An Easy Drill to Enhance Thoracic Extension

Thoracic mobility drills are commonly given to people to enhance mobility.  I have shown some common thoracic mobility drills in the past, and recently showed a newer muscle energy technique I have been using.  If you haven’t seen these yet, you should check them out:

 

One of my big principles of rehabilitation and corrective exercises is that you follow up mobility drills with some sort of activation or strengthening drill.  You want to use the body in this newly gained mobility.

For some reason, I feel like this is often ignored with thoracic mobility.

I would actually argue that a very common reason for having limited thoracic mobility is poor endurance into thoracic extension.  The muscles can’t maintain an extended posture and resort to the path of least resistance, a slouched posture.

If you are going to spend time working on thoracic extension mobility, you should follow that up by working on thoracic extension endurance.

In the video below I show an extremely easy way to start working on thoracic extension endurance.  Certainly not groundbreaking, but an important drill that is often overlooked.

 

An Easy Drill to Enhance Thoracic Extension

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

 

Enhancing Thoracic Mobility

enhancing thoracic mobilityLimited mobility of the thoracic spine is a common finding and something that tends to get worse over time.  To me, it’s one of those “use it or lose it” types of mobility in the body.  Several issues can occur from limited thoracic mobility, such as shoulder, neck, and even low back pain.

Thoracic mobility drills are common, but only part of the puzzle.  I have a new presentation where I’ll be reviewing some of the self mobility, manual therapy techniques, and corrective exercises I use to enhance thoracic mobility.

 

Enhancing Thoracic Mobility

This presentation will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

 

Access the Presentation

You can purchase access to this presentation for only $10, or join my online Inner Circle Mentorship program for only $10/month and gain access to this and ALL my past presentations, product discounts, exclusive content, member only forum, and more!

 

 

Thoracic Mobility Muscle Energy Technique

Have you ever worked with someone that never seemed to improve their thoracic mobility, especially thoracic rotation?

I work with the occasional person that doesn’t respond to many of the common thoracic mobility drills.  Sometimes their daily posture, especially if working a desk job for years, needs more than the simple drills.  Sometimes I feel that thoracic mobility limitations can be true mobility restrictions, but other times I also feel there may be some tone or guarding involved.

A common technique that can be used to enhance mobility drills, especially when tone is involved, is muscle energy technique, or MET.  Muscle energy is commonly used to enhance mobility in other areas of the body, like the shoulder or hamstring, but less frequently used for thoracic mobility for some reason.

In the video below I show a very easy muscle energy technique that you can use to enhance thoracic mobility into rotation.  This is very easy to perform on your own too.

Give it a try and let me know what you think, I’ve been pretty amazed at how much more mobility I can achieve in a short amount of time using this muscle energy technique, especially for those stubborn thoracic mobility limitations.

 

Thoracic Mobility Muscle Energy Technique

 

Learn How I Enhance Thoracic Mobility

If you want to learn more about how I enhance thoracic mobility, I have a presentation on Enhancing Thoracic Mobility.  I review some of the self mobility and manual therapy techniques I use to enhance thoracic mobility. This webinar will cover:

  • The importance of thoracic mobility
  • Manual therapy techniques to improve thoracic mobility
  • My favorite self mobility drills to improve thoracic mobility on your own
  • Correct exercises to enhance movement after gaining thoracic mobility
  • How to put it all together to maximize outcomes

To access this presentation:

 

The Use of Non Motorized Treadmills to Facilitate Gait and The Posterior Chain

We’ve recently started playing more with non motorized treadmills at Champion and have been very happy with the results.

Non motorized treadmills have gained popularity in the fitness realm as alternatives to self-powered conditioning machines like bikes and rowers. The Assault Air bikes and Concept 2 rowers have long been popular for their ability to produce amazing workouts.

I am a big fan of conditioning machines that increase their intensity based on the amount of effort exerted. Essentially, the harder you go, the harder they push back!

These have done wonders for high intensity interval training and sprint conditioning work.

Woodway has recently developed the Woodway Curve self-powered manual treadmill. Past non motorized treadmills seemed really cheap to me, but Woodway, who makes some of the best treadmills, has really made an exceptional machine with the Curve. I started using them for sprint work with the Red Sox, but have recently been using it more and more with my rehabilitation clients at Champion.

Because it is nonmotorized, your posterior chain is nicely engaged while walking and running on the Curve. A simple period of ambulation on the Curve does a great job engaging the hamstrings and glutes. I’ve been using these in everyone with diagnoses like patellofemoral pain, low back pain, and even postoperative. We start with a slow walk and slowly build up the speed and eventually get to running.

In the video below I explain more. I’m a big fan of nonmotorized treadmills to facilitate a proper gait form and engage the posterior chain.


Do Tight Hip Flexors Correlate to Glute Weakness?

Lower crossed syndrome, as originally described by Vladimir Janda several decades ago, is commonly sited to describe the muscle imbalances observed with anterior pelvic tilt posture.

Janda Assessment and Treatment of Muscle ImbalanceJanda described lower crossed syndrome to explain how certain muscle groups in the lumbopelvic area get tight, while the antagonists get weak or inhibited.  Or, as Phil Page describes in his book overviewing the Janda Approach, “Weakness from from muscle imbalances results from reciprocal inhibition of the tight antagonist.”  Assessment and Treatment of Muscle Imbalances: The Janda Approach is an excellent book that I recommend if you’re new to the concepts.

When you look at a drawing of this concept, you can see how it starts to make sense.  Tightness in the hip flexors and low back are associated with weakness of abdominals and glutes.

Lower Cross Syndrome

 

I realize this is a very two dimensional approach and probably not completely accurate in it’s presentation, however it not only seems to make biomechanical sense, it also correlates to what I see at Champion nearly daily.

Yet despite the common acceptance of these imbalance patterns, there really isn’t much research out there looking at these correlations.

 

Do Tight Hip Flexors Correlate to Glute Weakness?

Do Tight Hip Flexors Correlate to Glute WeaknessA recent study was publish in the International Journal of Sports Physical Therapy looking at the EMG activity between the two-hand and one-hand kettlebell swing.  While I enjoyed the article and comparision of the two KB swing variations, the authors had one other finding that peaked my interest even more.  And if you just read the title of the paper, you would have never seen it!

In the paper, the authors not only measured glute EMG activity during the kettlebell swing, but they also measure hip flexor mobility using a modified Thomas Test.  The authors found moderate correlations between hip flexor tightness and glute EMG activity.

The tighter your hip flexors, the less EMG was observed in the glutes during the kettlebell swing. [Click to Tweet]

While this has been theorized since Janda first described in the 1980’s, to my knowledge this is the first study that has shown this correlation during an exercise.

 

Implications

It’s often the little findings of study that help add to our body of knowledge.  This simple study showed us that there does appear to be a correlated between your hip flexor mobility and EMG activity of the glutes.  There are a few implications that you can take from this study:

  • Both two-hand and one-hand kettlebell swings are great exercises to strengthen the glutes
  • However, perhaps we need to assure people have adequate hip flexor mobility prior to starting.  I know at Champion we feel this way and spend time assuring people have the right mobility and ability to hip hinge before starting to train the kettlebell swing
  • If trying to strengthen the glutes, it appears that you may also want focus on hip flexor mobility, as is often recommended.  While a common recommendation, I bet many people skip this step.
  • This all makes your strategy to work with people with anterior pelvic tilt even more important.  Here is how I work with anterior pelvic tilt.

So yes, it does appear that hip flexor mobility correlates to glute activity and should be considering when designing programs.

 

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.

 

 

A Better Way to Perform Shoulder Exercises?

It’s pretty obvious that the shoulder is linked to the scapula, which is linked to the trunk.  So why do we so often perform isolated arm movement exercises without incorporating the trunk?  It’s a good question.  The body works as a kinetic chain that requires a precise interaction of joints and muscles throughout the body.

 

The Effect of Trunk Rotation During Shoulder Exercises

A recent study was published in the Journal of Shoulder and Elbow Surgery that examined the impact of adding trunk rotational movements to common shoulder exercises.

The authors chose overhead elevation, external rotation by the side, external rotation in the 90/90 position similar to throwing, and 3 positions of scapular retraction while lying prone (45 degrees, 90 degrees, and 145 degrees) that were similar to prone T’s and Y’s.  The essentially had subjects perform the exercise with and without rotating their trunk towards the moving arm.

A Better Way to Perform Shoulder Exercises?

EMG of the the upper trapezius, middle trapezius, lower trapezius, and serratus anterior were recorded, as well as 3D scapular biomechanics.

There were a few really interesting results.

  • Adding trunk rotation to arm elevation, external rotation at 0 degrees, and external rotation at 90 degrees significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation
  • During overhead elevation, posterior tilt was 23% increased and lower trap EMG improve 67%, which in turn reduced the upper trap/lower trap ratio.
  • Adding rotation to the prone exercises reduced upper trapezius activity, and therefore enhanced the upper trap/lower trap ratio as well.

 

What Does This All Mean?

I would say these results are interesting.  While the EMG activity was fairly low throughout the study, the biggest implication is that involving the trunk during arm movements does have a significant impact on both muscle activity and scapular mechanics.  Past studies have shown that including hip movement with shoulder exercises also change muscle activity.

This makes sense.  If you think about it, traditional exercises like elevation and external rotation involve moving the shoulder on the trunk.  By adding trunk movement during the exercises you are also involving moving the trunk on the shoulder.

This is how the body works, anyway.  Most people don’t robotically just move their arm during activities, the move their entire body to position the arm in space to accomplish their goal.

It’s also been long speculated that injuries during sports like throwing and baseball pitching may be at least partially responsible for not positioning or stabilizing the scapula optimally.  I think this study supports this theory, showing that trunk movement alters shoulder function.

Isolated exercises like elevation and external rotation are always going to be important, especially when trying to enhance the strength of a weak or injured muscle.  However, adding tweaks like trunk rotation to these exercises as people advance may be advantageous when trying to work on using the body with specific scapular positions or ratio of trapezius muscle activity.

 

5 Tweaks to Make Shoulder Exercises Even More Effective

I’m a big fan of understanding how little tweaks can make a big difference on your exercise selection.  If you are interested in learning more, this month’s Inner Circle webinar will discuss 5 Tweaks to Make Shoulder Exercises Even More Effective.  The webinar will be Tuesday August 25th at 8:00 PM EST, but a recording will be up soon after.

 

 

 

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