Exercise of the Week – Single Leg Overhead Press

Finding new ways to unload an athlete but still get in a good amount of work is always a challenge.  Finding lifts the athlete can do in a single leg stance position would be one way to do that.

I’m not claiming that I’m going to create any monsters (as Charlie Weingroff would say) with lighter weights here, but I am looking for ways to incorporate an injured limb with increased demands for trunk control and an expression of upper body strength.  This is a great way to bridge the gap in rehab back to the weight room.  It can also be a great way to unload an athlete from time to time to prevent over training.

Check out the video below for tips and progressions of the single leg overhead press:

 

Couple prerequisites:

  • full shoulder range of motion – you should be able to lie on your back with knees bent, low back flat on the floor, and arms should lie flat on the floor overhead.
  • hold single leg balance with a level pelvis 20-30 seconds statically
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2015 Sports Rehab to Sports Performance Teleseminar

In addition to owning Elite Physical Therapy and Sports Performance, I’ve also had the blessing to run the sports physical therapy website SportsRehabExpert.com.

It’s a site for physical therapists, chiropractors, strength coaches and others in those industries to learn from some of the best in the business.  Every year I run a teleseminar series where I interview 10 of the best clinicians and strength coaches in the world, and then post those interviews online for free.  A number of these interviews may appeal to you readers of this blog whether you are in the health care or training industries or not.

Here is this year’s list of speakers and topics:

Charlie Weingroff – Motor skill acquisition and long term athletic development, movement competency, and high performance programs

Donald Chu – The foremost authority on plyometric training discusses potential benefits, progressions, injury prevention, and more

Derek Hansen – Speed development qualities, hamstring injury mechanics and running rehab, front side vs. back side mechanics

Mike Cantrell – Exploring the mechanics behind sports hernia, FAI, and shoulder impingement through the PRI lens.

Rob Panariello – Single limb vs. bilateral training, Olympic lifts during performance training and rehab

Phil Plisky – Injury risk/prevention research, the state of current prevention programs, UE stability testing, and what’s new with the SFMA.

Gary Gray – Applied Functional Science (AFS) and it’s principles, functional soft tissue transformation, and functional movement screening systems

Linda Joy Lee – Thoracic Rings Approach and the Integrated Systems Model, finding the meaningful task and primary driver

Sarah MottramKinetic Control system, understanding the biomechanics of normal and abnormal function, and motor control retraining of uncontrolled movement

Chris and Jennifer Poulin – PRI principles in sports performance and injury prevention programs

Some of the topics can get quite complex but I’m sure there are certain interviews that will interest you whether you’re looking to get faster, stronger, or just get healthy!

The link to the sign up page is here:  http://www.sportsrehabexpert.com/public/982.cfm.  You’ll also find a more detailed explanation of each topic plus more info on each speaker.

Check it out and I’m sure you’ll pick up some tips that will bring you closer to your goals.

Joe Heiler PT

joe@elitepttc.com

 

 

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Band Walks and Hip Strengthening

Band walks (a.ka. Monster Walks) are a physical therapy staple for hip strengthening, and are often used with patients who have had knee injuries or are suffering from back and/or hip pain.

It has been shown in the research that weakness of the glute muscles of the hip can be a direct cause of poor alignment through the lower extremities creating problems such as patellofemoral pain (anterior knee pain) and also putting one at higher risk for ACL injury.

Weakness through the hips is also proposed to be a cause of lower back pain since one is using the hip inefficiently to stand up, squat, lift, etc then the tendency is to overuse the lower back muscles to perform these tasks.

So strengthening the hip muscles sounds like a great idea right?

It can be when done correctly.  In the video below I demonstrate the wrong way to perform these exercises along with some simple corrections (the corrections may look simple, but they make the exercise much more difficult – and effective).

Hopefully you noticed that I talked about the importance of the trunk remaining stable throughout the exercise.  Only through stabilizing the trunk can the hip truly generate efficient force.  This is the most common mistake made, and in my opinion, makes the exercise a complete waste of time.

Give it a shot and let me know if you have any questions.

Joe@elitepttc.com

 

 

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Shoulder Pain Prevention – Should You Even Be Lifting Overhead?

This article was originally posted on SportsRehabExpert.com by Andy Barker – head physiotherapist for Leeds Rhinos Rugby team in the U.K. This article is about preventing shoulder pain, but also would fit right in with our series on preventing back pain.  Cheating with the spine to create more shoulder mobility is a great way to get hurt. 

In this article, Andy shows a great way to assess shoulder mobility with the spine locked out of the equation.  Enjoy!

by Andy Barker PT

A great quick and easy test to use to clear overhead lifting in rehab/training. Begin seated on the floor, tuck your thumb into your hand, keeping your elbows straight and lower back and head against the wall take your arms overhead to touch the wall behind you.

From this video you can clearly see the subject is able to touch the wall whilst being able to keep the head and lower back in contact with the wall. As a result this would constitute a pass and as a result the subject would be cleared to lift overhead in the gym.

A fail would include inability to touch the wall overhead and/or any visible compensation (usually lumbar extension) needed to allow increased shoulder flexion to occur.

 

I wrote a similar article on wall posture shoulder mobility exercises here:  http://elitepttc.com/blog/?p=362.  These are standing exercises meant to address deficiencies in the test above, but they may be a challenge to start with.  Probably should use a supine version like the one below first.  Once your arms hit the floor with good spinal control, then move to the standing versions. 

 

 

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The Bird Dog – A Core Stability Classic

The ‘bird dog‘ exercise is a core stability classic in the physical therapy world, and is certainly a favorite of ours here at Elite Physical Therapy.

That being said I see this exercise done incorrectly more often than not.

The whole idea behind core stability is to resist unwanted movement through the pelvis and spine when moving through the hips and shoulders.  Watching most therapists, and even yoga and pilates instructors, teach this exercise you would think just the opposite.  Check out the video below to see the exercise performed incorrectly (first 3 reps) and then done correctly (next 3 reps).

When performed incorrectly you can see how much movement is occurring through the lumbar spine.  Many folks are stuck in excessive lumbar lordosis (too much inward curvature) which can become painful especially with prolonged standing and walking.  A majority of the athletes I work with, including the dancers and gymnasts, would fall in this category as well.  Going into even more lordosis is only going exacerbate the issue.

As you can see when performed correctly, nothing moves through the pelvis and spine.  It’s only my shoulders and hips.  Performing a bit of a posterior pelvic tilt (think tucking the tailbone) will bring the person out of the excessive lordosis and help to stabilize the trunk.  Also notice there is much less excursion with the upper and lower extremities.  There is no way you can lift the arms and legs as high as in the first example and maintain any type of stability.

There are times however that a bit of lumbar lordosis (arch) may be necessary to maintain throughout the exercise.  Sometimes this is just the more comfortable position to be in.  If that’s the case then that is going to be the appropriate position for your body.

To learn to stabilize in this position, using a water bottle either across or along the spine is a nice trick (the latter being the more challenging).  Focusing on keeping the water bottle from rolling off your back will reflexively fire more muscles and with the correct timing to keep your spine and pelvis stable.

Adding a resistance band would be a higher level challenge. Do not attempt to add resistance until you are able to control your body weight.

Give the bird dog a try yourself and see how much more challenging it can be when you actually stabilize the core!

If you have any questions, contact me at joe@elitepttc.com or at 231 421-5805.

 

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Taping for Plantarfascitis/Foot Pain

In this blog post I wanted to discuss the benefits of taping, specifically a technique known as ‘low dye’ taping, for relieving foot and heel pain while allowing the soft tissues of the foot time to heal. This is a technique we commonly use here at Elite Physical Therapy.

Plantarfascitis is the common term for the pain in the arch of the foot or even in the heel.  It’s usually worse during walking or running – activities that really stretch that tissue on the bottom of the foot.

Our treatment model for plantarfascitis includes:

  • soft tissue work using Graston Technique to the plantarfascia, as well as to the muscles of the foot and calf to promote healing and greater extensibility of the tissues.
  • low dye taping to support the foot in weight bearing and to allow for tissue healing.
  • therapeutic exercise to increase mobility through the foot, ankle, and calf, as well as strengthening for the musculature of the lower leg.
  • corrective exercise to address movement dysfunction or lack of stability further up the chain including the hips and trunk.  The underlying reason for your foot pain is often found here!

Orthotics can be an important piece to the puzzle here as well, but they are quite expensive and not always a slam dunk to work.  A successful trial of low dye taping along with physical therapy is either going to eliminate the patient’s pain to the point that orthotics are not really necessary, or it’s going to relieve the symptoms enough that I feel more confident recommending orthotics as a more permanent solution.

Check out the video below to see how we do it here at Elite Physical Therapy.  If you have experienced these types of symptoms and they just won’t resolve, feel free to contact me to see if physical therapy would be an appropriate intervention.

I also shot a video demonstration of using Graston Technique to treat the foot a few weeks back.  You can find that video here:  http://elitepttc.com/blog/?p=415

 

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Video Introduction to Functional Dry Needling

Functional Dry Needling can be used to target and treat trigger points in almost any muscle of the body.  The benefits are a decrease in pain, improved tissue extensibility (flexibility), and improved function (i.e. getting you back to doing what you want to do most).

Check out the video for a brief explanation of Functional Dry Needling plus see how I would use it to treat the upper trapezius muscle.  This muscle can be a contributor to neck and shoulder pain as well as headaches, but responds very well to the technique.

Questions?  joe@elitepttc.com

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Graston Technique and Plantarfasciosis

I can’t believe it’s taken me 3 years to think of this but I decided it would be helpful to shoot an educational video about Graston Technique and how we use it here at Elite Physical Therapy.  More and more doctors in this area are recommending Graston Technique specifically, but often the patient has no idea what it is.  Hopefully this video will help to explain.

I also show a quick demo of how I would treat plantarfasciosis (the chronic equivalent of the more popular term plantarfascitis).  I’ll be posting more examples of how we use Graston Technique, but for now this is one of the more common areas we treat.

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Back Pain Prevention – The Glute-Ham Raise

Low back pain is a huge part of what we treat at Elite Physical Therapy and Sports Performance.  Even folks coming in for treatment with knee replacement or shoulder pain (just a couple examples), will often complain of pain and tightness in their low back as well.   Dysfunction and pain in the lower back can certainly contribute and cause problems in other areas of the body.

This is article #2 in a series of articles written by Andy Barker (SportsRehabExpert.com contributor) and myself that discuss how to spare your lower back during the performance of popular strength training exercises.  Hopefully you’ll find some good tips to keep that spine healthy all the while making great gains with your training.

Enjoy and if you have any questions feel free to email me:  joe@elitepttc.com

by Joe Heiler PT, CSCS

originally published on SportsRehabExpert.com

The glute-ham raise has always been one of my favorite exercises, but what I’ve realized is that most people are going to rely too much on their spinal erectors to complete the movement at the expense of the glutes and hamstrings. Over the past couple summers I’ve worked with numerous athletes with sore backs from performing this movement, or they just felt this movement was supposed to work their backs because this is where they feel it the most.

It’s called a glute-ham raise for a reason so finding a way to lock out the lumbar spine is critical. Performing a bit of a posterior pelvic tilt will allow the athlete to ‘lock the ribs to the pelvis’ on the front side, and then place all the emphasis on the glutes and hamstrings as in the video below.

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Training to Prevent Low Back Pain – Feet Raised Bench Press

Low back pain is a huge part of what we treat at Elite Physical Therapy and Sports Performance.  Even folks coming in for treatment with knee replacement or shoulder pain (just a couple examples), will often complain of pain and tightness in their low back as well.   Dysfunction and pain in the lower back can certainly contribute and cause problems in other areas of the body.

In the coming weeks I’ll be posting a series of articles written by Andy Barker (SportsRehabExpert.com contributor) and myself that discuss how to spare your lower back during the performance of popular strength training exercises.  Hopefully you’ll find some good tips to keep that spine healthy all the while making great gains with your training.

Enjoy and if you have any questions feel free to email me:  joe@elitepttc.com

 

by Andy Barker PT

originally posted at SportsRehabExpert.com

I think we do a great job at cueing and coaching good pelvic position when using standing based gym exercises.  Equally, cueing the same position in supine in an unloaded state we also get it right.

However, when adding load to supine based exercises good pelvic form is often lost.

A great example of this is the bench press. Often when the load goes up so does load through the back as compensatory lumbar extension assists the lift. This is especially so when the feet are placed on the floor either side of the bench.

One easy way to reduce the effects of possible lumbar compensatory extension is to raise the feet to put the pelvis into posterior tilt and hence out of lumbar extension. This is shown in the video below:

Feet Raised Bench Press

One potential problem with the above technique is that athletes may feel less steady with the feet not placed on the floor and hence unable to shift as much load. This might be particular so the wider the athlete and/or the narrower the bench used.

As a result an alternative way to increase support whilst also raising the feet is using plyo boxes to act as foot platforms. Using the boxes allows athletes to push into the floor, via the boxes, as they would in a standard bench press, although in a much better pelvic position. This is shown in the video below:

Feet raised bench press (plyo boxes)

Have a blast and let me know what you think

BIO

Andy is the current head physiotherapist for the Leeds Rhinos first team squad and has been involved with the club for the past six seasons.

He graduated in Physiotherapy from the University of Bradford with a first class honours degree which followed on from a previous Bachelor of Science degree from Leeds Metropolitan University in Sports Performance Coaching.

Andy currently works privately in addition to his sporting work and has also previous experience within National League basketball and professional golf.

Andy has a keen interest in injury prevention and the biomechanics of movement in which he is continuing his studies with the start of a MSc degree later this year in Sports and Exercise Biomechanics.

Andy is also the creator and author of rehabroom.co.uk. RehabRoom is a free online rehab resource site aimed at but not exclusive to physiotherapists, strength and conditioning coaches and personal trainers. To visit the site, click here:  www.rehabroom.co.uk

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