Random Tips from Michael Stare

Written on January 17, 2008 at 10:11 am, by Eric Cressey

Random Tips from Michael Stare

Early in 2007, I interviewed physical therapist Michael Stare for one of our newsletters. As it turns out, that interview (featured HERE) was one of the more popular ones we’ve done – so I approached Mike about throwing a little more content our readers’ way. Here are five tips from Mike to get the ball rolling:

1. The sciatic nerve, not your hamstrings, is often the source of your chronic posterior thigh pain. It is alarming how often people are encouraged to stretch their hamstrings in response to an insidious onset of posterior thigh and buttock pain, often coupled with a nagging low back problem. In probably 90% of cases, the problem is not the hamstrings at all, but rather the sciatic nerve. So, if you have pain in the back of your leg and it wasn’t in the course of coming up lame after a sudden sprint, consider performing the following simple test before stretching your hamstrings:

Sit in a slouched position, head looking down to your lap. If this is pain-free, proceed to the next step. Dorsiflex the ankle on the side you are testing. Then, slowly extend your knee, stopping at the point where you first feel any symptoms, (stretch, pull, pain, tingling, etc). Next, while still holding this leg position, extend only your cervical spine. If this alleviates your symptoms, you are most likely dealing with an irritated sciatic nerve rather than your hamstrings. Why? Your hamstrings don’t connect to your head, so changing the cervical position shouldn’t influence the symptoms if the hamstrings are the source of the problem. Rather, the tension upon the sciatic nerve is alleviated with cervical extension as the dura of the spinal chord is connected with that of the sciatic nerve. So if your “chronic hamstring strain” isn’t healing, and your slump test is positive, you should stop stretching your hamstrings, and seek some professional advice.

2. Learn to posteriorly tilt your scapula. Poor control of the scapula is the root of most shoulder problems, as most informed conditioning and rehab experts will attest to. In fact, and anteriorly tilted scapula is the most common postural impairment found in those with shoulder pain. Posteriorly tilting the scapula removes a common mechanism of impinging the rotator cuff against the subacromial arch when elevating the arm. Furthermore, it helps to position the scapula to facilitate optimal length tension of the scapula and humeral musculature. So merely “pulling the shoulders back” doesn’t do the trick.

To practice scapular posterior tilt, lay supine on a firm surface, and attempt to bring the posterior aspect of the acromion to the table. If this is very difficult for you, you will likely require some activation work for your lower traps and stretching of your pec minor.

3. Stretch your psoas and your rectus femoris separately. Although it is common to hear recommendations to stretch your hip flexors, two major hip flexors, the psoas and the rectus femoris, should be stretched separately. This is due to the fact that they have separate origins and insertions. To stretch the psoas, ensure slight lumbar flexion via a posterior pelvic tilt, lumbar contra-lateral side bend, and hip extension. This can be done in standing or half kneeling. These motions can be quite tricky, so be sure to have a qualified coach or PT teach you. For the rectus femoris, posteriorly rotate the pelvis, flex the knee to about 120 degrees while placing the foot upon a stationary surface, and extend the hip. With both stretches, the most common mistake is to hyperextend the lumbar spine, which will reduce the effectiveness of the stretch and could contribute to back problems.

4. Train hip rotation rather than lumbar rotation. Tasks that involve powerful rotary force production, such as swinging, throwing, and kicking, mostly involve hip rotation versus lumbar rotation, at least when they are performed by skilled athletes. Emphasizing hip rotation makes sense from an anatomical perspective too. The hips are very stable joints, with a network of dense musculature designed to perform rotation. The lumbar spine is relatively more fragile. In fact, the annulus of the disc begins to experience failure at only 4% elongation, which usually occurs at only 3 degrees of rotation at each segment! Furthermore, the lumbar facets are orientated such that the joint surfaces are aligned in the sagittal plane, and are impacted at 3 degrees of rotation. Clearly, our training should reflect these biomechanical factors.

5. Try performing balance activities with your eyes closed. Balance is simply maintaining your center of mass within your base of support and is facilitated by many different sensory and motor qualities. Proprioception is a component of balance that is very important to athletes and fitness enthusiasts, as the training of it can reduce the incidence of some injuries, and the loss of it is the by-product of any joint injury. This is well researched with ankle injuries in particular. When performing single leg exercises, closing your eyes reduces the contribution of visual input towards the task of maintaining your center of mass over your base of support. Therefore, you must exclusively rely on feedback from the joint structures, and as a result enhance proprioceptive input.

About Michael Stare

Michael Stare is the Director and Co-owner of Spectrum Fitness Consulting, LLC, in Beverly, MA, where he trains young athletes and clients of various fitness levels. Mike received his BS in Kinesiology from the University of Illinois at Urbana-Champaign, his MS in Physical Therapy from Boston University, and his Doctorate of Physical Therapy from the Massachusetts General Hospital IHP. Mike recently completed Fellowship training in Orthopaedic Manual Therapy and currently practices with Orthopaedics Plus in Beverly, MA as a Physical Therapist. To learn more about Spectrum Fitness Consulting, go to www.SpectrumFit.net. Mike can be reached at mike@spectrumfit.net.

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A few buddies of mine are organizing events that are definitely going to be very solid. I’m only making it to the one here in Boston (June 6), but I’m sure that the rest will be excellent. Check ‘em out:

April 26: 2008 Georgia Strength Coaches Association Strength and Speed Coaching Clinic: More Info

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We’ll be back early next week with five more tips from Mike Stare and plenty of other new content.

All the Best,

EC