REHAB TIP: Do the Opposite
In this monthly series of articles, Mike will discuss the science and practice of physical training for Water Polo. Strength, flexibility, Water Polo science, rehab and other areas of interest with respect to the physical development of the Water Polo athlete will be covered.
NOTE: this article was originally published in 2-parts on http://proanox.com.
We do a lot to take care of our body. We exercise regularly, eat our vegetables, take our anti-oxidants and rest well but we still can develop nagging little aches, and pains which really impact our performance in our sport and our quality of life. Although, I highly recommend you see a medical professional when in pain, there are steps that you can take to be proactive in your care and this is what this article is all about. What can you do now or the next time you are in he gym to aid in getting your self feeling better and not worse.
The basic premise of this entire article is when a movement causes pain, do the opposite. Movement being the key word, not muscles but movement. You do not need to be an anatomy expert to apply this concept. I will show you some examples of how doing the opposite may be the key to feeling and performing better. Many times when seeing a rehabilitation professional for these common problems, part of the treatment plan will include the exercises I describe below.
If your are a 100% SAID or it has to be sport specific person then you may find this hard to swallow. SAID is a physiological principle which stands for Specific adaptation to Imposed Demands, which means you get good at what you do. With that in mind, when you have pain with a movement doing more of that movement only gets you good at doing that movement with pain. Doing the opposite may just be the key to many of our performance (i.e. pain) related problems. I truly believe that the movement you want improved performance in, always or at least most of the time, needs to be in balance with some amount of time doing the opposing movement.
The most obvious form of doing the opposite is training vs recovery. You want to be a better runner, swimmer, weightlifter, … so you run, swim and weight lift a lot but that sport or movement always needs to be in balance with the opposite and in the big picture that is rest and recovery. You move intensely with your sport and then you sleep which is about as opposite as you can get.
Here are 3 fairly common issues that many people experience and some opposing movements for them.PROBLEM #1: My shoulders hurt when Bench Pressing.
Do the opposite which is more rowing (pulling) exercises like Chin Ups or Supine Pull Ups. As you can see in the picture below of Supine Pull Ups (to make it harder put your legs straight), it resembles the movement of the bench press but the force is being applied in the opposite direction.
Another variation on doing the opposite for Bench Press is Push Ups. Yes, I know Push Ups is also a pushing exercise (essentially working the same muscles as the bench press) but it is opposite in another way. Push Ups are classified as a closed chain exercise while Bench Press is an open chain exercise. So, while working on your pulling you may be able to continue to develop your pushing strength and power by including some variation of Push Ups to substitute for your Bench Press (this of course is assuming that the Push Up is pain free).
PROBLEM #2: My low back hurts when I bend forward to tie my shoes.
This gets a little more complicated but what is happening is your low back is flexing (rounding forward). So doing the opposite would be taking the low back into extension (bending backwards). A great way to achieve this is by doing Press Ups.
While keeping your pelvis and hips flat on the floor, press yourself up and down holding the top position for 1-3 seconds and repeat 10-20 times. You can also just rest on your stomach (forehead on hands) or up on your forearms for a few minutes. If you feel a pinching sensation in your lower back at the top position then you are pressing up to high. It is not necessary to lock out your arms and everyone’s range of motion will be slightly different.
Hold the top position for 1-3 seconds and repeat 10-20 times.
PROBLEM #3: Long periods of working at my computer really gives me pain and discomfort in the lower/middle back, neck and shoulders.
When sitting at the computer (or reading) involves some flexion of the body or rounding forward. When this position is held for long periods it can cause pain and discomfort in lower/middle back in addition to the neck and shoulders. There are a few things that are potentially problematic here, first being the sitting, second the long periods of flexion and thirdly the long periods of not moving. Doing the opposite could be as simple as standing at your work station, getting up and going for a walk and/or doing some kind of whole body mobility drill like the Brugger Relief Position which is opposite of flexion.
Standing work station doesn’t have to be a separate apparatus. Just put a box or a small end table on top of your desk to raise up your laptop for standing work.
Hold the below position on the right for 5-15s for 3-5 repetitions. Perform this exercise before discomfort sets in. Be proactive and do it every 15 minutes when working for long periods at a desk. The movement is performed by first taking a deep breath in. Then while gently blowing the air out, externally rotate your shoulders (thumbs facing back with palms to the outside), squeezing your shoulder blades together while also lifting your sternum (chest bone) up and out.
Hold the position on the right for 5-15s for 3-5 repetitions You can even apply this concept to other movements. Identify what is causing you discomfort and do the opposing movement.
INTERLIMB NEURAL COUPLING: another take on doing the opposite
At the most fundamental level, Interlimb Neural Coupling describes the neural connections between the lower and upper limbs. There is actually a lot of research in this area and was really first noted back in the early 1900’s (2), so it’s not really a new discovery.
|Neural – Relating to the nerves or nervous system.
There are many research examples demonstrating Interlimb Neural Coupling. Some of them have subjects moving their arms only but still pick up muscular activity via EMG in their leg muscles (1). Other invoke a reflex in the foot and notice a reflex is activated in the opposing hand (3, 4). There is quite a bit of research in this area using animal and human subjects.
The application of this research is something that is still in its infancy. Some of the more “popular” applications is in designing rehabilitation programs for spinal cord injuries, stroke and other motor control pathologies.
The human nervous system.
An interesting and very accessible application of the research is by an USA based institute called Z-Health. They have developed a system which partly includes lots of specific dynamic joint mobility exercises. In the clinical application of this system they have noted that mobilizing a joint is often accompanied by increase performance (usually, but not limited to decreased pain or improved range of motion) in the opposing joint. So, if shoulders are an issue, then mobilizing the hips may be a very viable route to improvement. Please note that this is only one aspect of the Z-Health system. I suggest a visit to their home page for more information.
Better Hips = Better Shoulders?
Here is the drill.
- Check your shoulder flexion range of motion (ROM).
- Take note how far you are able to raise your arm plus the end feel (i.e. pain rating, ease of movement).
- Next do a drill that mobilizes your hips. There are many you can do but I demonstrate a very simple one below in the video.
- Retest your shoulder range of motion (ROM) and end feel.
Notice any improvement?
Video Link: Better Hips = Better Shoulders
Notes on the above video.
Testing shoulder ROM – keep as much the same as possible for the before and after test. I suggest wrist in neutral, elbow locked with thumb pointing backwards but it doesn’t matter to much as long as the same technique is used.
Mobilizing the hip into extension and on the opposite side of the shoulder you are testing will likely have the best results. There are many different drills you can do, the important thing is that you are active in the mobilization and it doesn’t cause any pain.
If you decide to try this technique, drop me an email with your results. Did it help, stay the same or get worse. These are all the possible outcomes.
Kao PC and Ferris DP. The Effect of Movement Frequency on Interlimb Coupling During Recumbent Stepping. Motor Control, (9)144-163, 2005
Sherrington CS. Further observations on the production of reflex stepping by combination of reflex excitation with reflex inhibition. J Physiol. Nov 7;47(3):196-214, 1913
Zehr EP and Duysens J. Regulation of Arm and Leg Movement during Human Locomotion. Neuroscientist 10: 347, 2004
Zehr EP, Klimstra M, Dragert K, Barzi Y, Bowden MG, Javan B and Phadke C. Enhancement of Arm and Leg Locomotor Coupling With Augmented Cutaneous Feedback From the Hand. J Neurophysiol 98:1810-1814, 2007