Holley Hudson Sports Therapist

01/04/2026

I am off now until Tuesday April 7th. Wishing everyone a Happy Easter weekend. ✝️

09/03/2026

The quadratus lumborum (QL) is a deep muscle of the posterior abdominal wall that sits lateral to the lumbar spine and deep to the erector spinae. It forms a muscular bridge between the pelvis, lumbar vertebrae, and the 12th rib, which is why it contributes to both spinal and pelvic motion as well as respiratory mechanics.

The muscle originates from the posterior iliac crest and the iliolumbar ligament. From there the fibres travel upward to insert onto the inferior border of the 12th rib and the transverse processes of L1 to L4. It receives its nerve supply from the anterior rami of T12 through L3, which are branches of the lumbar plexus.

When the quadratus lumborum contracts on one side, it produces lateral flexion of the lumbar spine toward the same side. Because it also attaches to the pelvis, unilateral contraction can also elevate the pelvis on that side, a motion commonly referred to as a hip hike. This action becomes particularly relevant during walking, where the QL helps control pelvic position when the opposite leg is off the ground.

22/02/2026

The image shows a characteristic referred pain pattern extending from the upper cervical region down the side of the neck to the top of the shoulder and scapular area. This pattern is most commonly associated with myofascial trigger points in the upper trapezius and levator scapulae muscles. These muscles play a key role in supporting the head and stabilizing the scapula, making them highly susceptible to overload and postural strain.

Pathologically, sustained forward head posture, prolonged desk work, emotional stress, and repetitive shoulder elevation create chronic overactivity in these muscles. Continuous low-level contraction reduces local circulation, leading to ischemia, metabolic waste accumulation, and the formation of hyperirritable trigger points. These trigger points can produce localized tenderness and referred pain into the neck, shoulder, and sometimes the head.

Upper trapezius trigger points often refer pain to the side of the neck, mastoid region, and temporal area, contributing to tension-type headaches. Levator scapulae trigger points commonly refer pain along the medial border of the scapula and into the posterior shoulder. Individuals frequently describe a deep aching discomfort, stiffness, and a sensation of heaviness across the upper shoulder region.

Biomechanically, forward head posture increases the load on the cervical extensors and upper trapezius, forcing these muscles to remain continuously active to support the head against gravity. Simultaneously, scapular stabilizers such as the lower trapezius and serratus anterior may become inhibited, shifting excessive load to the upper trapezius and levator scapulae. This imbalance alters scapular positioning and increases cervical spine stress.

Chronic trigger point activity can restrict cervical motion, contribute to cervicogenic headaches, and cause pain during neck rotation or shoulder elevation. Muscle tightness may also compress local neural structures, producing radiating discomfort toward the shoulder blade.

Effective management involves correcting postural alignment, reducing forward head positioning, and improving scapular mechanics. Stretching the upper trapezius and levator scapulae, strengthening deep cervical flexors and lower scapular stabilizers, and improving thoracic mobility help restore muscular balance. Manual therapy, trigger point release, stress management, and ergonomic modifications further reduce muscular overload and prevent recurrence.

Recognizing this referral pattern allows clinicians to differentiate myofascial pain from cervical joint or nerve pathology and implement targeted treatment strategies to relieve neck and shoulder pain.

22/02/2026

SIDE PLANK – COMPLETE BIOMECHANICAL BREAKDOWN

The side plank is a closed-chain, frontal-plane dominant stability exercise that challenges the body to resist gravity-driven lateral flexion and rotation. Biomechanically, the entire body functions as a long lever arm supported by the shoulder complex and the lateral hip, demanding precise neuromuscular coordination to keep the trunk, pelvis, and lower limb aligned in a straight line.

At the lumbopelvic region, the external oblique is the prime anti-lateral-flexion muscle. It works synergistically with the internal oblique and quadratus lumborum to generate a counter-moment against gravity, preventing the trunk from collapsing toward the floor. This creates high isometric tension across the abdominal wall, increasing intra-abdominal pressure and enhancing spinal stiffness without excessive compressive loading on the lumbar discs.

The hip biomechanics are dominated by the gluteus medius, assisted by the tensor fasciae latae and adductor longus. These muscles act as frontal-plane stabilizers, preventing pelvic drop on the unsupported side. Failure of this force couple results in pelvic sag, which shifts load to passive structures of the lumbar spine and sacroiliac joint. When properly executed, the side plank mimics single-leg stance mechanics seen during gait, making it highly functional.

At the shoulder girdle, the side plank places the glenohumeral joint in a weight-bearing role. The serratus anterior plays a critical role by stabilizing the scapula against the thoracic wall, preventing winging and maintaining optimal scapulothoracic alignment. Simultaneously, the lateral deltoid and rotator cuff generate compressive forces that center the humeral head within the glenoid, enhancing joint stability under load.

From a kinetic chain perspective, the side plank links the shoulder, trunk, and hip into a single load-sharing system. Force is transmitted from the ground through the supporting forearm or hand, across the shoulder, through the oblique sling system, and into the lateral hip and thigh musculature. This diagonal force transmission mirrors real-life activities such as cutting, reaching, and change-of-direction movements in sport.

Clinically and functionally, the side plank is a cornerstone exercise for addressing frontal-plane instability, commonly seen in conditions like low back pain, hip instability, and knee valgus patterns. When pelvic and trunk control improve, excessive compensatory motions decrease, reducing cumulative stress on the spine and lower extremity joints.

In essence, the side plank is not merely a “core exercise” but a whole-body biomechanical challenge that trains lateral stability, enhances load distribution across joints, and reinforces efficient movement strategies essential for both rehabilitation and athletic performance.

22/02/2026

Breathing is not only a respiratory function but also a fundamental biomechanical process that supports spinal stability and postural control. The diaphragm, abdominal wall, pelvic floor, and deep spinal stabilizers work together to create a pressure-regulating system that stabilizes the trunk. The illustration highlights how diaphragmatic breathing distributes pressure evenly throughout the abdominal cavity, forming a supportive internal cylinder.

During proper inhalation, the diaphragm contracts and descends, increasing intra-abdominal pressure. Instead of the abdomen pushing forward only, pressure expands in all directions — anteriorly, laterally, and posteriorly — creating 360-degree expansion. The pelvic floor responds by lengthening slightly, while the transverse abdominis and oblique muscles regulate the expansion. This balanced pressure supports the lumbar spine and reduces excessive reliance on passive structures like ligaments and discs.

From a biomechanical standpoint, intra-abdominal pressure functions like an internal brace for the spine. When pressure is evenly distributed, it enhances trunk stiffness and stability without excessive muscular tension. This mechanism is crucial during lifting, walking, and athletic movements, as it improves force transfer between the upper and lower body while minimizing spinal strain.

The side-view illustration shows how pressure interacts with spinal alignment. With efficient diaphragmatic breathing, pressure supports the lumbar curve and maintains trunk integrity. In contrast, shallow chest breathing elevates the rib cage, limits diaphragm descent, and shifts stabilization demand to the neck, shoulders, and lower back. Over time, this inefficient pattern may contribute to neck tension, lumbar pain, and reduced core stability.

Poor pressure management can also overload the pelvic floor. If pressure is directed downward without coordinated muscular support, it may contribute to pelvic floor dysfunction. Conversely, excessive abdominal gripping without diaphragm coordination can increase spinal compression and restrict breathing efficiency.

Restoring optimal breathing mechanics involves retraining diaphragmatic function, improving rib cage mobility, and strengthening deep core musculature. When the diaphragm, abdominal wall, and pelvic floor coordinate effectively, the body gains a stable foundation for posture, movement, and injury prevention.

Efficient breathing creates a stable yet adaptable trunk, enhances movement efficiency, and supports long-term spinal health — demonstrating that proper respiration is essential not only for oxygen exchange but also for biomechanical integrity.

18/02/2026

The image illustrates how the balance of hip musculature determines pelvic orientation and directly influences lumbar spine mechanics, hip joint loading, and overall movement efficiency. The pelvis serves as the mechanical bridge between the trunk and lower limbs, and its position governs how forces are transmitted through the spine and into the legs. When muscular forces are balanced, the pelvis remains in a neutral position, preserving normal lumbar lordosis and allowing efficient transfer of ground reaction forces during standing and gait.

In a neutral alignment, the anterior and posterior pelvic landmarks maintain equilibrium, enabling optimal joint congruency at the hip and minimizing shear forces at the lumbosacral junction. The iliopsoas and re**us femoris provide anterior support, while the gluteus maximus and hamstrings contribute posterior stability. Deep abdominal muscles and spinal stabilizers coordinate to maintain trunk control. This balanced state supports efficient shock absorption, reduces muscular fatigue, and allows smooth coordination between the spine, pelvis, and lower limbs.

The right side of the image suggests altered muscular force balance leading to anterior pelvic tilt. When hip flexors become tight or overactive and the gluteal muscles and deep abdominal stabilizers are inhibited, the pelvis rotates forward. This increases lumbar lordosis and compressive loading on the posterior spinal elements while increasing anterior shear forces at the lumbosacral junction. The femoral head may translate anteriorly, increasing stress on the anterior hip capsule and contributing to impingement syndromes. Functionally, anterior tilt reduces effective hip extension during terminal stance, leading to compensatory lumbar extension and hamstring overactivity during walking and running.

Posterior pelvic tilt represents the opposite imbalance, where dominant hamstrings and abdominal muscles rotate the pelvis backward and flatten the lumbar curve. This alignment increases anterior disc loading and reduces the spine’s capacity to absorb shock. Hip extension becomes restricted due to shortened hamstrings, limiting stride length and propulsion efficiency. Individuals often compensate with increased thoracic flexion and altered movement patterns during lifting or functional activities.

Pelvic orientation also influences femoral alignment and lower limb mechanics. An anterior tilt often accompanies increased femoral internal rotation and knee valgus stress, contributing to patellofemoral pain and increased ligament strain. Posterior tilt can reduce shock absorption and increase lumbar disc stress during dynamic tasks. Because the pelvis links trunk stability with lower limb mobility, even subtle deviations can propagate dysfunction throughout the kinetic chain.

Clinically, restoring pelvic neutrality requires addressing both mobility restrictions and neuromuscular control. Improving hip flexor flexibility, strengthening the gluteal complex and deep core stabilizers, enhancing thoracic extension, and retraining hip hinge mechanics help normalize load distribution. When pelvic alignment is optimized, spinal stress decreases, hip mechanics improve, and movement efficiency is restored across daily activities, rehabilitation, and athletic performance.

18/02/2026

Pronator Teres Syndrome is a compression neuropathy involving the median nerve as it passes between the two heads of the pronator teres muscle in the proximal forearm. This condition leads to pain and sensory disturbances in the forearm and hand, often mistaken for carpal tunnel syndrome. Unlike wrist-level compression, symptoms originate higher in the forearm.

The median nerve travels from the arm into the forearm through the pronator teres muscle. Repetitive pronation movements, forceful gripping, overuse, or muscle hypertrophy can compress the nerve in this region. Activities involving repeated forearm rotation—such as using tools, racquet sports, typing, or manual labor—may contribute to irritation and inflammation.

Patients typically experience aching pain in the proximal forearm, tenderness over the pronator teres region, and activity-induced numbness or tingling in the thumb, index, middle, and part of the ring finger. Weakness in grip strength and difficulty with fine motor tasks may also occur. Unlike carpal tunnel syndrome, nighttime symptoms are less common, and forearm pain is more prominent.

A key clinical sign is symptom reproduction during resisted forearm pronation or sustained elbow flexion, which increases pressure on the median nerve. Sensory changes may extend into the palm because the palmar cutaneous branch of the median nerve is affected before it reaches the wrist.

Management focuses on reducing compression and inflammation. Rest from aggravating activities, ergonomic modification, stretching of the forearm flexors, nerve gliding exercises, and strengthening of surrounding musculature can help relieve symptoms. In persistent cases, medical intervention or surgical decompression may be required.

Early recognition and treatment are essential to prevent chronic nerve irritation and functional impairment. Understanding the biomechanical stresses placed on the forearm can help clinicians and rehabilitation professionals design effective prevention and recovery strategies.

18/02/2026

-Angle & (OA) of Knee

1. Q-Angle (Quadriceps Angle)

Angle formed between the line from ASIS to midpoint of patella and the line from tibial tubercle to midpoint of patella, indicating knee alignment.

2. Normal vs Increased Q-Angle

Increased Q-angle leads to altered patellar tracking and increased stress on the knee joint.

3. Osteoarthritis (OA) of Knee

Degenerative joint disease characterized by cartilage loss, reduced joint space, and osteophyte formation.

4. Biomechanical Link

Abnormal Q-angle contributes to uneven load distribution, accelerating knee osteoarthritis.

5. Clinical Features

Knee pain, stiffness, crepitus, swelling, and reduced range of motion.

18/02/2026

17/02/2026

Power of Pure Movement: The Sacro-Iliac Joints Sacred. Strong. Stable. Live Online Monday and Tuesday February 23 & 24 from 12:30 – 2:30 MT (replay available) Early Bird On Now for $79 Sacroiliac joint pain is frustrating If you’ve been dealing with a consistent and persistent Sacroiliac Joint P...

16/02/2026

Understanding the Shoulder Painful Arc Test (Impingement Arc)

The shoulder painful arc test is a simple but clinically powerful screening method used to identify possible subacromial impingement or rotator cuff involvement. During this test, the examiner or patient actively raises the arm sideways into abduction from 0° to full elevation. What makes this test valuable is not just whether pain is present — but where in the range the pain appears.

In a typical positive painful arc pattern, discomfort occurs between approximately 60° and 120° of shoulder abduction. This mid-range zone corresponds to the position where the rotator cuff tendons — especially the supraspinatus — and the subacromial bursa pass beneath the acromion. If these tissues are inflamed, thickened, or compressed, this portion of movement produces a sharp or catching pain.

Interestingly, patients often report less or no pain below 60° and above 120°. Below 60°, the structures are not yet significantly compressed. Above 120°, the humeral head and acromion relationship changes and the compressed tissues may clear the tightest space, temporarily reducing symptoms. This pattern helps clinicians differentiate impingement from other shoulder pathologies.

From a rehab and biomechanics perspective, a positive painful arc highlights the importance of scapular control, rotator cuff strength, posture correction, and load management. Treatment is not just about reducing pain — it’s about restoring proper shoulder mechanics so the subacromial space is protected during movement.

Always combine this test with other clinical findings and functional assessment for accurate diagnosis and targeted rehabilitation.