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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Archive for 'rehab'

For those familiar with my blog, you know I like to post research updates and exercises that prevent injury and maximize performance.  In my setting, I get to work with a very active population ranging in ages from 10-50 in most cases, including elite and professional athletes.  I am pointing this out simply because I have an opportunity to test and measure unique and challenging exercises every day with fit, athletic clients.

As part of my world, I am often faced with restoring shoulder, core and hip stability.  As clients progress through rehab and conditioning, I am always seeking advanced training options that are feasible and functional.  One training tool I like to employ, especially in upper body, core and hip training is the BOSU Balance Trainer.

Emphasizing co-contraction and scapulothoracic and glenohumeral stability is essential for optimal shoulder function.  But more importantly, addressing kinetic chain function in the shoulder, torso and hips is a must if we are to soundly address energy leaks and reduce injury risk.  To that end, I like to incorporate unstable closed kinetic chain training when my athletes are ready.  The video below demonstrates two upper body step-up progressions (forward and side-to-side) on the BOSU Balance Trainer that I utilize for higher level clientele.

Upper Body Step-ups

Regression – in place stepping (this can be used to prepare clients for the step-ups)

This regression can also be a very effective training tool especially if the client lacks sufficient strength, endurance and form to execute the full step-up patterns.  Pain and form should always guide exercise selection and progression.

Below are two links to my Functionally Fit columns describing the execution and application of these exercises:

Unstable Upper Body Step-ups (forward)

Unstable Upper Body Step-ups (lateral)

The company I am privileged to work for has officially entered into a partnership with Athletes’ Performance. We are joining forces with them to take our performance training to an even higher level.  So, the Athletic Performance Center is now:

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I am pumped as we will be able to offer the same elite level training and nutrition services that are offered at other locations in AZ, FL, TX, CA and MA.  I will continue in my role as supervisor and sports physical therapist and look forward to all the great things to come.  If you are not familiar with AP, check them out at www.athletesperformance.com.

Click here for a detailed press release from Raleigh Orthopaedic Clinic.  I am confident this new venture will help me sharpen my saw and become an even better clinician and performance training expert.

Working with athletes of many disciplines affords me an opportunity to look at many shoulders week to week. Increasingly, I am seeing more Crossfit athletes for various shoulder problems.  In many cases, they have rotator cuff tendonitis, impingement, AC joint pain, labral pathology or a combination of the aforementioned issues.  The other big group of athletes I see is throwers.

These two groups share many of the same dysfunctions including posterior shoulder tightness and decreased mobility. Tightness in the pecs and lats is commonplace.  I feel latissimus tightness often goes unnoticed or perhaps is not an area of emphasis in prehab/rehab plans.  Tight lats will restrict elevation and contribute to postural dysfunction.

With restricted elevation, athletes may turn to excessive spinal extension and/or rotation to achieve elevation necessary (e.g. overhead squats, snatches, throwing) and this can contribute to poor movement patterns.  I have also seen this impact volleyball players asymmetrically with serving and hitting.

Lat tightness can easily be assessed by placing the athlete supine and simply asking them to bring the arms completely overhead.  While most people do not have 180 degrees of flexion, I feel working to achieve elevation greater than or equal to 160 is completely reasonable.  The body often uses abduction and external rotation to make things work (and this is natural for throwers), but the more pure elevation capacity we have the the better.

Crossfit involves lots of pull-ups and throwing heavily utilizes the pecs and lats for acceleration.  It only follows that muscular tightness in this region may need to be addressed.  Step one often involves soft tissue mobilization/compression techniques.  I prefer to use a Trigger Point ball or Grid to work on the soft tissue mobilizing it on the wall (TP ball) or floor (Grid) in an elevated position.

Next, I like to employ active mobility work.  I recently featured a simple exercise using the BOSU Ballast Ball in my PFP column. The pictures below reveal a rolling double arm version, as well as a single arm method/progression.  These active movements can also be complimented by sustained holds as desired.

For a more detailed description and application of this exercise, click here to read my “Functionally Fit” column.  I had one Crossfit enthusiast see me for limited shoulder mobility as it was hindering his overhead lifts and causing back pain.  He had about 130 degrees of shoulder flexion.  Daily STM using the foam roller, mobility work and some stretching increased his elevation by 10 degrees in 2-3 short weeks.

So, the take home message is that overhead athletes should assess and address this limitation if it is present as it may cause kinetic chain issues and energy leaks.  Improving mobility will better enable utilization of proper muscle activation and optimal movement patterns.

I hope you had a wonderful Thanksgiving Holiday. Today is Small Business Saturday, and as a small business owner I like to bring attention to it. In light of that, I am offering a whopping 40% off all my products today until the end of the day on Cyber Monday (3 days only).

This is my way of saying thanks to my readers and supporters. So, if you have been thinking about buying a book, DVD, or foam roller now is the perfect time to take advantage of this deal.

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Click here to see all the inventory. To receive the discount, simply enter coupon code SBS12 and hit apply prior to checking out. Happy Holidays!

Below are two videos demonstrating some sliding exercises I like to use in training and rehab.  The first video reveals one of my tougher hamstring exercises I prescribe, while the second video displays some shoulder/core stability variations using sliding discs.  I have included links to the PFP columns that better explain the set-up, execution and application for each exercise.

Click here for the Functionally Fit Column on sliding hamstring curls.

Click here for the Functionally Fit column on sliding shoulder raises.