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How Our Physical Therapists Coach Squats for People with Low Back Pain

Did you know that experts estimate up to 80% of the population will experience back pain at some time in their lives.

The sports physical therapy patients that we often assume that they no longer can perform common weight training exercises like squats.

However this is not the case. People experiencing lower back can continue to perform these exercises however may require the help of a performance physical therapist to learn how to most effectively do so.

Check out the video below to see how I coach squats for our physical therapy patients experiencing lower back pain.


One Quick Test of Shoulder Health

It’s not as easy as it sounds.

Maintaining a quadruped position (hands and knees) reveals a great deal about your upper body strength and preferred movement strategies. For these reasons, we use this position as a test and exercise within our sports physical therapy setting.

Even strong and muscular patients commonly assume a quadruped position with their shoulder blades pinched close together and deep lower back arch (belly button dropped towards the ground).

This position is often utilized because it conserves energy and allows the body to be lazy. Compression from the lower and upper back is used to hold the torso up against gravity, instead of the abs and muscles involved with reaching. These strategies are common among folks experiencing back pain, shoulder pain and a variety of other issues.

The abs and muscles involved with reaching (for example, the serratus anterior) are essential components of athletic performance, running, walking and pretty much being a human being.

As these skills diminish, the risk of experiencing various injuries may increase.

The bear test is a great way to see if test your upper body strength and movement capabilities.

Think you have what it takes to pass the test? Give it a shot with this drill!

Photo Credit

Polar bear” by tharendra is licensed under CC BY-ND 2.0.

When You Should Be Using a Workout Machine

Workout machines like the prone hamstring curl are underutilized in the sports performance setting and often get a bad rap in the sports physical therapy industry. I have heard people (physical therapists, strength coaches, running coaches, personal trainers, etc.) say negative things about using machines for a variety of different reasons.

“Machines are not functional. Humans should provide their own stability and not rely on a machine to do it for them.”

“X, Y, or Z machine isolates only one area of the body and we do not move 1 area at a time in real life.”

The support that machines provide, allowing people to focus on working one area has many advantages when used appropriately.

Even athletes can benefit from using machines.

High level sprinting requires an athlete to have a great deal of hamstring strength as the muscle is in a shortened position (when the knee is fully bent).

During the recovery phase of sprinting (as the leg is being brought back to the front of the body) the heel should be as close to the athlete’s bottom as possible. As this motion begins, the hip is a relatively extended position.

The prone hamstring curl trains end range hamstring strength when the hip is in this position. Dr. Cohen even pauses briefly in this video when at the end of the movement to stress this position.

During this exercise, the machine will dictate the movement however remember to use your abs to prevent the lower back from extending during any portion of the exercise.

There is no such thing as a good or bad exercise. Almost every exercise is appropriate when used properly. The key is to be clear on the desired outcome of the drill and how to implement it most effectively into your training routine.

Would you like to learn how to design your training most effectively to best accomplish your goals? If so, contact us to receive a customized training program designed specifically for you!

Speed Up Your Recovery From Back Pain

As anyone who has thrown their back out and needed physical therapy will tell you, bending over feels rough for several days after.

Putting on socks and even sitting down is uncomfortable as the body attempts to prevent the lower back from moving, especially into flexion.

Flexion of the spine is commonly the most aggravating movement for anyone experiencing an acute episode of back pain. In physical therapy we test this by asking our patients to touch their toes. Once the acute episode subsides, the next step is training and learning to tolerate slow, controlled movements of the spine.

When tolerated well, the reverse crunch is great drill to teach this quality and can be used effectively as a warmup in the gym.

Oftentimes this is where the injury rehabilitation process stops. At this point the body can tolerate all normal daily activities however it has not learned to manage rapid movements of the spine, such as those that occur in sport or in the gym.

The Med Ball slam is a great drill to train the spine to tolerate movements that involve rapid spinal flexion. This drill should be pain free before attempting any heavy Olympic lifts like a clean or a snatch.

Also, remember to avoid using a ball that bounces as we don’t want any broken noses from this drill!

The first drills that we teach to youth athletes

It is essential to understand the demands placed onto the body when working in a sports physical therapy, injury rehabilitation, and performance training setting.

Sports and weight training require athletes to control the body when moving rapidly.

If an athlete wishes to own the “stack” (stacking of our head, rib cage and pelvis over one another) and protect their lower back they must be capable of doing so when performing high velocity movements.

When youth athletes first train, we use medicine ball drills to teach this ability.

The medicine ball chest pass is a great drill to teach this capability. During this the drill, the athlete is generating enough velocity to propel the ball into the wall and back. As this occurs, it can be easy to lose the “stack” requiring the athlete demonstrate a higher of level of body control.

After mastering the chest pass, it is time to bring the arms overhead. More trunk strength and control are required with this movement and the ability to manage intra-abdominal pressure is further challenged. Check out this exercise here.

These are just a couple of the exercises that we incorporate into the training sessions and warmups for our youth athletes.

If you interested in learning more about the summer training options for youth athletes at CHP,  please contact us!

What All Rotational Athletes Must Be Capable Of

Low back pain with golf or arm pain with throwing. At our performance physical therapy practice, we see this constantly. 

Swinging a golf club, throwing a baseball and hitting a tennis ball involve a great deal of rotation. Many areas of the body should be involved in these movements, however that is not always the case.

It is common to see baseball pitchers that are experiencing arm issues demonstrate the habit of trying to “arm” the ball as they throw it. There is not much contribution from the legs which places a great deal of stress on the arm and over time results in overuse injuries. 

Many golfers and tennis players experience lower back pain because they do not effectively link the power that they generate in the lower body through the trunk, into the upper body and ultimately to the head of the club. As a result they compensate elsewhere, placing increased stress onto the lower back.

The rotational row is a great drill to train the body to generate rotational power through the legs and connect it through the trunk. View this exercise here.

Once you have mastered the rotational row and learned how to link the power generated in the lower body to the trunk, we can now add in the upper body! The rotational lift trains the body to generate rotational power through the legs and connect it through the trunk and arms. Check this exercise out here.

Interested in learning more ways you can address lower back pain while enjoying your active lifestyle? Sign up for a FREE phone consultation today!