Category: Case Studies

Help! I’m Not Sure What Infrasternal Angle I Have!

Those pesky people who have infrasternal angles right in the middle. What do you call him? Well in this case study, we talk about some tips and tricks for pinpointing the ISA that you are dealing. We also dive into the following topics: A couple quick tests to confirm the infrasternal angle Why the xiphoid process is an unreliable reference point How to prioritize treatments for someone who is compressed in all directions with asymmetries. How shifting at different degrees of flexion changes the pelvic mechanics

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A Narrow Infrasternal Angle with Right Oblique Tilt – Case Report

What do you do if you have someone who is a narrow infrasternal angle, stiff as all hell, with some glaring asymmetries? Check out this video below, where a colleague and I walk through a case who presents in this manner. It in, you’ll hear about the following: How to test shoulder flexion more reliably How to build someone into half kneeling Moves to utilize for this type of individual Watch the video to learn what we did!

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The Best Position for the Stack – A Case Report

Many times if you don’t get the result you are looking for movement-wise, it is often related to losing the stack (and not talking to Zac). How do you know where the failure occurred? That’s exactly what we sift through in this video. In it, we walk through a failed case, and look at where tweaks could be made to improve the outcome. Watch it to learn more! Looking at each component of the stack In this case of a person with shoulder pain, we look at some of the big limitations this person had: Decreased shoulder internal rotation biliaterally Decreased left shoulder external rotation Narrow infrasternal angle From here, you then need to look at each piece of the stack to determine how to design the activity with the best possible chance of success. What are those components? I’M GLAD YOU ASKED!! Here are the pieces we focus on for the stack in order of importance (though fam, you need to build it all!): Pelvic positioning Full exhale Pause and inhale with ab tension and relaxed upper thorax Reach without crunching Now based on what we need to maximize this person’s movement options, we can then engineer exercises with a high probability of increasing available movement. The keys we need to respect are restoring external rotation before internal rotation, respecting their anthropometric structure, and address asymmetry (shoulder rotation limitations indicate this person has a right rotation bias). Therefore, we can engineer activities that can create high odds for success:

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Improving Hip and Shoulder Internal Rotation WITHOUT STRETCHING!

Having shoulder and hip internal rotation is kind of a big deal. What if you could get it as quickly as possible without a single stretch? That’s exactly what we did in this case. I work with someone who is unfamiliar with my techniques, and in 3 moves (1 of them a failure), we were able to increase shoulder and hip internal rotation. Watch the video below to learn what we did. Case overview The “patient” is my nephew, Brad. He’s a football player and wrestler who is just a stiff bro. No pain. Objective findings Brad’s main initial findings were the following: Test Left Right Infrasternal angle narrow Shoulder flexion 155 155 Shoulder external rotation 95 95 Shoulder Internal rotation 90 50 Hip flexion 95 95 Hip external rotation 60 60 Hip internal rotation 10 10 Straight leg raise 65 65 Intervention selection Given the findings above, are major keys to focus on were making the infrasternal angle dynamic and restoring internal rotation. Brad appears to be a classic narrow infrasternal angle. Lewit tilt I chose this move because the 90 degree angle at the hips biases internal rotation. The supine position promotes lateral ribcage expansion, which is great for narrow infrasternal angles. If you want a super in-depth reasoning for this move, check out this post. After performing this move, B’s test results were as follows (improvements are bolded): Test Left Right Infrasternal angle narrow Shoulder flexion 155 155 Shoulder external rotation 95 95 Shoulder Internal rotation 90

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Treating Scoliosis with Breathing Basics – A Case Study

Have any clients with scoliosis?  Scoliosis can be quite a bugger and have some interesting consequences on an individual’s movement. I bet you feel unsure how to best help them maximize movement. Even though people can have wild and crazy curves,  utilizing a systematic approach that looks at the entire movement system can have profound effects.  I recently had the opportunity to run through a client with Scoliosis during Human Matrix: The Code for Maximal Health and Performance, where I was able to employ some of the skills taught in the class to lead to some nice movement changes. In this case study, you’ll see just how far coaching the basics savagely well can improve someone’s movement. We focused in this case on finding the best position for her to maintain the breathing strategies advocated in the seminar. And the results…well, you’ll just have to tune in and find out.

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How to Fix Neck Pain After Lifting – A Live Treatment

While in the Hamptons, my main man Cody Benz started developing some neck trouble. We thought it might be helpful for y’all to see what I would do to help a cat like him. Here you will see me go through an entire treatment session with Cody, while I do my best to explain every decision I make. A major kudos to Daddy-o Pops Bill Hartman for asking some great questions throughout the treatment. Instead of the typical transcript I provide for these longer videos, I decided to write this up similarly to my neck pain with sitting case study format. I reflected on this case while editing the video, so you’ll see some added thoughts I had while you read through. I would recommend watching the video and reading the case study to get the most out of the material. Enjoy watching the session.

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How to Treat Pain with Sitting – A Case Study

Case studies are much more valuable than many give credit for. It is this type of study that can often lead to sweeping changes in how further research is conducted, often create paradigm shifts in their own right. After all, there was only one Patient H.M. One thing that I wish I saw more in case studies was the clinician’s thought process. Why did they elect to do this treatment over that, what were they thinking when they saw this? How do they tick? I was fortunate enough to have an online client of mine suggest to that I make her a case study, and it was a very rewarding experience on both fronts. My hope is that you can see how a clinician thinks first-hand, and see the challenges a clinician faces… When you can’t work with your hands.

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The Ultimate Guide to Treating Ankle Sprains

A Humdinger No Doubt Ankle sprains. Such a bugger to deal with. Ankle sprains are one of the most common injuries seen in basketball. The cutting, jumping, contact, fatigue, and poor footwear certainly don’t help matters. Damn near almost every game someone tweaks an ankle. Treating ankle sprains in-game provides quite a different perspective. Rarely in the clinic do we work with someone immediately post-injury. Instead, we deal with the cumulative effects of delayed treatment: acquired impairments, altered movement strategies, and reduced fitness. The pressure is lower and the pace is slower. You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree. I had a problem. Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol. The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game. It’s a tough business. The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹.    Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective. Here’s how.

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