Breathing for Pain Relief

Breathing for Pain Relief

As I pointed out in earlier articles, chronic decreases in carbon dioxide (hyperventilation) can lead to muscle fatigue, which could then increase the prevalence of muscle spasms and trigger points. Inflammation from various causes, coupled with moderate increases in tissue pH can induce more sensitization than inflammatory processes alone.1 Decreasing levels of co2 can also cause restlessness, tension, and other changes in muscle tension and activation.

Along these same lines, breathing abnormalities could be causing certain motor units (muscles) to remain in constant tension (even if it’s not perceivable until its a full-fledged trigger point and starts referring pain). Whether trigger points are developed due to ischemia, constant stimulation leading to muscle fatigue, or were already present and changes in pH just increase sensitivity to pain signals, moderate hyperventilation’s role in these processes could make it a top suspect in the chronic pain mystery. Also, anxiety often causes increased respiration and hyperventilation, which then stimulates the sympathetic nervous system to cause more anxiety (and the cycle repeats).

With all that being said, clinically, a treatment plan that highlights breathing mechanics and education could be used as a more holistic supplement to manual therapy, postural restoration (which some lump breathing mechanics in with), modalities, and restorative therapeutic exercises.

Next, let’s take a closer look at the female population…

The ratio of women to men who are affected by breathing pattern problems is between 2:1-7:1, and usually it’s a subtle, undetected, chronic issue rather than an acute one.

Hormone levels likely play into this statistic. Progesterone is known to increase breathing rate, and as such, women experiencing the hormone influx of the maternity cycle could be at a higher risk of blowing off excess co2 and reaching level of hyperventilation.

Many manual therapists have implemented deep breathing with their treatment, which makes sense, since this stimulates the parasympathetic nervous system, decreasing muscular tone. But the effect may be further reaching than that. If patients could be taught basic breathing exercises, they could become more aware of their breathing rhythm and essentially decrease the factors contributing to chronic pain and dysfunction. 

Breathing retraining focused on breathing rate and mechanics can decrease respiratory alkalosis (basic pH within the body). This in turn could decrease the symptoms of anxiety, trigger point development, and chronic pain, while simultaneously increasing neurological and neuromuscular function, along with postural control.

So how to we start this journey of better breathing mechanics? Stay tuned for some drills and ideas to maximize your breathing efficiency, and decrease the negative effects of hyperventilation and faulty breathing patterns on your performance and life.

Here’s Quinn Henoch, to step you through some breathing basics.

Tyler

CSCS SPT

Owner Pathology Apparel

Resources:

Handwerker H, Reeh P. Pain and Inflammation. Proceedings V1th World Congress on Pain. Pain Research and Clinical Management. Amsterdam: Elsevier; 1991:59-70.

Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004;7(1):33-40.

 

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Breathing and Baseball Performance

Breathing and Baseball Performance

“Clear the Mechanism”

Baseball Photo Of Tyler Hitting for the Breathing and Performance Article

Controlling breathing and anxiety during competition could be much more important than just staying focused. It could actually impact the way you perceive the game and perform. The last thing that a hitter needs is decreased efficiency of the cns (the master board that controls all muscle control and timing). They are already being challenged to react in milliseconds, then deliver a clean, accurate, and powerful swing path to meet a baseball that’s changing planes.

Personally, a lot of the adaptation process to the “next level” of division 1 baseball from high school, was learning how to “slow the game down” again.

When the game gets faster (faster players, more velocity, better bat speed), it’s your natural response as a player to tighten up. Part of that involves rapid breathing. I’ve had so many players, coaches, and kids mention to me at some point that the pro’s look like they aren’t even trying. There’s an element of smoothness and swagger that’s tough to imitate, and it comes from a whole lot of God-given talent, yes, but also from being able to manage their emotions, thoughts, and movements, in order to apply the work they’ve put into their craft. Baseball involves speed. Quick decisions, and even faster reflexes often define the good vs. the great, and often the difference can be attributed to who is the better master over themselves. Sports like gymnastics are no different. No Olympic athlete skimps out on preparation, so the great divider is often who can maintain their composure, and master their mental approach (which is the category that breathing can attribute to) to perform exactly as they have practiced.

Looking back on my career, I can honestly say that moments when I was at my best, there was a moment of calm, where I was completely aware and locked into the moment. Some call it tunnel vision. But for each of those moments later in my career, I can also remember my first year fighting for a spot on the team, where I was overwhelmed and intimidated (for the first time in my baseball career). This is part of the reason why underclassmen often struggle making that leap. The game speeds up, and psychologically and physiologically, it can be tough for them to reign it all back in to something manageable. Sometimes the beginning step to slowing it all down could be learning to manage faulty breathing patterns.

Taking a deep Breath may mean more to your performance than you think.

And a link to end with…

Tyler

CSCS SPT

Owner Pathology Apparel

 

Resources:

Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004;7(1):33-40.

 

 

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(2) Breathing and Crossfit (The Application)

Breathing Applied:

Crossfit, Weightlifting, and Performance

If breathing affects all the physiological processes outlined in the previous article, then breathing can absolutely affect performance in skilled sports.

Don’t believe it? Let’s look at two more points:

Recently, a study demonstrated healthy individuals experienced increased sway in static stance after acute hyperventilation. This means that even when people without any type of injury or motor control pattern problems exhaled repeatedly until hyperventilation was achieved, they experienced decreased balance in their resting stance. If the effects were experienced in resting stance, imagine the effects in a dynamic (moving) sport.

Also, another study found that after 60 seconds of increased pH from hyperventilation, subjects experienced reduced or eliminated transversus abdominis and diaphragm activation levels, which means less core stability around the spine during movements that involve labored breathing and heavy loads/high exertion.

Let’s make up a scenario within the “Crossfit” realm:

There are two athletes who are equally conditioned in every aspect, and they are about to go head-to-head through the first workout of the Crossfit Games…

The metcon (metabolic conditioning) involves a ton of snatches and box jumps (in honor of 17.1), followed by a heavy snatch ladder to close out the workout, where the athletes will be scored on the best successful lift in the time remaining.

 

Athlete 1-

As the athlete approaches the snatch ladder, he’s winded and is breathing uncontrollably. His back feels tight, his muscles aren’t cooperating, and people can hear him breathing from the next town over.

 

Athlete 2-

Obviously, the athlete is gassed as well, but continues to monitor his breathing. He takes deeper, more diaphragmatic breaths, and gathers himself before approaching the snatch ladder. He feels tired but capable as he sets up for his first lift within the ladder.

 

It’s not hard to figure out that Athlete 2 would be at an advantage here, but regardless of who might edge it out in this scenario, I have to say that Athlete 2 will have a decreased likelihood of getting injured under heavy load. His sympathetic nervous system is definitely cranking from the competition, but it’s within control, so he’s limiting the anxiety, tightness, muscular fatigue, and deficits in motor control he could be experiencing if he were breathing more uncontrollably. With this approach, even in circumstances where he has to move under heavy load with fatigue, he’s giving himself a better chance to call upon proper movement patterns to hit a successful lift.

So while I could never say that it will definitely be the difference in winning or losing, I can say that it will help to tilt the scales toward movement efficiency.

This isn’t even factoring in the ability of breathing to improve recovery time. In a sport like Crossfit, simply winning one event will not put you on the podium, you have to recover and repeat. Athletes will not recover with a hyperactive sympathetic nervous system that is dropping down trigger points, causing increased pain signals, and decreasing oxygenation to muscles that are begging to recover.

Hopefully these articles are opening your eyes to the possible implications of breathing within not only the performance realm, but for daily movement efficiency.

 

Breathe well,

Tyler

CSCS SPT

Owner Pathology Apparel

Resources:

Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004;7(1):33-40.

 

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Breathing and Performance

First, some fun facts I’ve researched to get the conversation going:

1-smooth muscle is present in connective tissue (three layers around muscle fibers, and appears in discs, lumbar fascia, etc.)

2-smooth muscle is largely affected by the Central Nervous System and the sympathetic/parasympathetic relationship

3-the sympathetic nervous system is largely affected by breathing rate

Deeper, slower breathing up-regulates the parasympathetic nervous system, which decreases muscular tone, and faster breathing tends to up-regulate our sympathetic (fight or flight) nervous system, which creates increased muscular tone. While increased tone can be a solid survival mechanism when your life is on the line, it can also decrease motor control and movement efficiency (your brain isn’t concerned with efficiency of movement when it perceives that you are being chased by a bear, it’s just concerned with moving). When we get cold, we tend to increase our breathing rate, and this makes our muscles more rigid, decreases our motor control, and constricts our blood vessels to preserve heat and blood for our major organs (think about the last time you tried to type out a text message when you were watching a football game outdoors in November).

 

1-Hyperventilation occurs with rapid breathing, as large amounts of carbon dioxide are blown off from the body.

2-Hyperventilation is known to disrupt the flow of oxygen to muscles via the body’s mechanism of passive o2 transfer from hemoglobin to muscle tissues (which relies on a specific pH environment).

3-Normally, muscles release carbon dioxide (and lactic acid depending on the physiological system in use) when active, which creates a more acidic environment where hemoglobin is more likely to dump off extra (up to 10% more) oxygen molecules to keep them functional.

 

So, if pH increases in the blood (becomes more basic due to breathing off carbon dioxide), and hemoglobin hangs on to oxygen and won’t allow its passage to the muscle tissue, then rapid, uncontrolled breathing translates into increased fatigue and decreased efficiency of function.

 

Hyperventilation can cause not only muscle constriction and decreased blood flow to the muscles (and brain), it can also cause increased anxiety, encouragement of trigger points, heightened pain perception, increased speed of spinal reflexes, and hyper-excitability of the corticospinal tract (motor control to the body and limbs). While a few of these traits could be useful depending on the circumstances, if you are remaining in a hyperventilatory state, they could be a major problem, especially if you are moving under repetitive load, or trying to complete fine motor movements such as throwing a baseball).

Next post, we will have a short application to performance that will build off of the article you just read!

If you have any questions, feel free to let us know!

Blessings,

 

Tyler

CSCS SPT

Owner Pathology Apparel

Resources:

Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004;7(1):33-40.

 

McGill SM. Low back exercises: prescription for the healthy back and when recovering from injury. In: Resources Manual for Guidelines for Exercise Testing and Prescription. 3rd ed. Indianapolis, Ind: American College of Sports Medicine. Baltimore: Williams and Wilkins; 1998.

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Distance Running and Pitching

Distance Running and Pitching?

-Rob Rabena by way of Eric Cressey-

Thank you for the wealth of information you continue to post.

For a guy just finishing his PT school career, I know that experience and wisdom often go hand-in-hand.

 

LACTATE IS NOT THE CAUSE OF MUSCULAR SORENESS IN PITCHERS.

 

So let’s talk blood lactate levels.

screen-shot-2016-11-06-at-9-17-21-pmIn this study, “high levels” of blood lactate were considered as being between 10-15mM (Goodwin et al, 2007), which is double that of the average pitcher.

 

Upper level athletes may approach max blood lactate levels of 15-25mM for all out exercise (30-120 seconds of duration). The peak values in the blood are typically around 3-8 minutes post-exercise, and they can remain elevated up to 60 minutes (Goodwin et al, 2007). Since they typically return to resting levels within one hour, there is no way this could be the cause of next day soreness.

 

Pitchers increased lactate production from 1.0mM (resting) to 5.3mM-5.8mM during a 7-inning simulated game contest (Potteiger et al, 1992). This is way less than the 8-10mM/L produced when squatting multiple repetitions at 70% of your 1 RM (Reynolds et al, 1997). However, I don’t see many people immediately going to run three miles post squat session because it will eliminate their soreness (because it won’t). 5mM is certainly not as much as the 15-25mM listed in the all-out exercise test; instead, it’s barely a 1/3 of what was found for max effort exercise. So, while it is technically above OBLA (onset of blood lactate accumulation at 4mM), this small increase should decrease to close to resting rate during each rest period between innings.

 

What about VO2?

 

The VO2 of endurance athletes can surpass 60 ml.kg.min (elite), but pitchers rarely ever push theirs over 20 (Potteiger et al, 1992).

 

Most college and professional pitchers are between the ages of 20 and 40. The “ACSM’s Guidelines for Exercise Testing and Prescription” calls a VO2 max between 39-42 for this age group “good” (which put them between the 60 and 75th percentile of the general population). This is double the max VO2 they would experience pitching-so that can’t be the reason why we are distance training pitchers.

 

How about physiological muscle systems?

 

Pitchers need to run long distances because they need the aerobic endurance to pitch a complete game right? Wrong. Since their VO2 max isn’t ever surpassing 20, this is our first clue that they are using different physiological systems. All of the movements that a pitcher exhibits to complete a pitch happen in less than 10 seconds. Not only that, he is pushing himself to improve velocity constantly. Any time you are trying to generate as much force as you can in as little time as possible, you are talking about POWER. Power doesn’t involve aerobic pathways; it involves anaerobic ones (where your body does not use oxygen). So, this power generation followed by a short rest and repeat cycle starts sounding a lot more like ANAEROBIC INTERVAL TRAINING.

 

Evidence has already come out saying the following:

 

Long distance training resulted in a drop in power when compared to sprint training (Rhea et al 2008).

 

While in his thesis, “The Effects of Interval Training on Pitching Performance of NCAA Division II Pitchers,” Rabena found no significant difference between distance trained and sprint trained pitchers in categories such as velocity, WHIP, 30m sprint time, or in the fatigue index, there was a trend for increased soreness in the distance group.

 

So, even though there is still some debate over what exactly is the most beneficial option for training as it pertains to pitchers, a strictly distance-based approach must be considered outdated. Coaches need to be educated on the physiological processes and strength coaches need to consider the physiological systems that are pulling the weight for these athletes on the field.

So if I ditch long-distance running completely, I’ll throw 90+ and never get injured? False. Every body works differently, and the foundation of all this is optimizing functional movement. Your body is only as strong as the foundations. Find ways to get in front of skilled minds if you are having deficiencies. It may take time to clean them up; however, your body and career will be all the better for it.

To close, I have to stress the importance of aerobic conditioning in daily life. Don’t think this post is a jab at aerobic activity all together. As far as all-around fitness and cardiovascular function goes, aerobic training is paramount. Running 3 miles as a pitcher won’t immediately ensure you’re going to lose your sacred velo; however, it should not be the main focus of your training. That is not to say that some of your off-season training and de-loading could not have a few distance days to keep the cardiovascular system healthy, your BMI within a healthy range, and provide a stable core to dive into the following pre-season training period with.

If you still want to keep reading-

Let’s take a brief look at this in conjunction with the FITT principle

(Frequency, Intensity, Time, and Type of Exercise Prescription).

 

The Movement of Pitching:

-Less than 30 seconds between each pitch, depending on pace of pitcher

-Time to deliver pitch=Less than 10 seconds start to finish

 

Applied:

Sprint training somewhere between 60-100% of top speed for 30-60 yards (depending on the time of year and phase of training) should do the trick.

 

A good set of 4-10 sprints (depending on intensity and distance) would allow for multiple sets a week.

 

Other training ideas:

 

Power-

Cressey and Rabena recommend rotational exercises, and they have been supported in the literature in the form of medicine ball exercises. Pitching is not a single plane motion, but instead involves multi-planar rotational torque and power production. So, based on specificity, training should encompass the above movements.

If you like to go old school, grab some battle ropes (which would also target rotator cuff and most of the upper extremity as well), a sledge-hammer, or get going on some tire flips, and work in some interval sets to build functional endurance.

Plyometrics can be increasingly effective in training vertical, horizontal, and rotary force generation.

Lower extremity strengthening, such as squats, the deadlift, or lunges should be mainstays in a pitchers workout routine.

Broadly speaking, I’m a believer in Olympic lifts, such as the clean (both power and hang); however, it may be more efficient and safe to focus on the pull rather than the catch if the athlete doesn’t have a background or demonstrate a solid foundation in oly lifting (just my opinion at this moment). Programming some clean pulls can help with power generation in the hips (not to mention grip strength).

Don’t forget that core/trunk stability and anti-rotation exercises are important for stabilization in each phase of throwing process.

Also, the little guys that help to dynamically stabilize your shoulder (rotator cuff muscles) need to be trained, or often reprogrammed, to respond correctly to the overhead-throwing pattern.

Thank you guys for tuning in, and feel free to contact me! Life is a journey and wisdom is path that only reveals itself after much exploration.

-Go check out www.ericcressey.com for tips and ideas-

Tyler Vaughn

CSCS, SPT

Owner, Pathology Apparel

Pathology Performance

 

References:

1) Goodwin ML, Harris JE, Hernández A, Gladden LB. Blood Lactate Measurements and Analysis during Exercise: A Guide for Clinicians. Journal of diabetes science and technology (Online). 2007;1(4):558-569.

2) Potteiger, J., Blessing, D., & Wilson, G. D. (1992). The Physiological Responses to a Single Game of Baseball Pitching. Journal of Applied Sport Science Research , 6, 11-18.

3) Rhea, M., Oliverson, J., Marshall, G., Peterson, M., Kenn, J., & Ayllon, F. (2008). Noncompatibilty of Power and Endurance Training Among College Baseball Players. The Journal of Strength and Conditioning Research , 230-234.

4) ACSM. ACSM’s Guidelines for Exercise Testing and Prescription. Lippincott Williams & Wilkins; 2013.

 

 

 

 

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The Beauty of a Birddog

The Beauty of a Birddog

One of the most interesting concepts to me within the realm of “movement” is that some of the smallest and most simple exercises can be so much more beneficial in certain cases than other larger, more complex movements. I think it is fair to say that many individuals from the general public have the misconception that more complex movements are better and more beneficial to the body. We’ve all seen the video posts of people who are trying to achieve this end (aka doing overhead squats on balance boards). The reality is that in many cases, slower, more controlled movements could be more beneficial to clean up bad motor patterns or impairments. With all that being said, one of my favorite “simple” movements is the “birddog.” I put it in quotes because this exercise has taken me quite a bit of time and training to master (and there’s always more to learn), but has been largely beneficial in injury prevention within my daily training regimen.

So, what is a “birddog?”

It is one of the exercises included in Stuart McGill’s (an expert in spine function and rehabilitation) “big three” for lumbar spine stability.

The exercise basically involves starting out with your hands and knees on the floor. The knees should be below the hip, and the hands should be below the shoulder, with the back of the head, spine, and sacrum (tail bone) all in a fairly straight line. After setting up in this position, the progression involves the following:

Un-weighted, Progressing to (Lightly) Weighted:

1) Flexing one shoulder or one leg at a time while keeping the elbow extended until the arm is parallel with the spine.

2) Flexing one arm and the opposite leg while keeping the arm and leg in line with the spine.

-Fight the urge to allow your low back to sag to help with getting to the pointing position.

-I like to cue keeping the eyes straight down on the floor below you to prevent the excessive extension of the cervical spine that results when looking forward.

-Adding a dowel rod and encouraging 3 contact points at the back of the head, mid-back, and top of the sacrum can be a good tactile cue to maintain lumbar spine position.

-Think about reaching forward and kicking back rather than reaching or kicking up to prevent hyperextension of the spine.

-Try to limit to any motion side-to-side.

-Rather than increasing hold time, think about slowly building the rep and set numbers to increase endurance. The McGill link attached below recommends holding each pointing position for no more than 7-8 seconds due to rapid deterioration of available oxygen within the muscles of the lumbar spine (rapid fatigue).

Once this is achieved in an un-weighted manner, weight can be added in each hand to increase the difficulty of the task. A few more keys here are to cycle through two or three breaths while each arm is parallel with the spine, focusing on maintaining proper pelvic alignment, as well as a neutral position within the cervical spine.

Attached below is a clip of Eric Cressey from www.cresseyperformance.com introducing the birddog.

So how can something this simple be so beneficial?

It teaches control of the hips vs. the lumbar spine.

-Many people (athletes especially) are unaware of their lumbar spine and pelvic positioning throughout movement patterns, often leading to increased anterior pelvic tilt and low back pain. This exercise allows for a specific focus to be placed on what pelvic “neutral” really feels like, and the muscle coordination needed to maintain it (which is the most stable position for the spine). As one arm or one arm and the opposite leg are raised, the patient or athlete must actively resist allowing the lumbar spine to sag into a hyper-extended position to achieve a successful repetition.

It teaches you how to breathe while maintaining proper core activation/trains anti-rotational muscle groups within the trunk.

-Take a second to try this exercise moving at your own speed. Now, try it again moving much slower while allowing yourself to cycle through up to three full breaths when one of your arms and legs are parallel with the spine. I’m sure the second option was much more difficult. When you can’t rely on the intra-abdominal pressure created by holding your breath, you will feel a huge difference in the muscle activation requirements and resulting fatigue around the spine. Moving through this exercise will allow you to work on the muscle activation and endurance of these anti-rotation muscles and local stabilizers of the spine throughout each set, which will undeniably help with injury prevention in your sport or daily life.

It encourages lower trap activation along with a large majority of the stabilizers within your shoulders (rotator cuff).

-Moving the shoulder into flexion like you are reaching forward in the birddog position encourages muscle activation and strengthening within the rotator cuff muscles. There is a long lever arm where gravity is working against your either unweighted or lightly weighted hand. In order to achieve the desired flexed or pointing position, the lower traps have to get engaged to upwardly rotate the shoulder blade as well. Therefore, this exercise is useful for building endurance and proper motor control in the rotator cuff as well as in the pelvis and lumbar spine.

It affords the opportunity to work on activating the glute (butt) muscles in cases where the hamstrings are typically more dominant.

-People often struggle to involve the glutes in the extension of the leg. These recruitment issues often lead to increased joint shearing in the hip as the hamstring causes more translation of the femoral head within the acetabulum (head of the leg bone within the hip joint).

Slow and controlled movements have been proven to be more beneficial when trying to build motor control (your brain’s ability to fine-tune and program efficient movement patterns in the muscles through the communication lines that are the nervous system).

-While we often want to push the pedal down and move as quickly and with as heavy of a weight as possible, research has demonstrated that slow and controlled repetitions are more effective in establishing functional motor control.

As a patient or athlete gains more awareness and control of the pelvis and the lumbar spine through active bracing and more efficient movement patterns, the spine will be at less risk for injury. While one exercise cannot be perfect for everyone, this is one exercise that is definitely worth a further study. As you go about completing your olympic weightlifting program, daily WODs, or even your cardio/endurance routine, consider adding in a few un-weighted sets of birddogs 3-5 times a week and see how your body responds. You may find that the next time you max on your clean and jerk or try to PR your 5K, that you experience a lot less back pain from falling into an overarched and instable position.

If you have any questions or concerns, feel free to contact us or provide your feedback.

Until then, enjoy the journey.

Tyler Vaughn

Owner, PA

CSCS, SPT

Resources:

http://www.ahs.uwaterloo.ca/~mcgill/fitnessleadersguide.pdf

http://ericcressey.com/3-coaching-cues-strength-and-conditioning-programs-14

 

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Static Stability of the Shoulder

Static Stability of the Shoulder

Many people have asked why they continue to have trigger points and aching in their shoulders even after they continue to hammer them in the weight room. I just wanted to take a second to address the difference in scapulothoracic posture and its effect on static stability in the shoulder.

First, when you are actively engaging the shoulder in intense workouts or full ranges of motion, you are relying on the dynamic stability of your rotator cuff muscles to maintain the proper placement of the head of your humerus within the capsule (hopefully). While some people struggle (me included) to develop completely proficient recruitment patterns, this general idea of dynamic control remains the same. So, if you go in the gym and throw every plate in there on the bar and do some isolated rows or power snatches, you will absolutely build strength within your shoulder; however, this may not fix your issues with aching and pain in your static or resting stance.

In my journey towards becoming a licensed therapist, I have already seen the reactions that are typically returned when a PT mentions posture to his/her patient. The classic eye roll or attempts at jedi mind tricks to avoid the conversation are a norm. The reality is, people often don’t want to hear or believe that their posture can affect cause or fix their painful predicament. So, for the eye rollers out there, let’s look at the anatomy.

screen-shot-2016-10-22-at-11-51-27-am

Neumann, Pg. 141

This picture is a great representation of the bare bones of what’s happening at the shoulder joint (lame pun intended). The rope represents the suprahumeral structures such as the supraspinatus and a few of the capsular ligaments. Static stability exists at rest through a couple processes:

1) The head of the humerus sits against a relatively inclined surface, almost like a makeshift shelf in the shoulder. This angle of the glenohumeral joint is made possible by…you guessed it, proper posture of the scapula. For those that are chronically in a hunched over (kyphotic thoracic spine) position with forward rounded shoulders typically have downwardly rotated scapulae. These downwardly rotated scapulae result in the second picture, effectively eliminating the natural shelf and increasing the forces of gravity on the head of the humerus inferiorly. This places large amounts of stress on the supraspinatus, superior capsular ligaments, and increases the laxity of the axillary pouch (part of the inferior capsule).

2) Speaking of the supraspinatus and the glenohumeral ligaments, they also provide primary support to the glenohumeral joint. The coracohumeral ligament, the superior capsular ligament, and the supraspinatus all actively work to prevent the golf ball that is the head of the humerus from falling down off the tee (GH joint). It has also been shown that the posterior fibers of the deltoid could contribute to this as well.

3) It wouldn’t be right to completely leave out the labrum, because it effectively deepens the socket by 50%, which is monumental in terms of stability. This is nowhere near as deep as the acetabulum (hip joint), but you have to trade stability to gain the ROM needed in the shoulder (mobility).

So, as you continue to blow up the large muscle groups in your shoulders to counteract your static pain and irritation, take a second to remember that poor scapulothoracic posture could be a major cause of your frustrations. Try to remind yourself to steer clear of that downwardly rotated, protracted, kyphotic position, and watch as not only your shoulder pain decreases, but you are more easily able to utilize efficient motor patterns in dynamic overhead positions. Sometimes building muscle bulk is not the fastest path from A to B; you need to have a solid static foundation to build your dynamic efficiency!

Remember that achieving proper posture, movement, and wellness is a lifelong endeavor, so enjoy the journey.

Tyler Vaughn SPT, CSCS

Pathology Performance

Owner, Pathology Apparel

Embrace Abnormality

*All of these ideas are summaries of those much smarter than myself! If you like the material, keep an eye out for the references, because that’s the bank I am pulling from!

Resources:

Neumann DA. Kinesiology of the Musculoskeletal System, Foundations for Rehabilitation. Mosby; 2010.

 

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Banded Hip Mob for Deep Squats

Just a combination of a few different resources to get the most bang for your buck with this hip mobilization. It incorporates a posterior inferior femoral glide, subtalar eversion, and some neuro priming to open up your hips and prepare you to move more effectively throughout your squat range.

also available at www.instagram.com/pathologyapparel

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