Some Tidbits

Below is an edited e-mail response to a client who has his Strongman Pro Card and is on his way to going to PT school.  I actually have a lot of clients that double dip on working with me as they ask questions and use the choices we make in rehab and training as the backdrop to understand the concepts.

It's also a refreshing review of things that I probably too often assume everybody just knows.  I probably should get back to talking about the basics from T=R1 and that time period and remember there are new trainers and therapists getting exposed all the time.

1) Mobility / Stability 

Function:

Ankles - mobility

Knees - Stability

Hips - Mobility

Lower Back - stability

Thoracic - Mobility

Shoulders - Stability / Mobility

You would break up the shoulders into the scapula and the gleno-humeral joint.  The scapulae are stable, and the GH are mobile in the global construct.

Some things to consider particularly with the shoulders (GH) and the hips.....these joints, as the only ball and socket joints in the body, really teeter at like 51/49 in favor of mobility.  The socket of the femur into the acetabulum provides much stability, but the GH joint is much less deep, so it requires much mobility and stability at the same time.Also keep in mind that every joint requires mobility, and every joint requires stability.  Some require more mobility, and some require more stability.

And also of extreme importance is that stability does not mean holding in 1 place even if that place is efficient biomechanically, meaning it allows for maximal force production and minimal joint wear.  Stability means control in the presence of change.

And in an attempt to be competent for motion allowing maximal force production and minimal joint wear, we should consider training environments and methods that clear and then maximize the mobile joints of the Joint by Joint before applying strategies of control.

 

2) Strengthening the stabilizers of the shoulder joint (Rotators) is more important in the context of position than the general view of just " Strengthen the rotators via internal external rotations and empty / full cans "

The rotator cuff will contract any time the shoulder engages in motion or against resistance.

These muscles among others in the shoulder as well as other joints are not capable of responding to strengthening strategies as other muscles given their pennation, but also in most human performance, these muscles do not generate motion via kinesiology-based origin and insertions.

Training ER/IR or Full Cans (I would advise against Empty Cans in nearly all circumstances), the moment arms simply do not allow for the rotator cuff muscles to undergo enough stress of load/gravity to adapt towards limit strength or rate of force development.These motions can have utility for OTHER reasons such as developing directions of stabilization, but this isn't occurring in the rotator cuff in isolate, but through all the tissues that resist/control the opening or closing angle of that joint.  You might perform the movements the same way, and I'm sure I would suggest good-better-best with some of those choices, but you're not strengthening muscles.  In my mind, it's creating (tissue) resiliency to unique or random stressors to an already satisfactory motor skill.  The shoulder joint moves well enough, and if you know certain joint angles are going to be challenged or are even injury mechanisms, you can create lines of tissue that can sustain those forces.

Overall, training the rotator cuff is best progressed by putting heavy things in our hands and progressing to more provocative positions of the shoulder complex that require stability and control.

3) Keeping that perspective in mind then it would be fair to say to take this approach with the body parts listed above as long as they adhere to their function ( Regarding a certain sports movement...say the squat for example, eliminate any tracking of the knee medially for example, aside for it being bad technique, the knee doesn't function in that range of motion and of course an increase of a chance of injury in that position).

 

Training special or specific movements of a sport should reflect those positions of technical success.  Those positions are not always in line with maximal force production and minimal joint wear.  Sometimes to be successful, biomechanics will be damned.  When we know that known injury mechanisms are a necessary or at least potentially part of special and specific technical skills, then we should develop motor skills with extra attention to directions of tissue stability.  This can effectively negate the powerful stressors of those injury mechanisms and deliver the specific resiliency that a particular sport requires.  We can train against biomechanical injury mechanisms and render them insignificant, but it is hard/impossible to become strong and powerful at the same time.

4) From the above I'm assuming the FMS is used to single out certain anomalies in positions and angles, you can sum it up with if there are bodyweight pattern issues, adding resistance would just exacerbate the problem, considering the issue on the FMS is significant.

What you are saying in the question, I believe to be accurate.In spirit, the FMS is meant to identify major problems and right-left asymmetries.

In practice, the FMS tells us if joints can get into mechanically and neurologically ideal positions to absorb and adapt to stress.  It further can identify what type of stress the joint is proper to receive - one of mobility, one of motor skill acquisition, or one of fitness.

The choices of motions of the FMS force unlearned demonstration of joint competency which can lead to a cost analysis of movement-based selections in a training or rehab program.

5) I'm going to try to mention what you said about the shoulder impingement scenario from yesterday with the model you used to demonstrate:

 

 Supra - Humeral or Sub acromion  or both the same?....., but you did mention two other humeral head positions if you can just mention it to me one more time?

Suprahumeral and Subacromial are the same anatomical space.

I will discuss the Suprahumeral space when discussing Type I compressive impingement because the space is being encroached by hypertrophic structures from the superior, the top.

I will discuss the Subacromial space when discussing Type II compressive impingement because the space is being encroached by often normal (at the time) tissues from the inferior via inefficient stability and control of the shoulder complex.

The other types of impingement are Internal Impingement, which occurs typically with unstable external rotation and involves the labrum and long head of the biceps, and a frank rotator cuff tear where the subacromial space is filled with inflammation and wild input leading to a threat response.

6) Quick question, if I'm right and hips are primarily for mobility, then 4 way sleds, one-legged squats, single leg Romanian's you can put all in the same bucket when talking mobility only?....But by the same token can you say one-legged squats and single leg Romanian's offer stabilization as well for the hip while performing the movement and taking into consideration ankle-knee-hip position are aligned throughout?

Again using these exercises while keeping in mind that they would be the best for position in the athlete's sport for example regarding ankle-knee-hip position and angle.

 

We mentioned this briefly before where the shoulders and hips can be discussed/defended really as mobile and stable at the same time.

The intent of the exercises that you are choosing above should angle towards which quality you are going to achieve.  That being said, with active and loaded choices like the sled, 1-leg squat, and RDLs, it is impossible to not train for mobility and stability at the same time.  And this is part of what makes some exercises more efficient (better) choices than others.

Of course if these or any exercises have a specific or special carryover to their sport, it can certainly be defended if they are coached and executed with a different construct than the Joint by Joint.  We should just understand that there may be a wildly different cost to those choices, both mechanically and neurologically.