Written by: Kevin Cann
In my last article I explained how our tight muscles are a defense mechanism to provide us stability when we have lost optimal control of joint movement. We find the instability, we correct it, and the tightness will go away.
Just smashing our tissues may help for temporary relief due to some increased blood flow, but we will have to continuously do this to get relief if we do not identify the instability. In order to identify the instability we need to have a thorough assessment performed by a professional that understands the human movement system.
One of our elite lifters here at Total Performance sports is a perfect example of what I am talking about. She has been experiencing lower back pain in the area of her QL and the top of her glutes in conjunction with some tightness in her mid-back that she feels is having a negative effect on her squats.
She had tried multiple things to loosen up her mid-back with no avail. She was performing a lot of soft tissue work that was just not helping the matter. The fact that she had tried this and it did not work makes my job a lot easier because I can write off smashing the tight tissue as a means to fix this issue. This is not an exact science and often times you try something only to realize that it did not work. This is why we are constantly assessing and re-assessing.
The first part of any assessment should be learning a little bit about the person and their lifestyle. I happen to be familiar with this individual so that helps quite a bit. She just finished law school and studying for the bar exam. She spent far more time sitting down with her face buried in a computer or book then she has in a very long time.
This is valuable to know because we all know the problems that prolonged sitting can cause. One of her other complaints was that she feels she cannot turn her glutes on. Sitting down all day long does have a tendency to send our glutes on vacation and it can also change the shape of our spine.
With that said, it is much too early to draw the conclusion that her issue with her glutes is from sitting down. All I have done is ask a few questions. I need to see her move around for me to make a better guess as to what her issue is.
I have a specific assessment that I use and it includes pieces of the FMS and SFMA. I assessed her cervical spine range of motion, single leg stance ability, her ability to touch her toes, her multi-segmental extension (backbend), shoulder internal and external rotation, as well as t-spine rotation while standing.
She moves pretty well for a 74kg lifter that deadlifts over 450lbs. I assessed her hip ROM as well as strength and compared the two sides. Nothing very telling yet.
We continued the assessment by checking her active straight leg raise, which was symmetrical and adequate. It got interesting from the next assessment. I checked her t-spine rotation in the quadruped position with her shoulder in external rotation. There was far less range of motion here than there was when she was standing.
What changed between the standing t-spine rotation test and the quadruped version? The quadruped version requires much more shoulder stability. She had adequate t-spine mobility with her arms in the most stable position, down by her side, but far less when we got into the quadruped position.
Remember what I had said earlier that all tightness is a loss of stability somewhere. If we cannot stabilize our shoulder joint appropriately our mid-back will tighten us around our shoulder blades to provide us with that stability so we do not get hurt.
I gave her a couple of exercises to see how this would help. The first is a twist on the classic windshield wiper exercise. She laid on her back and squeezed a foam roller between her thighs while her hips were flexed past 90 degrees. She held a kettlebell over her shoulder with her elbow locked and her shoulder stacked. Maintaining this shoulder position she rotated her knees to the opposite side of the hand holding the kettlebell. She touched the knees on the ground and returned to that start. It is key to breathe through this exercise.
After we performed a few of these she said that it felt a little better. From there I wanted to re-establish appropriate communication of our posterior oblique system. Rolling patterns are great for this however; I wanted to improve this function while forcing shoulder stabilization. We performed a few kettlebell armbars in each direction and the tightness went away.
Our job is not done at this point. These are minimally loaded exercises being performed while she is laying on her back. I want to see her perform some loaded movements as part of my assessment. I prefer to see the movement that causes the most pain.
I watched her squat and noticed that she loses her packed neck when she comes out of the hole. This can also lead to tightness in the mid-back. We want our cervical spine to be stable. If it is mobile through the squat we will lose mobility in our thoracic spine to give us that stability that we need.
Her lack of stability in both the shoulder and the neck are leading to tightness in the mid-back. In order for that tightness to go away we need to fix both scenarios. As she performs her exercises and works on keeping the chin tucked during the squat, the mid-back will be able to relax and go back to being more mobile. Once we have corrected the stability issues we can add in some soft tissue work to help offset the increased sitting that she has been experiencing on a day to day basis.
This is why having a thorough assessment is important. Often times people will just feel tight and rollout those tight tissues, feel better, and think everything is ok. Only to find that those muscles just tighten right back up. All tightness is a lack of stability somewhere. Find that instability, correct it, and your soft tissue work will be much more effective.