About the Book
PreHab Exercise Book for Soft Tissue Therapy
Soft Tissue Therapy has been scientifically proven to improve an individual’s level of
Mobility in regards to Range of Motion, Flexibility, and Responsiveness. For this
reason, it deserves to be an integral part of any training program.
Corrective Measures
Soft Tissue Therapy is the process of using force via pressure to restore the
functionality of the muscles, tendons, fascia, and ligaments to improve an individual's
Movement Quality. This eliminates Myofascial Trigger Points, Adhesions, and Scar
Tissue, all of which contribute to Patterns of Compensation and Movement
Dysfunctions. These negative movements hinder an individual’s performance in
athletics as well as in daily life, increasing the risk of injury.
Additionally, Soft Tissue Therapy accelerates cellular Recovery and Regeneration,
speeding up the natural healing process of the tissues by decreasing stiffness and
eliminating Myofascial Trigger Points that lead to stagnation of fluids and metabolic
waste inside the tissue. It increases the blood flow and circulation that deliver much
needed nutrients and oxygen to damaged or compromised cells, a common
consequence of training.
Move better and move longer with Soft Tissue Therapy.
This book offers a score of exercises organized in varying skill levels accompanied by
detailed illustrations and directions to help an individual create and maintain an effective
soft tissue therapy practice.
Start a soft tissue therapy practice today and start to move in the right direction!
Author and Illustrator Michael Rosengart, CPT, CES, CSCS is a Certified Personal Trainer with the National
Council on Strength and Fitness, a Corrective Exercise Specialist with the National
Academy of Sports Medicine, and a Certified Strength and Conditioning Specialist with
the National Strength and Conditioning Association. Michael is also the author of the
PreHab Exercise Book for Runners.
Author & Illustrator: Michael Rosengart, CPT, CES, CSCS About the Author - Michael Rosengart, CPT, CES, CSCS
Michael Rosengart is a Certified Personal Trainer with the National Council on Strength and Fitness, a
Corrective Exercise Specialist with the National Academy of Sports Medicine, and a Certified Strength
and Conditioning Specialist with the National Strength and Conditioning Association.
Michael has been training athletes and clients since 2000. He started his personal trainer career at
Equinox Fitness in New York City before moving to Los Angeles to serve as a strength and conditioning
coach at Santa Monica College. Now, Michael and his wife live on the East Coast, near his family in
Hagerstown, Maryland.
Training Philosophy
Michael's progressive approach and philosophy of training has evolved greatly throughout the years, as
have many of the trends in exercise and fitness. From cross-training and functional movement training to
PreHab and periodized conjugate systems for strength training, Michael's training philosophy has always
been centered on progress and one simple mantra, ‘keep getting better.’
In regard to training, Michael uses PreHab Exercises and techniques as a tool to correct biomechanical
dysfunctions and eliminate patterns of compensation in movement to improve an individual’s Movement
Quality as well as the individual’s performance and longevity.
In 2012, Michael created the A.M.A.S.S. Method for PreHab and Training, which is a working framework
to evaluate an individual’s capacity for movement. It then provides information on how to integrate
exercises and techniques that help to restore Biomechanical Integrity and improve Movement Quality.
PreHab Exercise Book for Runners and More
At the same time he was inspired to create the A.M.A.S.S. Method, Michael was writing and illustrating
the internationally-sold book, PreHab Exercise Book for Runners, which chronicles his journey to
overcome previous football injuries (a twice-torn Achilles Tendon and broken leg) and improve his running
technique and get faster too!
Michael is the author and illustrator for the PreHab Exercises, a website dedicated to teaching individuals
how to improve their Movement Quality, prevent injuries, and perform their best in athletics and life. He
has presented seminars and led workshops about PreHab and Training at Santa Monica College, UCLA,
Medifit/Exos, YMCA, Spectrum Athletic Clubs, Fox Studios, Volvo Group Trucks, Xiong CrossFit and
CrossFit Chambersburg. Lastly, Michael has served as a Strength Coach for the YMCA Swim Teams and
the Santa Monica College Football team.
To learn more about Michael or PreHab Exercises, visit www.prehabexercises.com
.
PreHab Exercise eBook for Soft Tissue
I GETTING STARTED How to Use this
Book
This book comes with scores of exercise illustrations to help an individual develop an
effective Soft Tissue Therapy practice.
The key word is ‘practice.’ Due to the physiological nature of the body, soft tissue
therapy is an activity that ‘should’ be done several times throughout the week, if not on
a daily basis, because the soft tissue experiences trauma and ‘wear-and-tear’ on a daily
basis that ultimately effects the way an individual moves.
Practicing soft tissue therapy on a regular basis helps to eliminate patterns of
compensation or movement dysfunction that grow from daily ‘wear-and-tear’ as well as
acute trauma. Additionally, soft tissue therapy helps the body recover from exercise or
Daily Life Activities and prepares the body to perform again.
Use this book as a guide to developing an effective practice by following the sequence
of soft tissue therapy exercises listed in each section.
New to Soft Tissue Therapy
If you are new to soft tissue therapy, start with the exercise sequence in the Foam
Rolling section to familiarize yourself with the practice and develop the soft tissue
therapy habit.
Intermediate Practitioners
If you are already familiar with foam rolling, move on to the ‘Rolling with a Ball’ section
to pinpoint trouble areas that seem stiff or tight.
Intermediate Practitioners should also have ‘metrics’ to measure improvements. Select
a few stretches to be the measuring stick in finding how your soft tissue therapy practice
improves Mobility. If you cannot see improvement in these stretches, refer back to this
manual for tips and suggestions on how to refine your practice, both in Foam Rolling
and Rolling with a Ball techniques.
PreHab Exercise eBook for Soft Tissue Therapy
II GETTING STARTED Advanced Practitioners
If you already have a solid soft tissue therapy practice or habit and you are still looking
for ways to improve your Mobility, then focus on the Barbell Rolling and Self-Massage
sections in this book.
Advanced Practitioners still seeking improvement can benefit from Barbell Rolling as the
barbell delivers a higher magnitude of pressure into the soft tissue that has a deeper
effect on the tissues.
Additionally, the Self-Massage section helps an Advanced Practitioner refine his
technique within specific target areas as well as provides the opportunity to practice soft
tissue therapy anytime, anywhere. This is a huge game changer because a high level
of frequency in one’s practice conditions the soft tissue to be very responsive to
‘positive’ change. This helps eliminate compensation patterns that may still be affecting
one’s Movement Patterns.
It is also recommended that Advanced Practitioners use this book to revisit the Foam
Rolling and Rolling with a Ball sections.
Book Sections Are Sequences
Each segment of the book is organized in a prescribed sequence of soft tissue therapy.
Simply turn to the first page of a given section, i.e. Foam Rolling or Rolling with a Ball,
and start from there. Practice each exercise in the section to complete a soft tissue
therapy session that addresses the whole body.
Start.
Learn.
Improve.
Keep Getting Better!
PreHab Exercise eBook for Soft Tissue Therapy
III INTRODUCTION
PreHab Exercise Book for
Soft Tissue Therapy Why soft tissue therapy?
The answer to this question is rather simple. Soft tissue therapy helps prepare the body
to move (and move its best) while also helping the body repair itself from movement,
especially damage from exercise and training as well as repetitive Daily Life Activities
such as texting, sitting, walking, and standing.
Soft tissue therapy is therapy for the body, specifically the muscles, tendons, ligaments
and fascia, all of which are the physiological structures that create Human Movement.
Just as people seek out different therapies for the different stresses of life, i.e.
psychologists, spa days, shopping, etc., individuals interested in moving better (and
moving longer) seek out therapy for their bodies, namely through foam rolling, rolling
with a tennis or lacrosse ball, and/or other various forms of massage.
Soft Tissue Therapy will:
• Improve an individual's Mobility
• Assist in cellular Recovery and
Regeneration
Essentially, soft tissue therapy helps an individual move with improved Mobility, i.e. the
combination of muscle/tendon flexibility and joint Range of Motion, while helping the
body repair the cellular damage sometimes caused in movement, whether it's from
exercise or from working on the computer all day.
Soft tissue therapy is recommended for anyone and everyone. We all need to move to
maintain a healthy standard of living; soft tissue therapy is movement therapy. So, it's
important to treat the body right!
PreHab Exercise eBook for Soft Tissue Therapy
1 INTRODUCTION Soft Tissue Therapy
Soft Tissue Therapy is one of the main
ingredients in any effort to improve an
individual’s Mobility as well as imperative in the
support of Movement Practices, from team
sports and dancing to Powerlifting, Yoga, Martial
Arts, and everything in between.
Defining Soft Tissue Therapy
Before explaining the therapy portion of soft
tissue therapy, it is important to define the term
“soft tissue”.
Soft tissue is everything in the body from head
to toe, except for bones. This long list includes,
but is not limited to: organs, skin, fat, and
muscles. However, for the purposes of training
and fitness, the operational definition of soft
tissue will be reduced to include only the
physiological structures mainly responsible for
creating Human Movement. This includes the
following soft tissues:
Muscles
Tendons
Fascia
Ligaments
Muscles
Virtually everyone who has ever attempted to
exercise has a broad understanding of what
muscles are. In short, muscles cover the body
from head to toe and make the body move by
contracting and lengthening. However, a deeper
understanding of muscle structures and how
muscles work is necessary to be effective when
practicing soft tissue therapy.
Design of a Muscle Muscles are created by combining fibers into
small bundles, then bundling these bundles into
bigger bunches, which combine to make even
bigger groups, and so on and so forth. The
smallest fiber is a contractile cell called a
‘sarcomere.’ The sarcomere is the quintessential
building block of a muscle and the driving force
behind a muscle’s contraction or lengthening
phase.
Deep within a muscle’s sarcomere are two
myofilaments called Actin and Myosin. These
filaments are aligned parallel to each other. This
facilitates the ‘sliding’ function of a sarcomere.
The Myosin strand is equipped with ‘little hooks’
that grab hold of the Actin strand before
discharging a pulling force that allows the
myofilaments to slide over one another and
shorten the sarcomere. Essentially, the sliding
action of the Actin over the Myosin is the driving
force of a muscle contraction.
A large muscle contraction consists of millions of
sarcomeres (muscle fibers) generating a ‘pulling
force’ as billions of Actin and Myosin ‘slide’ over
one another into a shortened state.
PreHab Exercise eBook for Soft Tissue Therapy
2 INTRODUCTION Diagram of Muscle via Wiki Commons
Importance of the Sliding Filament Theory Limitations to Movement The ‘sliding’ process of a muscle contraction is
called the Sliding Filament Theory. This theory
provides the most fundamental understanding of
all Human Movement and its development. It
also points to an effective way to maintain an
individual’s capacity for movement.
Within the soft tissue itself, there are a few
natural physiological structures that can obstruct
or limit the body’s potential for movement. These
include Myofascial Trigger Points (knots),
Adhesions, and Scar Tissue.
Diagram of a Sarcomere
Author David Richfield
Myofascial Trigger Points or Knots Most people have experienced a painful ‘knot’ in
their muscles that either caused pain or impeded
movement to some degree, such as a ‘pain in
the neck’ or a ‘stiff neck.’ These knots are really
Myofascial Trigger Points, or areas in the soft
tissue where clusters of sarcomeres (muscle
fibers) have become ‘locked’ or shortened
because of overuse or a repetitive motion in a
given Movement Pattern.
Myofascial Trigger Points or knots usually occur
in Slow Twitch or Endurance-types of muscles
fibers. They are essentially the creation of high
neuromuscular activity within the sarcomere; a
continual flood of neurological impulses releases
an overflow of Calcium and Acetylcholine to the
sarcomere that causes the Actin and Myosin
filaments to bind together and remain ‘locked’.
Furthermore, the flood of Acetylcholine for
prolonged periods depletes oxygen levels within
the cell. This causes pH levels to turn acidic
which prohibits the release of Actin and Myosin.
In short, a knot is a prolonged process of
neuromuscular stimulation of Slow Twitch
muscle fibers that involuntarily sustain a
contraction and keep the muscle fibers in a
shortened state.
Consequences of Knots
Unfortunately, Myofascial Trigger Points have
consequences on Human Movement. These
knots disrupt the natural flow of kinetic energy
through the soft tissue and cause the body to
compensate in the way it produces and sustains
muscle. Ultimately, knots shift the way an
individual moves to ineffective patterns that put
stress on other physiological structures, possibly
creating injuries in the form of micro trauma in
PreHab Exercise eBook for Soft Tissue Therapy
2 INTRODUCTION the soft tissue from repetitive exposure to
inappropriate stresses.
Diagram of Myofascial Trigger Point by David
Parmenter via Wiki Commons
Remedies for Knots Fortunately, there are several easy ways to
eliminate knots and reduce the future formation
of these Myofascial Trigger Points and the pain
and compensation patterns that come with them.
Solution and Preventative Measures for
Myofascial Trigger Points
• Move in several different Movement
Patterns (Movement & Stretching)
o The practice of moving in different
patterns reduces the ‘overuse’ stress
that accompanies repetitive movements.
This includes changing positions when
you sit or stand at work, in the car, or
even in social engagements.
o Moving in different Movement Patterns
improves circulation and blood flow to
the affected area (trigger point), which
delivers more oxygen as well as
nutrients that help cells regenerate and
balance pH levels.
• Pressurize the Trigger Point Area (Soft
Tissue Therapy)
o Applying pressure to the affected area
influence
mechanoreceptors
and
proprioceptor (sensory) neurons to
command the Actin and Myosin to
release and allow the sarcomere
(muscle fiber) to lengthen.
o Additionally,
applying
pressure
increases circulation and blood flow to
the active area (trigger point), which
delivers more oxygen and nutrients
which help cells regenerate and balance
pH levels.
Recap: Myofascial Trigger Points
Myofascial Trigger Points or ‘knots’ are a natural
phenomenon that occur in the soft tissue,
particularly in Slow Twitch Muscle Fibers, when
those muscles are involved in repetitive
movements or ‘overuse.’ These ‘knots’ can
impede proper biomechanics and create
patterns of compensation in the way an
individual moves, which is not ideal as
compensation
patterns
further
distort
biomechanical integrity, eventually leading to
injury as well as inefficiency in movement.
Myofascial Trigger Points (Knots) can easily be
remedied and prevented with soft tissue therapy
as well as diversification in daily movements and
implementing a stretching practice.
Adhesions Another natural obstruction to the system of
Human Movement is adhesions. Adhesions are
‘casts’ or physiological ‘scaffolding’ that is
created within the soft tissue to provide
protection to damaged cells and assistance in
the natural healing process.
The term ‘adhesion’ literally translates as ‘stick
to’ or ‘bind to.’ The prefix ‘ad-’ infers that the
action of the word is going towards something,
similar to ‘advance’ or the act of moving towards
something. ‘Hesion’ means to ‘stick, bind, or
cling.’ Therefore, ‘adhesion’ means sticking or
binding to something, which is exactly what
happens in this obstruction.
Developing Adhesions
Deep within the soft tissue, cells experience
damage from inappropriate amounts of stress.
This damage can be a literal tear of the cell or it
may just be a stress on the cell that taxes the
physiological structure and impairs its ability to
function appropriately. In either case, the
occurrence of cellular damage, whether from an
accident, exercising, or just daily living, causes
the body to create an adhesion to assist in the
natural healing process of that cell.
An adhesion develops when a protein, either a
fibrin or collagen protein, attaches the damaged
cell to the neighboring cell. This process creates
a ‘bridge’ so all the stress of the damaged cell
can be shuttled onto its neighbor as a part of
mechanotransduction, the mechanics and
direction of force through the cells of the body.
Essentially, this adhesion acts as a cast or
scaffolding that shields the damaged cell and
PreHab Exercise eBook for Soft Tissue Therapy
4 INTRODUCTION diverts the flow of forces in the body to a place
that won’t damage it more.
Adhesions are purely natural and are an
essential part of the body’s physiological
system. There is nothing wrong with an
adhesion; the trouble occurs when an individual
attempts to move or exercise or participate in
sports with a host of adhesions in the body.
Leading to Compensation When the soft tissue is populated by adhesions,
the natural flow of kinetic energy (force) is
disrupted in the body. What does this mean? It
means that energy and force do not flow through
the body as it is designed to, which results in an
inappropriate amount of force accumulating on
cells that are not designed to handle those
forces.
Then, the body changes the way it moves to
avoid placing stress on the damaged cells. This
strategy leads to an alteration of an individual’s
Movement Patterns as the body compensates
for its current inadequacies.
For example, if a person sprains his ankle or
even stubs his toe, the individual quickly
changes the mechanics of how he walks. In an
instant, a normal walking stride (gait) turns into a
limp or compensation.
Trouble Sticks
Ultimately, the trouble with adhesions is the
development
of
lingering
‘Compensation
Patterns’ in the way a person moves, i.e. the
adaptive patterns don’t go away.
Using the previous example of a person walking
with a limp as a result of an ankle sprain or
stubbed toe, the formation of adhesions is only
natural, as is the body’s ability to alter its
mechanics so it moves different. This process of
forming adhesions and compensating in
movement is a natural way of protecting the
body.
The trouble begins when the individual
continues to move without fully recovering. This
means the individual continues to use patterns
of compensation in movement, which continues
to stress other segments of the body
inappropriately. This process causes further
cellular damage throughout the body and
eventually leads to injury.
Worse yet, the continual repetition of moving
with patterns of compensation can lead to a
habitual change of mechanics in the individual’s
Movement Patterns. In other words, the person
learns to move incorrectly and develops
inefficient movement habits that they repeat on a
continual, if not daily basis.
Continuing to perform movements with patterns
of compensation maximizes inefficiencies and
leads to injury.
Asymmetrical Weight Shift
Looking back at the previous example of the
ankle sprain/stubbed toe, a pattern for additional
dysfunction can easily develop within that
individual’s movement. For instance, let’s say
the individual does not allow the ankle or toe to
heal fully and continues to exercise. The body
naturally create patterns of compensation in the
way it moves to protect the injured ankle or toe.
This includes shifted weight and impact forces
from the injured foot to the opposite foot. The
real trouble occurs if this individual continues to
play basketball or exercises with this pattern of
compensation.
Over time this individual’s body will re-enforce
this pattern of shifting weight to the ‘healthy’ leg,
strengthening that side of the body, but more
importantly limiting the opportunity for the injured
side to develop the same amount of strength.
Every time this individual jumps, squats, or runs,
the body will inherently shift the majority of
weight to the stronger leg, only further
developing a strength imbalance between the
legs, eventually manifesting into a dysfunctional
movement habit.
Scar Tissue ‘Scar tissue’ is a phrase most people are familiar
with. However, most people do not understand
that scar tissue play the same role as
adhesions.
Scar Tissue uses strong collagen proteins to
bind and protect injured cells in an area of the
body that has experienced a form of trauma,
such as a tear, rupture, or laceration. The
amount of scar tissue accumulating in the
affected area is proportional to the severity of
the injury, which also dictates the length of time
and effort a person needs to put forth to recover
optimal mechanics afterwards.
Serious Business
PreHab Exercise eBook for Soft Tissue Therapy
5 INTRODUCTION Due to the severity of trauma, the risk of injury,
and the possible consequences of an
individual’s future biomechanics and Movement
Patterns, it is highly recommended that trainers,
coaches, and athletes refer to the expertise of
physical therapists and athletic trainers before
attempting to treat effected areas and the
associated scar tissue.
Here is a list of contraindications for treating
Adhesions and Scar Tissue:
• Acute inflammation (Swelling)
• Laceration (Open Wounds)
• Malignancy (Incorrect Alignment)
• Osteoporosis (Bone Decay/Disease)
• Ligamentous Rupture
• Herniated disks
• Nerve Compression or Damage
Refer the athlete or client to a Physical
Therapist, Athletic Trainer, or Physician.
Resolve to Restore
No matter where the client or athlete is in the
injury cycle, or even if the individual is simply
dealing with a knot or Trigger Point, it’s
important to fully commit to the process of
restoring one’s biomechanics and Movement
Quality with effective measures within an
appropriate time frame.
Any and all deviation from proper joint health,
including arthrokinematics and Range of Motion,
as well as soft tissue flexibility, length, and
responsiveness, will lead to patterns of
compensation that ultimately create movement
dysfunctions and can lead to injury.
Commit
to
the
process
of
restoring
biomechanical
integrity
and
optimizing
Movement Quality.
PreHab Exercise eBook for Soft Tissue Therapy
6 INTRODUCTION Practicing Soft Tissue Therapy
Before applying soft tissue therapy, first learn
the most effective ways of practicing soft tissue
therapy. Here are some effective soft tissue
therapy techniques:
Soft Tissue Therapy Techniques
Hold and Release
Articulate the Joint
Slow Roll
Quick Roll
Oscillating
Rotating
Hold and Release
In this technique, an individual uses a soft tissue
therapy tool, such as a foam roller or massage
ball, to place pressure on a particular area of
tissue where a knot of Myofascial Trigger Point
exists. This procedure is very similar to both
Swedish Massage and Acupressure techniques.
The method utilizes pressure to stimulate
mechanoreceptors within the soft tissue that
send signals to the corresponding Motor
Neurons so they release the Trigger Point or
Knot.
Hold pressure over targeted area for 5-30
seconds or until the corresponding Trigger Point
releases.
Articulate the Joint
In this technique, the individual places pressure
over a sensitive area just as in the Hold and
Release technique. Then the individual slowly
articulates the corresponding joint. Articulate
refers to moving the joint, i.e. flexing and
extending or rotating the individual joint. For
example, when the individual holds pressure on
the calf muscles, the next step is to flex and
extend or rotate the ankle. Movement at the joint
causes the targeted tissue to lengthen and
contract under pressure, which breaks up
Trigger Points and clears out/separates
adhesions in the area.
Hold pressure over a targeted area and
articulate the joint for 5-30 seconds or until the
sensitivity in the tissue dissipates.
Slow Roll
In this technique, the individual slowly rolls over
a sensitive area in an attempt to drain blood
from the tissue and pull out metabolic waste that
may be contributing to the formation of a Trigger
Point. At the same time, the Slow Roll improves
circulation in the area; the increased blood flow
adds more oxygen and nutrients to the affected
area, all of which facilitates the release of
Trigger Points and lengthens the tissue.
Perform several Slow Rolls in a smooth and
deliberate fashion over the affected area for
approximately 30 seconds or until the Trigger
Point releases.
Quick Roll
In this technique, the individual practices several
smooth and quick rolls of pressure over a
targeted area in an attempt to stimulate the
proprioceptors and mechanoceptors within the
tissue to increase neuromuscular activity in the
area, consequently improving blood flow and
flexibility. However, Quick Rolls are often
ineffective in regard to releasing Trigger Points
or breaking up adhesions. This technique is very
effective in increasing blood flow and stimulating
the tissue. It is recommended to be used as a
complimentary technique to the Slow Roll.
Perform numerous Quick Rolls over a targeted
area in a smooth and deliberate fashion for 1530 seconds.
Oscillating
Oscillating is a method similar to and can be
combined with the Slow Roll and Quick Roll. In
this technique, the individual practices several
smooth rolls over a targeted area and then
intermittently pauses and oscillates (rotate) the
roll from side to side at different positions. This
oscillation effect redirects pressure across the
cells of the soft tissue in a massage technique
called Cross-Fibering. Cross-Fibering uses
pressure to widen and separate soft tissue cells.
This extracts metabolic waste from the cells and
increases blood flow and oxygen to the cells that
release Trigger Points. Additionally, the lateral
direction of the oscillation force has the potential
of dislodging fibrin and collagen fibers that make
up adhesions in the soft tissue.
Perform numerous Oscillations while rolling over
a targeted area for approximately 30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
7 INTRODUCTION Rotating
This technique is very similar to Oscillating
except with a change in direction. In this
practice, the individual applies pressure in a
twisting fashion to a targeted area. More
specifically, the individual rotates an object, such
as a ball or a knuckle, while also pressing the
object into the tissue. The results are the same
as oscillating: improved blood flow to the
affected area, removal of metabolic waste, and
even dislodgement of possible adhesions.
Perform numerous Rotations while applying
pressure to a targeted area for approximately 30
seconds.
Soft Tissue Therapy Tools
The next step is to understand the
characteristics of the different tools used in soft
tissue therapy: foam rollers, lacrosse balls,
softballs, golf balls, specialized massage balls,
rolling sticks, barbells, PVC plastic tubing, and
much more.
Density Matters Each of the aforementioned soft tissue therapy
tools has a different density, which results
different types and/or levels of pressure applied
to the body using that particular tool. Simply put,
the density dictates the amount of pressure. The
harder the object, the greater the magnitude of
pressure available for the soft tissue therapy
technique.
The magnitude of pressure majorly impacts the
physiological reaction in the tissue. The more
the pressure increases in magnitude, the larger
the sensation emitted through the soft tissue.
The magnitude of pressure in soft tissue therapy
is similar to the volume of one’s voice in a large
auditorium. The louder the voice, the more the
sound is heard echoing in the auditorium. That
being said, a very well-trained voice can make a
whisper heard throughout the entire auditorium.
Sensitivity As noted above, louder and harder are not
always better. This is especially true in soft
tissue therapy as each person has a different
tolerance level for pain and discomfort. While a
greater magnitude of pressure creates a
physiological reaction in more tissue, all that
gain can be lost if the individual cannot tolerate
that level of pressure.
Many people tense their soft tissue as protection
against a pressure that exceeds their sensitivity
threshold. Therefore, it is more effective to use a
soft tissue therapy tool that creates a tolerable
magnitude of pressure for the individual.
Use a soft tissue therapy tool dense enough to
elicit a physiological change in the soft tissue
without creating unnecessary tension in the
tissue from exceeding the individual’s sensitivity
threshold.
PreHab Exercise eBook for Soft Tissue Therapy
8 INTRODUCTION Soft Tissue Therapy Tools
According to Density:
Foam Roller (Styrofoam)
Tennis Ball
Massage Ball
Foam Roller (Padded PVC Tube)
Rolling Stick
Lacrosse Ball/Softball
Golf Ball
PVC Plastic Tubing
Barbell
Human Hands
Note, the firmness and pressure produced by
each soft tissue therapy tool can be modified
and regulated by the way in which the tool is
used.
Self-Massage
The most accessible soft tissue therapy tool to
use is the Human Hand, which can be very
effective when used skillfully in a number of
different techniques.
Practicing soft tissue therapy with the hands
offers a number of advantages that ‘tools’
generally do not. For example, the size of the
fingers and knuckles allows for deeper infiltration
of the soft tissue, which breaks up ‘stiffness’ and
flushes out stagnant fluid that accumulates over
time around Myofascial Trigger Points. This
deeper penetration profligates the tissue with a
fresh dose of blood that carries much needed
nutrients and oxygen to the cells.
Another advantage of using hands for soft tissue
therapy is ‘dexterity.’ The hands offer an array of
different techniques that provide more leverage
in smoothing out the tissue.
Each Self-Massage Technique offers a different
‘texture’ of pressure or force that positively
effects the soft tissue and breaks up knots and
possibly adhesions. Ultimately, using hands for
Self-Massage techniques offers more options for
an individual to be effective in his or her soft
tissue therapy practice.
The biggest advantage of Self-Massage is that it
can be practiced anywhere and everywhere.
Therefore, there is no reason for an individual
not to practice soft tissue therapy on a daily
basis.
Remember to Breathe
It is extremely important to breathe with an
emphasis on large exhalations when practicing
soft tissue therapy.
This stimulates the
Parasympathetic Nervous System and causes
more beneficial changes in the soft tissue.
Self-Massage Techniques:
Press and Hold
Press and Slide
Press and Twist
Press and Cross-Fiber
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Squeeze and Cross-Fiber
Rake
Rake Apart
Rake Apart – Cross-Fibering
Tapping
PreHab Exercise eBook for Soft Tissue Therapy
9 INTRODUCTION PreHab Exercise eBook for Soft Tissue Therapy
10 INTRODUCTION Breathing
Human Beings can go:
Weeks without food.
Days without water.
Only minutes without breathing.
These truths put into perspective the importance
of breathing for survival. However, survival is not
the only thing to which breathing is critical;
breathing is essential to Mobility Training.
An individual can only 'go' as far as his breathing
takes him.
To understand the relationship between
breathing and mobility, we start with a simplified
description of the Nervous System.
Nervous System: A Tale of Two
Tones
The Nervous System in the Human Body is said
to have two 'subsystems' that influence
physiological and biochemical reactions in the
body.
The Nervous System is divided into:
The Sympathetic Nervous System
The Parasympathetic Nervous System
The general functions of these two subsystems
can be characterized in similar fashion to the
gas pedal and brake of a car.
The Sympathetic System (SNS) is the gas
pedal.
The Parasympathetic System (PNS) is the
brake pedal.
Fight or Flight The Sympathetic Nervous System (SNS) gets a
person to get up and go, especially in 'fight or
flight' situations, by creating tension in the body
that prepares the neuromuscular system to
create fast, explosive movements, i.e. Fight or
flight. The SNS also releases specific stress
hormones, including adrenaline and cortisol, to
provide an adequate amount of energy to
sustain the necessary movements of fight or
flight.
In general, the SNS acts as a 'gas pedal' that
creates a specific environment in the body
characterized by tension and stress hormones.
Rest and Digest On the other hand, the Parasympathetic
Nervous System (PNS) acts as a brake for the
'go-go-go' of the Sympathetic Nervous System
(SNS) and its 'fight-or-flight' responses. The
PNS is characterized as the 'rest and recover'
system because the chain of biochemical and
physiological reactions that occur enables the
body to engage in protein synthesis, cellular
regeneration, and the deflation of stores of
tension in the neuromuscular structures
(muscles, tendons and fascia).
More
specifically, the PNS transmits neurological
signals to command the motor units of locked
muscle fibers (myofascial trigger points, aka
knots) to release and lengthen again.
The PNS also assists in re-oxygenating the
blood supply. When combined with improved
circulation through the soft tissue due to the
absence of neuromuscular tension, this can
rectify the pH levels of the cells and accelerate
cellular regeneration.
In summary, the PNS helps the soft tissue
release, recover, and regenerate.
Regulating the Two Systems Long before science ever named and
categorized the Sympathetic Nervous System
(SNS) and the Parasympathetic Nervous
System (PNS), Human Beings created specific
ways to manage and regulate these two
systems. Many of these ‘practices,’ including
yoga and Tia Chi, are based on both breathing
and movement.
Or, more precisely, these
practices were based on a specialized
movement for breathing.
An individual can stimulate and/or regulate both
the Sympathetic Nervous System (SNS) and the
Parasympathetic Nervous System (PNS) with
the use of specified breathing techniques.
PreHab Exercise eBook for Soft Tissue Therapy
11 INTRODUCTION Inhale vs Exhale Exhale to Mobilize Each portion of the breathing cycle, the inhale
and the exhale, has a differing effect on the
Nervous System in terms of the subsystem
stimulated and prompted to action.
The biochemical and physiological reactions
associated with a Parasympathetic ‘Tone’ of the
Nervous System are a great benefit to any
individual’s Mobility practice, which is one of the
reasons many yoga classes begin with a ‘Lion’s
Breathe,’ or a large exhale.
Inhale > SNS
The Sympathetic Nervous System (SNS) is
stimulated or activated when an individual
inhales deeply, holds her breath or maintains a
1:1 breathing ratio of inhalation to exhalation.
This means that when an individual breathes in
deeply or holds her breath, her Nervous System
cultivates a more Sympathetic 'Tone.' This
meaning there is an increase in biochemical and
physiological reactions in the body that correlate
to the 'fight or flight' response, pumping the
individual with adrenaline.
Example – Many people ‘take a deep breath’
before heading into a performance, whether
shooting a foul shot in basketball or giving a
speech in front of peers and/or colleagues.
Exhale > PNS
Conversely, when an individual deeply exhales
or consecutively breathes in an exhalation cycle
longer than an inhalation (as is practiced in
some breathing meditations), that person's
Nervous System develops a Parasympathetic
'tone', which increases specific biochemical and
physiological reactions correlating to 'rest and
recover'.
The release of bound or locked Actin and
Myosin within a muscle fiber translates to the
length of a given muscle and is one of the
physiological responses or benefits associated
with a Parasympathetic 'tone' of the Nervous
System.
Emphasizing the exhale while practicing the
Mobility exercises in this book enhances the
effectiveness of the exercises.
Practicing the Exhale Breathing is a habit. More precisely, breathing is
a neuromuscular skill, the same as juggling,
shooting a jump shot in basketball, throwing a
curve ball in baseball, or doing a cartwheel over
a balance beam in gymnastics.
Individuals develop and constantly practice this
‘habit’ or specified Movement Pattern of
breathing. Some individuals are ‘high chest’
breathers and others are ‘relaxed belly’
breathers. The method in which an individual
breathes soon becomes a strong, welldeveloped movement habit or neuromuscular
skill as an individual breathes approximately
1,200 in a given day. This equates to 1,200
repetitions of the same Movement Pattern!
1,200 repetitions on a daily basis strongly reenforces an individual’s Movement Pattern or
‘habit’ of breathing – for better or for worse.
Developing a New Breathing Habit Essentially, the more the exhale is emphasized
in breathing, the more active the PNS becomes,
and the more release/lengthening occur in the
soft tissue. This translates to a greater Range of
Motion around the joints and improved overall
Mobility.
Since breathing is a neuromuscular skill, aka
movement habit, individuals who are “inefficient
breathers” need to develop a new way of
breathing to replace the inefficient way of
breathing as it relates to Mobility. A positive and
efficient habit of breathing leads to many
benefits in the rest of the body’s Mobility
Training.
An individual's Mobility greatly benefits when the
Nervous System has a Parasympathetic 'Tone,'
which can be induced with a breathing practice
that emphasizes the exhalation over the
inhalation (or the act of holding the breath).
Mobility
Training
receives
positive
reenforcement from breathing habits that
emphasize large or deep exhales as opposed to
breathing habits that either emphasize the inhale
or holding the breath.
PreHab Exercise eBook for Soft Tissue Therapy
12 INTRODUCTION Breathing Exercises
Here are two very simple breathing exercises an individual can use to develop a more effective breathing
habit.
Passive Breathing Exercise Lie on the floor with palms face-up alongside the
body and feet positioned shoulder-width apart.
Reach the crown of the head towards the
horizon and the heels of the feet towards the
other horizon to feel ‘tall’ or ‘long’ from head to
toe. Relax the body as much as possible and
close the eyes.
Next, allow the breath to enter and exit the body.
Do not try to actively breathe. Instead, remain as
passive as possible and just allow the breath to
breathe itself.
Start to give the ‘weight of your body’ over to the
floor on each and every exhale. In other words,
feel the floor hold the ‘weight of the body’ more
and more, which releases the neuromuscular
tension stored in the soft tissue.
Continue to give the ‘weight of the body’ to the
floor on each exhale for 60-90 seconds or a total
of 30 breaths.
This exercise teaches the body to use each
breath to release tension in the soft tissue,
which assists in all Mobility Training.
PreHab Exercise eBook for Soft Tissue Therapy
13 INTRODUCTION Active Breathing Exercise Lie on the floor with the arms placed alongside
the body with palms face-down and feet flat on
the floor, positioned shoulder-width apart and
knees bent at 90º angles.
Now, breathe and send the breath of each
exhale all the way up to touch the ceiling, as if
attempting to blow out birthday candles across
the room. This action engages the Core Muscles
when exhaling, which is beneficial to both Core
Stability
as
well
as
activating
the
Parasympathetic Nervous System.
Practice 3-5 Cycles of Exhalations.
Next, pull the belly button and sides of the torso
in towards the spine on each exhalation. This
action engages the Transverse Abdominis and
Oblique (Core) Muscles that drive a larger
breathe out on each exhale, which assists in
activating the Parasympathetic Nervous System.
Practice 3-5 Cycles of Exhalations.
Afterwards, press hands and feet into the floor
still constantly engaging the Core muscles and
attempting to ‘blow out birthday candles’ or
touch the ceiling with the exhalation.
Pressing hands and feet into the floor while
exhaling will engage Pelvic Floor Muscles, as
well as the Glutes (Hips) Muscles, Latissimus
Dorsi, and Rhomboids (Back) Muscles. The
engagement of these muscles, in combination
with the engagement of the Transverse
Abdominis and Oblique (Core) Muscles, creates
a synergy of forces in the body, in which five
sides of the torso drive the breath out towards
the ceiling to create the largest possible
exhalation.
Practice 5-10 Cycles of Exhalations.
This Active Breathing Exercise teaches an
individual the neuromuscular coordination
necessary to develop adequate Core Stability,
but more importantly, this exercise stimulates
the Parasympathetic Nervous System, which
helps the soft tissue relax, release, and lengthen
to improve the individual’s overall level of
Mobility.
PreHab Exercise eBook for Soft Tissue Therapy
14 INTRODUCTION Mobility
To make any improvement in Movement Quality
or
restore
Biomechanical
Integrity,
an
individual’s Mobility needs to be addressed and
appropriately developed.
Define Mobility
A Google search for ‘mobility’ reveals a host of
YouTube videos and Instagram posts of
elaborate, if not exotic-looking, exercises not to
mention the thousands of images of tactical
military vehicles or motorized wheel chairs and
accessories.
But in regard to Human Movement, Mobility
refers to an individual’s capacity to move
through a predetermined pattern of consecutive
shapes or positions with complete accuracy and
a full Range of Motion.
An easy way to address Mobility is to ask, ‘Can
the individual get into the correct position without
some degree of compensation?’
Mobility is the combined product of an
individual’s flexibility, joint health, and Motor
Behavior
(neuromuscular
coordination).
Together, these three attributes determine
whether or not an individual can ‘get into the
correct position.’
Flexibility Almost everyone knows that muscles contract
and lengthen. It is widely understood that all
Human Movement is created by the elaborate
process of multiple muscles contracting and
lengthening in a coordinated fashion, much like
an orchestra beautifully playing a symphony
together. However, muscles are not the only
physiological structures that contract and
lengthen.
All four soft tissue structures—muscles,
tendons, fascia and ligaments—have the ability
to contract and lengthen, some more than
others.
Flexibility relates to the soft tissue’s ability as a
whole to contract and lengthen.
Within the scope of the soft tissue, the Muscles,
Tendons and Fascia are the three structures
that contract and lengthen the most. Ligaments
have a limited capacity to lengthen and when
they are forced to lengthen, it is usually as a
protective measure and a way to avoid
immediate trauma, but may result in injury. On
the other hand, muscles, tendons and fascia (an
interwoven net of connective tissue spans
throughout the entire body) expand and contract
with great strength, speed, and accuracy.
However, their maximum performance is
reached only when all conditions are set
appropriately for these tissues, which is one of
the reasons why practicing Mobility exercises is
so important.
Joint Health What is a healthy joint? A joint that functions the
way that it was designed to function.
‘Joint Health’ refers to the level of functionality of
a joint, or arthrokinematics. Arthrokinematics is a
term that describes the structural design and
operational prescripts of a joint. More
specifically, it is the study of how joint surfaces
interact with one another to produce movement.
Arthrokinematics is primarily where the qualities
and measurements for Biomechanical Integrity
are established.
Good
‘Joint
Health’
means
that
the
arthrokinematics are functioning as designed
and that there is a high level of Biomechanical
Integrity. However, good Joint Health is not
always the case.
Many individuals experience obstructions
caused by acute trauma, major and minor, as
well as long time repetitive stresses that limit or
impair the arthrokinematics of joints resulting in
PreHab Exercise eBook for Soft Tissue Therapy
15 INTRODUCTION compensation in Human Movement. For this
reason, the habitual practice of Mobility
exercises
is
recommended
and
highly
encouraged.
(arthrokinematics),
and
Motor
Behavior
(neuromuscular coordination), all of which is
changing on a daily basis – sometimes for the
better and sometimes for the worse.
For the Worse Motor Behavior Human Movement is a product of the
neuromuscular system, which is the integration
of the neurological and physiological systems. It
is the combined efforts of the Nervous System
and the soft tissue, i.e. muscles, tendons, fascia
and ligaments that manipulate (move) the
Skeletal System (bones) to actually create
Human Movement.
Motor Behavior refers to the process of how
Human Movement is ‘learned’ and developed
over time through initiation, practice and
repetition by the neuromuscular system. More
specifically, it is the conceptual understanding of
how the Nervous System coordinates and
stimulates the soft tissue, particularly muscles,
tendons, and fascia, to create movement.
The idea of Motor Behavior is a conceptual
umbrella that includes Motor Learning (the way
the Nervous System interprets and learns
movement) and Motor Control (neuromuscular
coordination, or the detailed way that the
Nervous System communicates with soft tissue
structures to ‘activate’ specific muscle fibers and
initiate a contraction or lengthening sequence to
create movement).
Motor Behavior, more specifically Motor Control
(neuromuscular
coordination)
and
Motor
Learning, plays an important role in an
individual’s Mobility because often a limitation or
lack of mobility occurs due to the individual’s
inability
to
use
the
Nervous
System
appropriately to create a specific movement or
hold a particular position. More precisely, an
individual may not have the appropriate Motor
Control to perform a movement and must go
through the process of Motor Learning to
achieve success in that movement.
Any and all changes in both flexibility and joint
health also affect the Motor Behavior of the
individual – for better or for worse.
Mobility Changes
As previously mentioned, mobility is dependent
on the individual’s flexibility, joint health
Repetitive movements and inactivity can put a
strangle hold on an individual’s mobility as well
as ability to recover, leading to high levels of
stress and injuries. It’s important for the trainer,
coach, and athlete to understand what can
negatively impact mobility so that they can
safeguard against these causes and plan
appropriate countermeasures (PreHab and
Corrective exercises) to affect the limitations on
mobility.
Mobility Worsens with:
• Repetitive Movements – such as sitting
or texting
• Inactivity – Sedentary and Actively
Sedentary Lifestyles
• Lack of Recovery – Ineffective Work-toRecovery Ratio in Training/Life
• Continual High Levels of Stress –
Overactive
Sympathetic
Nervous
System
• Injuries – Formation of Adhesions and
Scar Tissue
Room for Improvement
Just as an individual’s level of mobility can
worsen, it can also improve. There are a few
different ways a person can change his mobility
for the better, including soft tissue therapy, joint
distraction exercises, and various forms of
stretching.
The Importance of Mobility
Why is Mobility important? There are numerous
answers that depend on the individual as well as
his or her point in life and the particular activity
he or she is trying to accomplish.
Mobility in Life Every movement in life has a geometric shape
constructed by the cooperation of the
neurological
and
physiological
systems,
constituting human biomechanics. These
geometric shapes are known as Movement
Patterns.
In order to perform a particular
movement, the body needs to be able to create
the appropriate shapes. If the body cannot
create the necessary shapes, then the body
cannot perform that movement.
PreHab Exercise eBook for Soft Tissue Therapy
16 INTRODUCTION Unfortunately, Human Movement is not held
hostage by a lack of mobility. People still
complete movements and tasks even when their
mobility is not at the level it should be.
However, a lack of mobility lessens the
mechanical efficiency and quality of movement.
Human Beings are very resilient and
subconsciously ‘compensate’ as much as
possible to complete a given movement.
Compensate to Achieve All Human Movement is ‘task orientated’, and
people move to accomplish specific goals or just
to ‘get things done.’ More specifically, every
movement a person makes is done to fulfill a
particular goal. Whether the movement is just
reaching up to scratch a nose, pulling open a
door, or shifting nervously from side-to-side in a
conversation, every movement made by a
Human Being serves to complete a given task.
Without adequate Mobility, people will alter the
way they perform a given movement to complete
the task associated with the given movement.
This is called “compensating” and it is a
consequence of moving without adequate
Mobility.
Example – an individual with limited mobility in
his hips will round his spine forward into deep
forward flexion to lift items off the floor despite
the items’ weight.
This altered form of
movement, i.e. pattern of compensation, can
and
will
create
additional
negative
consequences in regards the individual’s
biomechanics and level of Movement Quality.
A lack of mobility creates a pattern of
compensation in an individual’s movement,
which alters, if not, deteriorates the integrity
(proper functionality) of that individual’s joints
and corresponding tissues. The ultimate result of
a lack of mobility is a lessening of Movement
Quality that will create inefficiency in
performance and eventually lead to injury over a
long enough period of time.
Compensation Defined The act of altering the naturally prescribed
neuromuscular
coordination
and
arthrokinematics (joint function) within an
individual’s Movement Pattern is a form of
compensation in regards to Human Movement.
Consequences of Compensation Unfortunately, there are consequences for every
act of compensation. Whether the degree of
compensation was small and barely noticeable
or large and obvious, an act of compensation
will place an inappropriate amount of stress, in
this case, misdirected kinetic energy, onto
physiological structures, i.e. soft tissue cells and
joints that were not designed to handle that
amount of stress.
The exposure of these physiological structures
to an inappropriate amount of stress jeopardizes
and/or
immediately
compromises
that
individual’s biomechanical integrity and lowers
his or her Movement Quality.
Compensation Grows To make matters worse, compensation in
Human Movement has the innate ability to
escalate and express itself in prolonged and
repeated acts of dysfunction that steadily
increase the risk of physiological ‘break-down’
and injury.
Additionally, the repeated use of compensation
patterns in movement changes an individual’s
neurological approach to Human Movement. In
other words, the more an individual executes a
given movement pattern, such as squatting, with
a form of compensation, the more the
individual’s Nervous System learns and adapts
so the compensation becomes the default
neurological pattern to use in movement.
Exercising Makes Compensation Worse
It’s important to understand that compensation
negatively impacts biomechanical integrity and
Movement Quality. It’s also important to
understand that exercising while various forms
of compensation are present only decreases the
level of biomechanical integrity and Movement
Quality, unless the individual is practicing
Corrective Exercises that intentionally target the
corresponding movement dysfunctions.
Exercising Awareness Exercising is one of the rare opportunities an
individual has in his day to be consciously aware
of how his body is moving. Most movements an
individual makes through the course of the day
are executed subconsciously, or more precisely,
in a collection of ‘Movement Habits.’
PreHab Exercise eBook for Soft Tissue Therapy
17 INTRODUCTION Human beings utilize the ‘habit loop’ to
coordinate and execute movements as a way to
economize thought and provide more mental or
conscious awareness on completing the task
associated with that movement. However,
exercising provides the opportunity for an
individual to monitor as well as change his or her
movement.
Form Equals Function Placing ‘awareness’ on movement while
exercising is an excellent way for an individual to
assess, address, and eliminate patterns of
compensation.
Practicing Mobility exercises provides the
individual with the ability to get into the position
that offers the highest level of function for a
given task.
Reason to Stop
Once a pattern of compensation is recognized in
how a person moves during exercise, there is an
opportunity to interrupt that ‘movement habit’
and make an adjustment in the approach to
movement, thus attempting to change the habitlike form of that compensation.
Interrupting Patterns of Compensation
1) Recognize the Compensation Strategy
in the Movement Pattern
2) Cue and Coordinate Alternative Strategy
Before Next Rep
3) Evaluate the Change in Movement
If an individual cannot change the execution of a
Movement Pattern with three reps of cueing
during exercise, then alternative techniques
need to be applied to interrupt the pattern of
compensation. This might include practicing
Mobility exercises to increase Range of Motion
of Flexibility.
Reason to Improve
Many times, Mobility exercise provides the
missing flexibility and/or Range of Motion that
allows an individual to execute a specific
Movement
Pattern
with
appropriate
biomechanical integrity and optimal Movement
Quality.
Improvement in an individual’s Mobility also
improves an individual’s functionality in Human
Movement as well as increases the Quality of
Life.
Improved Mobility also results in a positive effect
within the realm of athletics, training, and
personal fitness/health programs.
As mentioned before, Human Movement is
formulated on geometrical shapes of the body.
In other words, form equals function when it
comes to Human Movement. The degree of an
individual’s Mobility dictates her ability to
function when it comes to sports, exercising, and
more.
Mobility Offers Mechanical Advantage When an individual is able to get into more
positions, he or she can then utilize a position
that offers a higher Mechanical Advantage, a
useful skill in both sports and exercise.
Mechanical Advantage is taught and trained for
in every sport, from Martial Arts to Gymnastics,
from Baseball and American Football to
Running.
Mechanical Advantage Improves Movement Quality Having the Mobility to create a better level of
Mechanical Advantage also benefits an
individual’s Daily Life Activities. Mechanical
Advantage allows an individual to reduce the
stress on physiological structures while also
limiting the risk of malalignments in the
functioning of the joint (arthrokinematics). More
importantly, having enough Mobility to create a
Mechanically Advantageous position limits
Compensation and Dysfunction.
The level of an individual’s Movement Quality is
inversely related to the degree to which the
individual moves with patterns of compensation
or biomechanical dysfunctions in his or her
Movement Patterns.
Ways to Increase Mobility
One of the most effective practices to use to
increase one’s own level of Mobility and
Movement Quality is Soft Tissue Therapy.
However, before starting Soft Tissue Therapy,
it’s a good idea to know some of the most
common limitations and dysfunctions in Human
Movement.
PreHab Exercise eBook for Soft Tissue Therapy
18 Common Patterns
of Compensation
and Movement
Dysfunctions
Within Human Movement, various patterns of
compensation and associated Movement
Dysfunction will limit an individual’s capability in
performance and also dramatically increase the
risk of, if not guarantee, a future injury.
Conversely, trainers, coaches and athletes that
can identify common patterns of compensation
in Human Movement, will have an opportunity to
correct the associative Movement Dysfunctions,
restore
Biomechanical
Integrity,
improve
Movement Quality and limit the risk of injury as
well as to contribute positively to both training
and performance.
Fall from Grace Patterns of Compensation develop in Human
Movement for many reasons. From injuries to
Daily Life Activities, the Human Body is
constantly being shaped and re-modeled
through ‘mechanotransduction,’ which is the
process in which biomechanical forces in
combination with biochemical reactions and
energy flows literally ‘deform’ (or change the
form of) each and every cell. In addition,
mechanotransduction manipulates and modifies
corresponding strands of DNA. In other words,
Human Movement continuously shapes and reshapes the Human Body.
What’s most alarming about this relationship
between movement and the body is that
movement can re-shape the body for the worst,
and will at times lessen the body’s capability to
function as it could or as it is designed to
function. Thus, the scope of Human Movement
can have a ‘negative’ influence on the evolution
of the Human Body.
Modern Living As many professionals have already laid claim
to in books and research papers, the collective
summation of Daily Life Activities (such as
texting or sitting) in the Modern World (referring
to ‘develop societies’ that utilize a high amount
of technology and automation systems for
survival) is undermining, if not eroding an
individual’s capacity to maintain Biomechanical
Integrity and correct joint and tissue function
when moving. In short, modern living is making
individuals move poorly.
Compensation A pattern of compensation is the body’s attempt
to make up for the lack of movement in one area
by adding a new movement. More specifically, a
compensation pattern is a neuromuscular
strategy of including a ‘new’ firing sequence
(Motor Units and Muscles) and/or utilizing
structural reliance (bones, ligaments, tendons,
fascia and joint structures) to supplement or
avoid another firing sequence and/or structural
reliance.
Essentially, a compensation pattern is an
alternate neuromuscular strategy that the body
PreHab Exercise eBook for Soft Tissue Therapy
19 COMPENSATION PATTERNS employs when the naturally prescribed
neuromuscular strategy is no longer a viable
option to use in the creation of a given
movement.
Walking on a limb after an ankle sprain is an
example of a compensation pattern. The body
simply replaces its normal gait (walking)
mechanics with an alternate version or strategy
that limits the amount of weight placed on the
injured ankle.
Subtle Changes Many compensation patterns are subtle or
hardly noticeable and grow over time to a larger
scaled compensation. This ‘domino effect’ is
detrimental to an individual’s Biomechanical
Integrity and Movement Quality.
A perfect example of the compensation ‘domino
effect’ is witnessed in an individual who
continually walks or stands on hard, flat
surfaces, such as a concrete floor in an average
workshop or a steel floor in high-rise building. In
each of those environments, the hard, flat floor
offers no ‘give’ (malleability or flexibility) as
grass, dirt, sand or other natural surfaces do.
Consequentially, the Posterior Tibialis (Calf
Muscle) becomes overworked in an effort to
maintain a support arch in the foot for the
individual who is constantly standing and
walking on hard, flat surfaces. This muscle
weakens over time due to the repetitive high
volume of stress, i.e. attempting to support all
the bodyweight over the arch of the foot while
standing or walking.
Next, the foot habitually pronates in an
excessive manner (allows the arch of the foot to
collapse towards the floor), a result of the
sequential Movement Dysfunction associated
with the weaken Posterior Tibialis muscle. The
excessive pronation of the foot adds additional
consequences over time.
Dominos Falling The act of habitually walking on hard, flat
surfaces overworks the Posterior Tibialis and
allows the arch of the foot to become
compromised, eventually collapsing towards the
floor. The next domino to fall is the adduction or
inward movement of the Tibia (Shin bone) that
causes the Peroneals (Lateral Calf Muscles) and
Biceps Femoris (Lateral Hamstring Muscles) to
eccentrically (negatively) contract as a
compensation strategy for neutral alignment and
stability of the knee joint. In short, one form or
strategy of compensation in Human
Movement eventually leads to another and
another – no matter how subtle the first form
of compensation is at the start.
Patterns Form In the game dominos, when one tile falls,
another is quick to follow, just like
compensations and Movement Dysfunctions.
When one muscle forms a compensation,
another compensation will follow, it’s only a
matter of where and when. For example, when
the foot continuously pronates (allows for a
collapsed arch), then there is a high probability
that the Peroneals and Biceps Femoris will
become overactive or tight because one
Movement Dysfunction leads the way for
another Movement Dysfunction. No movement
and no Movement Dysfunction ever occurs in
the body in isolation. The Human Body is a
symbiotic system of physiological structures and
Human Movement is an interdependent system
of movements and Movement Dysfunctions.
Thus, every structure in the body, i.e. joints,
muscles, tendons, ligaments, etc., is connected
to all other structures within the body.
All of Human Movement, as well as Movement
Dysfunctions and Compensation Strategies,
exist in ‘patterns’ within the body.
Important to Recognize
Having the ability to recognize patterns of
compensation and Movement Dysfunction
provides the individual with the opportunity to
correct and neutralize the risks and damage
associated with patterns, as well as allows the
individual to develop more efficiency and
integrity in regard to biomechanical functions
and Movement Quality.
Unfortunately, if uncorrected or undetected, the
patterns of compensation and associated
Movement Dysfunctions can and will disrupt
Human Movement, increasing the risk of injury
and damage to the body, even if the individual is
unaware of these risks.
Learning to recognize some of the common
patterns of compensation is a reliable tool an
individual should use in the effort to minimize
risk of injury and damage associated with
Movement Dysfunctions.
PreHab Exercise eBook for Soft Tissue Therapy
20 COMPENSATION PATTERNS Common Patterns of Compensation
Many patterns of compensation are ‘common,’ or found in the movement of many individuals across the
world, due to the high rate of exposure to the causes of these compensation patterns.
As mentioned before, walking on hard, flat surfaces creates a collapsed arch in the foot and initiates a
coordinating pattern of compensation in the body. Most of the modern developed world is equipped with
hard, flat surfaces, on which millions, perhaps billions, of people walk and stand every single day.
Therefore, the probability that a large number of people experience the same pattern of compensation in
their movements is highly likely if not almost definite.
An effective goal for an individual, especially for trainers, coaches and athletes, is to identify common
patterns of compensation in Human Movement to address and correct the associated Movement
Dysfunctions, limit the risk of injury, and improve Movement Quality.
PreHab Exercise eBook for Soft Tissue Therapy
21 COMPENSATION PATTERNS List of Common Patterns of Compensation and
Movement Dysfunctions:
Pronation Distortion Syndrome
Valgus Knee
Patellofemoral Tracking Syndrome
Patellofemoral Pain Syndrome
Quad Dominance
IT Band Syndrome
Asymmetrical Weight Shift
Glute Amnesia Syndrome
Buttwink
Posterior Pelvic Tilt
Anterior Pelvic Tilt
Lower Cross Syndrome
Sway Back - Excessive Lordosis
Upper Cross Syndrome
Rounded Shoulders
Excessive Kyphosis
Forward Head Posture
Shoulder Impingement
Winged Scapula
Flared Rib Cage
Elevated Shoulders
Uneven Shoulders
Hyperinflation
What follows is a brief summation of each of these Common Patterns of Compensation that may
help an individual identify and address the above Movement Dysfunctions.
PreHab Exercise eBook for Soft Tissue Therapy
22 COMPENSATION PATTERNS Pronation Distortion Syndrome
When assessing an individual’s Biomechanical
Integrity and Movement Quality, it is best to start
at the bottom of the body as the feet serve as
the platform upon which the rest of the body
operates. Therefore, it is recommended to start
with analyzing for the Pronation Distortion
Syndrome.
When the foot excessively pronates and the
arch of the foot collapses inward toward the
floor, the tibia (shin bone) also collapses
inwardly causing a Valgus Knee movement,
placing an inappropriate amount of stress on the
knee, especially the ACL.
Furthermore, the femur (thigh bone) adducts or
collapses toward the midline of the body, which
creates tightness in the Vastus Lateralis (Lateral
Quadriceps muscle), the Biceps Femoris
(Lateral Hamstring muscle), and the Peroneals
(Lateral Calf Muscles) as all three muscles
eccentrically contract to help stabilize the knee
joint. This pattern of compensation leads to the
development of a Valgus Knee movement in
squatting, lunging, jumping, running, and even
standing.
(Interior Calf Muscle) and the Gastrocnemius
(Calf Muscle) to activate and induce the
responsiveness of soft tissue in these muscles
to properly align and supinate the foot, i.e.
strengthen the arch of the foot.
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Medias
(Lateral Hip Muscle), Posterior Tibialis (Interior
Calf Muscle), Gastrocnemius (Calf Muscle) and
the Intrinsic Foot Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including squatting, lunging,
and
running.
Also,
challenge
stability,
coordination, and balance with single-leg and/or
Change of Direction (C.O.D.) exercises.
Lastly, Pronation Distortion Syndrome can even
cause Low Back Pain as the Hip Flexor complex
becomes overactive in the body’s attempt to
control the movement of the Femur (thigh bone)
and stabilize both knee and pelvis. Eventually,
overactive Hip Flexors anteriorly compress the
Lumbar Spine and create either an Anterior Tilt
of the pelvis and/or excessive Lordotic
Extension of the spine, referred to as Sway
Back.
RX: Start practicing a combination of soft tissue
therapy and effective stretching techniques on
the following overactive or tight muscles:
Peroneals (Lateral Calf), Biceps Femoris
(Lateral Hamstring), Vastus Lateralis (Lateral
Quadriceps),
Adductor
Complex
(Groin
Muscles), Tensor Fasciae Latae (TFL – Hip
Flexor) and Psoas (Hip Flexors). Also, practice
soft tissue therapy on the Posterior Tibialis
PreHab Exercise eBook for Soft Tissue Therapy
23 COMPENSATION PATTERNS Valgus Knee
A Valgus Knee movement is an involuntary
inward movement of the knee joint, caused by a
lack of Stability in the Ankle and/or Hip. It is also
influenced by the following overactive muscle
groups: Vastus Lateralis (Lateral Quadriceps
muscle), Biceps Femoris (Lateral Hamstring
muscle), and Peroneals (Lateral Calf Muscles).
leg and/or
exercises.
Change
of
Direction
(C.O.D.)
A Valgus Knee movement will disrupt the proper
patellofemoral tracking (tracking in the knee
joint) and place an inappropriate amount of
stress on the ACL.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Peroneals (Lateral Calf Muscles), Biceps
Femoris (Lateral Hamstring), Vastus Lateralis
(Lateral Quadriceps), the Adductor Complex
(Groin Muscles), and Psoas (Hip Flexors).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Medias
(Lateral Hip Muscle), Posterior Tibialis (Interior
Calf Muscle), Gastrocnemius (Calf Muscle) and
the Intrinsic Foot Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, and running. Also, challenge
stability, coordination, and balance with single-
PreHab Exercise eBook for Soft Tissue Therapy
24 COMPENSATION PATTERNS IT Band Syndrome
Another Movement Dysfunction and pattern of
compensation tied to Glute Amnesia Syndrome
and Pronation Distortion Syndrome is IT Band
Syndrome.
Semitendinosus
(Medial/Middle
Hamstring
Muscles), Gastrocnemius (Calf Muscles), the
Intrinsic Foot Muscles, and Transverse
Abdominis/Obliques (Core Muscles).
IT Band Syndrome is the process in which the
Iliotibial Tendon (IT Band) that connects the
Tensor Fasciae Latae (TFL) to the Tibia (shine
bone) becomes inflamed and sensitive due to an
inappropriate amount of stress being placed on
the soft tissue structure.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
IT Band Syndrome usually occurs in individuals
who do not properly activate their Gluteus
Complex, specifically the Gluteus Medius,
and/or do not properly activate their intrinsic foot
muscles and medial Gastrocnemius (Calf
Muscles) to provide adequate amount of control
and stability in the movements of the knee.
Consequentially, the TFL and IT Band attempt to
provide stability to the knee from a mechanically
disadvantaged position. The end result is
prolonged inflammation and sensitivity to the IT
Band from the wear-and-tear and stress of the
compensation pattern.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Tensor Fasciae Latae (TFL – Superficial Hip
Flexor), Gluteus Maximus (Posterior Hip
Muscles), Vastus Lateralis (Lateral Quadriceps),
Peroneals (Lateral Calf Muscles), and Biceps
Femoris (Lateral Hamstring Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Medius
(Lateral Hip Muscle), Piriformis (Posterior Hip
Muscle),
Internal/External
Hip
Rotators,
PreHab Exercise eBook for Soft Tissue Therapy
25 COMPENSATION PATTERNS Patellofemoral Tracking Syndrome
The structure of the knee is designed with two
condyles (shallow grooves) that cradle the
intercondylar fossa (two notches on the end of
the femur) and a sliding flat bone known as the
patella (kneecap) that forms a bracket and
guides the rotational motion of the knee.
When the tracking or movement of the knee
becomes distorted due to Valgus Knee
movements, Quad Dominance, and other
compensation
patterns
or
movement
dysfunctions, the movement dysfunction is
referred
to
as
Patellofemoral
Tracking
Syndrome.
Oblique (VMO – Medial/Inside Quadriceps),
Internal/External Hip Rotators, Gluteus Medias
(Lateral Hip Muscle), Posterior Tibialis (Interior
Calf Muscle), Gastrocnemius (Calf Muscle), and
the Intrinsic Foot Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, and running. Also, challenge
stability, coordination, and balance with singleleg and/or Change of Direction (C.O.D.)
exercises.
There are two main types of Patellofemoral
Tracking Syndrome. The first includes a lateral
shift in the positioning of the Patella (kneecap)
as the knee flexes or extends. This type is
usually associated with a Valgus Knee
Movement. The second type of Patellofemoral
Tracking Syndrome occurs when there is too
much tension or shortening in the Quadriceps.
This continuously pulls the patella (kneecap) into
the distal (bottom) end of the Femur (thigh bone)
while the knee flexes or extends. This type of
Patellofemoral Tracking Syndrome is heavily
associated with Quad Dominance and leads to
Patellofemoral Pain Syndrome or Knee Pain.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Quadriceps (Anterior Leg Muscles), Peroneals
(Lateral Calf Muscles), Biceps Femoris (Lateral
Hamstring), and the Adductor Complex (Groin
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Vastus Medial
PreHab Exercise eBook for Soft Tissue Therapy
26 COMPENSATION PATTERNS Patellofemoral Pain Syndrome
Pain that occurs at the front of the knee and
regularly just behind the kneecap is generally
categorized as Patellofemoral Pain Syndrome.
This knee pain is frequently a result of a type of
Patellofemoral Tracking Syndrome where the
patella (kneecap) is continuously pressed or
pulled into the bottom of the femur, resulting in
an increased amount of friction and wear-andtear on the structures of the knee.
Movement
Patterns,
including
squatting,
lunging/step-ups, and running. Also, challenge
stability, coordination and balance with singleleg and/or Change of Direction (C.O.D.)
exercises.
Patellofemoral Pain Syndrome is greatly
influenced by repetitive movements, i.e. running,
combined with lifestyle factors, i.e. sitting, that
create a pattern of compensation called Quad
Dominance.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Quadriceps (Anterior Leg Muscles), Peroneals
(Lateral Calf Muscles), Biceps Femoris (Lateral
Hamstring), and the Adductor Complex (Groin
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Vastus Medial
Oblique (VMO – Medial/Inside Quadriceps),
Internal/External Hip Rotators, Gluteus Medias
(Lateral Hip Muscle), Posterior Tibialis (Interior
Calf Muscle), Gastrocnemius (Calf Muscle), and
the Intrinsic Foot Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
PreHab Exercise eBook for Soft Tissue Therapy
27 COMPENSATION PATTERNS Quad Dominance
This pattern of compensation is a type of ‘Synergist
Dominance’ pattern in movement, wherein one of
the synergist or assisting muscles begins to overly
compensate for the prime mover or agonist muscle
within a specific movement pattern.
overactive and/or tight muscles: Quadriceps
(Anterior Leg Muscles), Psoas (Deep Hip Flexor),
Tensor Fasciae Latae (TFL – Superficial Hip
Flexor), and the Adductor Complex (Groin
Muscles).
Quad Dominance refers to the pattern in which the
Quadriceps (thigh muscles) are overactive and
compensate/take over for the Gluteus and
Hamstring muscles in movements that include
squatting, lunging, jumping, running and standing.
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Complex
(Posterior Hip Muscle), Hamstring Complex
(Posterior Leg Muscles), and Transverse
Abdominis/Obliques (Core Muscles).
Quad Dominance is tied to another Movement
Dysfunction called Glute Amnesia Syndrome; the
Gluteus muscles are inhibited or ‘turned off’ due to
inactivity, a lack of appropriate neural drive and
lifestyle factors, which includes sitting.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the following
Finally, practice a variety of exercises integrating
these underactive muscles with larger Movement
Patterns, including squatting, lunging/step-ups,
jumping, running, and even standing. Also
challenge stability, coordination, and balance with
single-leg and/or Change of Direction (C.O.D.)
exercises.
PreHab Exercise eBook for Soft Tissue Therapy
28 COMPENSATION PATTERNS Glute Amnesia Syndrome
As mentioned above, Glute Amnesia Syndrome
is a Movement Dysfunction where the Gluteus or
Posterior Hip Muscles are not used enough,
therefore inhibiting, or “turning off,” the
neuromuscular connections.
The neuromuscular connections do not truly turn
off; instead, the body remodels its Motor
Behavior (neuromuscular coordination) to use
an alternate pattern of Motor Control to perform
certain tasks. Over time, this pattern of
compensation is solidified as a pattern of Motor
Behavior or it becomes a ‘Movement Habit’ in
which an individual neglects to activate and use
his or her Glutes (Hip Muscles) to execute
specific movements including squatting, lunging,
and running.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Quadriceps (Anterior Leg Muscles), Psoas
(Deep Hip Flexor), Tensor Fasciae Latae (TFL –
Superficial Hip Flexor), the Adductor Complex
(Groin Muscles), Peroneals (Lateral Calf
Muscles), and Biceps Femoris (Lateral
Hamstring Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Complex
(Posterior Hip Muscle), Piriformis (Posterior Hip
Muscle),
Semitendinosus
(Medial/Middle
Hamstring Muscles), Gastrocnemius (Calf
Muscles), the Intrinsic Foot Muscles, and
Transverse Abdominis/Obliques (Core Muscles).
PreHab Exercise eBook for Soft Tissue Therapy
29 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
30 COMPENSATION PATTERNS Anterior Pelvic
Tilt
After assessing the feet and knees for
compensations, the next area assessed is the
pelvic region or Hips. The Hips are the
foundation and platform on which the Spine and
Upper Body operates. All patterns of
compensation and dysfunctions in the Pelvic
region have an effect on the movement and
alignment of the Upper Body.
One common pattern of compensation is an
Anterior Tilt of the Pelvis. An Anterior Tilt means
the top of the Pelvis rotates to the front of the
body, creating an exaggerated extension of the
Lumbar Spine and possibly the Thoracic and/or
Cervical Spine as well. An Anterior Tilt is
commonly caused by a combination of
overactive muscles, namely the Hip Flexors and
the Latissimus Dorsi.
The trouble with an Anterior Tilt is that it places
an uneven amount of strain on the vertebrae
and discs of the Lumbar Spine (Lower Back),
and can also disrupt the alignment of the
Thoracic Spine, Rib Cage, Shoulders, and
Head.
An Anterior Tilt can be linked to Pronation
Distortion Syndrome, Glute Amnesia Syndrome,
IT Band Syndrome, and Quad Dominance.
Furthermore, it can create even more patterns of
compensation or dysfunction including Forward
Head, Upper Cross Syndrome, Hyperinflation,
and Low Back Pain.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles: Psoas
(Deep Hip Flexors), Tensor Fasciae Latae (TFL
– Superficial Hip Flexor), Latissimus Dorsi (Back
Muscles), Thoracolumbar Fascia (Fascia Sheath
of the Lower Back), Lower Erector Spinae (Low
Back Muscles), Lower Multifidus (Low Back
Muscles), Iliocostalis Lumborum (Low Back
Muscles), Quadratus Lumborum (Low Back
Muscles), Posterior Portion of the External
Obliques (Posterior Core Muscles), Quadriceps
(Anterior Leg Muscles), the Adductor Complex
(Groin Muscles), Peroneals (Lateral Calf
Muscles), and Biceps Femoris (Lateral
Hamstring Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Complex
(Posterior Hip Muscle), Piriformis (Posterior Hip
Muscle), Internal/External Hip Rotators, Rectus
Abdominis (Anterior Core Muscles), Anterior
Portion
of
Internal/External
Obliques
(Anterior/Lateral Core Muscles), Semitendinosus
(Medial/Middle
Hamstring
Muscles),
Gastrocnemius (Calf Muscles), the Intrinsic Foot
Muscles, and Transverse Abdominis/Obliques
(Core Muscles).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
Posterior Pelvic
Tilt
Counter to an Anterior Pelvic Tilt is the Posterior
Pelvic Tilt, in which the top of the Pelvis is
rotated toward the back of the body.
A Posterior Pelvic Tilt places an unbalanced
amount of strain on the vertebrae and discs of
the Lumbar Spine (Low Back), which can lead to
other patterns of compensation, such as Sway
Back, while also effecting the movement and
alignment of the Upper Body.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Gluteus Complex (Posterior Hip Muscle),
Piriformis
(Posterior
Hip
Muscle),
Internal/External
Hip
Rotators,
Rectus
Abdominis (Anterior Core Muscles), Anterior
Portion
of
Internal/External
Obliques
(Anterior/Lateral Core Muscles), Semitendinosus
(Medial/Middle
Hamstring
Muscles),
and
Gastrocnemius (Calf Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Lower Erector
Spinae (Low Back Muscles), Lower Multifidus
(Low Back Muscles), Iliocostalis Lumborum
(Low Back Muscles), Quadratus Lumborum
(Low Back Muscles), Posterior Portion of the
PreHab Exercise eBook for Soft Tissue Therapy
31 COMPENSATION PATTERNS External Obliques (Posterior Core Muscles),
Psoas (Deep Hip Flexors), Tensor Fasciae
Latae (TFL – Superficial Hip Flexor), Quadriceps
(Anterior Leg Muscles), and the Intrinsic Foot
Muscles.
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
PreHab Exercise eBook for Soft Tissue Therapy
32 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
33 COMPENSATION PATTERNS Lower Cross Syndrome
An Anterior Pelvic Tilt plays a central role in
Lower Cross Syndrome, a compensation pattern
involving strength or muscle imbalances around
the Pelvis.
A Strength or Muscle Imbalance occurs in the
body when one set of muscles grows
disproportionately stronger than a reciprocal set
of muscles attached to the same joint complex
or bone structure. In the Lower Cross
Syndrome, two concurrent Strength or Muscle
Imbalances are evident; the Hip Flexors have
grown muscles stronger and/or tighter than the
Hamstring complex and the Posterior Trunk
(Low Back) Extensors have grown much
stronger and/or tighter than the Anterior Trunk
(Abdominals) Flexors. This strength dominance
of the Hip Flexors and Low Back Extensors
results in the shifting of the Pelvis into an
Anterior Tilt.
The Lower Cross Syndrome further disrupts an
individual’s movement as the compensation
pattern becomes both a static posture and a
habitual dynamic alignment. This habit causes
the individual to learn and initiate all movement
with the compensation, resulting in a repetitive
Movement
Dysfunction
that
places
an
inappropriate amount of stress on the vertebrae
and discs of the Lumbar Spine, ultimately
leading to Low Back Pain and/or injury.
Habitual and prolonged periods of sitting
increase an individual’s risk of developing Lower
Cross Syndrome.
following overactive and/or tight muscles: Psoas
(Deep Hip Flexors), Tensor Fasciae Latae (TFL
– Superficial Hip Flexor), Latissimus Dorsi (Back
Muscles), Thoracolumbar Fascia (Fascia Sheath
of the Lower Back), Lower Erector Spinae (Low
Back Muscles), Lower Multifidus (Low Back
Muscles), Iliocostalis Lumborum (Low Back
Muscles), Quadratus Lumborum (Low Back
Muscles), Posterior Portion of the External
Obliques (Posterior Core Muscles), Quadriceps
(Anterior Leg Muscles), the Adductor Complex
(Groin Muscles), Peroneals (Lateral Calf
Muscles)
and
Biceps
Femoris
(Lateral
Hamstring Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Gluteus Complex
(Posterior Hip Muscle), Piriformis (Posterior Hip
Muscle), Internal/External Hip Rotators, Rectus
Abdominis (Anterior Core Muscles), Anterior
Portion
of
Internal/External
Obliques
(Anterior/Lateral Core Muscles), Semitendinosus
(Medial/Middle
Hamstring
Muscles),
Gastrocnemius (Calf Muscles), the Intrinsic Foot
Muscles, and Transverse Abdominis/Obliques
(Core Muscles).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
PreHab Exercise eBook for Soft Tissue Therapy
35 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
35 COMPENSATION PATTERNS Low Back Pain
The National Academy of Sports Medicine
reports that 80% of adults will experience Low
Back Pain at some point in their lives. This is
highly likely considering the anatomical design
of the Human Skeleton. There is a lack of
structural support connecting the upper body to
the lower body, and the Lumbar Spine is the
only boney structure bridging the two halves of
the body together.
All the compensation patterns previously
mentioned, as well as the ones still to come,
negatively impact the biomechanical integrity of
the Lumbar Spine (Low Back), especially in
regards to alignment and stability.
To reduce, eliminate, or prevent Low Back Pain,
an individual’s alignment and stability of the
Lumbar Spine must be addressed and
integrated into a training program.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on all of the
muscles that connect to both the Spine and the
Pelvis, as well as for the muscles that operate
within the Foot/Ankle and Shoulder/Neck
Complexes. This ultimately means the entire
body needs to be treated with soft tissue therapy
and effective stretching techniques.
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences to as many
muscle groups as possible in the entire body,
especially the muscle groups that connect to the
Spine and Pelvis as well as muscles that run
through the Foot and Ankle complex.
Finally, practice a variety of exercises that use
the major joint structures (i.e. Foot/Ankle, Hip,
Spine and Shoulders) in smooth and controlled
movements. Smooth movements must be
accomplished before practicing larger Movement
Patterns, such as squatting, lunging/step-ups,
jumping, and running. Once movement is
completed in a controlled and stable fashion,
then challenge stability, coordination, and
balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
PreHab Exercise eBook for Soft Tissue Therapy
36 COMPENSATION PATTERNS Buttwink
The Buttwink is a compensation pattern
involving a dynamic Posterior Pelvis Tilt during
Hip Flexion that occurs in a squatting or Hip
Hinging movement. More specifically, the
Buttwink is a compensation pattern that attempts
to increase the Range of Motion of the Hip
and/or Ankle by rotating the Pelvis and flexing
through the Lumbar Spine.
The danger of this compensation pattern is the
inappropriate amount of stress placed on
anterior portions of the vertebrae and discs in
the Lumbar Spine (Low Back). This can cause
episodes of acute micro-trauma, eventually
leading to disc herniation and/or Low Back Pain.
Psoas (Deep Hip Flexors), Tensor Fasciae
Latae (TFL – Superficial Hip Flexor), Quadriceps
(Anterior Leg Muscles), and the Intrinsic Foot
Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
The
Buttwink
robs
an
individual
of
biomechanical integrity of the spine in regard to
alignment and stability; many times the
individual may not be aware this compensation
pattern is occurring.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Gluteus Complex (Posterior Hip Muscle),
Piriformis
(Posterior
Hip
Muscle),
Internal/External
Hip
Rotators,
Rectus
Abdominis (Anterior Core Muscles), Anterior
Portion
of
Internal/External
Obliques
(Anterior/Lateral Core Muscles), Semitendinosus
(Medial/Middle
Hamstring
Muscles),
and
Gastrocnemius (Calf Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Lower Erector
Spinae (Low Back Muscles), Lower Multifidus
(Low Back Muscles), Iliocostalis Lumborum
(Low Back Muscles), Quadratus Lumborum
(Low Back Muscles), Posterior Portion of the
External Obliques (Posterior Core Muscles),
PreHab Exercise eBook for Soft Tissue Therapy
37 COMPENSATION PATTERNS Asymmetrical Weight Shift
Another common pattern of compensation is an
Asymmetrical Weight Shift, or the habitual
process of shifting one’s weight over to one
specific leg while squatting and/or standing, as
well as in pushing and pulling movements.
An Asymmetrical Weight Shift is an indication
that a Strength Imbalance exists somewhere in
body. One limb or one side of the Pelvis and/or
Torso is compensating for the weakness and/or
dysfunction of the opposite limb or side of the
Pelvis and/or Torso.
The causes of an Asymmetrical Weight Shift are
as vast as the number of Strength Imbalance
combinations possible in the body… very large.
However, assessing the movement efficiency
and Range of Motion of various joints involved in
creating a given Movement Pattern are an
effective guide to uncovering and evaluating the
specific details of any possible Strength
Imbalance.
Spine and Pelvis as well as the muscles that run
through the Foot and Ankle complex.
Finally, practice a variety of exercises that use
the major joint structures (i.e. Foot/Ankle, Hip,
Spine and Shoulders) in smooth and controlled
movements. Smooth movements must be
accomplished before practicing larger Movement
Patterns, such as squatting, lunging/step-ups,
jumping, and running. Once movement is
completed in a controlled and stable fashion,
then challenge stability, coordination, and
balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
RX: When an Asymmetrical Weight Shift is
observed, assess the Biomechanical Integrity of
each joint involved in the given Movement
Pattern to uncover the possible Strength or
Muscle Imbalance affecting the individual’s
movement.
Start with a combination of soft tissue therapy
and effective stretching techniques on all
muscles that connect to both the Spine and the
Pelvis in addition to the muscles that operate
within the Foot/Ankle and Shoulder/Neck
Complexes. This ultimately means the entire
body needs to be treated with soft tissue therapy
and effective stretching techniques.
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences to as many
muscle groups as possible in the entire body,
especially the muscle groups that connect to the
PreHab Exercise eBook for Soft Tissue Therapy
38 COMPENSATION PATTERNS Sway Back
Another compensation pattern effecting the
alignment of the Lumbar Spine (Low Back) is
Sway Back. In this compensation pattern, the
Lumbar Spine (Low Back) has an excessive
amount of extension, placing an inappropriate
and unbalanced amount of pressure on the
vertebrae and discs.
Sway Back occurs due to many different
reasons and is characterized by a posture with
protruding (forward) Hips and an excessive arch
in the Lower Back. Many times, Sway Back is
caused by a combination of tightness and/or
overactive Hamstrings and Posterior Trunk (Low
Back) Extensors. Sometimes, a tight and/or
overactive Piriformis muscle contributes to the
protruding Hips. Regardless of the cause, Sway
Back is dangerous to the biomechanical integrity
and health of the Lumbar Spine and may lead to
Low Back Pain.
Muscles), Transverse Abdominis (Interior Core
Muscles), Quadriceps (Anterior Leg Muscles),
and the Intrinsic Foot Muscles.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement
Patterns,
including
squatting,
lunging/step-ups, jumping, running, and even
standing. Also, challenge stability, coordination,
and balance with single-leg and/or Change of
Direction (C.O.D.) exercises.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on the
following overactive and/or tight muscles:
Gluteus Complex (Posterior Hip Muscle),
Piriformis
(Posterior
Hip
Muscle),
Internal/External Hip Rotators, Psoas (Deep Hip
Flexors), Tensor Fasciae Latae (TFL –
Superficial
Hip
Flexor),
Semitendinosus
(Medial/Middle Hamstring Muscles), Lower
Erector Spinae (Low Back Muscles), Lower
Multifidus (Low Back Muscles), Iliocostalis
Lumborum (Low Back Muscles), and Quadratus
Lumborum (Low Back Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following
underactive
muscles:
Rectus
Abdominis
(Anterior
Core
Muslces),
Internal/External
Obliques
(Lateral
Core
PreHab Exercise eBook for Soft Tissue Therapy
39 COMPENSATION PATTERNS Excessive Kyphosis
A hunchback is an exaggerated example of
excessive Kyphosis, which is the forward flexion
or rounding of the Thoracic Spine (vertebrae that
run through the Rib Cage). The Thoracic Spine
has a natural Kyphotic or forward curve to its
alignment. However, this forward curvature can
increase resulting in a Movement Dysfunction
that affects the Shoulders, Head, Lumbar Spine
(Low Back) and Hips.
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), Rectus Abdominis
(Anterior Core Muscles), Internal/External
Obliques
(Lateral
Core
Muscles),
and
Transverse Abdominis (Interior Core Muscles).
An Excessive Kyphotic Spine can be observed
in a standing static posture assessment as well
as in a forward bending assessment, such as
the sit and reach test. The natural (neutral)
alignment of the spine is a skinny ‘S’ when
observed from the side in a static posture
assessment. The natural alignment of the spine
in a forward bend is ‘global flexion’ of the spine,
or an evenly proportioned arch. Excessive
Kyphosis will stand out in each assessment.
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), and Swings. Also challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
In a static posture assessment, the skinny ‘S’
balloons in the top curve and becomes a fatter
‘S’. Meanwhile, the evenly arched spine in the
forward bend also balloons through the rib cage,
assimilating a ‘hunchback-like’ curvature.
Excessive Kyphosis does not exist in isolation; it
is accompanied by other types of compensation
patterns and Movement Dysfunctions. This,
along with an excessively Kyphotic alignment of
the spine, are other compensation patterns an
individual may not realize he/she possesses.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Rib Cage and
Thoracic Spine. These muscles include: the
Upper Trapezius (Neck and Shoulder Muscle),
Pectoral Complex (Chest Muscles), Latissimus
Dorsi (Back Muscles), Psoas (Deep Hip
Flexors), Tensor Fasciae Latae (TFL –
Superficial Hip Flexor), Lower Erector Spinae
(Low Back Muscles), Lower Multifidus (Low
Back Muscles), Iliocostalis Lumborum (Low
Back Muscles), and Quadratus Lumborum (Low
Back Muscles).
PreHab Exercise eBook for Soft Tissue Therapy
40 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
41 COMPENSATION PATTERNS Forward Head Posture
The Forward Head Posture or Forward Head
Alignment is a compensation pattern prevalent
in developed societies due to the combination of
high levels of physical inactivity and high over
usage rates of electronic devices.
In this compensation pattern, the cervical (neck)
and suboccipital (head) muscles become
overactive and tight due to the demand to
position the head to optimally view an electronic
device, screen, or point of interest. At the same
time, the muscles of the torso, hips, and legs are
biomechanically designed to support the
positioning of the head. However, these latter
muscles become inhibited and/or weakened in
comparison to head and neck muscles due to
the imbalance between physical activity
(movement
of
the
body)
and
mental/communication activity (stimulation of the
mind and head sensory organs). The end result
is head and neck muscles compensating for the
lack of synergistic support from the rest of the
body, leading to tightened muscles and
transformed head/neck alignment.
Worse of all, Forward Head Posture is a
drastically inefficient biomechanical alignment
and position. The Head weighs (on average)
12lbs; for every inch the Head is moved ahead
of natural alignment, the 'mechanical' weight of
the head doubles. Thus, an individual whose
head protrudes an inch out of alignment
essentially is holding and moving a 24lb Head
due to the mechanical disadvantage of this
posture. Additionally, Forward Head Posture
disrupts the natural flow of kinetic energy
through the Spine as well as the rest of the
body. This disruption in kinetic energy causes
the individual to alter his Movement Patterns
thereby creating patterns of compensation.
Many times, Forward Head Posture exists in
combination with Excessive Kyphosis, Rounded
Shoulders, Upper Cross Syndrome and
Shoulder Impingement.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to the Head, Neck (Cervical Spine),
and Rib Cage (Thoracic Spine). These muscles
include: the Suboccipital Triangle (Posterior
Head/Neck Muscles), the Upper Trapezius
(Neck and Shoulder Muscle), Scalenes (Neck
Muscles) and the Pectoral Complex (Chest
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), and the Cervical
Flexors (Anterior Neck Muscles).
Finally, practice a variety of exercises integrating
the corrected Neck Alignment with all other
Movement Patterns.
PreHab Exercise eBook for Soft Tissue Therapy
42 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
43 COMPENSATION PATTERNS Upper Cross Syndrome
The Upper Cross Syndrome has a similar
schematic
framework
as
Lower
Cross
Syndrome, both of which are compensation
patterns discovered and studied by Vladimir
Janda, a renowned physical therapist.
The Upper Cross Syndrome is characterized by
a combination of Strength (Muscle) Imbalances
around the Shoulder Girdle and Thoracic Spine.
In this compensation pattern, the shoulder girdle
is held in a protracted position while the
Thoracic Spine experiences excessive flexion in
its alignment due to overactive and/or tight
Pectoralis (Chest) Muscles and overactive
and/or tight Upper Trapezius (Shoulder and
Neck) muscles. These are in combination with
underactive
and/or
weak
Mid-to-Lower
Trapezius and Rhomboid (Back) Muscles as
well as underactive and/or weak Cervical Spine
Flexors (Anterior Neck Muscles).
In short, the muscles of the chest and upper
shoulders/neck area remain in contracted or
shortened states. The reciprocal pairing of the
anterior neck and upper back muscles are held
in a lengthened state that altogether offers a
great mechanical disadvantage to the mobility
and stability of the shoulders. Additionally,
Upper Cross Syndrome can be viewed as the
combination of two compensation patterns:
Excessive Kyphosis and Rounded Shoulders.
Upper Cross Syndrome presents barriers in
efficiency and lowers the Movement Quality of
all upper-body-centric movements as well as
influences the alignment and movement of the
Lumbar Spine, Pelvis, and Feet. Essentially,
Upper Cross Syndrome can lead to injury
(including Rotator Cuff tears) and Movement
Dysfunctions (such as Low Back Pain) in any
part of the body.
Lifestyle Factors including computer work,
wearing a backpack, prolonged periods of sitting
and even texting. It is also heavily influenced by
the high volume of training or exercising ‘mirror
muscles,’ or, the muscles predominantly visible
in the mirror, i.e. the chest, abdominals, biceps,
and anterior shoulders.
RX: The ultimate goal is to ‘re-educate’ the
body’s habit of holding (continuously using) this
pattern of compensation.
Start with a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Head, Neck
(Cervical Spine), and Rib Cage (Thoracic
Spine). These muscles include: the Suboccipital
Triangle (Posterior Head and Neck Muscles),
Scalenes (Neck Muscles), Upper Trapezius
(Neck and Shoulder Muscle), Pectoral Complex
(Chest Muscles), and Latissimus Dorsi (Back
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: the Cervical
Flexors (Anterior Neck Muscles), Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), Teres Minor and
Supraspinatus (External Rotators in the
Shoulder).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), Swings. Also, challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
Many times, an individual develops the Upper
Cross Syndrome through a combination of
PreHab Exercise eBook for Soft Tissue Therapy
44 COMPENSATION PATTERNS Rounded Shoulders
Customarily, Internally Rotated and Protracted
Shoulder alignment is the biomechanical
description of ‘rounded shoulders.’
(Shoulder Girdle Muscle), and Teres Minor and
Supraspinatus (External Rotators in the
Shoulder).
Rounded Shoulders is a compensation pattern
that usually develops from the overuse of
pushing or pressing exercises that cause the
Pectoralis Complex (Chest Muscles) to be
overactive and/or tight in relation to the Posterior
Muscles, specifically the Rhomboids, Lower and
Mid-Trapezius, and the external rotators of the
Shoulders (Infraspinatus and Teres Minor).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), and Swings. Also, challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
The Strength Imbalance associated with
Rounded Shoulders reduces the stability and
mobility of the shoulder, which can lead to acute
injury or prolonged inappropriate wear-and-tear
of the shoulder.
Muscles activated in the
compensation include some physiological (soft
tissue and joint) structures that when overused
can lead to shoulder impingement or injury in the
future.
Rounded Shoulders also influences the
development of Forward Head Posture and
Excessive Kyphosis, not to mention an integral
part of Upper Cross Syndrome.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Rib Cage and
Thoracic Spine. These muscles include: the
Upper Trapezius (Neck and Shoulder Muscle),
Pectoral Complex (Chest Muscles), and
Latissimus Dorsi (Back Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
PreHab Exercise eBook for Soft Tissue Therapy
45 COMPENSATION PATTERNS Winged Scapula
Many times, an individual with Upper Cross
Syndrome will also exhibit a ‘winged scapula’ at
the same time. This compensation pattern
occurs when there is a Strength or Muscle
Imbalance around the Scapula, which forces the
flat, triangular bone to re-position and hold in an
internally rotated and/or anterior tilted alignment.
A winged scapula occurs when the Pectorals
(Chest) and Upper Trapezius (Shoulder/Neck)
Muscles are overactive and/or tight in
comparison to the Lower/Mid Trapezius (Back)
and the Serratus Anterior (Rib Cage) Muscles.
This Strength/Muscle Imbalance shifts and holds
the Scapula in a forward tilted position so the
Medial (Inside) Ridge of the bone sticks out,
away from the Rib Cage, like a ‘wing.’
Supraspinatus
Shoulder).
(External
Rotators
in
the
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), Swings. Also, challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
Winged
Scapula
compromises
the
A
Biomechanical Integrity of the Shoulder and
causes other muscles, such as the Pectorals
and
Upper
Trapezius
muscles,
to
overcompensate their contractile pull on the
Scapula to create enough stability for any
movement utilizing the Arms and/or Upper Body.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Rib Cage
(Thoracic Spine), Scapula, and Shoulder. These
muscles include: the Upper Trapezius (Neck and
Shoulder Muscle), Pectoral Complex (Chest
Muscles), and Latissimus Dorsi (Back Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), and Teres Minor and
PreHab Exercise eBook for Soft Tissue Therapy
46 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
47 COMPENSATION PATTERNS Shoulder Impingement
The National Academy of Sports Medicine
reports that 40% of shoulder pain is a result of
shoulder impingement. Approximately half of
those individuals experience a recurrence of
pain within the next two years, even after being
assessed and treated. These numbers suggest
that any trainer or coach has a high probability
of training an athlete/client who has or had a
shoulder impingement. Therefore, understanding
how to detect and address a shoulder
impingement is very beneficial.
Many times, Shoulder Impingement occurs
simultaneously
with
other
compensation
patterns including Upper Cross Syndrome,
Rounded Shoulders, Excessive Kyphosis, and
Forward Head Posture.
Mechanics of a Shoulder Impingement
A Shoulder Impingement usually occurs from
repetitive movements in an anterior (forward)
and superior (upward) direction, such as a high
volume of pushing or pressing exercises (like
the bench press) and/or an overuse of certain
Daily Life Activities including computer work and
driving.
Repetitive movements and overuse in an
anterior (forward) and superior (upwards)
direction creates overactive muscles and a level
of tightness in the Pectorals (Chest), Anterior
Deltoid (Shoulder), and Upper Trapezius
(Neck/Shoulder)
Muscles.
The
resulting
tightness of these muscles compresses or
sequences the Shoulder Complex until the
Acromian Process (front portion of the Scapula
that connects with the Collar Bone) presses
down onto the soft tissue below it causing an
abnormal amount of friction when the Shoulder
is in motion. Essentially, the friction caused by
the compression from the Shoulder Complex
accelerates the ‘wear-and-tear’ of the soft tissue
below the Acromian Process, causing pain in
addition to possibly leading to a rupture or tear
of these tissues.
RX: One of the main objectives of the treatment
of a Shoulder Impingement is to create more
‘space’ under the Acromian Process by using a
combination of stiff tissue therapy and stretching
to lengthen the short, tight, and overactive
muscles, specifically the Pectorals (Chest),
Deltoid (Shoulder), and Upper Trapezius
(Neck/Shoulder) muscles that connect to the
Shoulder Complex. Once the tightness in these
tissues is addressed, the next step is to increase
the Range of Motion and stability of the entire
Shoulder Complex as a way to prevent a
Shoulder Impingement from reoccurring.
Start with a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Rib Cage
(Thoracic Spine), Scapula and Shoulder. These
muscles include: the Upper Trapezius (Neck and
Shoulder Muscle), Pectoral Complex (Chest
Muscles), Anterior Deltoids (Shoulders), and
Latissimus Dorsi (Back Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), and Teres Minor and
Supraspinatus (External Rotators in the
Shoulder).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), Swings. Also, challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
PreHab Exercise eBook for Soft Tissue Therapy
48 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
49 COMPENSATION PATTERNS Elevated Shoulders
Many people experience the Compensation
Pattern of Elevated Shoulders due to the Daily
Life Activities of driving, working on a computer,
working at a desk, and carrying bags on their
shoulders. For many individuals, this pattern of
compensation occurs simultaneously with the
Upper Cross Syndrome and Forward Head
Posture.
Elevated
Shoulders
is
essentially
a
compensation pattern based on a Strength or
Muscle Imbalance around the Shoulder. In this
pattern, the shoulders are raised or ‘elevated’ by
the
Upper
Trapezius
and
Scalenes
(Neck/Shoulder) Muscles in an attempt to
stabilize and control the Scapula and Arm
because the inferior (below) synergistic muscles
of the Serratus Anterior (Rib Cage), Rhomboids
(Back), and Lower/Mid Trapezius (Back)
muscles are not adequately firing and providing
stability to the Shoulder Complex.
Since the Scapula acts as a platform for the
Shoulder and Arm to move upon, the lack of
synergistic support from the Serratus Anterior,
Rhomboids, and Mid/Lower Trapezius muscles
only compromises the positioning of the
Scapula, thus compromising the movement of
the Arm and Shoulder. This compensation
pattern inadvertently places an inappropriate
amount of strain onto the Cervical Spine (Neck),
weakening the force output of the Arms and
Shoulders.
RX: The first step is to use soft tissue therapy
and stretching to lengthen and release tension in
the tight and overactive muscles that elevate the
shoulders. The next step is to focus on
activating/strengthening muscles that can
depress or anchor the Shoulder Girdle onto the
Rib Cage with support of the Trunk (Core)
Muscles.
Start with a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect to and around the Rib Cage and
Thoracic Spine. These muscles include: the
Upper Trapezius (Neck and Shoulder Muscle),
Scalenes (Neck Muscles), Pectoral Complex
(Chest Muscles), and Latissimus Dorsi (Back
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following underactive muscles: Rhomboids
(Upper Back Muscle), Mid and Lower Trapezius
(Upper Back Muscles), Serratus Anterior
(Shoulder Girdle Muscle), Rectus Abdominis
(Anterior Core Muscles), Internal/External
Obliques
(Lateral
Core
Muscles),
and
Transverse Abdominis (Interior Core Muscles).
Finally, practice a variety of exercises integrating
these
underactive
muscles
with
larger
Movement Patterns, including Overhead and
Horizontal Presses, Vertical and Horizontal
Pulls, Diagonal 1 & 2 Movements (Chops and
Lifts), Swings. Also, challenge stability,
coordination, and balance with single-arm
(unilateral) and/or locomotive (crawling/climbing)
exercises.
PreHab Exercise eBook for Soft Tissue Therapy
50 COMPENSATION PATTERNS Uneven Shoulders
One of the most difficult patterns of
compensation to assess, ‘Uneven Shoulders’ is
a complicated Strength or Muscle Imbalance
occurring in many people without their
knowledge. This pattern of compensation
usually develops in an individual due to a
previous injury and/or lifestyle factors, including
simple habits such as carrying a bag on only
one shoulder.
repetitive movements that create ‘Uneven
Shoulders’ and have a negative effect on
posture.
Uneven shoulders are easily observed in a static
posture assessment. However, the causes or
the nature of the Strength/Muscle Imbalance
involved in this compensation pattern is not as
easily noticeable due to the complex nature of
the movement of the Hips, Torso/Core, and
Shoulders. In some individuals, the Upper
Trapezius (Neck/Shoulder) Muscle may be tight
and overactive, while in others it may be the
Latissimus Dorsi (Back) or Pectoralis (Chest) or
even the Quadratus Lumborum (Low Back)
Muscles that are tight and overactive.
RX: Use soft tissue therapy and stretching
techniques to systematically address all muscles
in the body. Practice movement in training with
the largest Range of Motion possible for the
individual. Additionally, attempt to change simple
Daily Life Activities, such as wearing a bag on
the opposite shoulder and opening doors with
the opposite (non-dominant) hand. The
combination of mobility training with the change
of Daily Life Activities will help eliminate the
PreHab Exercise eBook for Soft Tissue Therapy
51 COMPENSATION PATTERNS Flared Rib Cage
When the lower ribs protrude forward and stick
out, this is a sign that the Core musculature is
experiencing a Strength or Muscle Imbalance;
the alignment and stability of the Lumbar Spine
is being compromised.
A Flared Rib Cage points to overactive and/or
tight Posterior Trunk muscles that are attempting
to manage and stabilize the Spine without
adequate amount of assistance from the
Anterior
Trunk
muscles,
including
the
Internal/External Obliques and Abdominals. This
Strength or Muscle Imbalance places a
disproportionate amount of strain on the
vertebrae and discs of the Lumbar Spine (Low
Back) and may lead to Low Back Pain as well as
other
Movement
Dysfunctions
and
compensation patterns.
exercises that integrate the firing sequences
practiced in Core Activation exercises with larger
Movement Patterns, such as squatting, lunging,
running, etc. Once integration is achieved and
Rib Flare is eliminated, continue to integrate the
Core Firing sequence into exercises that
challenge stability, coordination, and balance,
i.e. single-leg and/or Change of Direction
(C.O.D.) exercises.
RX: Practice a combination of soft tissue therapy
and effective stretching techniques on muscles
that connect around the top of the Rib Cage,
especially the First Rib, which includes the
Upper Trapezius (Neck and Shoulder Muscle),
Scalenes (Neck Muscles), Pectoral Complex
(Chest Muscles), and the Latissimus Dorsi (Back
Muscles).
Next, practice Activation exercises to strengthen
and facilitate proper firing sequences of the
following muscles: Diaphragm (Deep Core
Muscle), Internal/External Obilques (Lateral
Core Muscles), Multifidus (Posterior Core
Muscles), and the Transverse Abdominis (Core
Muscle).
Finally, practice a variety of breathing exercises
that emphasize exhalation.
Also practice
PreHab Exercise eBook for Soft Tissue Therapy
52 COMPENSATION PATTERNS PreHab Exercise eBook for Soft Tissue Therapy
53 COMPENSATION PATTERNS Hyperinflation
Most people take the act of breathing for
granted. Not too many people pay much
attention to breathing, let alone the mechanics
involved. However, the mechanics of breathing
have a huge influence over an individual’s
posture and movement.
Hyperinflation refers to the habitual process of
inhaling and/or holding onto the inhalation of a
breath cycle to the point that the Rib Cage and
muscles surrounding the Thoracic Cavity (Upper
Torso) are held in an expanded or semiexpanded
position.
In
other
words,
Hyperinflation is the continual act of not
breathing out deeply enough to fully clear the
lungs of air and contract the Rib Cage.
Does Hyperinflation really matter? Yes.
Hyperinflation can disrupt an individual’s
movement
both
mechanically
and
physiologically.
In mechanical terms, Hyperinflation keeps the
Rib Cage expanded, diverting the flow of kinetic
energy through the body, forcing certain
muscles to compensate for the abnormal flow of
energy. Additionally, Hyperinflation creates
tightness in the muscles associated with the
inhalation cycle of the breath, namely the Upper
Trapezius (Neck/Shoulder) Muscles.
pattern of ‘Flared Ribs’ where the lower ribs
‘stick out,’ a dysfunction that commonly occurs
simultaneously with Hyperinflation.
Next, time the duration of an inhale (breath in)
compared to the length of an exhalation (breath
out). Are they even? Can the individual maintain
an even cycle of inhale/exhale for ten full
cycles? These are easy observations to
integrate while observing the mechanics of the
Thorax (Torso) and Rib Cage to get insight in an
individual’s habit of breathing. Some people may
be able to establish an even breath cycle for a
few breaths, but habitually become hyperinflated when left unchallenged.
Lastly, watch the individual breathe while
moving, especially when performing stretches
and/or exercises. Observing an individual’s
breathing mechanics while moving reveals
breathing habits. Do they hold their breath when
they move? Do they breathe easy and evenly?
What happens when they are cued to exhale?
How long can the individuals breathe easily and
evenly after cuing? These are all questions to
ask to get insight in individuals’ breathing habits.
RX: One very effective exercise to teach an
individual proper breathing technique is simply
lying on the floor while blowing up balloons.
In physiological terms, Hyperinflation reduces
stimulation of the Parasympathetic Nervous
System, which normally lets the muscles release
held contractions, restores their natural lengths,
and regenerates soft tissue cells that aid in an
individual’s full recovery from bouts of training as
well as from Daily Life Activities.
Jason Masek, MA, PT, ATC, CSCS, PR uses
balloons as an exercise at the University of
Nebraska to teach proper breathing mechanics
that focus on strong exhalation, also inducing
the Parasympathetic Nervous System to calm
the
student-athletes
before
training
or
competition.
It is nearly impossible to correct any pattern of
compensation if it is undetected. Therefore, it’s
important to have some keys or guidelines to
use when assessing for hyperinflation. So, what
does Hyperinflation look like?
‘Blowing up balloons’ is a very effective exercise
that can be practiced anywhere, even without
balloons. Simply imagining the act of blowing up
a balloon trains proper breathing mechanics and
restores mobility and function to the entire
Thorax (Torso) and Rib Cage.
First, observe the movement of the Rib Cage
and Thorax (Torso) while breathing. Notice if the
Chest and Shoulders rise and fall or if the belly
and Thorax (Torso) as a whole rise and fall. The
latter is the more appropriate mechanic for
breathing. Also, observe the individual for the
Also refer to the Passive and Active
Breathing Exercises mentioned earlier in this
book.
PreHab Exercise eBook for Soft Tissue Therapy
54 COMPENSATION PATTERNS Recap: Common Patterns of
Compensation
The Human Body is continuously being shaped and remodeled by Human Movement in
‘machotransduction,’ a process in which the forces experienced by the cells of the body in any and all
movement physiologically change the cell in direct correlation to the direction and magnitude of those
forces. Sometimes, as in patterns of compensation, this process of re-modeling the body increases
inefficiencies and can even lead to injury. However, an individual can marginalize, if not eliminate, the risk
of inefficiency and injury by observing patterns of compensation and then actively working to correct the
associated Movement Dysfunctions.
‘Common’
Due to similarities in Lifestyle and Daily Life Activities in the modern developed world, a collection of
‘common’ or readily recurring compensation patterns and Movement Dysfunctions has been developed.
This list can be used by trainers, coaches, and individuals to guide their own observations and
assessment of movement to proactively reduce and/or eliminate risk of injury and inefficiency.
PreHab Exercise eBook for Soft Tissue Therapy
55 FOAM ROLLING
Things to KnowBefore getting started, it is important to
understand how to effectively Foam Roll. Here
are some recommended techniques for Foam
Rolling:
Foam Rolling Techniques
Hold and Release
Articulate the Joint
Slow Roll
Quick Roll
Oscillating
Hold and Release
In this technique, an individual will use a foam
roller to place pressure on a particular area of
tissue where a knot of Myofascial Trigger Point
exists. This technique is very similar to both
Swedish Massage and Acupressure techniques.
The technique utilizes pressure to stimulate
mechanceptors within the soft tissue that will
communicate signals to the corresponding Motor
Neurons commanding the release of the Trigger
Point or knot.
Hold pressure over a sensitive spot within
targeted area for 5-30 seconds or until the
sensation dissipates and the corresponding
Trigger Point releases.
Articulate the Joint
In this technique, the individual will place
pressure over a sensitive area just as in the
Hold and Release technique. Then the individual
will slowly articulate the corresponding joint.
Articulate refers to moving the joint, i.e. flexing
and extending or rotating the individual joint. For
example, when the individual holds pressure on
the calf muscles, the next step is to flex and
extend or rotate the ankle. The movement at the
joint causes the targeted tissue to lengthen and
contract under pressure, which will help to break
up Trigger Points as well as clear out or
separate adhesions in the area.
Hold pressure over a sensitive spot within
targeted area and articulate the corresponding
joint for 15-30 seconds or until the sensitivity in
the tissue dissipates.
Slow Roll
In this technique, the individual will slowly roll
over a sensitive area in an attempt to drain
blood from the tissue and pull out metabolic
waste that may be contributing to the formation
of a Trigger Point. At the same time, the Slow
Roll will help to improve circulation to the area
and allow the increased blood flow to provide
more oxygen and nutrients to the affected area,
all of which can help create the release of
Trigger Point and lengthen the tissue.
Perform several Slow Rolls in a smooth and
deliberate fashion over the affected area for
approximately 30 seconds or until the Trigger
Point releases.
Quick Roll
In this technique, the individual practices several
smooth and quick rolls of pressure over a
targeted area in an attempt to stimulate the
proprioception and mechanoceptors within the
tissue in order to help increase neuromuscular
activity in the area, which can consequentially
improve blood flow and increase flexibility.
However, Quick Rolls can be ineffective in
regards to releasing Trigger Points or breaking
up adhesions. This technique is very effective in
increasing blood flow as well as stimulating the
tissue and is recommended to be used as a
complimentary technique to the Slow Roll.
To stimulate and help activate the soft tissue,
perform several Quick Rolls over a targeted area
in a smooth and deliberate fashion for 15-30
seconds.
Oscillating
This technique is similar to and can be
combined with the Slow Roll and Quick Roll. In
this technique, the individual practices several
smooth rolls over a targeted area and then
begins to intermittently pause and oscillate
(rotate) from side to side at different positions.
This oscillation effect will redirect pressure
across the cells of the soft tissue in accordance
to a massage technique called Cross-Fibering.
Cross-Fibering uses pressure to widen and
separate soft tissue cells. This will help extract
PreHab Exercise eBook for Soft Tissue Therapy
56 FOAM ROLLING metabolic waste from the cells, increase blood
flow and oxygen to the cells that will release
Trigger Points. Additionally, the lateral direction
of the oscillation force has the potential of
dislodging fibrin and collagen fibers that make
up adhesions in the soft tissue.
tissue therapy because each person has a
different tolerance level for pain and discomfort.
While a greater magnitude of pressure will
create a physiological reaction in more tissue, all
of that gain can be lost if the individual cannot
tolerate that level of pressure.
Perform several smooth and controlled
Oscillations while rolling over a sensitivity spot
within targeted area for approximately 15-30
seconds.
Many people can and will tense their soft tissue
as a form of protection against a pressure that
exceeds their sensitivity threshold. Therefore, it
is more effective to use a soft tissue therapy tool
that creates a magnitude of pressure that is
tolerable by the individual.
Types of Rollers
Next, it’s important to understand the
characteristics of different rollers in regard to
density and sensitivity.
Density Matters
Each kind of roller has a specific density, which
dictates the magnitude of pressure that can be
applied to the soft tissue. The harder the roller
is, the greater amount of pressure can be used
in rolling.
The magnitude of pressure will have a major
impact in regards to the physiological reaction in
the tissue. The more that the pressure increases
in magnitude, the larger of a sensation will be
emitted through the soft tissue.
The magnitude of pressure in soft tissue therapy
is similar to volume of one’s voice in a large
auditorium. The louder the voice, the more
sound can be heard echoing in the auditorium.
At the same time, a very well trained voice can
make a whisper heard throughout the entire
auditorium.
Sensitivity
As noted above, louder and harder are not
always better and this is especially true in soft
Use a soft tissue therapy tool that is dense
enough to elicit a physiological change in the
soft tissue without creating unnecessary tension
in the tissue from exceeding the individual’s
sensitivity threshold.
Rollers According to Density:
Foam Roller (Styrofoam)
Foam Roller (Padded PVC Tube)
PVC Plastic Tubing
Note, the firmness and pressure of each of
these rollers can also be modified and regulated
by the way in which the individual positions his
or her body over the roller.
Remember to Breathe
It is extremely important to remember to breathe
with an emphasis on large exhalations when
practicing soft tissue therapy to help stimulate
the Parasympathetic Nervous System and make
more beneficial changes in the soft tissue.
PreHab Exercise eBook for Soft Tissue Therapy
57 FOAM ROLLING FOAM ROLLING THE SUBOCCIPITAL TRIANGLE WITH OSCILLATION
HEAD AND NECK
Benefits:
Releases tension in neck from
repetitive movements in driving,
computer work, and texting.
Helps to correct Forward Head
Alignment and Upper Cross
Syndrome.
Assists to develop proper
Spinal alignment and stability.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Head every 2-3
seconds for 15-30 Seconds.
Breathe deeply with an
emphasis on the exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
58 FOAM ROLLING FOAM ROLLING THE UPPER TRAPEZIUS
NECK AND SHOULDERS
Benefits:
Releases tension and Trigger
Points in the neck and
shoulders that build up from
repetitive movements, such as
driving, computer work, wearing
a backpack or shoulder bag
and texting.
Also releases tension and
Trigger Points caused by
overhead and/or upper body
exercises.
Helps to correct Forward Head
Alignment,
Upper
Cross
Syndrome,
and
Shoulder
Impingement or pain.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Torso every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Quick Roll
Smooth Rolls synchronized
with a deep exhale to help
stimulate the soft tissue for 1015 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Assists to develop appropriate
Shoulder
alignments
and
stability.
PreHab Exercise eBook for Soft Tissue Therapy
59 FOAM ROLLING FOAM ROLLING THE UPPER TRAPEZIUS WITH OSCILLATION
NECK AND SHOULDERS
PreHab Exercise eBook for Soft Tissue Therapy
60 FOAM ROLLING FOAM ROLLING THE RHOMBOIDS, LOWER AND MID-TRAPEZIUS
THORACIC SPINE AND BACK
Benefits:
Increases the Range of Motion
and Flexibility of the Thoracic
Spine as well as the shoulders.
Improve
efficiency
and
Movement Quality in Overhead,
Throwing, Pulling and Pressing
movements.
Helps to correct Forward Head
Posture,
Upper
Cross
Syndrome
and
Shoulder
Impingements or pain.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Torso every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Quick Roll
Smooth Rolls synchronized
with a deep exhale to help
stimulate the soft tissue for 1015 seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
61 FOAM ROLLING FOAM ROLLING THE RHOMBOIDS & TRAPEZIUS WITH OSCILLATION
THORACIC SPINE AND BACK
PreHab Exercise eBook for Soft Tissue Therapy
62 FOAM ROLLING FOAM ROLLING THE LATISSIMUS DORSI AND TERES MAJOR
BACK AND SHOULDERS
Benefits:
Increases the Range of Motion
and Flexibility of the Shoulders
as well as the Thoracic Spine.
Improve
efficiency
and
Movement Quality in Overhead,
Throwing, Pulling and Pressing
movements.
Helps to correct Forward Head
Posture,
Upper
Cross
Syndrome
and
Shoulder
Impingement or pain.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Torso every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Flex and Extend the Shoulder
in a smooth and controlled
manner while applying pressure
to a sensitive area 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
63 FOAM ROLLING FOAM ROLLING THE TRICEPS
ARMS
Benefits:
Increases the Range of Motion
of the Elbow and Arm.
Increases the neuromuscular
responsiveness and the force
production of the arm.
Improves Movement Quality in
Overhead, Throwing, Pulling
and Pressing movements.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Arm every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Flex and Extend the Elbow in a
smooth and controlled manner
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
64 FOAM ROLLING FOAM ROLLING THE BICEPS
ARMS
Benefits:
Increases the Range of Motion
of the Elbow and Arm.
Increases the neuromuscular
responsiveness and the force
production of the arm.
Improves Movement Quality in
Overhead, Throwing, Pulling
and Pressing movements.
Helps correct Upper Cross
Syndrome and rectifies static
and dynamic posture.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Arm every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Flex and Extend the Elbow in a
smooth and controlled manner
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
65 FOAM ROLLING FOAM ROLLING THE PECTORALIS COMPLEX
CHEST AND SHOULDERS
Benefits:
Increases the Range of Motion
of the Thoracic Spine and
Shoulders.
Increases neuromuscular force
production and responsiveness
of the shoulders and arms.
Improves Movement Quality in
Overhead, Throwing, Pulling
and Pressing movements.
Helps to correct Upper Cross
Syndrome and improves static
and dynamic posture.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Torso every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Flex and Extend the Shoulder
in a smooth and controlled
manner while applying pressure
to a sensitive area 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
66 FOAM ROLLING FOAM ROLLING THE TENSOR FASCIAE LATAE (TFL)
SUPERFICIAL HIP FLEXOR
Benefits:
Increases the Range of Motion
of
Hip
Extension,
Triple
Extension and Gait Cycle or
stride length.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Increases neuromuscular force
production and responsiveness
of the Hips and Lower Body.
Improves Movement Quality in
Squatting, Hinging, Lunging,
Jumping and Running.
Include Oscillations
Turn the Hips every 2-3
seconds for 15-30 seconds.
Helps to correct Lower Cross
Syndrome, Pronation Distortion
Syndrome,
Asymmetrical
Weight-Shifts and improves
static
posture,
including
standing
and
dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
Target Area:
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Internally and Externally
Rotate the Hip in a smooth and
controlled
manner
while
applying pressure to a sensitive
area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
soft
and
PreHab Exercise eBook for Soft Tissue Therapy
67 FOAM ROLLING FOAM ROLLING THE GLUTEUS COMPLEX
POSTERIOR HIP
Benefits:
Increases the Range of Motion
of Hip Flexion, Internal/External
Rotation and Adduction.
Increases neuromuscular force
production and responsiveness
of the Hips and Lower Body.
Improves Movement Quality in
Squatting, Hinging, Lunging,
Jumping and Running.
Helps to correct Asymmetrical
Weight-Shifts, Buttwinks, Sway
Back,
Glute
Amnesia
Syndrome and improves static
posture
and
dynamic
alignment.
Foam Rolling promotes postexercise soft tissue recovery,
and regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Hips every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Internally and Externally
Rotate the Hip and/or rotate the
Pelvis from side to side in a
smooth and controlled manner
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
soft
tissue
and
proprioception
before
exercising to help reduce Glute
Amnesia Syndrome.
PreHab Exercise eBook for Soft Tissue Therapy
68 FOAM ROLLING FOAM ROLLING THE GLUTEUS COMPLEX WITH JOINT
ARTICULATION (ROTATION) OF THE PELVIS
POSTERIOR AND LATERAL HIP
PreHab Exercise eBook for Soft Tissue Therapy
69 FOAM ROLLING FOAM ROLLING THE GLUTEUS COMPLEX AND PIRIFORMIS
POSTERIOR AND LATERAL HIP
Benefits:
Increases the Range of Motion
of Hip Flexion, Internal/External
Rotation and Adduction.
Increases neuromuscular force
production,
coordination,
balance responsiveness, and
stability of the Hips and Lower
Body. Improves Movement
Quality in Squatting, Hinging,
Lunging, Jumping and Running.
Helps to correct Asymmetrical
Weight-Shifts, Buttwinks, Sway
Back,
Glute
Amnesia
Syndrome and improves static
posture
and
dynamic
alignment.
Foam Rolling promotes postexercise soft tissue recovery,
and regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Hips every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Abduct and Adduct the
Femur (Thigh) or smoothly
swing the Knee in and out (side
to side) in small, smooth, and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
70 FOAM ROLLING PreHab Exercise eBook for Soft Tissue Therapy
71 FOAM ROLLING FOAM ROLLING THE GLUTEUS MEDIUS
LATERAL HIP
Benefits:
Since the Gluteus Medius
(Lateral Hip Muscle) grows
inactive due to prolonged
periods of sitting, this muscle
can become overworked and
spastic
while
training
or
competing
due
to
the
accumulation of Myofascial
Trigger Points (Knots). It is
beneficial to habitually roll the
Gluteus Medius before training
and competition as well as in
Recovery and Regeneration
sessions. Foam rolling the
Gluteus
Medius
increases
responsiveness
and
coordination of the Hip, which
leads
to
improved
force
production and Stability in
Single-Leg Positions and/or
Movements. Helps to improve
Movement Quality in Squatting,
Hinging, Lunging, Jumping,
Running and Standing.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Rotate the Hips every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
soft
tissue
and
proprioception
before
exercising to contribute to force
production, coordination and
Pelvic/Spinal Stability.
Breathe deeply with an
emphasis on the Exhalation.
Foam Rolling promotes postexercise soft tissue recovery,
and regeneration.
Helps to correct Valgus Knee,
Pronation Distortion Syndrome,
Low Back Pain, Asymmetrical
Weight-Shifts and improves
static posture and dynamic
alignment.
PreHab Exercise eBook for Soft Tissue Therapy
72 FOAM ROLLING FOAM ROLLING THE HAMSTRING COMPLEX
POSTERIOR LEG
Benefits:
Increases the Range of Motion
of Posterior Chain, including
Hip
Flexion
and
Knee
Extension.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Increases neuromuscular force
production, responsiveness and
coordination of the Posterior
Chain
and
Lower
Body.
Improves Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running
and
Standing.
Include Oscillations
Turn the Thigh every 2-3
seconds for 15-30 seconds.
Helps to correct Hamstring
Strains, Pronation Distortion
Syndrome, Posterior Pelvic Tilt,
Buttwinks
Asymmetrical
Weight-Shifts and improves
static posture and dynamic
alignment.
Target Area:
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
soft
tissue
and
proprioception
before
exercising to contribute to force
production, coordination and
Pelvic/Spinal Stability.
Breathe deeply with an
emphasis on the Exhalation.
Foam Rolling promotes postexercise soft tissue recovery,
and regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
73 FOAM ROLLING FOAM ROLLING THE VASTUS LATERALIS AND ILIOTIBIAL BAND
IT BAND AND LATERAL LEG
Benefits:
Increases the Range of Motion
of
Hip
Extension
and
Adduction.
Increases neuromuscular force
production,
responsiveness,
and coordination of the Lower
Body. Improves Movement
Quality in Squatting, Hinging,
Lunging, Jumping, Running,
and Standing.
Helps to correct Patellofemoral
Tracking
Disorder
(Knee
Alignment), Pronation Distortion
Syndrome,
Asymmetrical
Weight-Shifts, and improves
static posture and dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Thigh every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area for
15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Reduces Patellofemoral Pain
Syndrome (Knee Pain) and IT
Band Syndrome.
PreHab Exercise eBook for Soft Tissue Therapy
74 FOAM ROLLING FOAM ROLLING THE QUADRICEPS
ANTERIOR LEG
Benefits:
Increases the Range of Motion
of Hip Extension and Knee
Flexion.
Improves force transfer and
coordination around the Knee,
which translates to increased
Movement Quality in Squatting,
Hinging, Lunging, Jumping,
Running and Standing.
Helps to correct Patellofemoral
Tracking
Disorder
(Knee
Alignment), Pronation Distortion
Syndrome,
Asymmetrical
Weight-Shifts, Glute Amnesia
Syndrome and improves static
posture
and
dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Thigh every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercises soft
tissue
recovery
and
regeneration.
Reduces Patellofemoral Pain
Syndrome (Knee Pain).
PreHab Exercise eBook for Soft Tissue Therapy
75 FOAM ROLLING FOAM ROLLING THE ADDUCTORS
MEDIAL LEG AND GROIN
Benefits:
Increases the Range of Motion
of
Hip
Extension
and
Abduction.
Improves force transfer and
coordination between the Hip,
Spine,
and
Knee,
which
translates
to
increased
Movement Quality in Squatting,
Hinging, Lunging, Jumping,
Running and Standing.
Helps to correct Pronation
Distortion Syndrome, Buttwink,
Glute
Amnesia
Syndrome,
Sway
Back,
Asymmetrical
Weight-Shifts, and improves
static posture and dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Thigh every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
soft
and
PreHab Exercise eBook for Soft Tissue Therapy
76 GROIN AND LEG WITH VARIOUS TECHNIQUES
FOAM ROLLING THE ADDUCTORS WITH JOINT ARTICULATION
FOAM ROLLING THE BICEPS FEMORIS (LATERAL HAMSTRING)
FOAM ROLLING THE QUADRICEPSWITH JOINT ARTICULATION
PreHab Exercise eBook for Soft Tissue Therapy
77 FOAM ROLLING FOAM ROLLING THE POPLITEUS
POSTERIOR KNEE
Benefits:
Improve the arthrokinematics
(joint function) of the Knee and
helps to prevent Valgus Knee
Movement, Pronation Distortion
Syndrome and ACL injuries.
Improves Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running
and
Standing.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Knee every 2-3
seconds for 15-30 seconds.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Foam Rolling promotes postexercise soft tissue recovery,
and regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
78 FOAM ROLLING FOAM ROLLING THE GASTROCNEMIUS AND SOLEUS
WITH OSCILLATIONS AND JOINT ARTICULATION
CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Helps to correct Glute Amnesia
Syndrome,
Sway
Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Promotes post-exercises, soft
tissue
recovery,
and
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Calf every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend and Circle
the Ankle/Foot in slow, smooth
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
proprioception
before
exercising to contribute to force
production, balance and Ankle
Stability.
PreHab Exercise eBook for Soft Tissue Therapy
79 FOAM ROLLING FOAM ROLLING THE PERONEALS
LATERAL CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Glute
Amnesia
Syndrome,
Sway
Back, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Calf every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend and Circle
the Ankle/Foot in slow, smooth
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercises soft
tissue
recovery
and
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
80 ROLLING WITH A
BALL
Things to KnowBefore getting started, it is important to
understand how to effectively roll with a ball.
Here are some recommended techniques:
Hold pressure over a sensitive spot within
targeted area and articulate the corresponding
joint for 15-30 seconds or until the sensitivity in
the tissue dissipates.
Effective Techniques for Rolling with
a Ball
Slow Roll
In this technique, the individual will slowly roll
over a sensitive area in an attempt to drain
blood from the tissue and pull out metabolic
waste that may be contributing to the formation
of a Trigger Point. At the same time, the Slow
Roll will help to improve circulation to the area
and allow the increased blood flow to provide
more oxygen and nutrients to the affected area,
all of which can help create the release of
Trigger Point and lengthen the tissue.
Hold and Release
Articulate the Joint
Slow Roll
Quick Roll
Oscillating
Rotating (New)
Hold and Release
In this technique, an individual will use a ball to
place pressure on a particular area of tissue
where a knot of Myofascial Trigger Point exists.
This technique is very similar to both Swedish
Massage and Acupressure techniques. The
technique utilizes pressure to stimulate
mechanoreceptors within the soft tissue that will
communicate signals to the corresponding Motor
Neurons commanding the release of the Trigger
Point or knot.
Hold pressure over a sensitive spot within
targeted area for 5-30 seconds or until the
sensation dissipates and the corresponding
Trigger Point releases.
Articulate the Joint
In this technique, the individual will place
pressure over a sensitive area just as in the
Hold and Release technique. Then the individual
will slowly articulate the corresponding joint.
Articulate refers to moving the joint, i.e. flexing
and extending or rotating the individual joint. For
example, when the individual holds pressure on
the calf muscles, the next step is to flex and
extend or rotate the ankle. The movement at the
joint causes the targeted tissue to lengthen and
contract under pressure, which will help to break
up Trigger Points as well as clear out or
separate adhesions in the area.
Perform several Slow Rolls in a smooth and
deliberate fashion over the affected area for
approximately 30 seconds or until the Trigger
Point releases.
Quick Roll
In this technique, the individual practices several
smooth and quick rolls of pressure over a
targeted area in an attempt to stimulate the
proprioception and mechanoreceptors within the
tissue in order to help increase neuromuscular
activity in the area, which can consequentially
improve blood flow and increase flexibility.
However, Quick Rolls can be ineffective in
regards to releasing Trigger Points or breaking
up adhesions. This technique is very effective in
increasing blood flow as well as stimulating the
tissue and is recommended to be used as a
complimentary technique to the Slow Roll.
To stimulate and help activate the soft tissue,
perform several Quick Rolls over a targeted area
in a smooth and deliberate fashion for 15-30
seconds.
Oscillating
This technique is similar to and can be
combined with the Slow Roll and Quick Roll. In
this technique, the individual practices several
PreHab Exercise eBook for Soft Tissue Therapy
81
ROLLING WITH A BALL smooth rolls over a targeted area and then
begins to intermittently pause and oscillate
(rotate) from side to side across the striations
(alignment of muscle fibers) at several different
positions. This oscillation effect will redirect
pressure across the cells of the soft tissue in
accordance to a massage technique called
Cross-Fibering. Cross-Fibering uses pressure to
widen and separate soft tissue cells. This will
help extract metabolic waste from the cells,
increase blood flow and oxygen to the cells that
will release Trigger Points. Additionally, the
lateral direction of the oscillation force has the
potential of dislodging fibrin and collagen fibers
that make up adhesions in the soft tissue.
Perform several smooth and controlled
Oscillations going across the striations of the
soft tissue while rolling over a sensitivity spot
within targeted area for approximately 15-30
seconds.
Rotating (New)
This technique is very similar to Oscillating
except a change in direction. In this technique,
the individual will apply pressure in a twisting
fashion to a targeted area. More specifically, the
individual will rotate the ball while also pressing
the object into the tissue. The consequences are
the same as oscillating; it will improve blood flow
to the affected area, remove metabolic waste
and even dislodge possible adhesions.
Perform numerous Rotations while applying
pressure to a targeted area for approximately 30
seconds.
Types of Rolling Balls
Next, it’s important to understand the
characteristics of different rolling balls in regards
to density and sensitivity.
Density Matters
Each kind of ball has a specific density, which
dictates the magnitude of pressure that can be
applied to the soft tissue body. The harder the
ball is, the greater amount of pressure can be
used in rolling. The magnitude of pressure will
have a major impact in regards to the
physiological reaction in the tissue. The more
that the pressure increases in magnitude, the
larger of a sensation will be emitted through the
soft tissue. The magnitude of pressure in soft
tissue therapy is similar to the volume of one’s
voice in a large auditorium. The louder the voice,
the more sound can be heard echoing in the
auditorium. At the same time, a very well trained
voice can make a whisper heard throughout the
entire auditorium.
Sensitivity
As noted above, louder and harder are not
always better and this is especially true in soft
tissue therapy because each person has a
different tolerance level for pain and discomfort.
While a greater magnitude of pressure will
create a physiological reaction in more tissue, all
of that gain can be lost if the individual cannot
tolerate that level of pressure. Many people can
and will tense their soft tissue in form of
protection against a pressure that exceeds their
sensitivity threshold. Therefore, it is more
effective to use a soft tissue therapy tool that
creates a magnitude of pressure that is tolerable
by the individual.
Use a type of ball that is dense enough to elicit a
physiological change in the soft tissue without
creating unnecessary tension in the tissue from
exceeding the individual’s sensitivity threshold.
Balls According to Density:
Foam Ball
Tennis Ball
Massage Ball
Lacrosse, Softball or Golf ball
Note, the firmness and pressure of each of
these balls can also be modified and regulated
by the way in which the individual positions his
or her body over the roller.
Remember to Breathe
It is extremely important to remember to breathe
with an emphasis on large exhalations when
practicing soft tissue therapy in order help
stimulate the Parasympathetic Nervous System
and change more beneficial changes in the soft
tissue.
PreHab Exercise eBook for Soft Tissue Therapy
82 ROLLING WITH A BALL PreHab Exercise eBook for Soft Tissue Therapy
83 ROLLING WITH A BALL ROLLING THE PLANTAR FASCIA AND INTRINSIC FOOT MUSCLES
FOOT
Benefits:
Increases the Range of Motion
of Foot, Ankle and Gait Cycle.
Improves force transfer and
coordination through the Ankle
and Foot into the Ground,
which translates to increased
Movement Quality in Squatting,
Hinging, Lunging, Jumping,
Running, Standing and SingleLeg Stability.
Helps to correct Pronation
Distortion Syndrome, Glute
Amnesia
Syndrome,
Sway
Back, Asymmetrical WeightShifts, Knee Pain, IT Band
Syndrome,
Lower
Cross
Syndrome, and improves static
posture
and
dynamic
alignment.
Promotes post-exercises soft
tissue
recovery
and
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Include Oscillations
Turn the Foot every 2-3
seconds for 15-30 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Toes
and Curl the Foot in slow,
smooth
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
proprioception
before
exercising to contribute to force
production,
balance
and
Ankle/Foot Stability.
PreHab Exercise eBook for Soft Tissue Therapy
84 ROLLING WITH A BALL ROLLING THE FOOT WITH A BALL IN DIFFERENT POSITIONS
ILLUSTRATION OF THE FOOT TRIPOD
PreHab Exercise eBook for Soft Tissue Therapy
85 ROLLING WITH A BALL ROLLING THE PERONEALS WITH A BALL
LATERAL CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Glute
Amnesia
Syndrome,
Sway
Back, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Toes,
Ankle or Foot in slow, smooth
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
86 ROLLING WITH A BALL ROLLING THE POSTERIOR TIBIALIS WITH A BALL
INTERIOR CALF AND FOOT
Benefits:
Increases the Range of Motion
of Ankle, Knee and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Glute
Amnesia
Syndrome,
Sway
Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Promotes post-exercises, soft
tissue
recovery,
and
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Toes,
Ankle or Foot in slow, smooth
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
87 ROLLING WITH A BALL ROLLING THE GASTROCNEMIUS, SOLEUS AND PERONEALS
CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased Movement Quality in
Squatting, Hinging, Lunging,
Jumping,
Running
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Glute
Amnesia
Syndrome, Sway Back, Knee
Pain, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend and Circle
the Ankle/Foot in slow, smooth
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
88 ROLLING WITH A BALL PreHab Exercise eBook for Soft Tissue Therapy
89 ROLLING WITH A BALL ROLLING THE HAMSTRING COMPLEX WITH A BALL
POSTERIOR LEG
Benefits:
Increases the Range of Motion
of
the
Posterior
Chain,
especially at the Knee, and Gait
Cycle.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Accelerates
force
transfer
through the Posterior Chain
and improves stability and
coordination at the Hip, which
translates
to
increased
Movement Quality in Squatting,
Hinging, Lunging, Jumping,
Running and Standing.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee, Quad Dominance, Sway
Back, Knee Pain, Asymmetrical
Weight-Shifts, and improves
static posture and dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
soft
and
PreHab Exercise eBook for Soft Tissue Therapy
90 ROLLING WITH A BALL ROLLING THE HAMSTRINGS – EMPHASIS ON THE BICEPS FEMORIS
PreHab Exercise eBook for Soft Tissue Therapy
91 ROLLING WITH A BALL ROLLING THE VASTUS LATERALIS AND ILIOTIBIAL BAND
LATERAL LEG AND KNEE
Benefits:
Improves the tracking of the
Patellofemoral (Knee) Joint and
increases mechanical efficiency
in
Lower
Body
Centric
activities, including Squatting,
Lunging, Jumping and Running.
Helps to correct Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), IT Band
Syndrome, Pronation Distortion
Syndrome, Valgus Knee, Quad
Dominance,
Asymmetrical
Weight-Shifts, Sway Back and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
92 ROLLING WITH A BALL ROLLING THE QUADRICEPS WITH A BALL
ANTERIOR LEG AND KNEE
Benefits:
Improves the tracking of the
Patellofemoral (Knee) Joint and
increases mechanical efficiency
in
Lower
Body
Centric
activities, including Squatting,
Lunging, Jumping and Running.
Helps to correct Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), IT Band
Syndrome, Pronation Distortion
Syndrome, Valgus Knee, Quad
Dominance,
Lower
Cross
Syndrome,
Asymmetrical
Weight-Shifts, Sway Back, and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
93 ROLLING WITH A BALL ROLLING THE ADDUCTOR COMPLEX WITH A BALL
MEDIAL LEG AND GROIN
Benefits:
Increases the Range of Motion
in Hip Extension, External
Rotation and Abduction.
Improves the Mobility of the
Hip,
which
increases
mechanical
efficiency
in
Squatting, Lunging, Jumping
and Running.
Helps to correct Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), IT Band
Syndrome, Pronation Distortion
Syndrome, Valgus Knee, Sway
Back, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Promotes post-exercises, soft
tissue
recovery,
and
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
94 ROLLING WITH A BALL ROLLING THE TENSOR FASCIAE LATAE (TFL) WITH A BALL
SUPERFICIAL HIP FLEXOR
Benefits:
Increases the Range of Motion
in
Hip
Extension,
Internal/External Rotation, and
Adduction.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility of the
Hip,
which
increases
mechanical
efficiency
in
Squatting, Lunging, Jumping
and Running.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct IT Band
Syndrome, Low Back Pain,
Patellofemoral Pain Syndrome
(Knee Pain), Patellofemoral
Tracking
Disorder
(Knee),
Pronation Distortion Syndrome,
Lower Cross Syndrome, Quad
Dominance,
Sway
Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Joint Articulation
Slowly
Internally/Externally
Rotate the Femur (Thigh) Bone
in slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration..
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
95 ROLLING WITH A BALL ROLLING THE PSOAS WITH A BALL
DEEP HIP FLEXORS
Benefits:
Increases the Range of Motion
in
Hip
Extension,
Internal/External Rotation and
Adduction.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility and
Stability of the Hip, which
increases mechanical efficiency
in force transfer throughout the
entire body and also directly
affects Squatting, Lunging,
Jumping and Running.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct Low Back
Pain, Lower Cross Syndrome,
Pronation Distortion Syndrome,
Quad Dominance, Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate the Femur (Thigh) Bone
in slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
96 ROLLING WITH A BALL ROLLING THE GLUTEUS COMPLEX WITH A BALL
POSTERIOR HIP
Benefits:
Increases the Range of Motion
in
Hip
Internal/External
Rotation, Flexion, Extension,
Abduction and Adduction.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility and
Stability of the Hip, which
increases mechanical efficiency
in force transfer throughout the
entire body and also directly
affects Squatting, Lunging,
Jumping and Running.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct Low Back
Pain, Lower Cross Syndrome,
Pronation Distortion Syndrome,
Quad Dominance, Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate and/or Abduct/Adduct
the Femur (Thigh) Bone in
slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
97 ROLLING WITH A BALL ROLLING THE GLUTEUS COMPLEX AND PIRIFORMIS WITH A BALL
POSTERIOR AND LATERAL HIP
PreHab Exercise eBook for Soft Tissue Therapy
98 ROLLING WITH A BALL ROLLING THE LATISSIMUS DORSI AND TERES MAJOR WITH A BALL
BACK AND SHOULDERS
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulders.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, assists directly in
Pushing, Pulling, Throwing, and
Overhead movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis,
Shoulder
Impingement,
Rounded
Shoulders, Low Back Pain,
Lower Cross Syndrome, Sway
Back, Uneven Shoulders, and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate and/or Flex/Extend the
Humerus (Arm) Bone as well as
Retract/Protract and Rotate the
Scapula in slow, smooth and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
99 ROLLING WITH A BALL ROLLING THE RHOMBOIDS & LOWER TO MID- TRAPEZIUS
THORACIC SPINE AND BACK
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulders.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, increases Spinal
Flexion, Extension and Rotation
as well as improves all
Throwing, Pushing, Pulling, and
Overhead movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis,
Shoulder
Impingement,
Rounded
Shoulders, Low Back Pain,
Lower Cross Syndrome, Sway
Back, Uneven Shoulders, and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate and/or Flex/Extend the
Humerus (Arm) Bone as well as
Retract/Protract and Rotate the
Scapula in slow, smooth and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
soft
and
PreHab Exercise eBook for Soft Tissue Therapy
100 ROLLING WITH A BALL ROLLING THE RHOMBOIDS & LOWER TO MID- TRAPEZIUS
INCLUDING JOINT ARTICULATION OF THE SHOULDER AND ARM
THORACIC SPINE, BACK AND SHOULDER
PreHab Exercise eBook for Soft Tissue Therapy
101 ROLLING WITH A BALL ROLLING THE POSTERIOR DELTOID, TERES MINOR &
SUPRASPINATUS (SHOULDER) INCLUDING JOINT ARTICULATION
POSTERIOR ROTATOR CUFF AND SHOULDER
Benefits:
Increases the Range of Motion
in the Shoulder, including
Internal and External Rotation.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, improves all
Throwing, Pushing, Pulling, and
Overhead
movements.
Contributes to an increase in
accuracy for Throwing as well.
Helps to correct Rounded
Shoulders, Uneven Shoulders,
Upper
Cross
Syndrome,
Shoulder Impingement, and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate and/or Adduct/Abduct
the Humerus (Arm) Bone as
well as Elevate/Depress and
Rotate the Scapula in slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
102 ROLLING WITH A BALL ROLLING THE PECTORALIS COMPLEX WITH A BALL
CHEST AND SHOULDER
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulder.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, improves all
Throwing, Pushing, Pulling,
Rowing
and
Overhead
movements.
Helps to correct Upper Cross
Syndrome,
Rounded
Shoulders,
Excessive
Kyphosis,
Forward
Head
Posture, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly
Internally/Externally
Rotate and/or Adduct/Abduct
the Humerus (Arm) Bone as
well as Elevate/Depress and
Rotate the Scapula in slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
103 ROLLING WITH A BALL ROLLING THE ERECTOR SPINAE WITH THE ‘PEANUT’
BACK AND SPINE
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulder.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility and
Stability of the Thoracic Spine
(Torso) and Shoulder, which
increases mechanical efficiency
in force transfer throughout the
entire body. Also, improves
Spinal Flexion, Extension and
Rotation, as well as directly
effects all Throwing, Pushing,
Pulling, Rowing, and Overhead
movements.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Helps to correct Upper Cross
Syndrome,
Rounded
Shoulders,
Excessive
Kyphosis,
Forward
Head
Posture,
Lower
Cross
Syndrome,
Asymmetrical
Weight-Shift, and improves
static posture and dynamic
alignment.
Joint Articulation
Slowly
Extend/Flex
and/or
Rotate the Torso (Spine) as
well as Elevate/Depress and
Rotate the Scapula in slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
104 ROLLING WITH A BALL Rolling with multiple balls is a simple progression of all of the previous rolling techniques.
PreHab Exercise eBook for Soft Tissue Therapy
105 ROLLING WITH A BALL ROLLING THE TRAPEZIUS AGAINST THE WALL
SHOULDERS, BACK, CERVICAL AND THORACIC SPINE
Benefits:
Increases the Range of Motion
in the Spine (Torso/Neck) and
Shoulder Girdle.
Improves the Mobility and
Stability of the Thoracic (Torso)
and Cervical (Neck) Spines and
the Shoulder Girdle, which
increases mechanical efficiency
in force transfer throughout the
entire body. Also, improves
Spinal Flexion, Extension and
Rotation, as well as directly
effects all Throwing, Pushing,
Pulling, Rowing, and Overhead
movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis,
Forward
Head
Posture, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Joint Articulation
Slowly
Extend/Flex
and/or
Rotate the Spine Torso and
Neck
as
well
as
Elevate/Depress and Rotate
the Scapula in slow, smooth,
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
106 ROLLING WITH A BALL ROLLING THE SCALENES, TRAPEZIUS AND PECTORALS
FIRST RIB, SHOULDERS AND NECK
Mobilization of the Soft Tissue connecting to the First Rib will increase the Mobility through the Shoulders
and Thoracic Spine as well as improve an individual’s capacity to breathe.
Benefits:
Increases the Range of Motion
in
the
Cervical
Spine
(Neck/Head) and Shoulder.
Improves the Mobility and
Stability of the Spine (Neck)
and Shoulder, which increases
mechanical efficiency in force
transfer through the body. Also,
assists in improving Throwing,
Pushing, Pulling, Rowing, and
Overhead movements.
Helps to correct Forward Head
Posture,
Upper
Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Protract/Retract and/or
Elevate/Depress the Scapula
and Shoulders as well as
Rotate and/or Flex/Extend the
Humerus
(Arm)
in
slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
107 ROLLING WITH A BALL ADDITONAL ROLLING TECHNIQUES AGAINST THE WALL
ROLLING THE SUBOCCIPITAL TRIANGLE, TRAPEZIUS & DELTOIDS
HEAD, NECK AND SHOULDERS
PreHab Exercise eBook for Soft Tissue Therapy
108 ROLLING WITH A BALL ROLLING THE PECTORALIS COMPLEX AGAINST THE WALL
CHEST AND SHOULDER
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulder.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, improves all
Throwing, Pushing, Pulling,
Rowing,
and
Overhead
movements.
Helps to correct Upper Cross
Syndrome,
Rounded
Shoulders,
Excessive
Kyphosis,
Forward
Head
Posture, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Rotate, Protract/Retract
and/or Elevate/Depress the
Scapula
as
well
as
Internally/Externally Rotate the
Shoulder in slow, smooth, and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
109 ROLLING WITH A BALL ROLLING THE BICEPS AND TRICEPS WITH A BALL
ARMS
Benefits:
Increases the Range of Motion
in the Elbow and Shoulder.
Improves the Mobility and
Strength of the Shoulder and
Arms, and will also assist in
improving mechanical efficiency
in Throwing, Pushing, Pulling,
and Overhead movements.
Contribute to more accuracy in
Throwing movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Shoulder Impingement, and
improves static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation.
Joint Articulation
Slowly Flex/Extend the Elbow
in slow, smooth and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
110 ROLLING WITH A BALL ROLLING THE FOREARM WITH A BALL - SUPINATED & PRONTATED
FOREARM
Benefits:
Increases the Range of Motion
in the Elbow and Wrist.
Improves the Mobility and
Strength of the Wrist and Arms,
and will also assist in improving
mechanical
efficiency
in
Throwing, Pushing, Pulling, and
Overhead
movements.
Contributes to more accuracy in
Throwing movements.
Helps to correct Tennis Elbow
and Tendonitis as well as
improving static posture and
dynamic alignment.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Include Oscillations & Rotations
Vary the direction of the ball
rolling to include circular and
perpendicular
movements
across the target area for 15-30
seconds.
Breathe deeply with an
emphasis on the Exhalation
Joint Articulation
Slowly Flex/Extend and Rotate
the Wrist in slow, smooth and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
111 BARBELL ROLLING
PreHab Exercise eBook for Soft Tissue Therapy
112
BARBELL ROLLING PreHab Exercise eBook for Soft Tissue Therapy
113 BARBELL ROLLING BARBELL ROLLING THE BICEPS
ARM
Benefits:
Increases the Range of Motion
in the Elbow and Shoulder.
Improves the Mobility and
Strength of the Shoulder and
Arms, and will also assist in
improving mechanical efficiency
in Throwing, Pushing, Pulling,
and Overhead movements.
Contribute to more accuracy in
Throwing movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Shoulder Impingement, and
improves static posture and
dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Elbow
and/or Rotate the Humerus
(Arm) in the Shoulder Socket in
slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
BARBELL ROLLING THE PECTORALIS COMPLEX
CHEST AND SHOULDERS
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulder.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, improves all
Throwing, Pushing, Pulling,
Rowing,
and
Overhead
movements.
Helps to correct Upper Cross
Syndrome,
Rounded
Shoulders,
Excessive
Kyphosis,
Shoulder
Impingement,
Uneven
Shoulders, and improves static
posture
and
dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Rotate, Abduct/Adduct,
and Flex/Extend the Shoulder
in slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
114 BARBELL ROLLING PreHab Exercise eBook for Soft Tissue Therapy
115 BARBELL ROLLING BARBELL ROLLING THE QUADRICEPS
ANTERIOR LEG
Benefits:
Improves the tracking of the
Patellofemoral (Knee) Joint and
increases mechanical efficiency
in many movements, including
Squatting, Lunging, Jumping
and Running.
Helps to correct Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), IT Band
Syndrome, Quad Dominance,
Pronation Distortion Syndrome,
Valgus Knee, Lower Cross
Syndrome,
Asymmetrical
Weight-Shifts, Sway Back, and
improves static posture and
dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee
and/or Rotate the Femur
(Thigh) Bone in slow, smooth,
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Exercise Illustration on next Page
PreHab Exercise eBook for Soft Tissue Therapy
116 BARBELL ROLLING PreHab Exercise eBook for Soft Tissue Therapy
117 BARBELL ROLLING BARBELL ROLLING THE ADDUCTOR COMPLEX
GROIN
Benefits:
Increases the Range of Motion
in Hip Extension, External
Rotation, and Abduction.
Improves the Mobility of the
Hip,
which
increases
mechanical
efficiency
in
movements
that
include
Squatting, Lunging, Jumping
and Running.
Helps to correct Valgus Knee,
Pronation Distortion Syndrome,
Patellofemoral Pain Syndrome
(Knee Pain), Patellofemoral
Tracking Disorder (Knee), IT
Band Syndrome, Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee
and/or Rotate the Femur
(Thigh) Bone in slow, smooth,
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
118 BARBELL ROLLING BARBELL ROLLING THE TENSOR FASCIAE LATAE
SUPERFICIAL HIP FLEXORS
Benefits:
Increases the Range of Motion
in
Hip
Extension,
Internal/External Rotation and
Adduction.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility of the
Hip,
and
increases
the
movement
efficiency
in
Squatting, Lunging, Jumping
and Running.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct IT Band
Syndrome, Low Back Pain,
Lower
Cross
Syndrome,
Pronation Distortion Syndrome,
Quad
Dominance,
Asymmetrical
Weight-Shifts
Sway Back, Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), and improves
static posture and dynamic
alignment.
Joint Articulation
Slowly Rotate the Pelvis and/or
Flex/Extend the Femur (Thigh)
Bone in slow, smooth, and
controlled movements while
applying pressure to a sensitive
area 15-30 seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
119 BARBELL ROLLING BARBELL ROLLING THE SCALENES AND UPPER TRAPEZIUS
SHOULDER AND NECK
Benefits:
Increases the Range of Motion
in the Thoracic and Cervical
Spines
(Torso/Neck)
and
Shoulders.
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Improves the Mobility and
Integration of the Torso, Neck,
and Shoulder, which increases
mechanical efficiency in force
transfer through the body. Also,
assists in improving Throwing,
Pushing, Pulling, Rowing and
Overhead movements.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct Forward Head
Posture,
Upper
Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Joint Articulation
Slowly Protract/Retract and/or
Elevate/Depress the Scapula
and Shoulders as well as
Rotate and/or Flex/Extend the
Cervical Spine (Neck) in slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
soft
and
Exercise Illustration on next Page
PreHab Exercise eBook for Soft Tissue Therapy
120 BARBELL ROLLING PreHab Exercise eBook for Soft Tissue Therapy
121 BARBELL ROLLING BARBELL ROLLING THE LATISSIMUS DORSI AND TERES MAJOR
BACK AND SHOULDER
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulders.
Improves the Mobility and
Integration through the Upper
Body, which leads to increases
in mechanical efficiency and
force transfers in all Throwing,
Pushing, Pulling, Rowing and
Overhead movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Rounded Shoulders, Uneven
Shoulders,
Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Protract/Retract and/or
Elevate/Depress the Scapula
and Shoulders as well as
Rotate and/or Flex/Extend the
Humerus (Arm) Bone in slow,
smooth,
and
controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
122 BARBELL ROLLING BARBELL ROLLING THE TRICEPS
ARM
Benefits:
Increases the Range of Motion
in the Elbow and Shoulder.
Improves the Mobility and
Strength of the Shoulder and
Arms, and will also assist in
improving mechanical efficiency
in Throwing, Pushing, Pulling,
and Overhead movements.
Contributes to more accuracy in
Throwing movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Shoulder Impingement, and
improves static posture and
dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Elbow
and/or Rotate the Humerus
(Arm) in the Shoulder Socket in
slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
123 BARBELL ROLLING BARBELL ROLLING THE HAMSTRING COMPLEX
POSTERIOR LEG
Benefits:
Increases the Range of Motion
of
the
Posterior
Chain,
especially at the Knee, and Gait
Cycle
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Assists force transfer through
the
Posterior
Chain
and
improves stability, integration,
and coordination in both the
Knee and hip Complex, which
translates
to
increased
mechanical
efficiency
in
Squatting, Hinging, Lunging,
Jumping,
Running
and
Standing.
Slow Roll
Practice smooth and controlled
rolls for 15-30 seconds.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Quad
Dominance,
Patellofemoral Pain Syndrome
(Knee Pain), Patellofemoral
Tracking
Syndrome,
Sway
Back, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Include Oscillations
Rotate the Femur (Thigh) Bone
from side to side while rolling
over the Hamstring. Perform
one oscillation every 2-3
seconds for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Knee in
slow, smooth, and controlled
movements
while
applying
pressure to a sensitive area 1530 seconds.
Target Area:
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
124 BARBELL ROLLING BARBELL ROLLING THE GASTROCNEMIUS, SOLEUS, PERONEALS
AND ACHILLES TENDON
PreHab Exercise eBook for Soft Tissue Therapy
125 BARBELL ROLLING BARBELL ROLLING THE GASTROCNEMIUS, SOLEUS, PERONEALS
AND ACHILLES TENDON
CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee, and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased mechanical efficiency
in Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Glute
Amnesia
Syndrome,
Patellofemoral
Tracking Syndrome (Knee),
Patellofemoral Pain Syndrome
(Knee Pain), Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Include Oscillations
Rotate the Calf from side to
side while rolling. Oscillate
once every 2-3 seconds for 1530 seconds.
Joint Articulation
Slowly Flex/Extend and Circle
the Ankle/Foot in slow, smooth,
and
controlled
movements
while applying pressure to a
sensitive area 15-30 seconds.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercises soft
tissue
recovery
and
regeneration.
ROLLING VARIATIONS FOR THE CALF – TOP VIEW
PreHab Exercise eBook for Soft Tissue Therapy
126 BARBELL ROLLING BARBELL ROLLING THE PLANTAR FASCIA
FOOT
Benefits:
Increases the Range of Motion
of Foot, Ankle and Gait Cycle.
Improves force transfer and
coordination through the Ankle
and Foot into the Ground,
which translates to increased
mechanical
efficiency
in
Squatting, Hinging, Lunging,
Jumping, Running, Standing,
and Single-Leg Stability.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee, Lower Cross Syndrome,
Glute
Amnesia
Syndrome,
Quad Dominance, IT Band
Syndrome, Patellofemoral Pain
Syndrome
(Knee),
Patellofemoral
Tracking
Syndrome
(Knee),
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Target Area:
Select Exercise RX:
Hold and Release
Apply pressure to sensitive
area for 5-30 seconds or until
sensitivity dissipates.
Slow Roll
Smooth and controlled rolls for
15-30 seconds.
Include Oscillations
Turn the Foot every 2-3
seconds for 15-30 seconds.
Joint Articulation
Slowly Flex/Extend the Toes
and Curl the Foot while
applying pressure for 15-30
seconds.
Activation: Quick Rolls
Use the Quick Roll technique
for 15-30 seconds to stimulate
the
proprioception
before
exercising.
Breathe deeply with an
emphasis on the Exhalation.
Promotes post-exercise
tissue
recovery
regeneration.
PreHab Exercise eBook for Soft Tissue Therapy
soft
and
127 SELF-MASSAGE
Things to KnowBefore getting started, it is important to
understand how to effectively practice SelfMassage Here are some recommended
techniques:
EFFECTIVE SELF-MASSAGE TECHNIQUES
Pressing
Press and Hold
Press and Slide
Press and Twist
Squeezing
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Squeeze and Cross-Fiber
Raking
Rake with Fingers
Rake Apart with Fingers
Rake Apart (Cross-Fibering) with Fingers
Knuckling
Press and Hold with the Knuckles
Press and Slide with the Knuckles
Press and Twist with the Knuckles
Tapping with the Knuckles
Press and Hold
In this technique, an individual will use the
hands to place pressure on a particular area of
tissue where a knot of Myofascial Trigger Point
exists. This technique used in both Swedish
Massage and Acupressure massages. The
technique utilizes pressure to stimulate
mechanoreceptors within the soft tissue that will
communicate signals to the corresponding Motor
Neurons commanding the release of the Trigger
Point or knot.
Hold pressure over a sensitive spot within
targeted area for 5-30 seconds or until the
sensation dissipates and the corresponding
Trigger Point releases.
Press and Slide
In this technique, the individual will use the
hands to press down into the soft tissue and
then slide through a sensitive area in an attempt
to drain blood from the tissue and pull out
metabolic waste that may be contributing to the
formation of a Trigger Point. At the same time,
this Press and Slide technique will help to
improve circulation to the area and allow the
increased blood flow to provide more oxygen
and nutrients to the affected area, all of which
can help create the release of Trigger Point and
lengthen the tissue.
Perform several Press and Slide in a smooth
and deliberate fashion over the affected area for
approximately 30 seconds or until the Trigger
Point releases.
Press and Twist
In this technique, the individual will apply
pressure in a twisting fashion to a targeted area.
More specifically, the individual will press the
hands into the tissue and then rotate or twist the
hands in order to cause changes to the targeted
soft tissue. This Press and Twist technique is
very beneficial as the twisting pressure can
remove metabolic waste and even dislodge
possible adhesions and/or scar tissue.
Perform numerous Twists or Rotations while
applying pressure with the hands to a targeted
area for approximately 30 seconds.
Squeeze and Hold
This technique is very similar to Press and Hold
in regards to benefits and prescription. The main
difference between the two is the application of
the techniques. This Squeeze and Hold
technique requires the hand to be able to wrap
around the targeted area of soft tissue, which is
not always possible. The advantage of the
Squeeze technique is that the applied pressure
can be more concreted and/or applied with a
higher degree of accuracy in terms of location.
The Squeeze techniques work very well on the
following areas of the body: Foot, Calf,
Hamstrings
(Thigh),
Quadriceps
(Thigh),
Latissimus Dorsi/Teres Major (Back), Deltoids
(Shoulders),
Biceps/Triceps
(Arms)
and
Trapezius (Neck/Shoulders).
PreHab Exercise eBook for Soft Tissue Therapy
128
SELF-MASSAGE
Hold pressure over a sensitive spot within
targeted area for 5-30 seconds or until the
sensation dissipates and the corresponding
Trigger Point releases.
Squeeze and Slide & Squeeze and Twist
Both of these techniques are similar to Press
and Slide and Press and Twist techniques
respectively. The only difference, as mentioned
previously, is that the Squeeze technique
requires the hand to wrap around the targeted
area of the soft tissue, which will help to apply
pressure more accurately to a specified area.
Squeeze and Slide: Perform several Press and
Slide in a smooth and deliberate fashion over
the affected area for approximately 30 seconds
or until the Trigger Point releases.
Squeeze and Twist: Perform numerous Twists
or Rotations while applying pressure with the
hands to a targeted area for approximately 30
seconds.
Rake Apart with the Fingers
The Rake with Fingers technique can be modify
to help improve the effectiveness of the
technique by changing the direction of the ‘rake.’
Instead of just raking in one direction, an
individual can rake into opposing directions,
which will send different waves of pressure into
the soft tissue and also help stimulate more
proprioception and mechanoreceptors in the
targeted area.
Practice Rake Apart with the Fingers over a
targeted area for 15-30 seconds.
Rake Apart (Cross-Fiber) with the Fingers
This technique is another various to Raking with
the Fingers that incorporates a massage
Raking with the Fingers
In this technique, the individual practices several
smooth and quick ‘rakes’ of pressure over a
targeted area in an attempt to stimulate the
proprioception and mechanoreceptors within the
tissue in order to help increase neuromuscular
activity in the area, which can consequentially
improve blood flow and increase flexibility.
These ‘rakes’ are performed with the spread-put
fingertips, which allows relatively deep
penetration due to the narrow width of the
fingertips. This technique is very effective in
increasing blood flow and ‘raking’ out metabolic
waste that may remain lodged in the soft tissue
creating an increased level of stiffness. It is
recommended to be use the raking techniques
in combination with other techniques.
Practice several Rakes with the Fingers over a
targeted area for 15-30 seconds.
technique called Cross-Fibering. Cross-Fibering
is the act of sliding pressure across the soft
tissue in a direction that is perpendicular to the
striations or pennation of the muscles. The
muscles and the corresponding connective
tissue, including adhesions and scar tissue, can
grow resilient to forces that travel in the same
direction of the soft tissue’s pennation or
striations.
Conversely,
the
Cross-Fiber
technique will apply force via pressure across
the cells in a direction that the soft tissue has not
been customarily conditioned for, which can help
to break-up myofascial trigger points (knots) and
even dislodge adhesions and scar tissue.
Practice Rake Apart with the Fingers over a
targeted area for 15-30 seconds.
PreHab Exercise eBook for Soft Tissue Therapy
129 Illustration of the ‘striations’ within the Soft Tissue that are targeted in the Cross-Fiber technique.
Articulate the Joint
As outlined in the previous sections for foam
rolling and rolling with a ball, ‘Articulating the
Joint’ is another soft tissue therapy technique
that can be combined with these Self-Massage
techniques. Simply, articulate or move the
neighboring joint that corresponds with the soft
tissue that is being targeted with a Self-Massage
technique. Flex/Extend, Abduct/Adduct or
Rotate the joint while applying pressure with one
of the aforementioned massage techniques. The
movement at the joint causes the targeted tissue
to lengthen and contract under pressure, which
will help to break up Trigger Points as well as
clear out or separate adhesions in the area.
Hold pressure over a sensitive spot within
targeted area and articulate the corresponding
joint for 15-30 seconds or until the sensitivity in
the tissue dissipates.
Knuckles: Density Matters
The magnitude of pressure will have a major
impact in regards to the physiological reaction in
the tissue. The more that the pressure increases
in magnitude, the larger of a sensation will be
emitted through the soft tissue. Unfortunately,
the hands, specifically the fingers, cannot
always provide enough magnitude, i.e. pressure,
to create the physiological changes that are
desired. Therefore, using the knuckles can serve
as a valuable approach in Self-Massage.
The use of the knuckles in Self-Massage
techniques can apply a higher magnitude of
force via a combination of increased density with
pressure as compared to the fingers, which is
beneficial when dealing with very stiff areas in
the soft tissue.
Knuckles: Self-Massage Techniques
• Press and Hold with the Knuckles
• Press and Slide with the Knuckles
• Press and Twist with the Knuckles
• Tapping with the Knuckles
Tapping
‘Tapping’ is a Self-Massage technique that will
use a repetitive percussion force, i.e. tapping, to
help break-up myofascial trigger points (knots)
and even dislodge adhesions and scar tissue.
Simply tap the knuckles against the targeted
area of soft tissue in a gentle manner and
gradually change location of the tap while
focusing on long exhalations and attempting to
relax. It is recommended to combine tapping
with other Self-Massage techniques.
Gently tap the knuckles over a targeted area of
soft tissue for 15-30 seconds.
Remember to Breathe
It is extremely important to remember to breathe
with an emphasis on large exhalations when
practicing soft tissue therapy in order help
stimulate the Parasympathetic Nervous System
and change more beneficial changes in the soft
tissue.
PreHab Exercise eBook for Soft Tissue Therapy
130
SELF-MASSAGE
Illustration of Self-Massage techniques.
PreHab Exercise eBook for Soft Tissue Therapy
131 SELF-MASSAGE
SELF-MASSAGE: PLANTAR FASCIA & INTRINSIC FOOT MUSCLES
FOOT
Benefits:
Increases the Range of Motion
of Foot, Ankle and Gait Cycle.
Improves force transfer and
coordination through the Ankle
and Foot into the Ground,
which translates into increased
mechanical
efficiency
in
Squatting, Hinging, Lunging,
Jumping, Running, Standing,
and Single-Leg Stability.
Promotes and accelerates postexercise soft tissue recovery,
and regeneration.
Recommended Techniques:
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee, Lower Cross Syndrome,
Glute
Amnesia
Syndrome,
Quad Dominance, IT Band
Syndrome, Patellofemoral Pain
Syndrome
(Knee),
Patellofemoral
Tracking
Syndrome
(Knee),
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake Apart (Cross-Fiber)
Joint Articulation (Toes)
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
132 SELF-MASSAGE
SELF-MASSAGE: GASTROCNEMIUS, SOLEUS AND PERONEALS
CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee, and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased mechanical efficiency
in Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Promotes and accelerates postexercise soft tissue recovery,
and regeneration.
Recommended Techniques:
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Glute
Amnesia
Syndrome,
Patellofemoral
Tracking Syndrome (Knee),
Patellofemoral Pain Syndrome
(Knee Pain), Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Breathe deeply with an
emphasis on the Exhalation.
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake with Fingers
Rake Apart (Cross-Fiber)
Joint Articulation (Ankle)
PreHab Exercise eBook for Soft Tissue Therapy
133 SELF-MASSAGE
SELF-MASSAGE: POSTERIOR TIBIALIS AND PERONEALS
CALF
Benefits:
Increases the Range of Motion
of Ankle, Knee, and Gait Cycle.
Improves force transfer and
coordination from the Hip
through the Ankle/Foot and into
the Ground, which translates to
increased mechanical efficiency
in Squatting, Hinging, Lunging,
Jumping,
Running,
and
Standing.
Promotes and accelerates postexercise soft tissue recovery,
and regeneration.
Recommended Techniques:
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Glute
Amnesia
Syndrome,
Patellofemoral
Tracking Syndrome (Knee),
Patellofemoral Pain Syndrome
(Knee Pain), Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and dynamic alignment.
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Joint Articulation (Ankle)
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
134 SELF-MASSAGE
SELF-MASSAGE THE QUADRICEPS
LEG
Benefits:
Improves the tracking of the
Patellofemoral (Knee) Joint and
increases mechanical efficiency
in many movements, including
Squatting, Lunging, Jumping
and Running.
Promotes and accelerates postexercise soft tissue recovery,
and regeneration.
Helps to correct Patellofemoral
Pain Syndrome (Knee Pain),
Patellofemoral
Tracking
Disorder (Knee), IT Band
Syndrome, Quad Dominance,
Pronation Distortion Syndrome,
Valgus Knee, Lower Cross
Syndrome,
Asymmetrical
Weight-Shifts, Sway Back, and
improves static posture and
dynamic alignment.
Breathe deeply with an
emphasis on the Exhalation.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake with Fingers
Rake Apart (Cross-Fiber)
Joint Articulation (Knee/Hip)
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135 SELF-MASSAGE
SELF-MASSAGE: HAMSTRINGS
LEG
Benefits:
Increases the Range of Motion
of
the
Posterior
Chain,
especially at the Knee, and Gait
Cycle
Assists force transfer through
the
Posterior
Chain
and
improves stability, integration,
and coordination in both the
Knee and hip Complex, which
translates
to
increased
mechanical
efficiency
in
Squatting, Hinging, Lunging,
Jumping,
Running
and
Standing.
Helps to correct Pronation
Distortion Syndrome, Valgus
Knee,
Quad
Dominance,
Patellofemoral Pain Syndrome
(Knee Pain), Patellofemoral
Tracking
Syndrome,
Sway
Back, Asymmetrical WeightShifts, and improves static
posture
and
dynamic
alignment.
Promotes
and
accelerates post-exercise soft
tissue
recovery,
and
regeneration.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake with Fingers
Rake Apart (Cross-Fiber)
Joint Articulation (Knee/Hip)
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
136 SELF-MASSAGE
SELF-MASSAGE: GLUTEUS COMPLEX
POSTERIOR HIPS
Benefits:
Increases the Range of Motion
in
Hip
Internal/External
Rotation, Flexion, Extension,
Abduction and Adduction.
Improves the Mobility and
Stability of the Hip, which
increases mechanical efficiency
in force transfer throughout the
entire body and also directly
affects Squatting, Lunging,
Jumping and Running.
Helps to correct Low Back
Pain, Lower Cross Syndrome,
Pronation Distortion Syndrome,
Quad Dominance, Sway Back,
Asymmetrical
Weight-Shifts,
and improves static posture
and
dynamic
alignment.
Promotes and accelerates postexercise soft tissue recovery,
and regeneration.
Breathe deeply with an
emphasis on the Exhalation.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake Apart (Cross-Fiber)
Joint Articulation (Thigh/Hip)
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137 SELF-MASSAGE
SELF-MASSAGE: PECTORALIS COMPLEX
CHEST
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulder.
Improves the Mobility and
Stability of the Shoulder, which
increases mechanical efficiency
in force transfer through the
Thoracic Spine (Torso) and
Arms. Also, improves all
Throwing, Pushing, Pulling,
Rowing,
and
Overhead
movements.
Helps to correct Upper Cross
Syndrome,
Rounded
Shoulders,
Excessive
Kyphosis,
Shoulder
Impingement,
Uneven
Shoulders, and improves static
posture
and
dynamic
alignment.
Promotes
and
accelerates post-exercise soft
tissue
recovery,
and
regeneration.
Recommended Techniques:
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake
Rake Apart
Rake Apart (Cross-Fiber)
Joint Articulation (Shoulder)
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
138 SELF-MASSAGE
SELF-MASSAGE: LATISSIMUS DORSI AND TERES MAJOR
BACK AND SHOULDER
Benefits:
Increases the Range of Motion
in the Thoracic Spine (Torso)
and Shoulders.
Improves the Mobility and
Integration through the Upper
Body, which leads to increases
in mechanical efficiency and
force transfers in all Throwing,
Pushing, Pulling, Rowing and
Overhead movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Rounded Shoulders, Uneven
Shoulders,
Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Promotes
and
accelerates post-exercise soft
tissue
recovery,
and
regeneration.
Recommended Techniques:
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake
Rake Apart (Cross-Fiber)
Joint Articulation (Shoulder)
Breathe deeply with an
emphasis on the Exhalation.
PreHab Exercise eBook for Soft Tissue Therapy
139 SELF-MASSAGE
SELF-MASSAGE: DELTOIDS
SHOULDER
Benefits:
Increases the Range of Motion
in the Thoracic and Cervical
Spines
(Torso/Neck)
and
Shoulders.
Improves the Mobility and
Integration of the Torso, Neck,
and Shoulder, which increases
mechanical efficiency in force
transfer through the body. Also,
assists in improving Throwing,
Pushing, Pulling, Rowing and
Overhead movements.
Helps to correct Forward Head
Posture,
Upper
Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Uneven Shoulders, Shoulder
Impingement, and improves
static posture and dynamic
alignment.
Promotes
and
accelerates post-exercise soft
tissue
recovery,
and
regeneration.
Breathe deeply with an
emphasis on the Exhalation.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake
Rake Apart (Cross-Fiber)
Joint Articulation (Scapula/Arm)
PreHab Exercise eBook for Soft Tissue Therapy
140 SELF-MASSAGE
SELF-MASSAGE: BICEPS AND TRICEPS
ARMS
Benefits:
Increases the Range of Motion
in the Elbow and Shoulder.
Improves the Mobility and
Strength of the Shoulder and
Arms, and will also assist in
improving mechanical efficiency
in Throwing, Pushing, Pulling,
and Overhead movements.
Contributes to more accuracy in
Throwing movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Shoulder Impingement, and
improves static posture and
dynamic alignment. Promotes
and accelerates post-exercise
soft tissue recovery, and
regeneration.
Breathe deeply with an
emphasis on the Exhalation.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake
Rake Apart (Cross-Fiber)
Joint Articulation (Scapula/Arm)
PreHab Exercise eBook for Soft Tissue Therapy
141 SELF-MASSAGE
SELF-MASSAGE: UPPER TRAPEZIUS, SCALENES AND
STERNOCLIEDOMASTOID
NECK AND SHOULDER
Benefits:
Increases the Range of Motion
in the Elbow and Shoulder.
Improves the Mobility and
Strength of the Shoulder and
Arms, and will also assist in
improving mechanical efficiency
in Throwing, Pushing, Pulling,
and Overhead movements.
Contributes to more accuracy in
Throwing movements.
Helps to correct Upper Cross
Syndrome,
Excessive
Kyphosis, Elevated Shoulders,
Shoulder Impingement, and
improves static posture and
dynamic alignment. Promotes
and accelerates post-exercise
soft tissue recovery, and
regeneration.
Breathe deeply with an
emphasis on the Exhalation.
Recommended Techniques:
Press and Hold
Press and Slide
Press and Twist
Squeeze and Hold
Squeeze and Slide
Squeeze and Twist
Press and Hold – Knuckles
Press and Slide – Knuckles
Press and Twist – Knuckles
Rake
Rake Apart
Rake Apart (Cross-Fiber)
Joint Articulation
(Scapula/Head)
PreHab Exercise eBook for Soft Tissue Therapy
142 SELF-MASSAGE
SELF-MASSAGE THE STERNOCLIEDOMASTOID, SCALENES
AND UPPER TRAPEZIUS
NECK AND SHOULDER
PreHab Exercise eBook for Soft Tissue Therapy
143 APPENDIX A: SOFT
TISSUE THERAPY
DIAGRAMS PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
144
APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
145 APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
146 APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
147 APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
148 APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
149 APPENDIX A: SOFT TISSUE THERAPY DIAGRAM PER JOINT
PreHab Exercise eBook for Soft Tissue Therapy
150 APPENDIX B:
MAPS OF COMMON
COMPENSATION
PATTERNS
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151
APPENDIX B: MAPS OF COMMON COMPENSATION PATTERNS
PreHab Exercise eBook for Soft Tissue Therapy
152 APPENDIX B: MAPS OF COMMON COMPENSATION PATTERNS
PreHab Exercise eBook for Soft Tissue Therapy
153 APPENDIX B: MAPS OF COMMON COMPENSATION PATTERNS
PreHab Exercise eBook for Soft Tissue Therapy
154 APPENDIX B: MAPS OF COMMON COMPENSATION PATTERNS
PreHab Exercise eBook for Soft Tissue Therapy
155 APPENDIX B: MAPS OF COMMON COMPENSATION PATTERNS
PreHab Exercise eBook for Soft Tissue Therapy
156 APPENDIX C:
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-Michael
www.prehabexercises.com
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