Brian Schiff’s Blog
Injury Prevention, Sports Rehab & Performance Training Expert
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I recently featured this exercise in my online column for PFP Magazine. This is a great arm care exercise that should be part of every overhead athlete’s routine, especially my throwers. I like to use these types of exercises to prepare the shoulder for higher level lifts as well as serve as staples of an in-season or off-season arm care program.
Click here to read the full column.
High school baseball season is upon us. My son is a high school junior and recently verbally committed to pitch for a Division 1 school. He has worked hard to earn that offer, but the part most people do not see is the arm care and recovery work we do for him behind the scenes. Below is a recent picture of him in action.
I see lots of baseball players in my clinic ranging from 10 year olds to my MLB guys. One of the biggest issues I confront in my players (more commonly pitchers and catchers) is a condition known as internal impingement. While not the same thing as subacromial impingement, it still can impact the rotator cuff. Essentially, there is friction that causes irritation and in some cases injury to the rotator cuff and/or labrum. This usually manifests as pain in late cocking and the inability to throw hard without pain. Pitchers report decreased velocity and catchers struggle to thrown down to second with their their normal ease.
One of the most common issues leading to this is a loss of total shoulder motion on the throwing arm. Most notably, some players display significantly less internal rotation (IR) range of motion. Some loss of internal rotation is normal and expected over time provided they gain enough external rotation (ER) on the throwing side to counterbalance the asymmetry. Often, too much throwing early in the season or a big jump in pitch count/intensity/volume coupled with the ROM loss causes pain. This can occur suddenly or gradually build up over a few outings or games.
Pectoralis minor tightness coupled with kyphosis often leads to postural dysfunction, limited thoracic mobility and shoulder problems. This can increase injury risk for overhead athletes, Olympic lifters and fitness enthusiasts participating in regular weight training.
This exercise is from one of my columns for PFP Magazine, and it can be integrated as part of a warm-up/movement prep session prior to engaging in overhead sports or lifting activities. In addition, it can serve as a daily corrective to improve shoulder mobility and posture. Finally, it can be used in recovery and the cool-down to address soft tissue tightness in the chest. When used post-workout, I suggest a slightly longer hold time to emphasize more passive stretching when force production is not a concern.
Click here to read the entire column including details on the execution.
Over the years, I have been fortunate to work with lots of athletes ranging from youth to professionals. Regardless of age or skill level, I have observed that each one approaches the recovery in their own way. Some are eager to tackle therapy, while others are apprehensive and fearful.
To be clear, the mindset of the patient is as important, if not more important than the physical part of the process as it relates to success. With ACL rehab, I pay close attention at post-op visit number one to determine if the patient is a coper, non-coper or somewhere in between. Having this awareness is crucial as I look to encourage the client and position him/her for success in the fist phase of rehab. The mindset of a patient recovering from their second or third ACL tear may differ greatly than that of a first timer.
With that said, assessing the state of mind of any athlete in the PT clinic is a must. An athlete’s identity, confidence and self-worth is often tied to his/her sport. Injuries separate the athletes from their teams and take away something very important to them. This can lead to depression, anxiety, anger, fear and loneliness to name a few.
It is imperative to connect with an athlete in the first 1-2 visits of rehab. I aim to bond with them and ensure they know I will do everything in my power to get them back to their prior level of performance. Fear of loss is powerful, and I want to partner with them to prevent the loss of playing time as quickly and safely I can though proper rehab.
Do you suffer with shoulder instability, shoulder weakness, poor trunk control or chronic shoulder/back pain? One of the biggest issues overhead athletes have is poor proximal stability, often leading to scapular dyskinesia. In turn, undue strain and force can cause stress on the rotator cuff and/or labrum.
In addition, nagging back pain can also occur as a result of repetitive micro-trauma. Improving pillar stability can reduce stress with hyperextension and rotation that creates stress and injuries in the lumbar spine.
This exercise is a unique and challenging way to improve shoulder and torso stability. In some instances, the stress on the wrist can be difficult, and in these cases I suggest using a closed fist on the stationary arm or moving to the knees. It is particularly effective exercise for swimmers, gymnasts, overhead athletes, and anyone with a history of shoulder instability.
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