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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.

What Does It Mean To Be “Out of Alignment?”

“My body feel out of alignment.”

“My <insert healthcare professional here> said that my hips are off.”

“I think I just need to be adjusted.”

These are examples of a few of the comments that patients may express in physical therapy or other injury rehabilitations settings.

The belief that we are like a vehicle that needs to be re-aligned is often the fault of the healthcare industry, including physical therapy.

In the past, healthcare providers would tell their patients that a part of their body is out of alignment and needs to be adjusted to put it back in place. They explain that this is the reason for any discomfort that may be present.

Thankfully, this is no longer taught by most healthcare providers as this thought process has been disproven.

Our bodies are incredibly resilient.

Our joints do not simply fall out of alignment. In fact, our bodies are designed to move and if we were constantly “in line”, it would be impossible to move anywhere!

So, what is happening when an area of our body feels “off”?

As we perform a movement repetitively, compensations and movement limitations become more noticeable.

One area of the body may be moving excessively, while another area of the body may be moving too little.  For example, if your ankle mobility is limited during a squat, you will move excessively at the hips to pick up the slack, causing more stress in that area. As a result, pain, or the feeling of being out of alignment may occur in the hips/pelvis.

If you feel “off” or have been told that you are out of alignment, the solution is likely to begin with discovering what movement limitations may have led to this feeling in the first place. This information can then be used to teach you strategies to move and feel better!

Are you interested in discovering what solutions may be right for you? Contact us to find out more about our physical therapy services!

How to Improve Your Mobility

Do your hips or lower back feel tight as you perform movements like a squat? Perhaps your shoulders feel stiff when trying to bring your arms overhead, or your ankles feel restricted. All of these are common reports in sports physical therapy field.

Regardless of where your mobility problems lie, it is your body, more specifically your nervous system that is intentionally causing this. The stiff muscle that you feel is the body protecting itself or adapting to the demands placed upon it.

I often think back to my previous experiences as a physical therapist and the players that I worked with in the National Basketball Association (NBA). Most of them had ankle mobility restrictions, which were an adaptation to constantly being on the balls of the feet. These athletes were constantly sprinting, jumping, and cutting with their heels rarely touching the ground.

As a result, their body adapted to make them better at these movements. The tissues around their ankles turned into tight springs that allowed them to remain explosive without expending too much energy.

Adaptations like this are beneficial for performance however occur at the expense of mobility. As these adaptations go too far the risk of injury increases.

How do we know that adaptations have gone too far?

When the body no longer has the prerequisite abilities necessary to perform the activities required of it. In this case the joints of the body have less mobility than life or their activities require. As a result, uncomfortable feelings of stiffness or injury occur.

For this reason, I encourage athletes and patients to perform daily exercises that practice movements outside of their preferred movement strategies. This way the body cannot excessively adapt to only one way of doing things.

Here is a drill that I recently gave to a patient with shoulder mobility limitations and this is a drill that I advised a runner perform within her daily routine.

Would you like to discover the daily essentials that will help you feel better and move better? If so, contact us today!

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!

Physical Therapy Didn’t Work…

I tried physical therapy and it didn’t work.

Many of our patients in Bethesda have seen other physical therapists prior to seeing us. In their previous physical therapy experiences, they did not achieve the results that they were looking for and are coming to us for answers.

Personally, I love working with these people because they continue to believe that our profession can help them. However, negative experiences in physical therapy often cause many others to lose faith in the profession.

Perhaps you are one of these people. If so, I don’t blame you as I once was in your shoes!

When I was in High School, I experienced a quadricep injury that was impacting my ability to play football.

I went to my local physical therapy practice searching for help in overcoming this injury and play in my junior season. It was going to be my first season starting on both offense and defense causing this injury to constantly remain in the front of my mind.

My introduction to physical therapy was not what I had hoped for, and I now realize that my physical therapists were not taking great care of me (to learn more about how you can determine if this is the case, see my latest blog here).

Luckily, I was still able to play in my season and was back to 100% by the middle of the year. However, I can’t help but wonder if I would have been fully healthy to start the season if I saw a different physical therapist.

Like all other professions, the physical therapy industry has great professionals and poor ones. Furthermore, some physical therapists specialize with athletes, some with cardiac patients and others with people living in nursing homes.

As a result, my hope is that instead of saying “I tried physical therapy and it didn’t work”, you say “This physical therapist or physical therapy practice didn’t provide the results that I was looking for and I need to find someone that is a better fit for what I need.” 

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!