Rehab Cafe Blog

Medial Tubing Pull for Grumpy Quads

Today's video from 2011 in Iceland trials different techniques that cause up to 25% increase in VMO activation by applying tubing in a medial direction. See how.

Ball Squeezing for Grumpy Quads? GQ12

Uh ohhh look out... this one might mess with a few heads because a "sacred cow" is being threatened ….and this one is controversial! Friends, we are talking about whether or not to squeeze a ball together between the knees during squat to help with knee pain.

Rehab Friday 115: Early Fx Integration for Grumpy Confused Quads 11

In all my Physiotherapy days treating knee pain, I was never more grateful for any piece of equipment than for the Leg Press they had in the massive gym next door to our Sports Medicine Clinic at Lutwyche in Brisbane. It was perfect! - the kind that moves your body away from the platform, not the platform moving (less functional I think).

Though I use a wall instead of the machine, today’s video brings together many critical elements that need to be taught to clients with Grumpy Knees (and therefore Grumpy Quads!)

Firing UP Grumpy Quads 10

It all starts with firing Up your quads every day if you are in pain, before sports or fitness in your warm-ups, and adding a very determined approach that may involve a bit of slapping as in the video!

Switching ON Grumpy Quads 9

Let’s just pause for a deep breath in this series on Grumpy Knees…we have spent a good few newsletters now on Quad releasing, trigger points, R1/R2, and stretching, and how have you found this? Anything new for you? What do you find hardest to do if you have Grumpy Knees?

No video today, instead just want to intro a new direction for us: activation and strengthening of Quads.

The challenging reality we face and discussed earlier was that "Stubborn Quadriceps are surprisingly vulnerable to inhibition and atrophy, and doesn’t like operating when pain and swelling is present. It’s a real Catch-22…weak quads result in knee problems, which result in weak quads. Chicken and egg.”!

Passive Stretching R2 Mobility for Grumpy Quads 8

Straight after myofascial release, use that window of freedom to lock in some longer term changes. These two passive Quad stretches should be absolutely taught to every client with knee, hip, and low back issues.

Myofascial R2 Mobility for Grumpy Quads 7

Sounds like a technique on a certain Star Wars character ;) Seriously though, watch today's video and reduce Myofascial “knots”!

VMO Trigger Activation for Grumpy Quads 6

Watch me tackle my VMO Trigger Points in the video in order to activate it!

Hypersensitive Fascia Grumpy Knee 5

To assess for tight fascia on your client I recommend the simple method in today's video. If it's tight, there will be areas of hypersensitivity in the fascia preventing easy expansion and movement of the local tissues down to the knee.

Triggered Quads Grumpy Knee: GQ4 R1 MFR Side Sit

If your Quadricep R1 has subtle tension that kicks in due to neuromuscular tension rather than tightness, now it’s time to get out your favourite myofascial release tools and have some fun!

We are searching for “landmines” (or Trigger Points)!

GRUMPY QUADS GRUMPY KNEE 3: R1 ITB & MFR

Grumpy Knees have Grumpy Quads that are tense and tight every time. Do your homework to release the triggers and fascial tightness - and today’s video shows me doing it to myself with the Rehab Dowel. Mark my words it’s a good pain!

Grumpy Quads Grumpy Knee 2

If you have knee pain, it ultimately will come down to this, and if you don’t then this is the ultimate knee injury prevention strategy!

Grumpy Quads Grumpy Knee 1

If you have a Grumpy Knee, you MOST DEFINITELY HAVE Grumpy Quads. Guaranteed. So how can we break the cycle for ourselves and our clients?

Grumpy Knee Diagnosis

What’s the Diagnosis of your Grumpy Knee?

Well, I’m going out on a limb here when I make the call that INSTEAD of focusing on structures and diagnosis, we SHOULD focus on these three things to improve knee function. Read on!

4 Realities for Grumpy Knees

Knees have lots of bits to get Grumpy. Here are 4 realities you need to know.

A Summary of Serratus

Let’s take stock of Serratus Anterior - a muscle surprisingly misunderstood and undervalued in the exercise and even allied health industries. Its the powerhouse of the active shoulder, and absolutely critical for overhead shoulder health.

Integrating Serratus Part II

Learn this complex integration exercise, guaranteed to increase whole body synergy, warm-up and a multitude of secondary benefits!

Serratus Conductor

Train the brain to automatically include Serratus in movement. That’s the goal. Train the BRAIN. Here's how!

Serratus Seatbelt work: a peek from Practitioner

Enjoy using the Rehab Belt to activate and empower Serratus Anterior!

Serratus Taping: a peek from Masterclass

Anyone can try this on clients. Who says you have to be a Physiotherapist to do this? Go ahead!

Serratus Q-mark Drill

Presenting the famous “Q-mark Drill” from Chris (actually it’s an upside-down Q-mark hahaha!) Use a towel or a swiss ball for this cute drill, teach your clients and make sure if they have any shoulder niggles they are doing 30-40 reps / day. NO compromise! ;

Iso-integrating Serratus II

Fire-up Serratus during elevation in the forward plane! Iso-integrating Serratus II is a “selfie” (a drill you do yourself)…so watch the video to learn!

Iso-integrating Serratus in Scaption - WTF??

If you can even understand what "Iso-integrating Serratus in Scaption” means, then boy oh boy! - you are no average Personal Trainer. Let’s unpack it to make sure this simple powerful concept doesn’t get lost in translation shall we?

The Serratus Plank with extras

Use Theraband tension to turn the simple plank into an “Iso-Integration” drill which Super-Activates Rotator Cuff and Serratus!

A Serratus Blaster for Chinese New Year!

Let’s take our Serratus Anterior work into new territory to deal with some of the more tricky and resistant types of athletic shoulder complaints: overhead impingement due to poor scapular positioning and control. Here are a few safety strategies!

Scapula Packing

How does Scapula Packing relate to Serratus Anterior function? Is Scapula Packing a functional movement? Are there times when it can be useful, or harmful? Enjoy the article today from our most experienced international educator Chris Mallac.

Sky Punching by Serratus Anterior

In this series a lot more than just Serratus is being targeted … in fact your abdominals may scream more in this series designed by Mark Davis and coached by Chris Mallac. Not for the faint-hearted.

Serratus with Thoracic Rotation Drills

You owe it to clients to educate them in how to use Serratus. Today’s video shows you a couple more cues helpful in the pushing movement and linking it to thoracic rotation.

Serratus Killer

Today we have a nice little Serratus Killer called the Supine High-Elbow Swiss Ball Push - full credit to Mark Davis for its subtle brilliance!

Serratus: The Upright Body Builder!

Here's a quick wake up for an inhibited or sleepy Serratus. Do 15-20 reps during a warm-up, in between sets, after a few hours at the desk or steering wheel. It’s my fool-proof Serratus for Dummies Drill.

Serratus: The Sleepy Body Builder Progressions

Are you ready to crack on a with a fantastic series of drills to wake up, integrate and empower yours and your client’s Serratus Anterior? Regardless if there is preexisting niggling pain in the shoulder or not, try each drill (check there is no pain of course when doing it) and see if you like it.

Don’t worry I won’t try and turn you into a Body Builder! :)

Serratus: Powerhouse of the Shoulder

Today’s video gives a functional anatomy summary of what the role of Serratus Anterior is, with my good friends Chris and Mark using skeleton Bonezy to demonstrate protraction and upward rotation.

Poor Serratus - Poor Overhead Press

Overhead Shoulder Press is the pinnacle of shoulder movements in terms of functionality and optimisation of movements of the whole upper body. If you haven’t got every element of your kinetic chain in good working order and synergising well, something will breakdown with niggling injury and chronic pain frustrating you.

There's a lot to keep in mind, so click through to watch my example-rich explanation.

Poor Serratus - Poor Elevation

Painful shoulders and a DEAD Serratus Anterior! Watch my video on how poor Serratus can look - and how it can be trained to disappear.

Poor Serratus - Poor Push

Do you know how to check if a client has a weak Serratus Anterior? It’s EASY - simply watch them do a Push-up from the knees (actually the All-4’s position is perfect, especially if they are elderly or have pain in the shoulder). Guess what? you’ll see those “Wings” pop up straight away if their Serratus is poor!

Poor Serratus - Poor Posture

The challenge is for you to find the Brain Switch for Serratus Anterior in standing posture without load. Not easy… Read more to learn the different Cues I am using to help people learn it, depending on what works for them.

Cutting-edge Shoulder Answers

How much of a Shoulder Rehab Specialist are you really? Be honest.

Jump into this Serratus Quiz (with answers)!

A Cutting-Edge Shoulder Quiz

Today, as we launch our series on the critical shoulder muscle Serratus Anterior (also termed “The Boxer’s” muscle), let’s begin with a small "cutting-edge” QUIZ.

The Upper Trap Mystery Part II

Should we stretch OR strengthen Upper Traps for rehab?? Do Shrugs work even work for strengthening Upper Traps? Chris and I tackle this controversy and continue our exploration of the Upper Trap Mystery in Part II.

The Upper Trap Mystery

Tight upper traps can be the tip of whole iceberg of headaches, nerve symptoms, and limited neck mobility. Take an in-depth look with Ulrik Larsen and Chris Mallac to unravel this mystery today. Free your clients from their persistent pain!

If you don't ask - you'll miss it!

When you have finished interviewing your client with this form, you will know everything from their brief medical history, dominance, other nearby injuries, what sports they played as a kid, and the intensity of their main experience… this knowledge is power to help.

Personal Trainers Beware! Neurological Issues

Let’s not forget that the body does break down at times around the nerve system! There can be real damage to structures like discs, that crush fragile nerves, inflaming them and altering how the body feels and works.

Personal Trainers Beware! Chronic Pain

The longer you are in pain, the more it messes with your head, begins to affect how you think about yourself, destroy healthy routines like exercise, how your relationships work, and finally your deepest beliefs about life, the Divine, and so much more.

Personal Trainers Beware! The Psyche will affect Pain

We all experience more pain if we are in a heightened state of (especially negative) emotion, and this may explain some client's pain levels.

Some people have termed it broadly as “Stress Biology”, and it means that the negative events and stressors in our lives will actually trigger our brain, which then triggers chemical and physiological processes in the area where our normal pain is felt.

Here are the essential points every PT needs to keep in mind.

PTs Beware: Older Shoulders

I’ve been looking forward to this! Rehab-Yoda Adam Floyd, in #6 of our "Musculoskeletal Conditions PT’s Need to be Aware Of”, brings more of his injury wisdom to the topic of “Older Shoulders”.

I’ve often thought how freaked out I would be, being a Modern Personal Trainer... True! Client’s bodies are tricky, joints can easily be worn out and old injuries are so vulnerable to aggravation! Loading them up; forcing them to adapt and get fitter, stronger, more functional…all sounds so easy - unless, that is, you’ve been a Physiotherapist to umpteen Personal Trainers….

And worst of ALL the risky areas would have to be Older Shoulders

Shoulder injuries are tricky regardless of the age of your client (or yourself!), and certainly Adam’s down-to-earth knowledge and advice needs to be heeded by every PT - have a quick listen to this surprising research he has dug up, and critical advice to go with it:

CONTROVERSIAL MEDIAL KNEE DRIFT IN ATHLETES

Physiotherapists and Exercise Professionals often become concerned when they see a client or patient demonstrate a valgus collapse during squatting and lunging type movements. Typically, they will encourage the client/patient to maintain a knee over third toe position during all knee bending movements to protect not only the patellofemoral joint but also the anterior hip joint and even the medial ankle structures that will be subject to pronation.

However, is it sometimes favourable to have a valgus knee collapse during execution of a particular skill? If we look at the photos below, we can see some classic examples of high end athletes who do allow some medial knee shift or valgus knee collapse.

6 TIPS FOR REHAB HOMEWORK

Client’s generally DON'T DO their Home Exercises we give them. The good news is that there are many ways to improve “adherence” to home rehab programmes, and have a positive attitude about the challenge. See my 6 tips.

Suspended Stretching - Anterior Chain

The most powerful on-going effects on your upright posture come from tightness somewhere in your Anterior Chain (these myofascial tissues include Quadriceps, TFL - Tensor Fascia Lata - and your anterior Adductors, to Abdominals and Psoas, right through to your Pec area.) Some of these parts of the Anterior Chain are so tight they really do feel pain when being stretched, so you have to really relax and deep breathe into those areas for them to let go!

Suspended Stretching - Posterior Chain

What a massive area of myofascial tightness most of us carry in our posterior chain! Whether that be hamstrings, adductors, piriformis or even glutes - any of them may have become too overloaded and tight, and consequently affecting negatively how your hips or low back perform.

Suspended Stretching - Lat Dorsi

Is there greater value in stretching the muscle you are about to train, or stretching to improve the biomechanics of the area? Find out in this video.

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