicycling or juggling like Mikaela did in order to get this type of training. CORE’s whole philosophy of training is based on identifying your “weak links” via The Performance Matrix platform and then targeting the specific stability muscles and conditions you need to train to eliminate your “weak links.” We take traditional training regimes to the next level with a comprehensive, multifactorial, total body approach. Athletes become so focused on power and speed that they forget about the other pieces of the puzzle. Mikaela is a great example of an all-around athlete who could probably kick our butts at any sport!
CORE will be following Mikaela throughout the Olympics and we are excited to see her excel. We also commend her parents for thinking outside the box when it comes to training a world class athlete.
Go For The Gold Mikaela!!!

Written by CORE Strategies PT Specialist on January 21, 2014
There are a lot of us out there who have pain in one or the other; knee, hip ankle, back, etc. When things are painful the general consumer will seek out treatment for this area by seeking medical treatment. As we seek treatment one would think that interventions would be focused on the joint or area that is painful, right? So why would your physical therapist give you an exercise for your hip or back when your came in for an ankle sprain?
As physical therapists we are trained to look at the whole body and to analyze full body movement and control. A good physical therapist will definitely assess the area that is painful, but a great physical therapist will also check the joints above and below to assess how they move and screen for faulty movement patterns that may be a contributor or cause of your pain. This is especially important in recurrent injuries. A recurrent ankle sprain cannot be solely due to just being clumsy; there must be a reason that the ankle is susceptible to injury.
To illustrate how this is, take the ankle sprain example. As the foot hits the ground during weight bearing exercises (walking, running, or landing from a jump) our body must be able to control itself through the ankle, knee, hip, and spine. For the body to properly control this motion, muscles up and down our leg must work together and in the proper balance to keep our leg and foot in the correct alignment. When the correct alignment cannot be achieved either due to faulty ligaments or muscle control the risk for injury to structures up and down the leg occurs. One common area of fault in control of the lower extremity is poor control of femoral medial rotation. This means the ability to not let your thigh bone rotate inward as the knee bends during weight bearing. Increased femoral medial rotation, leads to increased knee valgus (“knock knee” position), which causes tibial external rotation (rotation of the lower leg bone outwards), which can cause increased pronation at the foot (the foot excessively rolling inwards).
Whoa, that’s a lot of motion to control with every step! That is why having correct muscular and motor control up and down the “kinetic chain” is vital to a patient’s rehab success. If the poor movement control at the hip pre-disposed the ankle to injury then you could do ankle strengthening exercises for weeks and still have a risk of injury. This idea of having control though the entire kinetic chain can be applied to the upper extremity and the spine as well. It’s all connected! So stop blaming those pesky ankle tweaks, aches, and sprains on weak ankles or being clumsy, it just might be your hip that’s the culprit. 
Written by CORE Strategies PT Specialist on January 9, 2014
If you’ve searched around the CORE website or have had the pleasure of seeing one of our Movement Specialists, chances are you’ve heard us talk about “weak links” that are found throughout the body. Movement control and our bodies can be very complicated, so here’s the scoop on “weak links” and how CORE tackles them. CORE uses the term “weak link” to describe a region in your body that has poorly controlled motion and is at risk for pain or disability. “Weak links” are often caused by 1) control muscles that aren’t doing their job sufficiently or 2) some type of restriction. In many cases it is a combination of these factors.
A Muscle Problem
Pain changes how our body moves and disadvantages the control muscles of our body much more than the power muscles of our body. During pain or injury, our bodies compensate in order to relieve pain and maintain function. For example, if a runner begins to experience knee pain their immediate reaction is likely to alter their stride in an attempt to unload the knee pain. In essence the brain finds another way to move to decrease the knee pain and while this compensation strategy may be effective in the short term 1) it doesn’t address the muscle imbalance that lead to the knee pain and 2) it can load adjacent tissues at the hip or foot with excessive stress. Sometimes, the brain continues the less than ideal movement pattern even after all pain subsides and thus you have “weak links” or regions at risk for injury in your movement system. Yes, many of you reading this blog are unaware of the “weak links” in your system. You may be completely pain free and even functioning at a level that satisfies you. However “weak links” can lie dormant until just the right amount of stimulus causes a tipping point and pain makes you very aware of their presence.

At CORE we use The Performance Matrix platform to screen your body for “weak links” even before they become painful. Once identified, we will help you train to maximize the efficiency of your control muscles to alleviate your “weak link” and decrease your risk for injury. For most individuals, regaining control of your “weak link” takes about 4-6 weeks with additional strength benefits taking up to 10-12 weeks.

Restrictions can also be the driving factor behind a “weak link.” Restrictions are like road blocks in your ideal movement pattern that you have to deviate around. That deviation creates stress on another tissue and over time it can become painful and alter your function. For example, in today’s world technology is everywhere. Everyday people are typing on their computers or texting on their phones which can put the shoulders in a forward or rounded position. Repetitive positioning here can lead to muscles and ligaments tightening around the shoulder and thereby limit ideal movement at the shoulder, upper back or even the neck. Manual techniques and active stretching can help your body loosen up those restrictions so that you can prevent pain, restore efficient muscle function and perform at your best whether it’s in the office or on the soccer field.

Are you dealing with a “weak link”? There’s no need to wonder about the state of your movement health. The Performance Matrix tool will identify those “weak links” and our movement specialists will get you moving at your best. To schedule your screen, call our office at 913.322.4000 or schedule online.