Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, Knees Over Toes Course, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)
I remember coming out of physical therapy school and being so ready to tackle the world. I wanted to make a positive impact, the type that had encouraged me to go through so much schooling. It was working with a physical therapist when I injured both my shoulders from high level swimming that ignited my desire to become a therapist.
It wasn’t long into my career until the reality of working with patients taught me that I didn’t know as much as I thought and I wasn’t able to produce the results that I wanted to help people achieve.
Don’t get me wrong, I helped people, but I knew it could be so much better. I believe it was the great Shuri from the movie “Black Panther” that said, “just because something works doesn’t meant it can’t be improved.” That is the challenge for so many fitness professionals, strength coaches, and my fellow therapists, saying what we do “works” is never considered on a scale. Does it work as well as it should, as well as we want? What if we kept challenging the idea, “can we do it better?”
That is what led me to search for better methods. One of the people that got me thinking differently about how I treated the body was renown physical therapist, Gary Gray. There is so much I could say about Mr. Gray, but he did make me re-think the entire concept of training and treating the body. I wanted to take a few concepts that started with Mr. Gray and then grew as I learned more about the body into better ways of thinking about helping shoulders be healthier! These 3 key concepts should be foundational to any shoulder program.
PRINCIPLE: THE PELVIS, TRUNK, AND SCAPULA ALL TIE TOGETHER
When we tie in Mr. Gray’s work with that of Thomas Myers of “Anatomy Trains” we see that from a functional perspective, many of our shoulder exercises are OPPOSITE of what we should be doing. How do I mean?
How many times do we see people performing shoulder and scapular movements where there is little to no impact being made by the core and lower body? In fact, how many times do coaches deliberately take away the core and lower body by having clients lie on a bench or other apparatus to “isolate” the shoulder. Why is this such a mistake?
If we look at the connections that are found in an important system known as the “spiral line”, we see how flawed the idea of isolating the shoulder can really be in our efforts to build strong, mobile, and stable shoulders. “The spiral line loops around the body in two opposing helices, right and left, joining each side of the skull across the upper back to the opposite shoulder, and then around the ribs to the front to cross again at the level of the navel to the hip. From the hip, the Spiral Line passes like a ‘jump rope ’ along the anterolateral thigh and across the shin to the medial longitudinal arch, passing under the foot and running up the posterolateral side of the leg to the ischium and into the erector spinae myofascia (of either side, depending on posture or position) to end very close to where it started on the skull.” (1)
Bird Dog Progressions
How do we bring this science to life? Below are a few exercises that really tie in the lower body, core, and upper body in the manner we are designed to function.
You see how we can use science come to life and even make it better by using functional fitness tools that allow us to teach the concepts of better movement. Don’t see our training tools simply as a means of stressing the body, but being teachers to the body as much as our cuing is to their movement. Here is how we combine some great tools and movements to make these concepts so powerful.
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Adding a lunge emphasizes the connection of the hip to the core and upper body helping these strategies to be more effective.
PRINCIPLE: IN FUNCTIONALLY ANALYZING THE SHOULDER, WE WANT TO FOCUS ON ALL THREE PLANES AND AT BOTH ENDS OF ALL THREE PLANES
Whenever you read an article about shoulder training you typically see the first section reference the anatomy of the shoulder. You see muscles, tendons, ligaments, and joint structures, but what you rarely see or hear is how the body puts all of this together to produce motion. The shoulder should be a very mobile joint that should be able to move in all 3 planes of motion.
It is interesting that before gyms were mainstream, our understanding and appreciation of functional anatomy seemed better in many ways. You see, the 3 planes of motion means that the shoulder is made for circular motions like throwing. Yet, we train it typically in only up and down movements. That is why equipment like Indian clubs were popular in the early days of Physical Education classes. The purpose was to train circular patterns that were so natural and innate to the body.
While Indian clubs are fine to use, they don’t build a lot of strength with the mobility that we need. Often I see people use Indian clubs to warm-up their shoulders, but then their lifting is purely sagittal plane movement. One of the great things about what we do in DVRT is use tools and concepts that allow us to take these ideas and put them in very practical terms like you see below where we strength train, stabilize, and perform mobility all at once.
PRINCIPLE: FUNCTIONAL REHABILITATION OF THE SHOULDER REQUIRES THAT WE ALLOW EVERY PART OF OUR PATIENT ’S BODY TO BECOME SUCCESSFUL TO CONTRIBUTE TO THE SUCCESS OF THE SHOULDER
As I have been helping Josh return to training after his neck surgery, we have been using these principles to help solve the nerve damage that came with the spinal degeneration and surgery. Many times people don ’t know that the neck contributes to a lot of shoulder issues, but that is a topic for another time. Nerve damage in many ways can be more difficult than structural injuries because the nerves regenerate so slowly and we need coordination, stability, and strength all at once. That is why the exercises you may see Josh using for his shoulder don ’t look like what you might expect in your shoulder rehab.
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The way we have been able to restore function for Josh so fast is by thinking about the whole body contributing to his motion, not just his shoulders. That means again, everything from feet to hands. Not just putting him in positions where he has to use his whole body, but cuing it as well. From simple strategies like making sure he grips an implement tightly or the ground to giving feedback to using his feet. When we combine that with using important functional training ideas like diagonal patterns, we get some pretty powerful and unique shoulder exercises as you see me perform below.
My hope is the more you understand about the body, the faster and more significant the results you can achieve as well. NOTHING stops a well meaning training program like injury and exercise should NOT be a risk factor as Dr. Lee Burton says. Instead, our training should make us stronger, leaner, but also healthier and move better. I hope these training ideas show you how we can do it in fun and dynamic ways so you can enjoy not just the result of your training, but the journey as well.
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