Gallagher Performance Blog

Common Mistakes in Developing Young Athletes

Common Mistakes in Developing Young Athletes
When it comes to the understanding of various training methods utilized in the development of athletes across the globe, you don't have to be a rocket scientist to take notice that the majority of the research has been obtained from the study of elite level athletes. That's not by mistake. Elite level athletes are ideal research subjects because of...
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Stretching Won't Solve Your Tight Muscles

What you need to know: Many healthcare providers and trainers poorly understand why someone 'feels tight'. Dealing with muscle tightness is not as simple as just stretching.

Why Muscles Become Tight 

The human body is designed to move and movement requires varying amounts of stability and motion. When movement occurs, patterns of stability and motion can occur in efficient or inefficient ways. As structures accommodate movement, the load placed on everything from joints to muscles and tendons to nerves changes and these changes can produce symptoms. In the process of wanting to avoid symptoms, the body will often develop compensation patterns. A common result of this compensation process is the feeling of being 'tight' or 'tension'. This tension serves a protective role, thus it is referred to as protective tension.

The development of protective tension and the reason behind its presentation is one of the least understood mechanisms in musculoskeletal care. The body is smart enough to constantly monitor loads and prevent excessive load of any given structure to ultimately help prevent injury. If you are feeling 'tight', there is a reason and your body is sending you a signal. However, many people will ignore this signal until more pressing issues develop, such as pain. So how does one handle a muscle that 'feels tight'? Unfortunately, the solution is not as simple as just stretching. Stretching often provides temporary relief because of underlying joint dysfunction, stability and/or mobility deficits, or muscular weaknesses that need addressed.

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Drop the Confusion, Athletes Need Consistency for Efficiency

Drop the Confusion, Athletes Need Consistency for Efficiency
What you need to know: Neural efficiency is the key to becoming a better athlete, this is known as athletic mastery.Mastery requires time, intelligent programming, hard work, and dedication to consistency. Consistency Matters  The primary goal of any athletic and strength development program should be neural efficiency. Fact of the matter is t...
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The Functional Approach in Rehab & Sports Therapy

Functional approach to sport therapy and performance
FUNCTION IS AS REAL AS ANATOMY  The way our body functions is as real as our anatomy. There are some that like to act or state that "function" or "functional training" are fitness industry buzz words. They make light of the concept. And rightly so, as most of what is labeled  as "functional training" has very little to do w...
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MMA Neck Rehab & Strengthening

Neck pain can be quite common in MMA, grappling sports, and wresting. A big reason can be simply over reliance on the neck and inefficiency of the extensor system and trunk stabilizers.

Once an athlete learns to improve how their body works as a system, tissue and joint stress reduce and performance efficiency will be almost immediately noticed. Especially if they have keen body awareness.

Often times when there is a strength problem, the recommendation is to isolate that area and train it. In this case, the thinking was to strengthen the neck by using a neck harness. Now while local tissue strength and resilience is absolutely important, the problem in this case is that solving what can be perceived as a "lack of strength issue" isn't always solved by isolation training.

This athlete needed to learn to use his body as a complete system to better support his neck and enable him to express the strength that he already has. His over reliance on the neck was causing accumulation of stress on the neck, leading to his neck feeling pretty jacked up week after week of grappling.

Neck pain and tightness was become a recurrent issue for him. He was developing a pattern of having to take time off every couple weeks because his neck just couldn't handle the stress anymore. Rest did enough to reduce the presence of symptoms such as tightness and pain, but rest isn't doing anything to solve the underlying problem that is feeding his pain - lack of awareness of how to use his body as a system to reduce neck pain and improve performance. If an athlete is never taught how to efficiency use their body, then there will be breakdowns in the system at some point.

Avoid the breakdowns as best as possible by developing keen body awareness and how to use the body as system, not as isolated parts.

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Exercises to Eliminate Foot Pain and Improve Gait Efficiency

This one is for those dealing with foot pain, calf pain, Achilles tendinitis, plantar fasciitis, or maybe your running/sprint form needs a ground-up makeover. Whether it’s pain or performance issues residing in the lower body, if the foot isn’t working properly, the hip can’t do its job properly.

Most people get too nervous about pronation of the foot and internal rotation of leg and hip, as if these are bad things. Reality is when it comes to gait, extension -internal rotation-pronation are paired together. What do athletes and runners covet? Powerful and efficient triple extension as this is our gas pedal for propelling us over ground. But guess what, if you lack adequate pronation and internal rotation of the foot/leg/hip, you’re not going to get much in regards to extension. This is especially true of those with high arches of the feet or hip dysplasia. Often you’ll see these conditions together.

Enter the exercise progression in the video series. We need to re-educate the foot-Achilles-calf complex to work as a system.

1️⃣The focus in adequate pronation as this properly loads the plantar fascia and locks the foot for efficient load transfer. This will help to properly mobilize the foot. Likely they also need good manual therapy to restore normal mechanics.

2️⃣Then the focus goes to proper loading of the foot through the big toe for extension. This is critical because if you can’t access the big toe, you can’t fully access hip extension and the glute musculature. These athletes will short their gait and force inefficient compensations as they are over-reliant on their feet.

3️⃣ideal torso alignment and abdominal pressurization is reinforced. If patients or athletes aren’t able to perform these simple exercises with efficiency, they likely have spinal/pelvic stability issues that need addressed first.

Thank you Michal Truc for these golden bullets from the DNS course in Sweden as these same principles apply to the skating stride for efficient mechanics.

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Not Just "Back Doctors"

“I thought chiropractors only treated backs."  

This is one of the most common statements we hear in our office. Considering chiropractic is rooted in the treatment of the spine and that the majority of chiropractors treat spine-related conditions, this line of thinking is naturally expected.

However, at Gallagher Performance we do things differently. Gallagher Performance offers the latest in evidence-based treatment and hand-on care in the Murrysville, Monroeville, Plum, and surrounding Pittsburgh area. We treat more than just backs and necks. We treat a number of musculoskeletal conditions, such as:
  • Headaches
  • Migraines
  • TMJ
  • Shoulder pain
  • Rotator cuff injuries
  • Elbow pain (Golfer's Elbow and Tennis Elbow)
  • Tendinitis
  • Carpal Tunnel Syndrome
  • Hand and wrist pain
  • Hip pain
  • Piriformis Syndrome
  • IT Band Syndrome
  • Knee pain (Runner's Knee and Jumper's Knee)
  • Shin Splints
  • Plantar fasciitis
  • Ankle sprains
  • Nerve entrapments and compressions
  • Disc herniations
  • Sports Injuries
  • Post-Surgical rehabilitation
  • Prenatal and Postpartum care
  • and more

The Gallagher Performance Difference

Too often treatment precedes diagnosis. For far too many patients who are seeking care from a provider, treatment is often directed at delivering symptomatic relief without gaining a full clinical picture of why they are symptomatic in the first place. It's almost as if these providers deliver treatment goal of simply reducing or eliminating symptoms and that once absence of symptoms is achieved, the patient is free to return to activities as they were pre-injury status.

However, this model of treatment is why many patients are recurrently dealing with pain once they do return to activities.

For example, someone that works overhead or uses their arms all day (painter, drywall hanger, hair stylist, etc.) will more than likely run into shoulder impingement at some point in their professional careers.  An anti-inflammatory will help reduce pain. Getting a quick adjustment to the mid-back and cupping may provide a sense of relief in reduced muscular tension and improved range of motion, but what will really make a difference is making sure the muscles around the shoulder are doing their job to keep the joints stable and moving the way they’re supposed to. You see if proper function is not restored, pain will be quick to return because unnecessary stress is being placed on the shoulder joint. This unnecessary stress will eventually lead to injury.

Focus on The Root Cause, Not Symptoms


When it comes to many of the above musculoskeletal conditions, a trip to your primary care physician should probably not be your first stop. That's just being honest. Medical doctors have little training in the diagnosis of musculoskeletal conditions. This is generally why they simply prescribe anti-inflammatory medications, muscle relaxers, and tell you to go easy for few days.  Although this may enable your pain levels to reduce, it does not mean you are going to be problem free once you return to your activities. This is why making functional changes in the body is so important.

Again, this is why diagnosis is so important. Not only is it important to understand your sensitivities and what specific movements or activities you have pain with, but it's important to identify what is driving your pain. The driver of your pain is known as the root cause and, sometimes, the root cause of your pain is not in the same location as where you feel pain.

Once we identify what is driving your pain, then treatment is design to not only get you out of pain, but to also create the functional changes in your body to become more resilient so that pain does not return.

This is why we blend specific manual therapy, joint manipulation, and neuromuscular stabilization exercise progressions to improve control of movement and posture. If it’s a muscle or joint issue, we treat it. If it’s something we can’t treat, we’ll make sure you receive recommendations on the right specialist for your condition.
We want you to achieve your goals whether it’s getting back to work, sport, or just simply the activities you enjoy. Regardless of your goal, we pride ourselves on helping you achieve them as efficiently as possible.

Don’t let a joint or muscle injury stop you from reaching those goals. Let us help. After all, we take care of more than just backs.

How the Nervous System Unlocks Performance

The gateway to change in the body is the sensory system.

The balance of excitatory and inhibitory  signals coming from our body's sensory system influences the level of performance of the human body. And this balance of stimuli is always under the control of the brain/central nervous system (CNS).

Be it a chiropractic adjustment, massage or manual therapy, or exercise, the rich stimulation of sensory system is what drives changes in our nervous system that create responses such as:

✅ reduced pain

✅ increased body awareness

✅ improved neuromuscular control

✅ reduced muscular tension/tightness

✅ improved joint range of motion

How the Nervous System Unlocks Performance

The tissues and joints of the body are richly innervated with sensors that constantly monitor the conditions our body is exposed to. The external stimuli our body encounters will generate excitatory or inhibitory signals which will ultimately improved or shut down performance.

For example, our tendons are home to sensory receptors known as Golgi Tendon Organs (GTOs). GTO are responsible for sensing tension as it builds up in our tendons. If the load (resistance) our body encounters is too heavy, thus placing potentially damaging stresses on our muscles and tendons, the GTOs will shut down our muscles ability to contract as a protective mechanism. This inhibitory signaling is directed by the nervous system to protect our body from injury.

Conversely, our body can be elevated to higher levels of performance by the nervous system by means of excitatory signals perceived by our muscle spindles within our muscles. Muscle spindles are sensors that are sensitive to stretch. For those that are familiar with the myotatic or stretch reflex, muscle spindles enable our muscles to function like a "rubber band".

The balance of signals coming from our muscle spindles and GTOs is being monitored by our nervous system to either enhance or shut down performance. This occurs through what is known as the Stretch-Shortening Cycle (SSC).

Enter Plyometrics

The SSC is a normal function of all human motion, be it walking, jogging, running, throwing, etc. The training of the SSC occurs through what is known as "plyometrics".

Plyometrics are often mistaken for ballistic training. Plyometrics may be the most misunderstood and undervalued form of training as they specifically train the SSC function of our muscular system. More specifically they are undervalued and underutilized in rehabilitation and return-to-play procedures for athletes.

If the function of the SSC is not normalized, this is potentially why many patient's "fail" rehab and athletes are unable to return to play or are soon after sidelined with a relapse.

Experience the Difference

At Gallagher Performance, we place a priority of normalizing the function of the entire body. We follow criteria-based progressions which address complete neuromuscular function, including addressing strength deficits and normalizing the SSC function.

Below are same exercises we use regularly to improve the function of the nervous system and unlock the performance abilities - be it for rehabilitation or athletics.




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Active Stretch Routine to Improve Flexibility and Posture


Use active stretches to improve muscular flexibility, joint range of motion, and posture. These stretches and exercises can be incorporated into your warm-up routine, as an active recovery method, or used on a regular basis to improve the way you move and feel.

When compared to traditional static stretching, active stretches carry a number of benefits:

1. Enhanced proprioceptive input which facilitates changes in posture and the release of overactive/tight muscles.

2. Increased neuromuscular demand which drives activation of muscles in an end range position leading to improved motor control or dynamic joint stability.

3. When guided by postural principles, the increased global muscular activation leads to the coordination needed to enhance posture.

4. Helps create the 'feel' necessary for improving movement and posture. It's one thing to think through movement/posture, it's another thing to feel it. We want to feel movement/posture

5. Increased preparedness for training, practice, or competition.

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Advanced Balance & Coordination Exercises


Sensory Motor Training

SMT is a targeted approach to training the proprioceptive system and it’s pathways involved with the control of equilibrium and posture.

SMT is used to train the upright posture of the body with the emphasis placed on ideal posture during dynamic stability.

Benefits of SMT:

1️⃣ Increases speed of activation of muscle

2️⃣ Improves muscle coordination

3️⃣ Improves pelvic stability through the increased activation of the trunk and gluteal muscles

4️⃣ Improves foot function when ideal foot loading and posture is maintained

Indications for SMT (sub acute patients and performance training considerations):

✅ Post-injury or post-operative

✅ Chronic back or neck pain

✅ Faulty posture with respiratory dysfunction

✅ General hypermobility or instability

✅ Postpartum muscle imbalance

✅ Prevention of falls in senior populations

✅ General physical preparation or fitness

SMT has a wide range of applications and is traditionally trained through 1-leg balance drills, wobble boards, rocker boards, balance sandals, and mini trampolines. All tools we use regularly at GP.

Here we demonstrate a couple advanced variations which incorporate anti-rotational stressors via bands or kettlebells which only take muscular coordination and dynamic stability challenge to another level.

Source: Rehabilitation of the Spine by Liebenson

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Single-Leg Hip Thrust Technique Fix


Nothing beats properly performed squats, deadlifts, lunges, and RDLs for glutes that not only look great but work even better. Proper glute function is critical to hip extension that is prevalent in every day life (walking, sit to stand, hip hinge, lifting) as well as sport (running, sprinting, throwing, jumping, skating) Problem is most people don’t perform the big exercises well and therefore resort to ways to “activate” or better “isolate” glute function. This is why hip thrusts exist. They have their place when used with a plan and purpose. The single leg hip thrust is an advanced progression that is often performed incorrectly. The biggest mistake being the unleveling of the hips that can occur during the movement. By using the external cue of a tennis ball, we can promote better technique that results in improved muscular coordination of the glutes and core. This translates into more efficient movement mechanics, not only in this exercise, but in life and sport as well. Hopefully the video explains the set-up and execution well enough for you to give it a try.

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Trigger Points Are A Good Thing In A Poorly Functioning System

Trigger Points Are A Good Thing In A Poorly Functioning System
One of my favorite quotes I’ve heard. Period.

Identification and treatment of muscular trigger points is often a common therapeutic intervention of physical therapists, massage therapists, chiropractors, and other physical medicine providers. There’s an entire industry of products devoted to enabling people to work on their triggers points at home or at the gym. Clearly trigger points and muscular pain is a problem that many struggle with and yet never seem to resolve despite their own best efforts.

The bigger question many people ask is why. “Why do I have that trigger point?” Yes treatment of triggers points is valuable, but often the trigger point is a result of a poor functioning muscular and joint system. This is the why. Left unaddressed, poor function will continue to drive the presence of trigger points.

Trigger points arguably present to help stabilize our body and prevent unnecessary load or stress to tissues or joints that could potentially result in injury.

This is why we must evaluate for and restore proper joint function and proper movement function. Otherwise we have our answer to the recurrent presence of trigger points.

What this means is that resolution of trigger points is best treated with a combination of manual massage therapy/release techniques, chiropractic manipulative therapy when indicated, and restoring proper movement/posture habits to our body. Simply rolling on a foam ball is not enough. Sure you may get relief, but given enough time, that trigger point will return if not treated more comprehensively.

If you’re spinning your wheels why you can’t get out of pain or get rid of tight muscles, you need to identify the gaps in your approach because something is being missed that is driving those symptoms.

Looking for answers and a more comprehensive approach to helping you get out of pain? Give our office a call at (724) 519-2833.

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The Best Hip Exercise You're Not Doing


Introducting the Best Hip Exercise You’re Not Doing - Half Kneeling to Heel Sitting

For all you glute and booty fanatics, nothing beats properly performed squats, deadlifts, lunges, and RDLs for glutes that not only look great but work even better.

Problem is most people don’t perform the big exercises well and therefore resort to ways to “activate” or better “isolate” glute function. This is why hip thrusts, clam shells, and so on exist. They can all have their place when used with a plan and purpose.

From DNS we bring you a great drill to learn how to properly load the glutes, improve hip rotational mobility, and restore ideal function between the hips and torso. Introducing half kneeling to tall sitting.

Don’t underestimate this drill. It’s much more challenging than it looks. If you can perform this with control and precision of movement and posture, congrats you have beautifully functioning hips. For those that have challenges with it, be patient and focus on feeling the movement performed correctly. You want to feel the glute and vastus medialis of the quad working together through the movement.

Is this a real struggle for you? Plug this drill into your regular training routine. Follow the advice in the video. Perform it on the regular and watch how it not only helps your strength and movement improve but also gets rid of unwanted muscle tightness or pain in the low back, hips, and knees.

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Exercise Hacks Ep. 18 - Offset Kettlebell Serratus Bench Press 


This exercise is a hybrid of the bottoms up kettlebell (KB) serratus press and the McGill one arm bench press.

The bottoms up KB serratus press is often performed on the floor or on a foam roller. The problem is the floor will impede natural scapular motion and the foam roller is frankly awkward and uncomfortable. We want to enhance muscular activation, not create difficulty. This isn't to say that the other methods are wrong, they may not be ideal for everyone. Odds are, once you allow the scapula to move and track along the rib cage with greater freedom, the response to the exercise will be more positive.

This is why blending it with the McGill one arm bench press becomes an ideal variation. We just subbed out the bench press for the serratus press. The serratus press will enable one to learn how to "pack the shoulder", thus creating a more solid platform for pressing.

The added benefits being:
  1. By placing half your body off the bench, you will target the serratus and develop scapular control far better than from the ground and more comfortably than on a foam roller. By allowing the scapula free range of movement, we can better target the ideal mechanics for improved strength and muscular activation.
  2. You get the added benefit of enhancing rotary athleticism through the core and hips by eliminating energy leaks by oblique sling development. Developing rotary athleticism is critical to contact and combat sport athletes.
  3. Developing rotary stability in this sense has carry over to standing pressing strength and power. This is key as standing press strength is more often limited by the strength and coordination of our torso musculature than our chest or shoulders.
Note - In the video demonstration, the right half of my body is off completely off the bench. It should be clear from watching but if it isn’t - it’s stated here. 
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Pain-Free Training Is A Myth

Pain-Free Training Is A Myth

There seems to be a growing number of programs and trainers touting how they offer ‘pain-free training’ and that anything less than what they offer is simply inferior by design.

Any intelligent trainer, coach, or therapist will acknowledge the value of proper training to ensure no serious orthopedic issues develop. No one wants their clients becoming pain patients. Proper training is multi-faceted from proper form to proper exercise selection to proper volume and loading parameters. These are a given. These are essential to ensuring we minimize injury risk and improve tissue resilience.

However the reality is if you are going to push your body to new levels of performance, you are going to feel it. It’s going to be uncomfortable. It’s going to hurt at times. If you aren’t looking to better yourself, why are you even training in the first place? Essentially at the heart of training is pushing your body to a place it’s never been before. There aren’t many people out there who have pushed their bodies in training who haven’t ended up ‘feeling it’ in the form of soreness, physical discomfort, and yes - at times - pain.

By all means, yes, we shouldn’t train recklessly. We should be practical and intelligent in our execution of a training plan. But we also shouldn’t be alarmed and fear we are doing something terribly wrong when we deal with discomfort, aches and pains. It comes with the territory of pushing our bodies to new levels of fitness or performance. This is why recovery methods and seeking out qualified professional care from sports/rehab chiropractors, massage therapists, and physical therapists can do wonders for helping our bodies better manage the stress of training. ——

No one wants to be in pain, but push yourself hard enough for long enough, you’ll feel it. We need to understand better pain education, how to be more realistic with training expectations, and how to manage the stress of our bodies to avoid serious pain or orthopedic problems.

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Clinically Pressed Ep. 59 - Hockey Training

Dr. Sean Gallagher is a former high level hockey player that has turned into a hockey training and treatment guru.  His experience of playing at the highest levels along with a full academic career in chiropractic school have brought him a unique perspective on how to approach training hockey players.

This episode we get further into hockey training and what all goes into it. The planning for the year of training is difficult when it the playing season never ends.  We also dive into the specific demands that the sport places on the body and the unique ways that you have to approach exercises without forgetting to focus on injury prevention and resilience.  If you play hockey at any level you want to listen to this episode.

This episode we get further into hockey training and what all goes into it. The planning for the year of training is difficult when it the playing season never ends.  We also dive into the specific demands that the sport places on the body and the unique ways that you have to approach exercises without forgetting to focus on injury prevention and resilience.  If you play hockey at any level you want to listen to this episode.

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Maintaining Health & Athleticism Over the Long Run


I've never highly regarded myself. There’s tons more athletic and stronger people out there. For what I lacked in natural ability, I’ve been disciplined and worked to accomplish tasks and goals. Even at age 36.

I’ve loved training hard and learning about the human body since I was 14. Ultimately it’s what lead me to what it is I do today. I knew as much as I wanted to learn, I wanted to help people more.

There’s much I’ve learned and continue to learn. And the same can be said for my brother Ryan. We want to take what we’ve learned and pass that on to those we work with. We may not be super accomplished, but what we’ve learned we hope enables others to accomplish way more than we ever have.

Here’s some things I’ve learned that I strongly feel enable you to stay healthy and maintain athleticism over the long-term:

1) Chiropractic and massage therapy work. Leave the ‘evidence based’ nonsense out of the conversation. If it wasn’t for these professions, I would be beyond broken - living in pain and wondering what happened to my quality of life. If you find a good chiro and massage therapist - make them part of your team.

2) Training hard is essential. Training smart is vital. You must be driven and patient. Listen to your body and keep the long-term in mind. This really matters if you hope to train and compete into your late 20s, 30s, 40s, and beyond.

3) Be humble and be a student. Always be willing to learn and accept the fact that you don’t have it figured out. There’s countless people I’ve learned from and I’m truly grateful to them.

4) Practice ideal posture, movement, sleep habits, nutrition, and stress management - for you. These are so individualized it can be hard to give the best guidance with general recommendations. Learn what your body responds best to and be consistent.

5) Surround yourself with a strong support system. Nobody accomplishes much in life all by themselves. People that genuinely encourage you, sharpen you, and hold you accountable are rare and invaluable.

Video: Split squat 200x15/each leg (yeah it’s 14 on the right leg cause I’m no good at counting but no doubt I had 15 in the bag)
Landmine lateral split squat - 135x5/each
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Athletic Strength Guidelines


How strong should you be to establish a solid foundation for athletic performance? It’s a difficult question to answer given the shear number of variables.

It’s important to understand that athletes shouldn’t overly concern themselves with maximal strength. Not to the degree that a powerlifter, weightlifter, or strongman would. Strength athletics set an different set strength standards with regards to becoming a competitive athlete in those sports. As far as developing athletic strength is concerned, the conversation goes much deeper than the big lifts of the squat, bench, deadlift, and press.

The reality is athletic strength should be considered relative to general movement patterns as strength training is essentially general physical preparation for most athletes. The majority of athletes would be considered to have mediocre strength in the world of strength sports.While being strong is important, they have competing demands of conditioning, sport practice, competition, and additional technical/tactical attention that become just as important to achieving athletic mastery.

Determining an ideal level of strength for any individual athlete is truly an individualized process, but we can at least speak to some general guidelines for starters.

Meeting certain strength standards is essential to physical performance demands and durability. Athletes will benefit from these guidelines as they can help eliminate weaknesses and improve specific physical abilities. Specific physical abilities such as speed, power, and explosiveness that are dependent upon strength. Strength also becomes important in improving bone density, connective tissue resilience, and overall durability of the body which become important factors in reducing injury occurrence.

While limited research exists in regard to strength standards for athletes, there are some guidelines that many strength coaches can agree on from professional experience.

These videos demonstrate five athletic strength tests. The strength guidelines are relative to bodyweight. For reference I sit at 215.

1) Loaded carry - 100-200% of bodyweight for total load carried

Video: 225/hand (450 total)
2) RDL - 180% of bodyweight for 1RM

Video: 385x5
3) Reverse Lunge - bodyweight x 10/leg

Video: 225/leg x 10 
4) Chin-up - 140% of bodyweight for 1RM

Video: bwt+90 (305 total)
5) Close Grip bench press - 125% bwt for 1RM

Video: 225x5
Note - not all testing has to be a true 1RM (rep max). Testing can be 3-5RM and can project 1RM from there with decent accuracy.

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Muscle Action is Dictated by Muscle Function


Muscle action is also known as 'Direction of Muscle Pull'. The direction of muscle pull is a critical part of kinesiology that is often overlooked. It has huge importance in rehab and performance as it helps us better understand the motor control aspects of movement.

Direction of muscle pull defines the kinetic chain.

Most people that learn muscle action in anatomy learn how our muscles work in an 'open chain' environment. But that's only 50% of the action our muscles perform because they also have to work in a 'closed chain' environment. The change in the environment will change the muscle action.

When properly caring for a rehab patient or training someone for higher levels of performance, it's important to understand how our muscle action changes depending upon the environment they need to function within. This often times will dictate exercise selection.

Failure to recognize how muscle action changes is often a reason why some people fail to progress in rehab or in the gym. And this is why it's important you find a professional who understands these concepts. These concepts serve as the foundation for true 'functional' training, 'functional' exercise, and 'functional' rehabilitation.

'Functional' has been a buzz word in fitness and rehabilitation for over a decade now, yet what most trainers or therapists are claiming to deliver as functional training, functional exercise, or functional rehabilitation is anything but that. An exercise should never be determined to be functional based on how it looks, but rather what it is addressing in regards an individuals specific needs/weaknesses.  That requires we must first identify those specific needs and weaknesses, then determine how a specific muscles is 'acting' or 'pulling' during a given task, and finally determine how are we going to strength that specific muscle action through progressive exercises. This is the primary objective of functional training or functional rehabilitation.

Please watch the video for more in depth information!

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Achilles Tendinopathy Treatment


Contrary to what has been preached for years, it is now known that interventions such as rest, ice, anti-inflammatory medications and electrical stimulation will not solve the problem of tendinopathy. The application of these interventions was based upon the assumption that inflammation within connective tissue or joints was created by repetitive motions and sustained postures associated with labor, sport, or other forms of activity. However, this assumption has been proven to be wrong. New understanding of overuse injury is providing the foundation for treatment that truly addresses the root cause of your symptoms, not merely alleviating them.

New Understanding
We all know someone who has been told they have tendinitis, or inflammation of a tendon. Tendinitis is commonly referred to as an “overuse” injury.

Tendons are the structures that connect muscle to bone. They are critical in transmitting the force produced by muscles during movement. It was believed that tendons, when injured or over-stressed, became inflamed and painful. Inflammation is the body's natural response to injury. Inflammation begins the healing process. Applications such as rest, ice, and anti-inflammatory medication are prescribed to minimize the effects of inflammation.

Interesting thing is, research has demonstrated that inflammation is rarely present within tendons, thus providing a new understanding of how overuse injuries develop.

Back in 1979, a couple surgeons by the name of Robert P. Nirschl and Frank A. Pettrone examined sections of injured elbow tendons under a microscope. What they found was no presence of inflammation. None. What they did notice was how the tendons had degenerated. Their color and texture had changed. The tendons were grayish and swollen rather than white and soft.

No inflammation? No tendinitis. Tendinosis is the correct name for this condition. Tendinosis is the result of repeated or sustained muscular contraction associated with poor movement or posture, which decreases blood supply. The body begins to react in similar ways as if you had injured muscular tissue and scar tissue development is triggered. This would be a normal response if there were actual damage, but the body has been tricked. There is no injury, but scar tissue accumulates in healthy tissue due to compromised circulation. Accumulated scar tissue increases mechanical stress on tendons, limiting normal function of muscle contraction. Limited function means reduced strength, range of motion, and can lead to pain during activity.

Now that we understand the mechanism behind scar tissue production, the deeper question is, "What is the underlying reason for poor movement or poor posture that is responsible for the overload?" Because if the reason was simply just sustained postures or repetitive movements, wouldn’t we see more of the population coming down with overuse injuries?

Mobility vs Stability: Stabilizing the Confusion
Mobility seems to be the buzzword of the fitness industry and it’s certainly popular among certain camps within the physical medicine profession. There are plenty of products, assessments, and even entire workouts that are devoted to mobility. Some define mobility as the ability to achieve a certain posture or position, while others define it as the ability to achieve a certain range of motion specific to a movement (i.e. squat, push-up).

Advocates of mobility claim that mobility should be achieved first. We need mobility and lack of mobility is implicated as a predisposing factor for overuse injury. But is mobility the secret to preventing overuse injuries and unlocking athletic performance?

While mobility is important, if we consider the developmental model, stability should be the primary focus.

Enter the Developmental Model
Developmental kinesiology, or essentially understanding how we develop motor function through early childhood, emphasizes the existence of central movement patterns that are “hard-wired” from birth. For example, an infant does not need to be taught when and how to lift its head, roll over, reach, crawl, or walk. Each and every one of these movement patterns occurs automatically as the CNS matures. During this process of CNS maturation, the brain influences the development of stability before purposeful movement can occur.

The process begins with the coordination of spinal stabilization and breathing through what is known as the integrated spinal stabilizing system (ISSS). This constitutes the “deep core” and it is activated subconsciously before any purposeful movement. The musculature of the ISSS  contracts automatically under the control of the nervous system. The role of the ISSS is critical because it provides a fixed, stable base from which muscles can generate movement. The ISSS is essential to maintaining joints in a neutral position, thus maximizing muscular forces with minimal stress to structures such as ligaments, capsules, and cartilage.

Bottom line: Inadequate activation and stabilizing function of muscles may place greater stress within the body, compromising posture and movement. Mobility is DEPENDENT upon stability. You need stability first before you can achieve purposeful, efficient motion. A deficient stabilizing system is likely to lead to strain or overuse injury due to compensatory movements.

Managing Overuse Injury
Now that we have a better understanding of why scar tissue develops in the body and factors that contribute to poor movement and posture, its time to discuss what can be done in the treatment and prevention of overuse injuries.

#1 - Myofascial Release Techniques. Understanding that overuse injuries are most often degenerative scar tissue problems rather than inflammatory conditions, treatment strategies should change accordingly. Rest, ice, anti-inflammatory medication, and electrical stimulation are no longer ideal treatments. Treatment that involves myofascial release or soft-tissue manipulation becomes the focus in order to breakdown scar tissue and allow for normalized muscle/tendon function. Clinicians or therapists are able to locate scar tissue by touch. The hand is a powerful tool.  Characteristics they evaluate for may include abnormal texture, movement restriction, or increased tension. Treatment is often delivered by the hand or with the use of an instrument and is non-invasive in nature.

#2 - Improve the stabilization function of muscle. To ensure quality movement during functional activities or sport skill execution, it is critical that all stabilizers of the body are adequately activated. Insufficiency within certain muscles in the kinetic chain will result in muscular imbalances that can contribute to chronic pain or poor performance. Corrective stabilization strategies thus should always be the foundational concept of any training or rehabilitation program. Clinicians are beginning to recognize the importance of “training the brain” since the majority of motor dysfunctions may be more related to altered CNS function than local joint or muscle issues. The CNS is the “driver” and attention must be given to how it coordinates muscular patterns during movement in order to provide stability.

For example, if someone has difficulty performing a squat, rather than focusing on local “tight” or “weak” muscles or restricted movement in a specific joint, one may need to realize that the insufficiency is due to a dysfunctional ISSS pattern at the brain level.

Rather than focusing on mobilizing a tight glenohumeral capsule/joint and strengthening the rotator cuff musculature in the treatment of shoulder impingement in a baseball pitcher, should you focus on an inadequate ISSS and the "weak" link in the kinetic chain, such as poor dynamic scapular stability, proprioceptive deficits, or impaired lower extremity mobility.

The body functions as a single unit during complex movement, not in segments. The key is to maintain control, joint stability, and quality of movement. Every joint position depends on the coordination of stabilizing muscle function throughout the entire body. Through repetition, ideal stabilization patterns are achieved and then integrated in with sport-specific movements.

Patient Case (seen in video):
Presenting complaint of R Achilles pain during running and stiffness through the ankle upon waking or after prolonged sitting.

Finding of functional hallicus limitus on R (reduced big toe extension), R ankle dorsiflexion restriction, and lack of stability through the anterior oblique slings and R hip.

Treatment also included joint mobilization and manual soft tissue release not shown in video.

Address the cause, don't just address the site of symptoms.

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