Reverse Floor Block-Anti Keyboard Corrective Exercise

August 23rd, 2022

A client favorite, this exercise has multiple benefits to the upper extremities, thoracic spine and neck region. Utilizing the arm positioning and the cueing of the radial-ulnar and gleno-humeral joints, the motor system can access the peri scapular muscles in a very efficient way.

Lengthening through the chronically shortened muscles of the wrist and forearm and isometrically contracting the middle trapezius and rhomboids produces a noticeable change in the tissue tension and posture of the upper body.

Dead Bug Variation to Regulate the Core

June 8th, 2022

The following is a Level B in the Pain-Free Movement Specialist Levels of Designation

The Dead Bug is a popular and effective core stabilization exercise. And although it is done supine on the floor, it has a level of difficulty that may be underestimated.

When working with chronic pain clients, particularly those with lower back related issues, the many common versions of the Dead Bug may actually be too challenging. With the version we share below, the degree of difficulty can be self regulated. This means the individual has a degree of control over the intensity of the exercise by way of the force that they apply with the upper body.

With this control, the client/patient has the ability to choose a level of difficulty within their capacity and reduce the sense of threat of further hurting themselves. They will also be able to better assess their success or lack their off with fewer moving parts to the exercise.

Scoring Your Wins and Beating Your Pain

April 11th, 2022

If I have had the pleasure of working with you, you have probably heard me speak of the need to score your “wins” as you move through the process of beating your pain. “Wins” are those smaller victories along the way to the ultimate goal of eliminating pain and doing all the things we physically want to do.

For so many of those challenged by chronic pain, their assessment of their pain is either they have it or they do not. This black and white view of the situation can be one of the most burdensome mindsets, hindering one’s progress. The reality is that there are many, many shades of grey in between.

If the view is black and white, there is no win unless the pain has been completely eliminated forever. Eliminating the pain forever is an achievable goal worth pursuing, but without a progress meter along the way, we do not know if the goal is right in front of us or 6 months or 6 years away.

Let us say that you have lower back pain and at its worst it is an 8 (on a scale of 1-10 with 10 being the worst). The back pain is an 8 whenever you stand too long. And when the pain reaches an 8, your back is aggravated for a couple of days afterwards. On average your pain is a 5/6 on most days if you take 400mg of Tylenol, twice a day.

You are frustrated and fed up and decide to begin a new program (Function First, chiropractic, physical therapy, acupuncture, etc.). At Function First, we would want to know more accurately what is “too long” for standing that gets you to an 8. Is it 5 minutes or 50 minutes? These are more objective time frames and easier to compare. We would also want to know more accurately how long afterward is your back pain aggravated? Is it 24, 36, 48 hours? If you do not know, this is a major reason why we ask you to track and journal your experiences. By journaling, you are not reflecting on a situation when you are in the throes of the emotions associated with the pain.

Scoring Wins

After two weeks of your new program, you still have pain that is an 8. In the black and white pain scenario, you are exactly where you were two weeks prior, minus the time and money you have spent. But in the finding wins on our way to the ultimate goal, progress is there if we look for it.

There are 3 fundamental ways we can gauge our progress. They might present individually or in combinations of two or more:

1. The overall level of pain is less. Your average pain of a 5/6 on most days is now a 2/3. Or your pain is still a 5/6 but you no longer need to take the Tylenol to control it. You still have pain but that is progress!

2. Your tolerance is greater. You could only stand for 15 minutes, and the pain was an 8. Now you can stand for 30 minutes, and the pain is an 8. Yes, the pain is still an 8, but you have increased your standing tolerance 100%. Another example might be your range of motion. You would squat to 45 degrees and your knee pain would be a 6. Now you can squat to 90 degrees before your knee pain is a 6.

3. Your recovery is faster. You stand for 15 minutes, and the pain is still an 8. However, you do your Function First exercises, and the pain is back down to a 5 within a couple of hours. You are no longer physically and emotionally burdened with the extended recovery time every time you push your body to stand. Or you love golf or tennis and could only play once a month, because your back needed that long to recover before you could play again. Now, your back still is painful after a round or a match, but because you are doing a strategic exercise program, you can now play once a week as your body gets more functional and stress is removed from the back.

As I share with all my clients, this is not something anyone should be convincing you of. It is simply recognizing progress (wins) that have occurred on your journey. This provides extremely valuable affirmation to the brain that you are on the right track and making progress. It provides hope and motivation to continue to strive for what is possible.

No one wants to be spinning their wheels hoping one day that magical door to a completely pain-free life will suddenly open. With the right intervention, supportive and educational coaching and acknowledging your wins, the path is clearer, and the goal is within reach.

Corrective Exercise-Half Kneeling Hula for Hip Flexors

March 23rd, 2022

Following the PFMS A-D Levels of Designation, the Half Kneeling “Hula” is a Level “C” exercise. Besides the points of contact and relationship to gravity, this corrective exercise requires some kinesthetic awareness and movement coordination and is an excellent progression to the standard, static kneeling hip flexor.

Adding variability not only provides superior outcomes, but it also often exposes restrictions we didn’t know were more prevalent.

Corrective Exercise Creates a Positive Cascade for Change with Chronic Pain

October 28th, 2021

The pain itself is almost always the primary focus. But their are multiple inputs that can lead to a downward cascade in the quality of life of those challenged with chronic pain. And equally, the sum of many inputs can also lead to a positive cascade and opportunity for improvement.

This clip taken from a live webinar I did with the American Council on Exercise, sheds some light on how the right exercises, for the right person, at the right time can be a catalyst for positive change.

If we can appreciate and impact through exercise, more of the dynamic systems involved in the pain experience , we provide our clients with a path to positive change.

Corrective Exercise Full Body Functional Considerations

September 13th, 2021

Looking beyond the primary movement in a corrective exercise offers tremendous opportunities and insight into ways that we can influence our clients’ global movement needs. Here, I use an example of a familiar corrective exercise for the shoulder girdle and apply our Levels A-D strategy to demonstrate the different considerations when selecting a working posture/position.

It is common to focus on a joint or body segment only, when choosing corrective exercises for your client. Disregarding the implications (positive and negative) of the posture or position from where the exercise is initiated, means that we are not recognizing the integrated, functional biomechanics involved.

Corrective Exercise Sitting Leg Extensions for Lumbar Stability

April 14th, 2021

Don’t be fooled. This exercise has nothing to do with strengthening the quads or the provocative slump test for neural tension. Both of those exercise look similar at first glance, but the nuances of this exercise give it a completely different objective.

Sitting Leg Extensions is an incredibly effective exercise to introduce a lumbar stability strategy that does not involved bracing or conventional core work.

The goal is not terminal knee extension. The goal is to generate enough internal tension from above and below the lower back, that the tensegrity forces help to de-rotate and stabilize the lumbo-sacral-region.

This is a self limiting exercise, meaning that the breakdown of the form and execution will be a result of the individual’s own internal force generation.

Give this one a try and let us know what you think.

Foam Rolling for Lower Back Pain

March 12th, 2021

For as long as foam rolling has been around, it still seems that people are doing 90% of the same areas of the body and with the same moves. Having had the good fortune to speak on many of the facets around the myofascial component, I’ve both seen and explored many interventions directed toward myofascial mobility. Since most people have or have access to a foam roller, I’d like to share this very effective application for the lower back that you may have never tried.

When I have participants experience this self-myofascial release application at a presentation, the “oohs” and “ahhs” fill the room. That’s because they are exploring a stimulus to

    this tissue that is brand new to them.

    This particular application does have some nuances and precautions, so be sure to watch the entire video.

    Leave your questions and comments below.

Lower Back Pain Relief

March 5th, 2021

This non-technical video is directed toward our clients and readers of The Pain-Free Program or anyone else looking for an accurate way to perform this familiar, lower back exercise exercise. Anthony gives you the nuances with the execution and the “why” behind the value (hint: It is probably not why you think it helps).

Anthony also suggests the best place to add to an existing lower back pain care exercise program.

Corrective Exercise Frontal Plane Samurai Lunge

February 11th, 2021

We have one of our Level D correctives from the PFMS library that is part of our educational website. Level D exercises are what I refer to as “top of the foodchain” in the corrective exercise world.

These highly integrated exercises carry extensive value beyond the biomechanical integrations. For some clientele, the Level D is the immediate segue to their more traditional fitness workout. For others, the Level D is an element of a workout itself.

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Functional Purpose:
Improve Frontal/Transverse Plane Spinal Alignment

Biomechanical Outcomes:

• Momentum from desired pelvic list promotes lateral spinal flexion, which is enhanced throughout the vertebral column when torso and righting reflexes resist maintaining a level orientation to the horizon.
• Arm overhead act as an extension of the rib cage, creating a longer lever and greater mass to ensure that all vertebrae contribute to the lateral spinal flexion.
• Maintaining a pure frontal plane motion with thoracic extension counters any rotational tendencies of the torso.
• Slight rotation of the intervertebral joints are coupled with lateral flexion of the spine.
• Lateral trunk musculature on the lengthening side are eccentrically loaded & decelerate mass of the trunk in the side bend, then transition concentrically to return trunk to the vertical.

Neurological | Physiological Outcomes:

• Promotes connective tissue elasticity associated with dynamically loading / stabilizing sagittal, frontal and transverse plane motions of the thorax.
• Increase connective tissue compliance and resiliency through the promotion of tissue extensibility, amplifying the viscoelastic and force closure demand to uphold lumbar spine integrity and stability.
• Extensibility of the lateral hip musculature to allow for and additional hip adduction, flexion and internal rotation.
• Elicit a heightened somatosensory response due to the simultaneous bottom-up (lateral lunge) and top-down (lateral flexion / thoracic rotation) influence.

Psycho | Social Outcomes:

• Establish a multidimensional environment involving the neural-networks associated with managing heightened emotional states (anxiety, hyperviligence, etc) during the execution of a complex, autonomic motor task.

Modifications:
• Begin pre-positioned w/ both hips abducted, greatly reducing ground reaction forces.
• Remove ipsi-lateral glenohumeral abduction.

Contraindications:
• Subacromial impingement syndrome.
• Inability to control multi-segmental deceleration of descending body weight.