Squat Hip Pinch Fix

Pinching in the  hips during squats is one of the most common complaints I hear from CrossFitters and weightlifters. A variety of restrictions can lead to this form of hip impingement ranging from ankle mobility to core positioning and boney anatomy of the hip joint. In athletes without any glaring deficiencies to address first, the following stretch easily corrects the hip impingement in many of my athletes.

We will describe this stretch as if working on the left hip. First, have the athlete get on hand and knees. Then, extend the right leg and focus on having as much weight on the left knee as possible. The head of the femur (thigh bone) will be gently mobilized deeper into the hip joint. Maintain this position for 30 seconds to 1 minute before proceeding to rotate the leg up (bringing the foot towards the opposite shoulder). Finally, sit back until a stretch is felt in the buttocks. Spend ~1 minute per side stretching in this position (searching for areas of restriction).

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Build Your Own Functional Movement Screen Kit

Recently built my own Functional Movement Screen kit after looking at buying a kit and feeling the cost was too high for its’ simplicity – plus I’ve seen the plastic version break a few times. Thought I’d share my plans for building the kit: Continue reading

Weightlifting Ratios Calculator: Identifying Weaknesses

While not an exact science, examination of the ratios of various weightlifting ratios can help a lifter identify what areas to focus on in their programming. For example, the suggested optimal ratio for the snatch compared to the clean and jerk is 0.78 – 0.83. If a lifter C&Js 100kg but only snatches 70, they would likely benefit from shifting program focus to addressing the relative weakness of their snatch.

Snatch Set Up and CatchMany weightlifting coaches have suggested optimal ratios of different lifts to analyze weaknesses in these lifts. The following excel document allows for easy calculation of weightlifting ratios and comparison to suggested optimal ratios. The sources listed in the document also provide good resources for understanding why your specific weaknesses might exist.

Weightlifting Ratios Excel

Dorsiflexion ROM Test

Assessing Ankle Mobility

Dorsiflexion ROM Test

A variety of lower extremity injuries can occur as a result of decreased ankle mobility, specifically decreased dorsiflexion (see my posts on this HERE and HERE).  The ankle dorsiflexion test is my favorite tool for assessing dorsiflexion mobility because it doesn’t require any tools or training, can be quickly performed, and has been shown to have excellent reliability (source).

To perform the test, have the athlete barefoot and kneeling with the tested leg in front. The 1st toe should be 5 inches away from the wall. The athlete then shifts their knee forward, trying to touch the wall with the knee cap while keeping the heel flat on the floor. If the knee cap touches, you can be fairly certain that the athlete has sufficient dorsiflexion mobility. If they cannot touch, dorsiflexion is restricted.

It is important to note that the posterior leg can limit this as well if hip extension is very limited. In this case, have the patient/athlete perform the same test while standing with the tested ankle on a chair or stool.

The Face Pull Y Press

Great CrossFit Injury Prevention and Performance Exercise

The workout movement CrossFit has exploded in recent years and with good reason…this program rocks at getting athletes into great shape. Unfortunately the intense workouts and complexity of some of the exercises performed may increase the risk of overuse injuries in CrossFit athletes.

I was recently introduced to the Face Pull Y-Press, which I quickly fell in love with (click the link or see video below for demonstration). During one of my recent CrossFit workouts, I realized this may be the best accessory and injury prevention exercise out there for CrossFitters. Let me explain why I think this exercise is so good:

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Elbow Extension Test & Radiology Referral

Had a recent patient come to the clinic that has been previously treated with excellent results with some manual therapy. 40-year-old male fell onto outstretched hand 2 weeks prior while playing soccer. His team’s athletic trainer thought little of his injury the following day. As the next two weeks went on, pain remained high and was unchanging. During the elbow extension test, he was unable to fully extend his elbow. I referred him to his GP and X-rays revealed a radial head fracture.

The Elbow Extension test is very easy to perform. Simply have the patient to fully extend their elbow. Inability to fully extend the elbow would be considered a positive test and warrant imaging.

Elbow Extension Test

Several studies have examined the sensitivity and specificity of this test:

Hawskworth & Freeland: Sensitivity 90.7%, Specificity 69.5%

Appelboam et al. Sensitivity 96.8%, Specificity 48.5%

Docherty, Schwab, & Ma: Sensitivity 97%, Specificity 69%

Lamprakis et al: Sensitivity 92%, Specificity 61%

Appelboam et al concluded their study: “The elbow extension test can be used in routine practice to inform clinical decision-making. Patients who cannot fully extend their elbow after injury should be referred for radiography, as they have a nearly 50% chance of fracture. For those able to fully extend their elbow, radiography can be deferred if the practitioner is confident that an olecranon fracture is not present (Appelboam et al).”



Docherty, Schwab, & Ma. Can elbow extension be used as a test of clinically significant injury? South Med J, 2002.

Hawskworth & Freeland. Inability to fully extend the injured elbow: an indicator of significant injury. Archives of Emergency Medicine, 1991.

Appelboam et al. Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. BMJ,  2008.

Lamprakis et al. Can elbow-extension test be used as an alternative to radiographs in primary care? Eur J Gen Pract, 2007.

Snatch Set Up and Catch

Biomechanics of The Olympic Snatch

The Olympic snatch is a frequently used exercise is strength & conditioning programs, and for good reason.  This exercise allows the athlete to lift very explosively and with biomechanics similar to that seen in many other athletic movements such running and jumping.  However, this exercise is highly technical and requires time and a good coach to learn how to master.

The simplest explanation of the snatch is that it is a weightlifting exercise in which the athlete lifts a barbell from the ground to an overhead position in one explosive and continuous movement.

Snatch Set Up and Catch

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Bodyweight Overhead Squat Test

One of my favorite tests to use in the clinic has to be the overhead squat test. I have used this test for years since learning the NASM’s Performance Enhancement Specialist system while an undergrad (I use an altered version of their test now). This test is very simple and quick, yet provides a good deal of information regarding an individual’s movement deficiencies. Add in a step down test, some hopping/landing, a trunk stability pushup, and running analysis you will have a great picture of how an athlete moves.

To perform this test, have the athlete/patient raise their arms overhead so that it is in line with their ears (if able). With a shoulder width and barefoot stance, have them squat down as low as they are able 3-5 times while observing them from the front, side, and back.

Overhead Squat

From the front and back view look at the following:

A. Knee valgus (aka medial knee displacement) – the knees moving towards each other as the athlete descends or ascends. Compare the below picture to the above.

B. Feet rotating outwards

C. Feet collapsing – often associated with knee valgus

A) Knee Valgus Collapse B) Feet Out C) Foot Collapse

Feet turning outwards may indicate a dorsiflexion limitation, tight hamstrings or TFL, and weak glutes. Knee valgus may be from dorsiflexion restrictions, adductor overactivity, and weak glutes. Foot collapse may indication overactivity of peroneals, gastrocs, TFL or under activity of the tibialis muscles or glute med.

From a side view watch for the following faults:

A) Arm Drop B) Excessive Arching C) Low Back Rounding D) Heel Rise E) Forward Head F) Excessive Forward Lean
A) Arm Drop B) Excessive Arching C) Low Back Rounding D) Heel Rise E) Forward Head F) Excessive Forward Lean

A. Arm drop may indicate tight lats or other shoulder mobility restrictions. It may also indicate a weakness in the scapular musculature.

B. Excessive arching is often the result of tightness in the erectors, hip flexors, or lats. Glute weakness and core instability often accompanies this as well.

C. Low back rounding may be due to hip joint range of motion restrictions, dorsiflexion limitations, and under activity of the core/glutes.

D. Heel rise is most likely from restrictions of dorsiflexion.

E. Forward head is likely due to a combination of cervical muscle and joint restrictions, as well as weakness/under activity of postural stabilizers.

F. Excessive forward lean is often from excessive activity of the calf muscles, hip flexors, and abdominals. Weakness of the anterior tibialis, glutes, and erector spinae may also be the cause.

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