F.I.S.T Part 10: Integrated Hip-Core-Shoulder Exercises with Spinal Stabilization

Welcome back for yet another article on the topic of integrated hip-core-shoulder exercises. We have covered total body movement patterns that have biased the sagittal and frontal planes, and now will move onto training within the neglected transverse (rotational) plane. In regards to the body or the human movement system, a very old and wise saying has never been so true. “If you don’t use it, you’ll lose it.” If we fail to move the hips, torso, and shoulder girdle through the transverse plane on a regular basis, we will progressively lose the ability to efficiently rotate. Rotational movement in this regard could consist of; standing integrated stretching, standing dynamic range of motion exercises, standing functional integrated strength training, sporting activities, and dynamic activities of daily living.

Gravity is constantly pulling us forward and trying to collapse our movement system. If we take a hard look at most individuals as they age, it is very clear that gravity is winning the battle. It is very sad to see much of the older adult population walking with a significant collapsed posture and laboring just to move with ease. If you closely observe the gait pattern of someone described above, it is very evident that they cannot take advantage of transverse plane movement. A runway model would give us a clear picture of the exact opposite gait pattern, which takes full advantage and even over emphasizes transverse plane motion. I believe that as we get older, we just have to train smarter and be proactive to keep walking with some spring in our step and power behind our golf swing. Remember this is a battle, our body’s powerful anterior muscles are predisposed to get shorter due to the gravitational pull and loss of some muscle elasticity as a natural result of aging. We can fight this battle by not giving into gravity and becoming more aware of ideal posture at all times. We can also be proactive as I mentioned before and regularly stretch, move, and strengthen in a purposeful and life-like manner.

One of the most common areas of muscular tightness that affects gait performance is shortening of the hip flexors. This tightness creates more of a forward trunk inclination, anterior pelvic tilt, shorter stride length in gait, decreased power of the hip extensors, decreased deep abdominal wall recruitment, possible decreased lung capacity, increased overload placed upon the back extensors, and dysfunction within the lumbo-pelvic hip complex which may lead to back pain and discomfort.

Additional muscular tightness and postural deviations result from a failure to effectively fight gravity. The older adult population typically displays more of a forward head posture accompanied by a rounded shoulder and rounded upper back posture. Now more than ever before, this posture is also demonstrated by students as a result of carrying heavy book bags on their backs and prolonged slouched posture throughout the day while sitting at desks. We also see this posture demonstrated by individuals who have poor self-esteem or those who have not been taught and constantly reminded to focus on maintaining ideal posture from an early age. Even young females display this posture as a result of trying to hide their breasts. Many other sedentary seated activities foster this type of posture, such as; prolonged reading, studying, driving, computer work, video games, game boy games, etc… This type of prolonged posture will tend to shorten other anterior muscles such as the; pecotorals, internal rotators, latissimus dorsi, abdominals, obliques, and neck flexors. If these tight muscles go unchecked, the result will be poor movement pattern proficiency in the transverse plane.

Transverse plane motion can be dramatically improved by performing various rotational stretching exercises that incorporate the hips, core, and shoulder complex. In the last article we covered a standing thoracic mobilization or movement pattern in a square stance, and a pectoral/internal rotator stretch in a split stance that also incorporated thoracic mobilization. It is important to note that these exercises also effectively elongate the abdominal wall and can eventually turn on the abdominal/oblique muscles, making them less efficient power producers. Some individuals may need to be cued to draw the abdominal wall inward during the patterns of motion rather than push the abdomen outward. There are several additional stretches that I will incorporate into one’s program depending upon the client’s specific needs. I would like to offer three additional transverse plane stretches in this article that attack the hip flexors along with thoracic mobilization. The first two stretches will target the psoas (figure 1 & 2) and the third will target the psoas, rectus femoris, and quadriceps (figure 3). I am an advocate of active isolated stretching which incorporates moving into a range until the tension barrier is met, holding 3-5 seconds, moving back to the starting position, and repeated 6-10 times.

Figure 1	Figure 2

If we are poor gravity fighters, we will certainly become more rigid and inflexible, thus we will have less ability to take advantage of the transverse plane or rotation at all joints. Our bodies, over time, will become more robotic and sagittal plane dominant. Transverse plane movement is undoubtedly the key to producing optimal power. Rotational pliability, strength, and power are what give an individual the ability to move in a smooth rhythmic coordinated manner. Without these qualities, we will become less efficient power producers in simple tasks such as walking, running, climbing, jumping, hopping, planting, and cutting. The more complex rotational sport movements (such as throwing, hitting, striking, and catching) will also be hindered.

As we understand more of how the body operates in a chain reactive manner, it is easy to see that if one aspect of the chain is not operating to give us adequate movement, the joints above and below will unfortunately try to take up the slack and often become overly stressed. This is especially true when one has immobility and tightness caused by being a poor gravity fighter. If the thoracic spine doesn’t adequately extend and rotate during the throwing motion, the shoulder and back will try to cover for the inadequacy. Most of the time, if the thoracic spine is limited, the shoulder is limited in its ability to horizontally abduct, externally rotate, and extend. So, you guessed it, the back or lumbar spine will excessively extend to help out its friends. This type of reaction is also commonly seen in the golf swing if the same limitations are noted. If we observe the abdominal wall during this type of activity, it will be clear that it pushes outward, destabilizing the spine. This increases the compressive load placed upon the lumbar spine, ligaments, and discs. Simply stated, we will degenerate or wear out our spines at a much faster rate than normal.

A key focal point during all of the exercises covered in this article will be to control the core as one moves through the transverse plane. Emphasis should be placed on keeping a flat abdominal wall during this transition phase. It is often helpful to have the exerciser place the non-involved hand on the lower abdomen. The exerciser should never feel the lower belly push forward into the hand during any of the movement patterns. This will in turn create a proper reaction from the pelvis and lumbar spine, where they remain in a neutral orientation throughout.

Our bodies are crying out to us to train rotational movement patterns, but most traditional weight training and flexibility programs are dominated by sagittal plane exercises. I hope to breath some life into your programming with some of my favorite movement patterns. They will surely help to combat the negative effects of gravity in regards to posture. They will also serve to be a great asset for functionally strengthening the movement system that is used in all throwing, striking, and rotational sporting activities.

1 DB Overhead Raise w/ Trunk & Hip Rotation
(1/4- ½ Squat to Stand)

Figure 4	Figure 5

To start this exercise, hold one DB in the right hand with palm facing the right thigh. Assume a ¼-1/2 squat position, feet slightly wider than hips, with a slight hinge action at hips. Make sure to have client exhibit proper squat mechanics with buttocks back, rib cage lifted, and neutral lumbar spine mechanics maintained. Turn left foot outward 45°, rotate trunk 90° while simultaneously pivoting right foot 90° (heel up) and raising arm overhead with palm continuing to face mid-line. The arm should be raised in straight-arm fashion with minimal elbow bend. As the arm raises overhead, the legs should straighten to assume a fully upright posture with even weight distribution. During the rotational phase with overhead raise, the client should focus on drawing the abdominal wall inward and keeping the pelvis and lumbar spine neutral. The hand should finish directly over the shoulder with eyes focused straight ahead if proper flexibility and mobility exist. The non-involved hand can be kept on the lower abdomen to provide feedback or allowed to hang naturally to the side of the body. Again, we want to keep the belly in during the overhead raise, not pushing out into the hand. During the descent, it is important to bend the elbow and bring the weight toward the right shoulder, then back to the starting position. Perform 10-15 repetitions and repeat with opposite arm.

**If muscular tightness exists within the lattisimus dorsi, pectorals, internal rotators, coupled with limited thoracic extension and rotation, expect the client to display a limited range of motion at the end phase of the overhead raise. The client will not be able to get the hand to finish directly over the shoulder and most likely will try to compensate by over extending the lumbar spine. This individual needs to focus on the stretching and mobility exercises presented in the last article along with the stretching exercises from this article. An excellent alternate exercise will be presented next, and after a few weeks of flexibility and mobilization training, attempt this exercise again.

1 DB Upper Cut w/ Trunk & Hip Rotation
(1/4 – ½ Squat to Stand)

Figure 7	Figure 8

This exercise will be taught in a very similar manner as the above movement pattern. The only difference will be the arm action. During the rotational component, immediately supinate the forearm or turn the palm toward the body while bending the elbow with knuckles facing up at the ceiling. The goal is to finish with the upper arm parallel, or elbow at shoulder height while achieving a tight 90° angle at the upper-lower arm. Again, as the upper cut action is being performed, straighten the legs and assume a fully upright posture with even weight distribution from the front to back foot. Return to the start position and perform 10-15 times, repeat with the opposite arm.

**This shorter lever variation will create a much higher likelihood for successful core control if one is limited in flexibility and mobility.

As a side note, if proper core control and movement mechanics are displayed, I often perform the above exercises with two dumbbells. You can perform one set with left rotation and the next set with right rotation, or perform half of the reps to the left and half to the right. Note, this bilateral movement pattern will be more challenging to the inside arm or to the left arm if rotating to the left. Of course, single arm training is highly beneficial to restore balance and muscle symmetry in the beginning phase of a program and is encouraged as the primary method for those involved in a throwing or striking sport.

The following three exercises are specifically designed to restore posterior balance to the shoulder complex. I tend to bias a program with more posterior dominant exercises such as these when there is a postural deficit or if the client is involved in a throwing or striking sport.

1 DB Side Lunge & Reach to Goal Post w/ Trunk & Hip Rotation

Figure 10	Figure 11

This exercise is very similar to the goal post action presented in the last article, except now we will transform it to incorporate transverse plane movement.

Start with a DB in the right hand, place the feet wider than shoulder width. Shift the weight to the left and reach to the lower thigh or kneecap with palm facing down. It is important to perform a side lunge action to the left while reaching to the left. From the loaded position, shift the weight laterally to the right while simultaneously pivoting the left foot 90° (heel up) and rotate the trunk 90°. The progressive goal post action should accompany this motion. Remember to immediately bend the arm with palm down and progressively abduct and externally rotate the shoulder finishing with elbow at shoulder height and palm facing forward. As the shoulder abducts, the legs should straighten to assume a fully upright posture. The upper-lower arm angle should finish at 90°. The weight should be evenly distributed from front to back leg. Reverse this pattern and descend to the start position, perform 10-15 times, and repeat with the other arm.

1 DB D2 Pattern w/ Trunk & Hip Rotation
(1/4 –1/2 Squat to Stand)

Figure 13	Figure 14

Start with a DB in the right hand, assume a ¼-1/2 squat pattern, and position DB in between upper thighs with palm facing left thigh. Start pivoting the left foot (heel up) and simultaneously perform a row pattern bringing the DB to the outer right pectoral. Continue to rotate the torso and extend the right arm in an upward diagonal manner. Finish with the knuckles pointing at the back wall while assuming a fully upright posture.

This would reflect a 180° turn from the start position. The left foot should complete a 90° pivot action. Pause momentarily at this end phase, bend arm and return to the start position. Perform 10-15 repetitions, and repeat with opposite arm.

1 DB Lunge & Reach to D2 Pattern w/ Trunk & Hip Rotation

Figure 16	Figure 17

This exercise promises to create the greatest stability challenge. It is more of a specialized movement pattern that mimics reverse throwing mechanics. Although it is a great exercise for throwing and striking athletes, I use it with all clients that have the ability to stabilize effectively in the split stance. We covered a similar exercise in the first article of the integrated hip-core-shoulder series. The exercise I’m referring to was called the 1 DB Lunge & Reach to Overhead Raise.

Start with one DB in the right hand, assume a split stance equal to that of taking a large stride, and lift the back heel distributing weight onto the ball of the back foot. At this point one should still be in an upright posture with body weight evenly distributed from the front to back foot. In a controlled manner, perform the lunge and reach movement pattern. Remember, the reach can be modified to the height of the knee, mid-shin, and lower shin depending upon the goal. Make sure that the client loads the front hip properly by gliding the knee over the mid-foot. Tthe client should also draw the rib cage toward the thigh while avoiding a collapse of the thoracic spine. Once the descended position is achieved, the D2 pattern should follow while standing up to a fully upright position.

The D2 pattern is performed exactly as the above exercise. Have the client focus on pulling to the outer chest and then envision throwing the weight to the back wall. One should remain on the ball of the back foot throughout the motion and limit the toe out to approximately 45° during the D2 pattern. We want to avoid allowing the back foot to turn out beyond this point as excessive external hip rotation will be accompanied by excessive lumbar extension. We want our clients to think of their torso as being a rigid cylinder during the D2 pattern. Again, if they aren’t doing it naturally, we may need to remind our clients to tightly draw in the abdominal wall during all concentric arm actions (overhead raise, goal post, or D2 pattern) and focus on achieving a neutral position of the lumbar spine and pelvis.

Have fun being functional, I hope I’ve been able to put a little twist on what you already know. For further educational information on functional integrated strength training, check out Mark’s product section linked to his author page.

REFERENCES

1. Gray, Gary with Team Reaction, Total Body Functional Profile. Adrian, MI., 2001, Wynn Marketing Inc. & Gary Gray Physical Therapy Clinic Inc. 800-494-9555
2. Gambetta, Vern, The Gambetta Method. Sarasota, FL. 1998, Gambetta Sports Training Systems Inc. www.gambetta.com
3. Exercises 1-12. Cibrario, M., FIST 2 "The Next Level"-Core, Waukegan, IL., 2002,M.C. Training Inc. 847-562-1611