Click For Different parts

How to Assess the Scapula

The latest Inner Circle webinar recording on How to Assess the Scapula is now available.

How to Assess the Scapula

How to assess scapular dyskinesisThis month’s Inner Circle webinar is a live demonstration of How to Assess the Scapula.  In this recording of a live student inservice from Champion, I overview everything you should (and shouldn’t) be looking for when assessing the scapula.  When someone has a big nerve injury with significant winging or scapular dyskinesis, the assessment of the scapula is pretty easy.  But how do you detect the subtle alterations in posture, position, and dynamic movement?  By being able to identify a few subtle findings, you can really enhance how you write a rehab or training program.

In this webinar, I’ll cover:

  • What to look for in regard to static posture and scapular position
  • How to check to see if static postural asymmetries really have an impact on dynamic scapular movement
  • What really is normal scapulothoracic rhythm (if there really is a such thing as normal!)?
  • How to reliably assess for scapular dyskinesis
  • How winging during the concentric and eccentric phases of movement changes my thought process
  • How to see if scapular position or movement is increasing shoulder pain
  • How to see if scapular position or movement is decreasing shoulder strength

To access this webinar:




A Simple Test for Scapular Dyskinesis You Must Use

A common part of my examinations includes assessing for abnormal scapular position and movement, which can simply be defined as scapular dyskinesis.  Scapular dyskinesis has long been theorized to predispose people to shoulder injuries, although the evidence has been conflicting.

Whenever data is conflicting in research articles, you need to closely scrutinize the methodology.  One particular flaw that I have noticed in some studies looking at the role of scapular dyskinesis in shoulder dysfunction has involved how the assess and define scapular dyskinesis.

Like anything else, when someone has a significant issue with scapular dyskinesis it is very apparent and obvious on examination.  But being able to detect subtle alterations in the movement of the scapula may be more clinically relevant.  There’s a big difference between someone that has a large amount of winging while concentrically elevating their arm versus someone that has a mild issues with control of the scapula while eccentrically lowering their arm.

Most people will not have a large winging of their scapula while elevating their arm.  This represents a more significant issue, such as a nerve injury.  However, a mild amount of scapular muscle weakness can change the way the scapula moves and make it difficult to control while lowering.


A Simple Test for Scapular Dyskinesis

One of the simplest assessments you can perform for scapular dyskinesis is watching the scapula move during shoulder flexion.  Performing visual assessment of the scapula during shoulder flexion has been shown to be a reliable and valid way to assess for abnormal scapular movement.

That’s it.  Crazy, right?  That simple!  Yet, I’m still amazed at how many times people tell me no one has ever looked at how well their scapula moves with their shirt off.

However, there is one little tweak you MUST do when performing this assessment…

You have to use a weight in their hand!

Here is a great example of someone’s scapular dyskinesis when performing shoulder flexion with and without an external load.  The photo on the left uses no weight, while the photo on the right uses a 4 pound dumbbell:

scapular dyskinesis

As you can see, the image on the right shows a striking increase in scapular dyskinesis.  I was skeptical after watching him lift his arm without weight in the photo on the left, however, everything became very clear when adding a light weight to the shoulder flexion movement.  With just a light load, the ability to prevent the scapula from winging while eccentrically lowering the arm becomes much more challenging.

I should also note that there was really no significant difference in scapular control or movement during the concentric portion of the motion raising his arms overhead:

scapular winging concentric

This person doesn’t have a significant issue or nerve damage, he simply just needs some strengthening of his scapular muscles.  But if you didn’t observe his scapula with his shirt off or with a dumbbell in his hand, you may have missed it!


How to Assess for Scapular Dyskinesis

In this month’s Inner Circle webinar, I am going to show you a live demonstration of how I assess scapular position and movement.  I’ve had past talks on how to assess scapular position and how to treat scapular dyskinesis, however I want to put it all together with a demonstration of exactly how I perform a full scapular movement assessment and go over things I am looking for during the examination.

I’ll be filming the video and posting later this month.  Inner Circle members will get an email when it is posted.




How to Coach and Perform Shoulder Program Exercises

The latest Inner Circle webinar recording on How to Coach and Perform Shoulder Program Exercises is now available.

How to Coach and Perform Shoulder Program Exercises

How to Coach and Perform Shoulder Program ExercisesThis month’s Inner Circle webinar is on How to Coach and Perform Shoulder Program Exercises.  While this seems like a simple topic, the concepts discussed here are key to enhancing shoulder and scapula function.  There are many little tweaks you can perform for shoulder exercises to make them more effective.  If you perform rotator cuff or scapula exercises poorly, you can be facilitating compensatory patterns.  In this webinar, we discuss:

  • How to correctly perform rotator cuff and scapula exercises
  • Coaching cues that you can use to assure proper technique
  • How to enhance exercises by paying attention to technique
  • How to avoid compensation patterns and assure shoulder program exercises are as effective as possible

To access this webinar:




How to Assess for a Tight Posterior Capsule of the Shoulder

Over the years, the idea of posterior capsular tightness and glenohumeral internal rotation deficit (GIRD) in baseball pitchers has grown in popularity despite not much evidence.

I routinely see baseball players ranging from kids to MLB pitchers that have been told they have GIRD and need to aggressively stretch their posterior capsule and into shoulder internal rotation.  One of the first recommendations I make is essentially addition by subtraction – stop focusing on these areas!  I’ve discussed at length my feelings on why I don’t use the sleeper stretch, which is something I haven’t used in over a decade and none of my athletes have a loss of internal rotation.

Many people assume that GIRD is caused my posterior capsular tightness, without assessing the posterior capsule itself.  Blindly applying treatments without completely assessing the person is always a bad idea, especially considering GIRD may be normal and not even an issue.

Assessing the posterior capsule can be tricky and most text books continue to demonstrate the technique poorly.  I wanted to share a quick video showing how to assess the posterior capsule of the shoulder.



Perform your assessment of the posterior capsule this way and you’ll realize most people can actually sublux posteriorly and that mobilizing the posterior capsule isn’t what they need for GIRD!  Keep in mind this is applicable for athletes, you can certainly get a tight posterior capsule for many reasons, I just don’t think this is the primary cause of GIRD so shouldn’t be the primary treatment.


Learn Exactly How I Evaluate and Treat the Shoulder

If you are interested in mastering your understanding of the shoulder, I have my acclaiming online program teaching you exactly how I evaluate and treat the shoulder!

ShoulderSeminar.comThe online program at takes you through an 8-week program with new content added every week.  You can learn at your own pace in the comfort of your own home.  You’ll learn exactly how I approach:

  • The evaluation of the shoulder
  • Selecting exercises for the shoulder
  • Manual resistance and dynamic stabilization drills for the shoulder
  • Nonoperative and postoperative rehabilitation
  • Rotator cuff injuries
  • Shoulder instability
  • SLAP lesions
  • The stiff shoulder
  • Manual therapy for the shoulder

The program offers 21 CEU hours for the NATA and APTA of MA and 20 CEU hours through the NSCA.

Click below to learn more:





How to Know When to Push a Stiff and Painful Shoulder

If you have ever worked with someone with a stiff and painful shoulder, you know how challenging it can be to gain motion.  Regardless of if this is a postoperative shoulder or someone with adhesive capsulitis, push too hard or too fast often backfires and causes them to get worse!

One of the more common questions I get from students and new clinicians is – “how do you know when to push range of motion.”

Luckily, there is a pretty simple way to knowing when to push a stiff and painful shoulder and when to back off.


Assess End Feel

How to Know When to Push a Stiff and Painful ShoulderIn addition to assessing the quantity of motion, you should also assess the quality of motion.  This is essentially the “end feel,” or the quality of the end range of motion.

Every joint has a normal end feel.  Some common examples are:

  • Boney: Hard end feel of two bones approximating.  Elbow extension is a good example.
  • Capsular or Ligamentous: Often described as stretching a piece of leather.  This is normal joint end feel, such as with shoulder external rotation
  • Muscular: This is more like stretching a piece of rubber, like when stretching the hamstrings
  • Tissue Approximation: When the mobility is stopped because you run out of room to move, such as during elbow or knee flexion.
  • Empty: Pain does not allow you to get to the end of the range of motion, you stop in the middle of the range.
  • Spasm: An abrupt end of the movement that feels as if the person is in pain and guarded.  This feels like the muscles are stopping the motion and spasming.


Don’t Push Through a Spasm End Feel

A simple rule I have always followed and has helped me know when to push motion with a painful and stiff shoulder is to never push through a spasm end feel.

If someone presents with a spasm end feel, your primary treatment objective should switch from trying to gain motion to trying to reduce spasm.  Attempting to push through the spasm almost always backfires.

You’ll know you can push harder when the spasm end feel changes to a capsular end feel.  That’s your cue to get more aggressive.  But…  be careful!  It’s possible to push too hard or too fast again and revert back to a spasm end feel.


Learn How I Treat the Stiff Shoulder

If you are interested in mastering your understanding of the shoulder, I have an amazing sale going on right now for my acclaiming online program teaching you exactly how I evaluate and treat the shoulder!  You can save a HUGE $150 off the normal enrollment fee!

ShoulderSeminar.comThe online program at takes you through an 8-week program with new content added every week.  You can learn at your own pace in the comfort of your own home.  You’ll learn exactly how I approach:

  • The evaluation of the shoulder
  • Selecting exercises for the shoulder
  • Manual resistance and dynamic stabilization drills for the shoulder
  • Nonoperative and postoperative rehabilitation
  • Rotator cuff injuries
  • Shoulder instability
  • SLAP lesions
  • The stiff shoulder
  • Manual therapy for the shoulder

The program offers 21 CEU hours for the NATA and APTA of MA and 20 CEU hours through the NSCA.

Click below to save $150 off the program between now and November 1st:




A Simple Tweak to Enhance Glute and Reduce TFL Activity

Hip weakness is a common area of focus in both the rehabilitation and fitness fields.  Combine our excessive sitting postures and the majority of activities during the day that occur in the sagittal plane of motion, and hip weakness in the frontal and transverse planes is common.

There are many exercises designed to address glute medius and glute maximus strength in the transverse plane.  But a simple tweak to your posture during one of the most common exercises can have a big impact on glute activity and the balance between your glutes and TFL.


The Effect of Body Position on Lateral Band Walking

A recent study in JOSPT analyzed EMG activity of the glute max, glute medius, and TFL muscles during two variations of the lateral band walking exercises.

The subjects performed the lateral band walk in a standing straight up posture and a more flexed squat position.

A Simple Tweak to Enhance Glute and Reduce TFL Activity

I’ve personally used both variations in the past but tend to perform the exercise more often in the slightly flexed position, which we consider a more “athletic posture,” as we don’t really walk laterally with our hips and knees straight very often.

Results showed that EMG of both the glute max and glute medius was enhanced by performing lateral band walks in the partial squat position, and that TFL activity was actually reduced.  Glute activity almost doubled.


A Simple Tweak to Enhance Glute and Reduce TFL Activity

The finding of reduced TFL activity is just as important as enhanced glute EMG activity, as the ratio of glute medius to TFL is greatly enhanced by performing the lateral band walk in this athletic position.

Sometimes it’s the simplest studies that make the most impact.

The TFL also acts as a secondary hip flexor and internal rotator of the hip.  In those with glute medius weakness, which is fairly common, the TFL tends to be overactive to produce abduction of the hip.

Considering how our chronic seated posture can cause shortening of the hip flexors and we know many knee issues can arise from too much dynamic hip internal rotation and glute medius weakness, we often try to focus on developing the glute medius ability to become more of the primary muscle involved with abduction, instead of the TFL.

Another interesting finding of the study was that the stance limb, not the moving limb, had higher EMG activity for every muscle in both positions.  This shows the importance of the stance abductors in providing both a closed kinetic chain driving force as well as a lumbopelvic stabilizing force when the moving limb transitions to nonweightbearing.

We focus a lot on abduction based exercises to strengthen the glute medius, but closed kinetic chain exercises in single leg stance may be just as important to train the hip to stabilize the lower extremity.

One thing I would add is that I rarely perform this exercise with the band at the ankles as the authors did.  I much prefer to put the band around the knee and feel it helps develop better hip control.

Based on this study, I’m not sure I see why I would perform a lateral band walk in a tall upright posture.  I’m going to maximize glute activity and reduce TFL activity by doing the exercise in a more flexed athletic position.


How to Perform and Advance Rhythmic Stabilization Drills

The latest Inner Circle webinar recording on How to Perform and Advance Rhythmic Stabilization Drills is now available.


How to Perform and Advance Rhythmic Stabilization Drills

How to Perform and Advance Rhythmic Stabilization Drills Mike ReinoldThis month’s Inner Circle webinar is on How to Perform and Advance Rhythmic Stabilization Drills.  Rhythmic stabilization drills have become very popular since I discussed in my DVD Optimal Shoulder Performance several years ago.  These are easy and excellent drills to start working on dynamic stabilization.  However, I must say over the years I feel like people are getting pretty sloppy with these drills, which essentially makes them much less effective.  Just because an exercise is simple, doesn’t mean that we should be sloppy with how we perform.  In this inservice presentation, I discuss how to perform rhythmic stabilization drills and all the ways we advance them from simple to advanced.

In this webinar, we discuss:

  • Why rhythmic stabilization drills are a great way to start enhancing dynamic stability
  • How to perform basic rhythmic stabilizations
  • How to advance rhythmic stabilization drills by changing technique variables
  • How to know when to advance someone or scale back to get the most out of the drills

To access this webinar:



A Simple and Easy Hip Mobility Drill for Low Back Pain

Low back pain continues to be one of the most common health complaints that limit people, especially as we age.  Rehabilitation of low back pain has transition from simply focusing on reducing the local pain to emphasizing a biomechanical approach of how other areas of the body, such as the hips, impact low back pain.

Essentially we have done a great job moving away from simply treating the symptoms and working towards finding the movement impairment leading to the low back pain.  Sure, using something like a TENS device may have a role to neuromodulate pain, but it is now common knowledge that the improvements seen are transient at best and not addressing the real dysfunction.

One area that has received a lot of attention, and rightfully so, is looking at limitations in hip mobility as a cause of low back pain.  Much of the research to date has focused on looking at the loss of hip external rotation and internal rotation mobility.  In fact, I have an older article on the correlation between hip mobility and low back pain.

I can say that my own ability to help people with low back pain has greatly improved as I’ve learned to focus on hip mobility over the years.


hip extension mobility low back painHip Mobility and Low Back Pain

A new study was recently published in the International Journal of Sports Physical Therapy that adds to our understanding of the influence of hip mobility on low back pain.  In the current study, the authors evaluated hip external rotation, internal rotation, and extension mobility in two groups of individuals, those with and without nonspecific low back pain.

While using a Thomas test to assess hip extension, the authors found the follow:

  • Hip extension in those with low back pain = -4.16 degrees
  • Hip extension in those without low back pain = 6.78 degrees

That’s a total loss of 10 degrees of hip extension in those with low back pain.


A Loss of Hip Extension Correlates to Low Back Pain

So now in addition to rotational loss of hip rotational mobility, it has been shown that a loss of hip extension correlates to low back pain.  To me, this has always been something I have focused on and makes perfect sense, especially as we age.

The vast majority of our society sits for the majority of the day and becomes less and less active as they age.  Among many things, this results in tight hip flexors and an anterior pelvic tilt posture.

Putting recreational activities like sports and running aside, this anterior pelvic tilt posture with tight hip flexors causes a loss of hip extension mobility and the low back tends to take the load but hyperextending.  This happens while simply walking and in a standing posture.

Think about the results above, people with low back pain have negative hip extension, meaning they can’t even extend to neutral!

As we all know, the human body is amazing and will compensate.  Hips don’t extend?  No problem, we’ll extend our spine more.

So a pretty easy step to take to reduce back pain is to work on hip extension mobility.

One drill that almost everyone that trains at Champion PT and Performance gets is what I named the “True Hip Flexor Stretch.”  I’ve talked about it at length in past articles, but I am a believer that most of our hip flexor stretches commonly performed in the fitness world are disadvantageous and not actually stretching what we want to stretch.

The True Hip Flexor Stretch is a great place to start to work on hip extension mobility:

As you can see (and feel), this gets a great stretch on your hip flexors without causing any compensatory low back extension.  And by focusing on posterior pelvic tilt, we gear this towards those with a lot of anterior pelvic tilt.


I really believe that the “True Hip Flexor Stretch” is one of the most important stretches you should be performing.  [Click to Tweet]


Next, Focus on Reducing Anterior Pelvic Tilt in People with Low Back Pain

Updated Strategies on Anterior Pelvic TiltI’m not a big believer that static posture is the most important thing we should all be focusing on when outline our treatment and fitness programs, but it’s a start.  Someone in an anterior pelvic tilt static posture isn’t always evil, and can be the result of many things such as poor core control, poor mobility, and even excessive weight.  I tend to care more about how well people move.

But based on the current evidence, it’s a great place to start.

Once you’ve started to gain some hip mobility, there is a ton more work to do.  We also have to work on glute and core control, among other things.  If you’re interested in learning more, I have a hugely popular Inner Circle webinar on my treatment strategies for anterior pelvic tilt that goes into detail on what I recommend:


In summary, we now have a nice study that shows people with low back pain have 10 degrees less hip extension that those without.  This makes sense, and focusing on hip extension should be one of the key components of any low back pain program.



Optin webinar graphic

5 Things You Need to Understand to Master Functional Rehab and Performance

Join Mike's Newsletter and gain FREE access to his webinar overviewing his system of integrated functional rehab and performance training, PLUS these bonuses:

1. My 1+ Hour Functional Rehab and Performance Webinar

2. My 36-Page Solving the Patellofemoral Mystery eBook

3. My Accelerated ACL Rehabilitation Protocol

Thanks! Check your email for more information and your FREE bonuses!