Functional Stability Training

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FST$|$Functional$Stability$Training!
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Core!
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Michael!M.!Reinold,!PT,!DPT,!SCS,!ATC,!CSCS!
Eric!Cressey,!MA,!CSCS!
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FST!|!Functional!Stability!Training!|!FunctionalStability.com!
Copyright
2012 by Mike Reinold and Eric Cressey. This video and manual is copyrighted
by Mike Reinold and Eric Cressey. All Rights Reserved. Images, text, graphics,
and other intellectual property are protected by United States and International
Copyright Laws, and may not be copied, reprinted, published, reengineered,
translated, hosted, reproduced, or otherwise distributed by any means without
explicit permission. You may not copy, modify, create derivative works of,
publicly display or perform, republish, store, transmit, or distribute any of the
material in this video without the prior written consent of the Advanced
Continuing Education Institute.
Disclaimer
This video, manual, and the following guidelines have been provided as general
information for exercise and rehabilitation and are intended for educational
purposes. Any individual beginning exercises contained this video or manual, or
beginning any other exercise program, should first consult with a qualified health
professional. Discontinue any exercise that causes discomfort and/or dysfunction
and consult with a qualified medical professional. Please consult with a physician
prior to implementing any rehabilitation or exercise protocol. This video and
manual does not contain medical advice. The instructions and advice presented
are in no way a substitute for professional testing, instruction, or training. The
creator, producer, and distributor of this video, manual, and program disclaim any
liabilities or loss, personal or otherwise, in connection with the exercises and
advice herein.!
In order to function properly our joints need to be mobile, but control
and stabilization of this mobility is often less than
optimal. Unfortunately, stabilization is often overlooked in the design
of rehabilitation and performance programs. Traditional program
design relies too much on stretching what is tight and strengthening
what is weak. We are missing the boat on stabilization.
Functional Stability Training is designed to optimize
movement
It begins with the simple understanding of how the human body works
most efficiently and integrates those concepts into rehabilitation and
performance training. It is based on functional anatomy and
biomechanics, not simplistic anatomy.
It is a combination of functional assessment, mobility, strengthening,
corrective exercise, manual techniques, dynamic stabilization, and
neuromuscular control.
In essence, this isnt one system, but rather the integration of thought
processes from several sources and disciplines that Mike Reinold
and Eric Cressey have accumulated during their careers.
Basically, Functional Stability Training is how Mike Reinold
approaches building his rehabilitation programs for injured people
and how Eric Cressey builds corrective exercise progressions for
injury prevention and performance training.
Functional Stability Training is the integration of physical
therapy and performance enhancement training, the
integration of exercises and manual techniques, and the
integration between mobility, strengthening, and dynamic
stabilization.
Outline!
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Functional Stability Training An integrated approach to
rehabilitation and performance training Reinold
Recent Advances in Core Performance - Understand the concept of
Functional Stability Training for the Core, true function of the spine, and
how this impacts injuries, rehab, and training Reinold
Maintaining a Training Effect in Spite of Common Lumbar Spine
and Lower Extremity Injuries Outlines the causes and symptoms of
several common injuries encountered in the lower extremity, and how to
train around these issues to keep clients/athletes fit during rehabilitation
Cressey
Understanding and Controlling Extension in Athletes Looks into
the causes of and problems with excessive lumbar extension, anterior
pelvic tilt, and rib flairs in athletes Cressey
LAB Assessing Core Movement Quality: Understanding where to
begin with Functional Stability Training exercises for the core Reinold
LAB A Dynamic Progression of Core Performance Exercises Progression from simple core control to advanced rehab and training
techniques Reinold
LAB Understanding and Controlling Extension in Athletes
Progresses on the previous lecture with specific technique and
coaching cues for exercises aimed toward those with these common
issues Cressey
LAB Advanced Stability: Training Power Outside the Sagittal
Plane Traditional power training programs are predominantly focused
on the sagittal plane, but in most athletic endeavors especially
rotational sports power must be displayed in other planes of motion
Cressey
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About&the&Authors!
Dr. Michael M. Reinold, PT, DPT, SCS, ATC, CSCS
is considered a leader in orthopedic and sports
rehabilitation as a clinician, educator, and researcher.
Mike is currently the Head Physical Therapist of the
Boston Red Sox.
Mike has lectured extensively throughout the nation,
published over 50 scientific journal articles and book
chapters, and is the author of the textbook, The
Athletes Shoulder, 2nd Edition. Mikes contributions
to sports medicine have earned recognition by
groups such as the APTA, ESPN, Sports Illustrated,
The Sporting News, Mens Health, The Boston
Globe, and The Boston Herald.
MikeReinold.com
Eric Cressey, MA, CSCS is the president of

Cressey Performance in Hudson, MA. Cressey is a
highly sought-after coach for healthy and injured
athletes alike from youth sports to the Olympic and
professional ranks, with baseball development as his
greatest focus. Behind Erics expertise, Cressey
Performance has rapidly established itself as a go-to
high-performance facility among Boston athletes
and those that come from abroad to experience CPs
cutting-edge methods.
Eric has lectured in four countries and more than one
dozen U.S. states; written over 200 articles and four books; contributed on
scientific journal articles and book chapters; and co-created four DVD sets. A
record-setting competitive powerlifter, Cressey has deadlifted 650 pounds at a
body weight of 174 and is recognized as an athlete who can jump, sprint, and lift
alongside his best athletes to push them to higher levels.
EricCressey.com
FunctionalStability.com!
Visit FunctionalStability.com for more information on the FST integrated
rehabilitation and performance system. More information and modules on the
upper and lower extremity coming soon!
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ShoulderPerformance.com!
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Visit ShoulderPerformance.com to see Mike and Erics other DVD - Optimal
Shoulder Performance. A comprehensive 4-DVD resource of evidence-based
testing, treating, and training the shoulder for health and high performance.
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Michael(M.(Reinold,(PT,(DPT,(SCS,(ATC,(CSCS(
MikeReinold.com-
Introduction*
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4.
A!comprehensive!approve!to!rehabilitation!and!prevention!programs!
Traditional!programs!miss!a!critical!component!of!performance!9!stability!
Emphasis!on!training!the!body!by!replicating!how!the!body!functions!
Designed!to!work!in!tandem!with!manual!therapy!techniques!to!restore!
posture,!muscle!imbalances,!strength,!and!dynamic!stability!
The*True*Role*of*our*Muscles*
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1. Muscles!designed!to!be!both!prime!movers!and!more!importantly!stabilizers!
2. Joints!are!stabilized!through!static!and!dynamic!stability!
3. Static!stability!
a. Joint!
b. Ligaments!
c. Capsule!
4. Dynamic!stability!
a. Motor!control!
b. Proprioception!
c. Dynamic!stabilization!
d. Neuromuscular!control!
5. Different!joints!offer!different!amounts!of!static!stability!
6. The!knee!and!the!shoulder!
7. What!is!the!function!of!the!rotator!cuff?!
a. External!and!internal!rotation?!!Nope!
b. That!is!the!action!of!the!cuff!
c. The!"function!is!to!dynamically!stabilize!the!glenohumeral!joint!
The*Components*of*Optimal*Programs*
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4.
In!simple!form!!strengthen!what!is!weak!and!mobilize!what!is!tight!
What!about!what!is!loose?!
We!are!greater!at!strengthening!and!stretching!
Need!to!improve!our!ability!to!dynamically!stabilize!
FST!|!Functional!Stability!Training!! 2(
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Dynamic*Stability*
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1. Several!components!of!dynamic!stability!
Joint*Compression*
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1. Muscular!co9contraction!
2. Compression!of!joint!(closed!kinetic!chain)!
Dynamic*Ligament*Tension*
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1. Muscles!blend!to!fascia!and!capsule!
2. Contraction!tightens!capsule!and!reduces!tension!
Force*Couples*
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1. Muscles!working!together!to!move!and!position!the!joint!
2. Both!in!terms!of!agonists!and!antagonists!
3. Agonistic!force!couples!
a. serratus!and!lower!trapezius!
b. Hamstring!and!glute!maximus!
c. Internal!and!external!oblique!
4. Antagonistic!force!couples!
a. Subscapularis!and!infraspinatus!
b. Rectus!abdominis!and!paraspinals!
5. Kinetic!chain!force!couples!
a. Ripple!effect!
b. Fascial!continuity!
Neuromuscular*Control*
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1.
2.
3.
4.
5.
Proprioception!
Kinesthesia!
Efferent!response!(motor)!to!afferent!input!(sensory)!
Skills!can!be!learned!and!reflexive!!motor!learning!
Reactive!neuromuscular!control!
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FST!|!Functional!Stability!Training!! 3(
What*Influences*Dynamic*Stability?*
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4.
5.
Muscular!weakness!
Fatigue!
Muscle!imbalances!
Decreased!joint!awareness!
Injury!
Functional*Stability*Training*
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1. Training!the!body!to!perform!coordinated!functional!activities!without!
compensation,!minimizing!stress!of!the!surrounding!structures!
2. Combination!of!several!components!
a. Motor!control!re9education!
b. Isolated!strengthening!
c. Reverse!posturing!
d. Dynamic!stability!
e. Reactive!neuromuscular!control!
f. Endurance!training!
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Functional*Stability*Training*for*the*
Core!
MikeReinold.com-
Introduction*
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1. Paradigm!shift!in!core!training!and!the!treatment!of!the!lumbar!spine!
2. Movement!away!from!traditional!core!exercises!
a. Increasing!muscle!strength!and!spine!range!of!motion!has!not!been!
successful!
i. In!fact!some!studies!show!negative!outcome!possible!
b. New!research!assessing!effectiveness!and!safety!of!these!exercises!
c. Shift!to!more!functional!activities!
d. Shift!away!from!restoring!motion!and!towards!enhancing!stability!
3. Key!is!understanding!the!function!of!the!core!in!functional!activities!and!
spinal!control!
4. The!role!of!the!core!muscles!is!to!help!spare!the!spine!from!excessive!load!
How*Low*Back*Injuries*Occur*
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1. Typically!not!linked!to!one!specific!incident!(lifting!a!box),!but!rather!a!
history!of!excessive!loading!
2. Pathology!from!a!combination!of!lumbar!flexion,!twisting,!shear,!and!
compressive!loading!
a. High!repetition!and!light!load!
b. Low!repetition!and!high!load!
3. Motor!changes!are!present!in!those!with!low!back!pain!
a. Delay!in!onset!of!transverse!abdominis!
b. Decreased!multifidus!activity!in!unstable!spines!
c. Faster!fatigue!rates!in!spine!extensors!
4. The!lumbar!spine!will!buckle!at!20!pounds!with!no!muscular!contribution!
a. Muscular!contraction!dramatically!increases!stiffness!of!the!spine!
b. This!has!to!be!360!degree!stiffness!or!instability!occurs!
c. All!muscles!work!together!to!create!this!stiffness!
d. Any!deficits!will!create!an!imbalance!in!stiffness!and!vulnerability!
5. Ability!to!develop!spinal!stiffness!is!first!key,!keeping!that!stiffness!is!second!
key!!endurance!
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Functional!Stability!Training!of!the!Core! 2(
The*Problem*with*Traditional*Exercises*
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1. Many!put!the!spine!in!a!disadvantageous!position!
2. Lumbar!mobility!
a. Leads!to!greater!mobility!and!instability!
3. Abdominal!hollowing!
a. Does!not!produce!360!degree!spinal!stability!!isolated!TA!
4. Sit!ups!
a. Excessive!lumbar!flexion!places!3000N!of!compressive!force!
5. Posterior!pelvis!tilts!
a. Places!spine!in!too!much!flexion!
6. Supermans!
a. Places!very!high!compression!load!on!spine!
Keys*to*Functional*Stability*Training*of*the*Core*
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9.
DeWemphasize!lumbar!mobility!
Increase!muscular!stiffness!to!protect!the!spine!
Increase!muscular!stiffness!in!360!degrees!around!spine!
Emphasize!neutral!spine!
Emphasize!endurance,!not!strength!
a. Core!stability!not!designed!to!maintain!position!with!moderate!
activity!for!long!durations!
b. Holds!for!8W10!seconds!!longer!depletes!oxygen!and!builds!up!lactic!
acid!
c. Increase!endurance!through!repetitions,!not!holds!
Challenge!the!stabilizing!system!randomly!
Train!for!stability!in!functional!motions!and!positions!(athletes)!
Stop!worrying!about!specific!muscle!activity!
a. They!are!all!important!and!involved!in!spinal!stability!
b. Focus!on!groups!based!on!function!
This!is!not!an!independent!home!exercise!program!!!Importance!of!
coaching/cueing!
Functional*Stability*Training*Progression*
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4.
5.
Addition!by!subtraction!
Train!neutral!spine!
Train!abdominal!bracing!
Teach!proper!muscle!firing!patterns!
Train!simultaneous!bracing!and!extremity!movement!
a. Exercise!in!stable!position!
b. Exercise!in!unstable!position!
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c. Perturbations!and!rhythmic!stabilization!
6. Progression!to!functional!movement!patterns!
a. IsoWholds!
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General*Progression*
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1. Each!exercise!group!follows!the!same!progression!
Stable!!!Perturbation!!!Unstable!!!Perturbation!
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2. Exercise!progression!is!a!blend!of!levels!
Phase!1!stable!!!
Phase!2!stable,!phase!1!unstable/perturbation!!!
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3. Build!endurance!through!repetitions,!not!time!
4. Transition!from!reps!to!breathes!
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Neutral*Spine*
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1. Import!place!to!begin!
2. Gentle!pelvic!tilting!(avoid!forced!posterior!pelvic!tilting)!
3. Cat!and!camel!
Abdominal*Bracing*
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4.
Avoid!abdominal!hollowing!
Contraction!of!entire!core!stabilizers!
Palpate!and!facilitate!more!than!rectus!abdominis!
Biofeedback!
Each-exercise-progress-begins-with-finding-neutral-spine-and-then-bracing-
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Anterior*Chain*Progressions*
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1. Curl!up!
a. Movement!occurs!through!sternum!
b. Train!to!flex!the!thoracic!spine,!not!lumbar!
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2. Dead!bug!
a. Maintain!neutral!spine!and!brace,!incorporate!arm!and!leg!
movements!
b. Begin!with!one!extremity!at!a!time,!stable!
c. Progress!to!unstable!and!both!extremities!
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3. Front!plank!
a. One!of!the!exercises!I!see!most!abused!
b. Train!to!contract!the!abdominals!from!the!ground!up!
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4. Chop!&!lift!
a. Begin!to!get!off!the!ground!
b. Progress!from!half!kneel!to!tall!kneel!but!still!fairly!stable!
c. Upper!extremity!PNF!patterns!!D1!and!D2!
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5. AntiWextension!isoWholds!
a. Begin!to!get!into!functional!positions!
b. Add!rotary!component!!360!degree!stiffness!
Posterior*Chain*Progressions*
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1. Bridge!
a. Large!emphasis!on!glute!max!activity!!train!to!extend!the!hip!with!the!
glutes,!not!the!lumbar!spine!
b. Progress!to!single!leg!adds!rotary!stability!
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2. Hip!thrust!
a. Progression!to!add!some!resistance!to!bridge,!takes!pressure!off!
lumbar!spine!!
b. One!fault!with!the!bridge!is!that!hip!flexor!flexibility!will!limit!the!
motion!
c. Hip!thrust!can!help!
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3. Bird!dog!
a. Excellent!combination!of!abdominal!bracing,!back!extensor!strength,!
and!rotary!stability!
b. Start!with!clocks!!progress!to!arm!and!leg!
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4. AntiWextension!isoWholds!
b. Add!rotary!component!!360!degree!stiffness!
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5. Deadlifts!
a. Unspoken!term!in!rehabilitation,!does!not!have!to!have!aggressive!
weight!
b. Most!important!aspect!of!deadlifiting!is!technique!
c. Single!leg!RDL!
d. Standard!deadlift!!work!within!your!mobility!
Lateral*Chain*Progressions*
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1. Side!plank!
a. Effective!QL!and!oblique!activity!
b. Many!progressions!!knees!!!straight!leg!
c. Variations!for!shoulder!issues!
i. Feet!up!
ii. TRX!rip!trainer!
d. Incorporate!glute!strengthening!
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2. Front!plank!to!side!plank!progression!
a. Wall!!!table!!!ground!
b. Challenging!but!important!
c. Begin!with!rotary!stability!planks!
d. Avoid!lead!with!hips!
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3. AntiWsidebending!isoWholds!
b. Incorporate!unilateral!weights!into!workouts!
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Rotary*Chain*Progressions*
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1. Many!activities!require!us!to!train!rotation!
2. AntiWrotation!isoWholds!
a. Important!component!of!beginner!programs!
3. Training!for!rotary!strength!and!power!must!come!after!adequate!functional!
core!stability!is!achieved!
4. Disadvantageous!position!for!the!spine,!needs!proper!stabilization!
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Conclusion*
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1. New!concepts!in!Functional!Stability!Training!
2. Step!back!from!traditional!core!programs!and!emphasize!how!the!core!truly!
functions!
3. 360!degree!stiffness!
4. Ability!to!withstand!random!forces!
5. Ability!to!stabilize!while!performing!extremity!movements!
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11/13/11
The$Versa)le$Strength$Coach:$$
Maintaining$a$Training$Eect$in$Spite$of$
Injuries$$Part$1$(Lower$Body)$
Eric$Cressey$
www.EricCressey.com$
www.CresseyPerformance.com$
Spondylolysis:$The$New$ACL$Epidemic?$
Pars$interar)cularis$fractures$
(pars$defect)$
Pars$interar)cularis:$connects$
the$vertebral$body$in$front$with$
the$vertebral$joints$behind$
ScoQy$Dog$Fracture $$
Trauma)c$vs.$Insidious$onset$
Depending$on$loca)on,$pain$may$
be$centralized$or,$more$
commonly,$lateral.$$
Things$to$Consider$
Is$the$pathology$the$problem?$$Or,$are$
mul)ple$pathologies$making$people$more$
symptoma)c?$
Are$some$athletes$just$wai)ng$to$reach$
threshold?$$
My$guess$is$that$it$is$much$higher$now$(seven$
years$later).$$Why?$
$
Important$Prerequisites$
Primary$goal$should$always$be$to$x$what s$wrong,$
not$just$keep$things$ fun. $
When$applicable,$you$can$always$train$the$uninjured$
limb$with$great$benets.$
Know$when$to$refer$out.$Two$minds$and$skill$sets$are$
beQer$than$one!$$$
Make$the$athlete$feel$like$an$athlete,$not$a$pa)ent.$$$
Look$to$soS$)ssue$quality$earlyTon$
Incidence$
Soler$and$Colderon$(2000):$$
8%$of$elite$Spanish$athletes$aected$
highest$prevalence$(27%)$in$those$in$track$&$eld$throws$
17%$of$rowers,$14%$of$gymnasts,$and$13%$of$weightliSers$had$
spondylolysis$
L5$most$common$(84%),$followed$by$L4$(12%).$
Mul)ple$levels$of$involvement$in$only$3%$of$cases$
Bilateral$78%$of$the$)me$
Only$50T60%$of$those$diagnosed$actually$reported$low$back$pain$
Males$and$females$aected$equally$(although$associated$
spondylolisthesis$was$higher$in$females)$
Presence$of$spondylolysis$is$es)mated$at$15T63%,$with$the$highest$
prevalence$among$weightliSers.$
As$always$
Everyone$wants$to$compete,$but$not$train.$
Socially$and$economically,$opportuni)es$for$
sport$par)cipa)on$yearTround$are$available.$
We$sit$too$much.$
Modern$footwear$is$atrocious.$
11/13/11
Which$has$led$to$
Debated$Treatment$Protocols$
$Dr.$Jonathan$Reeser:$
Although$some$clinicians$recommend$
bracing$to$minimize$extension$and$resultant$shear$forces$
across$the$aected$segment,$some$evidence$from$
biomechanical$studies$indicates$that$lumbosacral$bracing$may$
actually$increase$intersegmental$mo)on$at$the$lumbosacral$
junc)on.$Therefore,$the$prevailing$opinion$appears$to$be$that$
bracing$should$be$used$only$for$individuals$who$remain$
symptoma)c$despite$aQemp)ng$to$limit$their$ac)vi)es,$or$for$
those$who$require$a$physical/tac)le$reminder$to$avoid$
provoca)ve$ac)vi)es. $
A$standard$rule$in$sports$medicine:$any$
adolescent$athlete$with$lumbar$pain$of$
dura)on$>3$days$must$get$a$bone$scan$to$
rule$out$a$fracture$
Frequently$go$undiagnosed$and$will$
frequently$respond$to$most$modali)es$
(heat,$ice,$EMS,$US,$massage,$exercise$w/
o$extension$and$even$chiroprac)c$
manipula)on).$$$
These$modali)es$treat$pain,$spasm,$
inamma)on,$etc.,$but$the$fracture$
remains.$$
Acute$diagnosis$is$rare,$but$if$it$happens,$
it s$12T16$weeks$of$bracing$$and$
generally$with$very$good$healing.$$$$
BackTBracing:$Bringing$The$Pendulum$Back$to$
Center?$
Spinal Level
Degrees of Rotation
T1-2
T2-3
T3-4
T4-5
T5-6
T6-7
T7-8
T8-9
T9-10
T10-11
T11-12
T12-L1
L1-2
L2-3
L3-4
L4-5
L5-S1
0-5
Remember$
Motor$Control:$$
Beginner$vs.$Advanced$
Risk$Factors$T$Intrinsic$
Poor$bone$mineral$density(*)$
Poor$lower$limb$alignment$and$foot$structure(*)$
Faulty$muscular$recruitment$paQerns$(*)$
Height$$Taller$(nonTmodiable)$
Body$Type$$longer$spine$(nonTmodiable)$
Poor$condi)oning/muscular$fa)gue(*)$
Bone$pathologies$(refer$out)$
Menstrual/hormonal$irregulari)es$(refer$out)$
Gene)c$predisposi)on:$Inuit$>$Caucasian$>$AfricanTAmerican$(nonT
modiable)$
11/13/11
Risk$Factors$T$Extrinsic$
Inappropriate$training$regimen$or$surface$(*)$
Spor)ng$discipline:$Sports$demanding$repe))ve$lumbar$hyperextension,$
trunk$rota)on,$and/or$axial$loading$(*$shortTterm,$poten)ally$modiable$
longTterm)$$
Footwear$(*)$
CigareQe$smoking$(*)$
Insucient$nutri)on$T$calories,$calcium,$vitamin$D$(*)$
Flexion$vs.$ExtensionTIntolerant$
More$pain$in$siqng$(exion)$or$standing$
(extension)?$
Look$at$a$basic$overhead$squat:$
Does$the$buQ$tuck$under?$(Flexion)$
Does$the$arch$remain,$but$the$individual$comes$up$
on$the$heels$$or$stop$dead?$(Extension)$
It s$just$the$path$of$least$resistance.$
Control$what$we$can$control$
Look$at$the$*$from$above$
Make$sure$there$a)$is$a$physical$therapist$
involved$(with$manual$therapy)$and$b)$he/she$
is$proac)ve$
Remember$the$psychological$aspect$of$this$for$
a$young$athlete$
Appreciate$the$restric)ons$of$the$brace$
Bracing$Issues$
1.
2.
3.
4.
5.
6.
7.
Flexion$Intolerant$
Tend$to$sit$in$exion/
posterior$PT$
Present$more$like$disc$
injury$cases$
Bring$center$of$gravity$
up$to$drive$subtle$
lumbar$extension$
Hamstrings$
mobiliza)ons,$psoas$
recruitment$
Overhead$SingleTleg$
Work$
It$is$so$easy$to$be$lazy$with$good$posture. $Loss$of$
motor$control$of$key$core$stabilizers:$therapist$should$
get$them$out$of$the$brace$weekly$
Restricts$full$hip$exion$and$extension$ROM$
Can$actually$restrict$TTSpine$ROM$
Tendency$toward$hip$rota)on$asymmetries$(especially$
postTbracing):$need$for$sprint$mechanics$work$postT
bracing$
Avoid$pronounced$axial$loading$
No$rota)onal$training$for$dura)on$of$bracing:$all$plyos$
(<90$hip$exion)$and$med$ball$throws$must$be$linear$
Think$an)Trotator$training$
ExtensionTIntolerant$
Glute$Ac)va)on$
Supine$Bridges$and$progressions$
Birddogs$
PullTThrough$and$Wall$March$Isometric$Holds$
Op)mize$ROM$into$hip$extension$
Check$feet$closely;$pronators$tend$to$be$
more$problema)c.$
11/13/11
The$Scoop$on$Disc$Injuries$
1994$NEJM$study$
Researchers$sent$sent$MRIs$of$98$"healthy"$backs$to$
various$doctors,$and$asked$them$to$diagnose$them.$$$
80%$of$the$MRI$interpreta)ons$came$back$with$disc$
hernia)ons$and$bulges.$$In$38%$of$the$pa)ents,$there$
was$involvement$of$more$than$one$disc.$$
Approximately$85%$of$lower$back$pain$cases$have$no$
deni)ve$diagnosis$
So$the$answer$to$the$trick$ques)on$is$
You re$probably$already$training$people$
around$disc$injuries!$
Most$just$aren t$symptoma)c$because$no$
nerves$are$being$impinged$(disc$issue$is$
stable).$
Adequate$func)on$of$the$ACTIVE$restraints$
protects$the$passive$restraints.$
How$do$we$prevent$disc$issues$
from$becoming$symptoma)c?$
More$Research$
Cappozzo$et$al.$found$that$squaqng$to$parallel$with$1.6$)mes$body$
weight$(what$I d$call$ average $for$an$ordinary$weekend$warrior$
who$liSs$recrea)onally)$led$to$compressive$loads$of$ten$)mes$body$
weight$at$L3TL4$(1).$$That s$7000N$for$a$guy$who$weighs$about$
about$150.$$
In$a$study$of$57$Olympic$liSers,$Cholewicki$et$al.$found$that$L4TL5$
compressive$loads$were$greater$than$17,000N$$
McGill:$The$spine$doesn t$buckle$un)l$12,000T15,000N$of$pressure$
is$applied$in$compression$(or$1,800T2,800N$in$shear)$$so$it$goes$
without$saying$that$we re$playing$with$re,$to$a$degree.$$
How$do$we$prevent$disc$issues$from$
becoming$symptoma)c?$
Deload$the$spine$
ReTeducate$clients$on$their$ neutral$spine $
Be$careful$with$early$morning$training$
Reduce$body$fat$
Lumbar$compensa)ons$
Makes$diagnos)c$imaging$easier!!!!$
Fix$asymmetries$
Avoid$lumbar$exion,$especially$with$rota)on$
and$compression,$by:$
Increasing$ankle$mobility$
Increasing$thoracic$spine$mobility$
Increasing$hip$mobility$
Stabilize$the$lumbar$spine$within$the$ROM$it$
already$has$
Hockey:$What$to$Expect$
Sports$Hernia$cases$
Femoroacetabular$impingement$(FAI)$
Hip$Labral$$issues$
Short,$dense,$bro)c,$ungodly$disgus)ng$
adductors$
Poor$hip$internal$rota)on$and$extension$
Poor$psoas$recruitment$
ExtensionTbased$back$issues,$history$of$groin/
lower$abdominal$pain,$hip$pain$
11/13/11
Sports$Hernia$Considera)ons$
Adductor$Longus$&$Rectus$Abdominus$Interac)on$at$
Adductor$Aponeurosis$on$Pubis$
Zone$of$Convergence$for$Adductor$Longus$(most$anterior$
of$adductors,$but$posterior$to$pec)neus)$
Omar$IM,$et$al.$Athle)c$pubalgia$and$"sports$hernia :$
op)mal$MR$imaging$technique$and$ndings.$
Radiographics.$2008$SepTOct;28(5):1415T38.$
Sports$Hernia$Training$Considera)ons$
Pain$is$your$guide!$
Most$unilateral$training$is$out.$
Everyone$can$s)ll$do$1Tleg$RDL,$1Tleg$hip$thrusts,$etc.$$
Some$can$do$stepTups.$
Overhead$pressing$AND$pulling$can$be$problema)c.$
Pronounced$axial$loading$should$be$avoided.$
Stay$away$from$an)Textension$core$work:$no$
rollouts,$overhead$medicine$ball$stomps,$uQers,$
fallouts,$etc.$Some$folks$will$even$have$issues$with$
prone$bridging$varia)ons.$
SoS$Tissue$Work$
Adductors$$
Hip$external$rotators$
Rectus$femoris$
IT$band$
TFL$
Vastus$lateralis$
Sports$Hernia$Considera)ons$
True$Antagonists$
RA:$posterior,$superior$force$T>$elevates$pubis$
AL:$anterior,$inferior$force$T>$depresses$pubis$
In$cadavers,$cuqng$the$RA$increases$anterior$)lt$and$pressure$
in$adductors.$
An$injury$to$one$of$these$tendons$predisposes$the$opposing$
tendon$to$injury$by$both$altering$the$biomechanics$and$
disrup)ng$the$anatomic$con)guity$of$the$tenoperiosteal$
origins.$In$turn,$such$disrup)on$leads$to$instability$of$the$
pubic$symphysis.$ $
Read$everything$you$can$from$Omar$IM,$Zoga$AC$et$al.$under$
athle)c$pubalgia. $
Sports$Hernia$Training$Considera)ons$
Rest!$
OSen$a$quick$return$to$
sports$w/out$addressing$
causa)ve$factors.$
Improve$hip$internal$
rota)on$and$extension.$
Ac)vate$glutes,$psoas,$
and$pelvic$oor$muscles$
Lavigne$M,$Parvizi$J,$Beck$M,$Siebenrock$KA,$Ganz$R,$Leunig$M.$Anterior$
femoroacetabular$impingement:$part$I.$Techniques$of$joint$preserving$
surgery.$Clin$Orthop$Relat$Res.$2004$Jan;(418):61T6.$
$
11/13/11
Is$a$Hip$Any$Dierent$Than$a$
Shoulder?$
FAI$Training$Considera)ons$
Anterior$scapular$)lt$=$anterior$pelvic$)lt$
Reac)ve$changes$to$acromion,$just$like$the$
femoral$head$and/or$acetabulum$
Where$do$we$see$FAI$the$most?$ExtensionT
rota)onTbased$sports:$hockey,$soccer,$
baseball$
A$lost$squat$paQern$in$a$9T12$yearTold$athlete$
is$a$big$concern,$in$my$eyes.$
Many$of$the$issues$are$similar$to$what$you$see$with$
sports$hernia$cases.$
DO$NOT$SQUAT$AN$ATHLETE$WITH$FAI!!!!!!$
Just$about$all$singleTleg$work$is$okay$$and$it s$
actually$very$benecial.$
Torn$labrum?$$Poor$hip$stability.$
Don t$overlook$associated$issues:$back$pain$
(especially$on$same$side),$sports$hernia,$labral$
pathologies$
Many$athletes$do$ne$w/out$the$surgery;$it$is$sportT$
and$posi)onTspecic.$
Anterior$Hip$Pain:$ Other $
Femoral$Anterior$Glide$Syndrome$
Consider$the$dierent$
femoral$aQachment$
points$of$the$glutes$and$
hamstrings$
Glutes$have$far$more$
control$over$the$femoral$
head.$
Working$around$ACL$rehabs$
Look$to$the$causes$
Hyperextension?$
Adduc)on/Internal$Rota)on?$
What$controls/decelerates$these$ac)ons?$
Related$Issues:$MCL?$$PCL?$$LCL?$$Meniscus?$
Dierent$reconstruc)on$strategies$
GraS$sites:$
Patellar$Tendon$
Hamstrings$
AllograS$(cadaver)$
Shirley$Sahrmann$
Anterior$capsule$irrita)on$can$occur$with$hip$
extension$if$there$isn t$adequate$femoral$
head$control$(posterior$pull)$during$hip$
extension.$
My$Experience$
The$Fastest$Recoveries$include:$
Manual$Therapy$
ROM$as$the$#1$indicator$
Build$strength$through$the$ROM$one$creates$
Training$the$uninjured$limb$extensively$
Loads$of$work$for$the$posterior$chain$as$hip$extensors$
Programming$is$a$pain$because$they$progress$so$
fast!$
Cyberne)c$periodiza)on$
11/13/11
Let s$Talk$Anterior$Knee$Pain$
Quad$dominant$vs.$Hip$dominant$squaqng$
It s$not$lateral$patellar$tracking;$it s$poor$
control$of$femoral$internal$rota)on!$
Posterior$Chain$Exercises!$
SingleTleg$classica)ons$
Sta)c$Supported/Unsupported$
Dynamic$Accelera)ve$and$Decelera)ve$
Training$the$Posterior$Chain$
DeadliS$varia)ons:$sumo,$conven)onal,$trap$
bar,$rack$pulls$
PullTThroughs$
KeQlebell$Swings$
Hip$Thrusts$
GluteTHam$Raises$
Ankle$Mobility?$$Hip$Mobility?$$Tissue$Quality?$
Sta)cs$
Supported$
Bulgarian$Split$Squats$
Split$Squats$
Unsupported$
1Tleg$squats$to$bench$(pistols)$
1Tleg$RDL$
1Tarm,$1Tleg$RDL$
Anterior$Knee$Pain:$Cueing$
Weight$on$heels$(pull$through$them)$
Ac)vate$glutes$and$hamstrings$
Drive$knee$over$liQle$toe$
Long$Stride$
Dynamics$
Accelera)ve$
Reverse$Lunges$
StepTups$
Decelera)ve$$most$stressful/advanced$
Forward$lunges$
Walking$lunges$
Ankle$Issues$
During$and$postTbracing,$dorsiexion$is$
limited.$
May$impair$everything$from$squaqng$to$
sprin)ng$
Load$unaected$leg$during$immobiliza)on$
period$
Reverse$Extensions$
Use$slideboard$reverse$lunges$as$progression$
back.$
11/13/11
Important$Takeaways$
Work$handTinThand$with$rehabilita)on$specialists$to$
formulate$an$appropriate$returnTtoTac)on$plan$
Remember$that$dierent$shoulder$condi)ons$
mandate$dierent$training$modica)ons$
Understanding$the$causes,$symptoms,$and$
exacerba)ng$exercises$for$each$condi)on$not$only$
makes$it$easier$to$recover$from$the$problem,$but$to$
prevent$its$recurrence.$
11/13/11$
Understanding$and$Controlling$
Extension$in$Athletes$
Eric$Cressey,$MA,$CSCS$
Founder/President$$Cressey$Performance$
www.CresseyPerformance.com$
www.EricCressey.com$
$
OverreacEon/UnderreacEon$
Alwyn$Cosgrove:$Bring$the$Pendulum$Back$to$
Center$
For$a$long$Eme,$we$didnt$think$the$core$was$
important.$
Then$we$overfocused$and$did$thousands$of$
sitLups$and$crunches$and$made$people$worse.$
Now$we$are$deathly$afraid$of$moving$a$spine$
through$exion$or$extension.$
Is$Flexion$the$Devil?$
Flexion$$$$Extension$
What$to$Visualize$
Anterior$Pelvic$Tilt$and$
Increased$LordoEc$Curve$
Anterior$Weight$Bearing$
PRI:$Diminished$Zone$of$
ApposiEon$
Altered$diaphragm$funcEon$
Supplemental$respiratory$
muscles$must$pick$up$the$slack$
Lean$guys$look$fat$secondary$to$
anterior$pelvic$Elt$
Maybe$in$desk$jockeys$
Actually,$the$devil$is$in$the$details.$
Flexion$to$neutral$is$much$dierent$than$
exion$from$neutral.$
Most$young$athletes$live$in$extension$(and$
rotaEon).$
FuncEonal$Anatomy$
Janda:$Lower$Crossed$Syndrome$
Many$think$it$is$just$an$X,$but$in$reality,$
there$are$many$checks$and$balances$within$
that$X.$
Examples;$Glute$Max/Hamstrings,$Glute$Max/
Adductor$Magnus,$External$Obliques/Rectus$
Abdominus$
1$
11/13/11$
PotenEal$Injuries$
Achilles$tendinosis/rupture,$anterior$knee$
pain,$proximal$hamstrings$tendinosis,$
hamstrings$strain,$hip$exor$strain,$anterior$
hip$irritaEon,$femoroacetabular$impingement,$
sports$hernia,$lumbar$stress$fracture,$lumbar$
erector$or$QL$strain,$etc.$
And$thats$just$the$lowerLbody$and$core!$
The$Big$Players:$LaEssimus$Dorsi$
Limit$shoulder$exion,$along$
with$long$head$of$triceps$
Lats$internally$rotate$the$
shoulder$$which$is$one$more$
reason$many$athletes$cant$
externally$rotate$the$shoulder$
w/out$lumbar$extension$
Dr.$Luke$Oh:$47%$of$elbow$
pain$cases$present$with$
subluxaEng$medial$triceps$
(snapping$elbow)$
The$Big$Players:$Lumbar$Erectors$
Where$is$the$hypertrophy?$
Lumbar$vs.$Thoracic$Erectors$
The$Big$Players:$LaEssimus$Dorsi$
Many$aiachments$
make$it$a$powerful$
extensor$
Moving$the$enEre$
spine$vs.$moving$the$
scapula$on$the$rib$cage$
Less$direct$control$
over$tLspine$
The$Big$Players:$Hip$Flexors$
Short?$
SE?$
TFL?$Rectus$Femoris?$
Psoas?$
Thomas$Test$
The$Big$Players:$Hamstrings$
Why$can$hamstrings$be$Eght?$
Previous$injury$
Shortness$
Neural$tension$
SEness:$ProtecEve$tension$
Hamstrings$posterior$Elt$the$pelvis;$they$may$
be$the$only$thing$prevenEng$debilitaEng$
extensionLbased$back$pain.$
2$
11/13/11$
The$Big$Players:$Plantarexors$
Constantly$on$
because$of$anterior$
weight$bearing$
Lack$dorsiexion$
Lose$the$squat$
paiern$
Can$only$squat$with$
heel$lim$(dorsiexion$to$
neutral)$
The$Law$of$RepeEEve$MoEon$
I(=(NF/AR(
I$=$Insult/Injury$to$the$Essues(
N$=$Number$of$repeEEons(
F$=$Force$or$tension$of$each$repeEEon$as$a$
percent$of$maximum$muscle$strength(
A$=$Amplitude$of$each$repeEEon(
R$=$RelaxaEon$Eme$between$repeEEons$
(lack$of$pressure$or$tension$on$the$Essue)$
So$we$just$need$to$stretch,$right?$
What$does$stretching$really$do?$$Do$we$even$
know$what$were$really$stretching?$
Weingro:$Get$Long,$Get$Strong,$Train$Hard.$
Get$Long:$Foam$Rolling,$Manual$Therapy,$
Dynamic$Flexibility,$Yoga,$Pilates,$PRI,$DNS,$
AIS,$MAT,$ASAP,$QRSTUV,$or$whatever$other$
acronym$you$prefer.$
Sahrmann:$more$about$creaEng$sEness$than$
stretching.$
The$Law$of$RepeEEve$MoEon$
I(=(NF/AR(
Why$is$it$so$challenging$to$change$lowerL
body$posture$and$anterior$pelvic$Elt?$
Standing$and$sipng$are$constant$N.$
There$is$no$R.$
Many$athletes$compete$at$extremely$high$
levels$with$raging$anterior$pelvic$Elt$and$
lordosis:$F.$
The$Big$Players:$Gluteus$Maximus$
AcEve$in$all$three$planes$
External$Rotator,$Abductor,$
Extensor$
Controls$Internal$RotaEon,$
AdducEon,$Flexion$
AnELPronator$
Bridging$!$Wall$March$
!Bowler$Squats$
!Strength$Training$
The$Big$Players:$External$Obliques$
Consider$points$of$
aiachment$as$compared$
to$rectus$abdominus$
Posteriorly$Elts$pelvis$w/
out$increasing$kyphosis$
Reverse$Crunch$
Progressions$and$
Regressions$
3$
11/13/11$
The$Big$Players:$Dorsiexors$
DB$Dorsiexion$
Band$Dorsiexion$
The$Big$Players:$Serratus$Anterior$
Serratus$anterior$is$more$acEve$at$greater$
angles$of$humeral$elevaEon,$which$isnt$
possible$with$limited$shoulder$exion$
secondary$to$restricEons$in$lat,$long$head$of$
triceps,$etc.$
Forearm$Wall$Slides$
Forearm$Wall$Slides$w/Band$
FeetLElevated$PushLup$VariaEons$
Scap$PushLups/PushLup$Plus?$
The$Big$Players:$Deep$Neck$Flexors$
Teach$the$Packed$Neck!!!$
Supine$Chin$Tucks$!$Standing$Chin$Tucks$
!$Quadruped$Chin$Tucks$
The$Big$Players:$Lower$Trapezius$
Works$w/serratus$anterior$and$upper$
trapezius$to$upwardly$rotate$the$scapula$
Prone$1Larm$Trap$Raise$o$Table$$
Forearm$Wall$Slides$at$135$degrees$
Remember$that$scapular$posiEoning$is$heavily$
inuenced$by$thoracic$spine$rotaEon$
The$Big$Players:$Posterior$Rotator$Cu$
Prone$External$RotaEon,$(Manual)$SideLLying$
External$RotaEon$$arm$abducted$30$degrees$
HalfLKneeling$(Manual/Cable)$External$
RotaEons$at$90$degrees$$scapular$plane$
Standing$(Manual/Cable)$External$RotaEons$at$
90$degrees$$scapular$plane$
Overlooked$Paierns$to$Regain$
Deep$Squat$
Deep$Squat$Belly$Breathing$w/Lat$Stretch$
TRX$Squats$
Goblet$Squats$
SingleLleg$Control$
SideLLying$Clam$!$Bowler$Squats$
Symmetrical$Loading$SingleLleg$Exercises$
OLSet$Load$SingleLleg$Exercises$
SingleLleg$Exercises$w/Raised$COG$
Full$Shoulder$Flexion$
Som$Tissue:$Rolling$and$Manual$Therapy$
SideLLying$InternalLExternal$RotaEon$
Forearm$Wall$Slides,$Overhead$Shrugs?$
Overhead$Carries$&$StabilizaEons$
4$
11/13/11$
Overlooked$Paierns$to$Regain$
Full$Shoulder$Flexion$
Som$Tissue:$Rolling$and$Manual$Therapy$
SideLLying$InternalLExternal$RotaEon$
Forearm$Wall$Slides,$Overhead$Shrugs?$
Overhead$Carries$&$StabilizaEons$
NonLRectusLDominant$Bridging$
Rotary$Stability$w/out$Extension$
A$Typical$Week$
Day$1:$AnELRotaEon$Drill,$Reverse$Crunch,$
Prone$Bridge$VariaEon$
Day$2:$AnELExtension$Drill,$Side$Bridge$
Day$3:$$AnELRotaEon$Drill,$Reverse$crunch,$
Prone$Bridge$VariaEon$
Day$4:$AnELExtension$Drill,$Side$bridge$
Also$mix$in:$GetLup$VariaEons$
Above$all$else:$change$the$way$athletes/
clients$live!$
5$
Assessing'Core'Movement'Quality!
MikeReinold.com-
Introduction*
!
1. Purpose!of!our!assessment!is!two!fold:!
a. Rule!out!pathology!
b. Find!our!starting!point!for!exercise!
2. Combination!of!several!components!
a. Posture!
b. Isolated!core!movements!
c. Integrated!functional!movements!
3. Provocative!tests,!myotomes,!dermatomes,!reflexes!
4. Standard!clearing!of!joints,!muscle!imbalances,!and!mobility!deficiencies!
should!also!be!performed!
!
Provocative*Screening*
!
1. Determine!if!beginning!exercise!is!safe!
2. 4!red!flag!questions!you!should!ask!every!person:!
a. Have!you!had!a!recent!traumatic!event?!
b. Do!you!have!any!numbness,!tingling,!burning,!or!weakness!in!your!
legs?!
c. Have!you!had!any!recent!episodes!of!illness,!fever,!chills,!or!night!
sweats?!
d. Do!you!have!any!issues!with!your!bowel!or!bladder?!
3. Provocative!tests!
a. Heel!drop!test!
i. Assesses!end!plate!fractures!
b. Seated!compression!test!
i. Assesses!compression!intolerance!with!poor!posture!
c. Prone!and!standing!extension!test! !
i. Assesses!the!facets,!pars,!lamina,!nerve!root,!anterior!disc!
d. Prone!instability!test!
i. Assesses!shear!instability!
4. Neural!tests!
a. Slump!
b. Straight!leg!raise!
Assessing!Core!Movement!Quality! 2&
[Type&the&document&title]&
Posture*
!
1. Standing!posture!most!commonly!observed!
2. Will!learn!a!lot!about!the!persons!deficiencies!
3. Goal!is!to!identify!areas!of!muscle!imbalance!and!mobility!deficiencies!that!
will!impact!core!movement!quality!
Integrated*Functional*Movements*
!
1. Start!with!functional!movement!pattern!assessment!!start!with!the!large!
pictures!
2. Likely!a!combination!of!mobility,!strength,!and!stability!deficits!
3. We!are!masters!of!compensation!
4. Can!assess!basic!functional!movements!or!progress!to!advanced!
a. Balance!
b. Activities!of!daily!living!and!transitions!
c. Functional!movement!screen!
5. Balance!
a. Standing!stork!stance!
b. Add!eyes!closed!
c. Add!perturbations!
6. Activities!of!daily!living!and!transitions!
a. Sitting!!!raising!from!chair!
b. Bending!forward!
c. Rolling!
d. Laying!down!!!sitting!
e. Walking!
7. Functional!movement!screen!
!
Isolated*Core*Movements*
!
1. Initially!more!important!than!functional!movements!
2. Functional!movements!require!mobility,!strength,!and!stability!
3. Impairments!in!isolated!core!movements!will!not!allow!proper!integrated!
functional!movements!
4. Stepping!stone!to!integrated!functional!movements!
5. Should!be!qualitative!and!quantitative!
a. Stability!and!endurance!
!*
*
*
*
Assessing!Core!Movement!Quality! 3&
[Type&the&document&title]&
Hip*Assessment*
!
1.
2.
3.
4.
5.
Janda!hip!extension!test!
Janda!hip!abduction!test!
Janda!trunk!curl!up!test!
Active!straight!leg!raise!
Standing!hip!flexion!test!
Qualitative*Core*Assessment*
!
1. Similar!to!the!exercise!progressions!
2. Break!down!into!core!quadrants!
a. Anterior!
b. Posterior!
c. Lateral!
d. Rotary!
3. Start!with!simple!variations!of!exercise!
a. Progressive!multi]phase!approach!
4. When!form!diminishes,!test!is!complete,!exercises!begin!with!previous!phase!
Quantitative*Core*Assessment*
!
1. Endurance!testing!of!the!four!quadrants!
2. Timed!tests!of!each!quadrant!
3. Overall!time!and!ratios!important!
a. Side!plank!
b. Curl!up!
c. Back!extension!
d. Anti]rotation!iso]hold!
4. A!few!things!about!the!data!
a. Endurance!decreases!with!age!
b. Females!tend!to!have!better!extensor!endurance!(body!weight?)!but!
poorer!side!plank!endurance!(strength?)!
c. Right!side!plank!tends!to!be!a!little!weaker!
5. Ratios!are!important!
a. Those!with!history!of!back!pain!usually!have!diminished!extensor!
endurance!or!imbalances!of!side!bend!side!to!side!
!
Ratio!
Flexion/Extension!
RSB/LSB!
SB/Extension!
!
!*
*
Normal!
0.70]0.85!
0.96]1.05!
0.40]0.60!
*
*
Dynamic(Core(Performance(Progression!
MikeReinold.com-
!
General!Progression!
!
!
1. Neutral,!Brace,!Breathe!
2. Each!exercise!group!follows!the!same!progression!
Stable!!!Perturbation!!!Unstable!!!Perturbation!
!
3. Exercise!progression!is!a!blend!of!levels!
Phase!1!stable!!!
!
!
4. Build!endurance!through!repetitions,!not!time!
5. Transition!from!reps!to!breathes!
6. Can!add!weight!to!extremities!
!
Neutral!Spine!&!Bracing!
!
1. Supine!
2. Quadruped!
3. Standing!
!
Dynamic!Core!Performance!Progression! 2(
Anterior!Chain!Progressions!
!
Curl!up!
1. Stable!surface!
2. Unstable!surface!
3. Perturbations!
!
Dead!bug!
1.
2.
3.
4.
5.
6.
7.
Stable!surface!
Single!or!single!leg!
Double!arm!
Double!arm!hold,!single!leg!
Alternating!arm!and!leg!
Unstable!surface!
Perturbations!
!
Front!plank!
1. Stable!wall!!!Table!!!knees!!!feet!
2. Unstable!surface!
3. Perturbations!!
Anti=extension!roll!outs!
!
1. Swiss!ball!
2. TRX!
Anti=extension!iso=holds!
1.
2.
3.
4.
Bilateral!
Unilateral!
Unstable!surface!
Perturbations!
Anti=extension!medicine!ball!throws!
1. Chest!pass!
2. Overhead!soccer!
!
!
!
!
Posterior!Chain!Progressions!
!
Bridge!
1.
2.
3.
4.
Stable,!two!leg!
One!leg!
Perturbations!
Unstable!surface!
!
!
Bird!dog!
1.
2.
3.
4.
Single!extremity!!clocks!
Alternating!arm!and!leg!
Unilateral!arm!and!leg!
Perturbations!
!
Anti=extension!iso=holds!
1.
2.
3.
4.
5.
!
!
Prone!ball!roll!outs!
Standing!two!arms!
One!arm!
Unstable!surface!
Perturbations!!
!
!
Lateral!Chain!Progressions!
!
Side!plank!
1.
2.
3.
4.
5.
6.
TRX!Rip!Trainer!
Table!
Knees!
Feet!
Perturbations!
Unstable!surface!
!
!
Rotary!Chain!Progressions!
!
Anti=rotation!iso=holds!
1.
2.
3.
4.
Tall!kneeling!
Standing!
Perturbations!
End!range!of!motion!
!
Front!plank!to!side!plank!progression!
1. Wall!!!table!!!ground!
2. Holds!
3. Turns!
Chop!&!lift!
1. Half!kneel!
2. Tall!kneel!
!
!
!
!
11/13/11$
Lab:$Understanding$and$
Controlling$Extension$in$Athletes$
Coaching$Prone$Bridging$
Glutes$Bght$
Anterior$core$engaged$
Chin$tucked:$stare$at$sts$
Watch$for$hump$(rectus$dominance)$
UBlize$dowel$rod,$if$necessary$
Stability$Ball$Rollouts$
Glutes$engaged$
Chin$Tucked$
IniBate$with$hips$and$hands$simultaneously$
Body$should$be$a$straight$line$
Nose$to$ball$
Shoulder$exion,$not$lumbar$extension!$
1$
11/13/11$
TRX$Fallouts/FluXers$
Virtually$idenBcal$cues$as$with$stability$ball$
rollouts,$but$more$challenging.$
The$lower$the$handles,$the$greater$the$
diculty.$
Reverse$Crunch$
Progressions$and$Regressions$
Simplied:$avoid$anterior$Blt$and$forward$
head$posture$
Heavier$counterbalance$overhead$=$easier$
movement$
Knees$to$elbows$
Once$load$is$as$light$as$it$can$be,$progress$to$
feet$to$oor$w/out$losing$proximity$to$glutes.$
SideaLying$InternalaExternal$RotaBon$
Improves$length$of$pec$major$and$minor,$lats,$
and$long$head$of$triceps$
Opposite$hand$up$
Head$resBng$on$oor$
Dont$allow$working$arm$to$drie$forward$
May$be$best$preceded$by$sidealying$windmill$
(greater$taspine$mobility$allows$for$greater$
glenohumeral$mobility)$
2$
11/13/11$
Lower$Trap$Progressions$
Prone$1aarm$Trap$Raise$(and$External$RotaBon)$$glute$
acBvaBon,$chin$tucked,$core$braced$
Forearm$Wall$Slides$(w/band)$
Forearm$Wall$Slides$at$135$degrees$(matches$line$of$
pull$of$lower$traps)$
Allowing$shrugging$is$okay$if$someone$is$stuck$in$
downward$rotaBon$(very$downsloped$shoulders).$
Regardless:$acBvate$glutes,$lock$rib$cage$to$pelvis$(no$
lumbar$extension)$and$avoid$forward$head$posture$
Make$the$shoulder$blades$move$on$the$rib$cage!$
3$
11/13/11$
Lab:$Advanced$Stability:$$
Training$Power$Outside$the$Sagi>al$Plane$
Pairing$#1$
$A1)$RotaFonal$Med$Ball$Scoop$Toss$
A2)$Glute$Wall$March$Iso$Holds$
B1)$Overhead$Med$Ball$Stomp$to$Floor$
B2)$Hips$High$Hand$Switches$
$
Pairing$#2$
$A1)$RotaFonal$Med$Ball$Shotput$
A2)$SplitPStance$Kneeling$Adductor$Mobs$$
B1)$Recoiled$Rollover$Stomps$to$Floor$
B2)$Supine$Bridge$w/Reach$
$
1$
11/13/11$
Pairing$#3$
$A1)$StepPBack$RotaFonal$Scoop$Toss$
A2)$Yoga$Plex$
B1)$SplitPStance$Overhead$Throw$to$Wall$
B2)$Seated$Scapular$Wall$Slides$
$
Pairing$#4$
$A1)$Figure$8$Med$Ball$Shotput$
A2)$Table$90/90$Stretch$w/TPSpine$RotaFon$
B1)$SplitPStance$StandPup$Stomp$
B2)$HalfPKneeling$Adductor$Dips$
$
Pairing$#5$
$A1)$Recoiled$Med$Ball$Shotput$
A2)$Adductor$Rolling$on$Box$
B1)$Overhead$Sledgehammer$Swings$to$Tire$
B2)$Hips$Flexed$Hip$Rocking$
$
2$
11/13/11$
Pairing$#6$
$A1)$HotPFeet$Recoiled$Shotput$
A2)$Squat$to$Stand$w/Diagonal$Reach$
B1)$Recoiled$Rollover$Throws$to$Wall$
B2)$TPPushPups$
$
Pairing$#7$
$A1)$StepPBehind$RotaFonal$Med$Ball$Shotput$$
A2)$Wall$Hip$Flexor$MobilizaFons$
B1)$Crow$Hop$to$Overhead$Med$Ball$Throw$
B2)$Bowler$Squats$
$
3$

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