Brian Schiff’s Blog
Injury Prevention, Sports Rehab & Performance Training Expert
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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.
Improving rotational strength and stability in the torso, shoulders and hips is important for injury prevention and performance. The ability to resist and control rotational loads can reduce stress on the body during transverse plane activities and deceleration during sport. This exercise will demonstrate how to train rotational stability in an unstable manner using water with the Aktiv AQUA Bag. The video below is my latest online column for PFP Magazine.
The water provides an unstable training environment that is effective for beginners and advanced users. You can read the entire online column by clicking here.
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.
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.
Improving proximal hip stability and reducing frontal plane collapse is critical for protecting the knee. Poor frontal plane control often contributes to anterior knee pain, IT band syndrome, shin splints, plantar fasciitis and other injuries. This exercise is an advance progression of the standing pallof press, and it is very effective for enhancing single leg strength as well as hip/core stability.
Click here to read my full column on this exercise in PFP Magazine.
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