Category — Posture & Movements

I just wanted to let everyone know that Strength Coach Mike Robertson featured a guest blog article written by me this week regarding the Deep Fron Line and what it means to our training programs.

The deep front line is a concept taken from Thomas Myers’ Anatomy Trains text and I basically jotted down a few ideas about this line and how it pertains to what we do in the weight room.

Hope you ENJOY IT!

Patrick
patrick@optimumsportsperformance.com

The suboccipital muscles are four small muscles attaching at either the C1 (atlas) or C2 (axis) vertebrae – from either the spinous or transverse processes.  All but one of these muscle, obliquus capitis inferior, go on to attach to the base of the occiput.

As a group, the suboccipital muscles function to rock and tilt the head into extension.  The rectus capitis posterior major and obliquus capitis inferior assist in rotation of the head to the ipsilateral (same) side.  Additionally, these muscles play a critical role in stabilization and fine movement control of the cranium on the atlas, and the atlas on the axis.

Rectus Capitis Posterior Minor: A Minor Muscle With Major Implications

Of the suboccipital musles, Rectus capitis posterior minor is particularly interesting. 

Rectus capitis posterior minor has been shown to have a high density of muscle spindles, which may indicate its role in movement is not as important as its role in proprioception of both the head and cervical spine.  For this reason, atrophy of the rectus capitis posterior minor that may occur following injury or trauma can lead to diminished proprioception and balance.  A study conducted by McPartland et al. showed that subjects with chronic neck pain and rectus capitis posterior minor atrophy displayed a decrease in standing balance when compared with a control group.  Interestingly, a study conducted by Moseley assessed voluntary trunk muscle activation (draw-in maneuver) as a way to pick out those with neck pain verse the control subjects.  Additionally, those who had neck pain were 3 to 6 times likely to develop low-back pain.  Perhaps the poor trunk muscle activation (inner core) in the neck pain patients was the reason that those with chronic neck pain in McPartland’s study also displayed a lack of balance?

Further, rectus capitis posterior minor has been noted to have a fascial bridge into our dura mater (the outer layer of the meninges which surrounds our spinal cord and brain).  A potential role that rectus capitis posterior minor plays is to try and regulate dural folding, or movement of dura towards the spinal cord – which occurs during head extension.  It has been inferred that individuals may experience headaches and pain when the rectus capitis posterior minor muscle acts inappropriately on dura.

Upper Crossed Syndrome & Forward Head Posture

Upper crossed syndrome is a postural distortion pattern noted by Dr. Vladimir Janda.  What we see in this pattern is an individual who displays a large amount of kyphosis in their upper back (thoracic spine), a forward head (poking chin) and rounded or slumped shoulders.  As we can see in the picture above, the individual with upper crossed syndrome will present with weakened deep neck flexors (longus coli and capitis), rhomboids and serratus anterior; and tight pectoral muscles (pectoralis major and minor), upper trapezius and levator scapula. 

This posture has become relatively common in today’s society:

One of the roles of the suboccipital musculature is to afford us the ability to see straight ahead.  In an upper crossed pattern, the only way this would be possible is for us to contract the suboccipitals, effectively extending the head and neck, so that our eyes can remain looking at the horizon.  Along with this, Janda has discussed the role of the oculopelvic and pelviocular reflexes, which show that a change in pelvic position will alter the position of the eyes and vice versa.  Eye movements play a role in muscle tone, especially for the suboccipitals, as looking upwards will increase tension in the extensor muscles (which the suboccipitals belong to) and looking down will increase tension in the flexors (and decrease tension in the extensors).

Chronic shortening of the suboccipitals that is observed in a forward head posture may lead to ischemia and trigger points.  As you can see from the picture below, trigger points in this region will refer a “headache like” pain pattern:

Appropriate soft tissue therapy, stretching and exercise can help to alleviate tension in the suboccipital muscles, and decrease trigger points which may be referring their common pattern.  Additionally, stress is often accompanied by tightness in the head and neck.  Relaxation techniques such as diaphragmatic breathing or massage therapy may help to decrease stress and subsequently decrease tension in the muscles of the posterior neck.

Suboccipitals and Hamstring Tightness?

Up to this point, we have focused on the suboccipital muscles locally.  Looking more globally, we can further discuss the utilization of suboccipital stretching to help inhibit hamstring tightness and improve hip flexion range of motion.

Aparicio et al. used a method called Suboccipital Muscle Inhibition Technique to evaluate the effect that “releasing” the subbocipital muscles would have on hamstring muscle elasticity.  This technique consisted of the therapist placing an upward pressure on the posterior arch of the atlas (C1) of the supine patient for approximately 2 minutes, until tissue relaxation had been achieved.  Following this technique, the subjects in the suboccipital muscle inhibition technique group saw greater improvements in finger-floor distance test, straight leg raise, and popliteal angle test compared to the control group (who received a placebo manual therapy technique).

There are several hypotheses for the positive result of this treatment:

1. The connection to dura mater – This plays to the continuity of the nervous system and how it links everything together.
2. Postural control - The suboccipitals play a role in postural control and will affect the coordinated movement of muscles down the chain.
3. Myofascial chains - Both the suboccipitals and the hamstring musculature are included in the superficial back line.  Addressing any of the structures in the superficial back line may have a positive effect of the entire line itself. 

In addition to the above technique, Chaitow and DeLany discuss using muscle energy techniques (contract-relax stretching) for the suboccipital muscles to help improve hamstring length. 

Finally, the therapist can include the use of eye movements while performing the muscle energy technique protocol for the suboccipitals.  Having the client look upward during the contraction of the suboccipitals will further increase contraction of the extensors of the body, increasing fatigue of those muscles once the contraction has ended.  Following the contract phase, the client will then relax and the therapist can stretch the suboccipitals and have the client look down with their eyes (towards their chin) to inhibit the extensors, including the hamstrings, via reciprocal inhibition as the flexors are “turned on”.

These techniques will come in handy in a couple of situations:

1. In dealing with clients with extremely tight hamstrings, that attempting to stretch them is painful, or not possible.
2. During times of injury, when it would not be advised to passively take the hamstrings through a stretch.

Soft Tissue Ideas of Suboccipital Treatment

There are several treatment options for the suboccipital muscles and the major players, are always a safe bet:

• Compression
• Friction (be aware of your hand position for this!)
• Positional Release
• Muscle Energy Techniques (as discussed above)

Trying to get the patient to relax and get comfortable is paramount over everything else when doing neck work (or any work for that matter!).  This is not an area that we should be aggressive in, and appropriate touch and palpation is critical to a safe and effective treatment. 

One area that we need to be particularly cautious of is the suboccipital triangle:

As you can see, the borders of obliquus capitis inferior, opliquus capitis superior and rectus capitis posterior minor form this triangle.  Not pictured in this photo is the vertebral artery, which runs through the center of the triangle and is relatively exposed.  Aggressively poking into this area or frictioning over it could potentially damage the artery.  In a nutshell, “It’s better to be safe than sorry”.

Compression & Friction

Applying compression or friction to these muscles can be done so at the base of the occiput and even on the posterior tubercle of C1 and the spinous process of C2.  Staying near the spinous process will ensure that you are not in the suboccipital triangle and you are away from the vertebral artery.  Obviously if you feel a pulse under your fingers, change the position of your palpation.  Take your time to slowly investigate these structures for trigger points and ischemia.  Additionally, it helps to remember that the suboccipital muscles lie deep to other muscles, so don’t be in a hurry to slam through all the superficial tissue.  Take your time to appropriately assess the tissue for tone and tension, and ensure that the techniques are not producing pain and the client is comfortable enough for you to work deeper.  When you find trigger points that are referring their common pattern (up into the head and behind the eyes) just hold that point for 8-12sec until the referral dissipates, and then move on to investigate the tissue next to it, keeping in mind that trigger points often form in clusters.

Sometimes, all that the client may need – or be able to tolerate – is gentle compression at the cranial base (and sometimes some light traction), as this generally gets people to relax, and when the tissue tension has been brought on by stress, this is a most welcomed technique.

Muscle Energy & Positional Release Techniques

Muscle energy and positional release techniques are two excellent choices for treatment of tissues that are hypertonic or tense.

Muscle energy techniques were discussed above with regard to hamstring release, however it is important to remind the therapist that the goal is to try and get all of your movement (contraction and then the passive movement to the next barrier of resistance) from the Atlas (C1) and Axis (C2).  A good way to do this is to place one hand behind the head of the supine client, and then other hand on top of their forehead.  This will help you move the head into flexion, stretching the suboccipitals, without getting too much contribution from the lower spine (C3-7).  Additionally, in some acute situations, where there is pain upon isometric contraction (extension) of the suboccipitals, you can try and have the client contract the deep neck flexors (nodding their chin towards their adam’s apple and placing an isometric contraction into your hand which is on their forehead) to try and allow the suboccipitals to relax via reciprocal inhibition before taking them to their next stretch barrier.

Finally, positional release techniques are a great non-painful way to address areas of tenderness.  For the suboccipitals, with the client lying supine, palpate to find a tender point.  The client confirms the point as being tender and is asked to rate the point as a tenderness score of “10”.  Maintaining pressure on that tender point the head is then eased back into slight extension until the client reports that tenderness has decreased.  From this position, with the current tenderness decreased from its previous score of “10”, the head is gently moved into rotation and side bending, to help “fine-tune” the position of release, and decrease the clients tenderness score even further.  For fine-tuning, you will need to play with this, as each client will have a different position that they favor.  Some like ipsilateral rotation and/or side bending, while others prefer contralateral rotation and/or side bending.  The client is in charge here, and whichever position decreases their tenderness score, that is the position you will go with.  Once the tenderness score has decreased by 70% (so down to a 3 out of 10), the client is then just asked to relax and monitor their breathing, as the point is held for approximately 90 seconds.  The head is then returned back to the test position and the tender point is re-palpated to see if tenderness has decreased.

A Word On Breathing During These Techniques

As with all of these techniques, breathing is very important, and developing healthy breathing habits are critical for decreasing upper neck tension.  Additionally, proper breathing will help lead to greater relaxation and a decrease in overall muscle tone.

Exercise

Integrating the individual back into function should be the overall goal, and taking care to teach appropriate neck position during exercise is an important part of the puzzle.  Care should be taken to ensure that during exercises, the client is not using the upper neck musculature to provide stability, a “high threshold strategy”, and the suboccipitals should not be allowing the head to go into hyperextension.  A good way to ensure that the neck musculature is in the appropriate position is to have the client perform a chin tuck during their exercises (pulling their chin towards their adam’s apple), as this will place the posterior neck muscles on stretch, and turn on the often weak deep neck flexors (longus coli and capitis).

Conclusions

The suboccipital muscles play an important role in movement of the head, posture, and function of the entire body.  Taking care to assess and treat these muscles with the appropriate soft tissue techniques and re-integrating them back into proper exercise and function is essential for well-being of your clients, patients or athletes.

References

Neumann DA. Kinesiology of the Musculoskeletal System. Mosby. 2002.

Kendall FP, McCreary Ek, Provance PG, Rodgers MM, Romani WA. Muscles: Testing and Function with Posture and Pain. Lippincott, Williams and Wilkins. 5th ed. 2005.

Chaitow L, DeLany J. Clinical Application of Neuromuscular Techniques Vol 1: The Upper Body. Churchill Livingstone. 2000.

Chaitow L, DeLany J. Clinical Application of Neuromuscular Techniques Vol 2: The Lower Body. Churchill Livingstone. 2000.

McPartland JM, Brodeur RR, Hallgren RC. Chronic neck pain, standing balance, and suboccipical muscle atropy – a pilot study. J Manipulative Physiol Ther 1997; 20(1): 24-9.

Moseley GL. Impaired trunk muscle function in patients with sub-acute neck pain: etiologic in the subsequent development of low-back pain. Manual Thearpy 2004;9:157-163.

Aparicio EQ, Quirante LB, Blanco CR, Sendin FA. Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome. J Manipulative Physiol Ther 2009;32(4):262-269.

McPartland JM, Brodeur RR. Rectus Capitis Posterior Minor: A Small But Important Suboccipital Muscle. Journal of Body Work and Movement Therapy 1999: 3(1), 30-35.

Today, Physical Therapist and Strength Coach, Charlie Weingroff had a great post in his BLOG about a discussion he, Carson Boddicker, and I had regarding program design. 

Check it out HERE.

The discussion started with me questioning the need to add extra mobility work into the actual training session since it should have been addressed properly in the warm up.  My idea was that we often throw so much at a client in the way of exercise intervention, that it may be better to just have them work on getting really really good at a few things.

Basically, Charlie’s reply was, “it doesn’t matter”, as long as people are moving well, and that may mean that not everyone needs to be doing extra mobility work.  I can respect that answer and it falls right in line with my overall philosophy on training:

1. Move Well – Improve your overall movement and be able to own basic/fundamental patterns.
2. Train Correctly - Use proper lifting technique and establish a program that allows for appropriate progression in exercise difficulty, volume, intensity, and frequency.
3. Get Fit - This can mean different things to different people.  To some it may mean losing body fat, while to others it may mean improving their vertical jump and sports performance. Honestly, whatever get fit means to you, it doesn’t really matter if you can’t grasp the previous two points, as you wont be able to get there without good movement and a sound training program.

Charlie went on to give some program design examples, and the thing that is most important to me is where he places the word need in the training program.  This “need” is based on the individual and will depend on what you have determined – based on your assessment - that the individuals weakest link is.

In my opinion, this is the most important part of Charlie’s post, as it plays to the importance of individuality in a training program.  One size does not fit all, and understanding your clients abilities are important.  Many develop their training programs in a general way that has every client performing the same mobility drill (be it hip mobility, t-spine mobility, ankle mobility, etc).  I have done this same thing before in the past as well and the most important thing I learned is that, when I did it this way…I missed people!  People may all have the same general needs – hip mobility issues, t-spine mobility issues, etc – but the reason those areas are problems may be different for each person.  Having our assessment govern the clients need is a better way, in my opinion, to get that client moving as best they can.   After all, you have to move well first!

This leads nicely into a blog that I should have posted next week titled, “Why Even Bother Assessing?”

Patrick
patrick@optimumsportsperformance.com

Two days ago I posted some of the pearls of wisdom that Gray Cook laid on us at the FMS Course this past weekend in Phoenix.  Below are some of the other notes I jotted down in my notebook during the two day seminar.

Gray’s Pearls Part 2:

- If you have an issue with your active straight leg raise or shoulder mobility, you don’t have the right to go anywhere else in a corrective strategy.  Don’t worry about your squat, clean up active straight leg raise and shoulder mobility FIRST!

- If you leave out one of the seven tests because of your own bias, your data will be flawed and you wont get the same result.  There are seven tests for a reason.  They are all important!

- After you clean up your active straight leg raise and shoulder mobility, shoot for cleaning up rotary stability, as this is a true test of “soft core” function.

- Pain is not a signal we can train through.

- You need to get your clients to stop doing negative activities that will hold back their progress in your program.  Once movement clears up and is above a minimum standard, they can work back to doing what they like to do.  If they aren’t willing to give these things up, the results of the program will always make you look bad, as they wont improve.  For example, the best back surgeons will not operate on smokers because smoking delays the healing process and their results will not be as good, making the surgeon look bad.  You wouldn’t ask your mechanic to run along side you car and fix the engine WHILE YOU ARE DRIVING IT!

- Don’t be ready to add a positive (corrective exercise/strategy) to a training program.  First try and remove a negative! 

- Any movement that you cannot score at least a two one means that you can’t do any conditioning or strength work on that movement.  You must meet the minimum standard.

- The definition of corrective exercise is move well and then move more.  Most people just want to move more.

- The best way to get your core to work right is to correct your worst movement pattern.  If you can get mobility back, your core will turn on automatically and do what it needs to do (mobility before stability).  Your core may not be able to work properly right now because your ankle is locked up, or your hips don’t move well, etc…Doing all the core work and plank exercises in the world wont fix this problem.

- Work backwards to the crib for correcting movements!

• This was one of my favorite comments of the weekend.  You can read more about how developmental kinesiology applies to the FMS in my article HERE.

- If you don’t move well in a pattern, don’t move often in that pattern until it improves.  For example, if the squat pattern is bad, don’t worry about doing plyos or jumping activities until it is better.

- It disappoints me to see research that tests stability without the researchers clearing mobility first.  Stability is driven by optimal mobility, as mobility improves mechanoreceptor stimulation.  Poor mobility = poor mechanoreceoptor function = poor stability.

- A higher center of gravity will make you authentically stabilize.  Seek to use a higher center of gravity in some of your exercises/movements.

- If you go into a movement pattern and the muscles that are being lengthened contract and push you out of the pattern, THIS IS NOT TIGHTNESS.  This is actually a contraction, even though the client describes it as tightness.  A good example of this is clients who can’t touch their toes and claim that their hamstrings are tight, when in reality, the hamstrings are turning on (when they should be lengthening) during the movement to provide stability to the pelvis since the core is not doing what it needs to do.  This is muscular contraction and not hamstring tightness.

- Inconsistencies in the FMS are usually stability problems, while consistencies are typically mobility problems.

- If you want to see your abs eat better.  If you want your abs to work better, move better!

- The definition of functional exercise is what it produces, NOT what it looks like.

- You gotta break a pattern before you can make a pattern!

- We’d like to think that we can verbalize to people how they can move better, but we can’t.  Try and tell someone who has never rode a bike how to do it and see if they can go out and reproduce it.  They can’t!  They have to actually go out, get on the bike, and try it out a few times to under stand what it feels like.  Exercise is the same way.

- You can’t motor learn authentically in a painful pattern.

Hopefully you found these notes useful and they made you think a little bit.  As I said, the course is excellent and I highly recommend it to anyone.

Patrick
patrick@optimumsportsperformance.com

Doctors like Janda, Vojta, Lewit and Kolar have made great strides in applying concepts from childhood development to physical rehabilitation of adults.  Additionally, Gray Cook and Lee Burton have taken some of these same concepts and applied them in their Functional Movement Screen. 

Below are a few notes from developmental kinesiology and what they mean to program design for our clients.

Infant Reflexes

Reflexes are movements that occur automatically (like blinking).  While a number of our reflexes occur throughout our entire life, some reflexes are only present when we are babies.  These are referred to as infantile reflexes.  There are three kinds of infantile reflexes – primitive, postural, and locomotor.

Primitive Reflexes – These are reflexes that deal with an infant producing an involuntary response to specific stimuli.  An example of this would be when you place your finger in the palm of a baby; the baby reflexively grasps your finger and squeezes it.  Other examples of primitive reflexes are:

• Sucking reflex- brought on by touching the face above or below the lip
• Asymmetrical tonic neck reflex- brought on when the head is turned to one side, causing the same side arm and leg to extend
• Startle reflex – brought on by tapping the abdomen or attempting to startle the infant, causing the arms and legs to flex
• Babinski reflex – brought on by stroking the bottom of the foot from heel to toe, causing the toes to extend

Postural Reflexes – These are reflexes that allow the infant to automatically adapt their posture to changes in environment.  These are also referred to as gravitational reflexes, as aside from the derotative righting reflex (which occurs in a supine position), the other reflexes in this category pertain to the baby being supported upright, sitting, or being lowered towards the floor, and how the infant reflexes prepares for different situations in these postures.  Some examples of postural reflexes are:

• Derotative righting - In supine, if the infant turns their legs and pelvis towards one side, the trunk and head will follow the rotation.  Similarly, if the head is turned towards one side, the body follows the head in that rotation.  This occurs around four months of age.
• Labyrinthe righting - When the infant is supported upright, if you tilt the infant, they will reflexively move the head to stay upright
• Parachute Reflex - While holding the infant upright, if you lower them towards the floor rapidly, their legs will extend reflexively in preparation for landing.  If you tilt the baby forward, sideways, or backwards, their arms will reflexively extend.

Locomotor Reflexes – As the name implies, these reflexes have to do with our movement.  There are three reflexes that make up this category: crawling, stepping, and swimming (Remember those evil moms that you would see throwing their infants into the swimming pool for swim lessons? It turns out…babies could swim!)

I hope those babies don't plan on peeing in the pool!

What does this all mean to training adults?

As we develop, these reflexive movements start to become more refined, coordinated and complex, ultimately leading to the specific movements we produce later in life – walking, running, jumping, reaching, grasping, etc.

However, developing these skills does not just happen magically.  Learning to control the body and developing fundamental skills make up our motor milestones.  Each of these milestones marks a turning point in our development and there is a progression that these milestones follow.  In simplistic terms, we need to be able to lift our head and support it, roll over, crawl and creep, support ourselves upright, walk with assistance, and then walk without support.

We can draw many parallels between motor milestones and the Functional Movement Screen and the way we develop training progressions for our clients.

The Functional Movement Screen and Evaluation of Primitive Movements

The Functional Movement Screen evaluates seven basic movement patterns, and those patterns are then graded on a 1-3 scale as far as the quality of movement being produced, with a score of 0 meaning that the client experienced pain during the movement.  The seven tests are:

1. Overhead Deep Squat
2. Hurdle Step
3. Inline Lunge
4. Shoulder Mobility
5. Active Straight Leg Raise
6. Trunk Stability Push Up
7. Rotary Stability

At first glance the, it looks like a series of movement tests (which is it).  The first three tests are looking at large global patterns and basically evaluating how well the joints of the body, both mobility and stability, play with each other.  Tests four and five can be considered mobility tests, as they evaluate what kind of range of motion we can move through at specific areas of our body, and the last two are stability tests, which look at how well we stabilize ourselves.

If I re-arrange the order of these tests to represent our motor milestones, suddenly the movement screen will look very different:

1. Active Straight Leg Raise
2. Shoulder Mobility
3. Rotary Stability
4. Trunk Stability Push Up
5. Overhead Deep Squat
6. Hurdle Step
7. Inline Lunge

The tests are now in an order that represents our movement milestones.

The first test, Active Straight Leg Raise, represents the spontaneous movement of supine kicking that we display as infants.  When lied on their back, infants will raise their legs up and kick them back and forth.  Additionally, at a young age, babies lie on their backs and play with their toes, which incorporates both hip flexion (Active Straight Leg Raise) and shoulder/arm movement (Shoulder Mobility).  Furthermore, the Shoulder Mobility test looks not only at shoulder mobility, but really how well the thoracic spine functions, as limitations in thoracic extension will surely lead to a poor score in this test.

Creeping and Crawling patterns are the first ways that the infant actually moves around.  Creeping is the infants first attempt at crawling and can be viewed as a crawl except the infant is moving close to the ground – belly on the ground – similar to a combat crawl.  Crawling is the progression from creeping, where the infant is now moving on their hands and knees.  Before the infant can get to a creeping or crawling position, they must first be able to roll over.  The Rotary Stability Test not only evaluates the individuals stability in a quadruped (all fours) position, but also tests the individuals rotational stability, which would be needed to perform a proper roll from supine (face up) to prone (face down), which is part of our infantile reflexes.  The Trunk Stability Push Up is a representation of the infant pushing itself up in preparation for standing and upright posture.

The Overhead Deep Squat would represent the infant’s ability to stand up without help.  As a continuation of the two previous tests, this is in line with our motor milestones as the child first rolls over and crawls (rotary stability), then pushes itself up onto the couch (trunk stability push up), and finally transitions to standing (Overhead Deep Squat).

The Hurdle Step is next in the progression as it represents us actually taking a step and how well we can establish single-leg stance.  After taking that first step, we typically fall and catch ourselves, and prepare to stand up again (Inline Lunge).

Rolling Assessment

Another important evaluation that can be used in the Functional Movement Screen is the multi segmental rolling pattern, where the client is asked to roll them self from both supine to prone and prone to supine using only their upper or lower extremity.  Multi segmental rolling is an evaluation of the pattern of rolling over, which is the part of the derotative righting reflex discussed above.  This tests gives us an appreciation for both stability and mobility of the client, as limitations in mobility will lead to the individual attempting to draw stability from somewhere else in order to complete the movement and appease the tester….after all, you asked them to roll over!  Basically, they are going to try and get there anyway they can. 

What About Exercise?

Our training progressions should represent these motor milestones, as people need to master the more primitive positions before moving on to more coordinated/skilled movements.  Essentially, we want to “fill in the blanks” so that our brain can give our body good feedback about how to appropriately move – you did it once before as a developing infant, and you just need to remember how to do it again!  

The goal of correcting movements from the screen should take a similar approach to our motor milestones.  Before trying to correct the squat, you would want to first correct the things that came before it, as they would be considered “more primitive”. 

The exercises that we prescribe to clients can follow a similar sequence of regression and progression.  Here is an example of this sequence for a chop:

• Tall kneeling would be more primitive than half kneeling, so we could start there.
• Half kneeling would come next as this would alter the clients base of support and make them feel less stable. 
• A half kneeling chop would be followed by a parallel stance standing chop.
• Parallel stance standing would be followed by an inline stance standing chop.
• Finally we could progress to a single leg chop.

Conclusion

All of a sudden, training clients looks a lot different!

It isn’t about what exercises we do but what we are actually getting when we perform them that is important.  Having progressions and regressions of exercises that follow the motor developmental sequence can be an effective way to help your clients get the most out of their training.

*Special thanks to Charlie Weingroff for his editing of this article*

Patrick
patrick@optimumsportsperformance.com