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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Archive for 'sports performance'

Blood flow restriction (BFR) therapy/training is one of the newer and more exciting techniques being used in the sports medicine field. I received training with Owens Recovery Science and have been utilizing personalized blood flow restriction (PBFR) therapy in my clinic since November 2017 using the Delfi personalized tourniquet system (PTS).

What exactly is BFR?

It is the application of a specialized tourniquet system to the proximal arm or leg, which is inflated to a personalized and specific pressure to reduce blood flow to an exercising extremity. For the lower extremity, the occlusion pressure is 80%, whereas the upper extremity pressure is usually set at 50%.

The application is brief and intermittent, usually lasting about 6 minutes per exercise. For most clients, a total of 3-4 exercises are used leading to 24-30 minutes based on the specific exercises prescribed. Typically, to increase strength and hypertrophy a person would need to lift a significant amount of weight (greater than or equal to 60% of a 1 repetition maximum). With PBFR you can create significant strength and hypertrophy gains with loads as low as 20% 1RM.

We utilize the Delfi tourniquets as suggested with the Owens training course. You can see the PTS and tourniquets below:

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What is the science behind this training tool?

The landmark study by Takarada published in 2000 revealed that significant hypertrophy gains are seen with occlusion and the use of lighter training loads. There is an increase in muscle protein synthesis as well as growth hormone secretion. Below you find some links to abstracts from Takarada’s work:

https://www.ncbi.nlm.nih.gov/pubmed/10846023

https://www.ncbi.nlm.nih.gov/pubmed/10642363

https://www.ncbi.nlm.nih.gov/pubmed/11128848

In addition to hypertrophy, there also appears to be an application for preventing disuse atrophy simply using occlusion. This may prove very beneficial for clients who are non-weightbearing after an injury or surgery, yet not able to perform much resistance training.


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I work with a lot of baseball players in my clinic.  In many cases, I see similar issues and recurring problems in them, especially pitchers.  Some of these issues include:

  • Scapular dyskinesia
  • Limited thoracic spine mobility (extension and/or rotation)
  • Soft tissue tightness (lats, post shoulder, pec major/minor)
  • Poor muscular strength/endurance in the rotator cuff and scapular stabilizers
  • Glenohumeral internal rotation deficit (GIRD)

I integrate routine mobility exercises for my throwers, as well as other overhead athletes (tennis, swimming, volleyball, etc) to better prepare them for training and their sport, as well as prevent poor mechanics and compensatory motion that may lead to aberrant stress on the rotator cuff and labrum.

The following video reveals five of my preferred exercises using a foam roller to improve thoracic spine mobility, decrease latissimus tightness, and stretch the pec major/minor while facilitating lower trapezius activation.

In order you will see:

  1. Lat rolling
  2. T-spine extension in supine
  3. T-spine extension coupled with lat stretch
  4. T-spine rotation
  5. Retraction and downward rotation

I advise performing 5-10 repetitions of each prior to training and sport. These will help improve performance, optimize overhead mechanics and reduce injury risk associated with overhead sports.

Well, it has been too long since my last post.  Between seeing patients and the onset of spring sports with my kids, I have not been writing as much as I would like.  I hope to get back to posting at least twice per month very soon.  In the meantime, I thought I would share two recent videos I did for PFP Magazine.  They include a half kneeling torso rotation and supine torso anti-rotation using the Surge.  Both are great ways to improve rotary stability.

Rotational stability within the shoulders, torso and hips is critical for optimal performance in sport and injury prevention. Often, clients will exhibit asymmetries with respect to trunk stability with pillar assessments and the Functional Movement Screen (FMS).  I often see 2/1 scores on the RS.  Addressing any asymmetry is important for athletes and weekend warriors involved in cutting, pivoting, and rotational sports.

There are several exercises that can be used to increase rotary stability.  One exercise I recently featured for PFP Magazine in my online column, Functionally Fit, uses a bottoms-up kettlebell hold with trunk rotation to accomplish this.  This particular exercise can be used to increase anti-rotation strength and improve rotary stability.  The pictures below illustrate a knee bent (beginner) and knees straight (advanced) version of the exercise.

kb-rs-corrective-1

kb-rs-corrective-2

The knee bent position allows for easier control of the lumbar spine while keeping the shoulder blades flat on the floor. cadence should be slow and deliberate avoiding momentum that may be caused by gravity.  Once this variation becomes easier, progress to the straight knee version below.

kb-rs-advanced-corrective-1

kb-rs-advanced-corrective-2

Form is everything here so be sure to use a weight that you can control, while slowly lowering the legs each direction.  This movement pattern blends in nicely with movement prep/pillar prep activities that work on hip disassociation as well.

Click here to see my video and full column for PFP Magazine on this exercise.

carter-runAs a father, coach and physical therapist working in a sports medicine environment, I am all too familiar with youth injuries. While we can not prevent every injury, I do believe we need to do everything possible to keep our young athletes out of harm’s way. In today’s ultra competitive society, parents are faced with pressure to “keep up” or fall behind.

Contrary to what research and real life has to say about it, organizations and coaches who want to win now tell parents and players you need to choose one sport at an early age if you want to be the best.  I see the club fees that organizations charge, the emotional heartbreak of not making the top tier teams and the grind of all the “extra” training sessions for skill work, speed training, etc. that athletes endure.

Gone are the days where just playing for your school team is enough to garner attention at the next level.  It seems as if athletes must play in AAU, clubs, travel teams or showcase opportunities to stand out.  It is apparent to me as if we have become hyper focused on training our children to obtain a scholarship at such an early age.  Some of the things I hear parents say illustrate to me their are pushing their children very hard to meet these expectations.  The idea that sports should be fun for young kids seems to be lost on the coaches and parents in many cases.

My 9 y/o son (picture above running the ball) told me one reason he does not want to play Pop Warner football next Fall is because of all the practice time required.  We practiced 5 days per week in August, followed by two hour practices 3 nights per week and a Saturday game during the regular season.  He loves the game and was one of the best players on his team, but the time and exhaustive training simply wore him out.  So, he says he wants to play soccer next Fall instead.  I told him this was fine as he needs to be the one that wants to play – not me telling him to play.  He also plays basketball in the Winter and soccer in the Spring.

As a parent, I want to encourage others to listen to their kids and put their own goals and interests aside.  We should not try to live vicariously through our kids on the court or field.  Sports should not be work for young people, and adults should not care more about the game than the participants at a young age.  As coaches and medical professionals, we need to do everything in our power to promote health and  life balance for young people.


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