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The most common gap in fitness programming is the absence of loaded ambulation, or activities that make you move around while under load.  Having two arms to carry and two legs to propel, make us very efficient at moving stuff around– Egyptian Pyramids, Easter Island heads, Stonehenge…  Only recently has the requirement that we lift, carry, push, and pull disappeared from our lives.  An excellent loaded ambulation activity to make part of your fitness program is the Reverse Sled Drag.

Performance

To perform the Reverse Sled Drag, connect a long strap to the base of the sled.  The strap should be at least six feet long.  The strap should either have a pair of handles, or you can attach a set of split handles to the strap.  Keep the spine straight -no rounding over- and sit back so the hips are flexed.  Imagine you are sitting back onto an invisible stool.  Let the arms be long and keep the shoulder blades down your back.  As you drag the sled backward, plant the ball of the foot and drive off the heel as you extend the knee.  Do not let the body turn.  Stay square to the sled.

Loads, Distances, and Frequency

Three or four Reverse Sled Drags for 20 to 40 yards is a good start.  The load you use will depend on your strength and fitness level.  I like to put sled drags at the end of a training session.  There is no eccentric muscle stress with Reverse Sled Drags, so it takes less time to recover from this exercise.  Two sessions a week is a good start.

Rehab Population

Reverse Sled Drags are a knee friendly way of training the quadriceps muscles without overloading the joint.  We use Reverse Sled Drags in our physical therapy clinics as a standing terminal knee extension activity that helps strengthen and increase quadriceps mass after a knee injury.   Reverse Sled Drags are an effective alternative for anyone who needs to avoid more stressful, knee-dominant exercises.

Female Knees

Female athletes have far more knee injuries than their male counterparts.  The good news is that, with appropriate training, we can reduce the incidence of knee injuries in female athletes.  Female athletes who back pedal on the field of competition—soccer, basketball, etc- should work on Reverse Sled Drags.

Fitness and Fat Loss

You will make greater progress toward reaching fitness and body composition goals with Reverse Sled Drags than with any seated leg exercise.  The metabolic demand of dragging a sled can only be matched if you are actually pushing the leg curl machine around the gym.

To view video demonstration of Reverse Sled Dragging, click on the link below:

https://www.youtube.com/watch?v=xBBDgzPFOFM&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

At one time, we all had a very stable and pain-free squat pattern.  As infants, we could transfer up off the floor through a deep and complete squat.  Deconditioning, prolonged sitting, and injuries all take their toll until we lose so much movement that many of us are unable to properly descend into a chair.  Regaining a functional squat pattern will reduce the incidence of injury, enhance functional mobility, and maintain lifelong independence.  One of the most effective squat restoration drills is the Overhead Stability Squat.

The Overhead Stability Squat is like riding a bike with training wheels.  The resistance provided by the tubing held overhead gives the spinal stabilizers something to push against.  As you move through the squat, the resistance feedback from the tubing allows you to stay in a more upright position.  Practice the squat pattern and the neural connections laid out early in your life will reconnect and your function will improve.

Overhead_SquatAnchor the resistance tubing at chest level.  Face the anchor point and hold the handles overhead.  The palms face inward and the shoulder blades are pulled down the back-similar to the football official signaling a touchdown.  Position the heels at least shoulder width apart with the feet slightly outwardly rotated.  The toes should point out no more than thirty degrees.    Push the hips back and lower into the squat.  Keep the chest proud and the spine tall as you descend.  Use a box (14-16 inches) as a gauge to measure the depth of your descent into the squat.  Drive through the hips and rise back up to the starting position.  A mirror that provides a side profile can be helpful for visual feedback on your performance. Perform two sets of ten repetitions.

Progress this exercise by using a lighter level of resistance tubing.  Increase the depth of the squat by lowering the height of the box to twelve inches.  Isometrically hold the bottom and middle portion of the squat for five seconds.

Some common mistakes are allowing the knees to collapse inward, permitting the heels to come up off the ground, allowing the trunk to collapse forward and losing the upright thoracic spine position, and developing a posterior tilting of the pelvis, or a “butt wink”, at the bottom of the squat.

To view video demonstration of the Overhead Stability Squat, click on the link below:

https://www.youtube.com/watch?v=0c6MN3d-GsU&feature=youtu.be

-Michael O’Hara, PT, OCS, CSCS

A $2500 Coat Rack

I have been in the physical therapy and rehab business since 1984.   I have learned many things about training consistency and fitness equipment.  Expensive fitness gadgets have an average utilization life of two months.  This is an updated version of an often requested article on my recommendations for home exercise equipment.  These are the holiday fitness gift ideas that keep giving.

A physical therapy patient of mine recently brought in an article that discussed the merits of different types of exercise equipment you can purchase for your home.  She wanted my advice on the piece of machinery I would recommend for her and her husband to use at home.  Should they get a $1600.00 elliptical machine, a $2500.00 treadmill, or $1100.00 recumbent bike?  My answer was that none of these machines are a good idea as most cardio machines become an expensive coat rack in less than four months.  If you are starting out on a fitness program and wish to be successful, my suggestion is to invest in the following:

Note Pad and Pen: $10.00
In advance, you will write out your monthly “plan of exercise action”.  Set down the date, time, place, and exercise activity.  The written plan is a commitment to stay on schedule.  Record your exercise sessions in a training log.  Write out the exercises you perform, the number of sets, repetitions, and loads.  The training log will help reinforce the single most important component of fitness–consistency.

Tape Measure: $1.00
A good exercise program is going to increase your muscle mass, reduce body fat, and add some bone to your skeleton.   In the beginning, the numbers on the scale may go up instead of down and this can frustrate fitness newbies looking to “drop twenty pound in four weeks”.  Put the bathroom scale away and record girth measurements.  Men should measure around the belly button and women around the hips. These are the regions that are quickest to change with proper training.

Alarm Clock App: $5.00
The most important aspect of exercise success is consistency.  Research at the University of Michigan department of psychology has demonstrated numerous times that training in the morning leads to far better training consistency.  Get out of bed and exercise in the morning before other aspects of life have a chance to interfere with your plans.

Kitchen Scale: $50.00
Food portion awareness is essential for fat loss. Knowing the number of calories present in a portion of food is critical to reaching body composition goals.  You will never be able to exercise enough to counterbalance the effects of a poor diet.  Consistent use of a kitchen scale will educate you on portion size and calorie consumption.

Home Exercise Equipment Recommendations: $245.00
Lifeline suspension trainer $100.
Two all-purpose resistance bands $50.
Two furniture sliders $5.
Fitness Sandbag $60.  The sandbag is my new recommendation for 2017.  The cost of fitness sandbags has decreased and construction has improved.  It is now much easier to add weight to the sandbag as you become stronger.  Lifting and carrying an odd object is one of the best total body strength training activities you can perform.  You can purchase all of these products from performbetter.com–estimate $30 shipping.  Total cost is about $245.

Activity Tracker $40.00
You can download an activity app onto your smart phone.  Increasing daily step count is the easiest way to produce big fitness improvements.  Record your daily step count and work on setting new records.  Ten thousand steps a day is a good goal for most people.

Professional Assistance $600.00
Hire an educated and qualified trainer to assist you in designing and implementing a customized training program.  The number two reason people stop exercising is injury and number one is no results.  A fitness pro can steer you around both of these issues.  The trainer will teach you how to properly use the home exercise equipment you have purchased.  No one executes exercises correctly after only one training session.  You need ongoing evaluation and correction on exercise performance.  Older and physically limited individuals need the assistance of a trainer more than any other group.

Total Cost $950.00
You will have more space in your house, more money in your pocket, and you will be much more likely to succeed in reaching your fitness goals.  Two years from now you will sell that $2500.00 treadmill on ebay for $200.00.

Merry Christmas,

Mike O’Hara, P.T., O.C.S., C.S.C.S.

Everyone needs to read the two part New York Times article on falls (see links below).  As a physical therapist who has worked with fall related injuries and fall prevention for the last thirty years, I applaud Katie Hafner.  For the last ten years, the number of emergency room visits and the number of deaths from fall related injuries has been climbing at an alarming rate.  Most people are unaware of how dramatically a fall can change their life.  The news we are not getting is that programs designed to prevent falls are very effective.  A properly designed fitness program can improve your balance, enhance your reaction skills, and make you less likely to fall.

Please Stand Up

If you want to improve your balance you must stand up.  There is specificity to exercise.  You will not get better at tennis with an exercise program of swimming.  Seated, supine, or prone exercise activities will not improve your balance, reaction time, or proprioception.

The Feeble Fall

Make strength training and the maintenance of muscle mass a priority in your fitness program.  The loss of muscle mass and strength is directly correlated to a higher incidence of falls.  It is good to improve flexibility and cardiovascular capacity, but they will not reduce your risk of falling.

Practice Reacting

If fall prevention is your goal, then your fitness training must make you move at quicker tempos.  Most of the training in fitness facilities is of the slow and controlled variety:  Slow seated knee extensions, slow down dogs, slow seated physioball leg lifts.  In life, much of what comes at you is fast and uncontrolled.  The time you spend training must focus on activities that make you move quickly.  Throwing a medicine ball, foot work on an agility ladder, or low hurdles and reactive resistance tubing drills are good examples of faster paced exercises.

Become a Better Shock Absorber

Your fitness program should make you impact resilient.   Fall events often occur because of an impact.  You get bumped or jostled and are unable to maintain your equilibrium.  The force of the impact causes just enough movement disruption that you topple over.  Just like any other physical attribute, impact resilience can be improved with proper training.

Ground Rules

Getting up and down off the ground enhances all aspects of balance, coordination, and positional awareness.  The capacity to transfer gracefully and safely from the floor to standing maintains independence.  Getting down on the ground and developing this skill should be part of your fitness program.

Fall prevention programs work, and they work better than most other disease preventative programs.  Most people start fall prevention training after they have tumbled over several times.  Whether it is heart disease, diabetes, or falls, it is far better to start prevention programs before problems develop.  My suggestion is that if you are over forty, you need to make fall preventative activities part of your exercise program.  Fear, denial, and the “old dog–new tricks” dilemma are the obstacles we keep tripping over.

To read Part I, click on the link below:

http://www.nytimes.com/interactive/2014/11/03/health/bracing-for-the-falls-of-an-aging-nation.html?_r=0

To read Part II, click on the link below:

http://www.nytimes.com/2014/11/04/science/a-tiny-stumble-a-life-upended.html

-Michael O’Hara, PT, OCS, CSCS

I get flak from some of my fellow gym rats because I do not believe in muscle isolation exercises.  While I do not think it will harm most young and recovery-resilient trainees to perform fifteen sets of shoulder lateral raises or five different styles of bicep curls, I do find that format of training less than optimal.  Older gym goers (30+ years) will see better results and fewer injuries if they stay far away from incline curls and the seated knee extension machine.  Father time and experience has taught me that, excluding the bodybuilder who trains solely for hypertrophy, most of us will be more successful by becoming proficient in multi-joint exercises.

That being said, there are a few isolation-type exercises that I regularly use with fitness and rehabilitation clients.  These isolation exercises are designed to improve posture, restore proper joint mechanics, enhance neural response, and reduce the risk of injury.  These activities will not put a “peak on your bicep” or give you “massive quads,” but they will make you less likely to develop shoulder and lower back pain.

Band No Money Drill

Most people have weak shoulder external rotator muscles and a rounded over shoulder girdle posture.  This is never a good combination if you are going to perform any type of upper extremity strength training.  The band no money drill helps remedy both of these problems.

Stand tall with the chest proud and the head pulled back.  Hold the band with the palms to the sky, elbows bent at 90 degrees held at the side-the palm up and no money in your hand position.  Concentrate your efforts on the muscles between your shoulder blades as you pull the band apart and bring the hands out to the side.  The tempo of the exercise should be controlled– two counts to pull the band apart and two counts to return to the starting position.  Choose a resistance band that is fairly easy and focus on making the motion smooth.  Perform two or three sets of ten repetitions.

Four Point Band Gluteal Activation

The gluteus medius is the muscle responsible for preventing unwanted rotation and inward collapse at the knee.  It also helps stabilize the pelvis and keeps damaging stress off the lumbar spine.  The four point gluteal activation drill activates the gluteus medius.

Place a mini band around both legs just above the knees.  Position on all fours–hands directly under the shoulders and knees under the hips.  Keep the spine stationary and lift the right leg up and out to the side so that the hip abducts approximately 30 degrees.  Hold for twenty to thirty seconds and then repeat on the other side.  Perform two times on each side.

Belly On Ball “Ys”

Postural Stress Disorder (PSD) is the new name given to the multiple pain problems associated with a flexed-over thoracic spine, forward head, and rounded shoulder posture.  Your fitness program should help you combat the damaging forces created by prolonged sitting.  The belly on ball Y exercise helps train away the postural flaws that create the symptoms of PSD.

Position yourself facedown over the top of a physioball.  You need a fairly firm ball that does not flatten out when placed under load.  Keep your spine stable and the chest off the ball.  Lengthen the neck and thoracic spine-they should not move at all during the exercise.  Keep the gluteal muscles tight and legs extended.  Start with the arm in front of the shoulders on either side of the ball.  The shoulders should be externally rotated in a thumbs up position.  Raise the arms overhead like a football official signaling touchdown.  This will create a Y shape with your torso and arms.  Hold the arms overhead for three counts and then lower back down in a controlled fashion.  Perform two sets of ten repetitions.  As you get stronger try adding resistance with some dumbbells.

Single Leg Hip Lifts

Gluteal amnesia is at epidemic levels in gyms and fitness centers across America.  A loss of gluteal muscle activity is the primary driver of lower back, knee, and hip pain.  Prolonged sitting, elliptical training, and a general lack of any type of sprinting has created a large group of people who are unable to efficiently fire their gluteal muscles.

The single leg hip lift facilitates a better neural connection to the gluteals and can help reduce the occurrence of anterior hip pain.  Lay supine with the knees bent and feet flat on the floor.  Lift the right leg off the floor and hold onto the front of the right lower leg with both hands.  Use the left leg to perform a single leg bridge.  Focus on contracting the left gluteal muscles in an attempt to reach full left hip extension.  Hold at the top of the bridge for three seconds.  Perform two or three sets of five to ten lifts on each leg.

To view video demonstration of Mike’s choice isolation exercises, click on the link below:

http://www.youtube.com/watch?v=VfizyEiadfQ&feature=youtu.be

-Mike O’Hara, PT, OCS, CSCS

 

 

Whenever we crawl, get up off the floor, walk, run, or sprint we use our legs in a reciprocal pattern:  One hip comes forward and the other hip backward.  We work on this pattern from the moment we are placed in the crib.  The control of reciprocal hip movement is a skill we must all master in order to successfully carry our body through space.  Unfortunately, age, inactivity, poor training choices, and injury can rob us of this basic movement skill.  The good news is that with some dedicated half-kneeling training you can improve the reciprocal hip pattern.

What is the half-kneeling position?Half_Kneeling

Sister Agnet taught me how to genuflect in first grade:  One leg forward, one leg back.  Get that back knee down to the ground with the eyes up and the torso tall.  I could tell that practice made perfect as Sister Agnet had to be at least 100 years old and could perform a flawless, split stance squat on either leg.  She had a rapid walk and a tall posture that made her look as though she could easily run you down on the playground.

The half-kneeling position is the bottom of the genuflexion.  The tibia (shin bone) of the front leg and the femur (thigh bone) of the back leg are held perpendicular to the floor.  Keep the torso tall and the head pulled back and up.

Why you need half-kneeling exercise?

Exercising from the half-kneeling position has multiple benefits. Not only do you need the split stance position to get up and down off the floor, but it will also improve your posture when you walk or run.  Becoming stronger in the half-kneeling position makes you a more efficient athlete and improves balance.   It also creates a buffer zone of functional mobility and strength that makes you less likely to suffer an injury.  Half-kneeling is the antidote for the physical damage produced by prolonged sitting.

Easy Half-Kneeling Progressions

There are many half-kneeling exercises you can perform.  Three of the most basic progressions are listed below.  Start slow with these drills and do not hesitate to add resistance and repetitions.

Sustained Half-Kneeling

Many fitness clients are unable to get into the half-kneeling position.  These are often the same clients who present with postural deficits and gait asymmetries (good stride and balance on one leg and not so good on the other).  The goal for these patients is to simply get into and sustain the half-kneeling position for thirty seconds on each side.  Make this exercise more challenging by holding a medicine ball at chest level for thirty seconds.

Half-Kneeling Rotation Stability

Once you can sustain a half-kneeling position, try adding on some rotational stability training with a resistance band or cable unit.  You will need an Airex pad or exercise mat under the knee.  Set up in the half-kneeling position with the right knee resting on an Airex pad and the left foot in line with the left hip.  Align the body so the resistance tubing, or cable column, is set up on the right side at waist level (standing).  Stay tall through the torso and pull the tubing or cable to the chest.  Do not allow your body to move as you push the arms out and back.  Keep the abdominal and gluteal muscles braced so the pelvis does not move.  Perform ten repetitions on each side.

Half-Kneeling Single Arm Rows

Set up in the half-kneeling position with the right knee resting on an Airex pad and the left foot in line with the left hip.  Align the body so the resistance tubing, or cable column, is in front of the body at shoulder level.  Place the handle in the right hand (same side as the down knee).  Stay tall through the torso and pull the tubing or cable so the right thumb moves toward the right armpit.  Keep the abdominal and gluteal muscles braced to keep the torso tall and prevent the legs from moving.  Hold for two counts and then return to the starting position.  Perform ten repetitions on each side.

You can purchase an all-purpose band ($25.00) from performbetter.com.   They have two handles and attach easily in any door.  Most people can start with the pink or orange bands.

To view video demonstrations for the above half-kneeling exercises, click on the link below:

https://www.youtube.com/watch?v=77p3tUyC9Ag&list=UUje3hqQBygH_JOPhWLQjtVw

-Mike O’Hara, P.T., OCS, CSCS

Biceps“I don’t want to get big and bulky”.  I hear this often from people who are new to exercise as well as lifelong gym members when it comes to lifting weights.  Don’t worry.  It’s not that easy. Bodybuilders and strength enthusiasts spend a lifetime trying to achieve it.

Most people’s goals to tone up, decrease body fat, and increase strength and mobility, require them to build more muscle. Let me explain why:

Research has demonstrated that after about the age of 25, Resting Metabolic Rate (RMR) starts to decrease by 2-4% each decade. This means, that by age 55, your RMR will likely have decreased by 6-12% or from 2000 calories/day to perhaps as low as 1760 calories/day. If your nutrition and/or activity levels don’t change, this will lead to weight gain.

This easily explains why the average American gains 3lbs every 5 years. Interestingly, we also tend to lose about 5lbs of lean mass (which is metabolically active) per decade after the age of 25. This is no coincidence. With less muscle, our metabolism slows, and we tend to gain weight in the form of fat. We start to move less because it’s harder, which leads to more muscle loss and a slower metabolism. It’s a vicious cycle. This cycle happens so slowly that many of us don’t see it coming until it’s too late and hard to reverse. We have now stored more fat (less toned), lost strength (and power), and don’t move as well.

Looking for the good news?  It’s all 100% preventable.  In many cases, it can also be reversed. Resistance training with the goal of hypertrophy (muscle growth) and strength gives your muscle reason to grow, or at the very least, not atrophy or wither away. Nutrition plays a vital role in this process as well.  You need adequate nutrients (particularly protein) in order to build and repair muscle. Increasing your muscle is a great way to “tone” and helps to ensure success with your long term fitness goals.

Step off the treadmill, pick up something heavy, eat a steak, and give your metabolic rate a fighting chance as you age.

-Jeff Tirrell, B.S., CSCS

I have received several requests for more recommendations on postural restoration exercises.  This is the third of three articles.  This pair of exercises is a good choice for athletes who swing a bat, racquet, or club as it helps restore thoracic spine and shoulder girdle rotation.

Most of us drive, commute, do computer work, watch television, and often sleep in the same position.  We become stuck in a forward flexed thoracic spine posture that rotates the shoulder blades downward and pushes the head forward.  Long-term postural flaws will limit your strength, functional mobility and are the precursor to many of the pain problems we treat in physical therapy.  Your fitness program should eliminate, not feed,  these postural problems.  I have some postural restoration training suggestions that nearly anyone can implement into his/her fitness program.

Many strength coaches and physical therapists have found that performing a mobility exercise followed by an activation (strengthening) exercise produces more expedient changes in postural flaws.  Your goal is to increase the restricted movement pattern and then strengthen through the newly acquired range of motion.

Four Point Torso Rotation and Half-Kneeling Rotational Rows

Assume an “on all fours” position with hands under the shoulders and knees under the hips.  Place the left hand behind the head.  Keep the right shoulder blade down your back and away from the neck.  Keep the neck long and do not let the head fall forward.  Turn the torso to the left and lift the left elbow toward the ceiling.  Hold the open position for two counts and then lower back down.  Perform ten repetitions into left rotation and then switch sides and rotate open to the right for ten repetitions.  Follow this exercise with half-kneeling rotational rows.

Half-kneeling rotational rows will improve the strength in the enhanced movement created with the four point rotation drill.  Assume a half kneeling position with the right knee down.  An Airex pad under the knee can increase comfort.  The left hand holds a cable machine or resistance tubing set at eye level while you are positioned in the half-kneeling position.  The left arm is fully extended and the left side of the body is rotated toward the tubing.  Pull with the left hand in a rowing motion and simultaneously rotate the torso to the left.  Keep the neck relaxed and eyes straight ahead.  Return to the starting position and repeat.  Perform eight to ten repetitions on the left and then switch leg positions and repeat on the right.

To view video demonstration of the above exercises, click on the link below:

 http://www.youtube.com/watch?v=rJUhtzFnj1o&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

 

I have received several requests for more recommendations on postural restoration exercises.  This is the second of three articles.  This pair of exercises is a good choice for overhead athletes such as tennis and volleyball players.  Watch for number three next week.

Most of us drive, commute, do computer work, watch television, and often sleep in the same position.  We become stuck in a forward flexed thoracic spine posture that rotates the shoulder blades downward and pushes the head forward.  Long-term postural flaws will limit your strength, functional mobility, and are the precursor to many of the pain problems we treat in physical therapy.  Your fitness program should eliminate, not feed, these postural problems.  I have some postural restoration training suggestions that nearly anyone can implement into his/her fitness program.

Many strength coaches and physical therapists have found that performing a mobility exercise followed by an activation (strengthening) exercise produces more expedient changes in postural flaws.  Your goal is to increase the restricted movement pattern and then strengthen through the newly acquired range of motion.

TRX “Stoney Stretch” and Belly On Ball “Y”s

Stand facing away from the TRX strap.  Place the handles at eye level on either side of your head.  Step forward with the right leg and simultaneously reach the hands up in a letter Y shape.  The TRX will provide an effective mobilizing stretch to the shoulders and upper thoracic spine.  Do not hold the stretch for more than three seconds.  Step back and then repeat with the left leg.  How far forward you step depends on your shoulder and upper thoracic spine mobility.  As your ability to move improves,  the step can be progressed to a full forward lunge.  Perform five repetitions with each leg and then move to the Belly on Ball Y exercise.

Position yourself face down over the top of a physioball.  You need a fairly firm ball that does not flatten out when placed under load.  Keep your spine stable and the chest off the ball.  Lengthen the neck and thoracic spine.  They should not move at all during the exercise.  Keep the gluteal muscles tight and legs extended.  Start with the arms in front of the shoulders on either side of the ball.  The shoulders should be externally rotated (keep a thumbs-up position of the hands).  Raise the arms overhead like a football official signaling touchdown.  This will create a letter “Y” shape with your torso and arms.  Hold the arms overhead for three counts and then lower back down in a controlled fashion.  Repeat for 10-12 repetitions.

Common mistakes include using a ball that is too small or too soft, swinging the arms up and down instead of in a controlled fashion, failing to hold the arms overhead for three counts, and/or extending the cervical spine (looking up) instead of maintaining a lengthened position through the spine.  You can make the exercise more challenging by adding dumbbells.

Click on the link below for a video demonstration of the above exercises:

 http://www.youtube.com/watch?v=ujoDgmzAsAQ&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

Most of us drive, commute, do computer work, watch television, and often sleep in the same position.  We become stuck in a forward-flexed thoracic spine posture that rotates the shoulder blades downward and pushes the head forward.  Long term postural flaws will limit your strength and functional mobility, and they are the precursor to many of the pain problems we treat in physical therapy.  Your fitness program should eliminate and not feed into these postural problems.   I have some postural restoration training suggestions that nearly anyone can implement in his/her fitness program.

Many strength coaches and physical therapists have found that performing a mobility exercise followed by an activation (strengthening) exercise produces more expedient changes in postural flaws.  Your goal is to increase the restricted movement pattern and then strengthen through the newly acquired range of motion.

Foam Roll T and Band Pull Apart

Position lengthwise on a foam roll.  The head, spine, and hips should all be supported.  Bring the arms out to the side so that the elbows are even with the shoulders and bent to 90 degrees.  Let the shoulders relax and permit gravity alone to pull the arms toward the floor.  Attempt to keep the forearms parallel to the floor and the elbows at 90 degrees.  Stretch for 20 seconds and then bring the elbows together in front of your body.  Repeat for three to five repetitions.  The foam roll stretch will increase the mobility of the shoulder girdles and correct upper thoracic and cervical posture.  You should eventually be able to get the elbows to the floor.

Immediately after the foam roll mobility exercise, perform ten band pull aparts.  Stand tall with the chest proud and the head pulled back.  Hold the band with the palms to the sky, elbows extended and the hands just below shoulder level.  Concentrate your efforts on the muscles between your shoulder blades as you pull the band apart and bring the hands out to the side.  The tempo of the exercise should be controlled–two counts to pull the band apart and two counts to return to the starting position.   Choose a resistance band that is fairly easy and focus on making the motion smooth.  If you sit at a desk all day keep a band at work and perform a few sets of band pull aparts every day.

Use this set of exercises as a stand alone daily posture restoration activity or as a warm up before more aggressive shoulder strengthening exercises.  It is far more effective and less likely to cause harm than the commonly performed ballistic, windmill flailing, shoulder warm ups that every physical therapist is happy to see in the gym.

For foam roll and band pull apart demonstrations, click on the link below:

http://www.youtube.com/watch?v=ly5XHjJTsKU&feature=youtu.be

-Michael O’Hara, P.T., OCS, CSCS

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