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The Overhead Athlete: Are you loading them enough to return them to sport?!

8/17/2018

1 Comment

 
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When you hear overhead athlete what do you think about? Do you think baseball or tennis player? Do you think about the weightlifter? Crossfitter? What about basketball? 
 
You see, there is many different types of overhead athletes.  Yet, preparing these athletes can be both entirely different and also very similar.  Many don’t consider basketball an overhead sport but next time you watch a basketball game take a closer look at the players blocking, dunking, and rising up for a shot.  It is indeed an overhead sport.  Furthermore, one of the greatest players to ever play the game, Kobe Bryant, underwent rotator cuff surgery late in his career.  Again, just more evidence that the game of basketball is an overhead sport. 
 
So, what is it about the overhead athlete that is unique?  Well, other than the lack of return to sport tests for the upper extremity, gaining end range stability is absolutely crucial for preparing them for their sport.  Later in this article I am going to show you some of my favorite end range shoulder stability drills that I’ve had success with.  These are drills that can be used across all of the athletes mentioned above (within your clinical reasoning framework of course).  
 
First, let’s talk about screening the overhead athlete.  This step cannot be overlooked as this is the cornerstone to determine what our overhead athlete needs.  For those of your who are also strength coaches, this is part of our “Needs Analysis” phase.  There are a few must have screens for this part.  The standing shoulder flexion screen gives us an overall first look at movement quality.  Does the athlete have full range of motion? Is it smooth?  Does the athlete substitute with the lumbar spine or forward neck? Is their rib flare? Pain? From here we can break down the motion in supine with a lat screen if the movement is limited.     See the video below for an explanation on this. We can also look at subscapularis and pec minor tone and mobility here.

Once we’ve established a baseline of movement quality and possible restrictions there are a few key muscles to look at testing.  While I hate MMT’s, they serve a purpose at times.  Looking at serratus anterior strength is one I often look at with this population. I will also look at middle trap, low trap, and RTC strength.  Again, without some type of assessment it does not matter how “good” of an exercise it is or how “cool” it looks.  There’s a lot of great exercises out there but they might not be appropriate for YOUR athlete. Assess, don’t guess.

Now for the fun part. Once you’ve worked on ROM and basic strengthening you will want to start working on end range stability.  I often see this phase botched and it’s a disservice to our overhead athletes because ultimately, we do have to load them to prepare the tissues and shoulder for more intense activity and their sport/positional demands. See below for a short list of exercises I use.  For the complete list and progressions/regressions check out my full videos on our Insider Access page. 

My favorite OH exercises
  • KB Walk
  • Banded OH Flexion Wobbles
  • Banded OH Flexion
  • Wall Slides with band
  • Quadruped Swiss Ball against wall
  • Landmine Press
  • T-Bar Single Arm Snatch
  • Quadruped Reach Turn Lift (Low Trap)
  • ER 90/90 Keiser Walkouts

Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
IG: @brianschwabedpt
1 Comment
testmyspeed.onl/ link
3/29/2023 09:48:38 am

Our treatment techniques will only go so far if a patient continues to regularly assume abnormal posture and display parafunctional habits, such as nail biting.

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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test