Physio & Rehab Lab - Andreas Antoniou

Cervicogenic Headaches 🤯⚠️

📝 A cervicogenic headache 🤦‍♀️ (CeH) is a secondary headache that arises for various reasons in the cervical spine 🩻 and its related anatomical components.

📚 Evidence based Recommended Treatment plan 💊 involves the use of

▶️ Exercise and Manual therapy 🙌 💪

➖Exercise therapy, when paired 🤝 with manipulative therapy, has proven effective in decreasing ⬇️ headache frequency and severity, with lasting effects. The combination of manipulative therapy and exercise can offer added benefits, although not notably* better than either therapy on its own.
➖ Spinal Manipulative Therapy (SMT) has demonstrated effectiveness in decreasing headache severity, duration, and medication usage in individuals with CeH.

▶️Effectiveness of Exercise Programs:

➖Specific 🎯 cervical and scapular stretching and strengthening exercises are beneficial for reducing ⬇️ pain and improving ⬆️ function in patients with cervicogenic headaches in both the short and long term

➖ Progressive 📈 therapeutic exercise programs, including proprioceptive 🏂 low-load and high-load exercises for the neck muscles, can decrease 📉 the intensity and frequency of cervicogenic headaches.
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📚 Scientific References

Jull, G., Trott, P., Potter, H., Zito, G., Niere, K., Shirley, D., Emberson, J., Marschner, I., & Richardson, C. (2002). A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic Headache. Spine, 27, 1835-1843. https://doi.org/10.1097/00007632-200209010-00004.

Ylinen, J., Nikander, R., Nykänen, M., Kautiainen, H., & Häkkinen, A. (2010). Effect of neck exercises on cervicogenic headache: a randomized controlled trial.. Journal of rehabilitation medicine, 42 4, 344-9 . https://doi.org/10.2340/16501977-0527.

Rinne, M., Garam, S., Häkkinen, A., Ylinen, J., Kukkonen-Harjula, K., & Nikander, R. (2015). Therapeutic Exercise Training to Reduce Chronic Headache in Working Women: Design of a Randomized Controlled Trial. Physical Therapy, 96, 631 - 640. https://doi.org/10.2522/ptj.20150267.

⚠️ Back pain and surgery 🔪⛓️

▫️When is it necessary, when is it not?

▫️Are there other solutions?

🔎 Let’s take a 👀 at what the research says:

▪️There is a substantial amount of evidence 🔍 indicating that structural damage to the back can be significant without causing pain. Conversely, back pain can be severe even in the absence of observable 👀 damage. This is a common occurrence, as most cases of chronic low back pain are classified as "non-specific"❓❓ meaning the cause cannot be pinpointed to a mechanical or structural issue. Despite the limited correlation ✖️between back pain and structural damage, many surgeries are performed to address any identified abnormalities on MRI scans 🩻. However, some of these surgical 🔪 interventions may not provide better outcomes than conservative treatments.

▪️For instance, vertebroplasty involves injecting 💉 bone cement into fractured vertebrae to alleviate back pain. A study from 2003 revealed that this procedure was no more effective than receiving no treatment after six weeks. Additionally, studies📚 from 2009 demonstrated that vertebroplasty was not superior to a sham procedure for fractures associated with osteoporosis.

▪️Another common procedure 🛠️, low back fusion, aims to stabilize ⛓️vertebrae that may be impinging on sensitive structures like nerves. In a 2013 study published in the Spine Journal, spinal fusion was compared to non-operative treatments such as 🧠 cognitive behavioral therapy and exercise 🏋️. The research found no significant difference in long-term outcomes and suggested that lumbar fusion should not be prioritized over conservative care and exercise for chronic low back pain patients.

▪️A meta-analysis in 2014 concluded that:

▶️“There is strong evidence that lumbar fusion is not more effective than conservative treatment in reducing perceived disability because of chronic low back pain among patients with degenerative spinal diseases. It is unlikely that further research on the subject would considerably affect this conclusion”
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PS: The intention of this post is not to disregard the effectiveness of any surgery and other experts opinions. Whenever you have to decide upon such important matters always seek guidance from a specialist such as a Neurosurgeon. The intention was to help people not rush when taking decisions that could affect their quality of life and their health, but instead search for more options!

📝 References
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↪️. Diamond, Terrence H, Bernard Champion, and William A Clark. 2003. “Management of Acute Osteoporotic Vertebral Fractures: A Nonrandomized Trial Comparing Percutaneous Vertebroplasty with Conservative Therapy.” The American Journal of Medicine 114 (4): 257–65. doi:10.1016/S0002-9343(02)01524-3.
↪️. Kallmes, David F., Bryan A. Comstock, Patrick J. Heagerty, Judith A. Turner, David J. Wilson, Terry H. Diamond, Richard Edwards, et al. 2009. “A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures.” New England Journal of Medicine 361 (6): 569–79. doi:10.1056/NEJMoa0900563.
↪️. Mannion, Anne F., Jens Ivar Brox, and Jeremy C.T. Fairbank. 2013. “Comparison of Spinal Fusion and Nonoperative Treatment in Patients with Chronic Low Back Pain: Long-Term Follow-up of Three Randomized Controlled Trials.” The Spine Journal 13 (11): 1438–48. doi:10.1016/j.spinee.2013.06.101.
↪️Saltychev, Mikhail, Merja Eskola, and Katri Laimi. 2014. “Lumbar Fusion Compared with Conservative Treatment in Patients with Chronic Low Back Pain.” International Journal of Rehabilitation Research 37 (1): 2–8. doi:10.1097/MRR.0b013e328363ba4b

🤸🏽‍♂️ Stretching: Some evidence based proven facts that most people do not know but should!

▪️. Flexibility is a trait dictated by many factors such as our activity levels, but more so our genetics 🧬

▪️. Stretching 🙆‍♂️ is done in many different ways such as the most common static holds, or more active, dynamic, and ballistic ways.

▪️. Stretching 🙆‍♀️ doesn’t really significantly improve your performance or reduce your risk of injury for most sports ⚽️ , with the exception of a few sports where joint end of ranges are routinely reached such as in gymnastics or martial arts 🤼‍♂️

▪️. Latest research suggests that eccentric training 🏋️(resistance training done at the lengthened positions of a muscle) is an effective method of increasing lower limb flexibility. And that when compared with static stretching it has no significant differences! ♾️
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References:

Lauersen JB, Bertelsen DM, Andersen LB The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials British Journal of Sports Medicine 2014;48:871-877.

Nuzzo JL. The Case for Retiring Flexibility as a Major Component of Physical Fitness. Sports Med. 2020 May;50(5):853-870. doi: 10.1007/s40279-019-01248-w. PMID: 31845202.

O'Sullivan K, McAuliffe S, Deburca N. The effects of eccentric training on lower limb flexibility: a systematic review. Br J Sports Med. 2012 Sep;46(12):838-45. doi: 10.1136/bjsports-2011-090835. Epub 2012 Apr 20. PMID: 22522590.

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▪️ Physiotherapy Assessment is the most vital part of any treatment plan 📝 , it allows the therapist 👨‍⚕️ to create a specific and specialised treatment 💊 that obeys and aligns with the patient’s goals 🥅 and lifestyle.
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Keep and increase your strength with every workout 🏋🏻‍♀️

▪️Therapeutic exercise

🤔 What exactly is therapeutic exercise?

“In the simplest terms, therapeutic exercise involves movement prescribed to correct impairments, restore muscular and skeletal function and/or maintain a state of well-being.”

📄Ref: Bielecki and Tadi., 2023

🤓 Which health care provider is suitable to prescribe this type of therapy?

“Personnel 👨‍⚕️ depends on the type and level of therapeutic exercise.

🔹For cardiac and pulmonary rehabilitation, there is an interprofessional requirement for Physical therapists, occupational therapists, and all levels of clinical involvement due to the acuity of patients involved.
🔹For individual sports ⚽️ and musculoskeletal 🦴 injuries, only physical therapists may be necessary to guide the patient through specific regimens. Incorporating home 🏠 exercises that are easy and safe ✅ to perform alone allows peripheral surveillance with minimal risk”

📄Ref: Li-Jun Xiao et al. Adv Exp Med Biol. 2017.

🆘 Some disadvantages of our Therapeutic exercise - Pilates classes:

🤓 you will
▪️feel better
▪️move better
▪️have a better overall quality of life
▪️be able to chase your fitness oriented goals pain free

Ow and Patients with chronic low back pain will have significant improvement in pain relief and functional ability.

Ref. : Hui-Ting Lin et al. J Phys Ther Sci. 2016 Oct.

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Results: The MT+Exercise Group showed significant better values post-intervention in all variables: neck disability index: 0% patient with moderate, severe, or complete disability compared to 31% in the Exercise Group (p = 0.000) at 6-months; flexion-rotation test (p = 0.000) and pain intensity (p = 0.000) from the first follow-up to the end of the study; cervical flexion (p = 0.002), extension (p = 0.002), right lateral-flexion (p = 0.000), left lateral-flexion (p = 0.001), right rotation (p = 0.000) and left rotation (p = 0.005) at 6-months of the study, except for flexion, with significative changes from 3-months of follow up; pressure pain threshold from the first follow-up to the end of the study (p values range: 0.003-0.000).

https://pubmed.ncbi.nlm.nih.gov/34900443/

🤓 Ready to rethink the role of Kinesio Tape and embrace the power of the body's innate healing abilities?

👉🏼 Delve into Paul Westwood's insightful blog and discover a new perspective on athletic performance and self-belief.

https://www.physio-network.com/blog/kinesio-tape-negatives/

▪️Physio & Rehab Lab is a proud and certified therapeutic exercise clinical Pilates provider.

Our program can help you
• achieve greater muscle strength ☑️
• overcome common musculoskeletal problems ☑️
• improve mobility, flexibility and coordination ☑️
• improve focus and reduce stress ☑️

And therefore improving overall quality of life!

You can join the program
▪️in small group classes
▪️or private and semiprivate sessions

*certain limitations apply to group classes

For more info contact us by Direct message or call ☎️ 99282647

WHEN "JUST REST" ISN'T AN OPTION...

No one wants an injury. But when they happen, often the worst advice is given when medical professionals say "just rest".

Resting will result in you losing a lot of your hard-earned fitness. And there are plenty of strategies available to minimize this loss!

Here are 8 different strategies you can use to keep active while injured. Make the necessary modifications to keep in the gym without making symptoms worse!

I've got a free eBook on Blood Flow Restriction training for those interested... http://thebarbellphysio.com/bfr/

Η Οστεοαρθριτιδα Γόνατος 🦵 είναι η πιο συχνή πάθηση του μυοσκελετικού συστήματος Είναι στην 🏆11η θέση ανάμεσα στους υψηλότερους παράγοντες αναπηρίας

💥ACL Return to Sport

🤦🏼 This happens all too often when recovering from ACL Reconstruction surgery...

❌ People falsely assume that just because they start to feel somewhat "normal" again and their pain minimal or not present, that it means they have the green light to go back to their sport again

🚨 However, in order to truly be "ready" to return to sport, an athlete needs to be able to pass certain criteria

🏋🏻 This can include strength testing, hop, cut, agility and sprint testing, and questionnaires that evaluate knee function (i.e. IKDC Subjective Knee Evaluation Form and ACL-RSI) as well as psychological readiness to return to sport (i.e. TSK-11)

🚨 Furthermore, rehab should typically be a MINIMUM of 9 months in most cases

📚 In fact, a study from 2020 found that young athletes who return to sport BEFORE 9 MONTHS after ACL reconstruction have a rate of new injury 7 TIMES that of those who delay return (Beischer S , et al 2020)

⏰ Furthermore, progression through rehab, all the way until the athlete returns to sport, should be CRITERION-based, not TIME-based (although healing times are still important to keep in mind in the early stages, and complete ligament healing can take up to 2 years in some cases - Axe, M. J. & Shields, C. L. 2005)

✅ This means that the athlete should be able to pass certain criteria in order to move on to the next stage of rehab, all the way until they are back to playing their sport

📈 Then, even after all of this, the athlete should be gradually progressed to playing their sport at a lower intensity until they are ready to return at 100%

🎯 So, as you can see, you need to PROVE that you're ready to go back to your sport

❌ You can't (and shouldn't) just go back to playing like you did before your injury just because an arbitrary amount of time has passed or because you no longer have pain

💯 Find a knowledgeable physical therapist (and likely a good strength coach toward the later stages) who can help you SAFELY and appropriately get back to your sport at 100%!

▪️Myofascial decompression aka cupping therapy

Cupping therapy has been used for thousands of years in traditional Chinese medicine for the treatment of several chronic conditions, such as low back pain, chronic arthralgia, radiculopathy and respiratory disease.

Conclusion of a 2016 meta analyses by Bedah et al. :

"There is a promising evidence in favor of the use of cupping for musculoskeletal pain, specifically non-specific low back pai, neck pain, carpal tunnel syndrome, and brachialgia."

▪️Dry Needling - Acupuncture

- Dry needling 💉 is a tool to reduce ⬇️/ relieve pain and enhance function for various musculoskeletal conditions with variable success.

📚 References:
Gildir, 2019
Gattie, 2017

Σύνδρομο Πρόσκρουσης ⚠️

Τι είναι ακριβώς; 🤔

Το σύνδρομο πρόσκρουσης του ώμου, το οποίο ονομάζεται επίσης
• υπακρωμιακή προστριβή
• σύνδρομο προστριβής ή/και υπερακανθίου
• ώμος του κολυμβητή 🏊‍♂️ ή ώμος του ρίπτη 🤾‍♂️,
είναι ένα κλινικό σύνδρομο το οποίο παρατηρείται όταν οι τένοντες των μυών του στροφικού πετάλου ερεθίζονται και φλεγμαίνουν καθώς
διέρχονται κάτω από το ακρώμιο.
Αυτό ενδέχεται να προκαλέσει •πόνο •αδυναμία •μείωση του εύρους κίνησης στην άρθρωση του ώμου.

Αιτίες Πρόκλησης 🔦

•Δυσλειτουργία των μυών του στροφικού πετάλου
•Αστάθεια ώμου
•Δυσκινησία ωμοπλάτης κ.α.

Η διάγνωση της πάθησης γίνεται μετά από αξιολόγηση του Ιατρού 👨‍⚕️ και με εξακρίβωση με μεθόδους διαγνωστικής απεικόνισης 🖥️.

Όταν σημαντικές δομικές βλάβες δεν διακρίνονται στον ώμο, η συντηρητική θεραπεία για 3-6 μήνες είναι η αρχική επιλογή.

•Το θεραπευτικό πλάνο αντιμετωπίζει κυρίως τον πόνο στην αρχή, μετά παθητική και ενεργητική κίνηση, και στο τελικό στάδιο τη δύναμη 💪 και τον συντονισμό 🤸
•Ένα ευρύ φάσμα μεθόδων θεραπείας είναι διαθέσιμο για αυτούς τους σκοπούς.
Αυτό που συνιστάται αρχικά στην οξεία φάση, είναι να αποφεύγονται:
• κινήσεις πάνω από το κεφάλι
•γρήγορες κινήσεις
• φόρτωση της άρθρωσης με εξωτερική αντίσταση
Η τακτική χορήγηση αντιφλεγμονωδών φαρμάκων για 1-2 εβδομάδες για τη μείωση του πόνου είναι επίσης βοηθητική.

English text following 🙏

Shoulder Impingement syndrome ⚠️

What is it exactly? 🤔

The shoulder impingement syndrome, which is also called
• subacromial impingement
• supraspinatus syndrome
• shoulder of the swimmer 🏊‍♂️ or shoulder of the thrower 🤾‍♂️,
is a clinical syndrome which is usually observed when the tendons of the rotator cuff muscles get irritated and inflamed while they cross underneath the acromion. This usually is the cause of pain, weakness and the reduction in the range of motion of the shoulder joint.

Etiology of how it is Caused 🔦

Dysfunction of the rotator cuff muscles Shoulder instability
Shoulder dyskinesia etc.
Usually the diagnosis is made from the Doctor👨‍⚕️ through diagnostic screening🖥️.

In the absence of major structural damage, conservative treatment for 3–6 months is the initial therapy of choice 👌.
The treatment mainly addresses pain at first, then passive and active motion, and lastly strength 💪 and coordination🤸‍♂️.
A wide range of treatment methods is available for these purposes. It is advisable to favor the affected arm in the acute phase,
• avoiding overhead movement,
• rapid movement,
• and heavy mechanical loading of the joint.
The regular administration of anti-inflammatory drugs for 1–2 weeks to reduce pain is also helpful.

What is Lower crossed syndrome?? 🤔
🙋 A lot of times when people suffer from lower back pain, they aren't aware that the cause of it might be Lower Crossed Syndrome (LCS). LCS occurs when weak abdominal and gluteal muscles are combined with tight iliopsoas and erector spinae muscles, forming a cross when a person is standing sideways.

What causes LCS?? 🤔
💡 Lower Cross Syndrome is often related to and caused by bad posture. It is caused by an increase in stress on these certain muscles. With improper posture, training, or low awareness on how to properly perform daily tasks, muscles can suffer from one-sided stress or high tension in certain areas.

🔑 How to prevent or treat this postural adaptation?
Physiotherapists 👨‍⚕️ as movement and mobility experts are a good choice in order to prevent and treat this postural syndromes.
💊 How do Physiotherapists ⚕️ treat LCS?
This depends and differentiates as every Physiotherapist has his own "toolbox 🧰" to treat patients, but since our proffession is an evidence based practise 🤓 there will be in most cases some similarities which are suggested from the evidence 📉 such as:
Stretching 🧘 of tight muscles which results in improved strength of inhibited antagonistic muscles, probably mediated via the Sherrington’s law of reciprocal innervation. This may involve purely soft tissue approaches. Deactivating trigger points and removing muscular adhesions, Myofascial release, Core stabilization exercises to strengthen the abdominal muscles.
📄Re-education of posture and body usage. It is necessary to relearn the specific activiation of every element within the Lower Pelvic Unit. This will establish the important fundamental patterns of intra-pevlic control and will also integrate these patterns into basis functional patterns of movement control iniated from the pelvis.

Greek Text following:

Τι είναι το κάτω χιαστό σύνδρομο; 🤔
🙋 Πολλές φορές όταν οι άνθρωποι υποφέρουν από πόνο στη μέση, δεν γνωρίζουν ότι η αιτία του μπορεί να είναι το Κάτω Χιαστό Σύνδρομο (LCS). Το LCS συμβαίνει όταν οι αδύναμοι κοιλιακοί και οι γλουτιαίοι μύες συνδυάζονται με σφιχτούς καμπτήρες του ισχίου και τους εκτίνοντες μύες της μέσης, σχηματίζοντας ένα Χ όταν ένα άτομο στέκεται πλάγια.

Τι προκαλεί το LCS; 🤔
Το Κάτω Χιαστό Σύνδρομο σχετίζεται συχνά και προκαλείται από κακή στάση του σώματος. Προκαλείται από την αύξηση του στρες σε αυτούς τους συγκεκριμένους μυς. Με ακατάλληλη στάση, προπόνηση ή ελλειπής ενημέρωση σχετικά με τον τρόπο σωστής εκτέλεσης καθημερινών εργασιών, οι μύες μπορεί να υποφέρουν από μονόπλευρο στρες ή υψηλή ένταση σε ορισμένες περιοχές.

🔑 Πώς να αποτρέψετε ή να αντιμετωπίσετε αυτήν τη προσαρμογή του σώματος;
Οι φυσιοθεραπευτές ως ειδικοί στην κίνηση και την κινητικότητα είναι μια καλή επιλογή για την πρόληψη και τη θεραπεία αυτού του συνδρόμου.
💊 Πώς αντιμετωπίζουν οι φυσιοθεραπευτές ⚕️ το LCS;
Αυτό εξαρτάται και διαφοροποιείται καθώς κάθε Φυσιοθεραπευτής έχει τη δική του «εργαλειοθήκη 🧰» για τη θεραπεία ασθενών, αλλά δεδομένου ότι ο επαγγελματικός μας τομέας είναι μια πρακτική που βασίζεται σε αποδεικτικά στοιχεία 🤓 στις περισσότερες περιπτώσεις θα υπάρχουν κάποιες ομοιότητες που προτείνονται από τα στοιχεία 📉 όπως:
Τέντωμα των σφιχτών μυών που έχει ως αποτέλεσμα βελτιωμένη αντοχή ανταγωνιστών μυών. Αυτό μπορεί να περιλαμβάνει προσεγγίσεις καθαρά μαλακού ιστού. Απενεργοποίηση σημείων πυροδότησης και αφαίρεση μυϊκών συμφύσεων, μυοπεριτονιακή απελευθέρωση, ασκήσεις σταθεροποίησης κορμού για την ενδυνάμωση των κοιλιακών μυών.
Επανεκπαίδευση της στάσης του σώματος και της χρήσης του σώματος. Είναι απαραίτητο να μάθει εκ νέου ο ασθενής τη συγκεκριμένη ενεργοποίηση κάθε στοιχείου στην Κάτω Πυελική περιοχή. Αυτό θα καθιερώσει τα σημαντικά θεμελιώδη μοτίβα του ελέγχου της πυέλου (λεκάνης) και θα ενσωματώσει επίσης αυτά τα μοτίβα σε βασικά λειτουργικά πρότυπα ελέγχου κίνησης που ξεκινούν από τη λεκάνη.





References:
Key J. 2010 July;14:299-301
Janda V. 1987;253-87
Ishida, H., Hirose, R., Watanabe, S., 2012. Man. Ther. 17 (5), 427- 431. Level of Evidence: 2CLiebenson C.

➡️ What is Upper-crossed syndrome (UCS) 🤷‍♂️?
UCS is the tightness of the upper trapezius and elevator scapula on the dorsal side which crosses with tightness of the pectoralis muscles. Weakness of the deep cervical flexors, ventrally, crosses with weakness of the middle and lower trapezius.
Specific postural changes are seen 👀 in UCS, including forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and rotation or abduction and winging of the scapulae.
Exposure of the human body to gravity forces ⬇️, e.g., when standing or walking, is necessary to ensure proper activity of the skeletal muscles. When these muscles are not stimulated to resist gravity for an extended period, e.g., during prolonged sitting 👩‍💻, their stabilizing function is disturbed by the hypoactivity reaction 😴 resulting in muscular weakness and atrophy .
🔑 When it comes to how to fix "bad" posture the evidence seems to agree that a well structured and tailored program is needed based on the persons anatomical characteristics and impalances.
⚕️ Contacting a specialist like physiotherapists should be the go to option in order to get your body posture assessed and follow a complete exercise and rehabilitation program
💡Some suggestions that most experts seem to agree upon are:
The mobilisation of the thoracic region of the spine, in order to better position our bodies for muscle strengthening and activation.
And strengthening 💪 of the lower traps, after once we’ve successfully mobilized our thoracic spine we’re going to temporarily be in a much better position to be able to activate and strengthen our lower traps that are the key muscles for long term results.

Greek text following:

Τι είναι το άνω χιαστό σύνδρομο (UCS) 🤷‍♂️;
Το UCS είναι το σφίξιμο του άνω τραπέζοειδή και του ανελκτήρα της ωμοπλάτης στην ραχιαία πλευρά που χιάζονται με σφίξιμο των θωρακικών μυών. Η αδυναμία των βαθιών αυχενικών καμπτήρων, διασταυρώνεται με αδυναμία του μεσαίου και του κάτω τραπέζοειδή.
Συγκεκριμένες μεταβολές της στάσης του σώματος παρατηρούνται στο UCS, συμπεριλαμβανομένης τη μεταφορά της κεφαλής πρόσθια, της αυξημένης αυχενικής λόρδοσης και θωρακικής κύφωσης, ανυψωμένων και στραμμένων προς τα εμπρός ώμων με στροφή ή απαγωγή στις ωμοπλάτες .
Η έκθεση του ανθρώπινου σώματος σε δυνάμεις βαρύτητας ⬇️, π.χ. όταν στέκεστε ή περπατάτε, είναι απαραίτητη για να εξασφαλιστεί η σωστή δραστηριότητα των σκελετικών μυών. Όταν αυτοί οι μύες δεν διεγείρονται για να αντισταθούν στη βαρύτητα για μεγάλο χρονικό διάστημα, π.χ. κατά τη διάρκεια παρατεταμένου καθίσματος 👩‍💻, η σταθεροποιητική τους λειτουργία διαταράσσεται από την αδράνεια 😴 με αποτέλεσμα τη μυϊκή αδυναμία και ατροφία.
🔑 Όσον αφορά τον τρόπο διόρθωσης της «κακής» στάσης, τα στοιχεία φαίνεται να συμφωνούν ότι απαιτείται ένα καλά δομημένο και προσαρμοσμένο πρόγραμμα με βάση τα ανατομικά χαρακτηριστικά και τις μυϊκές ανωμαλίες των ατόμων.
⚕️ Η επικοινωνία με έναν ειδικό όπως φυσιοθεραπευτή, είναι μια ιδανική ηεπιλογή για να αξιολογηθεί η στάση του σώματός σας και να ακολουθήσετε ένα πλήρες πρόγραμμα άσκησης και αποκατάστασης.
Ορισμένες προτάσεις που φαίνεται να συμφωνούν οι περισσότεροι ειδικοί είναι:
Η κινητοποίηση της θωρακικής περιοχής της σπονδυλικής στήλης, προκειμένου να τοποθετήσουμε καλύτερα το σώμα μας για ενίσχυση και ενεργοποίηση των μυών.
Και ενδυναμώνοντας 💪 τον κάτω τραπέζοειδή , αφού μόλις κινητοποιήσουμε επιτυχώς τη θωρακική σπονδυλική μας στήλη, πρόκειται να είμαστε προσωρινά σε πολύ καλύτερη θέση για να μπορέσουμε να ενεργοποιήσουμε και να ενδυναμώσουμε το κάτω τραπέζοειδή μας που είναι οι βασικοί μύες κλειδί για μακροπρόθεσμα αποτελέσματα.

*References available upon request