Is Thoracic Spine Mobility Important?

Shayna Robinson, MSPT, PhD | January 25th, 2014


Can Shoulder Stand Save You Too?

January 22, 2014 | Shayna Robinson, MSPT, PhD


The Body You Want

Ever wonder why you can’t change certain parts of your body when you exercise? It may be a lack of body awareness. Research shows that lack of body awareness creates an inability to engage muscle, and this awareness is an important tool in progress changes in your body. If there’s a certain part of your body that is especially challenging and just won’t budge, it may be because you are not activating the muscles that encompass it properly.

Tips for improving body awareness:

1) Start With Pressure; Notice where your body contacts the earth. For example, in this bow pose, my foot is in contact and is supporting my entire (5’10!) frame. That’s a lot of strength in that little foots. It’s all because I am applying pressure evenly across the four corners of my foot, and I am able to do this because I am cognizant of the muscular contractions in my foot.

2) Change Your Posture; Until you feel the proper activation, keep moving your body to a different position. For example, on my body, my left abdominal wall is weaker than my right, so I need a different angle to properly engage all my obliques and anterior abs. If I change the angle I am working in while engaging my left side, I get the same work done as my right.

3) Engage Your Multifidus; Remember those tiny muscles that support your spine I spoke of so lovingly last week? Yep, they’re integral in allowing you to engage all your muscles eloquently. Instead of over using the major muscle groups and getting bigger and bulkier because you lack the foundational strength of the multifidus, try working on pelvic tiles and engagement FIRST before you do any other exercise. I start my day with my multifidus pelvic tilts and ab exercises, then move on to other exercises that engage the larger muscle groups.


The Mystery of Foot Pain

What do the Lakers star Kobe Bryant, the quarterback Eli Manning, the Olympic marathon runner Ryan Hall and the presidential candidate Mitt Romney all have in common? Foot pain. Believe it or not, Plantar Fasciitis is one of the most common sports injuries, and it’s also one of the least understood.

While Plantar Fasciitis is a very common injury, the consensus on the cause and treatment remains clinically a mystery. Little is understood, medically, about overuse sports injuries in general and that’s why, as a result, they remain difficult to treat.

Most medical professionals agree that Plantar Fasciitis is, very basically, an irritation of the soft tissue that runs along the bottom of the foot, attaching the heel bone to the toes and forming your foot


Bone Mineral Density and The Athlete

Start thinking about Bone Mineral Density. It’s an important factor in injury prevention, now and in your future health–and it’s cumulative. That means if you’re an athlete and aren’t getting the proper nutrition, rest and relaxation your body needs now, you’re setting your body up for failure later.

Bone Mineral Density is a cumulative history of energy availability, hormonal fluctuations, genetics, good nutrition, behaviors and environmental factors. As you get older, bone mineral density falls as our muscular infrastructure changes. When you do damage to your body, by starving/binging yourself, exercising too hard, not getting enough sleep and allowing stress to become a regular component in your life, you seriously alter your future body.


Wake Up Call: The Importance of Sleep

Rebuilding Mode

Sleep is an essential functional part of being and staying healthy. For athletes, it is a strong factor in performance. Most of the repair and strengthening in your body occurs during stage 4 of the sleep cycle–your deepest sleep. But if you don’t go through all the cycles appropriately, you won’t get to the 4th stage, inhibiting many vital functions needed to repair, restore and strengthen your body.

Stage 1: In the first stage, your muscles relax as you fall asleep.

Stage 2: Five to ten minutes after falling asleep, you enter a deeper slumber and your brain starts to produce chemicals that release hormones.

Stage 3 & 4: These are the deepest and most reparative stages. The body releases growth hormone, which helps repair bone and muscle.

REM Stage: The 5th stage of sleep is vital for pain tolerance and motor skills. It strengthens cognitive and nervous system function.


According to the National Sleep Foundation, 75% of Americans have problems sleeping and are not getting the recommended 7-9 hours per night our bodies need to recuperate from the daily grind.

Here’s how sleep affects our system:


Cellular Repair
Repair for the daily wear and tear on the body is correlated with how much deep sleep you get. If you don’t have a regulated night cycle, you won’t get to the deepest stage of sleep that is required for release of growth hormone. These hormones shift the body’s process to anabolic–where it is able to initiate muscular repair, break down fat and stimulate cell division to replace old or malfunctioning cells.

Digestion and Weight Regulation
It is a digestion regulator, releasing hormones that break down fat to supply energy for tissue repair. Adequate sleep is required for weight management. Sleep deprivation causes hormones like leptin–a hormone that regulates a feeling of fullness–to decrease. You end up feeling hungrier without being satisfied by what you eat, causing you to eat more and gain weight.

Muscle Relaxation
During the night muscles can take a break and relax. Respiratory muscles also relax, resulting in the breathing rate slowing down. During REM sleep, muscles become so relaxed that they actually become temporarily paralyzed, called muscle atonia. When muscles are relaxed, there are less metabolites formed, allowing for additional cellular repair and replenishing.

It keeps the immune system in check by releasing hormones that act as messengers, telling the immune system to produce antibodies, kill potentially cancerous cells and decrease inflammation.

Cognitive Function
It also enhances cognitive function by consolidating memory. Storing short term memory to long term memory occurs during sleep through the strengthening of neuronal connections.


$100 Hangover Cure

“As for a hangover cure, an IV bag of D5 and water—what they give you at the hospital for dehydration—is a bag of dextrose 5% (sugar) and water. That’s like me handing you 4 vitamin waters and charging you $100.

Revive bills itself as a luxury hangover “cure” clinic, where one can lay down, put on headphones and get an intravenous solution of “whichever medications, vitamin additives, antioxidants, or additional fluids the physician deems appropriate for your unique condition and symptoms.” I called to find out just what they put into these packs that make it the $99 price tag worth our while, but have not been answered as of press time.

What can we be sure of when it comes to intravenous solutions? Though this “clinic” is presumably “run” by registered nurses and overseen by a licensed physician, typically this means the person administering the IV is not a registered nurse or physician. And, as for a hangover cure, an IV bag of D5 and water—what they give you at the hospital for dehydration–is a bag of dextrose 5% (sugar) and water.

That’s like me handing you 4 vitamin waters and charging you $100. My advice would be to save your money, get some vitamin water and make sure you sleep enough that your body can recuperate.


CoreFit Focus: Orthobiologics

In this article CoreFit focuses on Orthobiologics. Naturally formed substances, Orthobiologics in the form of matrix, growth factors and stem cells, can be injected into the injury site to speed up recovery. I break down the way these substances work within your body.

CoreFit Focus: Orthobiologics

Orthobiologics are substances that orthopaedic surgeons use to help injuries heal more quickly. They are used to improve the healing of broken bones and injured muscles, tendons, and ligaments. These products are made from substances that are naturally found in your body. When they are used in higher concentrations, they may help speed up the healing process.

Healing Process:

When you injure a bone, muscle, or tendon, there is bleeding into the injured area. This bleeding is the foundation for the healing response. It provides a way for healing factors to reach the injury site.

In addition to bleeding, there are three factors necessary for healing. All three are orthobiologic substances. They include:

The relationship between matrix, growth factors, and stem cells.
  • Matrix. This can be thought of as the house in which the cells live and where they will thrive and eventually make bone, tendon, or ligament. Matrix material is conductive. This means it can form the building blocks that help fill bone gaps.
  • Growth factors. These are the many different kinds of proteins necessary for cells to work during the healing process. Some proteins help speed up the healing process, while others help to control it or slow it down. These elements are much like the vitamins that we take every day to try to improve our health and body function.
  • Stem cells. These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament.

Matrix (Conductive Material)

This x-ray shows a broken shinbone (tibia) with a large bone gap, or void. A metal rod has been placed down the marrow cavity of the bone to help hold it together.

The matrix, or conductive material, provides housing for stem cells while they grow into mature cells. If stem cells do not have a house to grow in, they cannot develop into repair cells that can heal bone, muscle, tendon, or cartilage.

When someone breaks or fractures a bone, the healing process begins. As long as most of the bony substance is not lost, stem cells should be able to make new bone and promote healing. If, however, a significant portion of the broken bone is lost, a large gap may result. This can happen if the bone crumbled, or broke into several pieces and went through the skin.

Under these circumstances, the gap must be filled with matrix, or conductive material, to house stem cells. There are several types of substances that may be used for this purpose.

Bone Grafts

Bone grafts are often used as matrix material. There are two types of bone grafts.

Autograft. A bone graft can be obtained from the patient. This type of graft is called an autograft. Many different bones can be used to supply the graft. Grafts are most commonly taken from the iliac crest, which is part of the pelvis.

Harvesting a bone graft requires an additional incision during the operation to treat the injury. This makes the surgery take longer and can cause increased pain or risk of infection after the operation. Although autografts have been used with good results, some people may experience pain at the donor site for some time.

Most autografts are harvested from the iliac crest of the hip.

Allograft. One alternative to taking the bone graft from the patient is called an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank. Like other organs, bone tissue can be donated upon death.

This drawing shows a microscopic view of bone matrix material and the type of holes needed to house stem cells.

The use of allografts has grown because it avoids the risk of pain at the donor site. There are risks and benefits for both types of bone grafts, which your surgeon will discuss with you.

Artificial Matrix Material

Man-made materials, such as calcium phosphate, may also be used to fill a large void between bone ends. When treated properly, calcium phosphate can form material that closely resembles bone. It contains holes that are the right size for stem cells to enter and develop into mature cells.

Both calcium phosphate and cadaver bone eliminate the pain and other risks involved with having extra surgery to harvest an autograft.

Growth Factors

Growth factors are found inside bone in low concentrations, and in other parts of your body. They can be produced in higher concentrations through genetic engineering.

A lot of work is being done using genetic engineering to help with medical problems. Genetic engineering has made great improvements in making bone heal faster and better.

Genetic engineering can produce large quantities of a needed element in its pure form. During the genetic engineering process, signals inside a cell are altered in order to change the cell’s function. To help with bone healing, cells can be turned into factories that produce growth factor proteins.

Growth Factor Proteins and Bone Healing

Growth factor proteins play an important role in the healing process. They call stem cells to the injury site. This is called chemoattraction. The stem cells are drawn to the injured area where they develop into “repair” cells.

Chemoattraction works only when there is a good blood supply around the injured area. If there is not good blood flow, the proteins cannot attract stem cells, or provide them with a way to travel to the area where they are needed.

Bone Morphogenetic Proteins

Many types of proteins aid in bone healing and can be produced with genetic engineering. The most powerful of these are bone morphogenetic proteins (BMPs). These synthetic proteins also help with muscle, tendon, and cartilage healing. Discovered during the 1960s, BMPs today are produced in large enough quantities to effectively speed the healing of damaged bone, especially in fractures that have a difficult time healing.

Stem Cells

Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing – bone, muscle, ligament, and cartilage.

Stem cells can turn into muscle, tendon, bone, or cartilage.

Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program.

Stem Cell Harvesting

There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells.

The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process.

Stem Cell Donation

Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.


5 Golden Gifts of Rehab

1. Gaiam Yoga Block $10.95

2. Soybu Compression Pants $70

3. KT Athletic Tape $19.99

4. Yoga Tune Up Trigger Point Massage Ball $9.95

5. Garden of Life Vitamin Code Multi-Vitamin $24.99



The Athlete and The Anti-Inflammatory

Bullet Points:

  • Ibuprofen use prior to or during exercise, hampers the ability of muscles to rebuild themselves after exercise

  • Frequent use of ibuprofen, causes higher overall levels of bodily inflammation

In America, the average athlete has been trained to think that an ibuprofen will heal any injury. In fact, 70 percent of


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