For Wheelchair Athletes and Veterans
Tim Dempsey
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Strength & Conditioning Coach and Personal Trainer at the Riekes Center for Human
Enhancement in Menlo Park, California (Paralympic Sport Club Menlo Park)
Certified Personal Trainer – National Strength and Conditioning Association
Strength and Conditioning Coach – NSCA
Performance Enhancement Specialist – National Academy of Sports Medicine
Level I Coach – USA Track and Field
Club Coach – USA Weightlifting
Level 3 Coach and ACL Bridge Certified – Athletic Republic
Level I SICCED – Mexican National Coaching System
Contact Tim at tdempsey@riekes.org or 650-860-8004
Sharon Kelleher
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Manager of Communications and Coordinator of Veterans Programs and Adaptive Sports at
the Riekes Center for Human Enhancement in Menlo Park, California (Paralympic Sport Club
Menlo Park)
Paralympian in Wheelchair Tennis, 2000 and 2004. Former #1 in USA and #3 in the world.
Contact Sharon at skelleher@riekes.org or 650-298-3404
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Cross Patterning: Physical movement that involves crossing the midline of the
body, using the upper and lower body, or right and left side separately
Definition from Promislow, Sharon. Making the Brain/body Connection - “Each
brain hemisphere controls the opposite side of the body. So by intentionally
moving an opposite arm and leg across the midfield, we fire off both brain
hemispheres at the same time, creating and myelinating better neural connections
over the corpus collosum.” p 103
Paraphrasing from Suzana Zuzan, Prague Institute of Rehabilitation:
Developmental movement patterns are wired in our DNA, and when we correctly
activate those patterns, the body immediately relaxes and movement becomes
more fluid.
A fundamental energy therapy technique, homolateral patterning exercises are a
series of movements that encourage your body's energies to cross over from one
side of the body to the other. Walking, or marching in time with your arms
swinging freely beside you, are examples of movements that enable your body to
maintain its natural balance.
Read more: http://www.livestrong.com/article/490133-homolateral-patterningexercises/#ixzz1pyvZvMBI
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Benefits we have observed in our program participants include
decreased pain, improved sports performance, improved range of
motion, balance, posture, mental focus and emotional stability.
Participants report decreased anxiety levels, decreased depression
and improved self-esteem.
Traditional movement patterns (squat/lat pull/pull ups/bench press,
etc.) are all good exercises, however they may exacerbate problems
in certain populations. The familiarity of these movement patterns
also encourages the exerciser to go through the movement in “auto
mode.” Cross patterning movements require more body awareness
and focus, and they enhance the coach/client interaction.
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Energy therapists say that homolateral repatterning is a key to
restoring the communication pathways between the left and right
side of your brain. When your energies cross from one side of the
body to the other, your body is in balance and your ability to
perform physical and mental activities is restored.
Read more: http://www.livestrong.com/article/490133homolateral-patterning-exercises/#ixzz1pywjZgj0
Slow cross-lateral movement stimulates the manufacture of
dopamine in the frontal lobe of the brain (affecting our ability to see
patterns and to learn faster), in the limbic area (controlling our
emotions) and in the basal ganglion (intentional movement).
(Promislow, Sharon. Making the Brain Body Connection)
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Anatomy Trains 2nd Edition by Thomas W. Myers
Coyle, Daniel. The Talent Code: Greatness Isn't Born. It's Grown. Here's How. New York:
Bantam, 2009. Print.
Dolen, Carolyn E. Brain Injury Rewiring for Loved Ones: A Lifeline to New Connections.
Enumclaw, WA: Idyll Arbor, 2010. Print.
Feldenkrais, Moshe. Awareness through Movement: Easy-To-Do Health Exercises to Improve
Your Posture, Vision, Imagination, and Personal Awareness. New York: Harper and Row, 1977.
Print.
Hanna, Thomas. Somatics: Reawakening the Mind's Control of Movement, Flexibility, and
Health. Cambridge, MA: Da Capo Life Long, 1988. Print.
Hoge, Charles W. Once a Warrior, Always a Warrior: Navigating the Transition from Combat to
Home--including Combat Stress, PTSD, and MTBI. Guilford, CT: GPP Life, 2010. Print.
Promislow, Sharon. Making the Brain/body Connection: A Playful Guide to Releasing Mental,
Physical & Emotional Blocks to Success. West Vancouver, B.C.: Kinetic Pub., 1998. Print.
Ratey, John J., and Eric Hagerman. Spark: The Revolutionary New Science of Exercise and the
Brain. New York: Little, Brown, 2008. Print.
Effect of educational kinesiology on static balance of learning disabled students http://www.ncbi.nlm.nih.gov/pubmed/3211692
http://www.livestrong.com/article/490133-homolateral-patterning-exercises/
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Due to repetitive motion, wheelchair athletes often experience injuries to the
rotator cuff, impingement, muscle imbalances, carpal tunnel syndrome, neck
pain, and elbow strain such as tennis elbow. Strengthening the torso can
help alleviate stress on the shoulder joints. In particular, athletes who
participate in Tennis, Field Events, Volleyball, Para Canoe, and Hockey can
reduce their risk of shoulder injuries by using the torso for added power and
rotation. Cross patterning training techniques can increase core strength
and range of motion.
“More than two thirds of patients (with SCI) reported shoulder pain since the
beginning of wheelchair use (6). It is known that the upper extremity pain in
subjects with SCI is from muscle imbalance at the shoulder joint. These
subjects also have a higher risk of shoulder impingement syndrome (1).”
(Turbanski, Stephan, and Dietmar Schmidtbleicher. "Effects of Heavy
Resistance Training on Strength and Power in Upper Extremities in
Wheelchair Athletes." Journal of Strength and Conditioning Research 24.1
(2010): 8-16. Print.)
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“A selective 8-week home exercise program is effective in reducing
pain and improving function and satisfaction in this population of
wheelchair users.” (Nawoczenski, D. A., J. M. Ritter-Soronen, C. M.
Wilson, B. A. Howe, and P. M. Ludewig. "Clinical Trial of Exercise for
Shoulder Pain in Chronic Spinal Injury." Physical Therapy 86.12
(2006): 1604-618. Print.)
“Higher muscle strength and higher functional outcome are related
to fewer upper extremity complaints.” (Van Drongelen, S., S. De
Groot, H E J. Veeger, E L D. Angenot, A. J. Dallmeijer, M W M. Post,
and L H V. Van Der Woude. "Upper Extremity Musculoskeletal Pain
during and after Rehabilitation in Wheelchair-using Persons with a
Spinal Cord Injury." Spinal Cord 44.3 (2005): 152-59. Print.)
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Weakness of shoulder adductor muscles was observed in the
wheelchair athletes. They further suggest that this weakness may
heighten the wheelchair athlete's risk of shoulder impingement,
because the stronger abductors may pull the humeral head further
up into the subacromial space (Fabrisia Ambrosio, PhD, MPT,1,2
Michael L Boninger, MD,1–3 Aaron L Souza, PhD,1,2 Shirley G
Fitzgerald, PhD,1,2 Alicia M Koontz, PhD, ATP,1,2 and Rory A
Cooper, PhD1,2. "Biomechanics and Strength of Manual Wheelchair
Users." The Journal of Spinal Cord Medicine 2005; 28(5): 407–414.
Print.)
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Wheelchair - alternatively reach arms up
wall in a climbing motion
Standing - same as above, but add opposite
side leg
Injury prevention - teaches stabilization of
shoulder girdle while reaching overhead
Variations - same side terminal point
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Wheelchair - advance forward with opposite
side terminal point
Standing - single leg balance on opposite
side leg
Injury prevention - teaches scapula to move
independently (elevation/depression),
engages terminal point, elevate through
thoracic spine
Variations - same side terminal point
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Wheelchair – opposite arm abducts,
terminal point comes forward with same
side arm
Standing - pulling side glute contracts and
presses hip slightly forward
Injury prevention - teaches protraction and
retraction of scapula, using core to initiate
rotational movements
Variations - opposite side terminal points
contract
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Wheelchair - reach across centerline,
abduct pulling arm around torso
Standing – same as above, but load inside
side hip and transfer to outside (pulling
side) hip
Injury prevention - teaches pulling through
body, active transfer of load through
functional structures rather than passive
structures
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Wheelchair - elevate arm and opposite side
terminal point
Injury prevention - good warm up
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Wheelchair - cross arms and terminal point
Injury prevention - increases body
awareness and improves balance and
coordination
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Wheelchair – depends on upper body
strength. If desired, the athlete can get on
the ground to perform these exercises.
Injury prevention - can improve transfers in
wheelchairs, improves shoulder stability by
integrating core, teaches movement
sequencing
Examples:
 1. Cross arms and rotate rib cage, shoulders and head
same direction. Next, cross arms and rotate rib cage
and head one way, shoulders the other way
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2. Move rib cage sideways, then move rib cage sideways
while elevating same side terminal point. Lastly, move
rib cage sideways while elevating opposite side terminal
point
3. Pull one shoulder blade downwards. Then pull one
shoulder blade downwards while elevating opposite
shoulder blade. Next, pull both shoulder blades down.
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There is limited research on the benefits of
Cross Patterning Exercises. At the very least,
the exercises improve functional movement
patterns and sport specific performance. The
psychological and emotional benefits are
anecdotal at this point. Further research is
needed.
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We would like to thank the Riekes Center for
Human Enhancement and the following
individuals for their assistance with this
presentation:
Gary Riekes – Founder and Executive Director
Sagesse Graham – Video Production
Ron Curcio – Athletic Fitness Coach
The veterans exercise group and other
individuals who participated in the exercise
demonstration videos