Developmental Movement: Hips & Shoulders

Ah it’s been so long since I’ve been able to write!  Taking a little time off to focus on my work has been good and inspirational.  So let’s start off this new wave of inspiration looking at how to sequence in really healthy movement!

In this post today we’ll take a look at how Internally Rotating (IR) the Hips and Externally rotating (ER) the Shoulders can help activate the whole Posterior Chain of your body!

As per usual we’ll discuss the anatomy and biomechanics behind the motions and then I’ll show you an exercise, called a Crossfire, towards the end which will power up your whole body!

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Fired up for healthy movement!


Developmental Movement: Hip IR and Shoulder ER

To truly understand how powerful these movements can be, we need to start by looking at when we just a bundle of cells developing in our mother’s womb.

from-embryo-and-fetus

In the course of about 4 weeks we go from 1 fertilized cell to a tiny bundle of cells with little buds for arms and legs.  These buds are called limb buds, and they continue to grow over the course of our gestation.

limb bud development

As you can see they start developing facing the Coronal plane (standard anatomic position) then as we gestate further twist and rotate.  The Shoulders develop in External Rotation (ER), the Hips develop in Internal Rotation (IR).

You can see now that when we start to move the Shoulders into ER and Hips into IR we begin to move them into their developmental or preferred pattern.

These motions will also activate the Posterior Chain kinetic chain of muscles along our back body.

post-chain-ant-trains.png

The muscles along the Posterior Chain help to keep our spine lifted and upright against gravity.  Development of this kinetic chain is responsible for how we developed the secondary spinal curves of the Cervical and Lumbar spine.

The Functional backline (shown as Figure b above) clearly displays the deeper fascial connections of the Shoulders and Hips.  This is the kinetic chain that you’ll soon feel fire up in the exercise that will soon follow.

But first, let’s talk a little bit more about Hip IR and Shoulder ER because these motions are very commonly lost and often need to be restored.

oh no panda

Dysfunctional Hips and Shoulders make me a sad panda


Restoring Range of Motion (ROM): Hip IR & Shoulder ER

Range of motion is largely controlled by the Brain and nervous system.  Your brain only cares about your survival in the present moment and when it feels a threat to your movement it will restrict and lock down joints so that you will not hurt yourself.

Professional Opinion Note: If you have persistent restrictions/tightness you should see a professional to find the root of what your brain is perceiving as a threat in your environment.  The question is: Why is my brain continuously locking this part of my body down?  Repeatedly stretching/rolling/massaging/adjusting/etc the same thing will not address the root problem and only help to fix the symptoms.

When I was an intern I attended a great Mulligan Mobilizations seminar.  The instructor detailed how:

  • The first ROM to become restricted at the Hips is IR
  • The first ROM to become restricted at the Shoulders is ER

When we restore range of motion, unlocking these two will often clear up other restricted ROMs for both the shoulder and hip.  (Ex:  If someone is restricted in Flexion of the Shoulder [cannot lift their arm very high when reaching forward and up], by first restoring ER of the shoulder it will unlock or help to unlock the restricted Flexion)

glasseswhat

What!?

Yea!  Most people will have their other ROM restrictions restored when you address IR of the Hip and ER of the shoulder first.  This is because it all boils back down to developmental movement.  The first movement these joints learned is their respected rotations.  It makes sense that when our brain perceives a threat those are the first motions to go!

Clinical side note on restoration of rotation: (Note: These are my clinical experiences and a vague outline of what I do in unlocking these motions)

  • For the Hips: releasing the TFL, Glute Med, & Hip Adductors then activating the Glutes and some IR range of motion mobility work (bands, AROM, PROM, etc)
  • For the Shoulders: Releasing the Coracobrachialis, activation of the Posterior Scapular stabilizers & Serratus Anterior plus some ER range of motion mobility work.
    • Your Coracobrachialis is a lesser known muscle that when shortened (which it normally is with rounded forward cashew posture) will limit ER of the shoulder.
      • Find the lower end of your middle deltoid (See below: along the upper part of your arm, right where it divots a little between the bicep and tricep).
      • Rub that spot with your fingers, it’s often very tender and is where the Coracobrachialis attaches to the arm.
      • coracobrachialis-14953F094EB5BE6D2D1.jpg

 

So now that our shoulders and hips are feeling restored and good, it’s time to activate them so that we can maintain this level of openness!

feels good dog.gif


The Crossfire:

Now for the practical application to all that new developmental knowloedge.  In this exercise we Externally rotate the shoulders and Internally rotate the hips.  You’ll notice it will fire up your whole Posterior Chain too!

Notes:

  • The Shoulder and the Hip have to initiate the movement.  It’s very easy to compensate by using the hands & feet, rather than focusing on the motion occurring at the shoulder/hip joint.
    • Instead of focusing on your hands and feet, think and experience the motion at your shoulder/hip joint.  Only go as far as these allow, instead of fully twisting your hands and feet.
  • Chunk it and separate the components!  This is really really hard to coordinate when you first attempt it.  (You may need a partner to watch and help you)
    1. Start with the shoulders: Twist your hands down via the shoulder joint (Repeat 4x)
    2. Work the Hips:  Bring your big toes towards each other (Repeat 4x)
    3. Shoulders and Hips:  Try both at the same time (as shown above)  (Repeat 4x)
  • Go Slow!  This movement is not intended to be fast.
    • Initiate the movement for a 4 count
    • Hold the end rage for a 4 count
    • Twist back to starting position for a 4 count
    • Rest before each rep for a 4 count

 

For me, the greatest difficulty was working on initiating the movement from my hips.  I needed help and some external tapping from a partner to get my hips to fire and initiate the movement.  A lot of people lack the proper prime mover awareness (initiation at the shoulder and hip joint) and when first trying this may require some external feedback, such as light and quick tapping of the muscles around the shoulder/hip that should be firing to initiate.

You’ll know you’ve done it right when you feel your whole back body, from your butt to your shoulders ignite at the end of the rotations.

spongebobripped

Do a couple reps of this exercise and you’ll feel pretty damn good & strong


 Practical Applications of today’s knowledge bombs:

  • The Crossfire is an excellent warm up exercise since it activates the Posterior Chain and warms up the shoulders/hips
  • In your warm up or in the beginning of your yoga classes sequence in Hip IR and Shoulder ER mobility work or poses to create a great optimal movement environment for your body/yogis

As I’m sure you felt, this is some great movement!  I try to do it everyday and my back as well as my shoulders/hips have been feeling really great since it’s implementation.  I also have good many of my patients do this before they leave my treatment table as a way to reintegrate restored range of motion from my adjustments/mobilizations.

Big thanks to Dr. Perry at Stop Chasing Pain for introducing this to me!

Final note: Even if your back/shoulders/hips/etc are feeling good everyone can benefit from a little back body activation!

For more about your Posterior Chain check out these:

 

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Until next time my friends,

Dr. YG

One thought on “Developmental Movement: Hips & Shoulders

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