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Sorry, Sitting Isn’t Really Bad for You

Over the last several years, the health concerns surrounding sitting have really been highlighted by the health and fitness crowds, as well as the mainstream media.  In fact, there have been entire books published on this topic.  I’ve seen articles with titles such as “Sitting is Evil,” “Sitting is the New Smoking,” and even “Sitting will kill you.”

Wow, those seem pretty aggressive.  We’ve been sitting since the beginning of time!  I’m going to really shock the world with this comment…

Sorry, sitting isn’t really bad for you.

Yup.  There is nothing wrong with sitting.  I’m actually doing it right now as I write this article.  You probably are too.  Don’t get me wrong, sedentary lifestyles are not healthy, but let’s get one thing straight:

It’s not sitting that is evil, it’s NEVER moving that is evil. [Click to Tweet]

By putting all the blame on sitting, we lose focus on the real issue, which is lack of exercise.  So we see a shift in people switching to standing desks at work, still not exercising, but thinking that they are now making healthy choices.  

This is so backwards it boggles my mind.

The body adapts amazingly well to the forces and stress that we apply to it throughout the day.  If you sit all day, your body will adapt.  Your body will lose mobility to areas like your hips, hamstrings, and thoracic spine.  Your core is essentially not needed while sitting so thinks it’s not needed anymore during other activities.  And several muscles groups get used less frequently while sitting and weaken over time, like your glutes, scapular retractors, and posterior rotator cuff.

Unfortunately, when all you do is sit all day, and you never reverse this posture or exercise, your body adapts to this stress to make you the most efficient sitter.  That’s right, you get really good at sitting.

For example, think about what happens to the core when you sit all day.  One of the functions of your core is to maintain good posture and essentially to keep the bones of your skeleton from crashing to the floor.  The core is engaged at a low level of EMG activity throughout the day for postural needs.  

The problem with sitting is that the chair also serves this function, so your core isn’t needed to keep you upright, the chair serves this function. If sitting is all you do, then when you stand up, your core essentially isn’t used to providing this postural support so you rock back onto your static stabilizers by doing things like standing with a large anterior pelvic tilt and lumbar extension.  

sitting isnt bad for you

Unfortunately, this becomes the path of least resistance, and most energy efficient, for your body.  Your core gets used to relying on the chair to function, then when you need it, gets lazy.

It’s OK to sit all day, as long as you are reversing this posture at some point.  This can be as specific as exercises designed to combat sitting and as general as simply taking a walk in the evening.

 

3 Strategies to Combat Sitting All Day

I want to share the 3 things that I often discuss with my patients and clients.  You can apply these yourself or use them to discuss with your clients as well.  But if you sit all day, you really should:

  1. Move, Often
  2. Reverse your posture
  3. Exercise

But the real first step is to stop blaming sitting and calling a spade a spade.  It’s lack of movement and exercise that is the real concern, not sitting.

 

Move, Often

The first step to combatting sitting all day is to move around often.  The body needs movement variability or it will simply adapt to what it does all day.  

I get it, we all work long days, and sitting is often required in many of our jobs.  But the easiest way to minimize the effects of sitting all day is to figure out ways to get up and move throughout the day.

This doesn’t need to be 10 minutes of exercise, it could simply be things like getting up to fill up a water bottle or taking quick 2 minute walk around the office.  When I am not in the clinic or gym, I personally tend to work in hour long chunks, so I will get up and walk around in between chunks to get a glass of water, snack, or use the bathroom.  

This works well for me, but you need to find what works for you.  I know of others that use things like Pomodoro timers, or even some of the fitness tracking devices, which can remind you to stand up and move around at set times.

 

Reverse Your Posture

I’ve been talking about the concept of Reverse Posturing for years.  The concept is essentially that we need to reverse the posture that we do the most throughout the day to keep our body balanced and prevent overuse.

Sitting involves a predominantly flexed posture, so doing exercises that promote the posterior chain would be helpful.  These will depend on each person but a basic set of exercises may look like:

Chin Tucks

Shoulder W’s

Thoracic Extension Exercises

View one of my past articles for several more great thoracic mobility drills.

Bridging Exercises

True Hip Flexor Stretch

Perform each of these for 10 reps.  These should take 5 minutes to perform and will make a big impact on how you feel throughout the day.  

I also often tell people to perform the prone press up exercise, cobra yoga poses, or to simply lay on their stomach in the evening while reading or watching TV.  

fig 1 - sitting isnt bad for you

 

Exercise

Remember going back to some of the past concepts above, the body adapts to the stress applied.  To combat this perfectly, a detailed exercise program that is designed specifically for you and comprehensively includes a focus on total body and core control is ideal.  

This will assure that the muscle groups that are not being used while sitting all day get the strength and mobility they need, while the core gets trained to stabilize the trunk during functional movements.

If you want to get the most out of your body and stay optimized, you need to do things like work on your hip and thoracic spine mobility, strengthen your rotator cuff, groove your hinge pattern, and learn how to deadlift and work your glutes.

 

Sitting Isn’t Bad For You, Not Moving Is

As a profession, we need to get away from blaming sitting as the enemy and labeling it evil.  Our society is sitting more and more each generation.  We need to be honest with ourselves and realize that sitting isn’t the problem, it’s not moving enough that is the concern.  We need to stop pointing fingers and get to the root of the problem.  

Go ahead and sit, just move more often and use these 3 strategies to combat sitting all day.

 

 

 

How to Assess Thoracic Mobility

The latest Inner Circle webinar recording on How to Assess Thoracic Mobility is now available.

 

How to Assess Thoracic Mobility

how to assess thoracic mobilityThis month’s Inner Circle webinar is on How to Assess Thoracic Mobility.  In this presentation, I’m going to show you how I assess thoracic mobility from multiple perspectives.  Many people have thoracic mobility restrictions and just blindly throwing thoracic mobility drills at them is going to be suboptimal without an accurate assessment.  Some need to focus on extension, some rotation, and others can move well, they just don’t!

This webinar will cover:

  • The key things I look at to assess thoracic mobility
  • How to integrate posture, thoracic movements, and functional movements
  • How to assess for compensation elsewhere when the thoracic spine is limited

 

To access this webinar:

 

Shoulder Impingement – 3 Keys to Assessment and Treatment

Shoulder impingement really is a pretty broad term that most of us likely take for granted.  It has become such a junk term, such as “patellofemoral pain,” especially with physicians.  It seems as if any pain originated from around the shoulder could be labeled as “shoulder impingement” for some reason, as if that diagnosis is helpful to determine the treatment process.

Unfortunately, There is no magical “shoulder impingement protocol” that you can pull out of your notebook and apply to a specific person. [Click to Tweet]

I wish it were the simple.

A thorough examination is still needed.  Each person will likely present differently, which will require a variations on how you approach their rehabilitation.

But the real challenge when working with someone with shoulder impingement isn’t figuring out they have shoulder pain, that’s fairly obviously.  It’s figuring out why they have shoulder pain.

 

 

Shoulder Impingement: 3 Keys to Assessment and Treatment

To make the treatment process a little more simple, there are three things that I typically consider to classify and differentiate shoulder impingement.

  1. Location of impingement
  2. Structures involved
  3. Cause of impingement

Each of these can significantly vary the treatment approach and how successful you are helping each person.

 

Location of Impingement

The first thing to consider when evaluating someone with shoulder impingement is the location of impingement.  This is generally in reference to the side of the rotator cuff that the impingement is located, either the bursal side or articular side.

shoulder impingement assessment and treatment

See the photo of a shoulder MRI above.  The bursal side is the outside of the rotator cuff, shown with the red arrow.  This is probably your “standard” subacromial impingement that everyone refers to when simply stating “shoulder impingement.”  The green arrow shows the inside, or articular surface, of the rotator cuff.  Impingement on this side is termed “internal impingement.”

The two are different in terms of cause, evaluation, and treatment, so this first distinction is important.  More about these later when we get into the evaluation and treatment treatment.

 

Impinging Structures

To me, this is more for the bursal sided, or subacromial, impingement and refers to what structure the rotator cuff is impinging against.  As you can see in the pictures below (both side views), your subacromial space is pretty small without a lot if room for error.  In fact, there really isn’t a “space”, there are many structures running in this area including your rotator cuff and subacromial bursa.

Shoulder impingement

You actually “impinge” every time you move your arm.  Impingement itself is normal and happens in all of us, it is when it becomes excessive or abnormal that pathology occurs.

I try to differentiate between acromial and coracoacromial arch impingement, which can happen in combination or isolation.  There are fairly similar in regard to assessment and treatment, but I would make a couple of mild modifications for coracoacromial impingement, which we will discuss below.

 

Cause of Impingement

The next thing to look at is the actual reason why the person is experiencing shoulder impingement.  There are two main classifications of causes, that I refer to as “primary” or “secondary”shoulder  impingement.

Primary impingement means that the impingement is the main problem with the person.  A good example of this is someone that has impingement due to anatomical considerations, with a hooked tip of the acromion like this in the picture below.  Many acromions are flat or curved, but some have a hook or even a spur attached to the tip (drawn in red):

shoulder impingement

 

Secondary impingement means that something is causing impingement, perhaps their activities, posture, lack of dynamic stability, or muscle imbalances are causing the humeral head to shift in it’s center of rotation and cause impingement.  The most simply example of this is weakness of the rotator cuff.

The rotator cuff and larger muscle groups, like the deltoid, work together to move your arm in space.  The rotator cuff works to steer the ship by keeping the humeral head centered within the glenoid.  The deltoid and larger muscles power the ship and move the arm.

Both muscles groups need to work together.  If rotator cuff weakness is present, the cuff may lose it’s ability to keep the humeral head centered.  In this scenario, the deltoid will overpower the cuff and cause the humeral head to migrate superiorly, thus impinging the cuff between the humeral head and the acromion:

evaluation and treatment of shoulder impingement

 

Other common reasons for secondary impingement include mobility restrictions of the shoulder, scapula, and even thoracic spine.  We see this a lot at Champion.  In the person below, you can see that they do not have full overhead mobility, yet they are trying to overhead press and other activities in the gym, flaring up their shoulder.

shoulder impingement mobility

If all we did with this person was treat the location of the pain in his anterior shoulder, our success will be limited.  He’ll return to gym and start the process all over if we don’t restore this mobility restriction.

The funny thing about this is that people are almost never aware that they even have this limitation until you show them.

 

 

Differentiating Between the Types of Shoulder Impingement

In my online program on the Evidence Based Evaluation and Treatment of the Shoulder, I talk about different ways to assess shoulder impingement that may impact your rehab or training.  There are specific tests to assess each type of impingement we discussed above.

The two most popular tests for shoulder impingement are the Neer test and the Hawkins test.  In the Neer test (below left), the examiner stabilizes the scapula while passively elevating the shoulder, in effect jamming the humeral head into the acromion.  In the Hawkins test (below right) the examiner elevates the arm to 90 degrees of abduction and forces the shoulder into internal rotation, grinding the cuff under the subacromial arch.

Shoulder impingement tests

You can alter these tests slightly to see if they elicit different symptoms that would be more indicative to the coracoacromial arch type of subacromial impingement.  This would involve the cuff impingement more anteriorly so the tests below attempt to simulate this area of vulnerability.

The Hawkins test (below left) can be modified and performed in a more horizontally adducted position.  Another shoulder impingement test (below right) can be performed by asking the patient to grasp their opposite shoulder and to actively elevate the shoulder.

how to assess shoulder impingement

There is a good chance that many patients with subacromial impingement may be symptomatic with all of the above tests, but you may be able to detect the location of subacromial impingement (acromial versus coracoacromial arch) by watching for subtle changes in symptoms with the above four tests.

Internal impingement is a different beast.

This type of impingement, which is most commonly seen in overhead athletes, is typically the result of some hyperlaxity in the anterior direction.  As the athlete comes into full external rotation, such as the position of baseball pitch, tennis serve, etc., the humeral head slides anterior slightly causing the undersurface of the cuff to impingement on the inside against the posterior-superior glenoid rim and labrum.  This is what you hear of when baseball players have “partial thickness rotator cuff tears” the majority of time.

shoulder internal impingement

 

 

The test for this is simple and is exactly the same as an anterior apprehension test.  The examiner externally rotates the arm at 90 degrees abduction and watches for symptoms.  Unlike the shoulder instability patient, someone with internal impingement will not feel apprehension or anterior symptoms.  Rather, they will have a very specific point of tenderness in the posterosuperior aspect of the shoulder (below left).  Ween the examiner relocates the shoulder by giving a slight posterior glide of the humeral head, the posterosuperior pain diminishes (below right).

how to assess shoulder internal impingement

 

3 Keys to Treating Shoulder Impingement – How Does Treatment Vary?

There are three main keys from the above information that you can use to alter your treatment and training programs based on the type of impingement exhibited:

Subacromial Impingement Treatment

To properly treat, you should differentiate between acromial and coracoacromial impingement.  Treatment is essentially the same between these two types of subacromial impingement, however, with coracoacromial arch impingement, you need to be cautious with horizontal adduction movements and stretching.  This is unfortunate as the posterior soft tissue typically needs to be stretched in these patients, but you can not work through a pinch with impingement!

A “pinch” is impingement of an inflamed structure!

Also, I would avoid elevation in the sagittal plane or horizontal adduction exercises.

 

Primary Versus Secondary Shoulder Impingement

This is an important one and often a source of frustration in young clinicians.  If you are dealing with secondary impingement, you can treat the persons symptoms all you want, but they will come back if you do not address the route of the pathology!

I do treat their symptoms, that is why they have come to see me.  I want to reduce inflammation.  However, this should not be the primary focus if you want longer term success.

This is where a more global look at the patient, their posture, muscle imbalances, and movement dysfunction all come into play.  Break through and see patients in this light and you will see much better outcomes.

A good discussion of the activities that are causing their symptoms may also shed some light on why they are having shoulder pain.  Again, using the example above, if you don’t have full mobility and try to force the shoulder through this tightness you are going to likely cause some issues.  This is especially true if you add speed, loading, and repetition to elevation, such as during many exercises.

 

Internal Impingement

One thing to realize with internal impingement is that this is pretty much a secondary issue.  It is going to occur with any cuff weakness, fatigue, or loss of the ability to dynamically stabilize.   The athlete will show some hyperlaxity in this athletic “lay back” shoulder position.  Treat the cuff weakness and it’s ability to dynamically stabilize to relieve the impingement.  How to treat internal impingement is a huge topic that I cover in a webinar for my Inner Circle members.

 

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 at ShoulderSeminar.com!

The online program at takes you through an online 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:

  • shoulder seminarThe 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!

large-learn-more

 

Working Core Training in 360 Degrees

The notion of core training has been around for years and years.  As far back as I can remember, people have been doing crunches, sit-ups, weighted side bends, and more.  You could walk into any gym in the world and probably see someone doing some sort of “core” exercise.

core training sit ups

Photo credit

Even today, there are still people performing sit-ups or some other variation in their training program.  But as we continue to learn more about the spine, these traditional core exercises may actually be disadvantageous.  According to Dr. Stuart McGill, a noted spine biomechanist from the University of Waterloo:

“The spine may be more prone to injury when they are in a fully flexed posture.”

Last time I checked, when someone is performing a sit-up, they are in a great deal of flexion.  

Many other studies by McGill and other researchers have been published on the increased risk of high repetition and/or loaded lumbar spine motion.  Since this research has been published, there has been a pendulum swing towards performing more neutral spine movements such as planks.

core training plank

In another study by Cholewicki and McGill in Clinical Biomechanics:

“One important mechanical function of the lumbar spine is to support the upper body by transmitting compressive and shearing forces to the lower body during the performance of everyday activities. To enable the successful transmission of these forces, mechanical stability of the spinal system must be assured.”

By performing some type of plank or neutral spine exercise, this can potentially train the core to transmit force from the upper body to the lower body or vice versa without compromising the spine.

Performing plank variations is great, but as humans, we move in multiple planes of motion.  Therefore, we need to train the core to function in all planes of motion.

 

Core Musculature

360 degree core trainingThere are many muscles that contribute to the functioning of a stable core position.  These muscles include:

 

  • Rectus Abdominis
  • Internal Obliques
  • External Obliques
  • Transverse Abdominis
  • Multifidi
  • Quadratus Lumborum
  • Diaphragm
  • Pelvic Floor
  • Latissimus Dorsi

There have been studies performed over the years saying that transverse abdominis or multifidi are the main stabilizers of the lumbar spine.  Study after study, many by McGill, have refuted that 1 or 2 muscles are the primary stabilizers of the spine.  McGill et al. in the Journal of Electromyography and Kinesiology found that:

“The collection of works synthesized here point to the notion that stability results from highly coordinated muscle activation patterns involving many muscles, and that the recruitment patterns must continually change, depending on the task.”

Therefore, when we are training or treating our clients, we should not be attempting to isolate one muscle we performing lifting tasks.  Some muscles may be more active than others in one task as compared to another.  Instead, we should be working to maintain a neutral spine position and to resist motion through the lumbar spine.

The McGill Big 3

McGill came up with a series of 3 exercises, entitled “The Big 3” to help teach and re-educate patients or clients returning from a low back injury on how to properly stabilize their spine.

They include:

McGill Curl-Up

Key Points:

  • Place finger tips under low back.
  • Maintain a neutral spine position at low back and neck.
  • Slightly lift shoulders off ground while maintaining spine position.

Bird Dog

Key Points:

  • Maintain a neutral spine.
  • Imagine you have a drink on your low back. Don’t let it spill

Side Plank

Key Points:

  • Start on your side in a hip hinged position (hips slightly flexed).
  • Bring hips forward, not up.

These exercises are great implements to add into the beginning of a strength and conditioning program or during a rehab program for someone returning from a low back injury.  But, these exercises are a foundation for movement.  If we are going to build core stability throughout, thence need to have a solid foundation as well as solid “walls and a roof.”

 

Core Training Progression

There are typically two functions of the core:

  1. Transmit force from the lower body to the upper body or vice versa.  
  2. Resist motion.  

For example, if you are a baseball player and are throwing or swinging a bat, you want to have some motion through your lumbar spine, but predominantly through the hips and thoracic spine.  If we try to stop motion at the lumbar spine, your effectiveness as an athlete will be subpar.

Don’t forget…  the spine needs to move.  This is something Mike has covered in his article Are We Missing the Boat on Core Training?

Regarding the other aspect of resisting motion, if you are going to pick something heavy up off the ground, you want to maintain a neutral spine posture so that your core can transmit force from your legs and into your arms as you lift to the implement.

We need to appreciate these two different situations as we program for our clients.

The three planes of movement that the core musculature works in is the:

  • Sagittal Plane
  • Frontal Plane
  • Transverse Plane

The sagittal plane is lumbar spine flexion and extension. The frontal plane is lateral flexion or sidebending.  The transverse plane is rotation to the right or left.

The following progressions are a big part of Mike Reinold and Eric Cressey’s Functional Stability Training For the Core program.

 

Anti-Extension Core Training

Anti-extension core training consists of the body’s ability to resist movement into lumbar spine extension or to slow down motion from a flexed position to neutral, or from neutral to extension.

Exercises that focus on anti-extension stability are:

RKC Plank

Key Points:

  • Pull your elbows toward your toes.
  • Squeeze your glutes as hard as you can.
  • Maintain a neutral spine.

TRX Fallouts

Key Points:

  • Maintain a neutral spine.
  • Tuck tailbone/bring belt towards chin.
  • Slide arms out while keeping neutral spine.

Farmer’s Carries

Key Points:

  • Hold relatively heavy weight in each hand.
  • Ribs down/neutral spine.
  • Walk.  Don’t lose neutral spine posture as you walk.

Dead Bugs

Key Points:

  • Flatten low back to ground so that spine is neutral.
  • Bring right arm overhead and left leg out away from body.
  • Do not lose neutral spine position.  Return to starting position.
  • Repeat on other arm/leg.

Tall Kneeling Anti-Extension Press

Key Points:

  • Setup cable at head height when in tall kneeling.
  • Maintain a neutral spine and press cable overhead.
  • Cable will try to pull you into extension.  Don’t let it.
  • The only thing moving should be your arms.

Anti-Lateral Flexion Core Training

Anti-lateral flexion core training consists of the body’s ability to resist movement into lumbar spine lateral flexion to the right or left or to slow down motion from a flexed position to neutral, or from neutral to the opposite laterally flexed position.

Exercises that focus on anti-lateral flexion core stability are:

Suitcase Carries

Key Points:

  • Hold weight in one hand.
  • Do not let weight pull you out of a tall, neutral posture.
  • Don’t overcompensate to and flex to the opposite side.
  • Walk.

Side Planks

Key Points:

  • Start on your side in a neutral spine, slightly hips flexed position.
  • Maintain neutral spine and bring hips forward.
  • Maintain a straight line from your head, shoulders, spine, hips, knees, and ankles.

Racked Carries

Key Points:

  • Maintain a tall posture similar to the suitcase carries.
  • Walk.

Anti-Rotation Core Training

Anti-rotation core training consists of the body’s ability to resist movement into lumbar spine rotation to the right or left or to slow down motion from a rotated position to neutral, or from neutral to a rotated position.

Exercises that focus on anti-rotation core stability are:

Anti-Rotation Press

Key Points:

  • Start behind cable arm.
  • When you press your hands away, don’t let the machine rotate you.  Maintain a neutral spine.
  • Perform facing both directions.

1/2 Kneeling Chops

Key Points:

  • Leg closest to the machine should be up.
  • Bring arms down and across your body to you far side hip.
  • Only move head and arms.
  • Perform on both sides.

1/2 Kneeling Lifts

Key Points:

  • Leg closest to machine should be down.
  • Same cues as chops, but bring cable to far side shoulder.

TRX Anti-Rotation Press

Key Points:

  • Feet should be in tandem.
  • Maintain a neutral spine position.
  • Don’t let your body rotate or sidebend during press.
  • Perform on both sides.

 

Multi-Planar Movements and Rotational Sport Athletes

Once the body has mastered the basic core progressions and anti-movement-based drills, it is important to incorporate multi-planar and rotational movements.  These movements work on incorporating movement through the hips and thoracic spine versus some of the movements before where basically no movement was occurring.

As mentioned before, these exercises will help the athlete and client to control themselves going from one position to another.  As a rotational sport athlete, we don’t want to completely limit any spine motion.  We want the body to be able to control and decelerate the body using the musculature versus passive restraints (ie. bone, ligament, etc.) at end range.  These can also be used by non-rotational sport athletes as well.

Sledgehammer Hits

Key Points:

  • Bring the sledgehammer up over one shoulder.  Don’t let it bring you into lumbar extension.
  • Hit the tire while maintaining a neutral spine.
  • Alternate per side.

Medicine Ball Overhead Slams

Key Points:

  • Raise the medicine ball overhead.
  • Avoid going into lumbar extension.
  • Slam the ball to the ground while maintaining a neutral spine.

Medicine Ball Overhead Rotational Slams

Key Points:

  • Bring the ball up overhead.  Don’t let it bring you into lumbar extension.
  • Throw while maintaining a neutral spine.

Medicine Ball Scoop Toss

Key Points:

  • Load your back leg with your weight.
  • Transfer weight quickly from back to front leg.
  • Majority of the motion should be coming from the thoracic spine and hips.
  • Perform on both sides.

Medicine Ball Shotput Toss

Key Points:

  • Load medicine ball at shoulder height.
  • Load back hip/leg.
  • Quickly drive off back leg and twist through hips/thoracic spine.
  • Perform on both sides.

 

Breathing and Core Training

Implementing breathing with core training is very important.  If we are constantly holding our breath while performing core exercises, then we are compensating using the valsalva maneuver versus training the musculature to have to stabilize throughout the exercise.

Related Articles:

*Disclaimer*: if you have heavy weight in your hands or on your back in the cases of a deadlift or squat, then I am a proponent of using the breath to brace the core and spine.  When it comes to core exercises as mentioned above, remember to breath.  

With the said, here are a couple of exercises where implementing the breath adds another component to the movement.

Anti-Rotation Press with Full Exhale

Key Points:

  • Same as before with Anti-rotation Press.
  • Complete full exhale when hands are out in front of your body.
  • Maintain proper form during exhale and inhale.

Prone Plank with Full Exhale

Key Points:

  • Same as before with Plank.
  • Complete full inhale and exhale without losing form.

 

Strength Training and Core Stability

Lastly, we can’t go through an entire article and not discuss the use of core stability and strength training.  I am a firm believer that just performing squats and deadlifts are not enough to improve core and trunk stability.  Adding some of the movements mentioned above can add another component to create a well-rounded training program.

When it comes to performing squats, deadlifts, etc., maintaining a neutral spine during the lifts is extremely important.  Yes, there are some elite level lifters out there who can sway away from a neutral position in one direction or the other.   For the vast majority of people performing strength movements such as these, a neutral spine should be maintained.

There you have it.  By incorporating core stability exercises throughout all planes of motion, it will allow your clients and/or athletes to reduce their risk for injuries as well as improve their performance.

 

Learn More About Core Training

If you want to learn even more about functional core training, check out Mike Reinold and Eric Cressey’s Functional Stability Training for the Core.  The program goes over many of these progressions and a whole lot more to help you completely understand the true role of the core and how to incorporate functional core training into your rehab and strength training programs:

 

About the Author

andrew_millettAndrew Millett is a Boston-based physical therapist in the field of orthopedic and sports medicine physical therapy.  He helps to bridge the gap between physical therapy and strength and conditioning.  Visit his website at AndrewMillettPT.com.

 

 

 

 

Bridging the Gap From Rehab to Performance

I’m really excited to announce that the online version of the Champion Bridging the Gap From Rehab to Performance seminar that we had up in Boston last month is now available!

We see so many people at Champion that have rehabbed elsewhere for months and are still doing 3×10 of straight leg raises.  It’s no wonder that studies show persistent weakness after rotator cuff repair, ACL reconstruction, and other surgeries.  We aren’t bridging the gap!  

That’s why we wanted to put this together to show how we focus on acute rehab, but understand the process to transition them to performance-based activities.

On the flip side of the equation, the assessment process and program design for someone recovering from an injury that wants to transition to strength and conditioning is also different and important to understand.  

We’ll show how we integrate strength and conditioning concepts into our rehab programs, and how we assess and design strength and conditioning programs for people follow injury.

To me, this is the future our professions need to head towards.  We can’t just perform quad sets, straight leg raises and mini squats!

 

Bridging the Gap From Rehab to Performance

champion bridging the gap from rehab to performanceThe online version of the Champion Bridging the Gap From Rehab to Performance contains 7 modules and over 6 hours of content designed to help you build better rehab and post-injury training programs.  We’ll cover:

  • Applying Strength and Conditioning Principles into Acute Rehab – Lenny Macrina
  • Integrating Advanced Rehab and Early Strength and Conditioning – Dave Tilley
  • Integrating Performance Therapy to Optimize Performance – Mike Reinold
  • Live Q&A Session with the Rehab Team
  • Performance Training Post Injury: The Assessment Process – Rob Sutton
  • Performance Training Post Injury: Program Design – Kiefer Lammi
  • Live Q&A and Demonstration of the Assessment Process and Discussion on Program Design

Personal trainers and strength coaches will benefit from learning how we integrate rehabilitation concepts into our programs to properly assess, customize programs, and advanced people into strength and conditioning programs.  Likewise, rehabilitation specialists will benefit from learning how we integrate appropriate strength and conditioning concepts through the acute and advanced phases of rehabilitation.

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Integrating Performance Based Physical Therapy

The latest Inner Circle webinar recording on Integrating Performance Based Physical Therapy is now available.

 

Integrating Performance Based Physical Therapy

Integrating Performance Based Physical TherapyThis month’s Inner Circle webinar is on Integrating Performance Based Physical Therapy.  This presentation is actually my talk from the recent Champion Bridging the Gap From Rehab to Performance Seminar that we conducted in Boston last month.  

I wanted to share this with Inner Circle members as I feel the topic is important as performance based therapy is definitely the future of our professions.  Performance therapy is something that is performed to help people optimize themselves and improve performance, no matter what performance means to you.  You don’t need to be injured to benefit from performance therapy.  This is a lot of what we do at Champion and something that I really wanted to share.

We are actually going to be releasing an online version of the Champion Bridging the Gap From Rehab to Performance Seminar, which will include this presentation, plus others from Lenny Macrina, Dave Tilley, Rob Sutton, and Kiefer Lammi.  

Inner Circle members can access my talk now, and get early access to purchase the seminar.  Everyone else will have to wait until the official launch next week!  Plus, if you’d like to purchase the seminar, I also have a $10 off coupon just for Inner Circle members.  All the links will be in the Inner Circle Dashboard.

This webinar will cover:

  • What is “performance therapy”
  • The need for a paradigm shift in what we do
  • What I look for in my movement assessments
  • The components of manual therapy I perform
  • How to integrate and maximize your outcomes with corrective exercises

 

To access this webinar:

 

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!

 

 

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

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