Intro: A
Case Study w/ [sl]Amber:
A few hours prior my friend @amberm88 was a Cranky-McCranky-Pants,
mopping around the gym with a whole lotta low back pain. She had been unable to
pick up a barbell without pain for the past two weeks. Want to see what went
into these clips coming to be? Then PAY ATTENTION.
Amber was training hard for a competition. Amber moves a lot
of weight frequently. Amber is a proficient and fluid mover. Amber is athletic
and knows how to compensate really really well, almost to the point that you
probs wouldn’t even notice that something is wrong. WRONG: Amber has a really
stiff thoracic spine, or, upper back.
The training that goes into being an elite CrossFit athlete
involves weightlifting and gymnastics. These two modalities of movement exist
mostly in the sagittal (forward and backwards) plane, this is what one could
refer to as a training bias. Considering her impressive athletic history, Amber
used to ball on sucka’s in softball and basketball, both of which include
frequent thoracic rotation. Now, not so much.
With the foundational idea of treating the athlete as a
whole, I made a student-hypothesis: Make one segment move better to offload the
other segment. This is what happened.
**Disclaimer**: I am a student, and this is not medical
advice. If you are seeking medical advice refer yourself to a local physical
therapist.
Testing, Testing;
1, 2, Rotate:
You can think of most joints that don’t move well as a stuck
drawer. How do you open a drawer whenever it is stuck? There is a scientific
approach to mobilizing joints, but for the sake of simplicity and wit, do you
rip that beast straight out? NAH. You wiggle that thing. You wiggle it and then
see what happens. More often than not that wiggle will grease the tracks and
the drawer will slide right out.
Apply that to your thoracic spine. Amber had limited wiggle
once you limited movement in her hips and lumbar spine (low back) on the bench.
In my personal experience working extension on a foam roller is waste of time,
because you can so easily compensate in other areas.
Not to mention a lack of thoracic rotation can negatively
impact the relationship between our shoulder blades ribcage. And who wants
their shoulder being codependent and whinny all the time? I certainly don’t.
This being said, a hypomobile (doesn’t wanna move) upper back may have negative
effects up and down the spine. In Amber’s case, the issue surfaced in her low
back.
AAROM, Take
a Breathe, Re-Test:
I once read that if you can’t breathe in a position, you
don’t own that position. The statement holds true here. I apply gentle pressure
opposite the direction that I want Amber to go, I use Active-Assisted Range of
Motion (AAROM) to guide her in the range that is there, but dormant. I give her
some assistance to hangout in her end range, and to take a few breathes (sped
up here).
The same thing can be done by pressing up against a wall, or
using a band to pull you in the opposite direction. Just make sure you are
moving with your upper back, not your lower. Chances are you have the range of
motion, but you don’t know what to do with it because it’s 2017 and everybody
has a tight thoracic spine.
SPINE TIP (no, not the coccyx): if one segment is tight,
another segment will reflexively “loosen.”
But do you
Extend?
Ask a CrossFitter if they’ll get prone on the ground and
extend. They’ll get down there, crush it, and look at you and say, “I can do
this all day, I can do unbroken “Michael,” [a hero WOD: 3 rounds of 800m run,
50 back extensions on a GHR, 50 situps], duh.” But then you limit the degrees
of freedom, and BOOM, #gnarwhale.
Exercisers are fantastic at global extension, but it’s
really hard to extend your spine segmentally. I saw @unchainedphysio use this
exercise to prevent mashed-potatoes’ing on front squats, but it’s also a great
assessment.
Slow your roll, block the hips, and gain some control of how
your back extends. I’d say if you can do 3x30 of these your upper back moves
just fine.
Your Ribs
Aren’t Moving and Your Diaphragm Hates You
The average human takes 12 breathes a minute. There are 60
minutes in an hour, 24 hours in a day…and so on and so on, you do the math. I
don’t want to, that’s why I’m in physical therapy school. Did you forget that
your ribs attach to your thoracic spine? Its in the name ya’ll.
Here’s a way to get the intercostals (muscles between the
ribs) working double time to expand your rib cage. If you sit on one side of a
seesaw, does the other side move? Yes, yes it does. This is virtually what is
happening here, creating much needed movement around a bound down fulcrum.
Focusing on your breathing, and if you start to cough on your
exhales that OK – it just means your diaphragm is moving for the first time in
awhile. If you don’t have a wallball, just stack some sturdy pillows under your
ribcage and give it a go. And if you fall off like Amber, at least you’re
already right next to the ground.
Crawl
Before You Walk
As infants, we spend most of our time on our back. Our
baby-brains instinctually desire movement and exploration, so we rolled onto
our side and then on to our stomachs (in prone). You hated it, and you cried –
because your little baby neck was entirely too underdeveloped to hold up your
disproportionate noggin.
You began to spend to more time here, then you pressed up
onto your elbows, then you began to move around. Eventually beginning to pull
yourself up on furniture, getting onto your knees, eventually making your way
into standing. These concepts apply to learning exercises. It's easier to learn
stuff on the ground, especially if you are like me and tend to be a floppy
baby.
Stop extending solely from your low back and just hanging
out on your passive structures. Please: Use your muscles. Progress yourself with
these exercises. If King Soloman were a PT he would probs say something like,
“Guard your low back above all else, for from it flows the innervation for
everything downstream.” PTverbs 4:23
No comments:
Post a Comment