As a sports medicine professional and physical therapist working with lots of athletes after ACL surgery, I am always looking for ways to improve post-op rehab and prevent a subsequent ACL injury. While we have lots of research looking at neuromuscular, genetic, sex and morphologic risk factors, we have not been able to make significant progress in injury reduction. So many athletes suffer the dreaded “pop” making a simple athletic maneuver they have done a thousand times before.
Based on nearly 19 years of experience training and rehabbing athletes from youth to professionals, I see strong links to a genetic predisposition (family history and prior injury) as well as concerns over neural fatigue. We already know the age of injury is a significant as research indicates those tearing at a younger age (around 20-21 y/o) are more likely to suffer a second injury. But what we know less about is the impact of ankle biomechanics (namely limited dorsiflexion) and how proximal weakness in the hip affects injury risk.
The latter topic was the focus of a study just published in the current edition of the American Journal of Sports Medicine. In this prospective study, researchers sought to determine if baseline hip strength can predict future non-contact ACL tears in athletes.
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.
I work with many weekend warriors, strength training enthusiasts and overhead athletes in my practice. One of the more common dysfunctions I see in this population is either asymmetrical or general thoracic spine hypomobility (decreased range of motion).
This can predispose you to shoulder, back and hip dysfunction, as well as increase the risk for overuse injuries. In addition, it may also alter the natural biomechanics of movement, thereby negatively impacting performance. With all the sitting and screen time we engage in, it is no surprise we are developing a generation of people with forward heads, rounded shoulders and kyphotic posture.
This leads to reduced thoracic spine extension. Additionally, I often encounter decreased thoracic spine rotation. If this becomes restricted, asymmetrical overhead athletes may face increased stress on the lumbar spine, hips and glenohumeral joint. Common dysfunctions I treat related to this is rotator cuff tendinopathy, labral pathology, mechanical back pain, and hip pain to name a few.
To combat stiffness and promote more optimal mobility, I encourage my clients to perform daily mobility work. I have included a video I filmed for PFP Magazine in my column ‘Functionally Fit’ below that illustrates an effective way to combat reduced T-spine extension.
Be sure to check back for my next blog post on how to increase thoracic spine rotation.
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!
Why is it that athletes performing a movement they have done so many times suddenly tear their ACL? We have been studying ACL injury and prevention for many years now, and despite our best efforts, we have not made marked progress in preventing the number of ACL injuries. In addition to anatomical variants and perhaps some genetic predisposition, I feel that the earlier push for sports specialization in our society resulting in increased training/competition hours is a major factor.
The term ACL fatigue may or may not be familiar to you. But in essence, this theory would suggest that after a certain number of impacts/loading, the ACL becomes weakened and less resistant to strain. You could almost compare this to a pitcher who suffers an injury to his medial collateral ligament with too much throwing.
As someone who is consistently rehabbing athletes with ACL tears and screening athletes to assess injury risk, I am always interested in how we can keep people from suffering such a devastating non-contact injury. A recent article in the American Journal of Sports Medicine sought so assess ACL fatigue failure in relation to limited hip internal rotation with repeated pivot landings.
We already know that hip mobility is often an issue for our athletes. Researchers at the University of Michigan sought to determine the effect of limited range of femoral internal rotation, sex, femoral-ACL attachment angle, and tibial eminence volume on in vitro ACL fatigue life during repetitive simulated single leg pivot landings.
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