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My regular readers will know that I’m a big fan of assessing my clients so today’s post will come as a little bit of a treat to geeks like me.

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Next week industry experts Mike Robertson, Eric Cressey, BJ Gaddour, and Dave Schmitz are going to be launching a virtual mentorship program for trainers and coaches.  As a teaser they’ve released a video to show a sample of the type of content they’ll be providing.  It is literally a 37 minute information packed staff training talk given by Eric Cressey on lower body assessment filmed live at Cressey performance.  I just finished watching it and thought it was excellent.

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I really liked the fact that Eric discussed the need to use both general AND specific assessments and he’s goes to great lengths to cover almost every lower body assessment you might need.  He also talks about the several possible reasons for the  failure of various tests like the Thomas test and the active straight leg raise and what each of these mean with respect to programming.

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If you want to watch the video for free you can check it out HERE.

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I should say that you’re going to need to enter your email to acquire access to the video, but I think the video is worth it.  The audio is also a little difficult to hear in some parts due to some background noise so I’d recommend using earphones or turning up the sound a little bit to hear it clearly.  I’m actually going to shoot them a note to see if this can be improved in the future for the mentorship program by having the presenters wear microphones.  Regardless, the video is totally worth checking out.

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Complete Lower Body Assessment Video by Eric Cressey

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In addition to this video, a former intern at Cressey Performance named Eric Oetter has written a great guest blog post HERE on one further test that wasn’t covered in the video.  Combined, I think the information here is very valuable and you should definitely check it out.

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Enjoy!

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First off, I really want to thank everyone who purchased, promoted, or even just endured the launch of my product How to Read Fitness Research last week.  I think it went really well and I’m happy to have created such a much needed product in this field.  This week, we’ll be back to some regularly scheduled (non-promotional) content. 

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However, as part of the launch last week, my colleague (and super smart guy) Mike Reinold shared some content that I thought would be very useful so I decided to share it here as well for those who don’t follow his blog. 

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Basically, in last week’s post where I shared a video I talked about subscribing to the electronic table of contents of various journals to stay on top of the most current research.  And in my product I list the journals that I think every fitness professional or serious exercise enthusiast should follow.

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But Mike took it one step further and shared some journals that he thinks would also be valuable to those with more of a rehabilitative focus.  I figured I’d present those here so you didn’t miss them.

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Here they are…straight from Mike’s post:

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• JOSPT – Journal of Orthopedic Sports and Physical Therapy – the cream of the crop for ortho and sports PT journals.  Pretty technical but still quality.  The best reason to join the APTA and sports or ortho sections.
• AJSM – American Journal of Sports Medicine – another elite journal, geared more towards ortho and sports physicians and surgeons and a gold mine of information for us too.
• Sports Health – A fairly new journal designed for us all – docs, PT’s, ATC’s, fitnes specialists, etc. A little less technical (which is often good), but great.
• JAT – Journal of Athletic Training – Official journal of the NATA and always has some good content.  Similar to JOSPT, likely the best benefit of joining the NATA.
• JBMT – Journal of Bodywork and Movement Therapies – For those of us that enjoy different approaches, manual therapy, and expanding outside of the typical American thought process.  Edited by Leon Chaitow, you’ll enjoy the content.  As a side note, I believe that this is where Tom Myer’s Anatomy Trains concept really took a jump start.

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So if you’re interested in rehab and you want to get a jumpstart on the competition by reading some research…these journals would be a great place to start!

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As I mentioned in my product review on Monday, my good friend (and fellow Canadian) Rick Kaselj is releasing his Effective Rotator Cuff Exercises program at a 20% discount until Friday of this week.  Today I asked Rick to fill in some of the missing steps most fitness professionals and their clients make when attempting to rehabilitate a rotator cuff injury.  Check it out.

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Mark asked me to send in some details when it comes to what I do when a client comes to see me with a rotator cuff injury.

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Often times the client has gone to their doctor, got a diagnosis, and got clearance to start an exercise program dedicated to their rotator cuff.  Then they come to see me to determine what they can do in order to overcome their rotator cuff injury.

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These are some of the missing steps that I often see other trainers, coaches and therapists make with their rotator cuff injury clients.

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#1 – Strength is Important but…

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Most times my clients have gone on the internet and downloaded some exercises to do when it comes to their rotator cuff.  They are often strengthening exercises.

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You know, the typical type of rotator cuff exercises you see people doing in the gym.  The client had the right idea but it is too bad that those exercises alone are not that effective in fully overcoming a rotator cuff injury.

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Strength is important but there is so much more than just strength when it comes to overcoming a rotator cuff injury

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#2 – Work on Range of Motion

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If you don’t have fun range of motion with your rotator cuff, work on it.

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Having full range of motion of your rotator cuff, shows your brain that it is okay for you to move your shoulder through full range of motion and that you are not going to re-injure yourself if you do.  This decreases guarding in the shoulder, improves movement and speeds up recovery.

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A lot of time people just focus on movements to shoulder height.  It is important to work on strengthening the rotator cuff against gravity through the full range of motion especially overhead.  Often people avoid doing anything overhead and it leads to the cycle of loss of muscle bulk, loss of strength, loss of endurance, loss of activation and loss of range of motion.

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Remember, the most important part of the shoulder range of motion is the last 10 to 20 degrees in both flexion and abduction.  If you are missing this, there is a good reason why.  It probably means you need to work on the next part.

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#3 – Do Some Isometics

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I know, they aren’t cool but if you believe in rhythmic stabilization or oscillation training, then the step before is isometrics.

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I find a lot of the general public clients need this when it comes to their rotator cuff exercise program.

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When they master isometrics it is off to rhythmic stabilization or oscillation training but most time people stopping doing isometrics too soon or jump to the advanced exercises before their rotator cuff injury is ready for it.

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#4 – Get Away From Planes of Movement

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Most shoulder exercises evolved out of body building and follow planes of movement (front raises / sagittal plane, lateral raises / frontal plane, rotation/ transverse plane).  Start mixing it up.

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Get away from planes of movement and start mixing all of them up.  You can do this with tubing, dumbbells, pulleys, kettle bells, or any kind of resistance.

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Who is this Rick Kaselj Guy?

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Rick Kaselj is a personal trainer that focuses on helping clients overcome their injuries.  Rick’s specialization is the shoulder and he did his Masters’ degree project on designing effective exercises for the rotator cuff.  He shares with rotator cuff injury suffers and fitness professionals what he has learned in school and from his client’s and has put it all into the Effective Rotator Cuff Exercise Program.

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I think that is it.  If you have any questions, just let me know and leave a comment below and I will answer it.

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Thanks for reading and thanks for the opportunity to share, Mark.

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Rick Kaselj, MS

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Okay…it’s Mark again… 

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Also remember that if you purchase Effective Rotator Cuff Exercises before the end of day this Friday I’ll shoot you a short 3 minute video detailing a trick I use to instantly increase client strength and range of motion in their shoulders. 

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Effective Rotator Cuff Exercises <—- Go Get It!

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Guest blog by Rick Kaselj

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In the last blog post, I talked about a common muscle imbalance that I see in the lower body.  Now I want to go through an exercise I use to address this problem.

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EXERCISE: Wide Knees Side to Side

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Purpose:

To improve internal and external rotation of the hip with dynamic movement.  The primary focus of the exercise is on improving the length of the internal rotation of the hip.

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Starting Position:

Lying on you back with your knees bent and your feet hip width apart.

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Start

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End

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How to Do the Exercise:

1.  Drop you knees to one side until you feel light resistance.

2.  Hold this end position for a second and drop the knees to the other side until you feel light resistance.

3.  Perform 5 times on each side.

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Progressions:

- Perform the exercises at different range of motions of hip abduction.  Begin with 0 degrees and progress to 15, 30 and 45 degrees of hip abduction on both sides.

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You can see me talk more about this exercise and go through the exercise in this video:

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Contraindication & Common Mistakes:

- Focus on breathing that leads to greater relaxation of the body.

- Visualize the area that you are stretching and imagine it loosening up.

- Movement is slow and controlled.

- You are looking for a light stretch, not trying to rip apart the muscle.

- The primary movement is in the rotation of the hips and minimal movement in the lumbar spine.

- Those with hip replacements should not do this exercise.

- Those with sacroiliac joint dysfunction should be cautious of this exercises as it may mobilize the SI joint and lead to irritation.

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I do this one exercise and I am cured?

It is a little more than that.  I find this exercise is a part of the solution.  Other things that I will do is activation of the frontal plane stabilizers of the hip and self massage of the structures around the hip.  This often times will set people on the right track to recovery.

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I enjoyed sharing and I hope you enjoyed the blog posts.  If you have any questions, just comment below and I will answer your questions.

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Take care and thanks, Mark.

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Rick Kaselj, MS

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Rick Kaselj is a personal trainer that focuses on helping his clients overcome injuries using exercise.  He shares his tips and tricks with trainers, coaches and therapists in his Muscle Imbalances Revealed Program.

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And speaking of the Muscle Imbalances Revealed program, thank you to everyone for your comments!  It is great to see so many readers coming out of the woodwork.  I’ve just awarded the FREE copy of MIR 2.0 to Harry Fisher who commented on the original giveaway post.  However, if you’re still interested in a copy of Muscle Imbalance’s Revealed, just remember that it is only on sale until midnight tonight (Friday).  After that the price jumps by $50 so make sure you pick it up HERE.

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Have a great weekend!

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As you probably know, my friend Rick Kaselj is giving away a copy of Muscle Imbalances Revealed 2.0 and you only have a few more hours to drop a comment HERE to score your copy for free.  In the meantime, here is a great post from Rick himself looking at hip internal rotation deficits and tomorrow I’ll throw up a post on how to correct them.

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The Problem

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It is difficult to find anyone that does not have any kind of muscle imbalance, especially in the lower body.

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I look at muscle imbalance being very similar to parachute.  When you jump out of a plane and pull your parachute, you want the parachute to be balanced.  You want it to move straight compared to hooking in one direction.  If one of the straps of the parachute is tight, it will affect your balance, pull you in the wrong direction and you may end up on the freeway.  If one of the straps is too relaxed, you will move away from that side and could end up hung up on a telephone line.

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The body is very much the same.  Muscle can become over/under active or over/under used.   This all leads to potential inefficient movement, poor performance, increase risk of injuries and slower recovery.  Now that we have landed from our parachute ride, lets look at the lower body.

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Looking at the lower body, the area that I look at when it comes to muscle imbalances is the hip.  Specifically the internal and external rotation of the hip.  The most obvious thing we can look at in the hip is the muscles involved in external and internal rotation so let’s start there.

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External rotators of the hip (lateral rotators):

Gemellus superior

Gemellus inferior

Obturator internus

Obturator externus

Quadratus femoris

Piriformis

Gluteus maximus

Sartorius

Gluteus medius, posterior fibers

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Now the internal rotators of the hip (medial rotation):

Tensor fasciae latae

Gluteus medius

Gluteus minimus, anterior fibers

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(Yes, we can argue about the list above on what muscle should be added and not be added to the list but really will this help out our clients or our ego?)

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The most common issue we will see in most people is normal external rotation (45 degrees) range of motion and a decrease in internal rotation (less than 45 degrees).

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Geraci commented about this in runners:

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“These functional biomechanical deficits would lead to inadequate internal rotation of the tibia and femur and result in inhibition or decreased recruitment of the gluteal muscles, in particular the gluteus medius. Restoring pronation throughout the lower extremity would require joint play techniques or functional joint mobilizations for the foot and ankle.”

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Lets make it simple though.  What will often be seen is a decrease in internal rotation at the hip (shortened hip external rotator) due to poor movement in the ankle and poor stability at the hip.  Most times what trainers, coaches and therapist will do is just address the frontal stability (side-to-side) stability of the pelvis but it is also important to address the mobility in the ankle and decrease range of motion of the internal rotators of the hip.

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There has been a lot of discussion when it comes to ankle mobility but I will go through an exercise that I do that address the internal rotation of the hip.  I will have it for you in the next blog post tomorrow.

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Until then.

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Rick Kaselj, MS

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Rick Kaselj is a personal trainer that focuses on helping his clients overcome injuries using exercise.  He shares his tips and tricks with trainers, coaches and therapists in his Muscle Imbalances Revealed Program.

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Reference – Geraci MC Jr, Brown W. (2005). Evidence-based treatment of hip and pelvic injuries in runners. Phys Med Rehabil Clin N Am. 2005 Aug;16(3):711-47.

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