Consistency is the key

The importance of repeatability cannot be overstated. When you appraise someones ability to perform a particular exercise or movement it is absolutely imperative that your set up positions for testing are the same each time.

If you watch someones overhead squat and the first time you check their technique you cue them to have their toes straight forward; they struggle down, get halfway through and  their hands come forward and knees collapse inward, then when you re-test them after some intervention and their feet are turned out 5-10degrees and they dramatically improve, you cannot compare the two squats.

These three are all examples of unloaded overhead squats, but they are all very different mechanically, and place very different movement requirements on the body.

Overhead Squat? yes, but narrow stance and straight feet

Overhead Squat? yes, wide stance, wide grip (not good form)

Overhead Squat? yes again, but feet turned out this time. 

The difference between feet straight and feet 10degrees turned out, changes the entire assessment. Slightly externally rotating the feet, changes the position of hip to enable easier internal rotation, it brings the adductors into a position where they can act as a hip extensor (as opposed to adductor), it changes the strategy required at the ankle to allowing the arch to collapse slightly and fascial tension to change. All of these as result of slightly turning out the feet!

Thomas Myers (anatomy trains)
is definitely onto something.

The body needs to be thought of as an interconnected web of tissue, whereby an action in the toes can impact on the stability or mobility of the low back, a slight change of knee position could be implicated in the stability of the shoulder or neck. If your focus is too narrow when looking at the way you or your client moves you will get stuck trying to address limitations that might be caused by something in a different region all together. Conversely if you go too broad and don't approach your movement appraisal in a systematic way to ensure that each time you appraise something you do it exactly the same way, you will never actually know if what you are doing is working.

It is understandable that as clinician, trainer or coach we want to show our clients that what we are doing is helping them improve. However, if you are re-testing your client or even yourself and you are allowing modified positions from test to test, you will never know if the corrective exercises or training strategies you are using are working or not. You are only cheating yourself and your client, and eventually you or your client will pay a price either through injury or limitations in performance.

So, make sure you use objective measures and use a systematic approach to technique/movement appraisal. Whether you use Gray Cooks' Functional Movement Screen or another movement assessment standard it doesn't really matter just make sure your test re-test approach is clear and repeatable.

Getting it overhead - with a twist

Our shoulders get an absolute beating over our lifetime, in fact studies have found that 28% of people under the age of 60 with asymptomatic shoulders (without pain) had evidence of rotator cuff damage and 54% for those over 60years (1), and these are the lucky ones…without pain.

I think most people have an appreciation for the functional need to be strong overhead across the lifespan, crossfitters and olympic lifters in particular, place an enormous emphasis on the capacity to take weight from the ground and put it overhead, and rightly so. However, the last thing we want happening in our quest for increase performance, health and independence is injuries.

YES.

The loading of overhead lifts such as strict presses, clean and jerk, snatch, push press, crossfit style kettlebell swings etc. is fantastic full body strengthening if you are able to achieve the optimal body position to allow the shoulder to be stable and packed, doing the least amount of work as possible. Unfortunately not all of us using these lifts are getting there.

To get into this optimal position the shoulder needs some help from the thoracic spine (T-spine), or the upper back. The best way to take some load off your shoulders is to ensure you have good thoracic spine (T-Spine) mobility primarily the ability to extend and rotate. If you are in a rounded position with your  T-Spine, you place the shoulder joint in a forward position blocking it from using its full range. Other than looking crap from the side there are a couple of important issues with this position:

1. It can result in subacromial jamming, causing you to mash the tissues between your humeral head (top of the upper arm) and the acromion (boney structure at the point of your shoulder) = tears/ inflammation/ pain.

2. It requires you to arch you low back (lumbar spine) to make up for the lack of range at the shoulder/T-Spine = potential for low back aggravation/pain.

3. Your head position will move forward causing a pokey chin posture = increased susceptibility to neck problems/pain.  

Don't be that guy

Because of the oblique angle of the facet joints in your T-spine you can add a great deal of extension range by improving your rotation. So try this t-spine rotation exercise to improve your overhead position and save those shoulders:

Start.

Middle: Pause at end of each exhalation, inhale and rotate some more

Finish: After three breaths/rotations reach the arm. Pause and return to the start

 Key Points:

1. Make sure you support the top leg with a pillow or foam roller
2. Take a deep breath in, exhale and rotate stop when you run out of air, pause, take another deep breath and repeat.
3. Drive the rotation by turning your head
4.Try to relax your lower body completely
5. The upper leg must be at or above 90degree at the hip


The aim is to have both shoulder relaxed and flat on the floor.
Repeat 3-4times each side.


References:
1. Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77:10-15