It’s baaaaack. The largest fitness competition on Earth, the CrossFit Open, is finally here. Maybe you’ve trained all year for this, maybe you’re still new to CrossFit and are curious about all the excitement. Maybe you’re a seasoned vet, maybe this is your first Open you’ve ever participated in. Regardless of your CrossFit background, your fitness will be tested, your mental toughness will be challenged, and you will certainly have a blast working through these workouts with your crew at your local CrossFit affiliate.
That being said though, this is typically a time where we start seeing an uptick in the people we see coming in for CrossFit related injuries. Having an athletic background, where I had to personally sit out multiple seasons due to injuries, I speak from experience when I tell you there is nothing worse than working all year towards a goal/competition/test and not being able to perform at an optimal level, if at all, because of an injury. And, look, I get it. There is inherently an increased risk of injury when you're pushing yourself in a competitive environment. However, there are some very important things you can do to minimize this risk and allow you to perform your best. Let’s take a look at the three easy things you can do:
#1 Don’t Be Reckless
This is huge and something I see year after year. If you’re a CrossFit coach, or even just an observant CrossFit athlete, I’m sure you’ve seen what I’m about to explain...You’ve worked all year to create movement patterns that are both safe and effective. You know the importance of good, quality movement. However, throw in the element of an international competition and it seems like all these lessons about technique go out the window.
For example, last year’s first Open workout (18.1) consisted of three movements: toe-to-bar, dumbbell clean and jerks and rowing. Can you guess what type of injury we saw coming into our clinic after this workout? If you said back pain, you’re correct. But why? Well, with this workout people were trying to perform as many rounds as possible for 20 minutes. To get better scores people weren’t maintaining core control for a solid hollow position with their toes-to-bar, they stopped getting full hip and knee extension for optimal power production during the drive portion of the clean and jerks, and/or they started to over-extend during the rowing component. All of these create situations that are destined to increase stress on your low back. Keep in mind that this was just the first workout! Now you’re either completely unable to participate in the other workouts or will not be performing at an optimal level because you’re trying to grind through an injury.
#2: Protect Your Sleep
There are four main pillars of health care that we look at with every patient who walks in the door at Athletes’ Potential: Movement, Stress, Sleep, and Nutrition. Sleep is easily on of the biggest problems that we see out of these pillars. And check this out, Sleep affects everything you do and everything you do is positively affected by quality sleep. Good, quality sleep literally improves everything: every marker on a blood panel, weight management, sport performance and recovery, productivity, and numerous types of disease management. The list goes on and on, yet the percentage of sleep deprived Americans, particularly in Urban areas, continues to rise at an alarming rate. In fact, the U.S Centers for Disease Control and Prevention reports that more than 30% of Americans are sleep deprived getting fewer than 6 hours of sleep per night.
If you’re not getting enough sleep, you’re not giving your body a chance to recover. If you’re not recovering appropriately then you're leaving yourself at risk for injury and decreased performance. So bottom line, create an optimal sleeping environment, protect your night time routine, and get some good quality sleep sleep.
For more info on how to optimize your sleep. Check out this article we wrote.
#3: Maintain Perspective
This comes full circle with tip #1. For those of you trying to make it on to regionals, those extra few reps I mentioned could be the difference in making the cut vs staying home. However, for the vast majority of athletes competing in the CrossFit Open this is not reality. You all have careers, kids you need to take care of, and numerous other responsibilities that you need to keep rocking with once you leave the gym. Is bouncing off the top of your head to get an extra rep or two really going to mean that much if by doing so now you can’t look over your shoulder while driving? (yes this is a real scenario that we’ve worked on at our clinic...I’m looking at your 17.4). Or is that 2 position jump on the leaderboard really all the important if now you can’t bend over to pick up your kids?
Crossfit is meant to be a competitive, fun and challenging way to make all aspects of life outside the gym a little easier. This time of year is huge for all CrossFit athletes and it is truly impressive to see the physical accomplishments and PR’s that happen every single year in the Open. However, the Open isn’t an excuse to throw all safety out the window but it isn’t something you should be afraid of either. Following these three easy tips will ensure that you have a great time, reduce your risk of injury, and maybe even hit a PR or two.
Thanks for reading.
Dr Jake, DPT, CSCS, CF-L1
Have you ever been in the middle of a workout and feel an ache or pain? It’s completely normal if it’s something small and goes away. It’s another story if it continues to bother you or increase in pain.
Sometimes we just do too much (or too little) and it pisses off some part of our body.
You may start to realize it’s impacting the way you move and you may even avoid a particular movement that causes the pain altogether.
Often times, people see this as a sign to take some time off and rest. This may be the case in some instances, but it’s not always the best solution.
Some people go to a healthcare professional to find out what’s going on. Quite frequently, they’re told to stop that activity or exercise. We hear it all the time from new patients.
“Squats are bad for your knees.”
“Running will wreck your body.”
“Stop doing CrossFit. You’ll get hurt.”
[Credit: Barbell Physio]
But, what if you’re an Olympic weightlifter who has a competition coming up? What if you’re a runner who loves a good 5k? What if you have a stressful job and CrossFit is your outlet to relieve that stress?
Come on, healthcare - we can do better.
If these are your goals, we want to help you get there.
Here’s 5 different ways to train around pain and decrease stress on that painful area:
MAIN GOAL: MAKE THE LEAST CHANGES POSSIBLE TO THE MOVEMENT
Now, let’s break down each one of these using knee pain with front squats as an example.
[Credit: Barbell Rehab]
Here are a few other examples for you:
Here’s the overall concept:
Pain comes on --> scale back movement slightly --> train movement --> adapt --> progress difficulty --> adapt --> back to prior level --> continue training pain-free --> hit PR
I believe that any great coach or physical therapist should be able to modify and progress/regress any movement or activity.
If you have given these methods a shot and pain continues to impact your life, then find a healthcare professional who understands your goals and doesn’t tell you to stop.
Dr. Ravi, DPT
Elbow pain can be one of the most irritating and inconvenient issues. I once had a patient say that the most painful part of his day was just cutting butter for his toast in the morning.
Classically, we tend to blame the tissues at the joint—wrist extensors/flexors. Sure, the common insertion for these muscles becomes inflamed, but what causes that? I like to view the elbow similarly to the knee; it is a joint that is pushed and pulled on either side by very complex joints. The shoulders will largely influence the biomechanics of your elbow and the amount of torque that passes through the joint.
Although somewhat simplified, we could group you as either tight and immobile or mobile and bendy. Each characteristic has its own pros and cons, but the cons are where pain manifests. With decreased shoulder mobility and/or control, the elbow will take the brunt of the force when lifting weights or swinging a racquet. Shoulder stabilization and control are important for correct biomechanics of the shoulder girdle and upper extremity. Lack of control upstream, allows more movement downstream at the elbow. The repetitive, small insults at the elbow joint will eventually result in elbow pain.
Hammering away at the soft tissue around the elbow is often where athletes start when self-treating. Don’t get me wrong, a little forearm smash with a lacrosse ball or barbell is great. But if it does not improve your problems, move on! In this case, we are going to check out the shoulder.
Less mobile folks: To decrease the torque at the elbow, it would be ideal to improve both the external rotation (front rack) and flexion (overhead position) or your shoulder. Tight lats can often be the cause of the restrictions. Try these two mobility pieces:
More mobile folks: Shoulder stabilization is going to be the key for you. A simple way to start on this is kettlebell carries, all variations! Here are two simple, yet effective stabilization drills:
As always, do a movement screen/ form check first. Get a coach or super friend to watch you move and see if they notice any faults. Racquet sport athletes—if you constantly have elbow pain, check your grip size. Grips too small or too large can cause elbow issues as well. If you are a desk jockey, check out your work station and the ergonomics!
Try these mobility exercises and tips out. If you continue to have issues, come see us at Athletes’ Potential. We see elbow pain often and are able to effectively treat it with an evaluation! Keep devoting time to making your body work and feel better.
Guess what? Physical therapists sometimes have pain and dysfunction too! We are only human. Often times, people will see me wrapping a voodoo band here and there, or digging a lacrosse ball into my shoulder. It usually strikes up a conversation starting with, “What would you do if…..?”
My ol’ volleyball knees tend to get creaky and achy sometimes, just as many athletes and patients often describe. So, what do I do if I have knee pain?
These are my 5 favorite “quick fixes” for knee pain. Obviously, management of knee pain is more comprehensive than 5 quick tips. However, these are for when you are in the middle of weightlifting, running, playing your sport and you get that nagging knee thing. Ideally, you would consult a PT or watch a video of yourself moving to see what is causing the knee pain. But understandably, sometimes we just need it to feel better RIGHT NOW.
#1 Modified Couch Stretch- This is a great stretch for the front of the hip! It is important that you stay tall and do not let the band pull your hips forward so that your back is banana shaped. Propping the foot up on a ball takes up more slack in the quad and intensifies the stretch. If you squeeze your booty, you will feel the stretch even more. Please kneel on something soft! Prolonged pressure on the front of your knee will only exacerbate the issue.
#2 VooDoo Band- Using a voodoo band, wrap your knee beginning below the knee and leaving a gap for your kneecap. Be sure it wrap it tightly! After it is wrapped, any knee movement will be beneficial. I like to do air squats and butt kicks to get deep knee flexion. You could also sit down and bend and straighten your knee. Leaving it on for up to 2 minutes will give you the best bang for your buck.
#3 Soft Tissue to quad- Often times, tension in the quad will cause knee pain right at the top of the knee cap or on either side. Pressure to the soft tissue in the thigh area can help the quad relax and allow more pain-free range. My favorite tool for this is the handle of a kettlebell. It allows more direct pressure than a foam roller and you can easily push down and then move it side-to-side for some release. Another option is a lacrosse ball. Just lie on your stomach, pin the ball on a sore spot on your quad, then bend and straighten your knee. Spend at least 2 minutes on this one.
#4 Knee Gapping- Everyone’s favorite! We like to use Yoga Tune Up Balls for this (as seen in the photo) but a double lacrosse ball or even a towel rolled up will work. Simply put the balls in the bend of your knee, then use overpressure form your arms to bring your heel towards your booty. This should feel good- like a stretch to your knee. Two minutes of oscillating between overpressure and releasing it will do the trick.
#5 Modify- Some days, the knees just aren’t on board. If you have completed a thorough warmup and tried some self-management but the knee still feels iffy--- modify, modify, modify. Don’t work through the pain! There are plenty of ways to change a workout that will still be beneficial but not aggravating to the knees. A great example is the box squat. If I have knee pain, it’s usually with heavy back squats- ol’ volleyball knees, remember? Box squats are a good option. I am still loading in the pattern I want, hitting the lumbopelvic muscle groups, but allowing my knees to stay back further so that the shear force is less.
If you've been struggling with knee pain for more than a month, it's time to get some help from a profession.
We help people just like you get back to being pain free and back to the activities they love everyday.
With out three step process we eliminate pain, fix the root cause of the problem and teach you how to keep yourself healthy.
Click the blue button below to get started or call us at 470-355-2106
The Athletes' Potential Team
Last week I outlined some mobility restrictions that are likely the culprit if you have pain or trouble with squat pattern. Hopefully you have tried those mobility exercises out, even if you think you are flexible. There is sometimes a lingering asymmetry here and there from past injuries and such.
So, you checked your mobility and you have the ideal mobility for a squat. What else could it be?
The “butt wink” is a pelvic reversal or loss of the lumbar curve at the bottom of the squat. A few things can cause this—bony architecture and tibia to femur ratios, lack of mobility usually in hip flexion or internal rotation, and/or poor motor control throughout the squat pattern. I will not get into the debate of the first possibility. Yes, we are all unique snowflakes, but let’s make sure our mobility and control are up to par before we blame our parents.
To be sure you are setting yourself up for success, check and see if your foot placement is ideal for your bony make-up and mobility. This is best done on your hands and knees with a partner watching and preferably filming. Make sure that your hands are below your shoulders. Rock forward and backwards the finally settle at the center—ask your partner to confirm that you are actually centered. From here, slowly push your hips back as if moving to child’s pose.
Watch your pelvis; when you notice that is starts to rock backwards, this is where your butt wink starts when you are standing with this foot distance. Now widen your knees out a few more inches and repeat. Did the pelvic reversal look the same, better or worse? If better, a wider stance in the squat would work better for you. If worse, stay narrow. If the pelvic position was the same, check in with how your hips felt during each of the two foot positions. Say in the wider squat you felt a bit of pinching, then stay narrow.
Top picture: no butt wink, so a good foot position.
Bottom picture: butt wink, so I will likely have a pelvic reversal with a squat to this depth or deeper.
Going a step further, you can move to your forearms to mimic the forward inclination of the torso during a squat. Perform the same steps. In the picture below, this is right before I start to have a pelvic reversal, so this is my target depth with loaded squats.
After finding the correct foot placement, stand up and try a few more squats. Is the butt wink still there? Yes: if you are in the correct foot position and have ideal mobility, keep reading!
Many of the athletes that I treat fall into these categories:
Very flexible and can squat with their booty to their ankles
Report feeling tightness in their hamstrings, even though they can bend forward and put their palms on the floor
Have back pain with squats that increases at the bottom of the squat, often one-sided but not always
Always sore in the quads after squats, rarely glutes or hammies
Does this sound like you? Here are two of my favorite exercises to start working on motor control of the lumbar spine, hip and pelvis under load as well as posterior chain strengthening.
The tempo goblet squat: This exercise forces anterior stabilization by adding a weight at the chest. The deep core must fire to offset the kettlebell. With a 3 second count lowering to the box, motor control of the lumbopelvic area is even more challenged. Additionally, squatting to a target allows the athlete to sit back more in the squat, engaging the glutes and hammies. This is often a new input for these athletes who are quad dominant. Check it out here: Goblet Box Squat
The banded bird dog: Practicing moving your extremities while under the load of a small band is important before you try to move big weight. The bird dog requires hip and midline control with movement, made a bit harder by adding a band. Again, having a partner for a form check or performing this by a mirror is ideal. Many people will have a movement fault and not even realize! The goal is to keep the back and torso in the neutral position throughout. As soon as your form falters, take a break. Check it out here: Banded Bird Dog
Add these exercises to your strength days and/or warm up a few times each week. Maintaining your core and pelvic control throughout the range of motion is the first step to easing back pain and improving your strength in the squat!
If you try to self-manage for a few weeks and still see no change, let us know. We would love to help you here at Athletes’ Potential!
Appropriate shoulder rotation is essential for overhead athletes; I want to discuss this in the context of volleyball. My bread and butter. Think of a volleyball player hitting a cut shot or winding up to swing away at a set. You will see a great amount of external rotation during the cocking phase (the middle frame in the photo above). The greatest demand for internal rotation range of motion would be the follow through for a cut shot or “thumb down” (as in the photo below).
The amount of shoulder rotation range of motion for a volleyball player is that of a normal individual but you need a balance of range of motion, strength and control.
A quick side note worth mentioning: as an overhead athlete, you are likely to have greater range of motion in external rotation and less internal rotation. This is normal due to the demands of your sport. The baseline that we look for is that total range of motion side-to-side is the same. So you may look like the guy on the right in the picture below. It is also common for volleyball players to demonstrate greater internal rotation rather than external rotation strength, which may lead to injury down the road if the ratio becomes too skewed.
Let’s go through the steps of an arm swing and see where a weakness may be and how to address it:
Check your external rotation by laying on your back, arm out to the side and elbow bent. See how far you can drop the back of your hand down to the floor. Lacking here? Try this out: Subscap Smash
The shoulder joint is one of the most complex in the body due to its high mobility demands that compromises the stability. For volleyball players, shoulder maintenance is key for longevity, pain-free function, power and control. I broke the attack down very simply to highlight a few major areas of weakness that is often found in volleyball players. Give these mobility and strengthening exercises a try and see what works best for you.
At Athletes’ Potential, we believe that self-maintenance should be the first step toward managing pain and recovering properly. But if you have a nagging volleyball shoulder and cannot seem to find that silver bullet, give us a call!
Thanks for reading,
Since “retiring” from volleyball, my fitness regimen now consists of weightlifting, rowing, body weight movements, running (let’s call it casual jogging), and so on. What are all of these movements missing? Rotation! I have become very strong in the sagittal plane—cleans, jerks, rowing, squatting, pull-ups. No wonder when I play a pick-up game, I am sore as all get out!
This one goes out to those athletes who continue to be competitive in overhead rotational sports. Tennis players, softball-baseball-volleyballers, I’m looking at you! You guys hang out in the transverse plane a lot so this is where you need strength and control. This is why shoulder and spinal rotation is so vital for power and longevity in your sport and how to begin to maximize your performance.
The Anatomy of Rotation
Rotation in the thoracic spine is normally about 35 degrees but can be difficult to differentiate from lumbar rotation. However, the bony structure of the lumbar vertebra allow much less rotation than thoracic vertebra so we will focus there.
The two major anterior rotators are the external and internal obliques. The external oblique (EO) attaches to the last 6-7 ribs, to the upper fibers of the serratus anterior and lateral fibers of the latissimus dorsi (on the right in picture). Due to these connections, you see how rotation strength would also affect shoulder stability. It acts to cause contralateral rotation; so the left EO turns your trunk to the right. The internal oblique (IO) acts to rotate the torso ipsilaterally, or to the same side (on the left in picture).
Another muscle group that we cannot forget about is the multifidi. These small muscles live on the posterior vertebra and have short connections at each level. Rather than acting as a strength muscle that creates movement, they are stability muscles that control rotation. So as my torso rotates left, my right side fires more than my left to control the amount of rotation allowed.
Training these muscles for strength and motor control are important to maximize power through rotation and decrease the rotational load on the lumbar spine. Rotation at your hips, trunk and then arm are the secret to a powerful throw/swing and minimize damage at these joints. If your thoracic spine is not mobile, the hips and shoulders will take the brunt of the force. This often results in early rotator cuff damage and impingement as well as issues up and down the kinetic chain in the elbow, back, hips and knees.
Spinal mobility and strength is the foundation of overhead sports.
Check your thoracic mobility: kneel on the floor, hands and knees. Put one arm behind your head and then rotate your shoulder and torso on that side up toward the ceiling. How far do you get? For an overhead athlete, it would be ideal that you elbow and shoulder could be straight up. Be sure not to just crank your elbow back, its more about the thoracic spine and shoulder position!
“Wow, people can really rotate in this position?”--if that’s you, then it’s time to begin some thoracic mobility work! Check these out:
Better Upper Back mobility: This one is great for those who sit the majority of the day or who tend to have poor posture (that should have covered 98% of us!) All you need is a double lacrosse ball or Yoga Tune Up balls like those that Danny has in the video.
The thoracic rotation mobility drill is great to perform as part of a warmup. Beginning in position A, take a deep breath and open up the shoulders, lowering the top shoulder down towards the floor to reach position B. On exhalation, try to sink further into the stretch. Stay there for about 5 seconds then back to A. Move through this with your breath 10 times in each direction.
“That was easy!”—if you said this then let’s focus on your strength and control. Try these versions a Pallof Press. This exercise as described in the video is great for anti-rotation. The picture depicts another form that works on anti-extension. Just be sure that when you move your arms overhead, your ribs remain stacked above your pelvis. We want to avoid overextension of the back and the ribs poking forward. What I mean by “anti-“ exercises is that you are resisting the band tension that is trying to pull you into rotation and extension, thus working the muscles we highlighted earlier.
As I mentioned before, thoracic mobility and torso strength are just the beginning to a successful and long career as an overhead athlete. Hip complex rotation and shoulder rotation will be highlighted in later posts! But for now, it all starts here!
All of this overhead sport talk has me missing volleyball. So for that, here’s a #ThrowbackThursday.
Thanks for reading!
In the words of Jay-Z, “I’ve got 99 problems but wrist pain ain’t one.”
Nice front rack Mr. Farris!
Well maybe those aren’t his exact words but since I’m actively giving up using profanity (which is very hard to do) we’ll keep this quote the way it is. We know that Jay-Z doesn’t have wrist pain but in the last CrossFit Movement and Mobility Trainer Course I taught, about half of the class had wrist issues. Usually when I informally poll the class to see what problems most people are having,back pain comes up number one. This weekend wasn’t any different until the Sunday course. Wrist issues were a plague for this group, predominately in the front rack position. So we spent a ton of time working on the wrists right? Wrong, we fixed their shoulders!
How many of you have seen big strong guys/gals that can back squat a ton of weight but when you get them to front squat their weight drastically decreases? These are typically males that used to love bro'ing out at some globe gym where everyday is bench press day. They are pretty strong but have never put in some legitimate mobility work in their lives.
Don't be this freaking guy!
Let’s be clear on one thing. There are many reasons for why someone could have a very weak front squat compared to their back squat. In this example however, we are going to focus on improving the front rack position and unloading the wrist. The higher you can keep your elbows during the entire range of motion of a front squat, the easier that movement will be. High elbows also allow for the wrist to be unloaded during the lift.
How do we get those nice high elbows? By having enough shoulder flexion and lateral rotation. In coaching terms this allows us to keep our arms parallel with the ground and maintain a strong front rack position. There are multiple problems that occur when the elbows start to drop in the front rack. It’s a huge loss of force production potential but also puts the poor wrists in a terrible position.
A combination of these two movements at the shoulder makes up the front rack position.
Here’s a quick test. Un-rack a decent amount of weight (75-90% of your 1RM front squat) and hold it in your front rack position like the example in the top section of the picture below. See how your wrists feel and see if you can hold it for 30-45 seconds. Now do the same test but hold the weight in the position like the athlete in the bottom of the picture below. No wrist wraps allowed!
Thanks to www.twinfreakscrossfit.com for the photo.
Which one were you able to hold longer? Which one felt more comfortable?
For the majority of athletes the first position will feel dramatically easier when holding the load. If you have terrible front rack mobility you will always end up in some variation of the dreaded lowered elbow position. This is wrecking havoc on your wrists and costing you PRs. If your wrists hurt, fix your shoulders!
Now how do we fix the shoulders? Here is an old school (2011) Mwod video of Kelly going over fixing the front rack position. If you haven’t checked out Mwod recently, you really need to. Mwod Pro is only $8 a month and has new mobility techniques to help improve your performance and resolve pain everyday. That’s about the cost of two lattes! In the words of Kelly himself “make a better decision”.
Take a crack at fixing this stuff yourself first! If you're still having issues come and see us at Athletes' Potential! If you don't live in the Atlanta area, check out this out the 4 Keys To Picking The Right Physical Therapist in your area.
This used to be me, minus the 16 year old Asian kid part.
Like most kids in the United States, sports were a huge part of my life growing up. If you would have asked the 10-year-old me what I wanted to be when I grew up, it wasn't a physical therapist, it was a professional baseball player (that obviously didn't happen).
When I do look back on my athletic career (I guess you could call it that), it's riddled with injuries. Here's a list of the major injuries I have sustained playing sports to include, football, baseball, basketball, soccer and dabbling in military combatives.
-Broken right ankle at the growth plate age 15.
-Non-contact related right meniscal tear requiring surgery age 16.
-SLAP labral tear right shoulder age 18.
-Torn disc lower back L4-5 causing nerve root compression for 6 months age 24. (High volume deficit dead lifts with poor technique, my own damn fault)
-Torn disc neck C5-6 causing nerve compression for 3 months age 26.(Army combatives, accidents happen)
Looking back all the injuries that I have sustained it's a fairly long list. Some people would say that I'm injury prone, others may blame it on my genetics. I blame it on my horrific lack of mobility!
When I was in elementary school, I can remember taking the President's Physical Fitness Test. It was a big deal to me back then, mainly because I was sure I would be a professional athlete one day. I did great on all of the events and went into the last event with my confidence at an all time high. The last event was the sit and reach and I failed it! I could not for the life of me reach forward and just touch my damn toes. I was an emotional train wreck, my whole life revolved around sports and I couldn't even pass a national standard. That's a tough pill for a 10-year-old to swallow.
I think back to that test and I think of something different that could have come out of that. An educator, my parents or a coach could have seen that as a red flag or a warning sign. Sadly, the reality is that mobility is often overlooked and brushed aside as just being "tight". If you are making all-star teams and progressing in your athletic skill sets, who cares if you are a little on the tight side, right? Wrong, that's a big mistake and it needs to change.
We as coaches, parents and physical therapists have to prioritize movement first. That comes down to two components, motor control and mobility. Motor control is the ability to perform a movement correctly aka technique. Mobility is having enough available range in your joints and tissues to perform that movement optimally and safely. You need both to have proper movement, one without the other is worthless.
For me, mobility was my greatest obstacle to achieve better movement. Working on mobility sucks! I know, both as an instructor and from personal experience. Shit, two years ago I couldn't even touch my toes and now I teach Movement and Mobility courses across the country. It's very humbling for me to teach these courses for CrossFit and it's because I know first hand how much it can change people's ability to perform at a high level and stay injury free. Since adding MWOD concepts into my training I have not been injured once. I did get hit in the face with a surfboard that broke my nose a couple years ago but no amount of mobility/technique would have changed that. Some injuries are unavoidable but they are very rare.
Here's my advice for all my CrossFit athletes in Atlanta. If you suck at something, you need to focus on trying to improve that weakness everyday. This is not what most people want to hear. If you're flexible, you will enjoy yoga. If you're strong, you will enjoy powerlifting. The reality is, that super flexiblity yoga practitioner would benefit a hell of a lot more from doing some heavy squats than working on her pigeon position.
Find your flaws, chase them down, go for the throat and don't let go until your weakness becomes an asset!
Often times, external rotation is the focus in athletic movements. When the shoulder is externally rotated, it can be packed into the back of the capsule to improve stability and congruence. It also rotates the humerus in a way that the anterior structures of the shoulder have room to move without being pinned between bones. Many of the stretches people gravitate towards for the hip involve external rotation: sitting figure 4 stretch, pigeon, etc.
What is internal rotation and why do I need it?
Internal rotation is one of the movements of a ball and socket joint, such as the shoulder and hip. In the shoulder, it allows you to reach behind your back and pull your wallet from your back pocket or tie your bikini behind your back. More importantly for athletes, it allows you to keep the bar close to the body during Olympic movements and arrive at the bottom of a ring dip safely. Hip internal rotation is needed for athletes for proper biomechanics during any form of a squat or while running. Without full internal rotation, you will likely have a “butt wink” or your low back will slightly round at the bottom of the squat. It is also important for runners to have full internal rotation, coupled with extension, to allow correct biomechanics in the trail leg.
During internal rotation, the ball of the joint (humeral head and femoral head) will glide posteriorly and roll anteriorly. This movement can be restricted with a tight posterior capsule or muscles around the joint. Unfortunately, many people will have issues here due to increasingly sedentary lifestyles and desk jobs. As you sit all day, the hip rarely reaches full extension, allowing the posterior capsule to become tight. This in turn decreases the posterior glide and thus decreased internal rotation. The same deal happens at the shoulder when you sit all day at the computer with terrible posture.
Interestingly, hip internal rotation deficits have been correlated with low back and sacroiliac pain. It is better to start improving internal rotation now rather than trying to manage back pain!
How to check internal rotation
It is easiest to accurately check internal rotation of the shoulder with a buddy. Lay on your back, arm straight out to the side and elbow bent (as in the picture below). Your buddy should provide solid but comfortable pressure to the front of your shoulder to avoid it from raising off of the ground. Now move your palm down towards the ground. Ideally, you would be able to get at least a fists-width from the floor! Be sure to check both sides because noting an asymmetry is important. Also, be sure to do this same test after practicing the mobilizations below!
To check hip IR, lay on your stomach and allow your feet to drop out to the side. Again, we are looking for asymmetries and major deficits. Ideally, your leg will move about 40 degrees or roughly halfway down toward the floor.
Mobilizations to Improve Internal Rotation
Below are a few mobilizations for the shoulder and hip to improve internal rotation. They are by no means an exhaustive list but merely a starting point.
Bully stretch- used to mobilize the humerus into the back of the shoulder capsule, which increases internal rotation.
Pec smash- nearly everyone has a tight pec minor due to the poor postures we often keep throughout the day. This muscle is located in the front of the shoulder, so if it’s tight it can easily restrict the posterior glide!
Internal Rotation Stretch- start with your foot flat on the ground and the other leg crossed over. Slowly walk your foot out to the side until you feel a strong but comfortable stretch in the hip. You should feel this in the bottom leg.
Lateral Hip Opener- this does not have to be banded if you do not have access to one, you will still feel a stretch!
I hope this gives you a better understanding of what internal rotation means, how we achieve it and why it is needed. More importantly, I hope these videos give you a good idea of how to begin to manage internal rotation deficits!
At Athletes’ Potential we want to help every athlete remain healthy and meet goals. You don’t have to be in pain to come see us. If you find asymmetries with tests such as these or know you have movement deficits, we can help you with proper movement and self-maintenance. We also have recovery options to further augment your fitness and health. We look forward to hearing from you!
Thanks for reading,
If you're in Atlanta and you have questions about our Physical Therapy or if you're frustrated with your current situation, contact us and let us help you!
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.