Friday, December 28, 2012

The Janda Approach


GRIP Approach is pleased to present ‘The Janda Approach To Musculoskeletal Pain Syndromes’ as taught by his long time pupil Robert Lardner, PT


“Protective reflexes serve as the basis for all human movement and dominate in Pathology” – Janda 


Vladimir Janda Md, DSC is considered to be the father of Czech rehabilitation and one of a handful of physicians responsible for how the rehabilitation field was shaped internationally. He systematically defined characteristic and predictable muscle imbalance syndromes in relationship to the adaptations of the CNS and the ensuing chronicity – something we commonly call ‘Janda’s crossed syndromes’. He viewed the sensory motor system as an indivisible unit and stressed that effective treatment and the rehabilitation process would have to respect this unity and its implications. His teachings influenced many people, including Robert Lardner who co-authored the book ‘Assessment and Treatment of Muscle Imbalance – The Janda Approach’.




This unique 2-day lab intensive will introduce the main theories, concepts, and research of Dr Janda. Significant time will then be spent in hands-on lab learning diagnosis according to Janda via visual inspection, gait analysis, movement patterns, muscle quality, and trigger points. The final half of the seminar will be spent learning Janda’s treatment methods, normalization techniques, activation techniques, and sensorimotor training. This intensive promises to greatly enhance your understanding and abilities of treating musculoskeletal pain syndromes, and offer many additional clinical pearls from Robert Lardner.

For details and registration visit our website.
For more information about Dr Janda, visit the website of his US students and read this tribute paper.

Robert Lardner was born in Nigeria in 1961. His first career was as a professional ballet and modern dancer after studying at the Rambert Ballet Academy outside London, England. Going back to University he graduated from the Department of Physical Therapy, Lund’s University, Sweden in 1991. He has worked in several in- and out- patient rehabilitation facilities in Sweden prior to moving to the United States in 1992.
Having been a staff physical therapist at McNeal Hospital, Clearing Industrial Clinic, and a physical Therapy supervisor at Mercy Hospital, He has also been in charge of physical therapy services at a number of private outpatient and sports clinics.
He has studied extensively with Professors Janda, Lewit and Kolar from the Czech Republic who are pioneers of functional rehabilitation and manual medicine and who have strongly influenced his philosophy and practice of physical therapy. He is a member of the International College of Applied Kinesiology (ICAK). Currently, he is in private practice in Chicago and teaches various rehabilitation seminars throughout the United States and Europe.

Monday, December 3, 2012

Dr Pavel Kolar presents his Dynamic Neuromuscular Stabilization (DNS) in a 4–course Chicago Summit!​


We are pleased to announce that Dr Kolar and his faculty will be presenting DNS A, B, C and Sport Course 1 in Chicago in October 2013. The principles of DNS lay the groundwork to understanding habilitation, which leads to excelling at rehabilitation. The attendee will leave with a unique skill set, to diagnose and treat patients with deviations from ideal development. These deviations from ideal present in our everyday patients - in adults, children, athletes, and those with neurological injuries. This is an important opportunity to learn an approach that not only stands on its own, but also strengthens the diagnosis and treatment methods we currently employ.









Monday, November 26, 2012

The Mighty Mighty Peronei


As discussed in 'Reciprocal Implications At Play In Gait', we need to have a good foot-ground relationship to create a biomechanically appropriate blueprint for movement. Quite frequently aberrant development in the womb and in the first 4 years of life leaves the adult with a few bony malalignments or functional insufficiencies. When these deviations from ideal are in the foot, leg, or hip they can greatly disturb the foot-ground relationship and set off a cascade of poor neuromuscular control.


Here is a pedograph of a poor foot-ground relationship. We see an uncompensated forefoot varus, increased pronation, and slew of other findings in the foot.

Gray's

There are two obvious ways to solve this problem.

Gray's Fig 439 1) Orthotic therapy to allow the ground to meet the foot in a better way.
 2) Improve neurologic control of the foot to meet the ground in a better way.

The hotly debated topic of foot orthotics will be discussed in a later post, but for now lets focus on improving the control of the foot.

When a patient cannot achieve a firm base of support under the 1st mpj they will be at risk for hallux abducto-valgus, bunion formation, hyper-pronation injuries, and the list goes on. One of the muscles that helps to create the medial tripod is peroneus longus. The peroneus longus plantar flexes and everts the ankle, and based on its distal attachment also strongly plantar flexes the first mpj to support the medial tripod. When this muscle is not functioning properly we see a weak medial tripod, hyper pronation, genu valgum, and increased occurrence of inversion ankle sprains.

To test if the strength of the peroneus longus- completely plantarflex, abduct and evert the foot. While bracing the calcaneus and contacting the lateral foot, try to invert and adduct the foot against the patient’s resistance.

Beardall Clinical Kinesiology

A great exercise we use to get the peroneus longus firing is called the peronei pump and is demonstrated in the video below.




This exercise requires the patient to put the peroneus longus muscle into its shortest and strongest position (plantarflextion/abduction/eversion of the foot with plantarflexion of the 1st mpj). The foot is then slowly pumped between full plantarflexion and full dorsiflexion while all other values are maintained. If done correctly, the patient will feel a deep ache in the lateral leg as the peronei musculature clears fascial restrictions, activates full contraction, and eventually fatigues. This is typically achieved within the first 10-20 repetitions or within 1 minute. By doing a peronei pump exercise a few times daily, the muscle becomes easier to access in all phases of gait. This is not a perfect representation of the peronei function during gait, so further “gait training” may be needed to incorporate the mighty mighty peronei.