Beyond Mobility: The Case for Performance Care

The original version was written as a Guest Blog for CrossFit Hoboken.

With the rise of CrossFit came the need for self-care, mobility and stability. Enter folks and resources like Dr. Kelly Starrett’s MobilityWod and Supple Leopard as well as flocks of Massage Therapists, Physical Therapists and Chiropractors offering their services to these athletes.

So how do we know when to seek professional help and who is best equipped to serve functional fitness athletes?

As a health care professional, I not only got hooked on CrossFit, but also saw a need to go beyond simply mobilizing and stretching to improve function and reduce pain and injury risk. I’ve taken the best of my background as a Certified Athletic Trainer, Exercise Scientist and Doctor of Chiropractic to create a model I call “Performance Care.”

I completely value and support people who want to help themselves. This is one of the reasons I launched a video project called The 2 Minute Fix (free) and The Full Body Fix (premium). These instructional videos help people solve common movement problems from a mobility & stability standpoint.

But self-care can has its limitations.

Stretching, mobility and soft tissue work are great if there is a true soft tissue restriction. Soft tissue damage can create adhesions and scar tissue – essentially unhealthy tissue nestled amongst healthy tissue. These adhesions can limit movement and impair healing. This is one of the reasons I have trained and specialized in Active Release Technique (ART) over the past 10 years. ART is the gold standard in manual soft tissue care. It’s specifically designed to quickly and effectively isolate and remove soft tissue adhesions.

However, mobility and soft tissue work is only part of the story. The flip side of the mobility coin is stability. Stability is the body’s ability to regulate muscular control and tension via the nervous system.

Let me use a common example. Many people feel like their hamstrings are chronically “tight” so they stretch, foam roll, or get a massage, yet the problem persists. The common misconception is that if a muscle is tight, it must need to be stretched. But when I see this scenario in my patients, I see a body that is trying to stabilize the area by up-regulating neuromotor tone. Translation – your body is keeping it “tight” for a reason! The key to unlocking this sort of chronic muscular tension is to identify the root cause of the problem. The underlying WHY! Why is the body keeping this muscle ‘tight’?

Performance care modelThat’s where Performance Care comes in. My job is to assess the person as a whole. I combine a functional movement assessment and a soft tissue evaluation with a thorough chiropractic neurological screening to find the root cause of movement faults, dysfunction and pain.

In order to maximize athletic performance we must have mobility, sound biomechanics and balanced neuromotor control (muscular stability). Combining specific soft tissue treatments (ART) with functional movement & chiropractic care is the most effective solution for that equation.

I’d like to finish with a testimonial to illustrate the point. Recently I had a 35-year-old male athlete come to my practice with shoulder pain. Over 4 months the pain was progressively getting worse. He had tried self-mobility, massage, and PT with little success. The problem is that most providers and techniques simply chase pain. The pain was at the top of his shoulder so that’s where care had been focused.

But when I did my assessment I found the root cause of the problem to be a neurologically inhibited subscapularis muscle, which is literally under the shoulder blade. I see this often in athletes that perform a lot of heavy overhead bar work. In just a few visits under my care he was at 90% improvement and quickly returned to full activity with no pain, even hitting a new overhead squat PR the week following care.

Mobility can be helpful to improve movement restrictions, but there is often more to the story. To truly move and perform properly we can’t neglect neuromotor control and stability. We need the help of someone who understands root cause analysis and has the means to correct the problem.

I’d love the opportunity to be that solution for you here in San Francisco.

Click Here to Request an Appointment!

Yours in Health,

Dr. Scott


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5 thoughts on “Beyond Mobility: The Case for Performance Care

  1. Heather

    hi there- I am a NASM CPT and agree 100% with everything you say and preach it myself. I recently picked up a client that comes from a chronic cardio state of thinking, who is under weight with limited mobility particularly in the hips and knees and struggles with balance and has very little strength. She did not understand why I started her with stability exercises and SMR and static stretching and she wanted to move right into her requested weightlifting program that another CPT that is a friend of hers suggested she follow: deadlifts, military press, bench press, back squats, etc. I tried to example the importance of setting a foundation especially in her case of never having done these movements but she still pushed to do them. She is a pharmacist and is asking for evidence based research that stability training prior to and in concession with weightlifting is optimal. Do you have some good resources I could send her way?

    Reply
    • scottamillsdc Post author

      Hey Heather,
      Thanks for the inquiry. Off the top of my head I’d refer to Dr. Stuart McGill’s work and Gray Cook’s Functional Movement Systems and/or book. The other rehab “bible” for spinal conditions is Craig Liebenson’s work. These are all pretty in depth. I don’t have any specific journal articles on hand at the moment, but I’m sure you could take a quick look and find plenty…especially in the Journal of Manipulative and Physiological Therapeutics.

      At the end of the day, I hope your client trusts your process. Sounds like you’re on the right track. Although there is a differing opinion, as my coach says, “how do you get better at squatting???? you squat more!!!” 🙂

      I kid. Sort of.

      Best- Dr. Scott

      Reply
  2. Susan

    The “common” example you list here is my story. Sadly, I am no where near NJ to make an appt. Can you give me some things to look for in a chiropractor? I have had PT, which takes you part of the way there. I have massage which is helpful. I have had chiropractors who do adjustments that seem to help, but they never seems to have an answer as to why the same adjustments need to be made each time and they never do tissue work, just adjustments. I have never found anyone who can figure out why I have the chronic tightness down the back side, the root of the problem and how to begin addressing it. Is there a particular website that might list providers who are trained like you to get to the root of the problem and not just make adjustments. Thank you.

    Reply

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