Having trouble with shoulder pain related to your rotator cuff? Once I’ve evaluated a patient and we’ve found some strength and range of motion deficits, this is a couplet I like to initiate for progression. I’ve phrased it to patients as this: If you look to establish rep maxes on squats and presses, it makes sense to progress your rotator cuff training to where you can find 5-10 rep maxes on certain exercises as well.  90/90 External Rotations with Arm on a Bench The key he

Plenty of runners come in for a running assessment and at some point, I like to get a quick picture of how they hop on a single leg, generally up to 30 seconds (or up to a minute, if we’re feeling sadistic). We focus on quality of hops as much as quantity: Are you keeping your heel from drastically dropping and hitting the ground, are you keeping your foot active up and down striking the floor? If having trouble with strength, focus on your calf raises. If it’s motor control

If the front rack position feels uncomfortable, unstable, or limited by your wrists and shoulders, the missing piece is often scapular protraction —the ability to actively reach the shoulders slightly forward while maintaining thoracic extension. What Is Scapular Protraction? Scapular protraction occurs when the shoulder blades move forward around the rib cage. In the front rack, this isn’t a relaxed “slouch,” but an active, controlled protraction  driven primarily by the ser

Lots of patients may see me for one problem or another but inevitably over their course of care they end up mentioning having a frequently stiff upper trapezius muscle or a cranky neck. After a basic exam, I tend to ask how have they tried to load up their neck and traps in the past. This is the point where they admit not having really any familiarity with heavier overhead pressing or lifting. I love this point in care because it’s an easy win for them to have some upper body

We often evaluate and treat runners who’ve been having to reduce mileage or stay out of running altogether for quite some time and thus have quite a bit of deconditioning and general lack of movement preparation on board. In addition to a sensible graded return to run program, I like to include certain hopping progressions for overall tissue preparedness and to increase loading in different planes for a patient population whose entire sport is largely based on moving forwards

For a lot of my runners coming in for physical therapy due to foot pain, calf weakness, knee pain, etc., we end up loading the ever-loving heck out of their calves. Does that mean that all their pain is due to weak calves? No. Does performing strength training have good force production benefits when paired with doing their sport? Absolutely.  Enter: The Medially Wedged Calf Raise . I recently saw this variation on loading more medially in a calf raise but honestly forget if

Hip training has certainly become well accepted in the running and lifting community over the past several years, and it takes no convincing to have people include it in their routine (at least for a short time, that is). The main issue tends to be whether the dosage and style of exercises matches the person’s needs at the time. A common issue people “run into” is around the inner hip muscles, the adductors. Training the adductor muscles can feel a bit all or nothing, where p

We’ve been evaluating a lot of runners and Hyrox athletes in this busy marathon and Hyrox season, plus my regular CrossFit patients on a weekly basis. One common issue popping up is the feeling of stiff and achey hips and backs due to the higher volume training. Here are a few movements I’ve been playing around with to get the pelvis and hip musculature moving more accurately as opposed to the low back compensating for hip stiffness. Leg Tracing: Focus on keeping the pelvis a

Runners with anterior knee pain as they run may get stuck trying to return to running as they usually encounter two paths: traditional advice to rest, ice, and stretch, or 2) strengthen the legs with squats, glute and hamstring work. I vastly prefer the 2nd option if I had to pick, but let’s talk about a third choice.  Impact progressions make a big difference in preparation for running loads when properly dosed. Here’s a sample progression that can be done 2x/week while pair

Athletic pubalgia—commonly known as a sports hernia—is a frustrating and often misunderstood source of groin pain in athletes. Whether you're a soccer player, hockey player, runner, or weekend warrior, that deep, nagging discomfort in the lower abdomen or groin can sideline your training and impact performance. One key—but often overlooked—piece of the rehab puzzle? Hip strength. What Is Athletic Pubalgia? Athletic pubalgia is not a true hernia. Rather, it’s a soft tissue inj

Gone are the days of having to laboriously convince runners that jumping is helpful for running. Patients come in during marathon prep...

We commonly evaluate runners with ankle pain, history of ankle sprains, and issues further up in the knees and hips. Classic complaints...

Let’s dive into the differences in pain at the bone versus the tendon. Runners often assume tendon-based pain, but bone stress injuries...

An osteon is the functional unit of the bone. Osteons contain osteocytes, the cells basically responsible for managing bone activity....

When it comes to providing the best physical therapy for runners and patients, I rarely hear energy systems as being a target of the plan...

A common clinical pattern that I've been seeing recently has been some of my Crossfitters and weightlifters complaining of back pain up...

I commonly hear from patients on evaluation that they have a persistent hip tightness that only gets mild relief from the regular hip...

We commonly evaluate runners and lifters for knee pain that’s stopping them from squatting in the gym and from performing single leg...

In CrossFit, the front rack position is critical for many movements, including the front squat, clean, thruster, and overhead press....

Here at Zenith Performance Physical Therapy, we commonly evaluate patients with complaints of generally achy and beat up knees that are...