Brian Schiff’s Blog

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.

This is a follow-up from my previous post. Limited thoracic spine rotation can be detrimental for the shoulders, low back and lower extremities with sports and strength and conditioning activity. Consider the impact of asymmetry or stiffness on a golfer, swimmer, thrower, tennis player or even someone doing rotational and pressing working the gym.

Asymmetrical and repetitive activity can lead to deficits as can faulty positions during work and daily life. This simple exercise with the foam roller can be helpful in facilitating optimal mobility and better kinetic chain motion. This video comes from my ‘Functionally Fit’ column for PFP Magazine.

There are several things that contribute to shoulder impingement and rotator cuff pain.  Perhaps one of the biggest issues that impacts overhead athletes, Crossfit enthusiasts and the avid weight lifter is limited shoulder mobility.  Poor flexibility in the pecs, lats, posterior shoulder as well as limited thoracic spine extension and rotation all contribute to suboptimal movement.

Poor mobility can place the scapula in biomechanically flawed positions, increase glenohumeral internal rotation and restrict shoulder movement at end range creating compensatory movement and pain.  The video below is a snippet from my upcoming webinar on rotator cuff dysfunction and nonoperative treatment.

This webinar will be great for strength coaches, exercise enthusiasts, Crossfit athletes/coaches, athletic trainers and physical therapists. If you want to attend the webinar or catch the on-demand version, simply visit www.alliedhealthed.com.  In addition, you may find my DVD on rotator cuff training very helpful in overcoming shoulder pain and staying pain free in the gym.

Click here to see a brief video overview of the DVD or visit my site at www.BrianSchiff.com for more info.  Use the code Holiday15 at checkout from today until December 25 to save $10 off the retail price.

Have a great Thanksgiving and enjoy your time with family and friends!

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.

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.

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.

So many times, athletes and parents alike are singularly focused on the physical rehab necessary after an injury.  Often, what the athlete is not talking about is the psychological impact of the injury.  Suddenly, their identity and self worth may come into question.  They feel disconnected from teammates and coaches.  Their daily routine consists of rehab and not practice/play.  Deep inside their head they are quietly wondering, “Will I ever be the same again?”

Aside from some of the obvious questions that race through an injured athlete’s mind, one of the biggest and most often unspoken concerns is the fear of re-injury.  Having worked with athletes of all sports, ages and abilities, I have seen firsthand how important it is for an athlete to go through a functional and sequential progression that assures that they are able to run, jump, cut, pivot and decelerate again without pain or instability.

I have worked with hundreds of athletes over the course of my career that have suffered ACL injuries.  The longer I practice, the more I become convinced that we probably have been pushing or allowing these athletes to go back to their sports before they are really ready (physically and/or mentally).  Six months has long been the benchmark for most orthopaedic surgeons.  The graft is well healed, but often the mind and body are not really ready.

While I have seen athletes who have great strength, stability, hop testing scores above 90% and look good on movement drills, sometimes these same athletes still have asymmetrical squat patterns, FMS scores lower than 14 or apprehension about returning to their sport.  In addition, fear of re-injury is a big factor that impacts confidence and readiness to return to activity.

Consider some of these facts about modifiable factors with return to sports after ACLR from the May/June 2015 Sports Health Journal:

• Motivation, confidence, self-efficacy, optimism and low fear are associated with a greater likelihood of returning to preinjury level  after athletic injury and ACLR
• Lower fear of reinjury and greater pyschological readiness to return to sport favored returning to preinjury level after surgery
• Combinable data from 10 studies suggests that fear of reinjury, psychological readiness to return to sport and one’ subjective assessment of knee function were predictive of level of return to sport
• As many as 1 in 2 athletes who do not return to their preinjury level of sport report the main reason is fear of reinjury

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