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Dr. Ace Casiano

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Dr. Ace Casiano

Dr. Ace Casiano Ace combines his manual techniques and training experience to help his patients move away from pain!

03/20/2019

Had an awesome time this weekend at 4Point Taekwondo with a mix of parents, novice and master athletes and coaches, all learning about moving better for joint health, injury mitigation and improving sport performance.

Thanks again Kevin and 4Point Taekwondo for hosting!
@ 4Point Taekwondo

02/26/2019

from the mind of ...thanks for this doc!..one can also wish for hair that perfectly falls while treating pts lol

• • • • •
🕑Tissue adaptation to mechanical force over different time-scales 🕙 . . .
⠀⠀⠀⠀⠀⠀⠀⠀⠀
Connective tissue responds to mechanical loading differently, depending on “time under tension”. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
The immediate impact of sudden (milliseconds to seconds) mechanical force causes a rapid redistribution of cytosol through a dense meshwork of cytoplasmic fibers and organelles. After removal of this brief force, the tissue will return to its original state (ie no change in in tissue structural composition)
⠀⠀⠀⠀⠀⠀⠀⠀⠀
Mechanical force sustained for minute to hour time-scales leads to cellular changes in structural composition of tissue, via protein turnover and cell deformation 🦠Tissues begin to adapt structurally to improve its ability to distribute stress.
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At the furthest end of the spectrum, an organism (us) must generate and retain its complex 3D form in the presence of gravity. For forces sustained for days to years time-scales, the combination of stable boundaries and patterned tension generation can robustly guide tissue morphogenesis 🗓 ⠀⠀⠀⠀⠀⠀⠀⠀⠀
What is most interesting is that these tissue responses are similar for both internal (ex. Stretch) and external (ex. Manual therapy) force application 👐
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(Wyatt, Baum, Charras. A question of time: tissue adaptation to mechanical forces. Current opinions in cell biology. 2016)
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⠀⠀⠀⠀⠀⠀⠀⠀⠀ . . .
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01/30/2019

Thanks for the references and for the infographic 👌
• • • • •
💥𝐓𝐡𝐞 𝐀𝐦𝐚𝐳𝐢𝐧𝐠 𝐁𝐨𝐝𝐲💥
———
The body responds positively to progressive loading. Don’t spend too much time resting...get out there and MOVE!
••••••••••••
1️⃣Schoenfeld BJ, et al. Resistance Training Volume Enhances Muscle Hypertrophy but Not Strength in Trained Men. Med Sci Sports Exerc. 2019.
2️⃣Goodman CA, et al. Bone and skeletal muscle: Key players in mechanotransduction and potential overlapping mechanisms. Bone. 2015.
3️⃣Watson SL, et al. Heavy resistance training is safe and improves bone, function, and stature in postmenopausal women with low to very low bone mass: novel early findings from the LIFTMOR trial. Osteoporos Int. 2015.
4️⃣Grzelak P, et al. Hypertrophied cruciate ligament in high performance weightlifters observed in magnetic resonance imaging. Int Orthop. 2012.
5️⃣Mersmann F, et al. Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention. Front Physiol. 2017.
6️⃣Alentorn-Geli E, et al. The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017.
7️⃣Ponzio DY, et al. Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners. J Bone Joint Surg Am. 2018.
8️⃣Belavý DL, et al. Running exercise strengthens the intervertebral disc. Sci Rep. 2017.

01/26/2019

Backstage w Mike and Racheal Prince doing some treatment with Ballet BC before their final show last night.
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•

11/07/2018

Great post by

Thanks for this👌
• • • • •
[THE “PERFECT SQUAT” & SHOULD EVERYONE BE ABLE TO SQUAT PARALLEL TO GROUND? ft. The Hip Joint] 🏋🏽‍♀️🏋🏻‍♂️👀
•••
🙅🏽‍♀️ If you came here expecting to find rules on how to perform the golden squat to perfection, guess what? It doesn’t exist.
🤷🏽‍♀️ Truth is, there is no such thing as a perfect squat or ‘a cookie cutter approach’. Why? Simply because we are not all robots and designed the same from limb to limb or from one joint to another. No two people will squat exactly the same. So when you hear these supposedly “standardized cues” that “your toes must be slightly pointed out”, “your knees must not pass your toes”, or “that everyone should squat below parallel”, not saying that theses cues are wrong, but they may not be right for you. This post will take a look at one very common difference that impacts squat performance being the hip socket.
Hip specific anatomy will lead to widely different squat forms. But before we dive into differences, it’s important to understand basic hip anatomy. The hip is a ball and socket joint - where the end of our thigh bone (femur) is shaped like a ball (femoral head) and fits into the acetabulum of our hips, otherwise known as the “socket” (see image 2).
The second image is probably what you see in an anatomy text book, but swipe right to see some real life images of how the bone structure at the hips can differ from one individual to another. Keep swiping to see more subtle yet striking differences when it comes to structural anatomy. Below are a list of anatomical variations that should be taken into consideration when setting up for a squat:
1️⃣ Femoral neck angle
2️⃣ Length of femoral neck
3️⃣ Version/torsion of femur
4️⃣ Combination of femoral variations
5️⃣ Hip socket orientation
6️⃣ Depth of Hip Socket
Now, the variations that exist are numerous, and often structural anatomy is overlooked in coaching. For example, when someone has difficulty squatting “ass to grass” depth, or perhaps their initial set up is in a “wider than normal stance” or “squatting with your feet turned out” we may be tempted to jump on a band wagon

10/24/2018

Kara was experiencing clicking on her right shoulder that is giving her grief during workouts and randomly day to day. After an assessment and hands on treatment, it's important to solidify and train her to control the new range of motion she now has access to.

Using FRC principles (Functional Range Conditioning), Kara is cued to work on her end range retraction and axial rotation to help centrate her shoulder joint and mitigate the clicking she's experiencing. Squeezing the yoga block and the lacrosse ball also help create irradiation and isolate the joint being worked on.
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•

10/24/2018

▪Hardware Upgrade▪

Reviewing some
material in an FRC favourite position of all time - the 90/90.
I'm working on RAILs(regressive angular isometric loading) on my right hip. I focus on lifting the back foot off the floor and embrace the suck on the glute crampcity.
All the movement 'patterns' coached and 'functional movement' work done (software) will pretty much be limited my the capacity of the joints and surrounding tissues (hardware).
Try loading Windows 10, iOS 12 or any new software on a tech that is from 2005 and see how that bottlenecks performance.
Upgrade to the latest hardware and any software/game/app you throw at it, it can handle fine.
Same goes for movement - upgrade your joint and tissue capacity and the degrees of freedom with movement will improve accordingly.

09/25/2018

[DO WE PRACTICE GOOD FORM OR MULTIPLE FORMS?]
• • • • •
There is no such thing as good or bad form, or posture. There is no right or wrong “exercise”. What does “functional exercise” even mean, and what is this “core” thing everyone keeps talking about whilst planking or crunching?! My newsfeed is blowing up with these so-called “fitness coaches” and “rehab experts” putting all type of crap out there. For 1 of 2 reasons, maybe both
1. Pure ignorance
2. Trying to grow their following by giving people what they think they want
_
The only bad posture is the posture we spend too much time in (shout-out Andreo Spina). Life is not perfect posture, and neither is sports
As human beings, our movement capacity should be vast. If we only stay in a small handfuls of postures we aren’t fulfilling our movement potential, and we’re creating more dysfunctions and weaknesses because of it. Your body will devolve rapidly
_
If you always hammer down the same posture, even if it’s “good posture”, you’re only creating strength and neurological control in that specific posture. So when your body slips out of that particular shape, weakness and injury is the outcome - and that’s not a good sign
_
There is no such thing as a functional exercise, just functional (or non-functional) joints that can fulfill movement potential. If your joints can’t successfully control a range of motion that is necessary in your daily life, you should probably make that a priority for your training practice
_
So in conclusion, is it that you need to practice good form (and never lose it, ever)...or, practice multiple forms.
_
How do we practice in those ways? Well, it’s going to take a philosophical change first and foremost. Understanding our biology and neurology is important
If you do not know how to train in such ways, find those who do.
_

09/18/2018

Another one 👌
• •
🔬📚
Low back pain: best-evidence diagnostic rules.
💭
Clinical findings are used to give an initial diagnosis to patients with low back pain and related leg symptoms.
💭
Diagnostic patterns of signs and symptoms from history and physical examination may assist the explanation of the origin of pain and in directing treatment at the painful structure.
💭
Peterson, Laslett, and Juhl (2017), developed clinical diagnostic rules from best-evidence to identify common patho-anatomical disorders in the lumbar spine; .
💡💡
RESULTS
Intervertebral discs
-Centralization of symptoms
💡
SI joint:
-No centralization
-Dominant pain in SIJ w/o tuber area -3/5 positive physical exam findings (distraction, compression, thigh thrust, Gaenslens test, Sacral thrust)
💡
Disc herniation with nerve root involvement:
-Straight leg raise test + for referred leg pain
-3/4 positive history or physical exam findings (dermatomal pain in concordance with a nerve root, corresponding sensory deficits, reflex and motor weakness)
-Crossed straight leg raise test positive
💡
Spinal stenosis:
-3/5 positive history findings (age>48, bilateral symptoms, leg pain>back pain, pain during walking/standing, relief with sitting)
-Supplementary physical finding (improved walking tolerance with spinal flexion, relief with forward bend)
💡
Spondylolisthesis:
-Intervertebral slip by inspection
-Segmental hyper mobility by use of manual passive physiological intervertebral motion test
-Supplementary physical finding in the elderly (passive leg extension test positive)
🔬🔬
CONCLUSIONS
In some diagnoses sufficient evidence to suggest a clinical decision rule exists. In others, only preliminary evidence. Single clinical tests appear to be less useful than clusters of tests, which more accurately aligns with clinical decision making.
▪️▪️
LIMITATIONS
Search of the literature was not updated to year 2015 in all diagnostic categories.
▪️
Vast majority of patients most likely not representative of those that present for treatment in primary care.
📚📚
SOURCE:
Peterson, Laslett, and Juhl, 2017. Clinical classification in low back pain: best-evidence diagnostic rules base

09/14/2018

⚡PAIN WHEN TRAINING⚡
At first glance, pain seems straightforward - I slammed the door and my hand got caught and now my hand hurts. However, it is much more than that.
Prof. Moseley's work over the past years is a great start to understanding and reconceptualizing pain according to modern pain science.
⚡PAIN DOES NOT PROVIDE A MEASURE OF THE STATE OF THE TISSUES⚡
When something hurts a little or a lot, doesn't really tell you how things are at the tissue level
⚡PAIN IS MODULATED BY MANY FACTORS FROM ACROSS SOMATIC, PSYCHOLOGICAL AND SOCIAL DOMAINS⚡
Paying attention to pain, emotions and anxiety and your individual expectations all play a factor in the evaluative context of pain
⚡THE RELATIONSHIP BETWEEN PAIN AND THE STATE OF TISSUES BECOMES LESS PREDICTABLE WITH PERSISTENT PAIN⚡
When pain persists, the proprioceptive representation of that body part in the primary sensory cortex in our brain changes. It sort of smudges. This can affect motor control because we use these representations as maps to plan and execute movement. You need to upgrade/redraw your map regularly (daily movement, CARS)
⚡PAIN CAN BE CONCEPTUALISED AS A CONSCIOUS CORRELATE OF THE IMPLICIT PERCEPTION THAT TISSUE IS IN DANGER⚡
The implicit perception of threat determines the outputs of the brain, not the state of the tissues, nor the actual threat to the tissues. If the brain says duck, you will duck. If the brain feels sufficiently threatened, pain will be felt.
🔐CLINICAL RELEVANCE🔐
Teaching patients about modern pain biology leads to altered beliefs and attitudes about pain. When education is incorporated in management of patients with chronic pain, pain and disability are reduced.
📚Moseley, Lorimer. (2007). Reconceptualising pain according to modern pain science. Physical Therapy Reviews. 12. 169-178.

09/14/2018

Thanks for the summary
• •
🔬
Effects of reduced ankle dorsiflexion on biomechanics during landing
💡
There are a number of theories as to the mechanics behind the association between DF restriction and injury. .
💡
1. Restricted ability to pass the leg forwards over the foot to lower the center of mass during squatting movements; then compensated for via subtalar and midfoot pronation or knee valgus, both have been linked to chronic and acute injury.
2. Altering lower-extremity stiffness and landing forces is associated with reduction in hip and knee flexion and could increase GRFs or LRs as the reduced joint excursion causes increased stiffness.
3. Individuals are forced into alternative movement patterns that may be associated with various injuries.
💡
Mason-Mackay and Reid (2017) examined the effects of restricted ankle dorsiflexion on lower-extremity landing mechanics via systematic review.
📚
RESULTS:
📚
There is strong evidence that restricted DF alters landing mechanics. .
📚
There is moderate evidence that restricted DF does not reduce peak DF angle on landing and poor evidence for altered frontal plane ankle kinematics.
📚
There is moderate evidence that restricted DF alters knee kinematics and poor evidence for altered hip kinematics. .
📚
Evidence is conflicting regarding the effect of restricted DF on peak velocity GRF .
🔬🔬
DISCUSSION:
Differences in landing tasks between studies make comparisons difficult and may contribute to inconsistent results. .
🔬
Mechanical demands of a landing task change with varying height, distance, goals, and landing style, and result in participants utilizing different landing strategies.
💥💥
CONCLUSION:
Restricted DF ROM may alter landing mechanics and predispose athletes to injury.
💭
PRACTICAL IMPLICATIONS:
Reduced ankle flexibility may alter movement patterns and increase landing forces.
💭
Altered movement and greater forces may predispose athletes to injury.
💭
Screening athletes for ankle flexibility may assist in identifying those at an increased risk of injury.
📚📚
SOURCE:
Mason-Mackay, et al. 2017. Effect of reduced ankle dorsiflexion on lower extremity mechanics during

09/13/2018

THE SHOULDER JOINT IS AWESOME!
It also really sucks when things hurt.
Its mobility is second to none when it comes to degrees and planes of movement. But if neglected, it tends to be susceptible to injury. Look at all that 'stuff' on the left that have to work synergistically so you can do fun stuff like benching or fist pumping or bust out your floss moves!
All the passive stretching and soft tissue work in the world will not stabilize and protect your joints. You should regularly and actively engage your tissues in all available ranges of motion and train to expand and control those ranges to make them stronger and build resilience against injury.
In this video, I am doing low intensity glenohumeral CARS (controlled articular rotations) in between my bench press sets. I've found that I can position my shoulders better and have a more stable push after doing a couple quality rotations. Plus, I get to expose that joint in ranges I usually dont use throughout the day - most of the stuff we do daily happens in front of us and you rarely have to reach back!
I hug the power rack to keep my torso and my hips from moving. This makes me aware that I am not twisting and I do my best to direct all the motion possible through my shoulder joint.
Give it a try and let me know how it feels!
For more information on mobility, end range training, or if you have trouble with your joints, DM me or call to make an appointment.

09/06/2018

Repost from 4 WAYS YOU SHOULD BE TRAINING YOUR CORE -by Champion strength coach ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
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There are a million different exercises to train your abs/core/trunk/whateveryouwanttocallit. Regardless of which you choose, in my mind there are 4 staple ways that I think belong in every training program:⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
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1️⃣Anti-Extension - These consist mainly of plank variations, Rollouts, Fallouts, etc.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
2️⃣Anti-Rotation - The anti-rotation press or "Pallof Press" is the most popular of this category and can be done from a variety of stances with a variety of tools.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
3️⃣Anti-Lateral Flexion - Side planks and unilateral load carries are king here, but this would include anything resisting side bend.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
4️⃣Anti-Flexion - Loaded carries and Deadlifts are the top two in my mind, but anything where you have to work to avoid rounding forward will do.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
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What are your staples? Anything I'm missing? Disagree? Comment below!⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Address

18019 111 Avenue
Edmonton, AB
T5S2P2

Opening Hours

Tuesday	3pm - 7pm
Thursday	9:30am - 2pm
Saturday	9am - 1pm

Telephone

+14038089894

Website

http://ace.janeapp.com/

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Videos

@beardthebestyoucanbe [DO WE PRACTICE GOOD FORM OR MULTIPLE FORMS?] • • • • • There is no such thing as good or bad form, or posture. There is no right or wrong “exercise”. What does “functional exercise” even mean, and what is this “core” thing everyone keeps talking about whilst planking or crunching?! My newsfeed is blowing up with these so-called “fitness coaches” and “rehab experts” putting all type of crap out there. For 1 of 2 reasons, maybe both 1. Pure ignorance 2. Trying to grow their following by giving people what they think they want _ The only bad posture is the posture we spend too much time in (shout-out Andreo Spina). Life is not perfect posture, and neither is sports . As human beings, our movement capacity should be vast. If we only stay in a small handfuls of postures we aren’t fulfilling our movement potential, and we’re creating more dysfunctions and weaknesses because of it. Your body will devolve rapidly _ If you always hammer down the same posture, even if it’s “good posture”, you’re only creating strength and neurological control in that specific posture. So when your body slips out of that particular shape, weakness and injury is the outcome - and that’s not a good sign _ There is no such thing as a functional exercise, just functional (or non-functional) joints that can fulfill movement potential. If your joints can’t successfully control a range of motion that is necessary in your daily life, you should probably make that a priority for your training practice _ So in conclusion, is it that you need to practice good form (and never lose it, ever)...or, practice multiple forms. _ How do we practice in those ways? Well, it’s going to take a philosophical change first and foremost. Understanding our biology and neurology is important . If you do not know how to train in such ways, find those who do. _ #BeardTheBestYouCanBe #functionalrangesystems #frcms #controlyourself #calisthenics #mob

⚡PAIN WHEN TRAINING⚡ . . At first glance, pain seems straightforward - I slammed the door and my hand got caught and now my hand hurts. However, it is much more than that. . . Prof. Moseley's work over the past years is a great start to understanding and reconceptualizing pain according to modern pain science. . . ⚡PAIN DOES NOT PROVIDE A MEASURE OF THE STATE OF THE TISSUES⚡ . . When something hurts a little or a lot, doesn't really tell you how things are at the tissue level . . ⚡PAIN IS MODULATED BY MANY FACTORS FROM ACROSS SOMATIC, PSYCHOLOGICAL AND SOCIAL DOMAINS⚡ . . Paying attention to pain, emotions and anxiety and your individual expectations all play a factor in the evaluative context of pain . . ⚡THE RELATIONSHIP BETWEEN PAIN AND THE STATE OF TISSUES BECOMES LESS PREDICTABLE WITH PERSISTENT PAIN⚡ . . When pain persists, the proprioceptive representation of that body part in the primary sensory cortex in our brain changes. It sort of smudges. This can affect motor control because we use these representations as maps to plan and execute movement. You need to upgrade/redraw your map regularly (daily movement, CARS) . . ⚡PAIN CAN BE CONCEPTUALISED AS A CONSCIOUS CORRELATE OF THE IMPLICIT PERCEPTION THAT TISSUE IS IN DANGER⚡ . . The implicit perception of threat determines the outputs of the brain, not the state of the tissues, nor the actual threat to the tissues. If the brain says duck, you will duck. If the brain feels sufficiently threatened, pain will be felt. . . 🔐CLINICAL RELEVANCE🔐 . Teaching patients about modern pain biology leads to altered beliefs and attitudes about pain. When education is incorporated in management of patients with chronic pain, pain and disability are reduced. . . 📚Moseley, Lorimer. (2007). Reconceptualising pain according to modern pain science. Physical Therapy Reviews. 12. 169-178.

THE SHOULDER JOINT IS AWESOME! . It also really sucks when things hurt. . Its mobility is second to none when it comes to degrees and planes of movement. But if neglected, it tends to be susceptible to injury. Look at all that 'stuff' on the left that have to work synergistically so you can do fun stuff like benching or fist pumping or bust out your floss moves! . . All the passive stretching and soft tissue work in the world will not stabilize and protect your joints. You should regularly and actively engage your tissues in all available ranges of motion and train to expand and control those ranges to make them stronger and build resilience against injury. . . In this video, I am doing low intensity glenohumeral CARS (controlled articular rotations) in between my bench press sets. I've found that I can position my shoulders better and have a more stable push after doing a couple quality rotations. Plus, I get to expose that joint in ranges I usually dont use throughout the day - most of the stuff we do daily happens in front of us and you rarely have to reach back! . . I hug the power rack to keep my torso and my hips from moving. This makes me aware that I am not twisting and I do my best to direct all the motion possible through my shoulder joint. . Give it a try and let me know how it feels! . . For more information on mobility, end range training, or if you have trouble with your joints, DM me or call to make an appointment.