Leo Kormanik DC, MS, CCSP Ohio Sports Chiropractic

Leo Kormanik DC, MS, CCSP Ohio Sports Chiropractic

! Been running at a high level for 15 years.! 2012 Olympics Trials qualifier in the marathon and 6-time All-American in college! Owner of Ohio Sports Chiropractic in Cleveland, OH.! 75% of our practice is runners. Novice to Olympic level. Sprints to Ultra marathons.! These tests we perform on all runners regardless of injury.

! The Bunkie test is a functional performance test consisting of 5 test positions (performed bilaterally).! It is used to assess aspects of muscular function. This includes long chain muscle imbalance, instability, and activation issues.! The test is carried out on a bench (25-30 cm high). The athlete lifts the body up into neutral position, and then takes off one foot to test the specific fascia line.! The position is held for 20-40s depending on the athlete.! Scores: (0)pain/inability to do test. (1) holds for 0-10s. (2)11-20s. (3)21-30s. (4)31-40s.

! Any sensation of burning, cramping, pain or strain in the muscle indicates diminished mobility/tensegrity of fascia on that line.! Immediate pain indicates an area of locked-long fascia on the line. The muscles in that area will be inhibited and not able to contract to their full expected ability, often resulting in injury.! Only if a test shows up 100%, with perfect pain-free positions held on all lines, will the athlete be able to train or compete on full efficiency.! No athlete should be allowed to do high-intensity, sport-specific training if they cannot achieve a score of 20 (bilaterally tested).

Posterior Power Line (PPL) Medial Stabilizing Line (MSL) Anterior Power Line (APL) Lateral Stabilizing Line (LSL) Posterior Stabilizing Line (PSL)

! Why: To test for neural tension of the posterior chain.! How to Perform? Have athlete lay on back and flex hip to 45 degrees while maintaining full knee extension. Note any pain, discomfort, or even tension. Then bring foot into dorsal flexion.! *If patient is unable to get leg to 45 degrees have place legs onto wall and anteriorly tilt pelvis to see where tension lies*

! Positive findings: Increased pain into the distal extremity. Increased tightness in hamstring (may be accompanied by calf tightness) or vague tension in posterior chain.! Contributing Injuries Chronic hamstring/ calf tightness or strains Pain into buttock, hamstring, and/or calf Leg weakness Peripheral sciatica, tibial nerve or common peroneal nerve entrapment. A positive finding could be related to chronic PF/tarsal tunnel (via Baxter s nerve, the first branch of lateral plantar nerve near deep fascia of abductor hallucis)

! Why? Tests for superficial front and lateral fascial line mobility. The patient should be able to do this stretch. If they cannot, then break it out!! Breakouts. Look for imbalances. Modified Thomas. Thoracic rotation. Knee flexion. Supine with knee bent hip int/ext rotation..

! Why? To test for muscle imbalance between the gastrocnemius and the soleus muscles.! How to preform Test Begin single leg calf raise through full range of motion. Go to the point of fatigue (tiredness/point at which they feel LA.)! Positive findings Inability to preform 20 comfortable reps on a single leg! Common Injuries Soleus dominance over gastrocnemius! MTSS (shin splints)-> Tibial Stress fracture! Chronic soleus strains. Peroneals over recruited! Tendonitis, fibular stress fracture, Posterior tibialis tendonitis FHL tightening! Big toe restriction.

! Why? Lateral movements of the pinky toe allows for more of the force to be spread out throughout the forefoot and allows a greater push off force during gate.! How to preform: Isolation of the 5 th digit from the other 4 toes by abducting toe.! Positive findings Inability to separate and preform abduction of the pinky toe from other toes on own.! If positive findings, at risk for: Plantar fasciitis Tarsal tunnel. Metatarsalgia

! Why? To be performed on every runner to establish glaring imbalances and movement restrictions.! Ways to test 1) Deep squat, evaluate ankle dorsiflexion closed chain. 2) Open chain dorsiflexion, plantar flexion, eversion, inversion, full dorsiflexion with passive 1 st MTP dorsiflexion 3) External/Internal tibial rotation. 4) Forced dorsiflexion with hand on talar ligaments to assess abnormal talar glide.

! Running cadence is the number of repetitions the foot strikes the ground in a single minute.! Proper running mechanics states that 175-190 steps per minute is best with the average of 180 is ideal for easy/relaxed pace.! For chronic knee pain increase cadence 5-10%.! For chronic hip pain increase cadence by 10-15%.

Leo Kormanik, DC, MS, CCSP Ohio Sports Chiropractic 148 E. Aurora Rd. Northfield, OH 44067 330-908-0203 www.ohiosportschiropractic.com