Brian Schiff’s Blog

Research has shown that strengthening the gluteus medius is clearly an essential way to reduce anterior knee pain and improve pelvic stability and function.  The exercise I am sharing today is useful for improving hip strength and pelvic stability in a closed chain fashion.

In the video below, I demonstrate a very effective way to strengthen the gluteus medius and improve hip stability.

For a full description of the exercise, check out my latest column, Functionally Fit, by clicking here.

Seldom do I use my blog as a platform to rant, boast or anything in between.  I generally like to share evidenced based information that helps improve your health and performance.  But, every once in a while I feel the need to share my opinions on things I feel strongly about.  Today, I want to offer you my suggestions and theory on professional excellence within the fields of health and fitness.

Let me preface this post by simply saying I would never think of writing this or publishing it online for the whole world to read without having several years (15 now) of professional experience under my belt and a proven track record of getting RESULTS for my clients.  In my mind, the very reasons for my success include: being blessed with above average intelligence, a strong work ethic, a desire to help and serve others, unquenchable PASSION to be the very best I can be in my field, and an uncanny knack for seeing things others do not and using that information to make impactful exercise and treatment decisions for my patients and clients.

Where am I going with this?  Well, unfortunately, not all trainers, coaches and physical therapists share this same passion or possess this knack that I speak of.  Some are content after college (or certification) to be good enough and may not read literature, go above and beyond with continuing education, surround themselves with the best in the business or strive to be better each day.  Others may simply not have an innate ability to problem solve and synthesize given data to construct the right plan for the client.  Often trainers and clinicians default to what is easy or “what they know” as opposed to viewing each client in a different light.  In other words, they lack artistry.  They will never be revered like Picasso (pictured below).

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I thought a fitting way to kick off the new year would be to share the top 10 things I learned or embraced that have most shpaed and impacted my training and rehab this past year.  In no particular order I will rattle these things off.  I hope at least one of these little pearls has a positive impact on your training and/or rehab as well.

1. Often times it appears necessary to perform a biceps tenodesis or tenotomy in active adults undergoing a SLAP repair to ensure more predictable pain relief.  I heard this at a sports medicine conference last May and I can tell you those patients having this done alongside their shoulder surgeries seem to recover quicker with less pain relief.  With that said, keep in mind that SLAP tears are difficult to define and operate on as surgeons still do not have great agreement across the board on defining the extent of injuries and how to deal with them (operative vs. non-operative).
2. Performance on the Functional Movement Screen (FMS) has little to no correlation with athletic performance.  I screened an NBA player and an NFL player this year who both failed the screen.  However, they obviously have mad athleticism and genetic ability.  Keep in mind the FMS is a valuable tool used to assess movement and expose injury risk patterns based on the 7 tests.
3. Soft tissue therapy is undervalued and misunderstood by most lay people.  Assessing tissue restrictions and educating our clients to perform self myofascial release techniques is essential if they want to compete and remain healthy day in and day out.  Specific problem areas I have increased my focus on this year have been the psoas, soleus and posterior rotator cuff/joint capsule.  Click here for my soleus blog post.
4. Core training is probably as much about not moving as it is about generating force with movement.  I read work from Stuart McGill and other smart people in the field, and the concepts of anti-rotation and anti-extension are sound concepts to explore and look more closely at.  Many times, performance in sport and life require us to resist movement and maintain position so strengthening the core to resist potentially harmful and stressful motions is and should be an important part of training and rehab programs.  Understanding how to facilitate and activate core musculature in the training to protect the spine and improve mobility/strength is key.  Click here for more on my core training.
5. Hip dissociation is an important element to train as the lack of it can impact function and performance in a negative way.  We assess it on the active SLR in FMS and I see the lack of it show up on clinical exams all the time.  Whether it is HS tightness, hip flexor weakness or simply poor neuromuscular control, clients who are unable to effectively dissociate the hips are more prone to injury and limited performance.
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I wanted to take a brief moment to wish all of my readers a Merry Christmas and Happy New Year.

This time of year is one in which to look back and be grateful for all the blessings of the past year, as well as look forward to what the next year has to offer.

2011 has been a time of change as my family and I have embraced our new home in North Carolina.  I have thoroughly enjoyed my new position as supervisor and therapist at the Athletic Performance Center.  I work with a wonderful staff and a patient population consisting of youth to professional athletes.

As 2012 approaches, I look forward to new opportunities/goals such as becoming board certified in orthopaedic physical therapy, bringing Redcord training to our center as a master trainer, and launching a new program for runners.  I hope you have had a great year and I wish you continued health and prosperity in the year to come!

Stay tuned for some pearls of wisdom I will share in my next post about things I have learned and that have most impacted my rehab and training practice over the past year.  Thanks for all your questions, support and encouragement – keep it coming. Enjoy the Holidays with your family!

One of the most common PT clients I see is an injured runner.  There can be a umber of different reasons or factors involved leading up to a running injury, but I wanted to focus on this idea of gait retraining that is taking place today.  With the advent of Born to Run and minimalist footwear, people have begun to question and debate what the best way to run is.

Is this suited for everyone?

Let me just say right away that I do not believe there is a simple answer here.  Human beings are all unique and have different genetic and biomechanical makeups.  What this means in effect is that they have their own set of “issues” if you will that I classify into common categories such as:

• Static alignment problems (arch, knee, hip, etc)
• Static and dynamic balance deficits
• Inefficient gait mechanics
• Muscle imbalances
• Soft tissue tightness
• Recurring pain patterns

The list could go on and on, but you get the point.  The idea of “re-teaching” someone how to run differently than their natural motor pattern dictates in not easy and is a decision that should be well thought out and based on sound decision making.  We are pre-programmed at birth with certain native motor patterns and running is one of those patterns.  Generally, your brain finds the most efficient way for you to run in your own body.

Now granted, some run much better than others.  Perhaps we can say athleticism plays a role in this, but as we grow and reach skeletal maturity our body type, training experience, strength and environment are also major factors .  With that said, I know that runners with recurrent and/or chronic pain are looking for a finite solution to their problem.  They grow frustrated when they are unable to log all their miles or finish a race.

If traditional PT or relative rest fails to alleviate the pain, we must delve deeper and look more closely at their gait.  I think video analysis is a great tool for doing this.  We use Dartfish at my clinic, and this is very useful for breaking down gait mechanics and detecting things like heel versus forefoot striking, overpronation, asymmetry side-to-side, trunk inclination, etc.  Once we find things on video we must also correlate these findings to our clinical screening to uncover a cause and effect relationship.

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