https://crossoversymmetry.com/blogs/news.atomCrossover Symmetry - Crossover1012024-03-22T14:11:55-04:00Crossover Symmetryhttps://crossoversymmetry.com/blogs/news/why-swimming-should-be-in-your-training-program2024-03-22T14:11:55-04:002024-03-24T08:52:26-04:00Why Swimming Should Be In Your Training ProgramMatt Unthank
Guest Post by Abbie Fish from Swim Like A. Fish
Crossover Symmetry and I have been partners for a long time because their training programs and swimming go hand-in-hand.
Not only does their program help build strong and resilient shoulders for better swimming, but no matter how old or young you are, both swimming and resistance band training benefit your body, mind, and soul!
Why Should You Try Swimming for Exercise?
As a lifetime swimming enthusiast, I could go on and on about my love of swimming and why you should try adding swimming to your exercise routine.
A highlight for me is that you can swim at any age, and it's easy on the body. We see swimmers exercising well into their 80s and 90s, making this an incredible skill to have in your back pocket.
The buoyancy of the water helps soften the effects of gravity. That means people with knee or hip problems who shouldn't be running can keep up their cardio by swimming without causing pain.
That's one of the reasons Crossover Symmetry and I work together as such good partners. Their bands help YOU stay healthy at every age. Swimming can work in tandem to do the same!
What's To Love About Swimming?
Like anything, victory is sweeter when the road is challenging, and swim training offers a challenge every time you hit the pool.
Overcoming micro-challenges throughout a practice (like completing a set or fixing your technique) builds your confidence muscles.
I find that swimmers are highly focused on their goals.
Whether you're improving your technique, getting faster, or swimming longer, there are constantly tiny wins that will leave you feeling accomplished every time after every workout.
They also say you are the average of the five people you spend the most time with and around the pool you'll find people who make YOU a better version of yourself.
How To Start Swimming for Exercise?
Without a doubt, you should start by looking up a team or group that is already swimming together! If you're googling or looking it up on Facebook use words like "masters swimming group near me," "swimming team," or "swimming community" with the name of where you live.
One of the great benefits of swimming is that it's an individual sport that can be practiced as a team.
If you join a Swim Club, a lot of the guesswork is taken out of the equation. Masters Swimming teams have a designated coach who will write workouts, answer questions, and help introduce you to other swimmers.
If you have any questions about your swimming journey, head to my Instagram or my Website!
I look forward to being in your inbox in the coming months.
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https://crossoversymmetry.com/blogs/news/the-ultimate-self-rehab-guide-for-low-back-pain2023-06-13T15:05:20-04:002023-06-14T16:52:52-04:00The Ultimate Self Rehab Guide for Low Back PainMatt Unthank
You will put back pain to rest with this self-treatment guide. No doctors, therapists, or pain specialists are required, only a simple plan to help you feel better and move better.
You will learn about your back, the four pillars to reduce low back pain, and then create a two week prescription plan based on your needs.
It's your opportunity to kick the nuisance of pain flare-ups that stop you during sports and other activities. Of course, high-stress things like weightlifting and golf are common culprits, but it can also be simple life activities like playing with your kids, working in the yard, or even sitting at a desk that can set you back.
Even if it's not pain, but stiffness and those feelings of getting old, give self-rehab a shot to get back to your youth. Within a few weeks, your effort and commitment to this guide's training will decrease your pain and lead you to permanent improvement.
Then you'll be ready to start the second part of the program that will help your fight pain for the long run while also improving your strength and mobility.
As the name implies, you're the leader and patient for self-rehab.
We will give you the directions, but ultimately it's up to you to make it happen. For that reason, some people have better success with the accountability of a clinician to help guide them.
But, if you can stick to a plan and are motivated to save yourself from the time and expense of dealing with traditional therapy, then you meet the most important criteria for success with self-rehab.
Although, if your pain is so debilitating that you have trouble getting out of bed, we encourage more direct care to handle your symptoms. Then with better pain management, this self-rehab guide will lead to your long-term success.
Use these guidelines before starting rehab.
Red Light: Needs medical management.
Symptoms are severe and debilitating (you cannot move because your back hurts so bad.)
Any of the other "red flags" noted in Chapter 2.
Yellow Light: Use this guide, but alongside other medical directions.
Symptoms are moderate and constant to impact sleep and other stationary activities.
You frequently use pain medication to manage your symptoms.
Green Light: Self-care management
Symptoms are mild to moderate (you often notice it, but can fight through.)
You frequently need to stop or adjust your activities because your back hurts.
Pain centered on a single spot in the low back (you can touch the place that hurts.)
What to Expect
The Self Rehab Guide will first cover some misconceptions and beliefs about the cause of low back pain to empower you to take control of the problem.
But before starting your rehab journey, you will go through our Red Flag Screen to assess yourself for potentially more complex problems.
Once you clear the red flags, you'll be ready to start the first of two phases of the low back pain self rehab program.
Phase I - 2 Weeks
You'll start with a two-week plan to get you ahead of the pain.
This provides a good start to get you out of pain, but it's also where many people fail on their rehab journey. They complete two weeks of work and put the lessons away in the closet until the next flair-up.
The ultimate goal is to lead you to forever improvement without back pain ever setting in again. So once your pain has subsided, you're in a perfect position to begin Phase II of the plan.
Phase II - 30 Days
Phase II includes strengthening and stretching to improve your movement so that you can build some resiliency to continue your life pain-free, but as we all know, strength also lends itself to performance improvements.
Expect in this phase that your pain will continue to subside and you will start moving better as well.
Phase II will use the CS Hip & Core Band and follow the 30-Day Low Back Fix for a step-by-step plan to make you stronger.
Go here to learn more about the Low Back Fix and the Crossover Symmetry Hip & Core System. If you purchase now, you'll have it ready for when the time is right to move onward.
Ultimately, this program is for active people who can't get ahead of their pain, are committed to making a change, and are ready to do it independently.
Good luck on your journey! And remember, the prognosis for most low back pain is good, but it requires a consistent attack plan to be impactful.
The team here at Crossover Symmetry is available to support you. Please reach out to us at support@crossoversymmetry.com if we can answer any questions along the way.
Chapter 1: Why Does Your Back Hurt?
Low Back Pain Myths
Back pain is not as sinister as it was a decade ago.
Many of the previously held beliefs that led many to surgery or spending money on scans, medication, and other medical procedures are not usually necessary.
Or, at the very least, not without a bout of conservative care first.
In 2020, Peter O Sullivan, an internationally recognized expert on the complex science of pain, released an article summarizing the latest research on back pain.
The key conclusions will likely surprise you:
Persistent low back pain can be scary but rarely dangerous
Getting older is not a cause of low back pain
Constant back pain is rarely associated with serious tissue damage
Scans rarely show the cause of back pain
Pain with exercise and movement doesn't mean you are doing harm
Back pain is NOT caused by poor posture
Back pain has NOT been shown to be caused by a weak core
Backs do not wear out with everyday loading and bending
Pain flare-ups don't mean you are damaging yourself
Injection, surgery, and strong drugs aren't usually a cure
Keep these things in mind as you move forward with your self-guided rehab.
Anatomy & Understanding What Hurts
We won't go too far into the spine's anatomy; however, understanding the general framework will help clarify a few misconceptions about the back.
Spine Structure: The Vertebrae & Disks
Our spine has 33 vertebrae (or bones), with a disc between each vertebra to absorb shock and help disperse the load between segments.
Many clinicians describe the disk as a jelly donut between the two vertebrae. However, it is far more durable than a fluffy breakfast pastry. The best analogy is from physiotherapist Adam Meakins, who describes the disk as a truck tire filled with chewing gum.
It's not as appealing, but a much more accurate representation of the disk's durability and resilience to damage.
The thought of an injured disk tends to strike fear due to its association with ominous terms like "slipped" or "herniated," which leads people to believe a surgical repair is their only hope.
The good news is that disc protrusions are very treatable and will heal over time despite various issues. In fact, a good percentage of the population over 40 will find some disc abnormality on their MRI yet have zero symptoms.
Therefore, an image or MRI of your back doesn't reveal as much as people tend to believe and lead to unnecessary medical procedures. It may even prolong the pain. Several studies show your perspective is a massive factor behind pain because an underlying belief that you're broken will cause your brain to increase pain and limit movement to protect you.
Therefore, it's true that a damaged, swollen, or inflamed disk may cause pain, but remind yourself that just like other injuries, your body is capable of repair, and a progressive and consistent rehab plan is an effective fix.
Reframing the rhetoric is vital to the success of any rehab program.
Nerves
You may have seen images similar to the one below that show the nerves coming from different spine segments to monitor and control specific areas.
Knowing this anatomy is far from necessary for your recovery, but it's good to appreciate that other discomfort around your body might occur due to an interference of the nerve for that part of the body.
Essentially, sometimes your back problem might not feel like pain in your back. For example, you may feel pain in your glute or hamstring because of the specific nerve involved.
There is nothing to worry about specifically, but it explains how random symptoms may be back-related.
It also brings us to the complexity of pain. And what you're feeling is a perception of the brain based on tons of information it's receiving from the body. The pressure on a nerve root or inflammation in a region might be directly related, but it can also be emotions or stress that adds to that input.
The ultimate goal is to change the brain's perception of the danger signals it's receiving. This is done with time for healing and progressing through pain-free movement.
Muscles
The back muscles can get complex, but the big picture is simple by dividing them into the big movers and the smaller stabilizers.
Most people are familiar with the "big movers" and blame those for their low back pain. Examples include your abs and the big back muscles we tend to massage, stretch, and foam roll in an attempt to manage pain.
However, the deep stabilizers of the back are usually less appreciated. Those muscles include the deep and unseen abdominal muscles and the small muscles that connect one spine segment to the next. These less visible muscles are essential in controlling movement and creating "stability" of the spine.
The main point is that you may work your abs often and be rather proud of your plank time, but other less sexy stabilizers are equally as important.
The first goal of this program is to get you out of pain by using small but frequent doses from the pillars of back pain rehab that you identify as most important for your problem.
If you're serious about getting rid of low back pain, then make it your duty to complete the first phase for at least two weeks, and you should see significant improvement in your symptoms.
Once you've completed Phase I, you'll be ready to move to Phase II, where you will build your movement ability to help your back stay strong.
Phase II starts your forever journey to staying more active and committing to habits that will keep you loose and limber. But first, jump into the next chapter for The Red Flag Screen to determine if you're ready to take on a self-rehab program.
Chapter 2: Red Flags
You can fix most back pain on your own without the time and expense of medical care. However, some issues need to be assessed by a healthcare professional to get more advanced treatment.
The following will assess for more critical things that we call Red Flags.
Checking one of the following boxes does not mean this rehab plan won't work for you, but it does indicate that you should get an assessment to ensure you're on the right track.
Review the following red flags to see if you're ready to move forward.
Pain w/ Traumatic Onset
Pain with a traumatic onset (e.g., a fall, motor vehicle accident, or hard collision playing sports) should first seek medical attention. If pain is present, but its onset was progressive or from overuse (e.g., you spent a weekend shoveling rocks for a garden project,) this is not a red flag if all other screens are negative.
Atrophy or Asymmetry
Significant shrinking or asymmetry of the glute, thigh, or calf muscles can indicate progressive long-standing nerve involvement that needs further evaluation.
Obvious Dysfunctional Movement
Aberrant movement during or returning from a forward bend or moving between sitting and standing is a red flag—examples include walking the hands on the thighs and noticeable trunk shifts as you stand up.
Radiating Weakness, Numbness, or Tingling Below the Butt
Persistent sensations going down the leg such as burning, numbness, or tingling, or weakness that prevents walking on the heels or toes needs further evaluation by a medical professional.
Changes in Bowel or Bladder Function
Unable to Find a Position of Comfort
Significant pain at all times, unrelieved with rest or inactivity.
Unexpected Weight Loss or Gain
Rapid changes in body weight without deviations in lifestyle activities, especially with a history of cancer anywhere in the body.
Not Progressing
There should be improvements in pain and mobility as you go through rehab. Of course, not every day will be remarkably better than the day before, but your typical pain level should trend towards improvement over time.
Even slight improvements mean you are on the right track and should continue the program. However, if you've attempted self-rehab for 2-weeks with no improvement, then this is a red flag and should prompt a visit to a medical professional.
Chapter 3: The 4 Pillars of Back Pain Rehab
First, let's address one of the common complaints that people in pain have with their rehab: there is hardly ever consistency in treating low back pain.
You may see ten different back pain specialists and get ten unique plans—and I know if that's your situation, it feels frustrating! If ten doctors diagnosed your ankle sprain, you would likely get similar answers and solutions.
So, what gives with low back pain?
The biggest reason is that different providers see different problems for back pain more than any other pain. Some see tissue damage or inflammation, some see symptoms, and some see "underlying causes" that range from too much sitting to deep emotional scars from your past.
Also, different specialists will use varying words to describe a similar diagnosis. Depending on the source, your physician, physical therapist, chiropractor, osteopath, or massage therapist may all have similar ideas about what's causing your pain. Still, their words and emphasis may sound different.
But fear not! This guide (and how most modern-day providers tackle low-back pain) will focus on the treatment rather than a diagnosis. That means instead of focusing on "the image" that may highlight specific problems (i.e., your MRI or strength assessment), you will focus on things that provide relief and time to allow for healing.
Relieving stiffness and discomfort in the lower back has four primary treatment pillars.
4 Pillars for Treating Low Back Pain
Treatments for low back pain fall into four different categories:
Directional Preference
Stability
Mobility
Traction
As you start reading, understand that most people don't fall perfectly into just one category but a mix of each. If everyone fell perfectly into one treatment bucket, we wouldn't have as many challenges managing low back pain.
So look for trends, and understand you will likely need a few of these things.
Ultimately, the following chapters should help identify the priorities for your rehab and provide you with the foundation to craft a treatment plan in the next chapter.
Directional Preference
Some people find that moving one way aggravates their symptoms, whereas bending the spine in another way provides relief.
Essentially, your spine prefers one direction over the other.
Once you've confirmed your directional preference, you can use that knowledge to aid your relief.
You're probably familiar with the Mckenzie Method if you've researched back pain exercises. It's a standard treatment for directional-based back pain that's worked for many, but the key is consistency and building through the progression.
What's Your Preference?
We broadly categorize directional back pain as either a flexion or extension preference. You can determine this by doing an at-home assessment.
Flexion Preference
Your back has a flexion preference if you notice that you feel better by rounding the low back. Relief by sitting, pulling your knees to your chest, or doing a child's pose, indicates that you have a flexion preference. Additionally, if you find that extending the spine, such as a cobra position is painful, then you likely have flexion preference.
Extension Preference
Your back has an extension preference if arching your back provides relief. If a cobra pose feels good or walking helps your pain then you likely prefer an extension pattern. Or, if prolonged sitting or transitioning from a sitting to standing irritates your back, then you likely have an extension preference.
Assessment
To determine your directional preference, try moving in those directions to see what bothers you and what provides relief.
IMPORTANT NOTE!
Don't force your spine to move in any direction you feel apprehensive.
Stop the movement if symptoms go past your butt and into the leg.
Flexion Preference = Bend forward and hold for 5-10 seconds - Repeat this motion 10x and check in.
Extension Preference = Bend backward and hold for 5-10 seconds - Repeat this motion 10x and check in.
Test for Flexion Preference
Test for Extension Preference
Stability
Stability is a broad term that describes a lack of strength to support your body.
There are assessments to determine if and what needs better stability, but just assume you need stability work.
It will help you connect with your deep stabilizers better and overall movement is part of the healing process.
Another consideration is that some people are naturally exceptionally limber and need additional work on controlling their joints.
The Beighton Scale is the most common way to identify those with extra laxity.
Extra laxity isn't inherently a diagnosis but it does indicate a particular need for strength and stability. It can also be a sign of other rare conditions that would require additional medical testing.
Mobilization
Mobilization is a broad term that means you need to help your back to get it moving again. Mobilization strategies include stretching, massage, adjustments, and manipulations.
The reason for mobilization is that your body does an excellent job of protecting itself from danger.
When it perceives something as a threat, its first response is pain, to motivate you to stop doing something damaging. In addition to a painful danger signal, muscles lock down or "spasm" to restrict movement.
It's brilliant, and you should be thankful that this occurs, but sometimes, the body can be overly cautious and needs some input to understand what's truly dangerous.
It's a pretty simple criterion for who needs mobilization for their low back pain:
If your symptoms have lasted less than 16 days and your pain doesn't radiate down your leg, you fall nicely into the mobility category.
Should you get a spine adjustment?
If you meet the criteria for mobilization (your pain is a relatively new problem,) an adjustment or spine manipulation will likely help your symptoms. Many specialists do this, but you can get similar results with some self-mobilizations.
Either way, here is a helpful tip that can save you a lot of money:
An adjustment or manipulation you receive is not putting anything back into place. Instead, it's getting things moving again to reset the nervous system and reduce the restriction of tight spine sections. Also, while satisfying, the audible "crack" doesn't provide more than some stretching.
If you enjoy the "adjustments" a chiropractor or physical therapist provides, that's great! It's checking a box to help get you out of pain, but the clinician should advise you on other steps to help your issue.
And while mobilization done by a professional can provide a very specific stretch to an area of the spine, the general mobilizations covered in this guide can simulate similar techniques and reach the same outcome.
Please consider this if you have been stuck in a cycle of adjustments with only short-term relief. Simply following the Treatment Plan in Chapter 4 can work just as well.
Traction
When all else fails, take some pressure off! Traction is a catch-all category if you don't fit well into the directional preference or mobility categories.
The idea with traction is to give the segments of your spine a bit of breathing room. It gives you a window of opportunity to loosen up the back enough to move you into the next phase of the program.
Although, traction might provoke your pain if your back is exceptionally pissed off. So slow your roll before you flip yourself upside down.
Chapter 4: The Treatment Plan
The First Two Weeks
The initial program for back pain is to find some relief. You will turn up the dial on the pillars of back pain rehab to do this.
Add the directed rehab to your prescription for each rehab pillar you've checked off, and aim to complete your rehab program 5x per day.
Step 1: Stop the Thing That's Painful!
Think of the first few weeks as a reset button. We need to give your back a short vacation from provocative movements. Heavy workouts and other strenuous activities will keep poking at your pain, so take them out of your life for this first part of the plan.
Although, this rest doesn't mean you should do nothing. Finding ways to stay moving will help you progress and can satisfy your exercise itch to keep you from getting antsy.
Use the template for your exercise program.
Start with "green light" exercises for the program's first phase.
You may progress to the "yellow light" exercises after the first week, but test them first for tolerance as part of a light warm-up movement. If you don't notice any negative effects, add them to your program at lighter weights and volume than usual.
The red light exercises should be the last ones you add and will only occur later in the program's second phase.
Exercises Guidelines
Green Light
Walking
Bodyweight Exercises (that don't require bending the spine).
Squats, lunges, step-ups, planks, etc.
Biking
Upper body exercises for the chest, back, and arms.
Yellow Light
Running
Rowing
KB swings
Kipping Pull-ups
Red Light
Burpees
Wall Balls/Thrusters
Golfing
Deadlifts & Olympic Lifts
Step 2: Get Moving
It's a common thought to rest a painful area which is accompanied by fear that the pain will only worsen if you keep pushing things.
Taking time off from heavy or explosive movements is certainly good, but ultimately a painful back needs to keep moving.
Add more walking to your day and avoid getting stuck in a single position for too long.
Step 3: Treatment Pillars
Emphasize your treatment pillars every day for at least two weeks of Phase I.
Directional Preference
Start by feeding into the directional preference that you've found to prefer.
To refresh:
Flexion bending:
Sitting improves your pain.
Walking increases your pain.
Repeated forward bends decrease your pain.
A child's pose stretch reduces your pain.
Extension bending:
Walking improves your pain.
Sitting makes it worse.
Putting pants or shoes on is painful.
Repeated backward bends decrease your pain.
Extension Preference - Do 5 Sets of 10 Cobra Stretches Every Day
Flexion Preference- Do 5 Sets of 10 Knees to Chest or Child's Pose Every Day
This is more than one-and-done!
Instead, do the stretch of comfort multiple times per day. Start with five sets of 10 repetitions of the movement that decreases your pain, and then work up as your schedule allows.
Stability
Dead bugs and bird dogs aren't the end-all for treating back pain, but they are a beneficial place to start. These exercises are the nuts and bolts to learning how to control the spine and should be the initial focus.
Start by performing five sets of 10 reps of the following exercises throughout the day for two weeks.
These movements help you connect with your deep stabilizers to get them turned on. You can drop down and do a set of 10 in your work clothes without sweat.
Cat/Cow
Dead Bug
Bird Dog
Glute Bridge
Mobility
Do the following spinal twist exercise daily:
Traction
You can jump into this if you only have minor irritation and don't have a directional preference. But stop if you notice that it's causing more irritation, then wait a week to implement traction.
Or, if you've gone through the first week and have yet to improve, try implementing some traction.
Ask anyone, and they will likely mention something about strength when asked about back pain. But, at the same time, it remains extremely underutilized.
If you visited a chiropractor or physical therapist about your back pain, they likely showed you some basic exercises as they mentioned you need better stability.
That is an appropriate start, but true "stability" will require much more.
The body needs to feel safe to take on the movements your life demands, which is likely more intense than lying on your back and moving slowly.
Therefore, these simple therapy exercises will give you a good start, but that foundation is too small to sustain things like lifting weights, chasing kids, swinging golf clubs, and doing other physical tasks.
So while the initial phase likely got you out of pain, it will not be enough to keep you from tweaking your back again. The next step is to master and strengthen foundational movements that occur in your life.
You don't need to set any weightlifting records, but becoming proficient at lifting, bending, and rotating will prepare your back for an active life.
The next step is to develop movement patterns to reinforce those things that will keep you from spending all your time and money managing your low back.
You can take the next step with the CS Hip & Core System and the included 30-Day Back Fix. This program will help strengthen the key muscle groups and reinforce movement patterns that will help reduce your risk of injuring your back.
However, like the initial phase of this plan, the key to success is consistency. Unfortunately, this is usually a huge missing link for people following a back injury. They implement stretches and adjustments to get rid of the pain but then fail to do things to keep it away.
The 30-Day Low Back Fix will help you take that next step to keep your pain from returning and your performance moving upward.
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https://crossoversymmetry.com/blogs/news/how-to-maintain-your-strength-while-building-your-endurance2023-06-01T08:21:33-04:002023-06-01T21:30:03-04:00How to Maintain Your Strength While Building Your EnduranceMatt Unthank
Strength athletes have long feared aerobic exercise as a hindrance to their gains.
Unfortunately, this is proven valid for the very practical reasons that logging a bunch of miles makes you tired and takes time away from pushing weights.
However, it gets even more intricate with evidence suggesting that endurance work may interfere with the molecular pathways that drive muscle growth, known as the interference effect.
Therefore, avoiding long endurance activities is reasonable if you compete in a barbell sport or if your only joy in life hinges on how much you can lift. I recall a prominent powerlifter saying it was time to do some cardio if you got out of breath walking from the car to the gym door.
But for the bulk of us, we need an engine.
Most sports require sustained effort over an hour, and you can't be pooped after only 30 minutes if you want to enjoy an active lifestyle. Or even the buffest will sometimes find the itch to enter some type of endurance event.
The good news is that the interference effect may not be as prominent as we once suspected. And although it's challenging to chase two rabbits, it seems possible to maintain, or even build, your hard-earned strength while improving your cardiovascular fitness.
However, you do need some strategy for it to work. Here are some rules to follow if you've got your eyes set on building your aerobic fitness but are afraid of losing strength.
The Magic Dose for Cardio & Lifting
If you've got your sights on an endurance goal, such as a race, the bulk of your focus should be on your endurance training. But obviously you'll need to work weights into the schedule to keep your strength, while ensuring it doesn't interfere with the aerobic training you've prioritized.
The good news is that strength improvements are readily seen without a ton of work, as long as the intensity is high enough to elicit those adaptions.
Therefore for purely strength numbers, stick with the compound lifts, and drop the volume to only 2-4 sets of 4-6 reps. The reps should be heavy, but avoid going to your max effort on more than one set.
Doing this for your key lifts two days per week should be enough to maintain the barbell lifts, but it's also manageable so you're not excessively sore the next day.
Although, you'll need a bit more volume if you want to elicit some muscle growth. So if it's size you're after, then tack on 2-3 sets to failure for 2-3 exercise at then end of your training.
Then of course, one of the Crossover Symmetry Strength Programs for your finisher.
The key to pursuing both strength and endurance gains is training smarter and not harder.
Find a strength program with a clear linear progression.
The 5-3-1 Program by Jim Wendler is an excellent option for lower-volume strength training that's proven to add weight to your max lifts. It's a simple template that follows a monthly progression for the squat, deadlift, press, and bench press. Plus, there are several options to add if you're also interested in hypertrophy work.
Or, Run Strong by Crossover Symmetry has both power and accessory work designed specifically to make you a better runner.
Timing Your Lifts & Cardio for Maximum Gains
Getting in a lift after logging some miles is probably the most practical option, but this is also when the interference effect would be at its greatest.
It's recommended that the two activities be spaced by at least 3 hours, but 6hrs or longer is better to limit any potential interference between the two training sessions.
Not only does spacing out your workouts allow the body to prioritize the specific adaptations needed for each type of exercise, but it also allows for adequate recovery and replenishment of energy stores.
Pro Tip-
Some recommendations push for 24hrs between aerobic and resistance training, but this is problematic for managing the recovery schedule.
With key tempo and threshold runs during the week and a long run on the weekend, trying to add two more days exclusively for heavy lower-body lifting leaves little downtime for the legs.
Therefore, I opt for two mega training days, where I do a harder run in the morning and a lower body lift in the evening. This schedule gives me more complete recovery days for the legs.
What Type of Cardio is Best?
Of course, if you're preparing for a specific event, you'll need to train for that sport. But if you're only concerned with building cardiovascular fitness, then running long slow miles will have the most significant impact on your strength.
Doing aerobic intervals where you push your body close to max effort followed by a full recovery helps build aerobic fitness while emphasizing the fast twitch muscles needed for strength.
Nor does it have to be the traditional aerobic movements if you've got a focus on general capacity. For example, sled pushes, and extended circuits using body-weight exercises like lunges and squats may enhance muscle growth while building your ability to go longer.
Or, studies show that quadricep growth is promoted by cycling immediately after lifting, so that may be a better option for your cardio if you've got quad goals
Pro Tip-
I've found the Power Zone Endurance classes on the Peloton Bike are the perfect cross training for runners. It's the right blend of lower threshold endurance work with some power mixed in. Take anything led by Matt Wilpers and you're in good hands.
Nutrition
If there is one thing cardio is known for, it's burning calories, which is also what the body needs for muscle growth. So if you're gaming on cutting calories during this hybrid aerobic and resistance program, you will fail on both fronts.
This ensures that you've got all the necessary building blocks.
Additionally, getting enough carbohydrates will ensure you have the fuel stores to power through your long-distance work without breaking into the protein stores needed to fuel muscle repair and growth.
The importance of the nutrient timing around all of this has been called into question as of late with people debunking the magic window.
However, it's best to leave nothing up to chance, and if you don't get on nutrition quickly, it tends to get away. Therefore, finish your workouts with carbs and proteins to ensure you're recovered and ready for the next training session.
Pro Tip-
At this point supplements aren't a Pro Tip, but I'll go ahead and say it if you're struggling to get enough protein into your diet. I even broadly classify supplements as things I take purely for the nutrition gain.
Egg whites from a carton, shakes, cottage cheese, turkey jerky sticks, are all helpful foods to have on hand to hit your goals.
I'll secretly admit I regularly take Branch Chain Amino Acids as well. Many fitness nerds called out BCAAs recently for having limiting supporting research. Still, I like the taste, and it adds to the overall amino acid pool—specifically, leucine, an anabolic stimulus.
If anything it gets me to drink 32oz of water in the morning before I kick back my coffee.
But ultimately, find what works for you.
Train Smart
In conclusion, the fear that aerobic exercise hinders strength gains in strength athletes is valid to some extent. Endurance work can make you tired and take away time from weightlifting.
While there is evidence of the interference effect, it's likely not be as prominent as once believed. You might need to accept some loss in strength if you're going to be extreme, but overall the right approach and consistent effort in the gym will keep you strong while you build your aerobic base.
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https://crossoversymmetry.com/blogs/news/watch-our-presentation-on-improving-power-production2023-02-24T10:00:40-05:002023-02-24T10:00:40-05:00Watch Our Presentation on Improving Power ProductionMatt Unthank
We delivered this talk at the 2019 American Baseball Coaches Association. Obviously we were talking about Baseball, but if you’re in any sport that needs to move explosively this can help you out.
(We even give a full training on our Hip and Core System in this presentation).
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https://crossoversymmetry.com/blogs/news/how-to-increase-strength-using-crossover-symmetry2023-02-21T18:16:31-05:002023-10-18T12:41:57-04:00How To Increase Strength Using Crossover SymmetryMatt Unthank
Think back to day one in the gym. Your new membership card is so fresh the laminate is still warm to the touch.
You stroll to the back, where a long rack of dumbbells is neatly ordered, except somebody put the 15s where the 40s are supposed to go.
You then look at the fitness magazine with the 8-week exercise plan that promises to make major life changes, and you start with movement one.
Then each week after you notice, the movement gets a bit easier, so you grab the next set of heavier dumbbells.
Without knowing any better, you are following an essential rule of weightlifting called linear progression.
Never mind the gal who only lifts the pink dumbbells for fear of getting bulky in this story. The point is that even the most novice trainees realize that if they want to get stronger, they must keep increasing the stimulus to challenge their bodies to adapt.
However, what's under-appreciated is that the dumbbell size is only one part of the equation. There are many ways to add intensity and stimulate progression without changing weights.
Specifically, I want to answer the question: How do you make that jump to the next color resistance band when doing Crossover Symmetry?
First, What's the Goal?
Adding weight to the bar is a reasonable goal, but unless you're competing in a powerlifting competition, lifting the maximum amount of weight is probably not the most important thing for your fitness.
Most want to look good, feel good, and live past 100.
Thus, I would first define the intention for the exercises in your training program—and it doesn't need to be all the same. For example, in the same session, I will have a warm-up, power/speed, maximal strength, and movements for muscle gain.
For Crossover Symmetry Activation, I've used the same athletic resistance bands since I started the program almost ten years ago. And actually, I now often drop down to the novice resistance because it gets me closer to my goal: to feel warmed up and ready to work out.
So, if you're beating yourself up for not moving from novice to athletic or athletic to elite, remind yourself that nobody will be especially impressed by the color of the band you're using for your warmup.
Instead, I would focus on holding the end range for longer, slowing down your tempo, feeling more "relaxed" at the end range, and maybe even playing with the plyometrics included with Activation+.
These things are more aligned with the goals of Crossover Symmetry Activation—to help you move better and feel better—rather than moving up your resistance set.
Making the Jump
With the topic of goal setting covered, Crossover Symmetry is absolutely something you can use to get stronger. But, how can one do that with our bands when there are big jumps in resistance? For reference, our heavy bands go 10, 15, 25, then 40lbs.
First off, the numbers on our bands are arbitrary and will feel different between people. That's because resistance bands don't create tension from opposing gravity; instead, the resistance comes from the material's stretch, length, and density.
So if you're at the point where red feels easy, try moving back a bit from the attachment. Or, move closer using heavier bands. You're essentially increasing and decreasing the "weight" by changing the stretch.
We also have a very light band that are 3lbs. You could simply use a 15lb red and 3lb green band simultaneously to add a bit more challenge.
Strength Plan
The final option for gaining strength with Crossover bands is an intuitive one: use the Strength Program.
This program is intended to be challenging. The movements aren't necessarily harder than the exercises on Activation, but it's the superset of the exercises that fatigues the muscles as you go.
Paired with little to no rest between movements, it gets spicy as you get further through the series. Yet, another way, the stimulus to a training program is varied in ways other than the weight.
Also, my intention changes with this program as well.
Whereas with Activation, the goal is to stay smooth and focus on form, I allow my technique to bend a bit as I go through Strength. I will also use drop sets on this series, where I start with the heavy bands and then quickly move to lighter ones as I get fatigued.
I want to emphasize that this training doesn't build maximal 1RM strength like super heavy weights, but it does provide accessory work that builds greater endurance and capacity to hit those hard training sessions without breaking.
Conclusion
To wrap this thing up, if you're concerned about moving to heavier bands or want to add a greater strength focus:
Determine your goals and the tools you need to get there.
Resistance is varied with bands by moving further or closer to the attachment.
Increase the intensity by changing the tempo, decreasing the rest between movements, and pre-fatigue the muscle with other exercises.
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https://crossoversymmetry.com/blogs/news/what-is-crossover-symmetry-and-how-does-it-work2023-02-15T12:13:39-05:002023-04-11T07:56:08-04:00What is Crossover Symmetry and How Does It Work?Matt Unthank
Crossover Symmetry uses a combination of resistance bands and specialized training to build better shoulders.
We call it new shoulders in a box because everything you need to change how your shoulders feel and move will come kitted together and delivered to your door.
Read this article to get a better understanding of how Crossover Symmetry can help you live the active life you want.
Crossover Symmetry uses a combination of resistance bands and specialized training to build better shoulders.
We call it new shoulders in a box because everything you need to change how your shoulders feel and move will come kitted together and delivered to your door.
We've been told to "niche down" or find a "target market," but there is a world of people with arms, and they all use them for different reasons.
How do we possibly decide who needs the most shoulder love?
We've had the opportunity to help super elite athletes who push themselves in the arena everyday, but also active people who want to keep kicking butt and doing what they love until their final day on earth.
Then there is also the police, fire, and military who demand a lot from their body as part of their jobs, and youth athletes who need help starting a training program. And the physical therapy and medical professionals who need tools to help people past pain.
From ending a nagging injury or taking your performance to another level, Crossover Symmetry will be your friend for a lifetime.
1.1. The Equipment: The Best Resistance Bands
When it comes to exercise equipment that's easy and portable, there are few things more versatile than a good set of resistance bands.
Dumbbells and free weights are heavy and hard to transport. Plus, the resistance only works against gravity, so you must lie facedown or work your body into awkward positions to work specific muscles.
You can do bodyweight movements anywhere, but targeting specific muscle groups is challenging. And then exercise machines cost thousands of dollars and are only suitable wherever you put them.
1.1.1. What makes the Crossover Cords so good?
With our programs and goals in mind, resistance bands are the perfect workout tool, and trying to hack the programs with other devices won't get the same results.
They're super portable, lightweight, and relatively inexpensive, but most importantly, they fit exactly to our program. That means you know exactly what resistance to use for which exercise for your strength level.
The trouble that resistance bands face is that they can break. This is a bummer for your investment, and a broken band flying at your face is risky. Thousands of resistance band injuries happen every year, many of them causing long-lasting eye damage and even blindness, plus cuts and lacerations, and of course, some embarrassment if your gym fail happens in public.
Our solution is simple—add a safety sleeve around the band.
If the rubber resistance does break, the sleeve will keep you protected. The safety sleeve also protects the band from UV rays, abrasions, cuts, and other things that cause it to fail prematurely.
Plus, we warranty all of our equipment for years, so if anything happens to break, complete the simple online form for a hassle-free replacement.
But, we don't expect you'll need it. Most teams and gyms have been using our bands for over five years and are still in good shape.
1.1.2. Attachments for your Crossover Cords
Your Crossover Cords need to be a sturdy attachment to clip the bands.
For that, we've got you covered with three attachment choices.
You can click each option to watch the setup video to choose the best one:
Each Shoulder System comes with the choice of attachment, and then choose more if you need them.
1.1.3. Accessories for Crossover Symmetry
To help make the program easier, we've also added a few accessories to our kits to make them easier to use.
That includes a backpack to keep and carry your bands, master carabiners to manage the setup and use of multiple bands, and a sturdy training guide and workout chart to refer to when needed.
These may seem like simple things, but they add up to make reaching your goals easier.
1.2 The Crossover Symmetry Programs: 5 workouts to meet your goals
There is no limit to what you can do with the Crossover Symmetry Cords.
With the Crossover Cords, you can work out your chest, arms, back, and core with exercises provided by your favorite program or exercise instructor. We also show you plenty of exercises to try on our social and training platforms.
However, the heart of Crossover Symmetry is our Training Programs.
The Crossover Symmetry Shoulder System provides five different exercise sets designed with varying goals in mind. Each program is a superset of exercises (complete one exercise and then go to the next,) so the movements link together in a specific order to provide a balanced and complete workout.
Could we add more? You bet! But that adds to the time to get it done.
The Crossover Symmetry programs have efficiency in mind. We've created each program to help you get the most out of your workout without wasting any time and get maximum results in less than 5-minutes.
1.2.1 Activation
When most people talk about the Crossover Symmetry program, they mean Activation. But what is Activation, really?
We like to describe it as coffee for your shoulders.
It's the first phase of the Crossover System that will get your muscles firing. In other words, Activation is all about getting your body working.
It's not like a typical workout plan aimed to beat your body into submission. Instead, it gets your brain firing all the critical muscles for your shoulders to perform as designed.
Will you get big and beefy doing Activation? No, not really—that's not the goal of the program.
We're targeting better posture, improved shoulder mobility, and fixing achy shoulders. Then, with a body ready to perform, you can take on the heavier stuff or whatever training fits your fancy.
The key advantage is that it's an easy way to get your workout rolling.
For most Crossover Symmetry users, Activation fits into their workout plan as an easy-to-follow warm-up. After sitting around all day, it's the perfect recipe to get your shoulders moving and get straight into your workout.
You'll immediately notice a better range of motion, and many people say it flips a switch mentally to put them in workout mode.
Although, It's not just a warm-up.
Many will do Activation as part of their morning routine or throughout the day after being at their desk.
It's a small dose of movement that will make you feel better but adds up over days, months, and years to keep you healthy and active for a lifetime.
1.2.2 Activation+
Once you have Activation mastered, then take the challenge to do Activation+.
Activation+ is a bit spicier and uses plyometrics as part of the routine. Plyometrics are quick and explosive movements and are great for building performance.
It's a great way to challenge yourself to move with speed and stability if you need that for your sport.
1.2.3 Recovery
Recovery is perfect for tough training days or when your shoulders feel beat up.
The Recovery Plan uses eccentric exercises to help stretch the muscle and increase blood flow.
It's a go-to for pitchers and weightlifters, and gets used plenty as part of our shoulder rehab plan.
1.2.4 Strength
The Strength program is designed to challenge your strength and endurance. Unlike the previous 3 programs that should have you feeling juiced and ready, the Strength program is supposed to be a challenge superset that leaves you feeling fatigued.
We recommend that you do Strength 2-3x per week after your workouts to finish the training session with a final emphasis on building stability. It hones in on the smaller stabilizers that are often undertraining and will put you on the path to pain-free performance.
1.2.5 Mobility
Building stronger shoulders is a good start if you feel tight. But there is also a place for stretching, especially to improve your ability to extend and rotate your upper spine. The Crossover Mobility Program will help you fix it with a customized program built specifically for your limitations.
First, the mobility program will walk you through an assessment of your range of motion and then prescribes stretches and movements to help you tackle those limitations. Just a few minutes of stretching and moving around can make a difference, and we'll show you precisely what you need to work on.
1.3 The Training: You Become the Expert
With the Crossover Symmetry, you'll become the expert in building better shoulders. The Training Zone will walk you through every step of the program and cover the details of each movement.
The Training Zone also provides comprehensive rehab programs that will walk you through the steps of the rehab process for shoulder pain. The rehab starts with a Red Flag Screen to evaluate your shoulder pain, advice on what movements you should avoid, a day-by-day rehab program, plus strength moves to keep your workout plan on track during rehab.
If your shoulders feel great, then pick up any of our performance plans, where we'll show you how to fit Crossover Symmetry equipment into your workout program.
1.4 How to Start?
If you’re looking for a comprehensive program to improve your pain and performance, look no further than Crossover Symmetry.
With quality equipment, programs to follow, and world-class training available, you can trust that this system will get you where you want to be.
Head to the shop page now and get started on your journey to building better shoulders.
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https://crossoversymmetry.com/blogs/news/crossover-primer2022-03-05T12:16:24-05:002024-02-07T08:47:29-05:00The Crossover Primer: An Elite Warm-Up For Everyday TrainingMatt Unthank
The Crossover Primer— “The Formula for Success”
There are 2 pitfalls that often plague warm-up programs.
Too Little- Every warm-up should check the neurological and physiological needs to be maximally effective (we talk more about that here: The Must-Haves for Any Warm-Up). A 5 minute run with some squats and push-ups leaves out a ton of benefits that could be achieved by doing just a little bit more.
Too Much- Too much complexity can be just as detrimental as not doing enough. First of all, throwing in a laundry list of exercises takes away from precious training and practice time. Secondly, an overly complicated warm-up is less likely to get done, therefore limiting the results. Lastly, gathering and setting up equipment, and then the time to learn new exercises, is often at the detriment of getting hot and getting moving.
Specific to the Crossover Primer, it’s designed it to get the body ready to go, while solving common movement impairments, in a way that’s easy to fit into an everyday training program.
It’s the ultimate solution to getting your body ready, along with a daily dosage of movement needed for a lifetime of health and performance.
The Crossover Primer
1. Get Warm
If your warm-up isn’t getting you sweaty you are missing out on easy performance gains. Getting hot improves metabolism, muscle contraction, and joint mobility. If it’s the middle of the summer this won’t be a problem, but even if it’s slightly cool or you are going to be indoors, start by throwing on a hoodie while going to the gym or field and keep it on as you progress through the remainder of the CS Primer.
(Note- Becoming overheated is detrimental to performance, especially for longer endurance events, so take off your warm-up attire as you start to get sweaty).
2. Increase Blood Flow
Start the Crossover Primer with some light aerobic work. Getting the blood flowing will help wake up the body and further support the warming phase.
It doesn’t have to be running or biking either. Take this opportunity to improve your athleticism with activities like speed ladders, running football routes, shooting hoops, jump rope practice, and other fun movement things. These activities will make you a better athlete and aren’t all that boring, so throw on a hoodie and start playing.
3. Muscle Activation
Muscles don't necessarily need to be turned out, but starting with basic movements is the best way to quickly improve mobility and adds some training for the smaller muscle groups.
CS Shoulder- 1 set of 7 exercises to improve shoulder movement.
CS Hip and Core- 1 set of 8 exercises to engage the many stabilizers of the hip and core.
Everything to this point is a generalized plan to optimize movement for any sport or activity. It’s this foundation that will yield the most benefit long term, but will also have movement primed for the remainder of the training session. What’s best is that it can be done in less than 10 minutes if needed.
Moving forward it’s time to ramp-up into progressively more specialized movements for the activity at hand. If you are short on time or ready to get training, not a problem your body should be ready to go! Simply jump to step 5 to fast track the process.
(This is a good time to build in any favorite exercises for your specific activity. The examples below are specific to someone before they hit the weights.)
1. Mobility- Move through sport specific ranges of motion.
(Example- Wrist and Ankle Stretches, Lunge Matrix, Down Dog to Cobra, Thoracic Bridge.)
2.Speed- Turn on power and speed in different directions.
(Example- side shuffle, power skip, back peddle, carioca, high knees, butt kicks)
3. Ignite– Rev the engines by ramping up the intensity to 100%
(Example- 3 short sprints building in intensity, or 3 sets of 10 squat jumps)
4. Sport Specific Progression- A short time to practice movements that support the success in that activity.
(Example- Burgener Warm-Up; CompTrain Barbell Warm-Up: 5 Reps of Good-mornings, Back Squats, Elbow Rotations, Press, Straight Leg Deadlift, and Front Squats; CrossFit Warm-Up: Samson Stretch, Overhead Squat, Sit Up, Back Extension, Dips, Pull Ups.)
5. Ramp Up– Get into the main workout things for the day but with a modified load.
(Example- If you’re doing back squats, do a few sets building up to the working weight.
Getting Started
Like a recipe for your favorite dish, this will soon become second nature as a way to get your body ready. And feel free to adjust to suit your preferences.
Included are all of the tools, training, and education you will need to implement a perfect prep strategy for your everyday training.
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https://crossoversymmetry.com/blogs/news/essential-exercises-for-your-pregnancy-that-you-can-do-with-crossover-symmetry2021-11-21T10:09:14-05:002022-08-18T14:24:43-04:00Essential Exercises for Your Pregnancy That You Can Do With Crossover SymmetryMatt Unthank
Guest post by Gina Conley, MS, CD (DONA) from MamasteFit
There is an increased laxity of the pelvic joints (and almost all the joints) during pregnancy. This is so the baby's head can more easily navigate the pelvis for descent and delivery.
However, an increase in laxity can cause instability and result in discomfort or pain. But by strengthening the muscular connections that cross the pelvis, you can add support and stability to the pelvic joints, which can help address pelvic pain during and after your pregnancy.
In this article, I'll help you understand the important myofascial slings of the body and show you some easy exercises to strengthen them using your Crossover Symmetry System.
Plus, be sure to check out the 4-Week Postpartum Program now available on the Crossover Symmetry Training App.
The Myofascial Slings
There are four major slings in the body:
Anterior Oblique Sling
The main sling that supports the pubic symphysis, or the front pelvic joint, is the anterior oblique sling. It goes from the oblique to the opposite inner thigh. At the Mamastefit Gym, we've found that incorporating exercises for the anterior oblique slings in our prenatal programming helps decrease pain associated with pubic symphysis dysfunction.
Exercises to target the anterior oblique sling incorporates simultaneous activation of the oblique and opposite adductor. These exercises create an inward rotation, with the opposite shoulder or arm moving inward towards the opposite hip or leg.A great example is walking, and as one leg moves forward, the opposite arm swings forward, activating the AOS to help stabilize.
Posterior Oblique Sling
The posterior oblique sling goes from the latissimus dorsi (back muscle) to the opposite glute (your booty). It crosses and helps to support the SI joint at the base of the spine.
Posterior oblique sling exercises involve simultaneous contraction of the lat and the opposite glute by using movements that rotate one side of the back towards the opposite leg or glute.
A great example of this is when we are walking and pushing off the foot to move forward. The leg extends backward as the opposite side arm swings back.
Deep Longitudinal Sling
The deep longitudinal sling runs along one side of the body from head to toe along the backside.
Hinge type movements (leaning forward at the hip, like deadlifts) help to activate this sling.
Lateral Sling
The lateral sling runs along one side of the body, outside of the hip, and wraps to the inner thigh. This sling helps stabilize the hip in single-leg movements and supports both the pubic symphysis and SI joints.
Movements that focus on balancing like step-ups and single-leg deadlifts help to activate and strengthen this sling.
But It's Not That Simple!
Several slings help stabilize the pelvic joints, some of which don't even cross over it! The slings also weave together or share muscles and similar paths. For example, the posterior oblique sling blends with the deep longitudinal sling, and the anterior oblique sling blends with the lateral sling. They don't work independently, either. Each sling works together to help stabilize the pelvis!
The Need for Strengthening
Since pregnancy is a time of extra movement and mobility, it can also be a time of instability. We can usually remedy instability with additional strengthening, as opposed to more stretching or just waiting it out for birth! Strengthening these slings helps to increase stability and therefore decrease prenatal discomfort or pain associated with the pelvic girdle.Here are some exercises to add to your routine to help support a healthy body throughout and after your pregnancy.
Pallof Press
As mentioned earlier, pain of the pubic symphysis is common during pregnancy because, as the belly grows, the muscles become stretched. As a muscle lengthens, it has a more challenging time contracting and therefore, the function is decreased.
Strengthening the Anterior Oblique Sling helps to stabilize the pubic symphysis joint, which can help with this pain.The Pallof press is a great movement to target the obliques, paired with an adjunct to cause adductor contraction as well, and then boom, the anterior oblique sling is activated.
We do this by squeezing a ball or yoga block between the legs while doing a Pallof press.We have tons of progressions for the Pallof press and how to add the adductor co-contraction on the Mamastefit blog.Or, for an even greater challenge, try this variation of the Copenhagen Plank combined with an anti-rotation movement.
On the backside, the SI joints play a significant role as the junction where we transfer load between the upper and lower body, and there is a lot of musculature to support it.During pregnancy, we may find that we have increased SI joint pain as the pregnancy progresses.
To help with this, focus on strengthening the connection of the posterior oblique sling and diaphragmatic breathing. Strengthening the posterior oblique sling is done by creating exercises that focus on activating both the lat with the opposite glute simultaneously.
This is done with movements that include rowing or pulling motion and a hip extension movement. One of our favorites at MamasteFit is a glute bridge (either two-legged, staggered stance, or single leg) with a ball squeeze and a horizontal using a Crossover Symmetry band attached from above
Focus on exhaling as you pull/bridge, and inhale as you release. Squeeze the ball on the exhale, release the ball on the inhale.
Coordinating breath with movement is huge for stabilization, especially during pregnancy, and helps us learn how to relax and strengthen the pelvic floor (big for labor).Another option you can do while standing is a reverse lunge with a row.
Step back with the right leg, as you row with the right arm, and vice versa. Exhale as you lunge backward with an extended arm, and then exhale as you stand up while rowing towards the torso.
Pelvic Strength for Pregnancy and Postpartum
With some specialized focus on strengthening the slings that connect the upper and lower half, you can better support your body through the process.Try adding these exercises with your Crossover Symmetry gear, and if you're looking for more, we offer a bit more with the Mamastefit Pelvic Stability Program.
This is a 3-week program of added accessory work for your current workout routine, or you can use it as a standalone program if you cannot exercise due to pelvic joint discomfort/pain. I also have other in-person and online training programs to help you along the way.
I would be very happy to help you through all parts of your pregnancy, please reach out at info@mamastefit.com.
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https://crossoversymmetry.com/blogs/news/shoulder-pain-assessment2021-08-19T08:41:12-04:002022-09-09T10:51:37-04:00Take the Red Flag Shoulder Screen to Know if You're Ready for Self Rehab with Crossover SymmetryMatt Unthank
The Red Flag Shoulder Screen is an easy evaluation for your shoulder pain. It will help determine if your pain is a more complex issues that should seek guidance from a medical professional, or if it's more likely that there is an easier fix for your shoulder pain.
Any type of pain can be complicated and frustrating, but that's especially true for shoulder pain. A bad shoulder is a nagging issue that can hold you back from enjoying your favorite activities and may persist for months to years despite repeated efforts to solve it.
But rest assured that there is hope, and with a consistent plan of attack, you can get back to your life pain-free and performing even better. It only takes a simple approach of relative rest and a daily exercise routine to strengthen and stretch your shoulders.
It's the same formula that's helped thousands, and there's a good chance that it will help you too, even with issues like rotator cuff and labrum tears. We'll walk you every step of the way with our 30-Day Shoulder Fix, but before diving in taking our Red Flag Shoulder Screen to determine if it's the right program for you.
The Red Flag Shoulder Screen
The Red Flag Screen will assess for more complex issues that should seek guidance from a medical professional. These assessments will help identify problems that may need more advanced treatment or potential surgery to fix the problem.
1. Neck or Spine Disorders
Pain or a significant limitation in the range of motion of the neck or spine is a Red Flag and reason to see a sports medicine professional. It's ok if you cannot achieve the full range of motion. The goal is to assess for a significant limitation in range of motion and either pain, numbness, or radiating discomfort during the movements. If any of these conditions exist, visit a sports medicine professional.
2. Atrophy or Asymmetry
Atrophy, which describes the shrinking of muscle, will create an asymmetry when comparing one side of the body to the other. The atrophied muscle appears sunken in rather than rounded like the opposite side. Also, look for significant deviations in position or alignment between the right and left sides. Minor asymmetries of the resting scapula are expected, especially in athletes who compete in sports with a dominant side, like baseball players. Don't be too critical, as minor asymmetries are not Red Flags. You are only looking for obvious deviations such as muscle atrophy. These undeniable differences are Red Flags and should be evaluated by a sports medicine professional.
3. Obvious Dysfunctional Movement
Test this by raising the arms overhead in front of the body individually and then both arms simultaneously. The body shouldn't need to compensate with a lean to the opposite side or a full-body movement to elevate. Other issues may be a significant sudden jerk, collapse, or winging of the shoulder blade on the affected side compared to the normal shoulder. Look for these changes with both lifting and lowering. These noticeable dysfunctional movements are Red Flags and should prompt a visit to a sports medicine professional.
4. Numbness, Swelling, or Weakness
Look for persistent or recurring swelling or numbness from the shoulder to the hand. Additionally, check for noticeable strength limitations in the shoulders/arms/hands during simple daily activities, such as opening a door or washing your hair. Any of the above conditions meet the Red Flag criteria and should be evaluated by a sports medicine professional.
5. Shoulder Pain or Apprehension
Apprehension, which is the feeling that the shoulder will come out of the socket, is an issue to have evaluated. If certain shoulder positions make you feel like your shoulder may dislocate, this is a red flag and should be evaluated by a sports medicine professional.
Shoulder pain is not automatically a Red Flag. First, you should assess your pain for severity and limitation. Test your pain by lifting your arms at an angle in front of your body. Next, create a W with your arms. Pain so severe that you cannot move through these full ranges of motion, and you would describe it as a five on a scale to ten, is a red flag and should be evaluated by a sports medicine professional.
Results
If you answered no to the above questions, give the rehab approach a try and see how it works. The concerns are usually that you'll make things worse or that your issue will continue to decline to the point of no return, but rest assured that you will not be worse off than when you started, and it will only improve your outcomes.
We recommend a consistent 30-day trial to see how things improve, and if the issue is still unresolved, get a medical opinion on the best next steps. The worst-case scenario is that you'll have a more capable shoulder to take on the procedures that come next, but much more likely is that you'll resolve your pain without the costs and hassles of surgery and other medical procedures. Along with that, you'll be equipped for a long-term plan to keep your shoulders healthy and continue getting stronger.
Please continue to read up on common issues behind shoulder pain in our guide to shoulder rehab, starting with a common condition called shoulder impingement syndrome.
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https://crossoversymmetry.com/blogs/news/the-self-rehab-guide-to-anterior-knee-pain2021-08-15T09:28:58-04:002022-08-18T14:47:08-04:00The Self-Rehab Guide to Anterior Knee PainMatt Unthank
About 1 in 4 people will experience some bout of pain around the front part of their knee in their life, and it's even more likely among athletes. This type of pain is commonly called patellofemoral pain, but that's quite frankly, a garbage can term. Not in a bad way, but as an easy catch-all collection of medical phrases for anterior knee pain.
We could get specific and talk about fat pad impingement, patella alta and baja, patellar mal-tracking disorder, or chondromalacia. Yet, there's no need to untangle all those words since they have the common underlying issues of too much pressure or not enough stability.
Why Does The Front of Your Knee Hurt?
To start, let's review the knee for a better understanding of how and why it hurts.
The fundamentals are that the knee plays a middle man between the ankle and hip. It helps to disperse loads from the ground up (like jumping) and from the body back down (like landing.) Because it is the middle man, if there are issues above or below (at the hip or ankle,) the knee gets the brunt of it.
Specifically, at the front of the knee, the kneecap is the critical structure that gets tied with anterior knee pain issues. But again, the problem isn't usually the knee cap, but it's purely the messenger that something is not right.
If we look at a list of common impairments for knee pain, the major ones don’t involve the knee, but are related to strength and mobility above and below the joint.
Common Impairments for Knee Pain
Quadricep and hamstring flexibility
Pronation of your foot (how far can you turn it inwards)
Hip Strength
Hip Mobility
Ankle Range of Motion
Yet, even with those impairments, you would likely never notice pain if you never put your knees to work. But since you do fun things—like bike, hike, and run—those impairments result in magnified loads across the knee. These extra forces become a problem for the pulley system provided by the kneecap, and after enough time or reps, pain ensues in the area.
How do You Fix Anterior Knee Pain
The great news about anterior knee pain, in any form, is that it responds very well to relative rest, mobility, and strength work.
Step one with rehabilitating the knee is nearly the same as any other and that is relative rest. That means to keep up with everything you love to do, but if squats are particularly aggravating, take two weeks away from the painful stimulus and let your body recover.
This downtime provides a window to correct things that may be going wrong. Here are a few easy tests that can help isolate if you need to work on strength or flexibility at the hip and ankle joint:
Next, address the strength of the hips and leg muscles to better handle the demands of your activity.
The Crossover Symmetry Hip and Core system encompasses some of the most effective exercises to improve motor control of the hip and strength. These exercises have the highest level of EMG activity of the rotators and abductors of the hip and challenge your hip and core muscles in several different positions. They are also easy on the knee and can be started early in the rehab process.
Then lastly, the key to returning to your sport or activity is not too much too quickly—plan for a period of "rebuilding" where you slowly introduce load. An easy rule of thumb is a 10% increase in volume or intensity without regression in pain.
Don't Fret.
If the front of your knee hurts, it's usually a good prognosis.
Despite all those ominous words, it comes down to giving your body time to rest and finding the strength and mobility that you're lacking.
There's a good chance you can tackle this on your own, but of course, see a medical professional to assess and give you personal direction to solving your knee pain issue.
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https://crossoversymmetry.com/blogs/news/training-zone-tutorial2021-05-04T12:28:02-04:002022-08-18T14:42:32-04:00Guide to The CS Training ZoneNgoc Le
Here we'll walk you through the Training Zone so you can get the most out of your Crossover Symmetry System. And for easy use on your mobile phone, check out the pro-tip for saving the Training Zone to your home screen so it works just like a mobile app.
Press the three dots ( ) in the upper right corner.
Tap Add to Home Screen.
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https://crossoversymmetry.com/blogs/news/the-crossover-symmetry-user-guide2021-04-26T12:56:37-04:002022-08-18T14:30:13-04:00The Crossover Symmetry User Guide: Shoulder SystemMatt UnthankGet started on the right foot with your new Crossover Symmetry Shoulder System. This guide will teach you about the programs, how to set it up, and will walk you through your first CS Activation Session (no equipment needed.)
Here we'll show you everything you need to know about your new Crossover Symmetry Shoulder System.
1. How it works? It's all on the chart...
2. Set up your system.
How to Install CS Door Belts
How to Install CS Rack Straps
How to Install CS Anchors
3. Follow along for your first session
(No equipment? No problem. Just use your hands to get the feel.)
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https://crossoversymmetry.com/blogs/news/shoulder-pain-rotator-cuff-tear2021-03-11T07:32:44-05:002022-08-18T14:45:04-04:00Success for a Rotator Cuff Tear That Doesn’t Require SurgeryMatt UnthankMore]]>
Rotator cuff tears are common. Around 250,000 will be surgically repaired this year, and a couple million more will be treated via more conservative measures—ranging from rest, pain meds, injections, and therapy.
But get this…
A whole bunch of people will live with a rotator cuff tear and don’t even know about it. It’s believed that 25-40% amount of people will carry on their life pain-free. And that’s not just minor rotator cuff issues either. It’s shown that roughly 25% of people over 60 have full-thickness rotator cuff tears, which goes up to 50% for people in their 80s (ref).
The big question is, especially for those struggling with shoulder pain or potentially diagnosed with a cuff tear, what’s the secret to living through this injury pain-free?
We’ll address it plus more and put you on track to pain-free living.
Anatomy
Let’s start with a general understanding.
The rotator cuff describes the four muscles that create a ring of support for the arm bone in the socket—it establishes a cuff around the humeral head. These are often called the SITS muscles by exercise science students to remember their names as an easy acronym.
Although, this simple picture presents some misconceptions about the rotator cuff and how a tear occurs.
The first is a belief that tearing your rotator cuff is like splitting your pants. And while sometimes, it is this dramatic, a sudden tear like this requires a large amount of force to occur. The more common tear occurs over a lifetime, more like wearing a hole in your pants over years of use.
The next belief is that a rotator cuff tear will be forever limiting. The rotator cuff, along with other muscles, works together by combining their actions to keep the arm correctly placed in the shoulder socket—allowing it to roll, slide, and glide as needed.
This community effort is more evident by looking at a dissection rather than an anatomy illustration. There is continuity to the rotator cuff, which, to borrow from physical therapist Adam Meakins, secures the shoulder more like a large flat blanket.
The redundancy to the shoulder causes muscle groups to have overlapping jobs. If one of the muscles has a tear, there are still other ways to get the same motion. Improving the ability of different muscles to help with the job is how people live with tears unbeknownst to them and why progressing through a strengthening plan often works exceptionally well.
The important take-home is that while many considerations surround each person’s injury, not all rotator cuff tears need surgery!
The Cost of Surgery
If faced with the decision to rehab a rotator cuff tear or have surgery, most would do their best to avoid the latter. But still, it may seem appealing to bite the bullet and get it over.
Although there are several reasons why surgery is not the best option, some of which are obvious.
The top of many lists is that surgery is costly. Even with excellent health insurance, it will likely cost a few thousand dollars to cover the surgeon, anesthesiologist, surgical center, post-op therapy, and follow-up, plus many other add on costs. There is the expense that occurs from lost time from work and the overall disruption of your life.
After the cost, rotator cuff surgery requires a lengthy recovery. Expect a sling for about 6-weeks with some uncomfortable sleep, and then another 4-6 months to make a full recovery.
Beyond the expense, discomfort, and inconvenience, many aren’t aware that rotator cuff surgery often fails, and the tendon becomes re-torn (ref).
And even if the surgery is successful, a fix isn’t guaranteed like nothing ever happened. Many have stiffness, loss of mobility, and complain about a shoulder that doesn’t perform like it used to.
Due to these things, and the potential for success, a rehab plan is a great first step for many rotator cuff tear.
A Plan for Your Rotator Cuff
Now, in case you didn’t know, we sell a shoulder program that has been used by many to rehab their diagnosed rotator cuff tear, even after they’re told that surgery is the only option. So, yeah, we’re invested in getting you to go the route of NON-surgery, but I assure you that it’s more important to us than making a few dollars.
Allowing people to overcome their pain without the cost, pain, and risks involved with surgery is just as vital to us and as fulfilling as building a successful business.
Still, it would be unethical if the possibility of rehab wasn’t there. There is plenty of research and support in the medical community that the mere surgery process is a long route to the same end.
Consider what surgery leads to: forced rest and the treatment of inflammation (ice, anti-inflammatory medication, etc.,) then slowly reintroducing range of motion, then a carefully designed progressive return to strengthening exercises.
This process is likely the MOST impactful part… not even surgical repair.
What success would you have if you did all of those things and expected slow progress over 4-6 months without repairing the rotator cuff? It’s hard to say and remains disputed because, not surprisingly, nobody wants to get the sham surgery in a research study for their rotator cuff repair.
With that said, there are situations in which shoulder surgery has proven to be the best first approach. Generally, younger people with traumatic cuff tears should at least get it medically evaluated for the need for surgery. Meaning, if you took a nasty fall, resulting in a prominent, “Oh, crap” moment (especially under the age of 40), first see a sports medicine professional on the approach.
But suppose your pain was a gradual onset or started as just a twinge during a typical physical activity (like lifting a suitcase or even pumping heavy iron). In that case, a therapy plan is a great first approach.
With these cases, your body has had some time to build support structures in the form of scar tissue and strength from other muscle groups. With some time and focused strength and mobility work, you can further this support structure and most likely resolve the pain and return to one-hundred percent again…without the pains of surgery.
The Risk of the Conservative Approach
The question then is what the downside of a conservative approach is?
The biggest fear is that your shoulder will end up worse off. But the evidence shows that six weeks of physical therapy yields a very low risk of worsening things.
Regarding the time delay, it takes six weeks from initial evaluation, to an MRI, to follow-up, and then getting in for surgery. So don’t fret that your arm will end up worse if you’re not rushed off for an operation.
There is also concern that loading up an injured shoulder can only make things worse. But as mentioned earlier, this is important to the healing process by building a support structure around the tear.
Although, merely taking time off and then jumping back into things or pushing through the pain are not reliable strategies. The rehab process requires steps in which you restore mobility and progress through pain-free strengthening.
And please keep one thing in mind during the rehab process…
Be patient and give it your full effort!
Our bodies are DESIGNED to heal, yet if you expect to put in a few weeks of work and then be perfect, you’ll likely be disappointed. In many research studies, people get counted as “failed conservative attempts” at the 6-week mark, but what does it mean to fail?
A lot has to do with meeting the patient’s expectations set at the rehab program’s onset. When the sports med doctor throws out 6-weeks, many start a countdown clock to the day they’re good as new.
At 6-weeks, you might not be perfect, but that doesn’t mean that the rehab was unsuccessful. It’s merely a time to reassess how things are going and determine if it’s necessary to take different actions.
But the big priority for the plan is rest to allow for the resolution of inflammation around the injured area. However, if rest is interpreted as do nothing, it will not lead to success.
The better term is relative rest, which entails an active approach to improving your shoulder strength and mobility while avoiding things that might make it worse. Not only does this help build the necessary strength and stability to overcome the injury, but it keeps an athlete or active person from losing their mind during the rehab process.
Quite often, rehab’s downfall occurs when a person rushes back to things as they start to feel better.
We created our 30-Day Fix program with this in mind. With the help of our education and training, you can navigate the process of relative rest with something you can do every day to help improve your shoulders.
Along with progress checks based on what your shoulders can do without pain, you will progress back to full capacity.
You can follow this alongside your physical therapist’s guidance for a home program that will improve your outcomes. But many have had success using Crossover Symmetry alone, which we would be happy to support with the help of our medical team.
If you have questions about a rotator cuff tear or shoulder pain in general, please reach out at support@crossoversymmetry.com, and we would be happy to help!
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https://crossoversymmetry.com/blogs/news/a-quick-guide-to-knee-sprain-rehab2020-05-04T04:00:00-04:002022-08-18T14:53:08-04:00A Quick Guide to Knee Sprain RehabArctic Grey, Ltd.
A quick turn followed by a pop of the knee may be the pinnacle of oh s*** moments. It’s a common occurrence in sporting events but also happens in everyday life.
It’s not always a grave situation—knees make creaky noises all the time and are quite robust— but the dreaded knee sprain does happen to many and is immediately impactful.
Despite the suddenness of the injury, it leaves a prolonged aftermath. Not only painful and limiting, but the biggest struggle is the extended time to heal, and potentially the need for surgery.
In this article, we’ll help explain the knee sprain and guide a path to getting you back into action.
Anatomy Review
A knee sprain is the result of damage to the ligaments of the knee joint. There are several major ligaments, and a few lesser ones, that will be covered shortly.
A ligament is a fibrous tissue that attaches bone to bone. Ligaments are often confused with tendons, but it’s a different part of the anatomy.
If you want a full review of the knee and how everything ties together, check out our Quick Guide to Understanding How the Knee Works. But if you want to get straight to it, let’s focus specifically on the ligaments of the knee.
Understanding the difference between the types of tissue in the knee is important because it helps answer the usual question…
“How long will this take to heal?!!?”
The reason is due to blood flow! In general, the ligaments in our bodies have a poor blood supply. Bone has a great blood supply, the muscle has a great blood supply, but cartilage, tendons, and ligaments do not.
Without quick access to new blood, and therefore healing factors that our body uses to repair, it takes an extended time to heal those strained or sprained tissues.
Sprain vs. Strain vs. Tear
Damage to the ligaments gets classified as either:
A sprain is when we overextend a ligament.
A tear is when we overextend, and the two pieces lose their connection.
(Note- A strain is another common orthopedic injury term, but this occurs when we overextend a tendon or muscle.)
All ligaments have a threshold of strength. Just like a rope has an amount of force that it can withstand when holding two objects together. And just like the rope, if a ligament gets stretched too quickly OR too hard, then it gets damaged.
Each ligament provides a specific restraint to prevent the knee from going too far in one direction. Here are the major ones and usual suspects when it comes to knee sprains:
Anterior cruciate ligament (ACL) is commonly injured in fields sports, volleyball, gymnastics, and skiing. Typically injuries occur by a hit to the side of the knee, or if there is a twisting motion with hyperextension at the knee.
Posterior cruciate ligament (PCL) is most commonly injured in what is called the “dashboard” mechanism—when knees are bent to the chest (called hyperflexion) and the shin bone is pushed backward. This happens in a car crash (hence the name) or may also occur by getting tackled while the knee is bent.
Medial collateral ligament (MCL) commonly injured in field and ice sports. This ligament protects the knee from bending inwards.
Lateral collateral ligament (LCL) protects the knee from going out and is injured much less than the MCL.
Medial patellofemoral ligament (MPFL) is a small but mighty ligament that helps to stabilize the knee cap in the groove over the knee. An injury to the MPFL is likely anytime there is a dislocation of the knee cap.
You have other ligaments in the knee, but you’re not as likely to injure them.
Grading Your Sprain
Sprains are graded by the level of injury to the tissue. These grading systems vary for different ligaments in the body, but the most common scale for the knee ligament injuries is I-III (least to worst.)
A grade I sprain occurs due to overstretching. It is considered a “mild” sprain and usually results in minor swelling and stiffness of the knee. Current evidence shows that a grade I sprain in the knee will heal and return to normal in anywhere from 4-8 weeks.
It’s a frustratingly long time for some “minor” stretching. But the blood supply issue pushes the healing time out longer than most people suspect. And since the knee is so crucial to getting around, even minor discomfort doesn’t go unnoticed.
A Grade II sprain means there is a small tear, but it’s not all the way through the ligament. At this time, it’s unknown how much those sprains truly heal, but it’s safe to assume that you can get back to your sport after some time off.
A Grade III sprain is equivalent to a full tear in which the ligament has torn apart from itself and don’t expect these to heal. Grade III sprains often undergo surgery, although there are currently many valid non-operative options.
Diagnosing Your Knee Sprain
If you’ve been hit with a knee sprain, start by looking for the following Red Flags as a reason to seek further medical evaluation.
Medical Red Flags
Knee gets “locked” in position- either bent or straight
New onset of painful clicking or catching
Feeling of instability or giving out
Swelling that lasts >5 days
If you test out of all these and want to save the time and money, then it’s fine to wait it out.
But, if you’re worried about your knee, get it checked out by a medical professional for peace of mind. It’s not really an emergency situation though, so no need to rush to the emergency room.
If you have direct access to a physical therapist in your state, this is probably your best resource for the sake of time, cost, and a more comprehensive recovery plan when appropriate. Otherwise, a general practitioner or urgent care clinic can evaluate the issue and provide further recommendations, which are usually rest and anti-inflammatories, and potentially a referral for a sports medicine doctor (ref).
The Process for Knee Sprain Rehab
If you’ve sprained your knee, the first question is likely: What should be done? It’s a simple, yet challenging task, and that is resting the injury.
Rest will be slightly different for each type of sprain, but in general, it means eliminating painful activities. In the best-case scenario, inflammation takes about 14 days to resolve. Thus, the rule of “if it hurts, don’t do it” is a safe bet to follow for 2 weeks. Trying to push through the pain will only bring further inflammation and ultimately slow healing time.
In total, you’re looking at a healing time of 6-8 weeks, but will be feeling better between 2-4 weeks. You will notice a reduction in swelling, and your range of motion will return to normal. You’ll feel that it’s time to get back to life—unfortunately, it’s not done healing.
It’s in the window of weeks 2-4 that people run into issues because they jump right back into their previous activity level. Even though the knee feels better, it’s still missing some stability, which increases the risk of hurting the same ligament again. If not something worse!
It’s during these weeks that a properly structured exercise plan becomes super important.
Low impact exercises targeting the glutes, core, and leg muscles will keep those muscles engaged, while healing occurs. This makes it easier to return to full activity, and potentially even solving some of the underlying strength issues that caused the knee sprain to happen.
If you need help with this, we walk you through everything in our 30-Day Knee Fix.
Preventing Knee Sprains
As Ben Franklin once said, “An ounce of prevention is worth a pound of cure.” And considering the time and limitation caused by a knee sprain, an effort towards prevention is worth it. That’s especially true if you’re at higher risk, like in a sport with lots of contact or cutting.
When it comes to knee sprains, there are some things you can’t control. These are known as non-modifiable risk factors and include items such as:
Ligament Size (some people just have smaller ligaments)
Gender (women are at higher risk of knee sprains)
Physical requirements of a sport or task (for example, soccer players are at higher risk of knee sprains than bowlers.)
Background or history of training (previous time spent working with a strength coach)
Yet there are still things you can do to reduce the risk of knee sprains.
Strength
Building the strength of your muscles can help reduce the risk of a knee injury.
The knee is a rather simple joint—which flexes and extends—using the ligaments to keep it along its tracks. A blow to the knee can knock it out of place damaging the ligaments, or forces of just bodyweight moving in an awkward direction can strain a ligament as well.
That’s where strength and stability come into play for protecting the knee joint. Strong muscles slow the body and effectively transfer forces.
For example, the picture above shows the common mechanics for non-contact ACL tears. Someone with weak external rotators is 8x more likely to injure their ACL than someone who isn’t (ref). That’s because the external rotators (AKA- the glutes) help to control the position of the knee when landing and changing direction without overloading the ACL.
Speed and Timing
Again, speed is an essential component behind injuries to the ligaments as well. You could demonstrate the above position slowly and have no risk of injury, but if you got pushed that way, things could easily go wrong.
Again, we prevent entering these positions through the control of the hip extensors, abductors, and extensors. But it’s not enough to just have the strength of the muscles, it’s also essential to engage them quickly and with the right timing.
For that reason, practice and training of explosive cutting and jumping in a controlled situation helps prepare athletes to safely take on the demands of their sport. In sports performance training, this is commonly known as plyometrics, but it’s important for more than just sports performance.
For Now and Forever
If you landed on this to help get past your knee sprain, I hope you found the answers you were looking for. It’s going to take some time, and we would love to help guide you through that.
Our 30-Day Knee Fix will give you a progression of strengthening and active rest to get you back to where you once were.
But it doesn’t end there! Hip and Core strengthening is an important part of knee injury prevention and should be part of every athlete and active person’s regiment. Be sure to check out our glute and core guide to learn more about the key muscles needed to fight off injury.
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https://crossoversymmetry.com/blogs/news/guide-to-meniscus-tear-recovery2020-02-07T04:00:00-05:002021-03-18T09:14:28-04:00Guide to Meniscus Tear RecoveryArctic Grey, Ltd.
This article will be your guide to meniscus tear recovery and hopefully provide some clarity on this common knee issue. We’ll start with an easy understanding of the meniscus and what it does. Then we’ll help you identify potential issues and what research says about the most current treatment options.
The first note is that not all meniscus tears are the same and management will likely look a bit different for each case. Nonetheless, with a better understanding of your meniscus, you can help navigate the best treatment option for you.
It’s easily termed medial meniscus for the inner ring, and lateral meniscus for the outer ring. Together they create a bowl for the femur to sit. It helps provide stability for the knee and disperses loads evenly throughout the joint. It also reduces friction and adds padding to protect the bones from rubbing against each other.
When the doc says “bone-on-bone,” they’re trying to explain that the meniscus padding (along with other cartilage) is missing. But the impression that the body is worn out like old brake pads on a car isn’t accurate and may do more harm than good.
It implies there is no way to fix the issue without a repair and the problem will only get worse. Yet for many issues, including meniscus tears, a plan of exercise and rest often works well and is an ideal first approach (ref).
How Your Meniscus Becomes Damaged
Meniscus tears can occur in nearly any individual— ranging from elite athletes to older adults. Despite the different demands, abuse to the meniscus usually comes from landing and changing directions.
To help explain this, think of the meniscus as a wet paper towel squished between two rocks. If you merely compress the towel between the rocks nothing will happen. However, if you squish and twist the rocks, you can imagine how it would like the tear the paper towel.
For older adults, tears develop with much less force. Think of the same wet paper towel analogy, but using a thin towel rather than a thick super-absorbent one. The thinner towel won’t take as much force to tear. Depending on the quality of the meniscus, walking stairs, or sitting or standing from a chair, could be enough force to tear the meniscus.
All of this makes the meniscus seem all too fragile— but it’s far more robust than a wet paper towel. It’s thick and rubbery, built to take a beating. Thus, not everyone with knee pain has a meniscus tear, nor does a tear even mean you’ll have pain.
When Things Go Wrong
Depending on the type, degree, and location, people experience different symptoms. Below you will see the most common types of meniscus tears. The upper row is a milder version than the more progressed version under it.
Additionally, a traumatic tear in a young soccer player will feel and recover much different than general wear and tear that’s common in people over the age of 40.
Yet, the common symptoms associated with a meniscus tear include:
Pain with Clicking*
Swelling that progressively increases over 24 hours
There may be limited ability to straighten the leg completely or bend it all back all the way depending on the location of the tear.
(*Important Note- Many people have clicking in their knees that means nothing, so don’t freak out over the little creaks and pops you get in your joint.)
The gold standard for diagnosing a meniscus tear is by MRI. There are also clinical tests that can hint at a tear, which you can check out one in the video below. You can see it’s an aggressive test that could further your issue, so this is best left to a trained professional.
Acute vs. Chronic Meniscus Tears
The initial question a medical professional will often have about your injury is, “How did it happen?”
For many tears, it occurs from a sudden or specific event such as a hard cut or land, and many report hearing a pop. Despite the nature of the injury, most are still able to keep moving and many athletes will continue to compete in their event. It’s not until later when they notice swelling, pain, or tightness, do they realize there is an issue.
Meniscus tears due to accident or injury may also involve damage to other stabilizers as well.
“The unhappy triad” is the unfortunate, yet common situation, where the meniscus, anterior cruciate ligament (ACL), and medial collateral ligament (MCL) are torn during a fall, hit, or twist. It usually occurs with force moving from the outside of the leg inwards with the foot fixed on the ground. All three structures are critical components to the stability of the knee, thus it’s a different issue altogether than just a damaged meniscus.
The other type of meniscus tear is more chronic in nature, without a cause or explanation. These tears are more likely in people who have arthritis in the joint already. We’ll get more into treatment later, but many times chronic tears don’t make good surgical candidates due to complications from underlying arthritis in the joint (ref).
Blood Flow
Meniscus tears also differ based on their location within the ring. The “red-red” zone is the outermost part of the ring and has the best blood flow. This allows for increased nutrients and metabolites to give the tissue the best opportunity to heal. The middle section is the “red-white” zone and does not have direct blood flow, but is close enough to the red-red zone to get some trickle over. The white-white zone is the innermost portion of the meniscus ring and has the least amount of blood flow. Tears in this area can heal, but it’s much less likely.
Treating Your Meniscus Tear
The good news is many meniscus tears will heal on their own. Based on what we currently know, the location of the damage in either the red-red zone vs. white-white zone is most telling for the tear’s ability to heal.
Yet some factors make surgery a necessary option. Sometimes a meniscus tear can act like a hangnail, constantly getting caught up and aggravating things. Other times, the tear may not be severe, but in a location that gets extra abuse. Like the neverending cut on the finger that’s constantly getting bent, bumped, and reopened
The Conservative Approach
The difficulty is that you won’t know your opportunity for rehab success without giving it a try. A physician can make an educated guess, based on imaging and your history, but this is no guarantee.
Acute and or painful tears usually start with a period of rest to allow things to calm down, followed by physical therapy for 4-6 weeks to improve strength and range of motion.
Some patients will find that their tear won’t afford them the option of conservative treatment. For example, for a big flap that’s causing locking and severely limiting the range of motion point to surgery as the only option.
Other Potential Aids (That Aren’t Surgery)
Cortisone is a steroid injection into the location of the tear. Cortisone will NOT heal the meniscus, but reduces pain for 3-6 months for more effective stretching and strengthening.
It’s helpful for taking the sting out of the issue, but won’t likely have any lasting effect without strengthening. And the most significant trouble with cortisone is the lack of short and long term research on its use.
PRP (Platelet-rich plasma) is a newer treatment option and a hot-button topic. The short story is a mixture of your own blood cells is injected into the injury location to promote the healing process.
Studies on PRP for the meniscus have been promising but not definitive (ref). The red-red zone appears to be an effective target for PRP, while treatment in the white-white zone seems to be less effective. Again, the red-red zone heals the best because it has the best blood flow to the area.
Ultimately PRP needs more research. We currently don’t have a great answer for who it works for, making it a system of guess and check. Insurance is not reimbursing for it yet either, but if you’ve got a couple of hundred dollars lying around, it may be worth it.
Surgical Options
If the conservative options don’t work, there are two surgery types to help correct the issue.
Surgical Removal
One option, called debridement, involves the surgical removal of the torn area of the meniscus. This is a minimally invasive procedure using a small camera and tools inserted into the joint via keyhole incisions. Typically individuals return to their desired activities between 6-8 weeks.
Surgical Repair
Or it’s possible to repair the meniscus rather than cutting out. This is an arthroscopic procedure as well, using a small stitch to connect the meniscus back to itself.
Although, this is a delicate process that needs careful management afterward. Some surgeons describe the procedure as sewing tissue paper back together.
Depending on what research you are reading, the recovery for this process can take anywhere from 3 months to full year, but the big take-home is that it’s much lengthier than simply cutting it out.
Moving Forward with Your Meniscus Tear Recovery
At this point, this is what many of you are thinking…
I can give rehab a try, but won’t know if it will work for several weeks.
Or, I could have it stitched back together, and be out up to one year.
Or, I could have a doctor cut it out, and go right back to my activities in just a couple of months.
While the third option probably sounds the most appealing, looking past the 6-8 week recovery, there are long term consequences to consider for removing a piece of the meniscus.
Going back to the original function of the meniscus, its job to help disperse loads within the knee. Removing rather than repairing a torn meniscus leaves more contact of bone to bone, which increases the chance of developing arthritis later in life.
Ultimately it’s worth the time investment if the meniscus can be saved (ref).
Initially, try conservative management—and I mean seriously try—where you give your knee the best chance to rest and recover properly. Even if it’s not the ultimate fix for your knee, you only lost a few weeks and set yourself up to come back better and stronger after your procedure.
If you decide on the surgical route, it’s worth discussing with your surgeon about debridement vs. repair, and how it will change your rehabilitation process and the long term health of your knees.
Conclusion
Getting past a torn meniscus is not a one-size-fits-all solution. There are many options for managing a meniscus tear. Hopefully, this laid out some of the information to help you make a more informed decision going forward!
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https://crossoversymmetry.com/blogs/news/how-to-fix-a-torn-labrum2019-10-04T04:30:00-04:002024-01-16T15:00:58-05:00How to Fix a Torn LabrumArctic Grey, Ltd.A labrum is a structure in the shoulder that's prone to injury.
To understand why, take a second and observe the shoulder. We covered this issue with shoulder anatomy in the Intro to Shoulder Pain Rehab, but we'll reemphasize it here again.
The ball is 3x the size of the socket. It's more like a ball on a tee than an actual "ball and socket."
It's not all that stable, but the shoulder does have excellent mobility.
Now, sandwiched between the arm bone and shoulder socket is the labrum.
Most specifically, it encircles the shoulder socket and performs several important jobs, including:
Deepen the socket to support stability,
Provide an attachment to anchor ligaments and tendons,
Create a negative pressure to further stability—think of it as a suction cup.
In summary, the labrum provides extra stability for a joint needing help.
In this article, we'll explore the labrum further, especially related to pain and injury, and shine some light on how to fix issues related to a torn labrum.
But spoiler alert…the labrum doesn’t fix itself.
Labrum Injury 101
Sometimes, that failure is due to an accident—like falling on an outstretched arm or a lift that went wrong. This forces the arm bone into the labrum ring, causing it to tear.
Sometimes, the forces are so great that the shoulder dislocates. A labrum tear is almost guaranteed in these cases, resulting in a Bankart lesion.
The labrum can also be injured by pulling on it. Notice in the picture how the bicep tendon attaches to the upper ring of the labrum. Stress that pulls on this attachment can peel away the upper part of the labrum ring, causing what's called a SLAP tear.
The SLAP tear is extremely common in baseball players due to the extreme layback that occurs as part of the throwing motion. It can also happen from dropping down hard while hanging onto something (see: kipping pull-ups.) A SLAP tear can also occur due to a hard blow to the shoulder.
Either way, when the labrum tears, it leaves behind an issue of both pain and lost stability that must be dealt with, and this type of tissue doesn't regrow, so just taking some time off will not "repair" the issue.
However, that doesn't mean that all hope is lost and you're destined for surgery.
Next, we’ll cover the follow-up to a labrum injury.
Diagnose a Labrum Tear
If you dislocated your arm while hucking off jumps at the terrain park—or maybe something slightly less awesome—bet on a labrum issue.
This may follow up with a feeling that the shoulder will dislocate again. If your injury was related to an accident like this, it deserves a medical evaluation.
But sometimes, it's not so obvious, especially with SLAP tears.
Here are the signs and symptoms that you may have damaged your labrum:
Pain. Often deep and hard to pinpoint, with the feeling that it's too deep to touch.
Catching/clicking
Pain with overhead activity
Decreased force production on that side
Sometimes a loss in shoulder range of motion, especially with internal rotation (turning the arm inwards)
In the clinic, a PT or sports med doctor has lots of special tests to diagnose a labrum issue. You could search for them, but no one test will check yes or no.
It's a system of ruling out other pathology, manual assessment, and patient information to create a complete impression.
If you need assurance, you should get an evaluation with a specialist to feel more confident moving forward. However, it's not ridiculous nor harmful to initially work on a home fix for a suspected torn labrum with a program like Crossover Symmetry.
Now, we'll show you how.
The Labrum Fix
As we mentioned earlier, the labrum doesn’t repair itself. So what kind of hocus pocus might we recommend?
The answer is a conservative plan of strengthening and some rest.
Which isn’t actually a cure, because the labrum remains torn, yet have no fear! You can still be healed.
First of all, labrum tears rarely happen in isolation. Due to instability caused by the torn labrum, or potentially the underlying issue that caused the labrum tear to happen, things such as bicep tendinosis, rotator cuff impingement, and bursitis can pop up as well. These are pain generators that will usually go away if you stop poking them.
Secondly, strengthening the muscles can make up for the loss in stability, restoring function as before. To support this, a 2016 study showed that 72% of people over the age of 40 had a SLAP tear that was pain-free.
If you’re unconvinced, it’s been estimated thatclose to 80% of major league baseball players have some degree of labrum tearing. Showing that it’s possible to buffer a labrum issue well enough to sustain the forces required to play a pro sport.
Labrum Fix Using Crossover Symmetry
There is a good chance you can too, with a simple prescription:
Avoid things that are painful for at least 30 days. If you keep provoking your pain, it’s not going to get better.
The “protocol” for a labrum tear would follow the same principles for approaching other shoulder issues. Work on restoring range of motion and improving the function of the scapula and rotator cuff muscles in all planes of motion.
Even if you don’t have a labrum tear, you’re still taking the steps in the right direction for fixing whatever shoulder ailment that pains you. Most important to the process is that the program needs to be consistent with daily compliance.
It doesn't have to be extensive, but it does need to be done regularly.
More Advanced Treatments
Give it 30 days and if the pain is still limiting your progress, high dose NSAIDs or corticosteroid injections are an appropriate option.
You’ll feel good after an injection, but don’t sit around and assume everything is fixed. Instead, it’s important to use the relief to address strength deficits.
As an athlete progresses past the basic rehab template, more advanced movements may be necessary to take on the specific stressors that will show up as part of their sport. In the end, nearly 70% of athletes have good outcomes with pain relief and return to sport through conservative management (ref).
If after 4 to 6 months, there has been no improvement despite a consistent effort with a conservative approach, it’s time to consider more advanced medical procedures.
Imaging may be ordered, but an MRI is not great at picking up all SLAP tears, so an MRA may be ordered for a more accurate assessment.
The final approach is arthroscopic surgery, which follows up with a 6 to 9-month recovery. The bicep tendon is often relocated from the superior labrum to lower on the arm during the procedure as well. This is called a bicep tenodesis and tends to have less pain and reduced risk of the repair failing.
Conclusion
Whether you are a weekend warrior, throwing a baseball in the Majors or working to get to the CrossFit Games, a torn labrum is not a career-ending injury. It may disrupt training and competition for a few months, but the majority of labral tears can be addressed successfully with non-operative care.
Take this as a reminder to continue your active participation in your shoulder health. This includes a plan for warming up the shoulder, accessory work, and sport-specific training.
Click Here to learn more about the Crossover Symmetry rehab approach and how you can maximize your shoulder health despite a labrum tear.
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https://crossoversymmetry.com/blogs/news/how-to-use-crossover-symmetry-to-fight-frozen-shoulder2019-09-13T05:30:00-04:002023-11-06T16:14:26-05:00How to Use Crossover Symmetry to Fight Frozen ShoulderArctic Grey, Ltd.The worst part of Frozen Shoulder is the recovery timeline can drag out for many years with little way of knowing the prognosis. But with an exercise plan like Crossover Symmetry, you’ve got a tool for a crucial part of the recovery process. Although, the full scope of the issue is a bit more complex.
We have had the opportunity to help address many shoulder issues over the years and frequently have people reach out to us hopeful that the Crossover Symmetry System can help with frozen shoulder. Continue reading for insights into what is Frozen Shoulder and how best to manage it.
What is Frozen Shoulder?
Frozen shoulder, also known as adhesive capsulitis, is caused by inflammation and thickening of the connective tissue that surrounds the shoulder joint. The underlying causes remain uncertain and even sometimes just appear out of the blue.
Although there is a higher incidence in people with diabetes, shoulders that have been immobilized for a period of time (often following injury or surgery) and women; (specifically, women who are pre-menopausal or menopausal.) There is also mounting evidence that the condition is driven by low levels of systemic inflammation (ref).
Here is a rough timeline of frozen shoulder which is broken into 3 phases: freezing, frozen, and thawing.
Freezing (2-7 months) – During this stage, the shoulder is typically painful at end ranges of shoulder movement in all directions and often very painful at night.
Frozen (4-12 months) – At this time stiffness primarily limits the shoulder. There may still be some pain but it’s less than experienced during the freezing stage.
Thawing (5-24 months) – The thawing stage is the light at the end of the tunnel, albeit it may be a long tunnel. There’s typically minimal pain and a progressive improvement in range of motion.
Depending on where you’re at in the process you’ll have different directives for treatment.
Getting Past Frozen Shoulder
The good news is that 90% of people with frozen shoulder will recover with conservative management strategies like exercise and stretching (ref). However, it can be a long and frustrating road, especially for the active individual.
Here we’ll highlight the current best practices in dealing with frozen shoulder and help identify the best strategies for getting past it, and more specifically how Crossover Symmetry can support this plan.
During the Freezing Stage
In the early stage of frozen shoulder, the primary issue is pain.
NSAIDs and other oral steroids can be somewhat useful during this initial “freezing” stage. They don’t provide a significant change in the overall recovery or duration of symptoms but do offer moderate pain relief. It’s worth noting that long term use of NSAIDs and oral steroids are linked to stomach ulcers, weight gain, and have adverse effects on the liver and kidneys.
Another option shown to be more effective during the early parts of the freezing stage is Corticosteroid injections. During this early stage, a cocktail of corticosteroids alongside a high volume dose of saline and localized anesthetics offer promising results. Despite the risk of infection, the side effects are few, and it has better long term pain reduction.
During this time, aggressive stretching is counterproductive but gentle and light exercise in your pain-free range is a good thing. An exercise program like Crossover Symmetry is recommended. Although, stick with exercises that you can perform with little pain, and without having to compensate too much to achieve an adequate range of motion.
The best Crossover Symmetry options are usually:
Row
Pull-down
Reverse fly (with a modified range)
Scaption (just to shoulder height or pain limitation)
During the Frozen and Thawing Stages
Unfortunately, despite one’s best efforts during the freezing phase, most will spend some amount of time in the “frozen stage”. During this time there is usually less pain but the shoulder remains stiff and range of motion is limited. Because pain becomes less of an issue, injections and other pain relief agents are not as effective. Instead the focus transitions to more aggressive stretching and physical therapy.
Eventually, the stiffness will decrease and individuals will note an improvement in ranges of motion and little pain. These changes mark a progression to the “thawing” phase. Strategies encouraged during this stage include more aggressive stretching, physical therapy, aerobic exercise, and basic strength training.
So keep up with Crossover Symmetry as your range of motions allows, even trying the Strength program as mobility improves. This will help to limit the limitations caused by frozen shoulder and improve strength as you work through the issue.
Bringing Out the Big Guns
Despite injections, physical therapy, and pain medications, some will need more advanced treatment. If pain and limited range of motion persist for more than 6-9 months more advanced medical procedures may be indicated.
These are invasive protocols that aggressively attack the contracted shoulder tissue. Methods such as using anesthesia to put the patient out and then cranking on the shoulder, or more popular these days is arthroscopically cutting the capsule.
Of these more advanced methods, they do show good results but create lasting changes to the shoulder structure. Therefore, these options are a last-ditch approach in treating the condition, especially for one who hopes to return to more strenuous activity.
Crossover Symmetry for Frozen Shoulder
Unfortunately, there’s no slam dunk for frozen shoulder.
There is a lot that remains unknown, paired with the fact that each episode is unique, so what works for one may not help the other. Although what we do know is that movement is an important part of the recovery process for any ailment.
Specifically for frozen shoulder here is a quick take-home summary of a plan to help you get past the issue using your Crossover Symmetry System.
Frozen shoulder has 3 stages:
Freezing – The primary issue is pain with some restrictions in range of motion. Corticosteroid injections and high volume injections may be useful during this stage. This is not the time for aggressive stretching or strength training, but some light use of Crossover Symmetry exercises is beneficial for reducing the pain and limitations.
Frozen – Some pain may still be present but a loss in a range of motion is the primary limiter. More aggressive stretching and a shoulder strength program like Crossover Symmetry (but with modifications for the limited range of motion) are important during this stage.
Thawing – In the final stage, the shoulder range of motion progressively improves and pain is usually minimal. Keep up with aggressive stretching and you can progress your resistance training within your available range of motion.
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https://crossoversymmetry.com/blogs/news/self-treatment-guide-for-shoulder-separation2019-05-19T05:30:00-04:002022-08-18T14:42:53-04:00Self Treatment Guide for Shoulder SeparationArctic Grey, Ltd.
If you’ve got lingering shoulder pain following a nasty fall or direct blow to the shoulder, made worse by reaching across your body, you may have suffered a shoulder separation.
This is caused by the stretching or tearing of the ligaments of the AC joint. It’s a common injury among hard-hitting sports like football, rugby, and hockey. Or it also shows up in everyday life due to an unfortunate accident.
While they can be painful injuries, that cause swelling and an odd looking shoulder, most will progress with time and guided therapy. In this article, we’ll take a look at the types and plan of attack to help you get past your shoulder separation.
Know Your Grades and Recovery Timeline
Before going any further, let’s identify what’s going on.
Start by locating your collar bone and then trace it to where it meets your shoulder. You’ve found your acromioclavicular joint, or better known as the AC joint.
Notice the collection of ligaments that hold it all together. It’s the tearing or stretching of these ligaments that cause a shoulder separation.
There are six categories of shoulder separation based on the size, structures involved, and type of displacement,
Grades I and II
These are the most common tears and caused by either a partial or complete tear of the acromioclavicular ligament.
While they are painful and may present with swelling and a bump over the shoulder, they most likely don’t need surgery. They will return to normal within a few weeks to a couple of months with rest and exercise.
What to expect:
Grade I tears will need 1-2 weeks out of activity
Grade II tears anywhere from 3-6 weeks.
Grade III
Grade III separations involve the tearing of the coracoclavicular ligaments as well. This causes a complete separation of the clavicle and shoulder. These are easy to spot by a stair step that is formed over the shoulder.
It’s a more complicated issue because there isn’t consensus within the medical community on the best way to manage a Grade III tear. Even with new surgical procedures, the outcomes are nearly identical with and without surgery.
So it’s logical to approach a grade III tear conservatively to avoid the expense and potential complications of surgery. But individual factors such as goals, competitive level, and sports activities need to be weighed as well.
This makes a consult with an orthopedic specialist worthwhile to determine the best course of action.
What to expect:
As mentioned, there isn’t a consensus on the best treatment for a Grade III separation. The standard procedure is 3-weeks of rest and rehab and then consider surgery if there is little improvement.
The rehab process is like the grade I and II separations, yet may demand up to 3 months before a return to activities. It may also need more intensive strengthening to make up for the loss in stability. Again, another reason to get medical help for these injuries.
Grades IV, V, VI
The later grades (IV-VI) are less common and much more severe and usually caused by major impacts like car accidents. They are more advanced medical cases or even sometimes medical emergencies. These will need surgery and don’t fall into the scope of this article.
Shoulder Separation Treatment Guide
If you want a general understanding of the treatment approach to a shoulder problem then read The Approach to Shoulder Pain. It’s a nice overview of the plan of attack, although the rehab for an AC Separation, depending on the severity your rehab may look slightly different from our normal 30 Day Fix.
More specifics on shoulder separation rehab use the following treatment guide as a tool. This is directed at Grade I and II tears, anything more severe get it checked out.
1. Screen
If you suspect an AC separation start with a screen for more advanced issues. A quick run through our Red Flag Screen is a good start to pick these things out.
If nothing turns up there’s a good chance you can manage this on your own. But if you’re ever in doubt, rest easy by seeing a doctor about your issue.
2. Address Pain
Start by addressing the pain. Because you don’t want to live in misery, but it will also get you moving quicker, which is important to the recovery process.
In the first few days, if you’re uncomfortable, try wearing a sling to ease some stress on the joint. Most people don’t require the use of a sling, but if you are really struggling with pain, this may help in the initial few days. But you want to ditch the sling as soon as tolerated.
Ice is another good analgesic that will help with the swelling. If you visited a doctor, pain medications would probably be recommended, but for this self-treatment guide, that’s under your own discretion.
3. Movement
It’s important to start working on restoring movement as soon as possible following an AC joint injury. This will help speed up the return to activity and avoid other shoulder complications.
Initially, if you’re in significant pain or too afraid to move your shoulder, start with the basic pendulum exercise to help restore range of motion.
Otherwise, you’re good to go with basic rotator cuff work and scapula stability exercises below shoulder height.
When dealing with an AC tear, reaching across the body and overhead are the most aggravating motions, but basic pulling movements are usually ok. For this reason, the Crossover Symmetry program would not be appropriate at first, but you can still use the equipment to do go through your recovery work.
Use the following recovery program 2-3 times per day to help maintain rotator cuff function and scapular movement. It’s also important during this time to maintain thoracic mobility with foam roller mobilizations and side lying thoracic rotations.
Week 1 –
Start with the pendulum exercise if needed
2 Sets of 10-15
Prone Scap Retraction
Prone Single Arm Y in a pain-free range
Banded rows at the side from a single attachment
Banded ER and IR in a pain-free range
Week 2-
You should have ditched the sling and pendulum exercises at this point.
2 sets of 10-15
Banded rows at the side from a single attachment
Banded reverse fly from a single attachment
Banded ER and IR in a pain-free range
CS Scaption exercise to shoulder height
5lb Shoulder Press
As pain decreases and range of motion improves start returning to your normal activities and use pain as your guide. Pain should be less than a 3 on a 10 point pain scale and should return to baseline within 2 hours following exercise or your activity.
As functional range improves, you will progress into the full Crossover Symmetry activation program to prepare the body to return to normal activities.
Week 3-
Progress to the full Crossover Symmetry Activation program. Start with a lighter resistance if needed.
Start integrating sport specific training but stay away from contact.
Week 4-
Continue with Crossover Symmetry Activation.
Return to contact sports if pain-free, but go through 2 full practices before returning to competition.
Long Term Recovery
Most shoulder separations return to full activity without any long term complications.
Although there are some cases of ongoing nagging discomfort. For example, a study at the US Naval Academy shows 9% of Grade I tears and 23% of grade II tears continued to have pain that limited activity three and a half years later (ref).
A concerning statistic for anyone with an AC separation, but it highlights the need for ongoing care.
Continuing to promote scap movement and rotator cuff strength will help support and lessen loads placed on the AC joint. For that reason, don’t give up on the Crossover Symmetry program once you are “healed.”
Using CS Activation daily will support the long term care for a number of shoulder issues for whatever your sport or activity might be.
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https://crossoversymmetry.com/blogs/news/shoulder-pain-cause-of-shoulder-pain2019-03-29T12:30:00-04:002022-08-18T14:39:20-04:00The Most Common Cause of Shoulder PainArctic Grey, Ltd.
There is a common cause of shoulder pain—and there’s a good chance it’s the reason your shoulder hurts.
A condition called shoulder impingement syndrome.
It can also go by names like:
subacromial impingement,
painful arc syndrome,
supraspinatus syndrome,
swimmer’s shoulder, or
thrower’s shoulder
And in the medical world shoulder impingement will sometimes get defined by the pathology of what’s actually hurt. Things like rotator cuff tendonitis, biceps tendonitis, bursitis, or other medical ‘itis’ words.
It’s one reason why people get so mixed up about their shoulder pain. There are a lot of words, all describing the same thing!
What is Shoulder Impingement?
Take a quick review of your shoulder anatomy (which you can dig into this a bit more HERE), for an important structure to point out.
There is a small gap in the shoulder called the subacromial space. AndInside this space are muscles, tendons, and sacs of lubricating fluid.
For a long time, we considered the acromion to be the primary culprit of shoulder pain. It was observed as a nasty hook that would grab onto and rough up tissue in the shoulder, to the extent that shaving or cutting the acromion became a common procedure. But we’re now cluing in that “shoulder impingement” is actually supposed to happen, and with all shoulder movement, the tissues naturally glide between the bones of the shoulder.
But if it’s normal, then why does it hurt?
First of all, there’s not much room for error beyond the normal shoulder biomechanics. If shoulder function is thrown off, even just slightly, it will add extra compression to the tissues in the space.
Things like stiff and inflexible shoulders are likely to decrease the subacromial space…
Or if the scapula isn’t moving with the arm correctly, it can position the bony prominence too low…
Or if the rotator cuff isn’t doing its job to keep the arm stable in the shoulder socket…
All of these things will lead to a greater degree of shoulder impingement.
If this extra compression happens while sipping a cup of coffee, it’s not likely to flare anything up (unless it’s already irritated). But consider playing tennis, or throwing a ball, weightlifting, or painting a ceiling.
It’s usually through a cocktail of shoulder mechanics, loads, speed, and volume that our shoulder ends up in pain.
Additionally, if something is irritated, it’s likely to hurt if you poke it.
For example, if you twisted your knee playing soccer, it’s likely to hurt for a few weeks if you bend it. In this example, bending your knee causes pain, but it’s not the cause of your injury.
Likewise, even if impingement is normal, if you’ve irritated something in your shoulder, it’s likely to be bothered when it’s compressed.
So the impingement pain may be in response to other shoulder issues, like rotator cuff or labrum tears, that not only increase the degree of impingement but also make the shoulder cranky when it gets pinched.
Thus, it’s too simple to say that impingement syndrome is caused by the compression of the tissues inside the shoulder. Because by itself, that’s what’s supposed to happen.
is a hard one to say, so we’ll stick with shoulder impingement.
Tests for Shoulder Impingement
There are lots of assessments used to determine if someone has impingement syndrome.
A very simple one for someone to do on their own is to reach across the body and put the hand on the opposite shoulder. Then lift the elbow towards the face and check for pain.
There is another assessment called a painful arc test.
For this assessment, lift the arm up away from the body, into an overhead position. If there is pain between 60 and 120 degrees this is a positive test.
Shoulder pain during either of these tests would be an indicator that you’ve got some irritation that’s getting further irritated with impingement. Even if you check out on these tests, if you have shoulder pain, there is a very good chance that shoulder impingement is involved somehow.
Regardless, the corrective plan for shoulder impingement will help your shoulder, no matter the cause.
Which leads us to the next question…what to do about it?
Fixing Shoulder Impingement
If you want to fix your shoulder impingement, there are two big steps in order to get you there, which both involve lessening the degree of impingement.
The first is to lighten the stress on your shoulder, By reducing the loads and volume on your shoulder, the shoulder impinges less and allows for some healing. The best guide for this is to simply eliminate any painful movements. This should make sense, but many continue to push through pain, which only makes matters worse. As a general guideline, give it 2 good weeks of good shoulder rest.
Although the first step is for nothing without the second one—it’s critical and often missed or ignored.
The second step involves building shoulder strength and mobility. This not only improves shoulder mechanics for less impingement but progressing through pain-free movement is an important part of getting past your brain’s perception of pain.
These are the underlying principles of our 30 Day Shoulder Fix.
In this program, we walk you through a 30-day rehab program, designed to fix your pain and improve your shoulder strength and mobility, so that it never returns. But it’s not always the right fit for everyone.
In case you missed it, be sure to use our Red Flag Screen to determine if shoulder impingement is likely the cause of your pain and if our self rehab program is right for you.
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https://crossoversymmetry.com/blogs/news/how-to-build-rotator-cuff-strength-for-strong-and-pain-free-shoulders2019-03-22T09:30:00-04:002023-08-14T12:39:31-04:00How to Build Rotator Cuff Strength for Strong and Pain-Free ShouldersArctic Grey, Ltd.
I was fresh out of undergrad.
Sitting down for my final interview as a trainer at a high-end health club. Before me was the big boss over all the trainers in the area. A proud fellow, squeezed into a very small shirt, ready to grill me with questions.
The only question I remember was the one I fumbled big time.
He asked me, “Name the rotator cuff muscles and tell me their actions.”
But my mind was blank. I knew they were shoulder muscles, but that was about as far as I got with the question.
With a smug grin, he listed the four muscles and told me their actions, and said: “How would you know how to build rotator cuff strength?” One day later, I got an email that specifically read…
we chose someone else
But as fate would have it, not getting that job put me on a different path, which over 10 years later I now educate people about their shoulders (and talk a ton about rotator cuffs.)
So as my redemption, let me share with you…
Everything you need to know about the rotator cuff (and how to build rotator cuff strength.)
What the Text Book Tells You
Let’s start with the basics. It’s NOT called the rotator CUP, nor the ROTARY cuff. I hear these two mistakes all the time.
It’s called the ROTATOR CUFF.
Formed by four muscles that attach around the ball of the shoulder.
Supraspinatus
Infraspinatus
Teres Minor
Sub Scapularis
The acronym S.I.T.S. will help you remember them for that day they come up in a job interview.
The SITS Muscles
If you’re into this stuff, you can dive into each muscle below. If you could care less to know the actions, just skip on over The SITS Muscles, the important stuff comes after (and we’ll show you how to build rotator cuff strength.)
Supraspinatus
From the picture, you’ll see how the supraspinatus sits over the top of the arm bone. Lift your arm away from your body. Your supraspinatus was the main muscle that made that happen.
Keep raising your arm to shoulder height, and the deltoid (the big shoulder muscle) does more moving, but the supraspinatus keeps helping out.
The supraspinatus is a small muscle but it can be a huge problem. If you’ve ever had pain lifting your arm, there’s a good bet you’ve pissed off your supraspinatus. And you’ll quickly realize that this pain is a huge limiter when it comes to arm strength and range of motion.
Infraspinatus
The infraspinatus is on the back side of the shoulder. It’s known as the primary external rotator of the shoulder.
External shoulder rotation includes:
With your elbow at your side, rotate your palm so it faces forward.
Now, straighten your arm with your palm down, and rotate it upwards.
Now, reach a hand back like you’re going to throw a ball.
Teres Minor
The teres minor is the little brother to the infraspinatus. It’s so tightly connected with the infraspinatus, that muscles will often fuse together.
It helps out with external rotation of the shoulder, but not as much as the infraspinatus.
Although it does become more important as an external rotator as the arm gets above the head (with your arms overhead, point your thumbs back).
Subscapularis
The last of the SITS muscles is the subscapularis. It’s the largest of the four rotator cuff muscles and is the internal rotator of the shoulder.
Internal shoulder rotation includes:
With your elbow at your side, rotate your palm inwards so it faces backward.
Now, straighten your arm with your palm up, and rotate the palm downwards.
Now, pretend like you are throwing a ball
What You Really Need to Know
At this point in my life, I could list the muscles and actions in my sleep. But for that interview question, I would probably say…
“Does the rotator cuff ever work in isolation?”
When it comes to the rotator cuff for living an active life, one that’s uninhibited by pain or weakness, the textbook answer doesn’t mean much.
Here’s what really belongs in the rotator cuff instruction guide…
The Rotator Cuff is a Stabilizer
The rotator cuff has one big job, and that is to keep the arm bone in the center of the shoulder socket.
This single photo provides a nice summary of the shoulder construction. Notice how the arm sits on a small pivot point, like a golf ball sitting on a tee.
What you’re seeing is the position of the arm in the shoulder socket as it’s lifted overhead. The solid black line is a fresh shoulder, the dotted one is after a set of exercises to fatigue the rotator cuff.
The first point is at zero degrees, meaning the arm at the side. Even from the start, the ball is already riding a bit higher (not significantly higher though, so take that with a grain of salt.)
As the arm lifts away from the body, the ball does move upwards a bit. As the arm goes higher, when the rotator cuff is not fatigued it starts sliding down in the socket. That’s caused by the rotator cuff working to spin the ball in the socket.
But with a tired rotator cuff, the arm bone moves around in the socket.
Build Rotator Cuff Strength
Train your rotator cuff as it’s meant to work—as part of a bigger system of movement that pushes, pulls, and carries heavy things.
There are times to isolate specific rotator cuff muscles, and that’s when you would need to know those specific actions. But that’s usually for rehab clinics, or in cases when you have a big-time weakness that needs to be addressed.
If your goal is a strong and healthy body, there’s no better way to build rotator cuff strength than as part of a progressive strengthening plan.
In a study about rotator cuff training, a strength training program of pull-ups, overhead press, rows, and push-ups did much better than simple rotator cuff exercises (ref).
Not to mention, a much more effective way to tackle your fitness goals.
But that means adjusting your training some. If you want your rotator cuff to get the full effect as well as the prime movers, do the following:
Slow down your reps (not meaning super slow, but control the weight)
Use a full range of motion
Go for the free weights rather than machines
All of these things will require a decrease in weight but will help develop stability of the joint, which is essential to the strength and a lifetime of joint health.
Rotator Cuff Tuning
You may hear me saying …
Hit the weights (with balanced and progressive training program) and my cuff’s covered?
Well, not exactly…
That may get you strong, but you would also be one-dimensional.
The awesome thing about the shoulder is that is can move in a number of ways. For a complete shoulder program, it’s important to train the rotator cuff (and other shoulder muscles) to use all those movement patterns.
Which doesn’t happen with simple shoulder rotations with the arm at the side. Nor does it have to be any crazy shoulder exercise or tool either!
We’ve found that a simple progressive warm-up helps get the shoulder muscles coordinated and firing to optimize your shoulder movement.
Throw in the CS Activationprogram as part of your everyday warm-up routine— it’s a quick and effective way to tune up your rotator cuff.
(For elite performers—we do recommend more advanced stabilization drills and plyometrics for high-performance shoulders, to take things to the next level. We offer an Activation+ for that, but we recommend everyone starts with the basic CS Activation warm-up.)
Rotator Cuff Endurance
Lastly, challenge your rotator cuff endurance on occasion. Because as you remember from the fatigue experiment above— when the rotator cuff got tired, stability decreased.
So throw in 1-2 shoulder supersets (several exercises done without rest in-between) on the tail end of your training sessions to challenge your muscular endurance a bit.
If the loads are too heavy, or your form falls apart, you’re asking for a beat-up shoulder. But that’s not to say don’t challenge yourself a bit.
The key here is to bend, but not break.
Keep the volume at a moderate level, and the weights on the lighter end.
I’m a bit biased, but cruising through the CS Strength Program once or twice, is a nice challenge to build rotator cuff strength, without overdoing it.
In Summary
You cannot build a strong shoulder without a rotator cuff to support it. But that doesn’t mean you need to isolate each specific rotator cuff muscle to push your gains.
There are far more effective ways to get it done!
To build rotator cuff strength, 80% will come from properly progressing and balancing the pushes and pulls in your strength training plan.
The rest of it will come from a daily dynamic warm-up that uses your shoulder through many planes of motion. And for good measure, throw in a shoulder burner twice a week to build muscular endurance. This will do far more to build rotator cuff strength than the typical shoulder rehab type exercises.
Hopefully, you’ve got enough info to start doing more for your rotator cuff. If you’re still unsure then pick up a Crossover Symmetry System, we’ll lay out everything you need to know about training your shoulders.
Either way, it’s time to start doing rotator cuff exercises differently. Not dinky shoulder rotations, but making decisions in your workout plan that will help improve your smaller (but very important) muscle groups, along with the big ones.
Performance Based System
Crossover Symmetry is the smartest path to shoulder health and performance. In less than 5 minutes a day, you can prevent many injuries by enhancing the balance and function of the rotator cuff and scapular stabilizing muscles.
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https://crossoversymmetry.com/blogs/news/low-back-exercise-to-fix-pain-and-stiffness2019-03-15T02:00:00-04:002021-03-18T09:15:51-04:00Low Back Exercise to Fix Pain and StiffnessArctic Grey, Ltd.
A core training plan usually passes over the lower back exercises. Just mention the word “core” and everyone gets stuck on six-pack abs.
But if you really want a strong core, you’ve got to hit all the muscles— both big and small—that move and stabilize the spine.
Look at the core on a larger scale, we all know a tight midline is good for moving heavy weights, and transfers power, for things like hitting a softball.
But take a closer look at the core muscles, and you will find many small muscles that work on a smaller scale.
For the low back, many muscles connect each vertebra of the spine together. Those muscles control the smaller movements that occur at each segment of the spine.
If you neglect these little muscles for too long they get cranky.
As their strength and coordination decreases, it can lead to muscle spasms, which cause stiffness and pain.
Free Up Your Spine
So make sure you give your entire core some love and incorporate a low back exercise into your training plan.
This variation of the glute bridge doesn’t just build buns of steel, but also adds in a low back exercise as well.
In the video, you will see the focus on controlling each vertebra at a time. This is surprisingly much more difficult than it looks.
At first, your low back will probably lift and lower as a single unit. But with practice, you will find the intrinsic control to move each vertebra, one at a time.
As your segmental stabilizers get stronger and accustomed to movement, you will move less like the tin man. This is a huge help for the most common types of low back pain.
For more about core strength, and other lower body hang-ups, be sure to check out Glute
and Core Guide.
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https://crossoversymmetry.com/blogs/news/shoulder-pain-rehab2019-03-01T08:30:00-05:002022-08-18T14:38:26-04:00What You Need to Know About Shoulder Pain RehabMatt Unthank
Take some time to get to know your shoulder.
With a general understanding you’ll be ready to dive deeper into why it hurts and ways to fix it.
Shoulder Anatomy– “The Framework”
First, get to know the bones of your shoulder. They are the scaffolding that supports the entire structure, similar to a wood frame for a house.
The spine and rib cage create the shoulder foundation.. While technically these structures are not the shoulder, they do add a ton to its structure and movement.
You can easily feel the impact that the spine has on your shoulders by slumping your chest forward as far as you possibly can and then lifting your arms as high as you can overhead. You’ll notice that they get stuck earlier versus sitting tall with the chest up and spine extended.
The same goes with rotation. Look over your shoulder and try to reach something you see without turning your shoulders. You’ll have much greater success with the range of motion achieved by rotating your spine.
Thus, you need your spine to extend, bend, and rotate to accomplish the many different movement tasks demanded of the shoulders. This becomes especially important in sports and workouts that require greater speeds and heavy loads.
The big take-home is that often the shoulder relies on the body's posture to put it in a position to work most effectively. But for the classic shoulder bones, it comes down to three that make up the joint.
1. The Clavicle
Next on the list of supportive bones is the clavicle.
This creates a support beam to the shoulder and is the one bony attachment of the shoulder complex to the frame of the body.
2. The Scapula
Next is the scapula, also known as the shoulder blade, or sometimes called the scap.
The scapula hangs off the end of the clavicle and against the rib cage, held in place by 17 different muscles. Those muscles act as guide-wires, pulling the shoulder blade into various positions.
On the outer corner of the triangle is the insertion point for the arm bone and what most consider their shoulder socket.
Before moving onward, move your shoulder blade around a bit. Notice how the arm moves along with it. The term used to describe how the scapula and arm move together is scapulo-humeral rhythm. The key word rhythm describes the movement of two things in synchrony.
This is all too important for the shoulder. The scapula and arm must work together as a team, otherwise, it’s just a half working shoulder. What I’m getting at, is your fix for shoulder pain, or building arm strength, must include the muscles that move the scapula as well.
3. The Humerus
And finally, we’re at the true shoulder, and where most locate their pain. The arm bone (or humerus) attaches to the shoulder socket via a ball, hence the phrase ball and socket joint.
However, the ball of the arm bone is much larger than the socket, often described as a golf ball sitting on a tee. The advantage of this is movement! The shoulder isn’t bound up but can move freely in many different directions.
The Shoulder Trade-Off
In summary, the shoulder is highly capable of movement.
It can go fast, for things like throwing, or it can exert force in many ways for things like lifting weights or carrying bags of dog food, or it can be very precise to catch something tossed your way.
Compared to the hip, it’s much less clunky. Free to wave around like those tube dancers that jive in front of used car lots.
As with anything, though, there is a trade-off. And despite the luxury to move in so many ways, it brings about a problem of holding it all together, and actually where many problems creep in for the shoulder.
Holding it Together
The bones of the shoulder are held together by a combination of tissues that are classified as either static or dynamic stabilizers. What I like to describe as tape and rubber bands.
The tape describes the static stabilizers. Things that don’t move and aren’t all that stretchy. They do a good job of holding things in place. The most talked-about static stabilizers are the ligaments and the labrum of the shoulder.
We won’t talk much about the static stabilizers other than you can’t do much to change them and they don’t repair themselves. So when things go wrong, you’ll need to focus on the things that you can change (i.e.- the rubber bands.)
The rubber bands are the dynamic stabilizers that are muscles and their tendon attachments. They hold things together, but also lengthen and shorten to make the arm move.
The dynamic stabilizers can be strengthened and trained to improve their function, and are the primary target of a rehab program.
Therapy & Movement of the Shoulder
In an era of limitless information on the internet, it is easy to get sucked down a rabbit hole looking at all the structures that could be contributing to your shoulder pain. Pretty soon you might feel overwhelmed with all the areas to stretch, strengthen, mobilize and get treated by any number of “professionals”. The process can be exhausting, confusing, and even scary at times.
But like most things—You can’t believe everything you read on the internet.
Healing is largely a natural process that the body is designed to do without needing the perfect prescription of exercises. For most conditions, the pain will go away if you stop irritating it.
The thing is, if you appropriately screen all the red flags, strength and mobility are likely to take care of 90% of basic shoulder pain issues. It is really that simple. Give your body the opportunity to heal and work on mobility and strength— your body will take care of the rest.
We are going to show you how to do this on your own as a self rehab program, but first take a look at the different ways the shoulder moves.
Small Movements
Now let’s break this all down a bit more. Have you ever noticed even if you have a “shoulder issue” that some movements are actually just fine?
Small movements that mainly occur below shoulder height like picking up your cup of coffee, or typing at your desk feel ok but bigger movements like reaching up overhead seem to set your shoulder off a bit more? This gives a lot of information into what might be going wrong.
When making a small movement when your arm is close to your body it mainly happens by the ball of the arm moving in the socket. These actions rely on the four smaller shoulder muscles around the joint called the rotator cuff.
Big Movements
Now things get a bit more complex. As movements progress away from the body or overhead, it requires more moving pieces.
For things like washing your hair, reaching into the backseat of the car, or opening the overhead bin on an airplane, only so much can happen with the ball moving around the socket. To achieve the extra range of motion, the scapula needs to move simultaneously and in sync with the arm to free up additional ranges of motion and your rotator cuff has to keep the ball in the socket.
In order for your arm to create these bigger movements your shoulder blades need to move and create a foundation to support the load. Several muscles pull from opposing sides to pivot the scap for this action to happen. Moving the scap aligns the shoulder blade with the elevating arm bone and creates a stable support structure for the arm.
So not only do you need your shoulder blade to move well (while being stable) you also need the rotator cuff to be working in different directions. So big movements create more complex needs from our bodies.
Another reason to explain why sometimes small movements feel OK but big movements when your arm is up and out can be more painful or take longer to heal—it is a combined movement that needs a few layers of strength and stability.
Even Bigger Movements
What about moving heavy weight, pull-ups, and throwing fastballs?
Everything we've mentioned so far creates a foundation of strength, function and control for adding the additional pieces needed for high-performance. If you have proper synergy of the scapula moving through a full range of motion, and the rotator cuff effectively keeps the ball in the socket, the rest relies on proper form and strength of the prime movers.
Those are the workhorses responsible for strength and power. These are the muscles we hit in the gym—things like the pecs, deltoids, and lats.
Summing it Up
Working the remote or eating cheeseburgers doesn’t require too much from the shoulder. If this is your only goal, there probably isn’t much reason to worry. But to have an active life, as you can see, there are lots of working pieces that need to be strong and coordinated.
So when pain pops up, it’s usually because your strength or mobility isn’t meeting the demands. Future articles in this series will apply this understanding of shoulder anatomy and movement to explain the many shoulder breakdowns, how pain flares up, and put you on a path to fix it.
But before you begin, take the Red Flag Shoulder Screen to check for more complicated issues that need to be addressed by a medical professional.
Once you confirm that you’re all set for self-rehab, you can learn more about the different shoulder pain issues, or jump straight to one if you already have a diagnosis.
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https://crossoversymmetry.com/blogs/news/how-to-fix-your-tight-and-painful-upper-traps2019-01-19T17:30:00-05:002022-08-18T14:32:16-04:00Fix Your Tight and Painful Neck and ShouldersArctic Grey, Ltd.
We get comments like this all the time…
"There are always knots in my traps"
or…
"My traps are super tight, and I cannot stretch them enough"
Along with these complaints, there's also stacks of research implicating the upper traps as the driving force behind shoulder pain.
But we should stop thinking of the upper ‘Trap' as a four letter word.
It's not the bad guy in the relationship… It's just misunderstood!
This article will shine some light on this common complaint, and give you a better plan to fix the issue.
First…What is the Trapezius?
The trapezius has 3 distinct groups of muscle fibers that align in different directions. This divides it into upper, middle, and lower sections.
Based on their origin, insertion, and fiber orientation, when working alone (no muscle ever works in isolation, but muscles do play more dominant roles) each section plays a different responsibility in stabilizing and moving the scapula. Considering individual muscle actions:
The Upper Trapezius elevates the scapula, which creates a shrugging motion.
The Middle Trapezius retracts the scapula, or squeezes the shoulders blades together.
The Lower Trapezius depresses the scapula, which pulls is the scapula down.
But often left unrecognized, is how trapezius works synergistically with other muscles to produce more complex movement patterns. For the trapezius, it's got an important role in rotating the scapula upwards. Essential to any action that requires lifting the arm.
See below how the upper trap, lower trap, and serratus anterior work together to pivot the scapula. This is important to maintain space within the shoulder joint (i.e.-avoid impingement), but also create a stable position for the arm.
Related to this balance, the upper trap is often blamed for overpowering the balance of the other shoulder stabilizers (ref, ref), which leads to shoulder pain and faulty movement of the scapula—a condition called scap dyskinesis.
Dealing with Pain and Stiffness
Pain and stiffness of the upper trap is a common complaint, often paired with high stress and long work hours.
Notice that any mall or airport these days has a booth staffed with massage therapists ready to work on those tight trap pain points.
The underlying issues behind this pain and stiffness is diverse, not to mention complex and controversial, which we will almost certainly tackle in future articles. But for now understand that the unpleasant sensations are perceptions.
They're formed by messages traveling to the brain from the body, which the brain then translates into feelings of discomfort, tightness, or pain.
Techniques such as massage, foam rolling, and stretching can effectively alter those perceptions. Which is a good thing, because it often means relief from nagging discomfort.
However, these are usually temporary changes, that don't necessarily address the stimulus—leaving pain to return once again later on.
The point being, if you've had a long and stressful work week, find some relaxation with a massage. Or if you're feeling tight after a long flight, a massage ball may be useful.
But if these are regularly scheduled things to deal with chronic pain and tightness, you're barking up the wrong tree.
It's time to look at the underlying causes to the recurrent problem.
Carrying the Load
The usual suspect for the faulty upper trap is the everyday desk posture, which can mean that can be either shortened or lengthened for hours at a time. Or heavy workouts can make the traps knotted and sore, especially if they include an overload of heavy pulling exercises.
While correcting posture and workloads can lessen the symptoms, there are bigger and often unaddressed things underlying the issue….
That is the the upper trap has a weak supporting cast.
As discussed earlier, the action of the upper trap combines with the serratus anterior and lower trapezius to create upward rotation of the scapula.
The serratus anterior and lower trapezius are notoriously weak and lack proper neuromuscular control. With these muscle groups underperforming, something has to step in to carry the load. That is the upper trapezius, which must overwork to makeup for the inability to create upward rotation.
So rather than continuing to hammering the upper trap with mobility, try working on building a better movement system. A system where muscles effectively move together, contracting and lengthening in coordination with each other. Specifically for the upper trap, this means improving the balance for upward rotation of the scapula.
How to Create Better Balance
When working with people on Crossover Symmetry, there's often the tendency to shrug with many of the exercises. That's because the upper trapezius is doing what it's been told to do… carry the load.
The first step is recognizing that it's happening. Pause at the end of the movements, check into your position, and relax the shoulders down. At first it feels awkward or even impossible, but overtime the need to reposition will lessen. And with work, strength and motor control will improve and shrugging will be easier to recognize and correct.
In this Crossover Tipwe show some some easy correctives for the shrug when using Crossover Symmetry.
But if you continue to struggle with the shrug, or find yourself in discomfort without your Crossover System on hand to fix it, here are some additional correctives to try out…
(Notes: For the Thoracic Flexion & Extension exercise work on the movement of the scapula around the rib cage).
(Notes: For the Prone Sphinx, when reaching the scapula should rotate around the body, moving under the armpit.)
(Notes: For the L-Sit, keep the sets short, but the intensity high. Drive the shoulder blades down and around the body. Rest when you feel shoulders lifting up into the ears.)
The Upper Trap Fix
So next time you feel like your upper traps are tight, skip the stretching and give them a dose of movement.
Doing things like Crossover Symmetry will work the muscles that both oppose and complement the the upper trap, which will create feedback to the whole shoulder complex to be more active where it's needed, and to relax where it's not.
And over time this new found strength and balance will lend itself to better shoulder function and the elimination of tight traps. But stop trying to stretch the problem away! The 30 Day Shoulder Fix and get you on the path to less painful shoulders.
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https://crossoversymmetry.com/blogs/news/the-approach-to-shoulder-pain2019-01-11T07:30:00-05:002022-09-07T16:28:15-04:00The Approach to Shoulder PainArctic Grey, Ltd.
"Improvise, adapt, and overcome…"
The unofficial mantra of the United States Marine Corps and an important mindset for anyone looking to overcome an obstacle….and certainly applicable to getting past pain and injury.
Let's dive into an understanding of what's needed to overcome a shoulder problem, specifically when surgery is not an option, or the last resort.
The Initial Step to Healing
It shouldn't be a surprise that continuing to hammer the same painful movements is not an effective solution for pain.
Therefore, the fundamental first step is to deload the painful tissue…best known as rest!
Although rest by itself actually a poor solution to pain!
That's because it doesn't support the most difficult part of the healing process— fighting the urge to return to max effort as soon as possible.
There's not an athlete in the world who wants to sit back while their injury heals! Watching their hard work and effort go to waste! Any effective shoulder fix must address this and get away from the mindset of rest.
Instead create compensations to maintain activity levels.
These things keep performance moving forward, while lessening the engagement of painful tissues. This facilitates both physical and psychological success to get past the shoulder pain.
Examples of compensations are:
Movement modifications,
Taping techniques,
Avoiding specific painful stimuli and positions,
and workload modifications
For more information on this, take a look at ourshoulder scaling guide. It provides many effective ways to train the shoulder despite injury limitations.
Creating a Cure
As much we would like to profess to the magical band powers of Crossover Symmetry, healing is largely a natural process.
Demonstrated in a 2004 study in the Journal of Shoulder & Elbow Surgery (ref), which showed wearing a brace with activity modification was as effective as many weekly physical therapy sessions for treating shoulder impingement syndrome.
Despite this evidence, sitting back with a brace is far from the most effective healing plan. It does not address the strength, mobility, and coordination problems that may have led to the original injury.
Another look at the previous research reveals a short term study only considering pain levels, and not return to function, recurrence rates, or life satisfaction.
Thus, the next consideration for healing is remediation— derived from the latin word remediare, meaning to heal or cure.
Remediation first addresses impairments underlying shoulder issues. Correcting things like poor cuff strength, scapula control, and thoracic mobility creates a better environment for healing to happen and is essential to preventing pain from returning.
Remediation also involves gradually introducing load to painful tissue in a controlled manner. This builds the capacity to withstand the previous activity demands, beneficial to both meeting performance goals and avoiding shoulder pain recurrence.
Even structures that do not heal (e.g.-labrum, some rotator cuff tears, ligament tears) can return to full capacity through remediation. By improving strength and dynamic control of the shoulder, it removes loads and stress on the damaged area.
Many athletes can cover up their issues and continue to perform at high level despite permanent structural changes. For example, research shows up to 80% of major league baseball players continue to compete with a torn labrum (ref).
To further support this, we've seen many Crossover Symmetry users cancel their surgery and remain pain-free, despite things like rotator cuff and labrum tears.
Showing that a comprehensive plan of both compensation and remediation, known as relative rest, can alleviate most pain and keep a person moving towards their goals long term.
Healing Without A Cure
Unfortunately, some issues are beyond remediation and compensation.
A clear example would be a spinal cord injury, resulting in paralysis.
No amount of training can overcome this injury, yet adapting to the disability can restore life activities that bring joy and satisfaction.
Thus, despite a cure, adaptation is a form of healing.
Not all adaptive situations are this limiting or permanent either. For example, there are plenty of workarounds for dealing with an arthritic shoulder, or severe tendinosis which can take up to 9 months to completely resolve.
Ultimately it requires being smart with training and activities to continue pursuing goals. Whether it be adaptations around permanent limitations, or short term adaptations to stay invigorated while long term healing runs its course.
For example, it's very possible to be strong, athletic, and look great naked without doing squat snatches or muscle ups. You can go out and enjoy 18 holes of golf (and for most shoot the same score), without full swings off the tee box. And even for something as shoulder intensive as swimming, a great swimmer can be made by drilling mechanics, body position, and carefully prescribing volume.
If adapting or avoiding these movements is not an option for life enjoyment, it may be time for a surgical consult. No doubt there are situations when surgery is the best solution. It often has remarkable results that completely resolve pain and limitation.
Although surgery does have many drawbacks, it's not the solution for everyone, and should ultimately be the final approach. We get more in-depth on the decision making for surgery here: Important Considerations Before Going Under the Knife.
How to Approach Shoulder Pain
In dealing with shoulder pain, use the healing strategies outlined above.
Compensation- Find a Work Around
Remediation- Find a Cure
Adaptation- Find an Alternative
Start by creating a plan of relative rest, using a combination of compensation and remediation.
If you are following the Crossover Symmetry Shoulder Program, we help guide this in our training and education on the Training Zone.
Then after 30 days reevaluate how things have improved. If pain is gone or continuing to improve keep moving forward!
If things are not getting better, this will require some self analysis to understand what's most important to you. It may be time for more advanced medical procedures, or to create adaptations to satisfy activity cravings, without wrecking your shoulders in the process.
All the best on your road to recovery, however long that may be! And if you ever need help along the way, please reach out to us at support@crossoversymmetry.com.
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https://crossoversymmetry.com/blogs/news/why-runners-should-get-stronger2018-11-24T08:00:00-05:002024-01-22T18:17:26-05:00Enhance Your Running with The Crossover Symmetry Run Strong ProgramMatt Unthank
For many runners, strength training is a low priority, playing second fiddle to logging more miles and the occasional track workout.
But, to run fast (and pain-free), weightlifting should be a part of every runner’s game. I’m talking about the heavy stuff too! Not mall-walking with hand weights, but lifting weights where the 5th rep is hard.
Here are the reasons why strength training should be a part of every runner’s PR training plan…
How Strength Benefits Runners
VO2max—the measure of how much oxygen the body can take in and consume—is a classic performance metric for runners. It’s considered the gold standard for aerobic capacity and is linked to running performance. But, VO2max by itself never determines who will win a race. Many other factors are as important (if not more important) and don’t get talked about near as much.
1. Economy
This is the amount of energy needed to hold a given speed. Related to a vehicle, a car that gets 30-miles per gallon is more economical than one that only gets 20-miles per gallon. This is important for running, because the more economical runner, will have more firepower to go harder throughout the race.
The most significant impact on running economy is body type. East Africans dominate the distance running scene and believed to be due to their remarkable economy. Their smaller size and thin limbs require less energy to move them forward (ref).
But, there are also training components for building better economy. Specifically, training both heavily, and explosively, produces muscle and tendon adaptations. This improves the elastic components of the muscle, making the body more “springy.” A degree of springiness is good! It improves running economy by allowing the body to work less while going at a higher speed.
In a study of well-trained runners, an 8-week strength training program improved strength and running economy. But most important to the runners in this study was the 20% increase in time to exhaustion. Meaning they could go 20% longer when working at their max capacity (ref).
It’s important to note these runners didn’t put on any weight as part of the strength program, which is one of the biggest fears for many runners when it comes to strength training.
2. Power Output
Distance running isn’t considered a power sport. Yet, the ability to generate power, especially when fatigued, is important to running performance. Power output generates speed!
In fact, a muscle power test called vMART, appears to be a better predictor of running performance than VO2max (ref).
vMART is measured by 20 second runs with a 100-second recovery between the runs. The speed increases each round and goes until exhaustion. Having good aerobic capacity is helpful for this test, but equally as important is the ability to generate power under fatigue. A good vMART shows the ability to push faster speeds when the going gets tough.
Research proves that greater power improves speed without increasing cardiovascular demand (ref). And strength training is an important part of the equation to more powerful running.
3. Health
To this point, it’s been all about performance. But what about the runner who wants to log miles with their friends and show up for the occasional weekend race? Strength is important for this class of runners as well.
Strength is necessary for joint stability to protect the knees, hips, and back. Without adequate strength, the ligaments, tendons, and smaller support muscles take on the brunt of the load. This excess strain leads to pain and injury.
Despite thousands of calories burned, long runs backed by beer and burritos don’t build a body to impress.
Many assume strength training is about being big and bulky. A stereotype perpetuated by bodybuilding magazines, and scores of dudes showing up daily for bench and curls.
First, nutrition is most important to getting big (that goes for muscle or fat gain). With calorie intake in check, a few weight training sessions per week can provide muscle definition for those shirtless runs, without turning into the hulk.
Strength Program for Runners
Regardless of your goals, strength is the cornerstone of an active and healthy body. If properly structured, it doesn’t hinder running ability but instead boosts running performance (ref).
If you need help structuring a workout program that will help boost performance, then look no further than Run Strong. Run strong includes 2 workouts per week to build power, strength, and balance to improve performance and stay injury free.
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https://crossoversymmetry.com/blogs/news/end-your-pain-by-retraining-your-brain2017-07-12T17:00:00-04:002023-07-06T15:03:34-04:00How to End Your Pain by Retraining Your BrainMatt Unthank
Your shoulder doesn’t hurt for no good reason! The nervous system senses a problem and asks you to fix it.
Notice it's your nervous system asking for the change…not your body.
True pain is not something that occurs in the tissues. Rather it’s the summation of your environment and experiences in your past.
Yes, the past.
If something hurt you before, your nervous system will remember it and won’t readily grant you that movement. Or if something hurt your friend in the past, or if you heard a story that made you perceive something as dangerous, your brain will call upon that information under the right conditions to help ensure your safety.
Pain is your body’s way of saying this isn’t safe and something needs to change. So does this mean the pain is all in your head when you stub your toe?
Well…yes and no.
Nociception refers to the transmission of danger signals to the brain by free nerve endings called nociceptors. When they detect a noxious (translation: bad/unpleasant) stimulus, they send a danger signal to the spinal cord that is relayed to the brain.
To reiterate, they are not sending pain signals, nor are they pain receptors!
They are sending DANGER signals! The brain then weighs the danger signal and determines if it warrants a pain signal and how much of a pain signal. This pain signal in your brain changes your behavior to reduce the threat of the situation. It could mean taking your hand off the hot pan or lifting your foot off that sinister Lego piece.
Things get even more complex in conditions involving chronic pain states when no damage or nociception occurs. These cases prove the complexity of pain. They show that pain and tissue damage are neither synonymous nor necessitate the other. So you need to train your brain to get rid of the pain, and movement is a great way to do this.
The application of pain-free movement in the presence of acute or chronic pain helps mitigate and manage symptoms in both the tissues and the brain.
At the tissue level, movement aids circulation, improves mobility, and helps with joint and tissue health (only to name a few).
As it relates to the nervous system, movement lights up the brain and helps to create new neural pathways, pathways that are associated with movement patterns that are more efficient and are not accompanied by danger signals.
Thus movement is medicine, and as such, the dosage is critical.
The Crossover Symmetry shoulder pain prescription:
Use low to moderate resistance to provide a stimulus appropriate for the user’s current tissue and nervous system state.
Modify movements and resistance to recruit the appropriate muscles, decreases compensatory strategies, and activate patterns reflexively – all while allowing the nervous system to feel safe.
To quote Dr. Vilayanur Ramachandran,
Pain is the opinion of the brain.
Meaning your experience of pain is exactly that: an experience. To end your pain you must first change that experience from a negative to a positive one. Crossover Symmetry is the perfect agent to improve shoulder movement without pain, reducing the danger signals and changing your brain’s perception of the risk.
Dr. C. Shanté Cofield,is the creator of The Movement Maestro, a website and social-media-based platform devoted to all things human movement and mobility related. Shanté is a board-certified Orthopedic Clinical Specialist (OCS) who practices in Los Angeles, California, with specialties ranging from competitive fitness injuries to pelvic floor dysfunction. Shanté utilizes a movement-based treatment approach that incorporates manual therapy, NeuroKinetic Therapy (NKT), corrective exercises, and techniques such as kinesiology taping and instrument-assisted soft tissue mobilization. Additionally, Shanté is a Functional Range Conditioning mobility specialist (FRCms) and holds a CrossFit Level I trainer certificate.
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https://crossoversymmetry.com/blogs/news/how-coach-ben-bergeron-builds-elite-performers2017-02-18T16:00:00-05:002023-07-06T15:15:25-04:00How Coach Ben Bergeron Builds Elite PerformersMatt Unthank…So we showed up at CrossFit New England with a film crew ready to talk shoulder health and got way more than we expected….
We were there to grab a testimonial from Ben about his wife rehabbing her shoulder using Crossover Symmetry. But with a room full of professional and Olympic athletes, and world-class coaches, the conversation quickly switched to performance – and Ben did not disappoint.
Watch the video below to hear one of the best performance coaches discuss developing world-class athletes and what separates an elite performer from the rest. And you can learn more about CompTrain at https://www.comptrain.com/
We were expecting Ben to share secrets on exercises, programming, nutrition, and the other things he manipulates to gain an edge on the competition.
However, we were pleasantly surprised that he blew past the typical things we get caught up with and honed in on the details that are often overlooked or even looked down upon.
What distinguishes Ben and other elite coaches is the ability to get an athlete’s mind right. It is probably the most neglected aspect in training and competition prep, yet it has a huge impact in distancing, as Ben puts it, the super-elites from everybody else.
Another surprise was how willing Ben is to test a new approach or process. If you are stuck in a mentality that “this is how it is supposed to be done,” then you will quickly get passed up by people who are willing to innovate. This is true regarding equipment, training, recovery, or even things as small as the socks you wear….
We test them. If they don’t work, they go away… If it works, it stays.