It appears that Move Forward PT collaborated with Dr. Oz on their most recent segment: Could that pain be your unhealthy fascia? Before listening to the podcast, I prayed that it would be a 5 second segment with a long drawn out, "NOOOOOOOO!!!" Unfortunately, it was 23 minutes, 53 seconds of discussing fascia, how it is injured, and how the fascia can inhibit movement.
In one segment, the interviewee Mary Ann Wimarth PT, DPT, OCS discusses a patient example who benefited from myofascial release of the iliotibial band with part of her home program being foam rolling of the IT band. At OPTIM, I say Mary is likely neglecting the cause of the dysfunction. The IT band cannot be lengthened. It is a taut, fibrous band of connective tissue. Did Mary investigate the mobility of lumbar spine, hypertonicity in the hip flexors, gluteal muscle strength, and how the core is functioning during a functional assessment? I am not sure.
If the IT band is suspected to be "tight," I would perform an Ober's test. If the Ober's test is positive, investigate hip strength, hip flexor length, and the L4-S1 segments (since the TFL is innervated by L4-S1 and is the origination of the IT band). If the lower lumbar spine is not moving properly, I would choose to manipulate that region to provide a neurological reset and decrease any hypertonicity in the hip flexor musculature. The HEP would consist of more active hip and core motor control exercises, and less passive foam rolling.
My final grievance with this segment is the timing of which a consumer should seek physical therapy. Mary states that a person should try the foam roller for a while if they are having symptoms. If the foam roller does not work, then the consumer should receive an assessment from a physical therapist. The order is backward! If someone is having pain, they should go to a physical therapist first. Physical therapists are the front line of defense for musculoskeletal dysfunction. As movement specialists, we can evaluate the cause of one's dysfunction, then give appropriate management.
Do not believe everything you read!
-OPTIM Manual Therapy Fellowship
12/6/2014 11:35:41 pm
Dana, Brian, and Mike:
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