Low Back Pain Assessment & Management workshop | KDU | International Research Council | August 2015

Low Back PainAssessment and Management

Workshop-The Latest Developments from Australia-

Kotelawala Defence University IRCAugust 2015

Kusal Goonewardena (MaSpPhysio, GradCertSpPhysio, BaPhysio)Elite Athlete (APA) Sports PhysiotherapistHead of Sports MedicineElite Akademy Sports Physiotherapy Melbourne Australia

WHO I AM AND WHAT I DO…

One

15year CareerFounder/Director of 3 Sports Medicine

Clinics Australia

Over 50,000 Treatment Sessions in Sports Injuries & Performance

Melb Uni Sports Physio since 2002Head of Sports Medicine at Melb Uni

since 2008

Lecturer, Consultant Australia, China, Singapore, Sri

Lanka

Author

THE CHALLENGES OF TREATING LOW BACK PAIN

Two

The Most Common Types of Low Back Pain

Musculo-Ligamentous Strain/Sprain

Facet Joint Inflammation or

Stiffness Bulging Disc


Degenerative Disc Disease

SIJ Inflammation


MY STORY OF STRUGGLE AND FINDING A SYSTEM THAT WORKED

Three

3 Sessions or less

1. Reduce Pain

2. Correct Biomechanics

3. Exercises to Prevent Re-injury

Flowcharts

MY STORY OF FINDING A SOLUTION

Four

Why do I get Pain?

Why do I get Pain?

Why do I get Pain?

Why do I get Pain?

Solving Pain

The Performance Pyramid

The Ridgway Method

THE RESULTS WE HAVE ACHIEVED TO DATE

Five

Number of Sessions for Full Healing in Low Back Pain

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on 1

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OldNew

Results and Awards

THE MYTHS AND NEW TRENDS

Six

Myth

Pain is a feeling…NOPE!

Fixing your Pain ✔

75% of Low Back Pain caused by…Trend #1 - Neural tightness

75% of Low Back Pain caused by…Trend #2 and #3

75% of Low Back Pain caused by…Trend #4 - Gluteals

75% of Low Back Pain caused by…Trend #5 - Subscapularis

HERE’S THE STEP BY STEP GUIDE TO SOLVE LOW BACK PAIN

Seven

Elite Akademy Performance Pyramid™

1.What is it? 2. Where did it originate?

3. How does it work?

4. Why is it different?

5. What are the steps to learn?

6. What are the key areas to concentrate

on?

7. What should I do first and continue to

keep in mind?


Outlines all the fundamentals required for success with musculoskeletal injuries in sport

Answers the Question, “What will you do to help me?” and “How will you help me?”

Process for comprehensive treatment and rehabilitationImproves objectivity, increases understanding (increase compliance)Increases awareness of what you do as a practitioner

1.What is it?


1.What is it?


• Originated in 2014 at Elite Akademy Sports Physiotherapy- University of Melbourne

• Founded by Kusal Goonewardena and his sports medicine team’s pursuit of

• ‘Making a Difference in 3 Sessions or Less’

2. Where did it originate?



Each needs to improve by 85% for best outcome



Any Pyramid is as strong as its base

Keep working from the bottom up to complete the Pyramid

Start on 1. Biomechanics then 2. Functional Range 3. Functional Core 4. Functional Core and finally 5. Strength and Conditioning


EACH step of the process is measured

Same process is applicable for ANY athlete in - Rehabilitation, Prehabilitation, Performance Enhancement and Screening

Communication ‘Currency’ between players, coaches and other practitioners is the SAME

4. Why is it different?


5. What are the steps to learn?

The 5 Fundamentals Step by Step

The Weighting Score on each


1. Tests to Measure and Improve Biomechanics (Ridgway Method)

2. Tests to Measure, Improve Functional Range and Control(Ridgway Method)

3. Tests to Measure and Improve Functional Core (Clinical Pilates)

4. Tests to Measure and Improve Strength and Conditioning (Numerous!)

6. What are the key areas to concentrate

on?


1. Master how to measure and Improve Biomechanics – The Base of the Performance Pyramid

2. Communicate the Performance Pyramid to Coaches, Athletes, Athlete’s Parents, Other Practitioners

3. Refer back to the Performance Pyramid when identifying ‘How Your Athlete Is Going?’

7. What should I do first and continue to

keep in mind?


1.hat is it?

Let’s look at each fundamental…


Application of the Ridgway Method for best results

Objectively measure: Neural DynamicsMuscle ( Tight and Weak)Joint (Stiff and Lax)Behavioural

BIOMECHANICS36.0


Objectively measure and Use of Technology here

Show Your Athlete their Deficits and Areas of Improvement

FUNCTIONAL RANGE28.0



Objectively look at the quality of movement

FUNCTIONAL CONTROL20.0


Used at Elite Akademy Sports Physio – Uni of Melbourne:Clinical Pilates

Use current tests in individual sports or create tests for core assessment

FUNCTIONAL CORE12.0


Individual Programs (Strength vs Endurance vs. Sports Specific)Personal trainers, Gym Instructors

Strength & Conditioning

4.0


PRACTICAL SESSIONEight



Objectively measure: Neural DynamicsMuscle ( Tight and Weak)Joint (Stiff and Lax)Behavioural

BIOMECHANICS36.0

Neural Dynamic Testing


Neural Dynamic Testing


Neural Mobility - Treatment










Assessing where 75% of LBP Originates


Thoracic Spine



Gluteals



Lumbar Spine – Anterior Disc Approach



Subscapularis

Combine Treatment + Functional Test = Treatment Directional Test ‘TDT’

Results in Real Time

FUNCTIONAL RANGE28.0


Combine Treatment + Functional Test = Treatment Directional Test ‘TDT’Results in Real Time

FUNCTIONAL CONTROL20.0


Clinical Pilates

Use current tests in individual sports or create tests for core assessment

FUNCTIONAL CORE12.0


Individual Programs (Strength vs Endurance vs. Sports Specific)Personal trainers, Gym Instructors


4.0


Maintaining Your Gains

1. Posture - 3000 reps

2. Taping

3. Clinical Pilates

Live Client Demonstration

The Performance PyramidThe Ridgway Method

MEASURING PROGRESS AND REHABILITATION

Nine

Elite Akademy Performance Pyramid™ Scoring the Pyramid

FUNDAMENTAL % YOUR PERFORMANCE SCORE NORMAL VALUES

Biomechanics[36.0]

30.6 – 34.2

Functional Range [28.0] 23.8 – 26.6

Functional Control [20.0] 17.0 - 19.0

Functional Core [12.0] 10.2 – 11.4


[4.0] 3.4 – 3.8

Your Peak Performance

score: _____________Peak Performance 85.0

- 95.0


Loading Tolerance

When your Peak Performance Score is >85.00 your Loading (intensity of training, competing) matches your Tolerance. Result

is no pain, no symptoms. The body is a well oiled machine.


Loading Tolerance

7-14 DAYS

20%

Once your Peak Performance Score is >85.00 you can increase your Loading (training, intensity) by 20% over a

period of 7-14 days, and your body will be able to Tolerate it. For elite athletes, you can increase your Loading by

~30% over a period of 5-10 days. (I.e. you tolerate things faster).


Loading Tolerance

>20%

PAIN/SYMPTOMS

If you increase your Loading by >20% the body finds it difficult to Tolerate this amount of change. When your

body's Tolerance does not match the Loading then pain/symptoms are the result.


RECAPTen

What I want you to have achieved today

• Understand where 75% of low back pain comes from

• How to assess and treat Neural immobility, Lumbar Spine , The Thoracic Spine, The Gluteals and Subscapularis

• Understand Treatment Directional Tests (Real-Time Results)

• Learn preventative measures and rehab accelerators

• Objectively measure and communicate progress

WHAT TO DO NEXTEleven

Three things you should do now..

1. Assess Neural for every person

2. Assess Lx, Tx, Glutes and Subscap for every LBP sufferer

3. Use Performance Pyramid to map your progress

FAQ’sQ: Kusal will you be coming back for more lectures?A: Only if you want me to

Q: Do you have an online course I can do?A: Yes, we have created an Australian accredited online short Sports Physiotherapy course. Email me if you’re interested.

FAQ’sQ: Can I access Online Ridgway Method Training?A: Yes! Special PD video’s by Michael Ridgway for Sri Lankan Participants.

Click HERE to go directly there.

Or cut and paste this into your browserwww.ridgwaymethod.com/OnlineModules-SriLanka-pg29304.html

Any further Questions:[email protected]

http://ridgwaymethod.com/OnlineModules-SriLanka-pg29304.html




mailto:[email protected]

Final ThoughtsOur Mission at Elite Akademy Sports Medicine…1. Help Practitioners Achieve their Best2. To help Athletes Achieve the Best Results, in the Shortest Period of Time.

We love What We Do and We love Sport. (And So Do I!)

Congratulations!

You have successfully completed the

Low Back Pain Assessment and Management

Workshop

Thank You!If you have any questions at all please do not hesitate to

send a note or call our clinic +613 8344 4948

My email address is: [email protected] twitter address is @kusalkumar

The Elite Akademy twitter address is @EliteAkademy

We share practitioner and athletes success stories and advice on our Facebook site

www.facebook.com/EliteAkademy

Lastly these slides have been uploaded to www.slideshare.net/KusalGoonewardena

Here’s Wishing You A Career and a Lifetime of Happiness!

http://www.slideshare.net/KusalGoonewardena

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Low Back Pain Assessment & Management workshop | KDU | International Research Council | August 2015

Education