One of the tenets of the SFMA is looking for issues with motor control/stability, if a joint loses mobility after repeated manual techniques, it is very possible there is an underlying MC issue.
These are the clinical presentation I see most often presenting as "tight" but have significantly greater ROM when tested passively, often in an unloaded position.
1) Cervical Spine
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| Cervical rotation and flexion WB and AROM - DN! |
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| Cervical Flexion and Rotation PROM and NWB |
Solution:
- scapula stability exercises
- postural correction to decrease tone in upper quarter
- breathing correction to decrease tone in upper quarter
- repeated cervical retraction
- IASTM to cervical and upper trap patterns
2) Shoulder MRE
Someone may be limited DP/FP/DN in this common shoulder pattern, then check them passively and they have full motion. Before going to passive NWB in 90 degrees of shoulder abduction, place your hand on the inferior border of their scapula, give them some PNF cuing on to activate the scapula stabilizers, then have them repeat the test. Often they'll go farther and the pain/tightness also changes.
Solution
- IASTM to upper traps to reduce tone
- postural correction
- kettlebell overhead carries to facilitate scapula stabilizers
3) "Hamstring Tightness"
Everyone thinks they have tight hamstrings, but many times this is again a motor control issue rather than issues in the tissues. Someone at my Chicago Course said she couldn't touch her toes from a standing position since she was a kid. I cued her on an abdominal blowout (opposite of drawing in), had her hold the belly out as she exhaled and bent forward and her "tight" hamstrings magically lengthened before our very eyes.
Solution
Solution
- IASTM to hip flexors, light psoas release with diaphragmatic breathing
- ASLR with core activation
4) Hip Extension - previous post on this here!
This is a reason why I learned the hard way to have someone else examine you. I had been stretching my right hip flexors for years, literally. Self psoas release, hold relax, having others do IASTM on my ITB, ANYTHING to improve my "super" limited hip extension on the right.
We were teaching interns SFMA breakouts when my business partner watched me epic fail MSE, then in prone, my active hip extension was DP, but in PROM was FN... I couldn't believe it!
Solution
This is a reason why I learned the hard way to have someone else examine you. I had been stretching my right hip flexors for years, literally. Self psoas release, hold relax, having others do IASTM on my ITB, ANYTHING to improve my "super" limited hip extension on the right.
We were teaching interns SFMA breakouts when my business partner watched me epic fail MSE, then in prone, my active hip extension was DP, but in PROM was FN... I couldn't believe it!
Solution
- diaphragmatic breathing with MSE patterns as appropriate
- psoas release with breathing
- 90-90 balloon breathing
5) Deep Squat
My hips are so tight! My knees hurt! I can't do this!
Many times the hips anteriorly impinge if the patient starts with excessive anterior tilt, thus they have no choice but to move the hips posteriorly, pitch the trunk forward and come to end range hip flexion way too early.
There are too many problems and thus solutions to help this movement pattern, but a quick one is if all else is FN (thoracic, shoulder mobility, knee, ankle, tibial IR) and it's purely motor control, cue a posterior tilt in the beginning to open up the hips anteriorly. Many individuals who bring the hips posteriorly initially will be able to go down more vertically and go much farther into the pattern. Give them a weight for added grounding/proprioception and see what happens!
There are too many problems and thus solutions to help this movement pattern, but a quick one is if all else is FN (thoracic, shoulder mobility, knee, ankle, tibial IR) and it's purely motor control, cue a posterior tilt in the beginning to open up the hips anteriorly. Many individuals who bring the hips posteriorly initially will be able to go down more vertically and go much farther into the pattern. Give them a weight for added grounding/proprioception and see what happens!
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