Working with endurance athletes brings about a different set of challenges to physical therapy practice. This series led by Jay Dicharry, provides the tools needed to successfully rehabilitate patients following injury, prevent future injuries, and optimize performance. Swimming, biking, and running are the focus of this series with an emphasis on the different biomechanics each sport requires of its athletes. Become the expert on swim strokes, bike fit, and footwear and help your endurance athletes perform their best.
Rehabilitation clinicians (PT, PTA, ATC) who have a passion and interest in working with endurance athletes. All content is taught in a progressive manner to help both novice and experienced clinicians improve apply their own knowledge framework to assess, treat, and optimize this challenging patient population.
17 hours of online video lectures and patient demonstrations.
HEP and patient education resources to use with your patients.
Recorded Q&A sessions between instructors and practice managers.
Connecting the Dots: A Clinician’s Role in Endurance Sports Performancekeyboard_arrow_downCourse
Understand the rationale for tissue dysfunction that contributes to injury and performance. Understand the compounding effects of deficient stabilization and compensatory overuse patterns that individuals build into their activity. Develop a working hypothesis to best target the weak link. Progress clinical thought process from the exam room to functional sport training.
Be able to apply the load-deformation curve as it relates to stress, strain, and tissue remodeling. Understand the unique role of the structural alignment of collagen. Have a working understanding of the impact of training on tissue specificity, highlighting the capacity of each respective tissue within the body to adapt.
Discuss common questions regarding the clinician's role in endurance sports performance.
The Swimmer's Shoulders: Swimmers Aren't Pitcherskeyboard_arrow_downCourse
In chapter 1, we’ll present the framework for the etiology of swimmer’s shoulder. Swimming is by definition and an open and closed chain sport operating in a “swimmer’s paradox.” Essentially, the dominant muscles of the upper quarter all contribute to compromised scapular and glenohumeral dyskinesia, impairing the essential mobility and dynamic stability normally present. This model will allow us to build a working vocabulary for this course.
While you don’t have to be a swimmer, you likely treat them. We’ll break down the differences between throwing mechanics and swimming mechanics. We’ll demonstrate the location and amount of tissue compromise that occurs at each of the four phases of the swim stroke (Austrailian crawl) to enable you quantify the mechanical stress imparted each and every lap. We’ll highlight research that shows how to cue and correct swimming form to minimize stress on the shoulder exactly when and where your patient needs it.
Swimming is a technical and complex interaction, and it's critical that we send our patients to the water with the necessary mobility, coordination, stability, and postural endurance to achieve good stroke mechanics. We’ll highlight suggestions for clinical intervention at each of the phases of the swim stroke to ensure we are building better habits for better swim form.
The Swim Stroke Analysiskeyboard_arrow_downCourse
Don’t make swimming more complex that it has to be. In chapter one, we’ll introduce the Visual Stroke Tool to enable you to identify imbalances in causative biomechanics related to: body position, body rotation, head position, leg drive, and arm pull. You’ll learn powerful drills to help your swimmers feel specific improvements in form.
Let’s get hands on and dive in! We will use the Visual Swim Tool to identify issues and imbalances in our swimmers.
By now, you understand the pathomechaincs of the swim stroke. You can identify stroke flaws and MSK deficits. Let’s put this all together. We will build a framework to optimize clinical goals and technique goals using mobility and stability work, and will discuss transferring these goals directly into hands-on exercises and drills. You certainly don’t have to be a swim coach to treat your swimmers, but you do have to understand their sport and speak their language.
Bike Anatomy: The Bike and Bike Fit Rationalekeyboard_arrow_downCourse
“It’s just like riding a bike.” If only bike fitting were that simple! People are different. Bikes are different. Riding goals are different. In our introduction, we’ll discuss why bike fitting is important to unload tissue stress in rehab, and to improve performance in your patient’s/client’s goals beyond rehab. The bike fitting process is people-specific, equipment-specific, and event-specific.
If your athlete asks you if they should look for a bike with a steeper seat angle, you need to give them an educated answer. And if you need to call a shop to see if they have a 80mm x 7 degree stem in stock, you need to be able to say more than “the thingy that holds the bar to the frame." In this course, we’ll take a detailed look at all the parts of modern bikes, and ensure that you can speak the language of cycling. A working knowledge of this chapter is critical to the information in the rest of the Bike fitting series.
How should we think about bike fitting? Should we make every cyclist look like a Tour de France rider? What’s different about aero fitting vs. mountain bike fitting? what’s the same? There are a lot of myths out there, and what your patient thinks their bike fit should be, is not always what they need. This chapter will help you look beyond the obvious, ask the right questions, educate your patients on what they need, and build a dialogue with your local bike shop and the supporting community to help you expand your reach into the cycling community.
What do you need in your clinic to perform a bike fit? While it’s great to have an optical motion capture system, that dream is a far stretch for most of us. We’ll discuss how you can capitalize on your MSK knowledge, and use simple, low coast tool to yield outstanding results.
Clinical Bike Fit Processkeyboard_arrow_downCourse
There is a systematic way to think through and conduct a bike fitting. We’ll discuss the importance of listening to the rider’s goals, identifying critical issues that impact their fit, take the guesswork out of the science of bike fitting, and instruct how to adjust the contact points on the bike for success.
Cleat is the link between your feet and the pedals, the height of the rider above the pedals greatly affects the length-tension relationship of the lower quarter, and position of the upper body dictates comfort and handling. This chapter takes the learner through the bike fit process for these individual steps.
Cycling lore runs deep. It is essential to educate yourself, your patients, athletes, and local cycling community to get discussion moving in the right direction. We’ll discuss some common questions that are out there with respect to differences in fit on road bikes, time trial fits, cyclocross fits, and mountain bike fits. We’ll also discuss pedaling styles, frame stiffness, and some of the science behind the need for aerodynamics. Better understanding equal better outcomes.
Clinical Bike Fit Case Studieskeyboard_arrow_downCourse
In this chapter Jay Dicharry performs a bike fit for a road bike with a female athlete. Follow this case study to better understand bike fitting for an athlete working toward competing in a triathlon for the first time.
The second case study shows a bike fit for a time trial bike with an elite male athlete. This case study provides insights into the special considerations for a serious athlete looking for optimal efficiency.
In this chapter, we’ll show you how to correctly document the changes you’ve made in contact points. This should be saved to have a record of your fit so that the patient can re-check their fit if breaking down the bike for maintenance or travel, or to transfer these measurements to a new bicycle in the future.
Bike Hab: Exercises for Bikingkeyboard_arrow_downCourse
Cyclists are eager to get back to riding their bikes. You are eager to improve their symptoms. It is critical that your MSK rehab goals account for the demands that cycling places on the body. This course goes beyond fitting the bike, and aims to optimize the cyclist we are putting on the bike.
The repetitive nature of cycling builds some typical patterns in terms of tissue stress, mobility, and stability. The same slumped posture that most cyclists adopt sitting in their office is the same pattern we see play out on the bike. We’ll identify these faults and help you build a systematic approach to improve them with the end goal of improving positional endurance and pedaling technique under training loads.
Isolated mobility and stability work within your clinic walls doesn’t transfer to sports-specific skills unless we make it relevant, and cue those same recruitment patterns in the athlete’s sport. Yes, it's possible to do your core training while on the bike. In this chapter, we’ll progress through cycling specific approaches to ensure your exercise progression and cues always go back to concrete changes your patients can feel and demonstrate while on their bikes.
Clinical Examination of the Runner: Assessment, Testing, Gait Correlations, and Correctionskeyboard_arrow_downCourse
The participant will describe the relationship between running form and body function, and explain the need for a runner to adopt gait pattern that reflects their individual structural alignment. The participant will also describe the need for adequate mobility and dynamic stability to achieve a running gait that minimizes stress on the body and optimizes economy.
The participant will describe critical clinical tests and movement screens that are specific to running athletes, and be able to successfully conduct these assessments on their patients and athletes to identify specific deficits. Participants will also develop the skills to explain the impact of isolated deficits on body function both at the site, and the entire kinematic chain.
The participant will examine how clinical deficits in body function directly impact running gait, and describe how running with this compensated form can alter biomechanics and compromise the body via tissue overload or sub-optimal bioenergetics.
The participant will identify critical restrictions that impact postural alignment, joint mobility, stability, and end range control. Based on these observations the participant will develop a specific treatment plan to correct clinical imbalances and optimize body function for running.
The participant will demonstrate corrective techniques for tissue mobilization and elongation to the upper and lower quarter, and apply corrective exercises, drills, and feedback to optimize postural alignment and joint stability. The participant will learn to target specific techniques toward the level of deficit of each individual patient in order to optimize neuromuscular control, and to ensure that new movement skills are reflected in running training.
Clinical Gait Assessmentkeyboard_arrow_downCourse
Participants will learn the need to objectively describe a runner’s gait, and how to use the visual gait tool as an evaluation algorithm. Participants will also create a framework to integrate clinical information to firmly grasp the link between form and function.
Participants will discover the gait patterns that influence key diagnoses in running athletes, and learn to integrate clinical skills into the patient’s motor patterns to minimize tissue strain, alter kinematics, and kinetics. The participant will also discuss observed problems in a runners gait and/or clinical presentation and systematically dissect ways to address each causative risk factor for a specific diagnosis.
Participants will apply critical gait analysis concepts by conducting three running analyses on actual subjects.
Participants will discuss additional topics related to clinical gait assessment.
Run Better: Strength and Power Development for Endurance Athleteskeyboard_arrow_downCourse
Participants will discuss the need to understand a holistic model of causative mechanics (rather than isolated symptoms) when examining gait. Participants will also explore the need to look past kinematics, and develop a link between the abilities of the athlete and running gait.
Participants will develop an understanding of the importance of mobility, stability, strength, and power as they relate to the running athlete. Participants will also explain how ground reaction force influences the bioenergetics of running and discuss the role of symmetry, body stress, and economy with respect to optimal running form. The chapter concludes by describing how contact style, cadence, contact time, and stiffness influence form, and by applying these concepts to four real-world case scenarios.
Participants will discover how athlete’s symptoms, performance, and objective gait and body metrics are put to work to improve athletic capacity.
Participants will apply specific mobility, stability, strength, and power exercises and drills to optimize athletic capacity, with an understanding of its specific impact on running gait.
Participants will discuss common questions regarding the development of strength and power in endurance athletes.
Running Footwear: Shoes Impact Form, and Form Impacts Shoeskeyboard_arrow_downCourse
Participants will review the history of shoes, identify classic footwear categories and how they match up with foot type, and review the conventional tests used to prescribe footwear. Participants will then understand why these categories are not supported by the research, and debunk conventional footwear classification.
Participants will understand the research in barefoot and shod running gait, identify the four aspects of conventional shoes that impact gait, and discuss how heel height impacts running. In this chapter participants will also learn the impact of posting on knee kinetics and arthritis, be able to describe the impact of midsole stiffness on gait and stability, and describe shoe wear and its effects on gait. This chapter will conclude by providing essential criteria for shoe prescription.
Participants will identify essential criteria to transition patients into different shoe types, and apply foot mobility and stability assessments to shoe prescription. Participants will also be introduced to shoe trends looking forward, and the need to answer the right questions about shoe prescription moving forward.
CEU Approved17 total hours* of accredited coursework.
Our clinic could not be happier with MedBridge.
Amy Lee, MPT, OCS
Physical Therapy Central
MedBridge has allowed us to create a culture of learning that we were previously unable to attain with traditional coursework.
Zach Steele, PT, DPT, OCS
Outpatient Physical Therapy & Rehabilitation Services
MedBridge has created a cost-effective and quality platform that is the future of online education.
Grant R. Koster, PT, ATC, FACHE
Vice President of Clinical Operations, Athletico Physical Therapy