The Manual Therapist_ Q&A Time! Help With Rowers

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Q&A Time! Help with Rowers

Jodi Schneider, MS, ATC asked for help with this caseload.

Q: I see a lot of non-specific thoracic pain in rowers on average around T4-8, report painwith rotation, occurs mostly on inside (if you're not familiar with sweep rowing, the "in"side is the side they rotate to, so they're already predisposed to rotational issues). Mobilityis usually terrible in extension/ and bilateral rotation, MMT of lower trap/ rhomboidsusually extremely weak, and all are classic Upper Crossed Syndromes

I spend a lot of time trying to open up front of hips with soft tissue (IASTM, manual softtissue release), focusing on "in"side, psoas, superior quad, QL and paraspinals. Muscleenergy for any rib dysfunctions, and thoracic rotations if needed. To address Upper

Crossed syndrome, I also do soft tissue work to scalenes, pec minor, and follow that withdeep neck flexor activation and scapular retraction. Home program I send them away withincludes

-Hip flexor stretching maintaining neutral spine, with same side arm above head-Pec minor stretching and self soft tissue release with tennis ball-Chin tucks-Wall/ Foam roller angels-Side Lying T spine rotation or your open books

I have had good results once I started adding in a lot of hip/ anterior chain, but i have afew patients who just dont seem to respond to anything I throw at them and continue tohave pain. Rowing will always have thoracic issues due to the repetition, and the forcegenerated, but would love to hear any suggestions you have or how you would treat these

patients.

A: Thanks for reading Jodi! I will only focus on the things you may have missed, but I
http://farm4.staticflickr.com/3327/5717055376_f7a08d92a6_m.jpg


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start position for lumbar locked upper body rotation

end position for lumbar locked upper body thoracic rotation

start position for lumbar locked lower thoracic rotation
http://3.bp.blogspot.com/-taR7bftOy8o/T5WJJb-vBkI/AAAAAAAAqcQ/C6yKYkQYIPo/s1600/DSC00766.JPGhttp://4.bp.blogspot.com/-RQe9IspEoaI/T5WJK9wSkKI/AAAAAAAAqcY/fkkSNq4RrSo/s1600/DSC00767.JPGhttp://4.bp.blogspot.com/-gjWU-Pk4YsI/T5WJHgXOWAI/AAAAAAAAqcI/DADWJnqQ16s/s1600/DSC00765.JPG


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If the movement was limited in loaded, but not unloaded, or actively, but not passively,you do not have a mobility issue, you have a motor control/stability issue. Check rolling asin this videos.

Upper Body Supine to ProneUpper Body Prone to SupineLower Body Supine to Prone

Lower Body Prone to Supine , Thanks to SportsRehabExpert.com for great demonstrationsand form!

The significance here is that these movement patterns are from development. We should all be able to do these from a very early age, and indeed learn how to do them in the womb.You will be surprised how many even elite athletes lose the ability to roll in one direction.This is a movement pattern that only requires enough strength to move actively, it is not astrengthening exercise (but it sure feels like it!) The difficulty comes from sequencing themovement properly, firing the correct line of muscles in the proper sequence, and not

using your legs for upper body or assisting with your arms with the lower body rolling.

I would expect those that are not responding to your manual therapy and self care programhave a lack of thoracic motor control due to their over rotation in focusing more on onedirection. I would be fairly certain that many of them will have difficulty with upper bodyrolling in at least one direction, not cheating by using the legs (they should be deadweight). This movement may need to be broken down with wedges or foam rollers tomake it easier to get the movement down. Do not have them practice the incorrectmovement if they cannot do it right, that would just be enforcing poor movement patterns.

end position for lumbar locked lower thoracic rotation
http://2.bp.blogspot.com/-cwCW4VOpzoU/T5WJMoVYKTI/AAAAAAAAqcg/7jUAgpBgAZ0/s1600/DSC00768.JPGhttp://youtu.be/2UtgWCDfw4ohttp://youtu.be/luSuF64YSOEhttp://youtu.be/dpGAo7WfrDchttp://youtu.be/dqnR0EcW2YY


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If they are also mainly rotating to one side, their hips are most likely missing rotation to theother side, check for rotation actively and passively, and mobilize if both are limited. If only active is limited, but not passive, again we have a motor control issue that needs to beaddressed with corrective exercises. Let me know if you need examples of those.

I hope you find these suggestions useful and let me know how the rolling assessments

work out!
http://www.mylivesignature.com/

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The Manual Therapist_ Q&A Time! Help With Rowers