How the Gluteus Medius Plays a Pivotal Role in the Prevention and Recovery from Most Lower-body Injuries with Dr. BJ Smith and Ross Nachbi, PT
Season 3, Episode 12 | Podcast #48
Today we are joined by 2 special guests Sports Medicine Physician, Dr. BJ Smith, and Physical Therapist, Ross Nachbi. Today we will be getting into field sports injuries, the role of Platelet-rich plasma in regenerative medicine, and the importance of the gluteus medius in sports medicine injuries.
Dr. Bradley "BJ" Smith is a Sports Medicine Physician at the Rothman Institute and currently sees patients at the Limerick, Bryan Mawr, and Wynnewood locations. He graduated from Penn State University and completed medical school at Jefferson Medical College. After completing his residency in Family Medicine at Thomas Jefferson University Hospital in Philadelphia, he completed a Sports Medicine fellowship at Healthplex Sports Medicine of Crozer-Keystone Health System. Dr. Smith brings a total body approach to the treatment of athletes and non-athletes alike. He treats all types of musculoskeletal and orthopedic injuries, from sprains and strains to fractures, pediatric issues to arthritis. Dr. Smith also treats Sports-Related Concussions using the latest techniques, including integrative and complementary methods.
His clinical techniques include musculoskeletal ultrasound and alternative techniques to surgery include ultrasound-guided injections, Platelet Rich Plasma (PRP), Prolotherapy, and focused rehabilitative therapy regimens. He currently serves as Team Physician for Bryn Mawr College, Cabrini University, University of Valley Forge, as well as Lower Merion High School, Harriton High School, and Pope John Paul High School. Dr. Smith has been recognized by both Main Line Today and Philadelphia Magazine as a Top Doctor in Sports Medicine.
I am also joined by Ross Nachbi, Physical Therapist at Ivy Rehab in Ardmore, Pennsylvania. Ross graduated from the University of Rochester with a degree in Brain and Cognitive Science and went on to Northwestern University where he graduated with his doctorate in Physical Therapy. Ross is McKenzie Method Trained and is trained in FMS or functional movement screening as well as SFMA, or selective functional movement assessment. He is also a certified strength and conditioning specialist (CSCS). He is experienced in treating all orthopedic and sports medicine conditions, both operative and non-operative.
In this episode, we cover:
4:26 Why Dr. Smith went into the field of sports medicine, what his journey through medical school was like and how being the child of a trauma surgeon impacted his decision.
11:50 How Dr. Smith's training guided him to become the physician he is today and how the whole body approach of sports medicine allows for variety.
12: 00 “If you’re thinking about going in a certain area, some niches or specialties may have some things that are really cool but don’t think about the coolest thing that you do once in a random while. You have to think what is the 70% of normal mundane stuff like because that’s most of what you’re going to have. and if you’re only getting the really cool stuff every once in a while and the rest of the time you want to stab your eyes out, it’s going to be rough.”
15:00 Why sending a patient to a physical therapist that has a background in a similar sport is important and contributes to better outcomes.
19:00 How their treatment approaches have changed since first starting to treat several years ago.
21:00 Why it’s so important for sports medicine physicians to have a great relationship with the physical therapist they refer to.
23:00 Direct Access to physical therapy without seeing a doctor and how physical therapists approach that treatment and relationship.
25:30 Quote that Dr. Smith’s mentor Rob Good said: “When you’re seeing patients, it’s not about how much time you need to see them figure out what’s wrong, it’s about how much time they need.”
28:00 Why Nachbi loves being able to refer to a sports medicine doctor after direct access.
30:00 How good communication and good notes from the physical therapist help avoid a third referral and delay in care.
34:00 Dr.Smith’s roles and responsibilities with various schools in the Greater Philadelphia area.
36:00 Should school athletic trainers be employed by the school district or outsourced to an orthopedic group or other specialty groups?
40:00 The importance of an athletic trainer’s role and how they are so underappreciated.
42:00 Dr.Smith’s thoughts on the role of the glute medius as it pertains to the function of the lower body.
42: “I’m a strong believer that a large portion - probably even the majority - of lower extremity injuries, issues, and complaints are due at least in some part to not enough activation in the gluteus medius”
43:00 Why the gluteus medius not activating enough causes so many issues in the lower body and how lack of lateral movement contributes to this issue.
45:00 All the injuries that are associated with weak or slacking gluteus medius.
46:00 The test Dr.Smith uses to test if an athlete is quad dominant or struggling with their gluteus medius.
48:00 Why the clamshell is not an effective exercise for training the gluteus medius.
53:00 Where the gluteus medius is on the body and how tightness impacts function.
56:00 How Dr.Smith tests to see if an athlete’s gluteus maximus is activating well.
59:00 The progression Nachbi would implement when trying to improve gluteus medius activation and motor control.
1:00:00 What is the captain morgan exercise for glute activation.
1:05:00 Why we need to bring back the popularity of the jumping jack.
1:06:00 The best exercises to activate the glute medius
1:13:00 How Dr.Smith implements side-lying hip abductions to treat almost every lower extremity issue.
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