PhysioPraxis

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PhysioPraxis

Physio Praxis is run by Scot Morrison, PT, DPT, OCS, CSCS emphasizing applied sports rehab & S&C
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29/11/2024

One day only sale. See for all the details. Link in my bio to get this discount.

09/05/2024

Thanks for the nomination 🙏🏻🙏🏻

Credit goes to a great team making it easy.

14/01/2023

Be very clear on whether you’re trying to perform or train.

Performance is maximal and looking to achieve a clear external goal. It generally isn’t healthy and it flirts the edges of risk. It’s also going to be relatively acute.

Training is chronic and is directly targeting the specific adaptation desired. Occasionally it will have outputs at the level of performance (eg Sprint interval training) but volume and frequency are very controlled.

04/01/2023

A common training mistake is to assume the metric you’re tracking is informing you about whatever system is being overloaded. This is putting too much onto one specific metric.

A good example would be heart rate. This is a great proxy for estimating the cardiovascular response to what is being done (not perfect since HR response can change without changing the exercise eg beta blockers, anxiety, POTS syndrome etc) However, if you start running, cycling, and rucking aiming for the same HR zones without also tracking the musculoskeletal loads that occur you may find that your cardiovascular system is able to tolerate a dosage that your musculoskeletal system cannot.

I tend to find this concept is frequently novel to people I’m working with and since it’s also often revealed in their subjective narrative it’s a good place for some education. It’s also important for us to remember when designing programs. Things like HR and RPE are great but we need to be very aware of how valid our implementation of these metrics are for the individual we’re working with.

28/10/2022

We can view the imposition of exercise stress as information being given to our target tissue/systems about the demands they will face in the future. Our body is always adjusting to be prepared for future events which it anticipates from a best guess derived from available information.

So our job with ExRx is to closely mimic the challenges that will be faced in “the real world” in a progressive manner. This allows us to “lead” our adaptations to the place where the body is prepared for the task demands. And this is done with a good needs analysis and then matching those needs with our metabolic/mechanical/morphological specific interventions.

25/09/2022

I frequently think of this quote when I see an overly complicated narrative for a rehab approach. Being brilliant at the basics will always get you to your destination (hat tip to & who have been teaching this longer than I’ve been alive) - overly complicated lines of reasoning just increase the likelihood that your narrative is a product of telling a story to fit what happened (resulting).

Assessment of the stage of healing, clearing full and pain free ROM, loading the relevant systems/tissues till sufficient adaptation occurred to handle the necessary forces and reintegration into the task while staying within the envelope of function will always be the bedrock for a program. Many times this is more about removing extras than it is adding something special.

03/08/2022

Building on the Envelope of Function idea when someone is dealing with a post op (or conservative management) injury my general advice involves a description of MED vs MTD and the hormetic zone between them where we want to stay.

Then we go over “the rules” :

Don’t be stupid: Don’t do things you know will cause a problem or put you at high risk. If you would get injured doing something and describe what you were doing when it happened as “stupid” then don’t do that thing. This is based on an expectation of risk prior to the event which is different from an accident.

Don’t be stubborn: Listen to your body, use the soreness rules, effusion tests, load test etc. Stubborn isn’t going to bring on an acute injury but it will stall progress and create issues. Stubborn is getting feedback from your body and ignoring it over time.

Don’t be lazy: Some MED is necessary at a body level to address global fitness and at the level of the injury to drive healing. So avoiding activities while you heal is also a bad idea.

16/07/2022

Some thoughts on this exercise…

The Spanish squat has become popular for those looking to constrain movement options to the knee extensor mechanism. And it does a great job at this when performed well. However, I do see a lot of videos posted with rather light bands labeled a “Spanish squat”. Although the setup may appear the same, the more the band stretches the less it constrains the exercise to the quad. It basically becomes a normal squat with a mild forward weight shift (similar to what holding a weight in the goblet position does)

If the goal is to assist with a squat that’s great. But if the intent is to force the knee to work there is a ceiling effect in place which means that balance can limit you well before the quad strength does.

So basically just be clear on what you’re doing and why you’re doing it.

13/07/2022

90/90 shoulder ER endurance test via

I’ve been getting a lot of pm’s from mentioning this in the podcast with so figured I’d do a video.

Key considerations:

Setup needs to be consistent & tested loads the same on future re-tests.

Use visual & tactile cues for the loss of position. I didn’t set this up in the video so the setup could be viewed but I’ll use my hand or a stool etc ~1-2” below with the weight. The lets you see this based on force.

Be consistent side to side and between sessions both in setup and cuing!

12/07/2022

This paper by Lambrianides et al takes an interesting look at the role different training stimuli have on strength over time. The image above only touches on a few topics this paper covers so it would be worth a read if this interests you.

Two points it reinforces - there’s a wide range of testing time frames used in practice whereas adaptations can occur rather rapidly. By the 8-12 week mark most strength increases have stalled when programs don’t update to reflect those changes (auto regulation anyone?) So it’s important to test frequently enough to capture those changes in time to adjust as needed.

02/07/2022

An exercise I find I use a decent amount when getting back some lumbar endurance work.

11/06/2022

I’ve updated my torque app to solve a number of issues people had. See the linktree link for either an imperial or metric one.

The current iteration is definitely more beta than finished and the goals will refine as I add samples in but taking the 9 I included and sampling with replacement ~3 Nm/Kg was pretty much the estimated average. The upper and lower bounds should help with estimating range and the visual of the variance around the score should help with understanding some of the uncertainty surrounding this process.

Please drop a message if anything is an issue, you have requests or questions.

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