Stability for mobility... This is one of the key concepts that I've really taken and run away with. I'd say that my understanding of this concept would in large part be a product of my DNS learning, but this principle can definitely be applied to many other situations and techniques. We know that the rotator cuff can be a big problem for many of our athletes and patients and we know that with dysfunction of the cuff comes limited mobility. I used to be "that guy" who would soft tissue and mobilize the heck out of the glenohumeral joint only to be confused as to why the "restriction" would keep coming back. According to the Joint by Joint theory, we know that the GH joint needs mobility. But how often do we pull out the stability card to try and get this mobility? I would say that dynamic stability more often than not translates into mobility. Some of the techniques I typically use to get stability in the cuff include (but not limited to):
And sometimes I have to improvise. Like today. Here's a patient who presented with a ton of shoulder pain and very limited mobility. Yes, I am working with the Dysfunctional Painful pattern but I did work both the DN and the FP and well sometimes, you just do what you gotta do. I would have used a heavier weight if I had one but 25 lbs was the heaviest I had at the time.
My 50lb sandbad didn't work but I was able to get him to do a suitcase carry with it a little later on to work the cuff in an upright position. Obviously you need a HI-Lo table to do this and for me, the best way to do so is to do holds counting from 10 downwards. And for homework, aside from a few others, I just told him to do a bunch of suitcase carries with a sack of potatoes to simultaneously work his grip and his cuff.
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