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.

 

 

 

Learn the Champion Performance Therapy and Training System! [Save 20%]

champion pt and performance educationI am super excited to announce that we have just released an online version of our Champion Performance Therapy and Training Seminar that we filmed earlier this summer!

The seminar was AWESOME, with a great turnout of people from all around the country coming to Boston to learn how we integrate performance training and therapy at Champion.  But, we know that there were 100’s of people that wanted to attend that couldn’t make it that weekend, so we wanted to provide an online version of the program!

 

Champion Performance Therapy and Training Program

Champion Performance Therapy and Training SeminarThe Champion Performance Therapy and Training Seminar is an online educational product designed to overview the Champion system of integrated rehabilitation, fitness, and sports performance training for physical therapists, personal trainers, strength coaches and other rehabilitation and fitness specialists.  The program includes 9 modules and over 6 hours of live lectures and hands-on sessions from the entire team at Champion:

  • Introduction to the Champion System of Integrated Rehab and Performance – Mike Reinold
  • Optimizing Movement – Mike Reinold
  • Developing Strength and Power – Rob Sutton
  • Enhancing Speed and Agility – Malcolm Goodridge
  • Performance Therapy: Movement-Based Functional Rehabilitation – Lenny Macrina
  • Assessing and Optimizing Movement (Hands-On Session) – Mike Reinold and Lenny Macrina
  • Progressing and Regressing Movement-Based Strength Exercises (Hands-On Session) – Rob Sutton
  • Speed and Agility Drills (Hand-On Session) – Malcolm Goodridge
  • Plus tons of demonstrations and live Q&A Sessions

This is a HUGE resource for physical therapists, personal trainers, and strength coaches looking to enhance their skills and develop a well rounded program of performance therapy and training.

Personal trainers, strength coaches, and other fitness specialists will learn the concepts behind the Champion program design system, including how we select, regress, progress, and periodize exercises based on movement patterns to enhance performance.  You’ll learn how we emphasize developing complete athleticism by enhancing mobility, strength, power, speed, and agility.

Physical therapists and rehabilitation specialists will learn our concepts of movement-based rehabilitation, included strategies to assess movement dysfunctions and prescribe appropriate manual therapy and corrective exercises.  We emphasize a hands-on approach that includes a thorough biomechanical assessment of how the body moves and functions to determine what specific muscle imbalances and movement impairments may be leading to dysfunction or limiting performance.  We then offer an individualized approach that produces amazing results.

But what I like most about our model at Champion is that we integrate our rehab and fitness systems.

Fitness specialists will benefit from learning how we integrate rehabilitation concepts into our programs to develop appropriate self-myofascial release, mobility, and corrective exercise programs.  Likewise, rehabilitation specialists will benefit from learning how we integrate performance training concepts to understand how to integrate appropriate strength and conditioning concepts into advanced rehabilitation programs.

 

Save 20% This Week Only

The program is normally $99.99 but is on sale for 20% off this week only, starting today and going until Sunday 8/23/15 at midnight EST.  Get 9 modules and over 6 hours of content for only $79.99 this week.

Click below to learn more about the program and save 20%:

Order Champion Seminar

 

 

 

Do We Really Need Corrective Exercises?

This past weekend, I was speaking at the Elite Training Workshop that we hosted at Champion PT and Performance in Boston on the topic of Integrating Corrective Exercises with Performance Enhancement.  As I was going through my slides, I actually tweaked it a bit and added one new slide with a simple statement:

 

Stop Trying to Correct and Start Trying to Enhance

Do We Really Need Corrective ExercisesAt the beginning of the talk, I discussed what some people would use to define the term “corrective exercise.”  I even asked around the room.  In general most people refer to corrective exercises as an exercise designed to improve poor mobility, strength imbalances, and altered motor control.

But there are some people that still refer to corrective exercises as exercises designto “fix” someone or “reduce pain.”  I would argue, this is not what corrective exercises are supposed to be utilized for within a training program.  Fixing injuries uses rehabilitation exercises, not corrective exercises.  They are different.

This may be why you see people doing a squat on an unstable surface and calling it a “corrective exercise.”  What are you trying to correct with that exercise?

One of the major components of using corrective exercises is a thorough assessment.  Without an assessment you are just taking a stab at something.  Without a through assessment, you are looking at an incomplete picture.  This may be OK to try on some people, but will be ineffective with many people, and could actually be detrimental with people in pain.  I’ve talked about this before in what I call The Corrective Exercise Bell Curve.

corrective exercise bell curve

I would define corrective exercises more like this:

Corrective exercises are designed to enhance how well you move and perform.  [Click Here to Tweet This]

 

So Do We Really Need to Use Corrective Exercises in the Fitness and Performance World?

I still think we do, but perhaps we should really change our focus.  Corrective exercises shouldn’t be used to “fix” people.  That implies there is a problem.  Don’t think of it as taking someone that is below their baseline capacity and getting them back to baseline, think of it as enhancing someone’s baseline and raising their capacity.

“Corrective exercise” is probably not the best terminology, perhaps that is part of the problem.  Incorporate corrective exercises to help enhance people.   Again, I’ll go back to that original phrase from my new slide:

Stop trying to correct and start trying to enhance.  [Click Here to Tweet This]

Use corrective exercises to enhance someone’s mobility, or improve someone’s movement pattern, or to add a strength emphasis to an area that is weak.  In this last example, if someone is quad dominant, has poor glute strength, and overuses their low back instead of their hips to hips, a “corrective exercise” may be a deadlift variation!  That doesn’t seem like rehab to me, that seems like performance enhancement, doesn’t it?

 

Learn How I Integrate Corrective Exercises with Performance Enhancement

 

If you are interested in learning how I integrate corrective exercises into our performance enhancement programs at Champion, I have an Inner Circle webinar on the topic.  In the presentation, I discuss:

  • What corrective exercises really focus on
  • How to  classify corrective exercises into specific components
  • My system for determining which corrective exercises to perform
  • What you can do to maximize the effectiveness of your corrective exercises
  • How and when to integrate corrective exercises into your rehabilitation, fitness, or performance enhancement program

To access the presentation:

 

 

How to Assess Shoulder Capsular Mobility

The latest Inner Circle webinar recording on Assessing Shoulder Capsular Mobility is now available.

 

Assessing Shoulder Capsular Mobility

Assessing Shoulder Capsular Mobility - Social MediaThis month’s Inner Circle webinar is on Assessing Shoulder Capsular Mobility.  This is a recording of an actual inservice we performed with the students and interns at Champion this week.  I’m super excited to be able to record and share things like this with my Inner Circle.  It’s like having a front row seat at our inservices!  I think this offers many benefits over the traditional webinar/lecture format, as you can watch the interaction and also see some of the clinical techniques better.

In this webinar, we discuss:

  • The anatomy of the shoulder capsule and glenohumeral ligaments
  • How different arm positions stress different aspects of the capsule
  • How to determine which ligament and aspect of the capsule is tight
  • How to assess range of motion at different positions to assess different portions of the capsule
  • How to perform range of motion and capsular mobility assessment of the shoulder
  • Clinical tips on the assessment technique

To access this webinar:

 

 

Periodization for Strength Training and Rehabilitation

The latest Inner Circle webinar recording on my Periodization for Strength Training and Rehabilitation is now available.

 

Periodization for Strength Training and Rehabilitation

Periodization for Strength Training and RehabilitationThis month’s Inner Circle webinar is on periodization for strength training and rehabilitation.  In this webinar I’ll discuss:

  • Why you need to understand periodization concepts to maximize strength
  • How to enhance strength by strategically changing aspects of your program to stimulate adaptations
  • The many different kinds of periodization and what really works
  • How I use linear, non-linear, and undulating periodization concepts
  • How to chose your periodization strategy based on the experience of the person
  • How to apply periodization concepts to rehabilitation

To access this webinar:

 

 

 

 

Does Periodization of a Program Help Improve Strength?

When designing programs to enhance strength, there are many variables that you can (and should) manipulate to facilitate improvement.  These can obviously include the sets and reps (volume), loads (intensity), frequency, and rest time (density).  However, how we periodize these variables is also very important.  Periodization is the systematic structuring of how you plan on manipulating these variables over time.

You probably know me well enough by now to know that I value systems and planning.  One of our fundamental principles in program design at Champion is to “begin with the end in mind.”  It drives me crazy to see programs written month-to-month without a goal in mind.

So it makes sense to develop a system of how you plan on periodizing your strength training, wether in the personal training, sports performance, or even rehabilitation setting.

While the strength and conditioning world has really embraced the concept of periodization, physical therapists are notorious for a complete lack of periodization.  It’s not uncommon to perform “3 sets of 10” in the rehabilitation setting forever.

Perform a Google search for strength training periodization and you’ll find a sea of conflicting terminology that is likely to make you dizzy.  Linear periodization, reverse linear periodization, non-linear periodization, undulated periodization, conjugated periodization, concurrent periodization, and block periodization are some of the many types of periodization programs that you can find.

Unfortunately there is little consensus on terminology or definition, feeding the confusion for people looking to learn about periodization even more.  Add to that the ability to essentially say anything you want on the internet without needing any scientific validity and you’ll find a dozen different “best” ways to get strong.

But the real question still remains – does strength training periodization even matter?  And if so, what type of periodization is best?

 

Effect of Periodized Versus Non-periodized Programs on Strength

Since the rehabilitation setting does such as poor job at implementing periodization into programs when returning from injury, we should start by establishing the need for periodization.

Anytime I have a research question in regard to Strength and Conditioning, I head over to Chris Beardsley and Bret Contreras’ website Strength and Conditioning Research.  Chris has an excellent article on our current scientific understanding on strength training.

The article reviewed 7 studies comparing periodized and non-periodized programs on strength in untrained individuals.  Of these studies, 4 reported significant benefits of periodization over no periodization.

Similarly, there were 7 studies comparing periodized and non-periodized program on strength in trained individuals.  Of these 7 studies, 4 reported significant benefits of periodization and the remainder reported no differences. Using periodization may therefore have a beneficial effect on strength gains in both the trained and untrained population.

I wouldn’t say the research is overwhelming, but leans towards at least some form of periodization being more effective than using no periodization at all.  I think we would all anecdotally agree with this as well.

 

Effect of Linear Versus Non-Linear Periodization

Now that we have established we should use some form of periodization, the focus now shifts on determining what the best form of periodization may be to improve strength.

Lets simplify, and perhaps oversimplify, the forms of periodization for this conversation as either linear periodization or non-linear periodization.

Linear periodization refers to the slow decrease in reps and increase in load.  For example a 4-phase program may look like this:

  • Program 1 – 3 x 12 with a light load
  • Program 2 – 3 x 8 with a moderate load
  • Program 3 – 4 x 5 with a moderate to heavy load
  • Program 4 – 5 x 3 with a heavy load

Linear Periodization

As the reps go down, the weight goes up.  This has been the most classic form of periodization used for the last several decades.

Antagonists to the linear periodization model often point out that the benefits seen early in the program in regard to strength and hypertrophy are not maintained throughout the program as the focus continuously shifts from program to program.

This has lead to several variations of non-linear periodization, including one of the most common, undulated periodization.  Undulated periodization involves continuously shift the focus of the program on either a daily or weekly cycle.

A weekly undulated periodization program may look like this:

  • Week 1 – 2×15
  • Week 2 – 3×8
  • Week 3 – 5×5

While a daily undulated periodization program may look like this:

  • Monday – 2×15
  • Wednesday 3×8
  • Friday 5×5

Undulated Periodization

While many have stated that undulated periodization is more beneficial at eliciting strength gains, does the research agree?

A recent meta-analysis was publish in the Journal of Strength and Conditioning Research.  They reviewed hundreds of articles and ultimately select 17 that met all their strict criteria for analysis.

Of these 17 articles, here are a few bits of information:

  • 12 compared linear periodization to daily undulating periodization.  3 compared linear to weekly undulating.  1 study compared all 3.
  • 7 studies were on untrained people (<1 year experience), 10 on trained (> 1 year), and no studies included advanced trainees (>5 years).
  • 16 out of 17 studies reported significant increase in strength in both linear and undulated periodization.  12 studies found no difference between the two periodization models.  3 found undulating better than linear and 2 found the opposite.

The overall meta-analysis also agree and the article concluded that there is no difference in strength gains between linear and undulated periodization.

However, when analyzing trained individuals, people that had previous experience with linear periodization had an improvement in strength when switching to undulated periodization.  There was no difference between the linear or undulated periodization in untrained individuals.

Based on this it appears that as your training age increases, you may need to change your training stimulus to maximize your gains.  However, linear periodization will work fine in new trainees.

Realize that the majority of articles you read on the internet are geared towards the very small percentage of people that fit into the advanced trainee grouping, when in reality, this is not what 95% of us see on a regular basis, especially in the rehabilitation and general population personal training worlds.  Sure, advanced periodization programs are needed to get from 500 lbs to 600 lbs on a lift, but probably not as much from getting from 100 lbs to 200 lbs.

Linear periodization offers a great way to introduce and teach movement patterns with a lower load and higher rep scheme, then as the movement skill is perfected, the load can safely increase.

 

Periodization for Strength Training and Rehabilitation

Because the topic of periodization is so large, important, and so often neglected in the rehab and personal training setting, this month’s Inner Circle Webinar is going to be on Periodization for Strength Training and Rehabilitation.  In this webinar, I am going to discuss the above concepts in much more detail and show you how we periodize some of our programs for healthy people and those coming back from injury in the physical therapy setting.

The webinar is Monday May 18th at 8:00 PM EST and will be recorded for Inner Circle members.

 

 

 

 

How to Improve Overhead Shoulder Mobility

The latest Inner Circle webinar recording on my How to Improve Overhead Shoulder Mobility is now available.

 

How to Improve Overhead Shoulder Mobility

Improving Overhead Shoulder MobilityThis month’s Inner Circle webinar is on how to improve overhead shoulder mobility.  In this webinar I’ll discuss:

  • We we are losing overhead shoulder mobility
  • Why it matters
  • The 4 main reasons why we lose overhead mobility
  • How the body compensates when we lose overhead mobility
  • How to assess for a loss of overhead shoulder mobility
  • What you MUST stop doing immediately with people that have lost overhead mobility – you are making them worse!
  • Corrective exercises to enhance overhead position
  • Manual therapy techniques to improve mobility

 

To access this webinar:

4 Ways to Improve Overhead Shoulder Mobility

4 Ways to Improve Overhead Shoulder MobilityOne of the most common areas we attempt to improve in clients at Champion PT and Performance is overhead shoulder mobility.  If you really think about it, we don’t need full overhead shoulder mobility much during our daily lives.  So our bodies adapt and this seems to be an movement that is lost in many people over time if not nourished.

I’m often amazed at how many people have a significant loss of overhead mobility and really had no idea!

That’s not really the issue.  The problem occurs when we start to use overhead mobility again, especially when doing it during our workouts and training.  Exercises like a press, thruster, snatch, overhead squat, kipping pull up, toes to bar, handstand push up, wall ball, and many more all use the shoulder at end range of movement.  But here are the real issues:

  • Add using the shoulder to max end range of overhead mobility and we can run into trouble
  • Add loading during a resisted exercise and we can run into trouble
  • Add repetitions of this at end range and we can run into trouble
  • Add speed (and thus force) to the exercise and we can run into trouble

 

4 Ways to Improve Overhead Shoulder Mobility

In this video I explain the 4 most common reasons why you lose overhead shoulder mobility and can work on to improve this movement:

  1. The shoulder
  2. The scapula
  3. The thoracic spine
  4. The lumbopelvic area

The first three are commonly address, but not so for the lumbopelvic area, which is often neglected.  I’m going to expand on this even more in this month’s Inner Circle webinar.  More info is below the video:

 

Improving Overhead Shoulder Mobility

This month’s Inner Circle webinar is going to expand on this topic and discuss how and why you want to improve overhead shoulder mobility.  In this webinar I’ll discuss the importance of overhead mobility, how to assess the 4 most common causes of loss of mobility we discussed above, what corrective exercises to perform, and tips for manual therapy.  The live webinar will be on Monday April 20th at 8:00 PM EST, however will be recorded for those that can not attend live.