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.




Are Pre-Workout Supplements Good for You? Taking a Look Behind the Smoke Screen

Today’s guest post comes from Champion PT and Performance Strength Coach Rob Sutton (@rjsutton16).  Rob discusses the health concerns of many pre-workout supplements, and for good reason!  Rob shares a very personal experience of how he really hurt his own health from this class of supplements.  Great info for everyone.  I know I’m sticking to by cup of black coffee as my “pre-workout” supplement!


Are Pre-Workout Supplements Good for You?  Taking a Look Behind the Smoke Screen

When it comes to making gains in the gym, whether that be weight loss or muscle gain, many people often turn to supplements to help them reach their goals. A high number of gym goers use pre -orkout supplements to enhance their training experience in hopes of getting a better training session. This “pre-workout” class of supplements are promoted to give you more energy and stamina to get through a tough workout.

While there is most certainly a time and place for the right dietary supplements, I have a problem with the majority of these pre-workout supplements, which essentially are stimulants.


The Problem with the Supplement Industry

The supplement industry is a juggernaut. According to Forbes, what’s known as the Vitamins, Minerals, and Supplements group, reported nutritional supplements alone produced about $32 billion in revenue in 2012. By the year 2021, nutritional supplements plan to double in revenue to about $60 billion. Gone are the times where it was only meatheads looking to have muscles popping out of their eyelids, buying supplements. The general public and athletes everywhere are now using supplements to aid in their diet and increase performance.

My problem with the supplement industry is the misleading, sneaky, and deceptiveness that is present.

Companies use big words and outrageous claims to market their product to consumers. “Explosive Energy”, “Super Crazy Pumps”, “Increase Strength 317%”, “Growth Hormone Matrix”. All include buzzwords to help aid in claims and gimmicks that the companies want you to believe. And every company claims to provide the highest workout energy on the market. All use colorful labels and big fonts to blind your senses.

Have you ever read through the directions for pre workout supplements? Here some examples from popular pre-workout supplements:

  • “Warning: Use only in accordance with directions for use and warnings.”
  • “DO NOT exceed recommended dosage due to the extremely potent nature of ingredients contained in….”
  • “Assess your tolerance”.

What are we putting into our bodies? There are more warning labels on these than there are on heavy duty cleaning products.


How Pre-Workout Supplements Hurt My Health

Now, I was young once and fell into these traps before like so many others. Although, that has come with a price.

About 7 years ago I began experiencing an abnormal feeling in my chest. It was quite obviously in my heart. It felt as if my heart was skipping a beat. It was happening fairly often and I would notice it mostly at rest. I admit it was something I had ignored for many years. As it began to get worse, it was time to seek out medical advice. Long story short, I was diagnosed in 2012 with (Pre-Mature ventricular contractions, PVC’s). Through several holter monitors and experiments with supplements I was taking, I only remained using whey protein. After cutting out pre workout supplements, my PVC’s were diminished by 97.7%! It was determined the PVC’s were caused by a supplement I had been taking in years past. All bought through local nutrition stores.

There is 1 ingredient in particular that may have caused the heart arrhythmia that I continue to feel every single day. It’s called 1, 3 dimethylamylamine, or DMAA for short.


History of 1, 3 Dimethylamylamine (DMAA)

DimethylamylamineA brief history on DMAA, it was created in 1948 to be used as a nasal decongestant. It had a trademarked named called Forthane. The way the drug worked was via vasoconstriction. The blood vessels in the nose would constrict blood flow, leading to less mucus discharge. This is how many popular over the counter nasal decongestant meds work today but with the absence of DMAA.

Forthane was pulled from shelves in the early 80’s due to dramatic side effects including headaches, tremors, and high blood pressure. DMAA is what’s called a sympathomimetic drug. Which means its mimics the actions of the sympathetic nervous system. On an hourly basis at Champion, we are performing drills and exercises to relax the sympathetic nervous system not stimulate it. We are already stimulated enough!

Supplement companies use this drug because of its high stimulant properties. If DMAA was known to cause ill side effects 30 years ago, how is it still out there for the public to buy? It is in fact banned by the World Doping Agency and reads false positives for amphetamines on urine tests. There is a plethora of scientific journals and facts regarding this subject as well. But what I have learned from a very reputable Physical Therapist and Strength Coach Jeff Cavaliere in March 2011, is that through what we could call a loophole in the “system”, companies can include this ingredient by stating the source of the molecule. The source in this case is geranium oil. Which is an FDA approved food product. DMAA can be extracted from the geranium plant. Some research suggests that extremely small amounts are found in the plant itself. DMAA can also be seen on supplement labels under a giant list of other names including geranium extract, geranium oil extract, and methylhexaneamine, to name a few.

A list of all names and products known to contain the drug can be found here:


DMAACavaliere was ahead of the curve when he presented the problem with this drug in 2011 and the potential health problems related with a drug that causes the blood vessels to constrict. Constricting blood vessels and arteries, leading to high blood pressure, combined with exercise can be a harmful mix. Lets mix in a high amount of caffeine and even more ingredients with stimulant properties as well. This is when this subject was put on my radar and I began to research possible supplements that contained DMAA. And indeed I found some, and some I had taken in the past. The ingredient pictures shown are from 2 pre-workout supplement labels that I had used about 8 to 10 years ago. They have since been changed…. but why?

After Jeff Cavaliere turned me onto this issue, I discarded the supplements I had…sorry my heart just skipped a beat…. that included this potentially harmful chemical. And I then kept my eye on this topic in the future.

In 2012/2013 the FDA put its foot down on supplement companies, ordering them to pull this already illegal drug. As of April 11, 2013, the FDA received 86 reports of illnesses and deaths associated with supplements containing DMAA. These are just a few case reports associated with deaths and severe health problems linked to DMAA.

Hold on it gets better…

Companies began to comply with the FDA’s orders. One popular supplement company, also in April 2013 sent out an email to subscribers about a new formula for their pre workout supplement. Here’s what it stated:

“______has been our #1 selling pre-workout supplement for years and now it is no longer being produced. We are down to two flavors, ______and_______, and what we have in stock is it!! If you want to get your hands on some of the last remaining bottles, you should act fast…quantities on these are extremely limited and quickly selling off. Get it before this original formula is gone forever! Only $21.95!!”

This is complete BS!

Why are they creating a new formula? Because the old one is killing people!! So lets start giving this poison to as many people as we can for a discounted price. Like I said, misleading, sneaky, and deceptive.

The Center for Disease Control (CDC) had identified another product by the same company with DMAA in it. They identified 100 people who developed hepatitis from using this product. 47 of those needed hospitalization, 3 needed liver transplants, and 1 died.


What’s the Next Pre-Workout Ingredient to be Banned?

What will be the next ingredient that is in current supplements, to cause as big an uproar as 1, 3 dimeth? I bet you it’s out there.

Here are an unfortunate two possibilities. Beta-methylphenylethylamine (BMPEA) and Synephrine. Both have already had bad press and have been linked to health issues. An article published on WebMD talks about how in April of 2015, the FDA sent warning letters to five supplement companies whose products contain BMPEA, asking them to stop distributing products containing the drug.

This sounds strikingly similar to the beginning of the end of DMAA back in 2012.

In 2012, my cardiologist made me aware of the drug Synephrine. Synephrine, like BMPEA, and DMAA is a powerful stimulant. This was in one of, if not multiple pre workout supplements that I had taken in the past. (Refer back to photos). Synephrine is also disguised in many supplements just as DMAA was. It may also be labeled as Bitter Orange or Citrus Aurantium. Just as DMAA, the source of the drug is being labeled, which helps in the legality. Synephrine is not currently a banned substance.


Is it Worth the Risk?

Think about it, do we really need an exotic plant extract from China to help us lift more weight? Do we need to search for an ingredient buried at opposite ends of the earth to lose 10 pounds?


Work hard for your goals and they will come. What happened to eating properly, getting enough sleep, and staying properly hydrated. That is my pre workout.




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:



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