Brian Schiff’s Blog

One of the biggest problems clients run into with lunging is anterior knee pain. This is especially prevalent in middle-aged females. Patellofemoral joint pain is a consistent issue on this population. In light of this, I have gone away form forward lunges with programming to avoid irritating the knee joint. Instead, I will routinely use rear foot elevated split squats or a stationary lunge position with modified range of motion centered on the client’s capacity.

In a 2008 article published in the Journal of Orthopedic & Sports Physical Therapy, the authors conclude that the best way to minimize knee pain and stress is to perform the lunge with a long step compared to a short step and without a stride compared to with a stride. Research has shown that patellofemoral joint force and stress is much greater with a short step (front heel and back toe closer together) compared to a long step at higher knee flexion angles. In addition, forces were greater with a stride (stepping forward) compared to being stationary without a stride at lower knee flexion angles.

Therefore, using a stationary lunge (or stationary split squat) with a greater step length and no forward stepping pattern may be the optimal choice to increase strength and reduce knee stress. Check out my video below from one of my recent ‘Functionally Fit’ columns for PFP Magazine.

For the past 12 plus years since I moved to Raleigh, NC, I have been treating patients as part of Raleigh Orthopaedic Clinic. Along the way, it was called APC, then EXOS at Raleigh Orthopaedic, and more recently Raleigh Orthopaedic Performance Center. During that time, I have been able to work with amazing physicians, fellow PTs, ATCs and performance coaches along the way. I have been blessed to meet lots of great people, spend time mentoring DPT students and serve as a PT consultant for the Carolina Hurricanes.

With that said, I felt it was time to venture out on my own and bring my vision for sports physical therapy and performance to life. I want to create a true athletic refuge where injured athletes, exercise enthusiasts and weekend warriors can come to recover faster and perform better. My career has been built upon delivering individualized care based upon the unique history, goals and differences among each client I work with. In my humble opinion, there is no absolute, predetermined or one specific way to rehab or train a person.

As a clinician and strength coach, my job is to effectively listen to my patients, collect holistic data regarding injury and training history, perform a thorough screening/exam and synthesize that information to formulate a plan to optimize the function of each client’s body. I am fired up to do all of this in the new spacious clinic I recently opened on March 20, 2023 located in Raleigh, NC. Spark Physical Therapy & Performance offers traditional PT services (Insurance and cash pay options), recovery services, dry needling, post-rehab training, ACL injury prevention programs arm care assessment/training for throwers.

For more information, please be sure to check out our website at www.sparkptnc.com. You can also follow us on social media:

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It is that time of year where baseball pre-season throwing is ramping up. I am starting to see throwers coming in to my clinic with shoulder and elbow issues. In many cases, injury can be avoided with proper stretching and strengthening as well as effective loading programs.

Pectoralis major/minor and latissimus muscle tightness along with poor scapular control often leads to postural dysfunction and shoulder problems. Improving shoulder mobility and scapular control can reduce injury risk and shoulder strain.

The video below from one of my Functional Fit columns will demonstrate an excellent exercise that can be programmed for every thrower to aid in optimizing shoulder mobility and promoting shoulder health.

I often use this exercise following soft tissue release techniques and in conjunction with thoracic spine extension mobilization on the roller. It is an excellent warm-up and activation exercise.

Click here to read the entire Functionally Fit column.

Over the years, I have tested many different fitness products through my work with Personal Fitness Professional Magazine. I am not paid to promote any products on my site, and this latest review comes after spending the past few weeks using this particular product in the clinic with my patients. I am pleased to bring attention to it because I think it can help with recovery and training.

Recently, the inventor of the HECOstix, Josh Broeker, reached out to me to see if I have had a chance to use his product. Much to my surprise, I was not familiar with it. As a performance physical therapist working with many athletes from various sports and ranging from youth to professionals, I was naturally excited to see the product in action. I am always looking for ways to enhance neurocognitive training and my rehab. Josh was gracious enough to send me a few HECOstix to try out.

For those unfamiliar with the product, see the image of the Red, White and Blue version below:

As I rehab and progress athletes back to sport after injury, implementing tools to improve hand eye coordination, reaction time, cognitive skills and decision making is important prior to sending them back to practice and sport. A few of the really cool features I like about this product include:

• Lightweight and durable EVA make-up
• Different versions and multiple colors allow for auditory cues and quick reaction
• It can be used safely by all ages and abilities
• Travels easily with you anywhere

The HECOstix can be used for virtually any sport and done indoors or outdoors. Perhaps the greatest thing about the product is that it injects FUN into training while allowing users to compete against others or their own results in an effort to improve performance. This tool also allows for progressive challenges moving from underhand to sideways to overhead throws depending on the functional demands and skill level of the participants.

In the clinic, I have been using it with some of my patients rehabbing after ACL reconstruction. Adding neurocognitive training is essential for full recovery and secondary prevention. below is an article from Sports health discussing neurocognitive and neurophysiological functions related to ACL injury:

https://pubmed.ncbi.nlm.nih.gov/34236003/

Specifically, I have integrated it with dynamic balance and movement drills calling out a color while throwing the HECOstix toward the client. I have also had a pair of patients throwing and calling out the color as part of a rehab game. I will be continuing to use it with this population and other athletes working on hand eye coordination and cognitive training for their sport.

If you are looking to add a new wrinkle to your training or rehab, I highly recommend giving this product a try. For more information on the product, be sure to visit www.hecostix.com.

Tightness in the hip flexors is very common. If you have a job that requires extensive sitting or spend lots of time cycling, this may be a problem area for you. Stiffness can limit gait mechanics and optimal movement patterns thereby putting undue strain on the lower back. Below is a simple corrective exercise that can be done routinely to help improve flexibility using a sliding disc.