Sports Chiropractor Shoulder Rehab Seattle
My favorite hobbies of crossfit, kettlebelling, tussling my children and moving my patients can be hard on the body. Especially with a history of a torn right labrum. See LINK. I understand the importance of ongoing shoulder stability rehab as well as anybody. Life and training do get busy so it is critical to integrate shoulder rehab as seamlessly as possible into your existing strength training and accessory work. This modified banded face pull is best used as a series of long fast reps not to exceed 100 total. Add this in after max effort shoulder training days and see your shoulders recover faster and your lifts improve.
The Barbell Alternative to Side Plank should be used in two separate sessions per week, two sets each day. Over the course of 6 weeks, add weight each week and stay within the 30-45 second time domain on each set.
If your knee is hurting after last week’s 16.4 workout, don’t be so quick to blame the wall balls. Your kipping handstand pushups may be to blame.
When an athlete does a good job of recruiting the hips in the hspu kip, a violent end range knee extension at lockout is the result. This differs from the crisp knee extension in other movements such as the kettlebell swing because the lower extremity meets no resistance making it an open chain movement with with zero resistance to guide the normal screw-home mechanism of the tibia. The result can be repetitive hyperextension of the knee through the course of say 55 handstand pushups. Add the fact that leaning into the wall to achieve a legal rep further levers the knee into extension, and it should be no surprise that many athletes are limping their way into week 5 of this year’s Open.
Biomechanics of knee extension in hspu-
The likely source of knee pain following a set of kipping handstand pushups is the anterior cruciate ligament. The ACL comes to tension when limiting anterior translation of the tibia at end range flexion. In hyperextension, the ACL is vulnerable to impingement by the intercondylar notch roof of the femur. See article HERE.
The Take Home- Explosive knee extension in a kipping hspu is different than in other movements. The legs are flailing into the sky without any resistance to prevent hyperextension. The result is like the ACL getting slammed in a door.
The result of this repetitive ACL impingement is inflammation within the joint space and pain at end range flexion. The inflamed joint feels unstable, clicks and pops but should not lock up or give way. Getting into the bottom of a squat is very difficult in the week that follows this injury as the joint is swollen on the posterior side and the aggravated ACL is at tension at end range flexion of the knee.
Knee sleeves and Rock Tape
- Neoprene knee sleeves
- Hamstring Rock Tape
- Adds some tactile awareness of knee end-range
- Coactivation Exercises- Russian Swing/ Power Swing
- Focus on coactivation of glutes with quads to avoid end range extension.
- Hamstring prep- Death March/ Kang Squat
- Coactivate glutes, hamstrings, and quads during knee extension.
- Stay on the wall. Striking the heel into the wall at the top of the motion increases hyperextension forces. If possible, glide the heels up the wall as the knee approaches lock out.
- Closer hand placement-
- The further the hands are from the wall, the greater the knee is leveraged into hyperextension at lockout.
It is unlikely that serious mechanical damage has taken place. If you have apprehension or are experiencing locking up or giving way of the joint, have it assessed by your local knee specialist. Otherwise you are dealing with painful inflammation of the ACL.
Inflammatory measures- 4-7 days
Heat / Ice contrast therapy. 6/1 ratio
- 20 minute sessions level 8
- 3x/day on empty stomach
- The poor man’s normatec
Pray that there are not pistol squats in 16.5.
When and athlete is recovering from a lower back injury it is important to keep the lower body and posterior chain engaged. Deadlift alternatives for the compressed spine include the TRX, Ring or erg supine knee flexion from a reverse plank set-up.
As a Seattle Sports Chiropractor I see a lot of middle back and shoulder injuries in overhead crossfit athletes due to their lack of T-Spine mobility. When you are deficient in middle back flexibility you will buckle at the T-L junction to get a weight centered overhead. Avoid that painful trip to my office with an injured lower back. This mobility can open up your range, protect your shoulders and stabilize your midline with overhead loads.
I am often asked the question “What exercises are safe after an exertion headache?” Assuming that your headache is a primary exertion headache or exercise headache it is safe to reintroduce progressive exercise after a 4-7 day rest. Here are some guidelines to and progressions to follow in the early reintroduction phase:
You begin with low-threshold activities. Those are the movements least likely to bring about a relapse of symptoms. Those are low intensity movements that keep the athlete upright, keep the neck neutral, are low impact and do not require aggressive upper trap activation.
High Threshold activities that are re-introduced last include:
1) Bearing down or valsalva monouvers.
2) Increasing intracranial pressure by lowering the head below the waist. (Bench press, burpee, deadlift)
3) Extending the neck during a lift. (Burpee, The bottom of an overhead squat)
4) Aggressive Upper Trap Activation. (Clean grip shrug, power snatch, deadlift)
5) Jarring impact (Reboundig box jumps)
Early on in the process it is important to eliminate all of these factors and slowly re-introduce these challenging elements phase by phase WITHOUT reproducing any headache symptoms. This is critical to avoid chonicity of these episodes. Picture letting a scab heal without ripping it off and causing scar tissue formation.
Today’s post will focus on safe initial re-introduction movements.
Keep the above criteria in mind with all of the following movements as all can be done in a way that will trigger a vulnerable condition. To keep it simple, apply this guideline to the following movements for best success: Exhale during the concentric phase of all motions, keep the head and neck neutral, avoid shrugging motions and eliminate jarring impact with the ground.
Phase one introductory movements:
Belted Sled Drags and Reverse Sled Drags
- Reverse or backwards sled drags are at the core of your exertion work this early phase. Use them as the base and integrate the following low-threshold movements in alternating fashion
- Reverese Sled Drag- Belt the sled off from the hips and walk backwards looking back at the sled with the hips sitting back and the neck in neutral.
- Sled Drag- Belt the weight from the hips and walk forward with a consistent, slow and even pace focusing on hamstring recruitment and neutral neck position.
- Banded Shoulder traction cervical stretches
- Supine Deep Neck Flexor Drills 3 planes, 10 reps
- Towel traction
- Isometric Supine extension
- Upright Towel Isometric Extension