Share   Subscribe to RSS feed

Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Bridging is a fundamental exercise to promote hamstring and glute strength. In addition to hip strength, I look for opportunities to enhance anti-rotation/pelvic stability with many bridging progressions due to the weakness and asymmetries I see in my clinic. It will also facilitate hip dissociation.

The stability ball provides an element of instability that can further challenge hip and pillar stability. This exercise is big bang for your buck exercise that can be used in rehab and training circles. Check out the video below that is part of my ‘Functionally Fit’ column for PFP Magazine.

Click here to read the entire column.

 

If you follow my blog, then you already know I have a 16 y/o left-handed son who pitches. As a sophomore, he is in the early stages of recruiting and has been to 3-4 showcase camps. He has good size at 6’3″ tall and 184 pounds. He has been up to 82 mph.

We have been told he projects at the D1 level, but he just needs to throw a little harder. Baseball is all about bigger, faster and stronger these days. Analytics and numbers rule the day. Coaches have told us that once he consistently throws 85 plus, the offers will start to roll in.

So, the big push for many pitchers today is gaining velo. There are lots of programs and “experts” on the subject offering online programs, weighted balls, velocity training tools, throwing programs, etc. The two questions I always have are:

  1. What is safe for throwing athletes?
  2. What is effective?

As a physical therapist, I only want to pursue things that satisfy both questions above. Personally, I do not believe there is a quick fix, or any one program that will deliver the goods.


Continue reading…

One of the biggest challenges for clients overcoming knee injuries and surgery is regaining their quadriceps strength and fighting atrophy. This is increasingly so for my clientele on crutches for any extended period of time. It is paramount to use modalities early on in the rehab process such as electrical stimulation and blood flow restriction training to combat atrophy and loss of strength.

Once appropriate, I always move to single limb training to eliminate imbalance and asymmetry. While pistol squats are one of the most effective single leg quadriceps exercises, not all clients can perform this movement. So, in many cases I opt to use a single leg box squat (see video below).

For more information on specific progressions and regressions, click here to read my entire online column. Keep in mind that you should never force through any painful range of motion as this likely indicates excessive strain on the patellofemoral joint.

Knee pain is prevalent among adolescents and active adults. Patellofemoral pain and osteoarthritis are the most likely causes of pain. It may be present with squatting, lunging, prolonged sitting, kneeling, running, jumping or twisting.

Research seems to support a combination of hip and knee strengthening as a primary line of defense and treatment for knee pain. Interestingly, males with PFP do not seem to have weakness in the gluteus medusa like their female counterparts. The link below is an abstract that speaks to this difference between the two groups:

https://www.ncbi.nlm.nih.gov/pubmed/30090674

Other modalities used to address anterior knee pain include patellar bracing/taping, blood flow restriction training, dry needling/acupuncture and soft tissue work seems to bring more questions accordion to some experts.

Click here to read the 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain from the 5th International Patellofemoral Pain Research Retreat.

Clinically, I have seen good results with the following:

1. Activity modification
2. Glute and quadriceps strengthening
3. Blood flow restriction (BFR) training
4. Sequential and progressive loading based on pain response


Continue reading…

One of the bigger issues I see with athletes who have shoulder dysfunction is upper trap dominance. The upper trap needs to work in concert with he lower trap and serratus anterior for optimal shoulder function. However, in many cases, it tends to dominate the action during elevation.

I recently evaluated a professional baseball player who presented with upper trap dominance. In standing, his right scapula was elevated and slightly protracted. In many cases, you will see scapular infera in the dominant side of a thrower, but that was not the case with him. During active elevation, you could see excessive upper trap firing/activation compared to his left side. This can lead to altered glenohumeral mechanics and compression/irritation of the rotator cuff with repetitive throwing.

Performing low trap raises (the standard ‘Y’ exercise) and serratus anterior work is a no-brianer when you see something like this in order to activate the lower trapezius. But, I also like to focus on getting the client to pull the shoulder blades down and back if you will. Below is one of my favorite exercises I recently featured in PFP magazine to address this issue:

In addition, I like to use shoulder snow angels as well. Click here to see how to perform that exercise. Together, these two movements can really help eliminate upper trap dominance in your clients.