Is Aquatic Exercise Therapeutic?
Don’t assume water aerobics or exercises such as swimming are always therapeutic for your back. In cases of spinal instability, the buoyancy provided by submersion in water can add to instability. Therefore, all back patients are cautioned to test the spine’s tolerance. Start at waist height submersion; slowly walk into deeper water. As long as there are no residual increases in your back symptoms, activity may continue. Transition slowly out of the water, recognizing that you are placing weight back onto the spine.
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Swing into Golf: Part 1
If you are an avid golfer or a “want to be” golfer but have become frustrated with inconsistencies-shot to shot or scores week to week-then practice alone may not be your downfall. To develop a consistent swing and golf game you must have good biomechanics.

When addressing the ball, look at the relationship of the pelvis (hips) to the feet. A significant pelvic rotation to the right for a right-handed golfer drives an excessive uncontrolled backswing and predisposes you to slice the ball. Excessive left pelvic rotation predisposes you to uncontrolled follow-through and the potential to hook the ball.
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Swing into Golf: Part II
To improve your golf game, upper trunk biomechanics need to be centered over the pelvic base. Excessive shoulder drop on the right for a right-handed golfer will limit upper trunk rotation to the right and force you to drive the club head into the ground or loft the ball resulting in decreased distance. If you are right-handed and the right shoulder is excessively high, you are likely to top the ball resulting in a low distance roll.

Shoulder drop when addressing the ball should not exceed the width of your clenched hand. If you have a significant shoulder drop your short game will be more consistent than your long game.
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Tennis Part I
Like golf, tennis is a game of athletic performance, skill, and strategy.  Skill and strategy are influenced by practice and competition, athletic performance is influenced by joint biomechanics.

There are four key components of biomechanics that must be integrated for top athletic performance:
  1. Position and mobility of the lower extremities (feet/legs)
  2. Position and mobility of pelvic to trunk rotation in relation to the lower extremities
  3. Position and mobility of the arm relative to shoulder girdle and trunk
  4. Position and mobility of the wrist and hand with the grip to control face angle of racquet
When considering components #1 and #2 above, if body weight is carried on the heels, the player struggles to stay on the balls of their feet and keep mobile.  If weight is distributed on the forefeet, the player may struggle to step back on a shot and feel confident in transferring weight. With component #3, if a right-handed player lacks full rotation to the left, a two-handed backhand is easier to perform as it forces greater trunk rotation.  However, it will result in decreased reach of the racquet.
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Tennis Part II
Upper trunk and extremity (arm/hand) biomechanical influence:
A. Increased stability of the shoulder girdle allows for free movement of the arm and adds power to any stroke.
B. A shorter lever (shortened arm position) or a shorter racquet increases control but decreases power of a shot.
C. Contrary to popular belief, stroke power is more a product of body leverage than body weight.
D. Mobility of the wrist/hand in controlling angle of racquet face (open-up/closed-down) has a greater influence on the ball’s path than the power behind the stroke. Limited arm/wrist/hand mobility can lead to tennis elbow and reduce leverage effectiveness.
E. Increase in stroke accuracy comes through repetitive movement patterns that are unrestricted and automatically reproducible as a result of proper joint biomechanics.
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Soccer and Biomechanics
Biomechanics can influence a player’s ability to execute necessary skills for soccer: running, dribbling, shooting, blocking.

Biomechanical Influences:
1) Playing Field Preference
An open (rotated) pelvis on the left will tend to gravitate a player to the left side of the field and vice versa.
2) Dribbling Ease
Dribbling right/left - in/out side of the foot is influenced by pelvic, hip, knee and ankle biomechanics.
3) Stamina/Endurance/Speed
Good biomechanics requires less physical effort enhancing all three elements of a player’s performance.
4) Balance and Recovery
Optimal biomechanics tends to improve balance and recovery from a fall, expediting
return to play.
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Bowling – It’s Still a Ball!
Bowling is one of many sports that has lasted generations, drawing thousands of newcomers and occasional bowlers like me back to it every year. It is a dominant one-sided sport. It requires a balanced body to coordinate a weighted ball on a long lever arm during the approach to allow an accurate release.

Key factors influencing balance:
1) Weight and finger placement in/on the ball: If the ball is too heavy, added weight can lever the trunk into increased sidebend and backward rotation resulting in a gutter ball (to the right if right-handed and left if left-handed).
2) Lever Arm/Movement Path: The length of the arm, degree of bend in elbow/wrist, and directional release of ball plays a role in hitting one’s target (pins). To increase consistency and score, focus on each aspect separately, then together.
To score high, combine the right ball with a smooth lever arm.
Good luck!
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Hockey – Pucker Up!
Hockey requires repetitive use of a dominant hand/upper trunk. In the clinic, we frequently see trunk muscles that have developed asymmetrically in hockey players due to repetitive one-sided use. In a right-handed player, the trunk is predisposed to a pattern of sidebend and rotation back to the right. Vice-versa if left-handed.

Prevention is good medicine:
Skating/running with the stick in the non-dominant hand during conditioning drills (vs. shooting drills) may assist trunk muscle balance.
Using the non-dominant side in other sports or weight training on the non-dominant side may help negate asymmetry. Stretching trunk muscles before, during, and after play is great intervention. Specific stretches can elongate short/tight trunk muscles and increase trunk symmetry.

Look in the mirror – What do you see?
Could you hold a hockey puck on the top/outside cap of each shoulder and walk several feet without dropping a puck? Try it! How good are your biomechanics in controlling posture to maintain trunk and shoulder balance?

Is the puck staying up (PUCK-ER UP) or falling down?
Good luck!

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Hunting: How to minimize risk to back
1. Positioning in tree stand
Secure stand and safety strap body to stand. Due to back immobility in stand, change angle of hips and knees every 15 minutes to provide back relief.
2. Removing Game
To minimize strain to the back, place game on tarp or makeshift sled to drag with rope placed around hunter’s waist. If two people are available, tie animal’s legs around a tree limb and brace limb on top of hunters’ shoulders to walk game out.
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A Helmet in Play will keep the Doctors Away
I can’t stress enough the importance of wearing a protective helmet for active participation in competitive or leisure sports. Studies have proven that head traumas can be minimized, and in many cases, prevented if a helmet is worn at time of impact.

The most recent area of concern comes with skiing and snowboarding. Falls onto the frozen ground as well as collisions with unyielding trees and lift poles or even other skiers can cause serious injury. The body is quite forgiving when it comes to most bodily injuries, but that is not the case with head traumas. Get a helmet today!
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Training/Racing Tips
Everyone who has ran a race or trained for one knows that being prepared is everything. As race day approaches and the months dwindle to weeks, the weeks to days, and the days to hours, the starting line is now in sight. Many rehabilitation goals are set and met every day. Few, however, compare to the milestone of competing in a race. In order to get to the finish line, though, it is imperative to stay on course and avoid any changes in routine that could affect your performance.

Race Preparation Checklist:
  1. Make sure your race footwear is comfortable and lightly broken in. Even though the shoe name and style may be familiar, shoes may vary slightly..
  2. Wear race attire that is comfortable and easy to remove if it hinders your performance.
  3. Make sure your motion is symmetrical in your lower and upper limbs and that your gait is rhythmic.
  4. If you are a student/patient of BCT, perform your checks and corrections the night before the race and again in the morning prior to racing.
  5. Once the race begins, attitude is the key to connecting the starting line to the finish line.
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Cycling is Hip!
With the recent surge in interest of the Tour de France, patients have asked if the injuries sustained during the race could benefit from BCT. There is no question that BCT could maximize peak performance of all joints and would be of tremendous benefit to all riders.
Is the performance of a joint that has sustained a significant fracture beyond BCT help? The answer is no.

If the forces are great enough to separate bone, they are great enough to displace the joint position and all joints that are directly and indirectly connected to the fractured site.

Often, with a hip fracture, there is significant rotation of the ilium relative to the lumbosacral spine. Changes can also occur at the tibiofemoral joint and the talocrural joint. Secondary changes can occur at the shoulder girdle relative to changes at the pelvic girdle.
Visual changes are apparent with a trained eye. More importantly, biomechanical changes are apparent with a trained clinician’s manual assessment of joint glides and arthrokinematic performance.

Cycling can be HIP! – but not with a dysfunctional hip!
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Cycling Tips
The American Physical Therapy Association's web site ( lists tips for achieving a good bike fit with details to set height, foot position, and overall riding posture.

There is no question that BCT can maximize postural positioning and enhance cycling performance.

Balancing the body relative to the bike is important. The ability to find that point of balance was often achieved by “letting go of the handle bars”. Safety is the utmost concern and so “letting go” is not a recommended option.

To achieve a balance between you and the bike, keep your center of gravity low and centered over the bike frame aligning the ball of the foot, knee at peak bend, and the shoulder to the pedal in the down position.

Trunk weight should be equally distributed over the seat with minimal pressure on the handlebars other than for balance and steering control. A light touch is the best touch.
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