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Brian Schiff’s Blog

Injury Prevention, Sports Rehab & Performance Training Expert

Tag: rehab

Over the years, I have tested many different fitness products through my work with Personal Fitness Professional Magazine. I am not paid to promote any products on my site, and this latest review comes after spending the past few weeks using this particular product in the clinic with my patients. I am pleased to bring attention to it because I think it can help with recovery and training.

Recently, the inventor of the HECOstix, Josh Broeker, reached out to me to see if I have had a chance to use his product. Much to my surprise, I was not familiar with it. As a performance physical therapist working with many athletes from various sports and ranging from youth to professionals, I was naturally excited to see the product in action. I am always looking for ways to enhance neurocognitive training and my rehab. Josh was gracious enough to send me a few HECOstix to try out.

For those unfamiliar with the product, see the image of the Red, White and Blue version below:

As I rehab and progress athletes back to sport after injury, implementing tools to improve hand eye coordination, reaction time, cognitive skills and decision making is important prior to sending them back to practice and sport. A few of the really cool features I like about this product include:

  • Lightweight and durable EVA make-up
  • Different versions and multiple colors allow for auditory cues and quick reaction
  • It can be used safely by all ages and abilities
  • Travels easily with you anywhere

The HECOstix can be used for virtually any sport and done indoors or outdoors. Perhaps the greatest thing about the product is that it injects FUN into training while allowing users to compete against others or their own results in an effort to improve performance. This tool also allows for progressive challenges moving from underhand to sideways to overhead throws depending on the functional demands and skill level of the participants.

In the clinic, I have been using it with some of my patients rehabbing after ACL reconstruction. Adding neurocognitive training is essential for full recovery and secondary prevention. below is an article from Sports health discussing neurocognitive and neurophysiological functions related to ACL injury:

Specifically, I have integrated it with dynamic balance and movement drills calling out a color while throwing the HECOstix toward the client. I have also had a pair of patients throwing and calling out the color as part of a rehab game. I will be continuing to use it with this population and other athletes working on hand eye coordination and cognitive training for their sport.

If you are looking to add a new wrinkle to your training or rehab, I highly recommend giving this product a try. For more information on the product, be sure to visit


Halo Trainer

I recently received a Halo Trainer from Bryce Taylor, its inventor and program director.  I am fortunate enough to test and sample many new products related to fitness and rehab.  Many of them are one dimensional, full of fluff or new takes on an old product. This product really delivers for those in the rehab and fitness worlds.

Disclaimer: I am not being compensated for this product review or paid to endorse this product.  I simply love what it has to offer. The Halo Trainer offers countless training possibilities for so many people despite their backgrounds and abilities.

In fact, here is an excerpt from the Halo Trainer website:

Halo Training currently consists of 4 levels of difficulty for functional bodyweight training.   We all know that people have various levels of strength, flexibility, coordination, etc. so we at Halo Rehab & Fitness believe that individuals should not be performing the same exercises.  Although it is always to goal to increase the challenge, it is not always appropriate.  Sometimes an exercise can be advanced and other times an exercise needs to be made a little easier to meet the specific level of the individual.

For this reason, the Halo training development team has created four distinct levels of difficulty based on scientific principles. Our team has created levels of difficulty for over 300 exercises so that you can create a specific progressive individualized program to maximize bodyweight training.  Just pick a starting level and progress to the next level when you are able to complete the challenges of your current level.

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One of my favorite quotes from a well known fitness professional, Alwyn Cosgrove, is: “Exercise is a drug.  If we give the right drug in the right dose – everything works.  But, if we give the wrong drug or even the right drug in the wrong dose, we cause more problems than provide solutions.”  In essence, dosage matters a whole lot.  This means that getting it just right is also not by accident, but by careful analysis and exacting prescription.


After a thorough evaluation, exercise selection and progression must be predicated on the end goal for the athlete.  Where are they now?  How do I get him/her back to 100%  Understanding the injury itself, training and medical history as well as inflammation and healing time frames is important, but that is just one part of the equation.

For those with experience, you already know athletes heal differently and no two injuries are ever just alike.  Addressing the mental components outlined in my previous post, Return to Play: Part 1 (The Athlete’s Mindset), is the starting point.  Next, you must formulate a plan to physically mend, challenge and prepare the athlete’s body to return to its previous functional level.

Below are some BIG mistakes I have either made along the way or witnessed in my career:

  1. Prescribing exercise solely based on the diagnosis – while logical and not entirely off base, we must learn to think globally and make sure we assess the whole athlete as opposed to isolating one area.  In my early days, I tended to focus on the affected area where symptoms were prevalent.  Keep in mind the symptoms may simply be the result of another weak link in the chain.  The FMS, SFMA and myofascial chains have taught us the importance of kinetic linking
  2. Pushing too hard too fast – progressing sessions simply based on what the athlete tells me as opposed to properly moving through a sound functional progression with specific criteria needing to be met prior to moving on to the next phase of rehab can cause more harm than good.  While you may be able to go faster in some cases, do not get too greedy without satisfying set goals along the way.  You do not want to reinforce a poor movement pattern.  A misstep here may cause a recurrence of the injury, perpetuate inflammation or weaken healing tissue.
  3. Not pushing the athlete hard enough – it is paramount that we assess client response “in the moment” rep to rep and set to set as opposed to just session to session.  Observe form and fatigue, but do not let the athlete coast or get bored with the lack of progression.  Understanding and applying fundamental exercise physiology principles and recognizing periodization is necessary to ensure complete restoration.

Now, on the my next big point.  I strongly believe you need to know how HARD the exercises you suggest are in order to effectively prescribe them.  One of my primary philosophies is that I will not prescribe exercises I cannot do.  Not only is this critical for teaching proper form, it is a must to gage fatigue, workout demand, recovery needs and so on.

Possessing a solid grasp of volume and intensity is also essential.  For example, having an athlete who is 6 weeks post-op with a bone-tendon-bone ACL autograft reconstruction do too much eccentric quad loading will inevitably lead to anterior knee pain or patellar tendonitis.  Would you do 10 separate eccentric quad exercises (2-3 sets of 10-15 each) in one hour ?  I do not do this type of volume on my healthy knee, but I have seen rehab done this way.  We must always keep a watchful eye on load, time under tension and overall volume throughout the rehab process.  The proper balance is critical.

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I have spent the past 16 years helping athletes get back to their sport or desired activity following an injury. Whether dealing with muscle strains or ACL ruptures, every injured client shares the same goal of making a full recovery and getting back to their previous activity level. My purpose in writing a blog series on this topic is simply to share some pearls I have picked up along the way and to help others learn from my mistakes and successes.

Beyond the severity and nature of the injury itself, there are several considerations that play a significant role in the rehabilitation process including: the athlete’s emotions, goals, mental toughness, age, experience, previous medical history, relationships with parents/coaches/teammates, innate movement patterns, etc. I feel the first and perhaps most important step in the recovery process involves connecting with the athlete on an emotional level.


Injured clients want to know that their medical team (MD, PT, ATC and strength coach) really care about their well being, that they truly understand the impact of the injury on his/her life, and that they can provide the skilled care necessary to restore the body to its prior level of function. Too many times, we as health care professionals speak first espousing all our expertise and often forget to LISTEN enough.  Our athletes want to feel special during this low point in their life.

Pearl #1 – Spend more time listening on the first meeting/visit to gain a thorough understanding of how the injured athlete “feels” and views their current injury. I spend the majority of my eval time interviewing the client to allow them to describe their physical symptoms, but more importantly fully elaborate on their goals, perceptions and thought processes surrounding the rehab timeline and expected outcome. Knowing how they feel (afraid, angry, depressed, etc) is essential in order to connect as well as properly motivate/coach throughout.

Many athletes (especially those who have been injured before) tend to want to dictate how things will go or pre-determine when they will be able to return to the playing field.   I will re-direct them, but it is wise to listen to them tell you what did not work for them in the past.  Mistakenly, they often compare their injuries to past experiences of their own or peers. While prior experience dealing with the same injury is helpful mentally preparing for the recovery process, it is critical to remind the athlete coach and family that no two injuries are exactly alike and that the recovery process will be guided by specific milestones and processes as opposed to “what happened in the past.”

Pearl #2 – Thoroughly educate the athlete on his/her condition, the anticipated timeline for return to sport and the implications for pushing too hard and fast in rehab. Never assume he/she does not want to know all the details. Emphasize that your goal is to return to sport as soon as possible but in a safe manner that ensures adequate recovery and minimizes the risk for re-injury. Telling your athletes the “why” behind each and every decision (exercise selection, reps, sets, practice limitations, etc) will help put the athlete at ease early on and foster trust and collaboration. This is an absolute must.  To ensure success, we need the athlete to honestly and openly communicate throughout.  I tell every athlete I work with that we are a team dedicated to the same goal – this achieves buy in from them up front as they see I am fully committed and invested in them.

In almost all cases, I find the athletes fear losing their starting position and/or letting down the coach far more than long term damage to their bodies. As such, I tell them it really is okay to rest and recover. They seemingly feel guilty about not contributing and their self-worth may markedly diminish. Recognizing this and encouraging them to be patient, stay the course and see the light at the end of the tunnel is very important. You see, the emotional and psychological healing is a HUGE part of the process during rehab. Being an advocate for the patient and not the sport provides security and emotional support for the injured client.


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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:


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

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.