Prehabilitation and Deloading

Written on January 16, 2008 at 11:01 am, by Eric Cressey

New Article

I had a new article published on Tuesday at T-Nation; be sure to check out The Prehab Deload.

You can never get enough Hartman…

Earlier this week, Bill Hartman provided us with seven great tips; here are eight more than certainly won’t disappoint!

8. Unilateral lower body training is well accepted, but unilateral upper body training is no less valuable and gets ignored by most trainers and coaches. It’s not uncommon for strength and conditioning coaches to recommend unilateral lower body exercises in an effort to maintain functional relationships in the trunk and hips. There are equally if not more important relationships between the upper extremity, the trunk, and the hips. Consider working toward developing the ability to perform a single-arm push-up as much as you develop your single-leg strength. It will go a long way toward maintaining your shoulder health and improve your performance.

9. It is a rare occasion that athletes needs complex training programs. Most athletes, regardless of level, are not well-trained strength athletes. Just as many HATE supplementary strength/performance training and don’t understand the value that it provides by allowing them to perform at their highest levels of performance. They would rather just play their sport. The exceptions are those athletes who have spent 3 to 4 years in a progressive, controlled, and properly designed strength program. Being advanced in a particular sport does not mean they are advanced in regard to supplementary training. When in doubt simplify.

10. If you choose to emphasize bench pressing in your training program, you need to spend more time strengthening your lower trapezius and rotator cuff.

The lower trapezius tends to be the weak point in your ability to stabilize the scapula and the rotator cuff is the big stabilizer for the glenohumeral joint. It is the ability to stabilize these areas that allows the larger prime movers to lift big weights. If these muscles don’t keep pace, your bench press will stall and you will most likely get injured.

11. Stand more and sit less. If you’re sitting on your ass, you’re not using it. If you’re not using it, you’ll forget how to use it when you train or play a sport. This can result in lower back pain, hip pain, or pain anywhere down the kinetic chain. You’ll also go a long way to prevent the loss of hip motion that will increase joint wear and tear and rob you of your athleticism at a premature age.

12. I recommend four recovery/restoration tools for everyone: sleep, food, soft-tissue work, and ice because they work for everyone.

I know a lot of things that have been used as recovery tools with world-class athletes. Most people are not world-class athletes and I question the value of many restorative tools. I’ve never been able to identify a measurable effect from something like a contrast shower other than shrinkage (you know what I mean). However, the four tools I recommend will apply to everyone.

Sleep is essential. The nervous system needs sleep to function at top efficiency. Food provides energy, reparative materials, and nutrient-based recovery. Soft-tissue work, whether it be massage, foam rolling, ART, or whatever, will maintain a more optimal condition of the soft-tissues. Trigger point, adhesions, and scar tissue affects mobility, tissue extensibility, and the ability to produce strength. An ounce of prevention goes a long way to assure optimal functional relationship between and within muscles and groups of muscles. Ice is under utilized by just about everyone. It is inexpensive and will go a long way to preserve your joint surface. Fifteen minutes of ice to heavily trained joints has been shown to have a preservation effect on joint cartilage.

13. Make your icing more effective by periodically moving the joint or muscle to which you’re applying ice. It promotes a more uniform application of the cold to the affected area. After you remove the ice, limit the motion of the affected area to preserve the cooling effect, as movement will increase rewarming.

14. Hip mobility affects more than you think. A lack of hip mobility will promote overuse of the lumbar spine to compensate for the lack of mobility. In patients with unilateral shoulder instability, almost half of those patients also showed poor hip mobility on the opposite side.

15. There are “money muscles” in almost every type of injury that when treated or activated immediately improve function. For shoulders, it’s the subscapularis. The subscapularis prevents the humeral head from moving forward and upward into the acromion in cases of impingement. Many times it’s overused due to repetitive movement, heavy loading, or both. Get it functioning again (ART does wonders) immediately restores shoulder function in a majority of cases.

For lower back pain, it’s the psoas. If someone has trouble forward flexing AND extending the spine (you can also see that they limit hip extension when they walk) check the psoas for spasm or adhesions. Restoring normal psoas function immediately restores spinal range of motion.

For lower back pain, it’s the psoas. If someone has trouble forward flexing AND extending the spine (you can also see that they limit hip extension when they walk) check the psoas for spasm or adhesions. Restoring normal psoas function immediately restores spinal range of motion.

For the knee, it’s the popliteus. Many times when rehabbing an athlete or patient with a knee injury, there’s sense of residual instability. Rather than going for the wobble board, consider checking the function of the popliteus. The popliteus assists in rotatory control of the knee. Restoring the popliteus function with soft-tissue work and a little strengthening often restores stability in no time.

About Bill

Bill Hartman is a physical therapist and strength and conditioning coach in the Indianapolis area.  Bill is the co-creator of Inside-Out: The Ultimate Upper-Body Warm-up and a contributing author to Men’s Health Magazine.  He is also the creator of Your Golf Fitness Coach’s Video Library, available at www.yourgolffitnesscoach.com.  You can contact Bill directly via www.billhartman.net.

I’m off to Maine to lift some heavy stuff and see the family. Have a great weekend, everyone!

All the Best,

EC