Stefan Düll

16. October 2017

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11 - 17. September 2017

Lille - Davis Cup Semifinals - Serbia vs. France

Official Dinner

12. September 2017

Lille - Davis Cup Semifinals - Serbia vs. France

Can't wait to absorb some incredible positive energy the upcoming week!

Looking forward to join the serbian Davis Cup by BNP Paribas team in a few hours!

On my way to Lille/France to support my friends at the semifinals tie Serbia vs. France.

28. August - 10. September 2017

New York - US Open - Grand Slam

US Open with Doubles No. 1 Team in the world Melo/Kubot and Yen-Hsun Lu.

10 years - one team!

In New York at US Open Tennis Championships. 
One of the tennis players I am working with this time is Yen-Hsun Rendy Lu and exactly this month we are celebrating 10 years of working together.

20. August 2017

New York - US Open - Grand Slam

Not a perfect but good week with the World No. 1 Doubles Team #MeloKubot in Cincinnati at Western & Southern Open.

Congrats to Lukasz on a new career high of No. 3 of the Emirates ATP World Tour Rankings! 

Next stop New York City for US Open Tennis Championships!

Just arrived to an amazing city!

18. August 2017

Cincinnati - Western & Southern Open - ATP 1000

11. August 2017

Montreal - Coupe Rogers - ATP 1000

08. August 2017

Montreal - Coupe Rogers - ATP 1000

Marriott Hotel Chateau Champlain

06. August 2017

Washington - Citi Open - ATP 500

Another good week with these guys in Washington.

Not the tournament win but runner-up at Citi Open! 

An incredible 17-match winning streak ends today for team #MeloKubot, congrats on that!

05. August 2017

Washington - Citi Open - ATP 500

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29. July 2017

Washington - Citi Open - ATP 500

Back in business at Citi Open with the Wimbledon champions!

Looking forward to the next weeks of hard work and lot's of fun at US OPEN series with the World No. 1 Doubles Team #MeloKubot! Let's do it! 

Partner: 
Blackroll® | Sportsline 運動前線 | Dynamic Tape | Premax | Voss Water | SEIRIN Corporation | Bounce Canada | adidas

23. July 2017

Taipei - Workshop 

Thank you Sportsline 台灣 for your invitation and trust to talk in front of an amazing class for 2 days!

Enjoyed every minute!

Thank you to all my partners:
Sportsline 運動前線 | Blackroll® | Dynamic Tape | Premax | SEIRIN Corporation | Voss Water | Bounce Canada | Bounce Balls UK 

21. July 2017

Taipei - Workshop 

Final preparations for tomorrow's workshop with my translator, thank you Sportsline 台灣!

Only a few seats available!

You can register here:

20. July 2017

Taipei - Workshop 

Just arrived at Taipei!

Happy to be back to this amazing city and am looking forward to my workshop this weekend!

You can join me for a 2-day education session for health professionals and fitness trainers, in which I will share a lot of practice-oriented insights into my work with professional tennis players, such as: how to prepare an athlete for a competition, how to provide acute treatment on court, how to support recovery, how to keep an athlete injury-free and a lot of further treatment tips and tricks out of my daily work to solve any kind of injury issues!

Additionally, I will introduce some very helpful tools which I use myself for my daily work with professional athletes: Blackroll® products, Dynamic Tape, Premax, SEIRIN Corporation or @PulsYoga.
Thank you @SportslineHK for the invitation. Looking forwards to it!

The course will be held in English and supported by a simultaneous translation into Chinese!

#Repost Sportsline 台灣

職業網球 - 運動物理治療師研討會
Conference of Professional Sports Physiotherapist - Perspective in professional tennis
主辦單位：#sportslinetaiwan @sportslineasia 
協辦單位：壢新醫院 - 聯新運動醫學中心
講者： @stefanduell 
翻譯： 陳祐榕老師
日期：22-23, July 2017

報名辦法：
https://www.eventbrite.com/e/35134671749 
22 July - 職業網球 - 運動物理治療師研討會 - Conference of Professional Sports-Physiotherapist for Tennis

23 July - 職業網球 - 運動物理治療師治療手法工作坊 - Workshop of Professional Sports Physiotherapist for Tennis

研討會簡介：
來自德國的運動物理治療師 Stefan Düll 擁有豐富的國家隊與運動賽事防護經驗，包含德國奧運代表隊、塞爾維亞國家隊甚至是中華台北代表隊都是他曾經服務的單位；而Stefan也是眾多網球職業選手的指定防護師例如職業網球球王祖高域，世界青少年網球第一的，世界職業網球排名第9位的，還有我們台灣最熟悉的盧彥勳(世界排名56)以及謝淑薇選手(最佳排名16)。 http://www.stefanduell.com/

Partner: 
BLACKROLL 台灣® | Sportsline 運動前線 | Dynamic Tape | Premax | SEIRIN Corporation | Voss Water | Bounce Canada | Bounce Balls UK | Adidas Originals東區旗艦店

#Physiotherapy #Osteopathy

19. July 2017

Würzburg

#1 

Happy to be part of this incredible 2017 journey so far: 

BNPParibasOpen runner-up
Miami Open champion
Mutua Madrid Open champion
Ricoh Open champion
GERRY WEBER OPEN champion
Wimbledon champion
World No. 1 
First team to qualify for Nitto ATP World Tour Masters (Tennis World Championships)

17. July 2017

Würzburg

Just got back home from an very exciting Wimbledon working with Marcelo Melo and Łukasz Kubot who won the tournament!

Now preparing already for my workshop in Taipei/Taiwan which will be held on 22-23 of July 2017! 
This time I am invited to hold a 2-day education session for health professionals and fitness trainers to provide them with the praxis-oriented insights into my work with professional tennis players, such as: how to prepare an athlete for a competition, how to provide acute treatment on court, how to support recovery, how to keep an athlete injury-free and a lot of further treatment tips and tricks out of my daily work to solve any kind of injury issues!

15. July 2017

London - Wimbledon - Grand Slam

Still under impression of being part of an incredible grass court season run with team #MeloKubot: 

3 grass court tournaments, 3 grass court titles plus on top Wimbledon champions! Can't get better! 

28. June 2017

London - Wimbledon - Grand Slam

Just checked in at Wimbledon - it's always special to come back to 'The All England Lawn Tennis Club' to work with some of the world's best tennis players at the most important tennis tournament of the year!

25. June 2017

Halle - Gerry Weber Open - ATP 500

2nd grass court tennis tournament, 2nd grass court tennis title!

Mission GERRY WEBER OPEN accomplished, another great week with this crew! 

Congrats to Marcelo Melo and Łukasz Kubot on their 4th ATP World Tour crown this year!

18. June 2017

Halle - Gerry Weber Open - ATP 500

Just arrived in Halle/Germany at GERRY WEBER OPEN.

Congrats on 25 years of ATP World Tour action!

Definitely one of the best #ATP500Series events!

17. June 2017

s`Hertogenbosch - RICOH Open - ATP 250

Mission Ricoh Open accomplished - another great week with this crew!

Congrats to Marcelo Melo and Łukasz Kubot on their 3rd ATP World Tour title this year - great job!

Thank you to the whole team of Ricoh Open for a great tournament organization! 

Off to Halle/Germany for the next tournament GERRY WEBER OPEN!

15. June 2017

s`Hertogenbosch - RICOH Open - ATP 250

LOWER CROSSED SYNDROME (LCS) SERIES 18/19 - ACTIVATION OF THE GLUTEUS MUSCLES - COOK BRIDGE

Your glutes are an incredibly important muscle group for many reasons, including preventing injury and improving performance!

This is why it is essential to do exercises with which you can get your glutes properly fired up and working for you. These will help you move better, feel better, and kick your training up to another level!

11. June 2017

s`Hertogenbosch - RICOH Open - ATP 250

LOWER CROSSED SYNDROME (LCS) SERIES 14/19 - MYOFASCIAL RELEASE OF THE GLUTEUS MUSCLES

Link zu Artikel mit Bild!

LOWER CROSSED SYNDROME (LCS) SERIES 15/19 - GLUTEUS MAXIMUS MUSCLE SELF-RELEASE EXERCISE

Why are the glutes so inactive?

- The first and most common reason people suffer from underactive glutes is due to lifestyle. Even when people train hard every day, if they spend the majority of the remainder of the day sitting down, then they are simply not using their glutes! 

The glute med stabilizes the pelvis when you walk or run and abducts the leg away from the body.

A common reason I see glutes that aren’t working properly is due to trigger points or fascial tightness which disturbs the intramuscular coordination (quality of muscle contraction) and therefore the ability to contract the full muscle properly.

LOWER CROSSED SYNDROME (LCS) SERIES 17/19 - ACTIVATION OF THE GLUTEUS MUSCLES - GLUTE BRIDGE

From my previous posts you know the result of lower crossed patterns is an inhibition of the glute muscles.

These muscles (gluteus maximus, medius and minimus) are main stabilizer of the pelvis and also help level the pelvis therefore they control every joint below them, including the ankle/foot.
They are essential for hip, pelvis and low back stability and balance each time our foot hits the ground, thats why it is very important to work on a proper activation of these important structures!

29. May 2017

Paris/Roland Garros - French Open - Grand Slam

LOWER CROSSED SYNDROME (LCS) SERIES 11/19 - LOW BACK ERECTOR MUSCLES

28. May 2017

Paris/Roland Garros - French Open - Grand Slam

LOWER CROSSED SYNDROME (LCS) SERIES 1/19

Upper and Lower Crossed Syndromes are two of the most common aberrant postural patterns. Today's therapist benefit from working with Janda's upper and lower, or proximal-and-distal, crossed syndrome theory when dealing with clients who suffer from neck or back pain!

Lower Crossed Syndrome (LCS):
This 'swayback' posture typically develops from prolonged sitting and sleeping with knees and hips flexed. As lumbar and SI-Joints become fixated, protective spasm further compresses the spine causing low back, hip and leg pain. Therapists must restore balance and symmetry to all lower crossed muscles and re-check firing order patterns in hip extension, hip flexion and hip abduction! 

https://www.instagram.com/p/BUovaBggSfV/?taken-by=stefanduell

LOWER CROSSED SYNDROME (LCS) Series 2/19 - TIGHT/FACILITATED HIP FLEXORS

The hip flexor muscle group gets a lot of attention because it is common to have dysfunction at the LCS. The iliopsoas is the main hip flexor muscle, however the TFL, Sartorius, and Rectus femoris (Quad) also act as hip flexors.

The iliopsoas has a vital role in everyday activities like walking and running. The psoas originates at the lumbar spine and connects with the iliacus to insert on the femur. Because of this, it is often a cause or contributor to low back pain, pelvic/hip instability, problems with maintaining a neutral spine etc. It functions as a powerful hip flexor and a stabiliser of the spine and trunk during other movements.

https://www.instagram.com/p/BUqhJKzA8RO/?taken-by=stefanduell

LOWER CROSSED SYNDROME (LCS) SERIES 3/19 - MYOFASCIAL TREATMENT OF THE ILIOPSOAS MUSCLE

The iliopsoas muscle belongs to the inner hip muscles and is innervated by the femoral nerve + lumbar plexus. It consists of:
▪️Psoas major: origin. from 1st-4th lumbar vertebrae, costal processes of all lumbar vertebrae and 12th thoracic vertebrae + ins. at the lesser trochanter of the femur.
▪️Iliacus: runs from the iliac fossa to the lesser trochanter.
The psoas major and iliacus unify in the lateral pelvis shortly before the inguinal ligament becoming the iliopsoas. There they pass below the inguinal ligament through the muscular lacuna together with the femoral nerve. Both muscles are completely surrounded by the iliac fascia. The lumbar plexus lies dorsally from the psoas major which is penetrated by the genitofemoral nerve.

23. May 2017

Paris/Roland Garros - French Open - Grand Slam

Back at work:

17. May 2017

THORACIC OUTLET SYNDROME SERIES 1/9: Thoracic Outlet Syndrome (TOS) and Self-Treatment

TOS are a group of syndromes involving pressure on the brachial plexus.
Each syndrome is named according the structure that is causing the compression.

16. May 2017

LOW BACK PAIN SELF TREATMENT SERIES 1/7: 3 MUSCLES TO FOCUS ON

There are 3 muscles which from my own treatment experience you should always keep in mind and work on if you suffer from back and leg pain: the QUADRATUS LUMBORUM (QL), the GLUTEUS MEDIUS and the ILIOPSOAS !

The QL is a low back stabilizer, helps to depress your ribs during exhalation, and acts to laterally flex and extend the lumbar spine.

15. May 2017

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 11/13: TEMPORALIS MUSCLE SELF-RELEASE TECHNIQUE

As a follow up to my previous post about the temporalis muscle and myofascial treatment I wanted to show how you can self-release this muscle.

The temporalis is a fan shaped muscle on each side of the skull. It attaches at the jaw, and is a major muscle involved in moving the temporomandibular joint. Excess tension here can be a big cause of headaches. This muscle works a lot, and gets brutally tight over time. Clenching the teeth due to things like stress and anxiety will greatly increase this tension. Address causal factors such as jaw clenching, stress etc. in order to get to the root of why this muscle may be developing too much tension.

https://www.instagram.com/p/BT5gf1kgoPD/?taken-by=stefanduell

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 12/13: OCCIPITAL MUSCLES

There are 4 muscles involved in the suboccipital region also called 'Upper Cervical Spine':
1-Rectus capitis post. major
2-Rectus capitis post. minor
3-Obliquus capitis superior
4-Obliquus capitis inferior

https://www.instagram.com/p/BT6R9zvgVDm/?taken-by=stefanduell

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 13/13: OCCIPITAL MUSCLE SELF-RELEASE TECHNIQUE

As a follow up to my previous post about the occipital muscle and myofascial treatment I wanted to show how you can self-release this muscles.

The suboccipital muscles are a group of muscles that are located below the occipital bone (base of the skull). These muscles attach at different angles and are responsible for subtle movements of the head and upper neck.

14. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

Team #MeloKubot tournament champion:

09. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

Center Court

08. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 9/13: MASSETER MUSCLE SELF-RELEASE TECHNIQUE

As a follow up to my previous post about the masseter muscle and myofascial treatment I wanted to show how you can self-release this muscle.

The masseter muscle (originates at the zygomatic bone and inserts at the mandible) is the strongest muscle in the human body and can harbour some of the most common trigger points. It is a major muscle involved in moving the temporomandibular joint (Jaw joint muscle). Excess tension here can be a big cause of headaches. This muscle works a lot and gets brutally tight over time. Clenching the teeth due to things like stress and anxiety will greatly increase this tension.

07. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 1/13: TRAPEZIUS MUSCLE

The trap muscle is one of the largest superficial muscles that extend longitudinally from the occipital bone to the lower thoracic vertebrae and laterally to the spine of the scapula. Its functions are to move the scapulae and support the arm.

The trap has three functional regions: the superior region (descending part), which supports the weight of the arm; the intermediate region (transverse part), which retracts the scapulae; and the inferior region (ascending part), which medially rotates and depresses the scapulae.

Contraction of the trap can have two effects: movement of the scapulae when the spinal origins are stable, and movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula.

This muscle tends to develop too much tension for postural reasons, such as forward head posture (where it has to work overtime to stabilise the head and neck due to poor alignment). Other reasons include poor breathing patterns (shallow neck breathing all day), and muscle imbalances elsewhere.

Trap muscle trigger points can lead to referred pain in the shoulder, neck and head as you can see on the red marked zones in the picture. They also can initiate trigger points in the jaw joint muscles. Additionally, the muscle can cause biomechanical problems in the cervical and thoracic spine.

The trap is innervated by the accessory nerve (Cranial nerve XI) which is content of the jugular foramen, where the accessory nerve can get compressed or entrapped. If so, it can lead to hypertension in the trapezius. That's why it is very important to treat (release) this foramen to give the nerve enough space to work properly.

On the picture you can see several myofascial treatment techniques for the trap muscle incl. the Jugular foramen release.

https://www.instagram.com/p/BTv-tHsA_LK/?taken-by=stefanduell

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 2/13: TRAPEZIUS MUSCLE SELF-RELEASE EXERCISE

As a follow up to my previous post about the trap muscle and myofascial treatment I wanted to show how you can self-release the trap! This muscle has 3 functional parts:

- Descending (or superior) part: runs from the occipital bone and nuchal ligament to the lateral third of the clavicle.
- Transverse (or middle) part: originates from the spinal processes of the first to fourth thoracic vertebrae and inserts at the acromion. 
- Ascending (or inferior) part: extends from the spinal processes of the fifth to twelfth thoracic vertebrae to the scapular spine.

Take a Blackroll® BALL, Lacrosse ball, Basball or Tennisball. Place it on the muscle and try the release exercises which you can see in the picture:
1-Ascending and transverse part
2-Descending part

Roll slowly among the muscle, trying to identify areas of tightness or discomfort. Pause on these areas for several seconds and the tightness should begin to ease. Ensuring you roll from the origin to the insertion is a good way to target the entire length of the muscle.

Releasing some of this tissue can directly affect and relieve your headache without the use of any medicine!

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 3/13: OSTEOPATHIC DISTRACTION MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE CERVICO-THORACIC-JUNCTION HVLA

The C7-T1 spinal segment, also referred to as the cervico-thoracic-junction (CT Junction), is located at the very bottom of the neck.
More specifically, this is where the neck (cervical spine) connects with the upper back (thoracic spine).

Referring to my previous posts the trap muscle can force a CT Junction subluxation which requires a distraction mobilization. First of all you should make sure to have released all myofascial structures which cause a CT Junction subluxation (Trap muscle, Rhomboids, Serratus posterior superior, Erector spinae and Intrinsic back muscles).

Usually if you do a proper myofascial release treatment the CT Junction will correct itself but sometimes it can still stay subluxated. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the joint to the right position otherwise it can force thoracic, cervical or shoulder problems and even headaches through an so-called ascending kinematic chain.

The patient is seated, almost the same hight then the therapist. The patient places his hands behind the neck and then the therapist wheels through the space in front of the shoulders and applies a distraction force!

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 4/13: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE UPPER THORACIC SPINE SUPINE HVLA

Referring to my previous posts the trap muscle can force an upper thoracic spine subluxation which requires a mobilization. First of all you should make sure to have released all myofascial structures which cause an upper thoracic spine subluxation (Trap muscle, Rhomboids, Serratus posterior superior, Erector spinae and Intrinsic back muscles).

Usually if you do a proper myofascial release treatment the upper thoracic spine subluxation will correct itself but sometimes it can still stay subluxated. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the joint to the right position otherwise it can force thoracic, cervical or shoulder problems and even headaches through an so-called ascending kinematic chain

We will assume a restriction at T2/3 on the left:
With the patient supine the therapist stands to the right of the patient. The patient crosses the hands behind the neck to creating stability allowing the therapist to introduce flexion to the level of dysfunction. The therapist makes a fulcrum fist with the right hand which is then placed underneath the patient with the spinous processes of T2 to T3 within. Compression is added via the therapists sternum. Through the patients flexed elbows a thrust is then delivered once the forces are focused down the line of the patients arm via the glenohumeral joint through the fulcrum hand. The force can be focused further by adding the principles of minimal leverage and enhanced by using breathing.

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 5/13: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE LOWER THORACIC SPINE SUPINE HVLA

Referring to my previous posts the trap muscle can force a lower thoracic spine subluxation which requires a mobilization. First of all you should make sure to have released all myofascial structures which cause an upper thoracic spine subluxation (Trap muscle, Serratus posterior inferior, Erector spinae and Intrinsic back muscles).

Usually if you do a proper myofascial release treatment the c-t-junction will correct itself but sometimes it can still stay subluxated. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the joint to the right position otherwise it can force thoracic, cervical or shoulder problems and even headaches through an so-called ascending kinematic chain

We will assume a restriction at T9,10 on the left:
With the patient supine the therapist stands to the right of the patient. The patient crosses the elbows in front of the chest creating stability allowing the therapist to introduce flexion to the level of dysfunction. The therapist makes a fulcrum fist with the right hand which is then placed underneath the patient with the spinous processes of T9 to T10 within. Compression is added via the therapists sternum. Through the patients crossed elbows a thrust is then delivered once the forces are focused through the fulcrum hand. The force can be focused further by adding the principles of minimal leverage and enhanced by using breathing.

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 6/13: STERNOCLEIDOMASTOID MUSCLE

The sternocleidomastoid muscle (SCM) is a paired muscle in the superficial layers of the side of the neck. It is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The muscle tends to be overactive in many people we see. It is commonly recruited to help stabilise the neck/head when we adopt poor postures and positions (forward head posture). It is also an accessory muscle to breathing along with the scalenes, so having poor breathing patterns and habits will cause this muscle to overwork all day long and develop too much tension and trigger points.

The SCM trigger points can cause a variety of symptoms including headache and face pain, balance problems, visual disturbances, ear and sinus symptoms, and more body wide symptoms. They also can initiate trigger points in the jaw joint muscles. Additionally, the muscle can cause biomechanical problems in the cervical spine. It is the only muscle that creates such wide spread problems!

The SCM is innervated by the accessory nerve (Cranial nerve XI) which is content of the jugular foramen (a foramen in the base of the skull), where the accessory nerve can get compressed or entrapped. If so, it can lead to hypertension in the SCM. That's why it is very important to treat (release) this foramen to give the nerve enough space to work properly.

On the picture you can see several myofascial release techniques for the sternocleidomastoid muscle incl. the Jugular foramen release.

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 7/13: STERNOCLEIDOMASTOID MUSCLE SELF-RELEASE EXERCISE

As a follow up to my previous post about the sternocleidomastoid muscle (SCM) and myofascial treatment I wanted to show how you can self-release the SCM.

Excessive muscle tension in the SCM can often refer into the head and be a cause of headaches. Relieving tension can be done using a @BLACKROLL® TWISTER, Lacrosse ball, Tennisball or even your thumbs.

Especially the BLACKROLL® TWISTER is very useful as it does not only work with applying body weight to it but also allows the combination of pressure and twisting. The result: circulation rises, trigger bands and -points are stimulated and the fascial tissue becomes well hydrated: 
Make sure to find the right tension areas of the SCM and apply good pressure into the muscle. Then you can twist it and move your head while the TWISTER or ball is pressed in. 1-2 minutes per side is good for the beginning!

Releasing some of this tissue can directly affect and relieve your headache without the use of any medicine!

https://www.instagram.com/p/BT1GURyAhJJ/?taken-by=stefanduell

 

 

 

MUSCLES WHICH CAN INITIATE NECK PAIN AND HEADACHES SERIES 8/13: MASSETER MUSCLE
.
The masseter muscle (originates at the zygomatic bone and inserts at the mandible) is the strongest muscle in the human body and can harbour some of the most common trigger points. It is a major muscle involved in moving the temporomandibular joint (Jaw joint muscle). Excess tension here can be a big cause of headaches. This muscle works a lot and gets brutally tight over time. Clenching the teeth due to things like stress and anxiety will greatly increase this tension.
. 
The masseter muscle trigger points can lead to referred pain in the head as you can see on the red marked zones in the picture. The masseter muscle can force headache, toothache, tinnitus, bruxism, jaw clenching or TMJ syndrome and is connected to the suboccipital muscles + shoulder muscles. Trigger points in the masseter can initiate trigger points in the suboccipital muscles and shoulder region (esp. in the trapezius muscle). That means whenever you treat the masseter you always have to focus on the cervical spine and shoulder region as well!
. 
On the picture you can see several myofascial release techniques for the masseter muscle.
.
If you suffer from headaches, or directly after any muscle release via fascial soft tissue work, it is very important to stay well hydrated. Pure water or Coconut water are the best options!
.
P.S.: If you have any dentist treatment, you should always have checked all the Jaw joint muscles after, as it can lead to exactly those problems mentioned above. Usually they won't appear right on the next day after, as the human body is very good at compensating, but they can appear anytime later on. Each single dental treatment is a kind of a micro-trauma, and if the body can no longer compensate them, it will come to pain

https://www.instagram.com/p/BT2ASMvANEU/?taken-by=stefanduell

06. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

Just got in...

05. May 2017

Madrid - Mutua Madrid Open - ATP Masters 1000

QUADRATUS LUMBORUM MUSCLE (QL) SERIES 5/9: STRETCHING OF THE QL

As a follow up on my QL series I wanted to show how you can stretch the QL and help yourself in case you suffer from lower back pain.

Before you start stretching your QL always make sure you saw a health professional first who confirmed you doesn’t suffer of a herniated disc!!! Then the stretching is not for you as there is a totally different process of rehab for that! 
Also make sure your health professional has cleared your hips and pelvis first! 
The stretching will bring the maximal effect if your health professional has freed your QL muscle from trigger points and tightness!

QUADRATUS LUMBORUM MUSCLE (QL) SERIES 6/9: OSTEOPATHIC MANIPULATION OF THE SACROILIAC JOINT USING THE CHICAGO TECHNIQUE HVLA

The QL is influencing the position of the SI-Joint. A shorten and tight QL can restrict the SI-Joint movement:

An anterior rotated Ilium bone causing a functional long leg requires posteriorization. First of all you should make sure to have released all myofascial structures which cause an anterior rotation of the ilium bone: Quadratus lumborum, Iliacus, Erector spinae, Latissimus dorsi, Adductors, Rectus femoris, Tensor fascia latae, gluteus medius and External obturator. Usually if you do a proper myofascial release treatment the ilium will correct itself but sometimes it can still stay anteriorized. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the ilium bone to the right position otherwise it can force lower back problems or even knee or foot problems!

30. April 2017

Physiotherapeut Stefan Düll Sports-Physiotherapy über die folgen einseitiger Belastung beim Tennis. Lies den gesamten Artikel hier: http://www.hammer.de/…/richtig-…/bilaterales-training-tennis

29. April 2017

The piriformis is a small, relatively short, and little-known muscle buried deep within the muscle tissue in your hips.
In each hip, it runs from the back of your pelvis to the top of your femur. Because of its unique positioning, the piriformis muscle helps rotate your leg outward when your hip is extended, but rotates your leg inward and into abduction when your hip is flexed.

23. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

21. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

The popliteus muscle is a fairly small muscle located behind the knee. It runs from the lateral side of the femur to the medial side of the tibia, lying deep beneath the main calf muscle. Its role is to unlock the knee just after the heel touches the ground when you are walking or running. It also has an important role when running downhill as it assists the posterior cruciate ligament (PCL) in decelerating the femur and preventing its sliding forward on the tibia.

20. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

There are 4 muscles involved in the suboccipital region also called 'Upper Cervical Spine': Rectus capitis posterior minor, Rectus capitis posterior major, Obliquus capitis inferior and Obliquus capitus superior. These muscles are deeper than all other muscles in the back of the neck and they are very strongly connected to our eyes to give the feedback to the larger neck muscles as to where the head is positioned!

MYOFASCIAL RELEASE OF THE TRAPEZIUS AND STERNOCLEIDOMASTOID MUSCLE (SCM)

The trapezius muscle is one of the largest superficial muscles that extend longitudinally from the occipital bone to the lower thoracic vertebrae and laterally to the spine of the scapula. Its functions are to move the scapulae and support the arm.
The trapezius has three functional regions: the superior region (descending part), which supports the weight of the arm; the intermediate region (transverse part), which retracts the scapulae; and the inferior region (ascending part), which medially rotates and depresses the scapulae. Its main function is to stabilize and move the scapula.
The trapezius muscle trigger points can lead to referred pain in the shoulder region and head as you can see on the red marked zones in the picture. Additionally, the muscle can cause biomechanical problems in the cervical and thoracic spine.

MYOFASCIAL RELEASE OF THE LONGUS COLLI/CAPITIS MUSCLE

The longus colli gets its name for the Latin for long muscle of the neck. The muscle acts as a flexor of the head and neck when its acts bilaterally, and causes rotation to the ipsilateral side when it acts unilaterally. The longus colli consists of three sections: a superior oblique, an inferior oblique and a vertical. The arterial supply to the muscle comes from the muscular branches of the ascending cervical artery. The innervation to the muscle comes from the anterior rami of the 2nd to 6th cervical spinal nerves.

19. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

18. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

Now that you've worked on different stabilizing muscles of the scapula in the previous posts let's work on more advanced functional exercises to prepare the scapulothoracal joint for tougher situations in daily life or your overhead sport ->  HIGH END SCAPULAR STABILITY!

The exercise shown in the video requires a lot of scapular and core control!
Being able to move slowly under control is the key to this for any given movement, make sure you can do it slowly. You need to dictate the movement and be in control the entire time. Choose random exercises every once in a while that are outside of your usual routine!

For video click here:

https://www.instagram.com/p/BTEAFzUAOiN/?taken-by=stefanduell

SHOULDER PAIN SERIES 22/23 - SHOULDER GIRDLE STABILITY - SHOULDER BLADE ADDUCTION AND SHOULDER JOINT EXTERNAL ROTATION EXERCISE:

Now that you've worked on scapular stability in the previous posts let's work on some exercises for the rotator cuff of the shoulder joint to give the shoulder girdle even more stability and being ready for the competition!

Crossover Symmetry training to protect the shoulder joint is very important and a basic part of an injury prevention or rehab program. This video shows a combined shoulder blade adduction and external rotation exercise which is very important to keep the shoulder girdle in the right position. Essential for all athletes especially professional tennis players to keep them free of pain and injuries in the shoulder joint!

17. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

Now that you've worked on your serratus anterior muscle, rhomboids and mid traps in the previous posts let's work on another very important structure to create even more control in the scapulothoracic joint, the ascending part of the trapezius muscle.

The video shows how to train and put some load into the lower part of the trapezius muscle (ascending part) which is essential for a good posture and therefore a well functioning cervical spine, shoulder joint and upper limb. It is very often forgotten in the conventional workouts to work on this particular movement. This exercise is designed not only for professional athletes - it´s very important for everyone to include it into your training routine especially if you suffer from cervical spine or shoulder problems!

16. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

In this video you can see another possibility to target the rhomboids and middle traps to get them firing!

I actually prefer this exercise compared to the one I posted yesterday, but the yesterday's one might be easier for beginners to get used to the movement!

15. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

14. April 2017

Monte Carlo/Monaco - Monte Carlo Rolex Masters - ATP 1000

12. April 2017

Würzburg

SHOULDER PAIN SERIES 15/23 - THE FASCIAL DISTORTION MODEL™:

Fascial Distortion Model™ (FDM) developed by Dr. Stephen Typaldos D.O., a very good and effective therapy method not only if you work with professional athletes. I experienced incredible good results with that method!

What is FDM?
FDM is a model of diagnosis and treatment for common musculoskeletal conditions. FDM practitioners can diagnose and treat virtually every musculoskeletal injury. Using six specific problems (or “distortions”) in the body’s connective tissue, we can improve conditions such as pulled muscles, strains, sprains, and frozen shoulders. So why use FDM? Patients can benefit from a quicker reduction in pain, and often immediate improvements in movement restrictions.

11. April 2017

Würzburg

The subclavius muscle is a short muscle of the shoulder girdle. It originates at the first rib (border between the bone and cartilage) and inserts at the lower surface of the lateral clavicle. The main task of the subclavius muscle is the active stabilization of the clavicle in the sternoclavicular joint during movements of the shoulder and arm. Furthermore its contraction leads to a depression of the clavicle and elevation of the first rib respectively. .
Its importance lies in the fact that it can influence the movement and position of the shoulder joint.
Despite its importance, the subclavius isn’t well known or appreciated which is very unfortunate, as in my experience it is a very important key muscle to have always in focus, especially if your patient is suffering from shoulder or cervical spine problems!

Once you understand its position and actions, it is not surprising that the subclavius can be a source of shoulder pain, not only because it is sore or hurt, but because when it gets too tight it can pull the shoulder forward and down, thus misaligning the shoulder joint. Any time the gleno-humeral joint, sterno-clavicular joint or acromio-clavicular joint aren't aligned properly, pain can arise. The subclavius muscle triggerpoint can lead to referred pain in the arm as you can see on the red marked zones in the picture. Additionally, the muscle can cause biomechanical problems in the cervical spine, due to its influence on the first rib in terms of elevating it, as the rotation in the cervical spine will be irritated.

On the picture you can see different possibilities of treating the subclavius muscle.

SHOULDER PAIN SERIES 13/23 - THE LATISSIMUS DORSI MUSCLE:

The latissimus dorsi muscle, whose name means “broadest muscle of the back,” is one of the widest muscles in the human body. Also known as the “lat,” it is a very thin triangular muscle that is not used strenuously in common daily activities but is an important muscle in many exercises such as pull-ups, chin-ups and lat pulldowns.
The latissimus dorsi muscle has its origins along the lumbodorsal fascia of the lower back, arising from the inferior thoracic and lumbar vertebrae, sacrum, iliac crest, and the four most inferior ribs. From its many widespread origins, it runs obliquely, superiorly and laterally through the back and armpits to insert on the posterior side of the humerus of the upper arm. As the latissimus dorsi approaches its insertion point, the many muscular fibers from its many origins merge to a point, giving the muscle a triangular shape.
The latissimus dorsi has several different functions, all of which involve movements of the arm. The primary function of the lat is the adduction of the arm, which is often used when performing a pull-up or chin-up or when pulling a heavy object down from a shelf above one’s head. Another function of the lat is extension of the arm, as in swinging the arm toward the back. This motion is used when swinging the arms while walking as well as during rowing exercises. Finally, the latissimus dorsi medially rotates the arm, moving the front of the arm towards the body’s midline. It also plays a role in extension and lateral flexibility of the lumbar spine and has an impact on pelvic positioning!

SHOULDER PAIN SERIES 14/23 - THE SERRATUS ANTERIOR MUSCLE:

The serratus anterior muscle also known as the ´boxers muscle´ originates on the top surface of the eight or nine upper ribs and inserts exactly at the anterior surface and medial border of the scapula. The muscle has three sections: the superior, intermediate or medial, and the inferior. The function of the serratus anterior muscle is to allow the forward rotation of the arm and to pull the scapula forward in protraction and around the rib cage. The scapula is able to move laterally due to the serratus anterior muscle, which is vital for the elevation of the arm. The serratus anterior muscle also allows the upward rotation of the arm, which allows a person to lift items over their head. It is intimately connected to the Rhomboids and makes a sling for the Scapula to balance between protraction and retraction! Unfortunately it is a muscle that commonly gets overlooked!

10. April 2017

Würzburg

Protracted Shoulder Girdle and Automobilization with the Blackroll® and BLACKROLL® BALL:

Why your shoulders and thoracic spine are rounded? 
Many people suffer nowadays from this alignment which is caused mainly by 2 key muscles: 1 the pectoralis minor and 2 the lower trapezius muscle (ascending part of the trapezius). 1 The pectoralis minor runs from the coracoid process down to ribs 3-5. It will become adaptively short when sitting at the desk, working with computers, favor exercises such as the bench press or other pressing exercises etc., which most people do! Being in poor positions and using the pecs will cause this adaptative shortening and tightness. When the pec minor is positioned short it will pull down on the scapula tilting it forward. It also will inhibit (weaken) the rhomboids, lower trapezius and serratus anterior which will lead to muscular imbalances!
2 The lower trap runs from vertebra T7-T12 up to the spine of the scapula. Normally this muscle pulls down on the scapula from the back creating a balancing act with the pectoralis minor for the scapula position. But if the pec minor is getting tight and short throughout poor positioning the lower trap gives up and gets weaker and weaker!

SHOULDER PAIN SERIES 8/23 - PROTRACTED SHOULDER GIRDLE - MYOFASCIAL RELEASE OF THE PECTORALIS MAJOR MUSCLE:

Regarding my yesterdays post about the 'Protracted Shoulder Girdle and Automobilization with the Blackroll® and BLACKROLL® BALL' I wanted to show some treatment techniques to my colleagues on how to work on that problem especially if the patient suffers from shoulder or cervical spine problems!

In the video you can see a myofascial release technique for the pectoralis major muscle. It is very important to perform the fascial technique from proximal to distal to lengthen the fascia of the pec major to give the shoulder girdle enough freedom to move back to the right position (Retraction + Depression)!

SHOULDER PAIN SERIES 9/23 - PROTRACTED SHOULDER GIRDLE - MYOFASCIAL RELEASE OF THE PECTORALIS MINOR MUSCLE
. 
Regarding my previous post about the Protracted Shoulder Girdle and Automobilization with the BLACKROLL® and Blackroll® BALL I wanted to show some treatment techniques to my colleagues on how to work on that problem:
. 
Role of the pectoralis minor muscle?
The pectoralis minor runs from the coracoid process down to ribs 3-5. It will become adaptively short when sitting at the desk, working with computers, favor exercises such as the bench press or other pressing exercises etc., which most people do! Being in poor positions and using the pecs will cause this adaptative shortening and tightness. When the pec minor is positioned short or tight it will pull down on the scapula tilting it forward. It also will inhibit (weaken) the rhomboids, lower trapezius and serratus anterior which will lead to muscular imbalances. Further it can lead to thoracic spine, cervical spine or shoulder problems!

In the video you can see an active myofascial release technique for the pectoralis minor muscle by Dalton Myoskeletal Therapy. I experienced very good results with this technique, you should try it! Thanks to Erik Dalton for showing me that one! 

SHOULDER PAIN SERIES 10/23 - PROTRACTED SHOULDER GIRDLE - MYOFASCIAL RELEASE OF THE PECTORALIS MINOR MUSCLE:

Check my yesterday's post about the myofascial release of the pectoralis minor muscle! 
Here is another possibility regarding treatment: in this case the therapist is moving the arm of the client in abduction and adduction while the elbow of the opposite arm of the therapist is treating the pectoralis minor muscle.

SHOULDER PAIN SERIES 11/23 - PROTRACTED SHOULDER GIRDLE - MYOFASCIAL RELEASE OF THE PECTORALIS MINOR MUSCLE:

Another possibility regarding my previous post about the myofascial release of the pectoralis minor muscle:

Out of this position with your thumb you can perform 1 a trigger point technique, 2 a release technique between the fascia of pec major and minor or 3 a release technique for the complete pec minor muscle!

1 If you want to perform a trigger point technique make sure you hold the pressure as long the patient tells you the pain or the radiation goes down or the pain is not radiating anymore but at least for 1 minute and finish the technique then with a Ponçage. I usually hold the pressure until i feel a myofascial release under my finger!

2 If you decide to release the fascial connection between pec major and minor use your thumb or finger 2-4 and stay between pec major and minor until you feel a fascial release!

3 If you do the complete pec minor fascial release technique make sure you perform the technique from proximal to distal to lengthen the fascia of the pec minor to give the shoulder girdle enough freedom to move back to the right position (Retraction + Depression)! 

07.-09. April 2017

Belgrade - Davis Cup - Serbia vs. Spain

06. April 2017

Belgrade - Davis Cup - Serbia vs. Spain

05. April 2017

Belgrade - Davis Cup - Serbia vs. Spain

#DavisCup #TeamSerbia #Belgrade #TeamSpirit ‬

SHOULDER PAIN SERIES 6/23 - MYOFASCIAL RELEASE OF THE SUPRASPINATUS MUSCLE

I m in Belgrade right now preparing with the Serbian Davis Cup by BNP Paribas team for the tie vs. Spain, thank you Dusan Lajovic Official for the pictures!

Regarding to my previous post about the Impingement Syndrome I wanted to focus on the supraspinatus muscle and show some treatment possibilities.

04. April 2017

Belgrade - Davis Cup - Serbia vs. Spain

#DavisCup #TeamSerbia #SRBvsESP #Physiotherapist

03. April 2017

Würzburg

ANATOMY TRAINS 

Just received this awesome delivery: BLACKROLL® foam rollers especially prepared for the Serbian Davis Cup by BNP Paribas team including flag. Thank you so much Blackroll® for the support! Ready to head out to Belgrade! 

#Blackroll #DavisCup #TeamSerbia

SHOULDER PAIN SERIES 4/23 - LEVATOR SCAPULAE MUSCLE PAIN AND MYOFASCIAL RELEASE OF LEVATOR SCAPULAE MUSCLE:

The levator scapulae muscle resides at that back and side of the neck. Levator means to lift in Latin, so as the name implies, its goal is to lift the scapula. It comes up by tendinous slips from the transverse processes of the atlas and axis and from the posterior tubercles of the transverse processes of the third and fourth cervical vertebrae. It is embedded into the vertebral border of the scapula, amid the medial angle and the triangle smooth surface at the root of the spine.

Great post by @dr.jacob.harden which actually fits exactly to my previous post on how to perform a self-treatment for the levator scapulae muscle!
. 
#Repost @dr.jacob.harden
・・・
THIS MUSCLE IS A REAL PAIN IN THE NECK - SWIPE LEFT!

02. April 2017

Miami - Miami Open - ATP 1000

6 weeks USA ATP World Tour trip - on my way home for one day and Tuesday to Belgrade to support my serbian friends (Novak Djokovic, Janko Tipsarevic Official, Viktor Troicki, Nenad Zimonjić and Dusan Lajovic Official) at the Davis Cup by BNP Paribas quarterfinals tie Serbia vs. Spain! #TeamSpirit

01. April 2017

Miami - Miami Open - ATP 1000

Congrats to Marcelo Melo and Łukasz Kubot on an incredible run the last 4 weeks: runner-up at BNP Paribas Open and tournament win at Miami Open - Bravo! Keep it going guys! #TeamMeloKubot

31. March 2017

Miami - Miami Open - ATP 1000

Mobility, Flexibility and Stability of the spinal system are very important aspects to watch at! The 'Lower Trunk Rotation' and 'Upper Trunk Rotation' exercises as shown on the picture can help to manage it!

Don't forget to activate your core muscles before you start doing this exercises but also in general before exercising like I explained in yesterday's post.
Good muscular control of the core and spine is the!

#Core #Stabilization #InjuryPrevention

SHOULDER PAIN SERIES 1/23 - TRAINING ADVICE:

If you suffer from shoulder pain, check your training habits!

#Repost @vinnierehab

SHOULDER PAIN SERIES 2/23 - TRAPEZIUS MUSCLE PAIN AND MYOFASCIAL RELEASE:

Your trapezius muscles are some of the first to bother you when you are under stress. They ache and burn from the base of your skull to between your shoulder blades. The good news is that the pain is relatively easy to get under control!
When we are under stress, one of the first muscles to cause us pain is our trap muscles, and part of that reason is because of the role they play in our movement. 
The trapezius is a broad triangular muscle which attaches to the base of the skull, and lies at the back of the neck, over the upper shoulders and extends down your upper back to your mid back. It is one of the most likely muscles to get sore knots or “trigger points”.
The trap muscles are the only muscles which can lift the outside of your shoulders to create a “shrug”. They move the head and neck toward the shoulder of the other side. The middle of the muscles pull the shoulder blades together, while the lower draw the shoulder blades downward. They support the weight of the arms.
Often these movements are at play when we are under stress, and doing the activities that cause stress.

SHOULDER PAIN SERIES 3/23 - MYOFASCIAL RELEASE OF THE TRAPEZIUS MUSCLE AND OSTEOPATHIC VIEW:

The trapezius muscle is one of the largest superficial muscles that extend longitudinally from the occipital bone to the lower thoracic vertebrae and laterally to the spine of the scapula. Its functions are to move the scapulae and support the arm. The trapezius has three functional regions: the superior region (descending part), which supports the weight of the arm; the intermediate region (transverse part), which retracts the scapulae; and the inferior region (ascending part), which medially rotates and depresses the scapulae. Contraction of the trapezius can have two effects: movement of the scapulae when the spinal origins are stable, and movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula. 
This muscle tends to develop too much tension for postural reasons, such as forward head posture (where it has to work overtime to stabilise the head and neck due to poor alignment). Other reasons include poor breathing patterns (shallow neck breathing all day), and muscle imbalances elsewhere.
The trapezius muscle trigger points can lead to referred pain in the shoulder region and head (headache) as you can see on the red marked zones in the picture. They also can initiate trigger points in the jaw joint muscles. Additionally, the muscle can cause biomechanical problems in the cervical and thoracic spine.

30. March 2017

Miami - Miami Open - ATP 1000

29. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 14/15: THORACIC ROTATION AUTOMOBILIZATION EXERCISE (SELF-TREATMENT) 

Your thoracic spine needs to be mobile - our body is smart and will find to get that motion from somewhere else! Those areas of compensation might lead to poor movement patterns, overuse and pain.

An immobility or stiffness in the thoracic spine can lead to rounded shoulders, shoulder pain, elbow pain, wrist pain, neck pain, lower back pain and even hip pain. That´s why it is very important to include thoracic mobilization exercises in your daily training routine!

This post describes how to mobilize the thoracic spine included in the mobilization of 'The Posterior Spiral Line' by @AnatomyTrainsOfficial:

You don't even need a training device as you can perform it with a simple automobilization exercise! Flexibility is very important and it keeps the fascial connective tissue in good condition as well as to prevent injuries! Stretching is a 'Must Do' for every athlete and human being! 

THORACIC SPINE (T-SPINE) SERIES 15/15: THORACIC ROTATION AUTOMOBILIZATION EXERCISE (SELF-TREATMENT) 

Your thoracic spine needs to be mobile - our body is smart and will find to get that motion from somewhere else! Those areas of compensation might lead to poor movement patterns, overuse and pain.

An immobility or stiffness in the thoracic spine can lead to rounded shoulders, shoulder pain, elbow pain, wrist pain, neck pain, lower back pain and even hip pain. That´s why it is very important to include thoracic mobilization exercises in your daily training routine!

This post describes how to mobilize the thoracic spine included in the mobilization of 'The Anterior Spiral Line' by @AnatomyTrainsOfficial:

Use the @TRXtraining T-Spine Rotation Exercise which is a simple active thoracic spine automobilization everybody can perform! It is very important to keep the fascial connective tissue in good condition as well as to prevent injuries!

28. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 12/15: SEGMENTAL THORACIC EXTENSION AUTOMOBILIZATION EXERCISE WITH THE BLACKROLL® (SELF-TREATMENT)

In my previous posts about the thoracic spine I showed mainly the treatment techniques for my colleagues on how to work on misalignments in this part of the human body. Following on, I will provide some input to you all out there on how to work on it by your own especially after receiving some treatment to keep up the balance ⚖ - stay tuned!

The thoracic spine is built from its anatomical structure to be mobile! That's why it is very important to keep it mobile and even to visualise and feel the possible movement in the thoracic spine. Many people don't even know or just are not able to feel that there is a specific movement possible, for visualising this movement the Blackroll® is an excellent training device.

THORACIC SPINE (T-SPINE) SERIES 13/15: SEGMENTAL THORACIC AUTOMOBILIZATION EXERCISE FOR ROTATION (SELF-TREATMENT)

Your thoracic spine needs to be mobile - our body is smart and will find to get that motion from somewhere else! Those areas of compensation might lead to poor movement patterns, overuse and pain.

An immobility or stiffness in the thoracic spine can lead to rounded shoulders, shoulder pain, elbow pain, wrist pain, neck pain, lower back pain and even hip pain. That´s why it is very important to include this mobilization exercise in your daily training routine.

27. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 9/15: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE THORACO-LUMBAR-JUNCTION HVLA

The T12-L1 spinal segment, also referred to as the thoraco-lumbar-junction (TL Junction), is located at the very bottom of the thoracic spine.
More specifically, this is where the thoracic spine connects with the lumbar spine.

26. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 7/15: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE UPPER THORACIC SPINE SUPINE HVLA

An upper thoracic spine subluxation requires a mobilization. First of all you should make sure to have released all myofascial structures which cause an upper thoracic spine subluxation as I explained in my previous post about the intrinsic back muscles. Usually if you do a proper myofascial release treatment the upper thoracic spine subluxation will correct itself but sometimes it can still stay subluxated. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the joint to the right position otherwise it can force thoracic, cervical or shoulder problems.

THORACIC SPINE (T-SPINE) SERIES 8/15: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE LOWER THORACIC SPINE SUPINE HVLA

A lower thoracic spine subluxation requires a mobilization. First of all you should make sure to have released all myofascial structures which cause an upper thoracic spine subluxation as I explained in my previous post about the intrinsic back muscles. Usually if you do a proper myofascial release treatment the c-t-junction will correct itself but sometimes it can still stay subluxated. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the joint to the right position otherwise it can force thoracic, cervical or shoulder problems.

25. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 4/15: THE IMPORTANCE OF THE INTRINSIC  BACK MUSCLES (AUTOCHTHONOUS BACK MUSCLES) + MYOFASCIAL TREATMENT  

The muscles of the back can be divided into three groups – superficial, intermediate and intrinsic:

Superficial – associated with movements of the shoulder.

Intermediate – associated with movements of the thoracic cage.

Deep – associated with movements of the vertebral column. The deep muscles develop embryologically in the back, and are thus described as intrinsic muscles. The deep muscles of the back are well-developed, and collectively extend from the sacrum to the base of the skull. They are associated with the movements of the vertebral column, and the control of posture. The muscles themselves are covered by deep fascia, which plays a key role in their organisation.

Anatomically, the deep back muscles can be divided into three layers: superficial, intermediate and deep. 

The superficial muscles are also known as the spinotransversales. There are two muscles in this group – splenius capitis and splenius cervicis. They are both associated with movements of the head and neck. 

There are three intermediate intrinsic back muscles – the iliocostalis, longissimus and spinalis. Together these muscles form a column, known as the erector spinae. The erector spinae is situated posterolaterally to spinal column, between the vertebral spinous processes and the costal angle of the ribs.

All three muscles can be subdivided by their superior attachments, into: lumborum, thoracic, cervicis and capitis.

The deep intrinsic muscles are located underneath the erector spinae. They are a group of short muscles, associated with the transverse and spinous processes of the vertebral column. There are three major muscles in this group: the semispinalis, multifidus and rotatores.

This deep muscles can cause subluxations in the facet joints of the thoracic spine, that's why it is very important to apply a proper myofascial release treatment on these structures. Usually I do not use a lot of treatment devices, but in this case the Small Bevelled-Tip T-BAR (St. John Neuromuscular Therapy) is very useful!

On the picture you can see several myofascial release techniques for the thoracic intrinsic muscles.

THORACIC SPINE (T-SPINE) SERIES 5/15: MANUAL THORACIC SPINE EXTENSION MOBILIZATION

The thoracic spine is built from its anatomical structure to be mobile for rotation, flexion and extension! That's why it is very important to keep it mobile and even to visualise and feel the possible movement in the thoracic spine. Many people don't even know or just are not able to feel that there is a specific movement possible. But it has to be known because the thoracic spine must be used and must be moved! If people are unable to visualise and feel the movement of the thoracic spine, they will find another way to get that motion from somewhere else like lumbar spine, cervical spine or shoulder blades because our body is smart and very good in compensating. Those areas of compensation might lead to poor movement patterns, overuse and pain!

24. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 3/15: NERVOUS SYSTEM AND VISCERAL INFLUENCE OF A THORACIC FACET JOINT SUBLUXATION

23. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 2/15: THE IMPORTANCE OF THE THORACIC DIAPHRAGM AND MYOFASCIAL TREATMENT

Diagnosis and treatment of the thoracic diaphragm muscle is very important not only if you work with professional athletes - it is very important for every human being!

The thoracic diaphragm muscle is the most important muscle of inhalation. The diaphragm separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity and performs an important function in respiration: as the diaphragm contracts, the volume of the thoracic cavity increases and air is drawn into the lungs. It has a lot of very important fascial connections to the sternum, the ribs, the thoracic/lumbar spine, to abdominal organs as well as to an other very important muscle in our body - the iliopsoas muscle, which can cause a lot of problems too! There are three large openings in the diaphragm through which structures pass between the thorax and abdomen: the aortic, the esophageal and the caval opening plus a series of smaller ones which are very important for blood circulation and lymph circulation. The diaphragm is also involved in non-respiratory functions, helping to expel vomit, feces and urine from the body by increasing intra-abdominal pressure and even preventing acid reflux by exerting pressure on the esophagus as it passes through the esophageal hiatus. If you are familiar with the anatomy of the diahragm you will easily understand that it can cause spine or stomach problems, it can prevent injuries, increase endurance and even support recovery as this muscle is involved in breathing mechanism and blood circulation! The diaphragm muscle plays a very important role during the examination of the human body, especially when I am working with professional tennis players. If it has any restrictions, it can limit the movement especially in the THORACIC SPINE rotation and decrease the performance, and even increase the risk of injuries due to the fact that other parts of the human body have to compensate it!

#Physiotherapy #Osteopathy 

(Treatment technique: Lutz M. Scheuerer - Deutsches Fortbildungsinstitut für Osteopathie)

On my way to work! 

22. March 2017

Miami - Miami Open - ATP 1000

THORACIC SPINE (T-SPINE) SERIES 1/15: THE IMPORTANCE OF THORACIC SPINE MOBILITY

The thoracic spine is built from its anatomical structure to be mobile for rotation, flexion and extension! That's why it is very important to keep it mobile and even to visualise and feel the possible movement in the thoracic spine. Many people don't even know or just are not able to feel that there is a specific movement possible. But it has to be known because the thoracic spine must be used and must be moved! If people are unable to visualise and feel the movement of the thoracic spine, they will find another way to get that motion from somewhere else like lumbar spine, cervical spine or shoulder blades because our body is smart and very good in compensating. Those areas of compensation might lead to poor movement patterns, overuse and pain!

An immobility or stiffness in the thoracic spine can lead to rounded shoulders, shoulder pain, elbow pain, wrist pain, neck pain, lower back pain and even hip pain. That´s why it is very important to include mobilization exercises and stretching exercise in your daily training routine!

In my next posts I will talk about specific treatment possibilities for therapists and self-treatment possibilities for patients - stay tuned!

#Thoracic #Spine #Physiotherapy #Osteopathy

21. March 2017

Miami - Miami Open - ATP 1000

Thank you @vinnierehab for this post! I don't know how many discussions I had already with fitness coaches or even doctors about exactly this issue and unfortunately many of them just don't or don't want understand!
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@vinnierehab
・・・
THE CRUNCH : Analysis + Advice
[A+A / CORE]
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Who hasn't at some point in their life done thousands upon thousands of sit-ups / crunches in hope of having a sculpted midsection?
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I remember when I was younger at karate school, the warm-up at the start of every class was 100 sit-ups and planks till you puked lol.
Ain't going to lie, as much as I don't think it was functional to do that back then, it definitely was a character builder, to push past the pain and keep going  #feeltheburn
.
However, as you grow older, have injuries and more experience in this life, you realize that pushing through bad form and poor exercise programming is a silly idea! 
.
Especially if you suffer from back pain, this exercise does nothing but compress your lumbar spine
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This exercise according to some studies can cause hundreds of pounds of compression on the discs of your spine, and the repeated bending can potentially herniate your discs
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To fully understand why this is a bad exercise, let's have a look at the function of the abs!
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Common misconception out there is that people think the function of the abs is to flex the lumbar spine when really the abs mainly contract eccentrically in functional movement to DECELERATE extension of the spine in the sagittal plane
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There is never a point in time in functional movement that your abs are asked to contract CONSCIOUSLY. Your core is meant to react to movement SUBCONSCIOUSLY as you go through life
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That is why the crunch doesn't make sense as an exercise functionally because not only does it crush your spine, your body is never asked to do such a movement consciously
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So if your goals are more functional than aesthetic, there is much better options out there that will not only get you looking shredded, but will also make you move like a ninja!!!

20. March 2017

Miami - Miami Open - ATP 1000

THE SACROILIAC JOINT SERIES 4/4: FOAM ROLLING WITH THE Blackroll® ON IMPORTANT STRUCTURES WHICH CAN FORCE LOWER BACK, HIP, KNEE AND FOOT PROBLEMS:

Some general information about foam rolling on the important muscles which keep the ilium bone in the anterior rotated position regarding my previous post: 'Osteopathic Manipulation of the Sacroiliac Joint using the Chicago Technique HVLA'.

How to perform a self myofascial release (self massage) to your muscles? Every foam rolling fanatic knows how to do it but it is very important to make sure to spend time on each of the individual muscles which keep the ilium bone in anterior rotated position (Iliacus muscle, Erector spinae muscles, Latissimus dorsi muscle, Adductor muscles, Rectus femoris muscle, Quadratus lumborum muscle, Tensor fascia latae muscle, gluteus medius muscle and External obturator muscle).
Make sure that you roll slowly among each muscle, trying to identify areas of tightness or discomfort. Pause on these areas for several seconds and the tightness should begin to ease. Continue this process on each muscle until it feels as though you have an improvement or a decrease in general tightness. Ensuring you roll each muscle from the origin to the insertion is a good way to target the entire length of the muscle.

19. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

THE SACROILIAC JOINT SERIES 3/4: OSTEOPATHIC MANIPULATION OF THE SACROILIAC JOINT USING THE CHICAGO TECHNIQUE HVLA

An anterior rotated Ilium bone causing a functional long leg requires posteriorization. First of all you should make sure to have released all myofascial structures which cause an anterior rotation of the ilium bone: Iliacus muscle, Erector spinae muscles, Latissimus dorsi muscle, Adductor muscles, Rectus femoris muscle, Quadratus lumborum muscle, Tensor fascia latae muscle, gluteus medius muscle and External obturator muscle. Usually if you do a proper myofascial release treatment the ilium will correct itself but sometimes it can still stay anteriorized. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the ilium bone to the right position otherwise it can force lower back problems through an so-called ascending kinematic chain or even knee or foot problems through a descending kinematic chain.

18. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

THE SACROILIAC JOINT SERIES 2/4: OSTEOPATHIC MANIPULATION OF THE SACROILIAC JOINT USING THE LUMBAR ROLL TECHNIQUE HVLA

A posterior rotated Ilium bone causing a functional short leg requires anteriorization. First of all you should make sure to have released all myofascial structures which cause an posterior rotation of the ilium bone: Hamstring muscles, Gluteus maximus muscle, Rectus abdominis muscle, Obliquus externus abdominis muscle and Adductor magnus muscle. Usually if you do a proper myofascial release treatment the ilium will correct itself but sometimes it can still stay posteriorized. If so, it requires a high velocity low amplitude (HVLA) thrust technique to get the ilium bone to the right position otherwise it can force lower back problems through an so-called ascending kinematic chain or even knee or foot problems through a descending kinematic chain.

17. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

THE SACROILIAC JOINT SERIES 1/4: SACROILIAC JOINT DYSFUNCTION AND PAIN

Low back pain is very common, the sacroiliac joint (SI-Joint) is a major source of lower back pain. Pain originating from the SI-Joint is usually unappreciated, underdiagnosed, misunderstood and usually intributed to other sources such as the hip and spine! Patients experiencing lower back pain can spent months or even years in treatment without the correct diagnosis. Diagnostic injection at the SI-Joint is the only means to confirm diagnosis. Pain from the hips, spine and SI-Joint can overlap in the associated regions. If the patient has a back problem and it doesn’t improve for several months it is important to look at the SI-Joint!

16. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

Thank you for 100 thousand views on my previous Instagram post! @StefanDuell

I wanted to share another great taping technique to support the foot and the calf in terms of injury prevention or even if you suffer from an injury like plantar fasciitis, achilles tendinitis or a calf muscle strain/tear.

Dynamic Tape to support the longitudinal arch of the foot incl. the achilles tendon and the calf muscle. 

15. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

Regarding my previous post on 'how to prevent feet of a professional athlete from blisters and serious injuries in the ankle' I wanted to show another great taping technique to support the foot in terms of injury prevention or even if you suffer from an injury like Plantarfasciitis or Metatarsalgia.

Dynamic Tape to support the longitudinal and transverse arch of the foot: in that case the tennis player suffered from a Metatarsalgia. The pain was gone after I have put the tape and the athlete was able to play pain-free!

14. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

INVERSION TRAUMA SERIES 5/5: HOW TO PREVENT FEET FROM INVERSION TRAUMA

The video describes how I prevent the feet of a professional athlete from blisters and serious injuries in the ankle! In the video you can see how I prepare Janko Tipsarevic Official for his singles match at Davis Cup by BNP Paribas competition Serbia vs. Czech Republic.

13. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

INVERSION TRAUMA SERIES 4/5: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT) OF THE TIBIO TALAR JOINT HVLA

Regarding my previous post about myofascial treatment of the inversion trauma, it is very important to correct the tibiotalar joint if it is still in the wrong position. Usually if you do a proper myofascial release treatment it will correct itself but sometimes it can still stay in the wrong place. If so, there is a high chance to suffer from an ankle dorsiflexion range of motion (DO ROM) deficit which can be reduced significantly through this kind of manipulation! 

!!! But watch out: never do this manipulation in the acute phase of an inversion trauma as it can lead to an internal bleeding and edema. To be on the secure side you can apply the HVLA thrust technique 4-5 days after the injury happened!!!
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The tibiotalar joint involves the talus moving in the ankle mortise, the major motions of this joint are dorsiflexion and plantar flexion. Dorsiflexion is more functional, more stable because the talus is wider anteriorly and fits securely into the ankle mortise. Reduction in dorsiflexion usually indicates that the tibia is anterior on the talus.

12. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

INVERSION TRAUMA SERIES 3/5: OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT)  OF THE PROXIMAL (SUPERIOR) TIBIOFIBULAR JOINT HVLA PRONE POSITION

Another possibility regarding my previous post about the manipulation of the proximal tibiofibular joint. In this case the patient is laying in prone position and the therapist is using his pisiforme bone of the right hand as a hypomochlion to pull the fibula head to the right position with a high velocity low amplitude (HVLA) thrust technique. 

#Chiropractic #Adjustment #Physiotherapy #Osteopathy

11. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

INVERSION TRAUMA SERIES 2/5: MOBILIZATION AND OSTEOPATHIC MANIPULATION (CHIROPRACTIC ADJUSTMENT)  OF THE PROXIMAL (SUPERIOR) TIBIOFIBULAR JOINT HVLA SUPINE POSITION

Regarding my previous post about myofascial treatment of the inversion trauma, it is very important to correct the proximal tibiofibular joint if it is still in the wrong position. Usually if you do a proper myofascial release treatment it will correct itself but sometimes it can still stay in the wrong place. If so, there is a high chance to get lateral knee problems or to force an so-called ascending kinematic chain which even can lead to a wrong position of your pelvis and furthermore to lower back problems, if you don´t work on it properly! Additionally, the patients usually suffer from an ankle DF ROM deficit which can be reduced significantly through this kind of manipulation!

10. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

INVERSION TRAUMA SERIES 1/5: FASCIAL TREATMENT

09. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

MYOFASCIAL RELEASE OF THE JAW JOINT MUSCLES

There are 4 muscles which are basically involved in the movement of the jaw joint: Masseter muscle (Originates at the zygomatic bone and inserts at the mandible), Temporalis muscle (Originates at the temporal bone and inserts at the coronoid process of the mandible), Medial pterygoid muscle (Originates at the lateral pterygoid plate and inserts at the mandible) & Lateral pterygoid muscle (Originates at the sphenoid bone and lateral pterygoid plate and inserts at the mandible). The masseter muscle is the strongest muscle in the human body and can harbour some of the most common triggerpoints. The masseter muscle triggerpoints can lead to referred pain in the head as you can see on the red marked zones in the picture. The masseter muscle can force headache, toothache, tinnitus, bruxism, jaw clenching or TMJ syndrome. The temporalis muscle triggerpoints can lead to headache and toothache as well. The lateral pterygoid muscle triggerpoints can lead to cheek pain (like sinusitis), tinnitus, sore throat and TMJ pain. The medial pterygoid muscle triggerpoints can lead to the same symptoms as the lateral pterygoid. The jaw joint muscles are connected to the suboccipital muscles and shoulder muscles. Triggerpoints in the jaw joint muscles can initiate triggerpoints in the suboccipital muscles and shoulder region (esp. in the trapezius muscle). That means whenever you treat the jaw joint you always have to focus on the cervical spine and shoulder region as well!
On the picture you can see different possibilities of treating the jaw joint muscles intra and extra oral.

08. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

SEGMENTAL THORACIC AUTOMOBILIZATION EXERCISE WITH THE BLACKROLL®

The thoracic spine is built from its anatomical structure to be mobile! That's why it is very important to keep it mobile and even to visualise and feel the possible movement in the thoracic spine. Many people don't even know or just are not able to feel that there is a specific movement possible, for visualising this movement the Blackroll® is an excellent training device.

Your spine needs to be mobile - our body is smart and will find to get that motion from somewhere else! Those areas of compensation might lead to poor movement patterns, overuse and pain.

07. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

MUSCLES WHICH CAN INITIATE HEADACHES - SERIES 5/5: THE SUBOCCIPITAL MUSCLES

There are 4 muscles involved in the suboccipital region also called 'Upper Cervical Spine': Rectus capitis posterior minor, Rectus capitis posterior major, Obliquus capitis inferior and Obliquus capitus superior. These muscles are deeper than all other muscles in the back of the neck and they are very strongly connected to our eyes to give the feedback to the larger neck muscles as to where the head is positioned! The purpose of these muscles is to provide fine motor function in movements of the head. The actions of trapezius, sternocleidomastoid and other larger muscles that move the head are refined by the relatively small suboccipital muscles. As the neck starts to flex in the lower cervical, our eyes always want to look forward, the head and upper cervical spine starts to extend, the suboccipitals shorten and hold the back of the skull to the top two vertebrae (Atlas and Axis) and lock it in place. As I described already in my previous post, these muscles are also a common area to develop trigger points that can cause terrible headaches as you can see on the red marked zones in the picture. Approximately 50% of the neck rotation should come from the first two vertebrae. The rest of the cervical spine splits the other 50%, gradually rotating less and less as you progress from C3 to C7. The suboccipital area is very prone to get stiff and immobile, when the upper cervical spine can't rotate properly, that motion get picked up by the lower cervical spine, which we want to be actually more stable!

06. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

MUSCLES WHICH CAN INITIATE HEADACHES - SERIES 4/5: THE TEMPORALIS MUSCLE

The temporalis muscle originates at the temporal bone and inserts at the coronoid process of the mandible, it is a fan shaped muscle on each side of the skull. It is a major muscle involved in moving the temporomandibular joint (Jaw joint muscle). Excess tension here can be a big cause of headaches. This muscle works a lot and gets brutally tight over time. Clenching the teeth due to things like stress and anxiety will greatly increase this tension. The temporalis muscle trigger points can lead to headache and toothache as well. The temporalis muscle is connected to the suboccipital muscles and shoulder muscles. Trigger points in the temporalis can initiate trigger points in the suboccipital muscles and shoulder region (esp. in the trapezius muscle). That means whenever you treat the temporalis you always have to focus on the cervical spine and shoulder region as well:

05. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

MUSCLES WHICH CAN INITIATE HEADACHES - SERIES 3/5: THE MASSETER MUSCLE

The masseter muscle (originates at the zygomatic bone and inserts at the mandible) is the strongest muscle in the human body and can harbour some of the most common trigger points. It is a major muscle involved in moving the temporomandibular joint (jaw joint muscle). Excess tension here can be a big cause of headaches. This muscle works a lot and gets brutally tight over time. Clenching the teeth due to things like stress and anxiety will greatly increase this tension. The masseter muscle trigger points can lead to referred pain in the head as you can see on the red marked zones in the picture. The masseter muscle can force headache, toothache, tinnitus, bruxism, jaw clenching or TMJ syndrome. The masseter muscle is connected to the suboccipital muscles and shoulder muscles. Trigger points in the masseter can initiate trigger points in the suboccipital muscles and shoulder region (esp. in the trapezius muscle). That means whenever you treat the masseter you always have to focus on the cervical spine and shoulder region as well!

On the picture you can see several myofascial release techniques for the masseter muscle.

P.S.: If you have any dentist treatment, you should always have checked all the Jaw joint muscles after, as it can lead to exactly those problems mentioned above. Usually they won't appear right on the next day after, as the human body is very good at compensating, but they can appear anytime later on. Each single dental treatment is a kind of a micro-trauma, and if the body can no longer compensate them, it will come to problems!

04. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

Just got in at this beautiful place on the tennis planet: BNP Paribas Open. Definitely the best ATP World Tour Masters tournament of the year! #IndianWells #USA 

04. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

MUSCLES WHICH CAN INITIATE HEADACHES - SERIES 2/5: THE STERNOCLEIDOMASTOID MUSCLE

The sternocleidomastoid muscle (SCM) is a paired muscle in the superficial layers of the side of the neck. It is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The muscle tends to be overactive in many people we see. It is commonly recruited to help stabilise the neck/head when we adopt poor postures and positions (forward head posture). It is also an accessory muscle to breathing along with the scalenes, so having poor breathing patterns and habits will cause this muscle to overwork all day long and develop too much tension and trigger points. The SCM trigger points can cause a variety of symptoms including headache and face pain, balance problems, visual disturbances, ear and sinus symptoms, and more body wide symptoms. It is the only muscle that creates such wide spread problems.

03. March 2017

Indian Wells - BNP Paribas Open - ATP 1000

If you or your patient is suffering from headaches, watch out to my upcomig posts!

MUSCLES WHICH CAN INITIATE HEADACHES - SERIES 1/5: THE TRAPEZIUS MUSCLE

The trapezius muscle is one of the largest superficial muscles that extend longitudinally from the occipital bone to the lower thoracic vertebrae and laterally to the spine of the scapula. Its functions are to move the scapulae and support the arm. The trapezius has three functional regions: the superior region (descending part), which supports the weight of the arm; the intermediate region (transverse part), which retracts the scapulae; and the inferior region (ascending part), which medially rotates and depresses the scapulae. Contraction of the trapezius can have two effects: movement of the scapulae when the spinal origins are stable, and movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula. 
This muscle tends to develop too much tension for postural reasons, such as forward head posture (where it has to work overtime to stabilise the head and neck due to poor alignment). Other reasons include poor breathing patterns (shallow neck breathing all day), and muscle imbalances elsewhere.
The trapezius muscle trigger points can lead to referred pain in the shoulder region and head (headache) as you can see on the red marked zones in the picture. They also can initiate trigger points in the jaw joint muscles. Additionally, the muscle can cause biomechanical problems in the cervical and thoracic spine.

The trapezius is innervated by the accessory nerve (Cranial nerve XI) which is content of the jugular foramen, where the accessory nerve can get compressed or entrapped. If so, it can lead to hypertension in the trapezius. That's why it is very important to treat (release) this foramen to give the nerve enough space to work properly.

(Treatment techniques by Lutz M. Scheuerer - Deutsches Fortbildungsinstitut für Osteopathie)

01. March 2017

Acapulco - Abierto Mexicano del Tenis - ATP 500

Piriformis Muscle Syndrome (PMS) and Myofascial Treatment

The piriformis is a small, relatively short, and little-known muscle buried deep within the muscle tissue in your hips.
In each hip, it runs from the back of your pelvis to the top of your femur. Because of its unique positioning, the piriformis muscle helps rotate your leg outward when your hip is extended, but rotates your leg inward and into abduction when your hip is flexed.
Your piriformis is positioned immediately adjacent to the sciatic nerve, a very thick nerve which runs from the base of your spine along your glute muscles and down the back of your legs, providing the nerve signals that allow all of the muscles on the back side of your lower body to fire when needed.
When the piriformis muscle is irritated, the sciatic nerve can get irritated too.
In around fifteen percent of people, the sciatic nerve actually passes through the piriformis, which, according to some researchers, leaves these individuals more susceptible to piriformis syndrome.
Symptoms of PMS:
1 - Classically, it feels like an aching, soreness, or tightness in your butt, between the back of your pelvis (the sacrum, specifically) and the top of your femur.
2 - Pain, tightness, tingling, weakness, or numbness can also radiate into your lower back and down the back side of your leg, through your hamstrings and calves.
3 - Buttock pain and tightness with prolonged sitting is also a common occurrence.
4 - When you run, you will probably feel pain in your butt throughout the stance phase of your stride.

28. February 2017

Acapulco - Abierto Mexicano del Tenis - ATP 500

THE POPLITEUS MUSCLE:

The popliteus muscle is a fairly small muscle located behind the knee. It runs from the lateral side of the femur to the medial side of the tibia, lying deep beneath the main calf muscle. Its role is to unlock the knee just after the heel touches the ground when you are walking or running. It also has an important role when running downhill as it assists the posterior cruciate ligament (PCL) in decelerating the femur and preventing its sliding forward on the tibia.

Because of its role in assisting the PCL on downhills, runners can start developing symptoms after an abnormally long hill-training session. People with unstable knees (torn ligaments, torn meniscus, arthritis…) are also prone to develop a popliteus problem because of its important role in stabilizing the knee. The popliteus muscle is kind of a key muscle, if there are any irritations inside or outside the knee happening the popliteus usually reacts with tightness and triggerpoints which can lead to pain situations of the knee.

27. February 2017

Acapulco - Abierto Mexicano del Tenis - ATP 500

Just arrived at this beautiful place, unfortunately not for vacation but there are worse places in the world to work at! With Marcelo Meloand Yen-Hsun Rendy Lu the upcoming week in Acapulco at Abierto Mexicano de Tenis.

26. February 2017

Delray Beach - Delray Beach Open - ATP 250

PROTRACTED SHOULDER GIRDLE AND HYPERKYPHOTIC T-SPINE SERIES 5/5:

Another possibility regarding my previous post about the myofascial release of the pectoralis minor muscle:

Out of this position with your thumb you can perform a Triggerpoint technique, a release technique between the fascia of pec major and minor or a release technique for the complete pec minor muscle! If you do the complete pec minor fascial release technique make sure you perform the technique from proximal to distal to lengthen the fascia of the pec major to give the shoulder girdle enough freedom to move back to the right position (Retraction + Depression)!

25. February 2017

Delray Beach - Delray Beach Open - ATP 250

PROTRACTED SHOULDER GIRDLE AND HYPERKYPHOTIC T-SPINE SERIES 4/5:

Another possibility regarding my yesterday's post about the myofascial release of the pectoralis minor muscle. In this case the therapist is moving the arm of the client in abduction and adduction while the elbow of the opposite arm of the therapist is treating the pectoralis minor muscle.

24. February 2017

Delray Beach - Delray Beach Open - ATP 250

PROTRACTED SHOULDER GIRDLE AND HYPERKYPHOTIC T-SPINE SERIES 3/5:

Regarding my previous post about the Protracted Shoulder Girdle, Hyperkyphotic T-Spine and Automobilization with the @BLACKROLL® and BLACKROLL® BALL I wanted to show some treatment techniques to my colleagues on how to work on that problem:
Role of the pectoralis minor muscle?

23. February 2017

Delray Beach - Delray Beach Open - ATP 250

PROTRACTED SHOULDER GIRDLE AND HYPERKYPHOTIC T-SPINE SERIES 2/5:

Regarding my yesterdays post about the Protracted Shoulder Girdle, Hyperkyphotic T-Spine and Automobilization with the Blackroll® and BLACKROLL® BALL I wanted to show some treatment techniques to my colleagues on how to work on that problem:

In the video you can see a myofascial release technique for the pectoralis major muscle. It is very important to perform the fascial technique from proximal to distal to lengthen the fascia of the pec major to give the shoulder girdle enough freedom to move back to the right position (Retraction + Depression)!

22. February 2017

Delray Beach - Delray Beach Open - ATP 250

PROTRACTED SHOULDER GIRDLE AND HYPERKYPHOTIC T-SPINE SERIES 1/5:

Protracted Shoulder Girdle, Hyperkyphotic T-Spine and Automobilization with the BLACKROLL® and Blackroll® BALL:

Why your shoulders and thoracic spine are rounded? 
Many people suffer nowadays from this alignment which is caused mainly by 2 key-muscles: 1 - the pectoralis minor and 2 - the lower trapezius muscle (ascending part of the trapezius). 
1 - The pectoralis minor runs from the coracoid process down to ribs 3-5. It will become adaptively short when sitting at the desk, working with computers etc., which most people do! Being in poor positions and using the pecs will cause this adaptative shortening and tightness. When the pec minor is positioned short it will pull down on the scapula tilting it forward. 
2 - The lower trapezius runs from vertebra T7-T12 up to the spine of the scapula. Normally this muscle pulls down on the scapula from the back creating a balancing act with the pectoralis minor for the scapula position. But if the pec minor is getting tight and short throughout poor positioning the lower trap gives up and gets weaker and weaker!

21. February 2017

Delray Beach - Delray Beach Open - ATP 250

Great comeback today Rendy from 4:6 and 0:3 down. 

20. February 2017

Delray Beach - Delray Beach Open - ATP 250

THORACIC OUTLET SYNDROME SERIES 4/4:

#Physiotherapy #Osteopathy

19. February 2017

Delray Beach - Delray Beach Open - ATP 250

THORACIC OUTLET SYNDROME SERIES 3/4:

Regarding my previous post about the Thoracic Outlet Syndrome (TOS) I wanted to show some techniques to my colleagues on how to solve the PECTORALIS MINOR SYNDROME - MYOFASCIAL RELEASE OF THE PECTORALIS MINOR MUSCLE:

In this case, the compression occurs where the neurovascular bundle passes between the tendon of pectoralis minor and the coracoid process of the scapula. Tractioning is greatest with the arm in abduction, but even with the arm dependent, enough pressure frompostural problems or tight pectoralis muscles can cause symptoms.

On the picture you can see several myofascial release techniques for the pectoralis minor muscle.

18. February 2017

Delray Beach - Delray Beach Open - ATP 250

THORACIC OUTLET SYNDROME SERIES 2/4:

Regarding my yesterday's post about the Thoracic Outlet Syndrome (TOS) I wanted to show some techniques to my colleagues on how to solve the SCALENE ANTERIOR SYNDROME - MYOFASCIAL RELEASE OF THE SCALENE MUSCLES AND STERNOCLEIDOMASTOID MUSCLE:

Anatomy:
The fibres of the brachial plexus and the subclavian artery must pass through a narrow aperture between anterior and middle scalene muscle. If this aperture makes a problem it can lead to paresthesia or weaknessin the upper limb.

17. February 2017

Delray Beach - Delray Beach Open - ATP 250

TOS are a group of syndromes involving pressure on the brachial plexus.
Each syndrome is named according the structure that is causing the compression.

13. February 2017

Memphis - Memphis Open - ATP 250

Centre Court:

Cryo-Therapy:

12. February 2017

Memphis - Memphis Open - ATP 250

Piriformis Muscle Syndrome (PMS) and Automobilization (Self-Treatment):

The piriformis is a small, relatively short, and little-known muscle buried deep within the muscle tissue in your hips.
In each hip, it runs from the back of your pelvis to the top of your femur. Because of its unique positioning, the piriformis muscle helps rotate your leg outward when your hip is extended, but rotates your leg inward and into abduction when your hip is flexed.
Your piriformis is positioned immediately adjacent to the sciatic nerve, a very thick nerve which runs from the base of your spine along your glute muscles and down the back of your legs, providing the nerve signals that allow all of the muscles on the back side of your lower body to fire when needed.
When the piriformis muscle is irritated, the sciatic nerve can get irritated too.
In around fifteen percent of people, the sciatic nerve actually passes through the piriformis, which, according to some researchers, leaves these individuals more susceptible to piriformis syndrome.

10. February 2017

Memphis - Memphis Open - ATP 250

How good is that!? Checked in at my hotel and at the reception is a delivery from Bounce Canada waiting. Thank you guys, really appreciate it! 

09. February 2017

Memphis - Memphis Open - ATP 250

On the ✈️ to USA for the next ATP World Tour work journey. Upcoming destinations are Memphis (Memphis Open), Delray Beach (Delray Beach Open), Acapulco (Abierto Mexicano de Tenis), Indian Wells (BNP Paribas Open) and Miami (Miami Open).

07. February 2017

HAMMER SPORT AG Article

Thank you HAMMER SPORT AG for interviewing me and featuring an article about "muscular dysbalances in tennis" in their current issue!

Vielen Dank an Hammer Sport AG für das Interview und die Veröffentlichung eines Artikels über "Muskuläre Dysbalancen im Tennis"!

http://www.hammer.de/…/richtig-…/bilaterales-training-tennis

05. February 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Davis Cup Match Day 3: Dusan vs. Kravchuk

Match preparation for Dutzi :-)

04. February 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Davis Cup Match Day 2 Doubles: Viktor/Nenad vs. Kravchuk/Kuznetsov

03. February 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Davis Cup Match Day 1 Singles: Viktor vs. Khachanov and Novak vs. Medvedev

02. February 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Davis Cup Team Serbia at official draw ceremony today #Davis Cup by BNP Paribas #TeamSerbia

01. February 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Official Davis Cup Dinner at World Group 1st Round tie Serbia vs. Russia #Davis Cup by BNP Paribas #TeamSerbia

(Picture Credit: Teniski savez Srbije)

31. January 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Incredible team spirit in the Serbian Davis Cup by BNP Paribas Team, proud to be one part of it! 

#SRBRUS #TeamSRB #Physiotherapist #TeamSpirit

30. January 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

In Niš/Serbia for World Group 1st Round Davis Cup by BNP Paribas tie Serbia vs. Russia #TeamSerbia

29. January 2017

Nis/Serbia - Davis Cup - 1st Round Serbia vs. Russia

Looking forward to join the serbian Davis Cup team in a few hours... on my way to Belgrade to support the team at the 1st Round tie Serbia vs. Russia. Proud to be a member of one of the best national tennis teams of the world, let´s go! #DavisCup #SERvsRUS #OfficialPhysiotherapist #TeamSpirit

28. January 2017

Donaustauf/Regensburg - Eden Reha - Faszientherapeutische Arbeit im Spitzensport

The Master himself at work: Robert Schleip demonstrating a myofascial release technique of the lumbar fascia (2nd layer) - very effective if you suffer from lower back problems!

#Rolfing #MyofascialRelease #Bodywork #Physiotherapy #Osteopathy

27. January 2017

Donaustauf/Regensburg - Eden Reha - Faszientherapeutische Arbeit im Spitzensport

Just arrived back form Melbourne/Australian Open and got very lucky to catch a spot in a 2 day course regarding the newest techniques of fascial treatment in professional sports provided by two legends in their job: Klaus Eder, Physiotherapist for DFB-Team (Die Mannschaft) and Davis Cup by BNP Paribas Team Germany: One of the most important persons responsible for my own physio career with all his knowledge he provided to me and basically opened the door for me to start working in professional tennis 10 years ago! Dr. biol. hum. Robert Schleip (PhD), International Rolfing® Instructor and International Fascial Anatomy Teacher, one of the most important persons regarding #FasciaResearchworldwide: www.fasciaresearch.de! Always a pleasure to listen to this guys. Thank you to EDEN REHA for letting me attend in last minute!

#Physiotherapy #Osteopathy #FascialTreatment

24. January 2017

Melbourne - Australian Open - Grand Slam

Always a pleasure to do physiotherapy treatment with Boris Becker! #ChildhoodHero #WhenDreamsComeTrue

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19. January 2017

Melbourne - Australian Open - Grand Slam

MYOFASCIAL RELEASE OF THE TRAPEZIUS AND STERNOCLEIDOMASTOID MUSCLE (SCM):

The trapezius muscle is one of the largest superficial muscles that extend longitudinally from the occipital bone to the lower thoracic vertebrae and laterally to the spine of the scapula. Its functions are to move the scapulae and support the arm. The trapezius has three functional regions: the superior region (descending part), which supports the weight of the arm; the intermediate region (transverse part), which retracts the scapulae; and the inferior region (ascending part), which medially rotates and depresses the scapulae. Contraction of the trapezius muscle can have two effects: movement of the scapulae when the spinal origins are stable, and movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula. 
The trapezius muscle triggerpoints can lead to referred pain in the shoulder region and head as you can see on the red marked zones in the picture. Additionally, the muscle can cause biomechanical problems in the cervical and thoracic spine. Trapezius muscle and SCM triggerpoints can initiate triggerpoints in the jaw joint muscles.

17. January 2017

Melbourne - Australian Open - Grand Slam

MYOFASCIAL RELEASE OF THE SUBOCCIPITAL MUSCLES AND OSTEOPATHIC MANIPULATION OF THE OAA COMPLEX HVLA:

There are 4 muscles involved in the suboccipital region also called 'Upper Cervical Spine': Rectus capitis posterior minor, Rectus capitis posterior major, Obliquus capitis inferior and Obliquus capitus superior. These muscles are deeper than all other muscles in the back of the neck and they are very strongly connected to our eyes to give the feedback to the larger neck muscles as to where the head is positioned! 
The purpose of these muscles is to provide fine motor function in movements of the head. The actions of trapezius, sternocleidomastoid and other larger muscles that move the head are refined by the relatively small suboccipital muscles. 
As the neck starts to flex in the lower cervical, our eyes always want to look forward, the head and upper cervical spine starts to extend, the suboccipitals shorten and hold the back of the skull to the top two vertebrae (Atlas and Axis) and lock it in place. As I described already in my previous post, these muscles are also a common area to develop trigger points that can cause terrible headaches. Another cause for headaches can be a suboccipital nerve entrapment (Occipital neuralgia). The nerve is content of the suboccipital triangle bounded by the Rectus capitis posterior major, the Obliquus capitis superior and the Obliquus capitis inferior. The nerve may become entrapped beneath the attachments of the trapezius and semispinalis capitis muscles to the occipital bone especially if the Occiput-Altlas-Axis-Complex (OAA) is in the wrong position. Approximately 50% of the neck rotation should come from the first two vertebrae. The rest of the cervical spine splits the other 50%, gradually rotating less and less as you progress from C3 to C7. The suboccipital area is very prone to get stiff and immobile, when the upper cervical spine can't rotate properly, that motion get picked up by the lower cervical spine, which we want to be actually more stable! On the picture you can see several myofascial release techniques for the suboccipital muscles as well as a mobilization technique for the upper cervical spine to flexion and a Osteopathic Manipulation of the Occiput-Atlas-Axis-Complex (OAA) using the Chin-Hold-Technique (HVLA). Usually if you do a proper myofascial release treatment, the Occiput-Atlas-Axis-Complex (OAA) will get into the right position by itself. If not, it requires a high velocity low amplitude (HVLA) thrust technique! In this case the Atlas had a shift lesion to the right.
#Physiotherapy #Osteopathy

15. January 2017

Melbourne - Australian Open - Grand Slam

MYOFASCIAL RELEASE OF THE JAW JOINT MUSCLES:

There are 4 muscles which are basically involved in the movement of the jaw joint: Masseter muscle (Originates at the zygomatic bone and inserts at the mandible), Temporalis muscle (Originates at the temporal bone and inserts at the coronoid process of the mandible), Medial pterygoid muscle (Originates at the lateral pterygoid plate and inserts at the mandible) & Lateral pterygoid muscle (Originates at the sphenoid bone and lateral pterygoid plate and inserts at the mandible). The masseter muscle is the strongest muscle in the human body and can harbour some of the most common triggerpoints. The masseter muscle triggerpoints can lead to referred pain in the head as you can see on the red marked zones in the picture. The masseter muscle can force headache, toothache, tinnitus, bruxism, jaw clenching or TMJ syndrome. The temporalis muscle triggerpoints can lead to headache and toothache as well (red zones in the picture). The lateral pterygoid muscle triggerpoints can lead to cheek pain (like sinusitis), tinnitus, sore throat and TMJ pain. The medial pterygoid muscle triggerpoints can lead to the same symptoms as the lateral pterygoid. The jaw joint muscles are connected ⛓to the suboccipital muscles and shoulder muscles. Triggerpoints in the jaw joint muscles can initiate triggerpoints in the suboccipital muscles and shoulder region (esp. in the trapezius muscle). That means whenever you treat the jaw joint you always have to focus on the cervical spine and shoulder region as well! I will show in my next post how to treat the suboccipital region and the trapezius muscle.
On the picture you can see different possibilities of treating the jaw joint muscles intra and extra oral.

14. January 2017

Melbourne - Australian Open - Grand Slam

You suffer from lower back pain?

Add foam rolling to your workout! It is very helpful and supports myofascial treatment to reduce the fascial tension in TFL muscle and IT band which can cause an outflare ilium and additionally a sacrum contranutation, that leads to an asymmetric position (hypolordosis) in the lumbar spine and to lower back problems! #Blackroll®

13. January 2017

Melbourne - Australian Open - Grand Slam

Just checked in at Australian Open, the best Grand Slam of the year!

10. January 2017

Auckland - ASB Classic - ATP 250

MYOFASCIAL RELEASE OF THE SUBCLAVIUS MUSCLE

The subclavius muscle is a short muscle of the shoulder girdle. It originates at the first rib (border between the bone and cartilage) and inserts at the lower surface of the lateral clavicle. The main task of the subclavius muscle is the active stabilization of the clavicle in the sternoclavicular joint during movements of the shoulder and arm. Furthermore its contraction leads to a depression of the clavicle and elevation of the first rib respectively. 

Its importance lies in the fact that it can influence the movement and position of the shoulder joint.

Despite its importance, the subclavius isn’t well known or appreciated which is very unfortunate, as in my experience it is a very important muscle to have always in focus, especially if your patient is suffering from shoulder or cervical spine problems!

Once you understand its position and actions, it is not surprising that the subclavius can be a source of shoulder pain, not only because it is sore or hurt, but because when it gets too tight it can pull the shoulder forward and down, thus misaligning the shoulder joint. Any time the gleno-humeral joint, sterno-clavicular joint or acromio-clavicular joint aren't aligned properly, pain can arise. The subclavius muscle triggerpoint can lead to referred pain in the arm as you can see on the red marked zones in the picture. Additionally, the muscle can cause biomechanical problems in the cervical spine, due to its influence on the first rib in terms of elevating it, as the rotation in the cervical spine will be irritated.

On the picture you can see different possibilities of treating the subclavius muscle.

09. January 2017

Auckland - ASB Classic - ATP 250

FOAM ROLLING with the BLACKROLL on important structures which can force lower back, hip, knee and foot problems:

Some general information about foam rolling on the important muscles which keep the ilium bone in the anterior rotated position regarding my post on 5th of January: 'Osteopathic Manipulation of the Sacroiliac Joint using the Chicago Technique HVLA'.

How to perform a self myofascial release (self massage) to your muscles? Every foam rolling fanatic knows how to do it but it is very important to make sure to spend time on each of the individual muscles which keep the ilium bone in anterior rotated position (Iliacus muscle, Erector spinae muscles, Latissimus dorsi muscle, Adductor muscles, Rectus femoris muscle, Quadratus lumborum muscle, Tensor fascia latae muscle, gluteus medius muscle and External obturator muscle).

08. January 2017

Auckland - ASB Classic - ATP 250

Center Court:

Segmental Thoracic Automobilization Exercise with the Blackroll

The thoracic spine is built from its anatomical structure to be mobile! That's why it is very important to keep it mobile and even to visualise and feel the possible movement in the thoracic spine. Many people don't even know or just are not able to feel that there is a specific movement possible, for visualising this movement the BLACKROLL is an excellent training device.
An immobility or stiffness in the thoracic spine can lead to rounded shoulders, shoulder pain, elbow pain, wrist pain, neck pain and even lower back pain. That´s why it is very important to include this mobilization exercise, together with a pectoralis muscle stretching exercise in your daily training routine. Because if the pectoralis muscle is locked short it won't be possible to mobilize the thoracic spine properly!

07. January 2017

Auckland - ASB Classic - ATP 250

Walking around and trying to kill Mr. JetlagWalking around and trying to kill Mr. Jetlag after a 24h trip #Chennai #Dubai #Auckland #NewZealand #ASB Classic #ATP World Tour

06. January 2017

Chennai - Aircel Chennai Open - ATP 250

Thank you Aircel Chennai Open, it was a great week supporting Yen-Hsun Rendy Lu and Andre Begemann in an amazing city. Ready for a 24h trip to Auckland for ASB Classic, next tournament of 2017 ATP World Tour season!

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