David's Blog

  • Dave Drummer takes impressions for custom PRI foot orthotics manufactured by Dr Paul Coffin. The Hruska Clinic strives to meet all needs of our patients to help them address why they have the issues they do. This is one more example of how we will address all needs you have to give you the bast care we can.

  • After giving out a bunch of balloons this week we felt revisiting this great video from Dave would be beneficial. Keep breathing!

  • The last of our #MySoreSpot series looks at the very important left hamstring muscle. Dave does a great job explaining and demonstrating potentially #WhyYouHurt

  • Dave shows a unqiue way to improve balloon blowing technique for those people who struggle to find the power to get air into the balloon. This technique, that originated at the Hruska Clinic(TM), is taught as a core exercise through the Postural Restoration Institute® (www.posturalrestoration.com) and has been adapted and utilized to assist in treating anyone from the geriatric population to college athletics and professional sports teams.

  • David Drummer talks about flexibility

    Can a person be too flexible? I think most would argue the more flexible the better, but I have to disagree. I can’t tell you the number of patients I’ve worked with that I’ve told to stop stretching. And I always love the response I get of utter disbelief. Many will say something to the effect of “But I stretch everyday so I can place my palms on the floor”, yet they often have been fighting chronic pain for years with no idea why. After all, they’re active, otherwise healthy, and they stretch everyday.

    Have you ever been on a walking bridge with a lot of other people? If so, you’ve probably felt the bridge give or drop beneath your feet. That is by design. If the bridge doesn’t give with the varying frequencies of all those feet pounding on it, the bridge could collapse. Being too rigid could be devastating to the structure. On the other hand, there needs to be some rigidity or structure to the bridge, or again the bridge could collapse. Neither scenario is good.

    It’s the same with our bodies. Being too rigid, or lacking flexibility can lead to problems. Maybe you can’t reach down to put on your shoes and socks, or you can’t turn to see behind you when changing lanes in your car. But if you’re too flexible and you don’t have stability you may have back pain every time you lean over to pick something up or work in your garden. The list of problems that develop from too much or too little flexibility too long to cover in a short blog, but I hope you better understand why sometimes when you come to the Hruska Clinic you may be told to stop stretching.

    If you have any thoughts or questions regarding my thoughts on flexibility, please feel free to contact me personally.


  • Lets get “Hip”

    Dave Drummer Gives A Basic Anatomy Lesson To Explain The Integrated Nature Of Your Body

    That is really hip! That saying may be a little out of the times (it dates back to when I had a full head of hair), but maybe it’s time for a comeback. If you’re familiar with our clinic, you likely know that we concern ourselves a lot with the pelvis (not to mention hamstrings, rib cages, breathing, feet…). As I tell a lot of my patients, your pelvis in many ways is your foundation. If you have a problem with your foundation, your whole body may be affected.

    For those of you who may not be familiar with our clinic and the way we practice let me explain. We will need to start with a basic anatomy lesson. The bony pelvis is made up of three basic parts: the left half of the pelvis (called the left ilium), the right half of the pelvis (the right ilium), and in between them is what is called the sacrum (at the end of which is the tailbone). The joint or connecting point, of either ilium with the sacrum is called a sacro-iliac joint (you have a left one and a right one). Your hip sockets are part of the ilium bones, and is where the large, upper leg bone (called the femur) attaches to the pelvis. If you were to look at the back of your pelvis, you would see a notch where a very large nerve called the sciatic nerve leaves the pelvis and travels down the back of your leg. Your spine or the column of bones of your back, are attached to the sacrum, and your head rests upon your spine. I think it is important to know that each of your rib bones attach to a specific region of the spinal column called the thoracic vertebrae and your shoulder blades rest on your rib cage. Finally (sort of), your arms attach to a portion of your shoulder blades that becomes the shoulder socket.

    Now, imagine that your pelvis is tilted, rotated, or generally out of a “normal” healthy position. A lot of pain issues can develop, including (but certainly not limited to), plantar fasciitis or other some foot pain, knee pain, hip pain, sacro-iliac joint pain, sciatica, or back pain. Even if you have shoulder, rib, neck or even jaw pain, it is possible that there are issues with your foundation (i.e. your pelvis) that will need to be addressed.

    When you come to the Hruska Clinic, we will perform a series of objective tests that will help us decide if there are postural issues related to your pain. We will then explain why you have your pain and what we can do to resolve the problem so you can feel good and resume the activities that you love. Who knows, when you’re done, you may find yourself saying, “Wow, the therapists at the Hruska Clinic are really hip”. Please, just don’t forget that we also love breathing, rib cages, feet…

  • YOGA and PRI - Do they go together?? Dave’s new blog shares some insight into this question…

    Every Wednesday morning here at the Hruska Clinic, we have a staff meeting during which we try to address the issue of how we can best serve our patients. Often we talk about the needs of our patients, and what many of them desire. Some of our patients are involved in yoga, or state that they desire to become more active and wonder if yoga would be an activity that would integrate well with their PRI program. Because of this, we recently invited yoga instructor Sheila from Lincoln Yoga Center, to one of our staff meetings. What wonderful insight we received.

    Sheila, I believe, has a philosophy that is right on track with the Hruska Clinic and our approach to Postural Restoration (PRI). I think we all agree that breathing, rib mechanics, body control, balance, and position are critical pieces to health and/or rehabilitation. I think that we all are in agreement that to be healthy and feeling good, a person needs to be able to use (not abuse) their bodies. Sheila did a great job at educating our staff that not all yoga instructors share her philosophy and that there are many brands of yoga.

    If you’re wondering if yoga is appropriate for you, my answer would be, “It depends”. I would caution you to learn the philosophy of the brand of yoga that you’re considering becoming involved in. I personally feel that the breathing component should promote easy inhalation through the nose and full exhalation through the mouth. Ideally, because we see many people who are hyper-inflated, I would avoid a program that promotes holding your breath after you breathe in. I would however encourage breathing that promotes pausing after full exhalation. This will promote your ability to achieve a flexed or rounded position through your body.

    Also, if you’re going to be involved in yoga, I think it is very important to understand flexibility and how to appropriately improve your flexibility if you feel tight. This may be my biggest concern with yoga. All physically healthy people in my opinion should be able to touch their toes. The ability to touch your toes appropriately demonstrates both strength and flexibility. The word appropriately in the last sentence is in italics because I’ve seen many people, especially young women who’ve been involved in dance, cheer, or gymnastics, who can touch their toes easily (many of them can place their palms on the floor), but I would argue that biomechanically they are not doing so appropriately. You see, the problem lies in where your movement is coming from. If your back is flat and you’re simply pivoting at your hips, I know that your hamstrings are too long. That may be the hardest pill for people to swallow. The reason appropriate hamstring length is important is because among other things, our hamstrings lend stability to our bodies, our posture. Therefore, excessive hamstring length lends itself to instability and a host of physical problems. Please note that hamstrings can appear short when they’re not, and they can even appear short when they are too long. (For greater understanding of this, click on the link in the next paragraph).

    So if you’re interested in becoming involved in yoga, as a PRC (Postural Restoration Certified) physical therapist, I recommend that you understand the philosophy of the style of yoga you’re going to pursue. Ask your instructor such questions as: “How do you teach people to breathe?”; “Can a person be too flexible?” (The correct answer should be “yes”); “Do you promote hamstring stretching for most people who can’t touch their toes?” (The answer to this one should be “No”. For reasons why the answer is no, read Hamstrings: To Stretch or Strengthen); “How do you address imbalances that you see between the left and right sides of a person’s body?” The answers to these questions will let you know if that style of yoga will positively integrate with your PRI program.

    If you have questions about how Yoga, Pilates or other activities integrate with the PRI philosophy of the Hruska Clinic, leave a comment or contact me at 402-467-4545.

  • Looking at the Clouds - Dave’s new blog talks about living in our “close-up” world…

    When was the last time you laid down on the ground and looked up at the clouds? When was the last time that you stopped and focused on objects in the distance, as far as you could see for a few minutes? I’m sure it has been a long time for most of us, possibly years. As I spend more time working with Ron and the other therapists here at the Hruska Clinic, not to mention our patients, I realize how much we as busy people are possibly hurting ourselves by neglecting to do such simple things. You see, our bodies were made to work, but they also need rest. And our eyes are made to see both up close and at a distance. Unfortunately, I believe, we are really good at working, and looking at things up close (on our smart phones and computers, as well as our TVs) which ramps up our systems and tightens us up, but we’re not so good at pausing and taking in the beauty of the world around us which can help us shut down or relax our muscle tone. We learn to accommodate, or adapt, to this close up world by always focusing on objects that are near to us. Neurologically, this process usually leaves our bodies tenser than if we were to focus on our distant surroundings.

    Why would a physical therapist write about such strange stuff? Because it has been my experience that many, if not most, of my patients could be their own best therapist, if they just learned to pause, breathe, and look around (maybe I shouldn’t let this information get out). You see, as we keep ourselves all cranked up we tend to get more extended or hyper-inflated and hyper- vigilant (ultimately, this means we keep trying to breathe in while we resist getting the air out). This leads to arching our backs, developing big barrel chests (men and women alike), and we often breathe using our back and neck rather than our diaphragm. The next thing you know you’ve got back pain, headaches, and even more trouble shutting down and going to sleep at night.

    Now throw into the mix a tendency to look at the world as if it only exists between 10 inches to a few feet from us most of the time and you begin to develop visual-vestibular issues that also lock us into a state of extension (this is when we have deep, arched backs, tight hamstrings, and we can’t touch our toes, not to mention a host of other issues). I am convinced that if we can take ourselves out of our artificial world (change the way we accommodate/adapt), even for a little while, by getting out and moving and taking in a world that is more than a few feet away from us, and function the way our bodies are made to, much of the pain that people have will resolve naturally.

  • Many of our patients have learned over the years that footwear, among other things, can play a major influence on their rehabilitation. A few years ago, ASICS made a shoe that worked wonders for many of our patients. It was the ASICS, Foundation 8. Over the years, ASICS has made structural changes to the Foundation that decreased the effectiveness of the shoe for some of our patients. Recently, we have learned that the Foundation, and another model, the Evolution, will no longer be made. They are being replaced by a new model that is nothing like either of those shoes. There are currently no shoes that we are aware of that offer the benefits that the Foundation (or even the Evolution) have provided for our patients.

    Dave has written a letter to the ASICS production manager to explain our need for a shoe like the Foundation. The efforts of one person’s plea will not be enough to have an impact on the production of such a shoe. We are therefore requesting that you read the letter, print it, and sign your name below Dave’s with a short personal request for ASICS to continue production of the Foundation, and mail it to the address at the top of the letter. If you’ve had a personal experience where the shoe helped with your rehabilitation, please include a brief summary of your experience for the ASICS people as well. Even if you haven’t had a personal experience, please support our efforts by signing your name to the letter and sending it to ASICS.

    Please click on the first link to read/print the letter, and on Lori’s video blog to better understand what a quality shoe means to our efforts. You may also leave us a comment, and we will forward on to ASICS. Thank you for your help.

  • Got Guts? Read Dave’s latest blog to see how your pelvis position may influence them…

    Over the years I’ve had a number of patients come in with a variety of pain concerns, and I have often been amazed by the number of people in the process of talking about a seemingly unrelated issue who will make a point of saying something like, “I don’t know if it’s related but I also have irritable bowel syndrome (IBS)” or “I struggle with acid reflux”. What may be even more remarkable is the number of people who don’t initially bring the topic up, but after several sessions will make comment about how since they’ve started physical therapy their irritable bowel syndrome or acid reflux has improved. I will always remember one patient who stated that prior to starting physical therapy for a hip issue of all things, she had to sleep in an elevated position and take medicine for the acid reflux and by the time her hip was feeling better, she no longer had to take medicine for acid reflux and now can sleep without being in an elevated position.

    My goal today is to as briefly as possible, explain why this phenomenon is not uncommon. You see, so many of our patients have a very common pattern. This pattern is one where their pelvis, according to the tests that we measure, is in a forwardly rotated position (maybe you’ve heard the term tilted pelvis). It is possible for one side or both sides of the pelvis to be forwardly rotated. Because of this the normal resting position of the spine and ribcage (and consequently your diaphragm), have been changed leading to a “shift” in the resting position of your abdominal contents including your stomach and your intestines (your bowels). Your whole system can truly be affected by this leading to symptoms of IBS or acid reflux. The good news is that by addressing the position of your ribcage and the way you breathe, and the position of your spine and pelvis, a lot of people can experience a noticeable improvement in these symptoms. I’ve seen it happen a lot. Often, these people may look something like this (click this link from the Hruska Clinic website).

    If you or someone you know is dealing with either of these issues, feel free to give us a call.

  • Do your feet hurt? Dave’s new blog talks about Plantar Fasciitis…

    Do your feet hurt? It is very common to have foot pain, and there are a variety of diagnosis’s you can have. Today I would like to talk about one of the most common forms of foot pain that people come to our clinic with - plantar fasciitis. Although it may not always present this way, a common scenario for a person with plantar fasciitis is that you wake up in the morning with very bad pain on the bottom of your foot that seems to get better as the day goes on. You may feel like your foot tightened up overnight, then as you first put your feet on the floor you feel like the bottom of your foot is being ripped apart. It often affects people who spend a lot of time on their feet, especially on hard surfaces like concrete, though it seems that anyone can experience plantar fasciitis.

    There are a variety of ways to treat plantar fasciitis including stretching, new shoes, orthotics, injections, ice, ultrasound, and changing your daily activities/routine. After working at the Hruska Clinic for several years now, I have become biased to believe that often, plantar fasciitis can be resolved with a home exercise program to change the way we move or function each day. If slight changes in your daily activities fail to resolve your pain within a few days or a couple of weeks, you likely need new shoes and/or orthotics.

    Because of the way our bodies are made, we all have natural, predictable imbalances. Because of who we are as individual people, the jobs we do, and activities we participate in, some people are less balanced than others. When this happens, normal mechanics at our feet and ankles may not be optimal and may lead to tension on the plantar fascia, ultimately leading to plantar fasciitis. There are occasions when we may guide you towards a new pair of shoes or we may need to utilize orthotics and ultrasound, but the thing I want you to know is that plantar fasciitis is very treatable. If you’ve been suffering from plantar fasciitis, give us a call so we can help.

  • What makes us different? Dave answers this question in his new blog…

    If you’ve looked through a Hruska Clinic brochure recently, you’re aware of our mantra “We Are Different”. I want to touch briefly on the idea that we at the Hruska Clinic are different. It is not my goal to put down other physical therapy clinics in Lincoln, Omaha, or anywhere else. In fact, I feel there are a lot of great facilities in our area with some great clinicians, many of whom I know personally and respect. That being said, I take great pride in our clinic and I do feel we have something special here.

    One thing that I believe sets the Hruska Clinic apart from the other fine clinics in our area is the fact that the way we practice is supported by the science of Postural Restoration (PRI) which was developed here in Lincoln by Ron Hruska. Ron also founded The Postural Restoration Institute, which is an organization that teaches this science to PTs, athletic trainers and other health professionals across the country. Because of the Postural Restoration Institute we have scientific reasoning for the programs we develop for our patients. If you were to come into our clinic with, for example, back pain or sciatica, we would perform a series of objective tests to logically and scientifically guide us through a PRI program that would be tailored to you, the patient. I can’t tell you how many times I’ve talked with therapists from around the country who’ve stated their frustration with the lack of scientific reasoning or objective justification for the programs they create for their patients. Traditional physical therapy treatment plans often are comprised of a generic protocol for various pain issues without the ability to truly tailor programs to individuals.

    At Hruska Clinic, we not only serve our local community, but we also treat patients from all over the state and even many patients from around the country. You know you’re doing something different when you have patients drive or fly to Lincoln, Nebraska from every corner of the country, and even from outside the US, for your unique services. Some of those patients come here on their own accord, but many are referred to us by friends, family, or other health professionals, including their previous physical therapists.

    This is just a small taste of what makes us different. I think we would have to write a book to go into all the details that make us different, or to explain, for example, how we occasionally understand the need to integrate with other health professionals such as a podiatrist, dentist, or optometrist in order to help some of our patients achieve their physical therapy goals. Whether you’ve had physical therapy in the past somewhere else, or are considering coming here for your first ever physical therapy treatment, I think you’ll agree there is something special, something different about the Hruska Clinic.

  • Dave’s new blog explains SPONDYLOLISTHESIS…

    One of the reasons it is important not to take a diagnosis of spondylolisthesis lightly is because there are a network of nerves that travel from your brain downward through a canal in your spine to their various destinations. Therefore, if the integrity of your spine is compromised because of spondylolisthesis, there is risk of damage to some of those nerves depending on the degree or grade of slippage. When people who’ve received a diagnosis of spondylolisthesis hear this, they begin to think they have to be super cautious for the rest of their lives and give up many of their preferred activities. Although you want to make intelligent choices, life as you’ve known it, usually isn’t over.

    Our backs have a natural lordotic curve in the lumbar region (this means there should be some depth to your lower back); A person can have excessive lumbar lordosis, (i.e. too much depth in the low back; compare the photos of the two girls below), which, by nature of the structure of our vertebrae, can be one contributing factor for a person developing spondylolisthesis. You don’t have to have excessive lumbar lordosis to develop spondylolisthesis, but a combination of excessive lumbar lordosis with spondylolisthesis is bad because not only have you lost the natural prevention from forward translation of one vertebrae on another (when you have spondylolisthesis), but now also have increased forces that promote forward movement of one vertebrae on the one below it because of the position you’re in. Therefore, a key component of a physical therapy program for a person with spondylolisthesis is to make sure that you have an appropriate amount (not excessive) of lumbar lordosis. In conjunction with proper spinal positioning, you need to have stabilizing abdominal activity. Frequently, people with excessive lumbar lordosis have tight and/or overactive hip flexor muscles (muscles on the front of the pelvis that, among other things, affects the position of your pelvis, legs and spine), and therefore, these muscles should not be ignored when you have spondylolisthesis. At the Hruska Clinic, your program will focus strongly on your posture with a repositioning program to help reduce the harmful forces on your spine if you have spondylolisthesis. This is a very brief synopsis of spondylolisthesis, but I hope you’ve found it informative and helpful.

  • Do you participate in extreme workouts? Here are some thoughts from Dave in his new Blog…

    What is it about people that make us love extremes? I’m not sure that I know the answer to that question but I’ve come to realize it is why we’re in business here at the Hruska Clinic. (If you’ve been reading some of the other blogs on our website, you’ve come to realize that we’re all right side dominant people, and when we’re too far out of balance-often to an extreme, you have a problem). I was recently discussing the topic (of extremes) briefly with one of my patients and we both wondered what drives people to participate in extreme training regimens that are beyond their ability to perform correctly. Often, patients come into the clinic after starting any number of these extreme programs, yet they don’t necessarily see a correlation between their new extreme activity and their pain. It’s not that participating in challenging activities has to be a bad thing, but where you may get into trouble with some of these activities is when your muscular balance is so far off, that you can’t do those activities without compensating. Another reason people may compensate in a way that will lead to pain is by trying to do an activity that is generally too challenging for you, or trying to lift more weight than you can handle.

    For example, maybe you can normally handle doing dumbbell curls with a pair of twenty five pound weights, but if you go through an aggressive cardiovascular and/or resistance training routine and finish it up with dumbbell curls, you may only be able to handle ten or fifteen pounds at that time without cheating. The next thing you know you’re jerking your shoulders up and back and trying to get momentum to curl up those weights. Guess what? You’re compensating and putting yourself at risk of injury. Also, you’re not even getting the intended benefit from the activity. Can you believe this is coming from a guy who used to participate in competitions to see how much weight I could lift? Realize that I always worked out with people who wouldn’t let me lift a weight if I couldn’t do it right. I’ve never experienced a training injury because of this attitude.

    So what’s the message today? I think being active and doing challenging activities can be a very good thing, but be sure if you do any activity, especially one of the many extreme workout options that are available today, that you do so with control over your body and the activity, or you’ll likely find yourself needing our services.

  • When is it ok to add squats to your workout? Dave addresses this topic in his latest blog…

    Often I have patients who enjoy lifting weights ask me: “When can I squat again?” They ask because they’ve been educated to know that a large part of the reason they’re in our clinic seeking treatment is because they have a forwardly tilted pelvis and a strong tendency to arch their backs backward, and that doing resisted squats with a barbell on their shoulders will make it difficult to get out of this position. This is because when they do squats with a barbell on their shoulders, they have to arch their backs, which is not something we want when going through a PRI physical therapy program. I think many postural restoration therapists would tell a weight lifter that they should NEVER perform a resisted squat. As a former power-lifter, a former patient at the Hruska Clinic, and now a certified PRI therapist at the Hruska Clinic, I have a slightly different perspective, though don’t misunderstand what I am about to say. Don’t tell people that Dave at the Hruska Clinic says its okay to squat, if you don’t inform them of the parameters REQUIRED before I allow them to squat.

    If a person cannot perform a full functional squat (See photo 1) without cheating, and without falling over, they have absolutely no business squatting with a barbell on their shoulders. I also feel it is important for a person to be able to touch their toes (See photo 2) without straining and without stretching their hamstrings before they can squat. The reason is because if you can’t do a full functional squat or touch your toes then you still do not know how to live without depending on your back and you’re only going to make matters worse if you squat with a barbell on the shoulders.

    After my patients have reached these parameters, I still make suggestions as to what they could do to work their legs aggressively while minimizing back activity. I suggest squatting on a platform holding dumbbells (See photos 3-5). If you look at the pictures provided you’ll see that my back is rounded as I perform this squat with the dumbbells. Try to do controlled reps…you don’t have to go super slow, but don’t rush through them either. You should also keep your weight through your heels and don’t rock forward over your toes. This will help you get a great sense of your quads and glutes working. Taking short breaks (30-45 seconds rather than, say, several minutes) between sets will help to intensify your workout. Another option for working the legs would be walking lunges (See photos 6-7). I would suggest that you be sure your heels strike the ground before your toes or forefoot, and maximize pushing your weight through your heels rather than your toes/forefoot throughout the exercise. The key to keeping your back activity to a minimum is to stay rounded through your back. Try reaching for or touching your toes as you do this. If this doesn’t sound like much of a challenge, try walking a hundred yards this way…go get on a local football field and see how your quads and glutes feel afterward. If you’re trying to minimize your reps and maximize your leg strength say for football consider hip sledding, seated leg presses or supine (on your back) leg presses as you’ll be less likely to overuse your back compared to squatting with a barbell on your shoulders.

    With this all said (not forgetting that you ALWAYS need to be able to perform a full functional squat and be able to touch your toes) I do feel for a select few individuals (i.e. a football lineman come to mind) squatting is an appropriate exercise. Few others in my opinion really have a need to squat with a barbell on their shoulders. If you truly can perform a quality functional squat without compensation, can touch your toes, and you decide to do barbell squats, you’d better frequently be checking to see if you can maintain these parameters or you’re increasing your risk for injury.

  • Dave says “Scratch No Pain No Gain from Your Vocabulary”... Read why in his latest blog entry.

    I’m sure most people have heard the phrase: No pain no gain. As a physical therapist I have noticed for several years the meaning of that phrase has been lost. Occasionally when I teach patients activities for their physical therapy program it is clear that they are experiencing a reproduction of the pain we are working to overcome. On numerous occasions I’ve heard a patient say, “No pain no gain, right?”. The answer to that question is “wrong”. A better phrase in my opinion would be “No effort no reward”. Pain should not be a part of the equation. Don’t get me wrong, when you use some muscles more effectively because of a new exercise program or even occasionally from your physical therapy program, your muscles may become sore, sometimes to the point of feeling like a cramp. Sometimes that soreness/stiffness can last for days.

    When we guide our patients through a program there are specific muscles you should feel working (and some you should not), but when the word pain is associated with those activities we have a problem. If you’re actually experiencing pain beyond what I’ve just described from an activity, I would argue that you’re doing the activity wrong…and it is your therapist’s job to help you learn to do the activity correctly. Once we understand that, we can now start making changes in your life that can help take away your pain.

    Train smart and train hard.


  • Today's Challenge - how do you sit?

  • Fall Into Some Good Habits - Dave’s latest blog entry…

    Yea, I know it’s cheesy, but hey it works. With fall comes a little outdoor work, and one of the biggies is raking leaves. In our clinic we try to help patients understand the importance of overcoming right side dominant tendencies which can be seen when you rake. With rare exception, when people rake, they stand with their weight shifted to the right and position the right hip behind the left. Next, we pull the rake in front of ourselves from right to left by rotating through the trunk to the left. Because of the way our bodies are made it is just easier and more natural to do it this way, but it also feeds into a pattern that increases imbalances in our bodies that lead to dysfunction and pain. Therefore, we recommend that you try to change things up by doing just the opposite. Try it. You’ll find it awkward at first, but with some diligence you’ll get the hang of it and likely find you have less back discomfort after you rake this year.

    Along with the idea of shifting your weight to the left, positioning the left hip behind the right hip and pulling the rake in front of you to the right, I suggest you also try to use a broom this way, and in a few months try to shovel snow the same way. And if you’re a gardener who will be digging up your garden this fall to prepare for next spring, try to support your weight on your left leg as you push the shovel into the ground with your right foot, then turn the shovel over clockwise with your right hand being closer to the shovel head than the left hand. I hope this helps you experience less discomfort this fall with your outdoor chores.

  • Are You Really Cross-Training? Dave’s Latest Blog Entry Will Help You Answer This Question…

    Often, we see athletes in our clinic who are involved in a variety of activities and they wonder why they have pain. After all, they’re “in shape”, and often they’re young and otherwise healthy. Many of them report that they are sure to cross-train because they’ve heard cross training helps to prevent injuries and over training. Part of the problem is their understanding of real cross training. If your idea of cross training includes running, biking and weight lifting, then you’re missing something very important. It’s something we try to stress to our patients, and you may have read about it in some of our other staff’s writings. It’s the fact that our bodies can and therefore should be worked through multiple planes of motion.

    I think sometimes we as therapists think this idea is self explanatory, but may in reality confuse many of our patients or readers, so let me explain. Think of the different planes this way: Imagine you’re standing and do any of the following moves: 1) Walking straight forward (or backward) is one plane of movement we call the sagittal plane, 2) Side Stepping either left or right is another plane called the frontal plane, and 3) Rotating either left or right (this can be your whole body, or can occur throughout your body. i.e. at your hips, trunk, neck) and is called the transverse plane. Ideally, when you are training for any sport, it is in your best interest to work all of the planes of motion. If, as stated above, you’re only running, cycling, and weight lifting, you are neglecting the frontal plane and have minimal transverse plane motion.

    I would suggest any of the following activities to make your training more dynamic through multiple plane of motion: tennis, basketball, volleyball, roller blading/skating, racket ball, throw a Frisbee with a friend, play catch with a football/baseball (just don’t throw the ball/Frisbee directly to your friend, but rather chase it a little). Don’t be limited by these few suggestions. Come up with some activities that you can do with your friends/family that make your body work in multiple directions.

    Train smart and train hard.


  • Is the Bench Press Part of Your Weight Training Program? Then Read Dave’s Recommendations…

    A couple of weeks ago, I wrote about my perception of problems associated with sports performance and weight training. I shared my thoughts on traditional barbell squats, and gave some suggestions for alternative ways to strengthen your legs. Today, I would like to touch briefly on another common lift that is performed, and that is the bench press. A couple of thoughts I have with the bench press are: 1) If you’re going to perform bench presses, I would like to see you place your feet on the seat of the bench rather than on the floor. What this will do for you is reduce or eliminate extension through your back (refer to my previous blog entry for the problems with too much back extension). It will also decrease your stability on the bench and make the lift a more dynamic activity. Sure this will reduce the amount of weight you can safely manage, but I believe you will actually reap much bigger rewards in terms of sports performance; and 2) Don’t forget to work the muscles that oppose the pecs that you’re developing with the bench press. If you don’t incorporate activities that draw the shoulder blades back, you will develop forward head and shoulder posturing that can lead to neck and shoulder problems which will certainly not boost your sports performance. Until then, continue to check out blog entries from all of the therapists here at the Hruska Clinic.

  • A Physical Therapist’sThoughts on Sports Performance and Weight Training…

    Now more than ever, weight lifting has become an integral part of sports training programs at all levels, including in our high schools and junior high/middle schools. I appreciate the idea of integrating weight training into sports to maximize strength and performance, but unfortunately, like many things, we have taken it to an unhealthy extreme. It is my opinion that weight lifting, especially in the high schools, has become more a focus of lifting the maximum amount of weight possible at all costs, regardless of form and control, so we can place our names on the wall of the training room at school. I have to admit that more than twenty years ago when I was in high school it was the same way. I loved the feel of a heavy barbell across my shoulders when squatting, or a bar that starts to bend when dead lifting or bench pressing, but somewhere along the line things have changed. I don’t remember athletes injuring themselves weight lifting when I was in high school, but today we see a lot of young athletes coming into the clinic with back injuries from squatting, dead lifting, and power cleans. As of yet, I haven’t seen any pec tears from bench pressing, but I assure you, if our attitude on weight lifting doesn’t change, it will be a common occurrence.

    In our practice, there are certain tendencies or patterns that we see in essentially all people. Some of those tendencies are for people to be extended through their backs (pelvis is rotated forward causing you to compensate by arching backward through the spine). This leads to pain from strained back muscles, or other injuries such as a spondylolisthesis (this is when one of your vertebrae becomes injured leading to instability of one vertebrae on another, thus allowing the vertebrae on top to shift forward on the lower one & is a serious injury). Improper lifting or even simply lifting excessive amounts of weight can increase this tendency, and lead to even greater degrees of injury, pain, and dysfunction. The power lifts for your back and legs which include squats, dead lifts, and power cleans, all by nature require some back extension and therefore increase the risk for injury as the weight is increased.

    Because athletes want to increase their power and overall sports performance, I would like to suggest the following: First, before you embark on or continue with a weightlifting program, I believe you always need to be able to perform a full functional squat where you can keep your feet roughly shoulder width apart and parallel to each other (not turned out or in). You also need to be able to keep your weight through your heels, reach forward and down slightly with your arms to round your back, and then squat without letting your knees turn out as you squat low. You should also be able to hold this position as you breathe repeatedly in through your nose and out through your mouth.

    If you can do this, it would then be appropriate to begin a strengthening program that might consist of the following dead lift or squatting exercises: Stand on a platform while holding dumbbells with your palms facing in, and then perform multiple sets and repetitions of squats while keeping your back rounded and weight through your heels. Another alternative for squatting would be single leg squats where one foot is resting on a bench or chair behind you while the other is on the floor. Keep your back rounded while you perform several sets and repetitions of squats. When doing this, you must keep the knee of the leg that is working forward, rather than letting it turn in or rotate out. Also, you should keep your weight through your heel as you reach down to touch your toes with each rep. You can alternate legs after every ten reps or so.

    These are just a couple of options, but the key is keeping your back rounded, performing multiple sets and reps and not getting caught up in “maxing out”.

    Train smart and train hard.

  • Hamstrings - What Every Runner Should Know About Stretching (or Not)

    Runners are known to be very ambitious and dedicated athletes. They are also known to stretch a lot, especially their hamstrings. For many if not most runners, the more they stretch their hamstrings, the tighter they feel. There is good reason for that. If you would like some insight into the problem with overstretching hamstrings from a physical therapist’s perspective, click here. You might be surprised by what you learn. Our next entry will focus on the difference between static (example typical hamstring stretch) versus dynamic warm-up for preparation for running.
    Train hard and train smart!

  • Dave has written an article for Performance Conditioning, Volleyball edition, on the hamstring muscle. To read his article, click here.