Leo Kormanik DC, MS, CCSP Ohio Sports Chiropractic

Leo Kormanik DC, MS, CCSP
Ohio Sports Chiropractic
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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.
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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.
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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.
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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)
Anterior Power Line (APL)
Medial Stabilizing Line (MSL)
Lateral Stabilizing Line (LSL)
Posterior Stabilizing Line (PSL)
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Why:
◦  To test for neural tension of the posterior
chain.
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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*
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Positive findings:
◦  Increased pain into the distal extremity.
◦  Increased tightness in hamstring (may be accompanied by calf
tightness) or vague tension in posterior chain.
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Contributing Injuries
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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)
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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!
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Breakouts. Look for imbalances.
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Modified Thomas.
Thoracic rotation.
Knee flexion.
Supine with knee bent hip int/ext
rotation.
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Why?
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How to preform Test
◦  To test for muscle imbalance between the gastrocnemius and the soleus
muscles.
◦  Begin single leg calf raise through full range of motion.
◦  Go to the point of fatigue (tiredness/point at which they feel LA.)
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Positive findings
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Common Injuries
◦  Inability to preform 20 comfortable reps on a single leg
◦  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.
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Why?
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How to preform:
◦  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.
◦  Isolation of the 5th digit from the other 4 toes by abducting toe.
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Positive findings
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If positive findings, at risk for:
◦  Inability to separate and preform abduction of the pinky toe from
other toes on own.
◦  Plantar fasciitis
◦  Tarsal tunnel.
◦  Metatarsalgia
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Why?
◦  To be performed on every runner to establish glaring
imbalances and movement restrictions.
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Ways to test
◦  1) Deep squat, evaluate ankle dorsiflexion closed chain.
◦  2) Open chain dorsiflexion, plantar flexion, eversion,
inversion, full dorsiflexion with passive 1st 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%.
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Leo Kormanik, DC, MS, CCSP
Ohio Sports Chiropractic
148 E. Aurora Rd.
Northfield, OH 44067
330-908-0203
www.OhioSportsChiropractic.com