“Mobility programming is like pizza, even when it’s bad, it’s still pretty good! “
-Danny Matta (yes I just quoted myself)
Here’s a scenario that never happens. A CrossFit athlete leaves his 9-5 job where he just sat at a desk for 8 hours. He drives to his local box and is giddy with shear joy and anticipation over what the mobility work might be for this day’s WOD. He wonders to himself if his coaches will have him work on his hip capsules or maybe he if he’s lucky the sliding surfaces of his latissimus dorsi and serratus anterior.
This is obviously a fabricated scenario because the truth is most people don’t get excited about mobility work. Even though you or your athlete’s might not like it too much, it’s kind of like having to eat your vegetables when you were a kid. You know it’s good for you and you still have a hard time accepting it (unless the vegetables were covered in cheese, then they were acceptable.) Sometimes the toughest part of programming is where to fit mobility work into a WOD. If your athletes are busy people like I am, they may get one golden hour at the gym between 3-5x per week. We want to use our time as efficiently as possible. Programming for a group of people with different mobility problems can be a bit tricky. Here are two strategies you can use to make it more effective.
We’ll use this simple programming below to show different areas you can add mobility work in to your WOD. By the way, this programming is not for competitors, this is an example of programming for a novice to intermediate CrossFit athlete.
Dynamic Warm Up: some type approx. 8-10 minutes
Back Squat: Strength Block work up to 3 sets of 5 reps
(Rest 2 minutes between sets)
Annie: 50-40-30-20-10 Double Unders and Sit Ups, cut off time of 12 minutes.
Cooldown: 3 rounds 200 M run forward, 200 M run backward 5 hand release push ups 65-75% effort on the run. Focus on keeping the forearm perpendicular with the ground during hand release push ups.
* The most basic mobility goal should be to focus on improving fundamental positions that are being challenged in that day’s WOD. *
If our athlete’s are squatting, we want to improve the bottom position of the squat. If our athlete’s are pulling from the ground, we want to improve the position in the start of a pull and so on and so forth. If you wanted to improve the position of one of the movements above, which would you, pick?
My answer to that question would be the squat. It’s the one movement we are dedicating the most time to in the WOD and is a fundamental archetype shape. So if we wanted to improve this movement we have a few options, but here are two that we use most often.
1. Exaggerate reality
By this we mean, program a mobility drill that exaggerates the squat position. This could either be a drill that drivers your knees out further than you normal do squatting, forces you into a deeper bottom position than normal or driving your knees further forward to improve the ankle range. Don’t try and get too complex here, do something that looks like a variation of the squat but exaggerates it in some way.
Here are a few videos of ideas that you could add in for this WOD’s programming.
2. Mobilize the muscles that were the primary force producers
If we take the programming from above, we could say that the quads and hip flexors are going to be the two muscle groups that are most likely to be sore over the next few days. In this second strategy, we focus on trying to help the athlete’s have less soreness by doing some fascial techniques right after the cool down. You can really set your athletes up for success this way, especially the newer athletes that might be sore for a few days after a WOD like this.
Here are a couple techniques you could add in after the WOD to get the quads and hip flexors feeling better.
Fast-forward to minute 3 if you just want the specific techniques.
Now that we have some ideas of what we might want to work on, when should you add your mobility work to this WOD?
If you’re really strapped for time and want to be super efficient I would recommend doing the mobility work during the built in rest periods of the squat block. If you have a built in two minute rest period, throw a band around a hip and open it up for a minute on each side before doing your next set. This is one of our favorite ways to save time and improve a movement position in the process. By the time you get to your last couple of sets, your hips should be nice and mobile to hit that new 5RM PR.
If you can’t add it in between sets for some reason, the next best option is to make it part of the warm up in some way. Maybe add a kettle bell to the rocking sumo technique(show nabove in the first video) and get that heart rate up while improving the bottom position of the squat.
Programming for a group can be hard but if you follow these two strategies it will help get your mobility work organized. You’re never going to be able to pick one mobility technique that’s the best mob for every person in your 5 PM class. Everyone is a bit different, so focus on improving positions used in the WOD and fascial techniques for muscles that are most likely to be sore. This will help everyone get something useful out of their mobility programming.
If you have any mobility programming questions leave us a comment or hit us up on Facebook. We’re more than happy to help you get on the right track!
-Dr. Danny, PT, DPT
One of the most enjoyable parts of teaching the Movement and Mobility Trainer Course for CrossFit is the one on one time I get with hundreds of CrossFit athletes. Many people come to our courses with a ton of questions and it’s always surprising to me how appreciative they are when I spend a few minutes listening to them and giving them advice. It makes me think, what the hell are most medical providers, physical therapist and chiropractors doing? My opinion is most of these providers are extremely busy with large patient caseloads in order to have a profitable business.
I understand this problem well. I have worked in clinics where I have seen 20-25 patients per day. You basically are just putting out fires all day and you don’t get the opportunity to just listen to someone. The number one, most important aspect to successfully treating someone that is injured is listening. Nine times out of ten, the patient tells us exactly what’s wrong with them and what we need to do to help them out. All we have to do is just check our over-educated egos at the door and just shut up. It’s that simple! For this reason anytime a course attendee asks me for a physical therapist recommendation in their area I base my decision off four factors and I feel you should as well.
1. Pick someone that sees no more than one person per hour.
Physical therapy is not unlike any other business. The saying “you get what you pay for” applies to physical therapy as well. Most physical therapy clinics do not publicize how many patients they see per hour. I doubt you are going to see a physical therapy clinic bragging about how they routinely treat 4 people at once.
Let me put it to you this way. Would you go to an accountant that set up meetings with 4 different clients at the same time? Hopefully you answered no to this question or pray that you never get audited. So why is it ok for people treating your most important asset, your body, with less respect that your accountant gives to your tax preparation?
I find that many of the physical therapists that treat patients in a one on one setting use a model known as fee-for-service or accept insurance on a very limited basis. The reason these physical therapists set up their practices this way is out of necessity. They refuse to sacrifice quality of care with their patients.
Let’s be honest, healthcare is one of our nations biggest problems. So far, healthcare reform has done little or nothing to change it. Many medical physicians, dentists and physical therapists have started to reject accepting insurance. The reason why is it frees them up to treat patients the way they deserve to be treated.
Medical providers with above average skills and a true passion for helping people are shifting to this model everyday. It’s good for the provider and it’s even better for the patient. It’s vital that you find someone that will treat you like they would want their own family to be treated.
If you’re doing a quick Google search in your area use key words such as fee-for-service, out-of-network and cash based physical therapy. Also, you’re physician may refer you to a physical therapist specifically. Understand that you have a choice of where you go, knowledge is power so doing your own research can go a long way.
2. Pick someone that specializes in hands on treatment.
We know that the act of physically putting your hands on someone is powerful! Think about when you go to the doctor. If they just stood their and looked at your, you wouldn't feel as comfortable as you would if they listened to you breath and your heart beat. They have to actively put their hands on your to do this and it's very reassuring.
I can tell you this much, when I use my hands for physical therapy treatment, people get better dramatically faster. If you find yourself in a physical therapy clinic where all you get is a handout and they have you doing some useless leg extensions and then put a hot pack on your knee, you’re in the wrong place! Leave immediately and don’t turn back. Places like this give physical therapy as a profession a bad reputation.
Here are some recommendations when looking at key words to find physical therapists that specialize in hands on treatment. Anyone that says they perform manual therapy is probably a good bet. Also, dry needling is a hands on treatment that works phenomenally well. Key words such as mobilizations, manipulations, soft tissue or fascia techniques are also all good to see.
3. Know what the alphabet soup means behind a name.
I’ll give you an example of what I mean. My title is this, Danny Matta DPT, OCS, CSCS. To most of you that aren’t physical therapists it just looks like a bunch of random capitalized letters. What it actually means is that I have a Doctorate of Physical Therapy, I’m an Board Certified Orthopedic Clinical Specialist and a Certified Strength and Conditioning Coach. It’s basically a bunch of letters that show I’ve passed some tough tests.
Here’s the list of credentials you should look for if you are an athlete and looking for a physical therapist.
OCS or SCS. These two are specialty board certifications through the American Physical Therapy Association and they are not easy to get. Either one of these credentials means the physical therapist has in depth knowledge of athletic injuries.
FAAOMPT, MTC, COMT. These three are manual therapy certifications that show the provider has passed testing for hands on treatment. It takes a while to get these so most providers with these credentials should be a good choice.
CSCS. This is an advanced strength and conditioning certification. This is the gold standard for someone that wants to be a high school, college or professional strength coach. If your physical therapist has this, it's a great fit for anyone playing a sport like tennis or training like CrossFit.
4. Lastly, ask your prospective physical therapist how much they can snatch.
This is an easy one and is a take on a recommendation that Kelly Starrett has on mobilitywod.com. His recommendation is to ask your prospective physical therapist what their deadlift is. I’ll take this a step further and throw in an Olympic lift.
If your prospect physical therapist doesn’t even know what lift the snatch is, you've called the wrong person. He or she is not the physical therapist for you. I'm not saying your PT needs to be able to snatch bodyweight but they should at least understand the movement and have done it before.
If you’re a CrossFit athlete, many physical therapists will tell you to stop doing CrossFit. This is like telling a runner to stop running, it’s just not going to happen. Finding a physical therapist that understands your sport is vital.
Hopefully you are healthy and you do not need to seek out a physical therapist. If you are injured I hope this blog post helps. No matter where you are in the country, you can apply these principles to picking the right PT to help you achieve your goals.
If you're in the Atlanta area and have been struggling with an injury, we can help. You don't have to live in pain. You don't have to avoid activities you enjoy. We help people just like you everyday get back to the CrossFit gym, get back to playing with their kids and stop waking up every morning with pain.Take a look at our client testimonials here.
If you're interested in learning more about how we can help you, we can set you up on a free 10 minute phone consultation with one of our Doctors of Physical Therapy.
Thanks for reading.
-Dr. Danny, PT, DPT
Dr. Danny and staff's views on performance improvement, injury prevention and sometimes other random thoughts.