Presentation of a personal training client with notes:
significant posterior pelvic tilt
protracted shoulders, computer guy posture
–progressed to 2:1, 3:1 pull to push ratio
working on t-spine and upper body stretching
–don’t feel much during stretching
–sidelying GH motion appears normal
lot of tone in SCM and upper traps
a) if there’s anything else you think I should be focussing on, or if its just a case of the t-spine changes are going to take quite some time.
b) As a personal trainer, what can I do or whats the joint-by-joint thinking in cases on substantial tone in SCM & traps?
This is a picture of the SCM. Just the SCM.
This situation may very well take some time. Depending on age and tissue quality to begin with, when fibrosis sets in, there is some belief that there is very little if anything that can deform it and/or change it.
Also keep in mind that maybe everything you are doing is spot on, and this individual is doing some things outside of your training sessions to reverse what you are accomplishing.
I would ask you in this case to take a step back and maybe ignore the static postural limitations such as the resting tone in the upper quarter and neck. Ignore what he feels or how effective a certain exercise is or isn’t right now.
If he is not in pain, go to the FMS and trust it. If all else is not getting where you want to be, you have little to nothing to lose. Go with the weakest link or refer out if there is pain.
Without manual therapy skills or some muscle energy tool, all you can do to limit SCM tone is continue to remodel the shoulder girdle and t-spine. Even in a non-painful individual, you are still very warranted to refer out to work soft tissue. I think when you can go after soft tissue with manual therapy instead of a foam roller or Stick, you can get a lot of quick mileage out of the FMS corrections.
The neck is making up for a lot of limitations in the upper- and lower-crossed. Go back to the FMS if you can and play by the book while you put some good training behind the patterns that equate to the 2s. If he has improved recently, run with that stuff. Keep it going, but reset the remedial goals to maybe fill in the blanks.
Twist and Tilt
Establishing a quiet neck, starting with the supine position, work the diaphragmatic breathing pattern in everything you do.
ASLR Leg Lowering – breath at the top and 2 breaths at the bottom, make sure the neck is packed
Hold your upper body and t-spine stretches for breaths. When you use Twist and Tilt, hold it for a breath before you go for more.
3D Stretching – hold for breaths AND keep the neck packed.
Choices like these that you are already doing will chip away at the tone and get you closer to a reset of the system.
Keep in mind that if you lose the excursion of the “stretch” with the breath, you went too far. When you asked for stability, you robbed mobility. That’s always how it works.
I think we have some better ideas to train the neck.
