Brian Schiff’s Blog

This is a follow-up to my previous post with respect to scapular strengthening for optimal shoulder function. Serratus anterior weakness is a common issue with overhead athletes, especially throwers. It may present clinically as scapular winging, however, it often fatigues quickly with repetitive throwing and contributes to scapular dyskinesia and shoulder dysfunction. Since throwing is an asymmetrical activity, I like to include some unstable and progressive strengthening exercises for the dominant arm.

In the video below (as part of my ‘Functionally Fit’ column for PFP Magazine) I will demonstrate how to use a bottom up kettle bell approach to strengthen the serratus anterior muscle.

To see the full article with progressions and regressions check out the link below:

http://fit-pro.com/article-4136-Unilateral-bottom-up-serratus-punch.html

In the case of shoulder pain and dysfunction, the lower trapezius and serrates anterior are often implicated as part of the problem. Research has shown that these two muscles often fatigue and don’t contribute equally to the force couple between them and the upper trapezius that facilitates upward rotation of the scapula.

Building scapular stabilization and dynamic stability is a must for those doing repetitive overhead activities such as throwing, swimming, serving, or work-related tasks.  It is a given that asymmetries will exist, so optimizing the strength of the rotator cuff and scapular stabilizers is paramount to prevent injury and recover from overuse syndromes.

To strengthen the lower trapezius, one of my ‘go to’ exercises is the lower trap raise. It can be done with just the weight of your arms or using light dumbbells.  The link below includes the full description for the exercise, and I also embedded the video below.

http://fit-pro.com/article-4137-Lower-trap-raise.html

In the next column, I will include a serratus anterior exercise using a kettle bell as a follow-up to this post.

I rehab far too many athletes under the age of 18 with ACL tears. In many cases, I am rehabbing some who have suffered multiple ACL ruptures before they graduate from high school. The burning question is why do so many clients suffer a graft failure or contralateral injury so so often?

Is it related to genetics? Is sports specialization to blame? Perhaps fatigue and limited recovery is a problem. I think the answer is multifactorial, but to be perfectly honest we as a profession have yet to truly arrive at a consensus as to when the “right time” to return to play is. Opinions vary widely based on the athlete, sport, native movement patterns, graft choice, additional injuries (ligament, cartilage or soft tissue) and the provider.

As a clinician dedicated to both prevention and the best rehab, I am always re-evlauating my own algorithm and rehab techniques, while looking for scientific rationale to direct my exercise selection and decision making processes. A recent paper by Webster and Feller in the November 2016 edition of AJSM looked at subsequent ACL injuries in subjects who underwent their primary ACLR under the age of 20 utilizing a hamstring autograft reconstruction procedure.

Continue reading…

I work with a lot of baseball players in my clinic.  In many cases, I see similar issues and recurring problems in them, especially pitchers.  Some of these issues include:

• Scapular dyskinesia
• Limited thoracic spine mobility (extension and/or rotation)
• Soft tissue tightness (lats, post shoulder, pec major/minor)
• Poor muscular strength/endurance in the rotator cuff and scapular stabilizers
• Glenohumeral internal rotation deficit (GIRD)

I integrate routine mobility exercises for my throwers, as well as other overhead athletes (tennis, swimming, volleyball, etc) to better prepare them for training and their sport, as well as prevent poor mechanics and compensatory motion that may lead to aberrant stress on the rotator cuff and labrum.

The following video reveals five of my preferred exercises using a foam roller to improve thoracic spine mobility, decrease latissimus tightness, and stretch the pec major/minor while facilitating lower trapezius activation.

In order you will see:

1. Lat rolling
2. T-spine extension in supine
3. T-spine extension coupled with lat stretch
4. T-spine rotation
5. Retraction and downward rotation

I advise performing 5-10 repetitions of each prior to training and sport. These will help improve performance, optimize overhead mechanics and reduce injury risk associated with overhead sports.

Many of my clients need to improve shoulder and pillar stability.  Combating poor glenohumeral and scapular stability and insufficient trunk stability is a must to reduce injury risk, resolve shoulder and back pain and eliminate compensatory motion with exercise, sport and life.

The following two exercises are “go to” ones I utilize to do just this.

Plank Push-ups

Stir the Pot

The links above are for two recent exercise columns I authored for PFP Magazine.  These exercises include load bearing using the client’s bodyweight and include progressions and regressions.