Basketball is one of those sports that requires so much mobility and stability at some of the same joints.  Yet this is a sport that requires a lot of mobility at primarily three joints.  Here is an example of the basics I use for many of the basketball players I see....

​** The Big Three: Ankles, Hips, T-Spine **

• TFL/glute/psoas ball rollouts

• Hip Flexor Half Kneeling Stretch
  • With Overhead reach
  • With Twist

• T-Spine Foam Roller Extension (Pick 3 spots)
• T-Spine Rotation

• Adductor/groin stretch in flexion and extension of the hip

• Ankle Mobilization Matrix & Calf Stretch (in all 3 planes)

• Bretzel Stretch

 
-  Brian

I think that most of us can agree the squat is one of the more important fundamental movements in strength and conditioning.  Yet it is also one of the worst botched movements out there.  Many of the athletes who come to me have no idea how to squat properly yet have back squats in their programs.  This is a perfect recipe for injury. 

Lets recap on some of the things we will see that demonstrate poor squatting patterns: extensor tone, poor t-spine mobility, poor hip mobility, poor ankle DF mobility, quad dominant patterns, lumbar spine flexion (aka butt wink), forward head, knee valgus, foot pronation, and more.  This is where re-teaching the fundamentals can be very important.  Once you've worked on all the mobility issues and basic strength progressions you need to see what your patient presents as.  If they have a tendency to be in a high threshold pattern or very extended then a barbell back squat is a poor choice.  Instead, starting them with a squat from the bottom position is better.  Progressing that to a KB or DB goblet squat can further help balance front to back.  Only then if their squat pattern has improved can you progress them to a barbell back squat.  If it hasn't then continue to work on what needs to be fixed to get them there and opt for a front squat or if you have access to a safety bar you can use that.  Furthermore, sometimes getting people into a trap bar and using a squatting pattern can be beneficial.  The point is, read your athletes position and determine if they are appropriate for the squat you prescribe for them.  

​- Brian

As someone who has suffered from multiple hamstring strains I've done quite a bit of reading and research on this topic.  And while this topic is not going to be all inclusive in today's post, I am going to introduce you to a great video.  In the below video Matt talks about how to perform a motor control exercise for the hips.  What I love about this exercise is that you are working on hip stability on one side and mobility on the other.  

We often think about single leg control but don't alway recognize it with our motor control prescriptions.  A sprinter is a perfect example of someone who must have the proper balance of mobility and stability in each hip.  However, its not just the hip that plays a large role in this exercise.  It's the core muscles and the diaphragm that plays a role.  Both of those components are vital for this exercise to be a benefit.  For those of you without a band, I would encourage you to use the opening of a door.  

- Brian

I recently read an article on how cueing and coaching play a vital role in how athletes respond to you.  I couldn't agree more.  But I want to take that a step further by adding that your attitude and demeanor play a larger role.  What I mean by that is your ability to respond to the situation and athlete is more important.  Every athlete's needs and psychological state is different and to be able to gain their trust you must be able to read them.  

For example, take a minor league baseball player that has some rotator cuff tendinopathy but wants to get to the big leagues.  Many of these guys are barely making ends meet trying to get to the majors and keep their dream alive.  As a medical professional you have an obligation to try to help them get there.  It's about trust with your athletes.  They need to be able to trust that you have their best interest at heart.  For some, it will be as easy as educating them.  For others you will have to show them day in and day out that you care.  

Another thing you will have to understand is that they have a certain way of doing things.  Many times if you are a new clinician in their lives they are going to be reluctant to change.  Thats okay.  It's your job to figure out if what they are doing is absolutely putting them at risk or if it's just not perfectly optimal.  Trying to force change is surely a way to get them to not trust you.  Many times when that is the case you can let their team (or agent, or front office) know this so that your communication is on point.  You may be able to change their way of doing things over time but don't try to force things.  

Coaching and cueing is definitely important when dealing with your athletes.  Don't forget that your attitude and demeanor play a larger role.  Read each athlete and understand what drives them and what THEY want.  You may not always agree with them but you can't help them if they don't trust you.  

​- Brian

Why is it important to study biomechanics of different sports?  Simple, to train them the right way.  If you don't know what your end goal is then its hard to create a great program.  Understanding how one pitches or hits can be crucial to their program.  For baseball its quite easy, the pitch is one of the most studied movement out there.  Check out this guest post on Eric Cressey's website for Albert Pujols swing biomechanics for an impressive read.

Brian was recently featured in an article talking about soft tissue mobility and the importance of distinguishing stretching benefits and soft tissue mobility benefits.  Check it out!

http://blog.paleohacks.com/why-stretching-isnt-helping/

Really great video on sleeping positions below by Kelly.  Sleeping positions is one of the first things I ask with my cervical and shoulder patients because it often plays a role.  Furthermore, just by adjusting a sleeping position can help a patient get temporary relief to get more out of therapy.  Kelly does a good job explaining sleeping positions and correctives with the first rib which can often be a culprit of poor sleeping and poor posture.

In everyday practice it is easy to forget how important mobility in all three planes of motion can be.  Even so, its common among rehab professionals to forget about how important this is to our athletic population.  Too often we hang out in the sagittal plane and mobilize without considering other planes of motion.  Yet our players rarely ever stay in one plane of motion. 

So how do we make this easy?  What can we do to help create triplanar mobility exercises?  Arm drivers.   Using arm and trunk movements can create those other two planes of motion quickly.  So how do you do this?  Lets take a basic half kneeling hip flexor stretch for example.  The key components to this stretch are to keep the core engaged (decreasing lumbar lordosis) and involved glute contracted (back leg).  This on it's own could be a good stretch.  But now lets add another plane of motion.  Lets have the involved side arm reach overhead while holding that stretch (see picture).  Another way to gain planes of motion is trunk twist.  Both of these ways helps the mobility exercise add components. 

Now that you have an example of how to add planes of motion to your mobility exercises, I encourage you to play around with different drivers to gain planes of motion.   


- Brian

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