4 Things I learned in 2010

imageLast year around this time I published a pretty popular post, called “5 Things I learned in 2009.”  In this post I reflected on a few changes in thought that I had been progressing towards in regards to things such as posture and trigger points.  I am a fan of always evolving and publishing that post last year actually changed my thought process in 2010.  During the course of the year, I thought back to that post and challenged myself to learn new things in 2010.

Not everything below is rocket science, and I have been thinking about these for several years, but here are few small trains of thought I’ve had over the last year.


1. Asymmetry Might Not Always Be a Bad Thing

I have been preaching this a bunch lately, but I have openly questioned if we could really achieve symmetry, and if we could would we want to.  Everyone is jumping on this bandwagon lately and just like anything else, we are probably getting a little to dramatic with this and overanalyzing to an extent.  Let me explain.

imageThe human body isn’t as symmetrical as we all would like to think it is, specifically in regard to our internal organs and their impact on our core.  Realistically, our organs are not symmetrical, our diaphragm is not symmetrical, and it’s dynamic function on the thoracic cage is not symmetrical.  Thus, our scapula, pelvis, and everything else down the kinetic is not going to be symmetrical.

I first noticed this when I started to explore some of the hypothesized that have been proposed in regard to scapular dyskinesis and contralateral hip rotation in overhead athletes.

The two common theories in regard to postural imbalances and causative factors with injury are that the scapula is more depressed (well actually it is upwardly rotated, anteriorly tiled, and protracted, as shown in my article here, but we’ll simplify it and call it “depressed”) and that the contralateral hip is more internally rotated.  Both have been deemed “disadvantageous” and have been speculated to but athletes at risk for future injury.

I have 2 main issues with these statements, but make no mistake I am not refuting them, I am just questioning them.  First, these hypotheses have come from people observing injured athletes and making assumptions that what they see must then be pathological.  Second, when you look deep into the subject matter, the right scapula may be more depressed and the left hip may be more internally rotated in both right handed AND left handed overhead athletes!  I don’t have definitive data on this (yet) but have noticed this potential trend.  Obviously we see far more righties and lefties so, we assume.  This isn’t new information and the Postural Restoration Institute has some interesting info on why this occurs if you want to dig deeper.

Of course, huge asymmetries are undesirable, but realistically some asymmetries are going to happen when performing a unilateral sport or activity everyday, and these asymmetries are probably even desirable.  Food for thought.

What can you do to get better?

  1. Know the unique demands of the activities that your patient/client participates in.
  2. ASSESS, DON’T ASSUME – pretty simple


2. The Upper Trap can Wreak Havoc on Shoulder Function

imageI’ve talked about the effect that the upper trapezius muscle has on shoulder function and we discussed an articles about how imbalances between the upper and lower trap can cause impingement. How often have you noticed a patient or client is “upper trap dominant,” using their upper traps excessively when using their arm functionally?  I see it all the time.  This not only causes many soft tissues dysfunctions but it shuts down the lower trap and serratus.

So a goal of mine before I start any strengthening or advanced exercises with everyone is to re-educate them to not be “upper trap dominant.”  It actually isn’t that difficult but is often overlooked.  It is very similar to what Gray Cook says about restoring normal movement patterns, it seems like the motor pattern is still in our system somewhere, we just have to bring it back out.  Like riding a bike, you never forget.

What can you do to get better?

  • Before you try to enhance lower trap and serratus function, fix the upper trap motor pattern, otherwise you’ll be spinning your wheels.


3. Online Education Continues to Grow

imageI said it in this article last year, but I really do think online education is going to be the predominant continuing education source in the future.  I’ve been teaching online and performing webinars now for almost 8 years.  Over the course of the year, I have seen so many other opportunities – the NATA and NSCA are now doing webinars, there are other sites out there like mine, it’s amazing!

People are catching up, it took me WAY TOO LONG, but my online eval and treat of the shoulder program was just recently approved for CEU credit by the NSCA and APTA and I’m still waiting to here from the NATA  This learning experience is still growing and becoming excepted but we are getting there.

What can you do to get better?

If you haven’t gotten into any of these online programs and webinars, you are missing out.  I highly recommend you do and see how much you can pick up by participating in small bouts of clinical development more frequently in comparison to sitting in a hotel conference room for an entire weekend and zoning out.

Don’t get me wrong, there will always be a place for live and hands on learning, but online is going to continue to grow in addition to this.  I hope that very shortly live seminars will be at least 95% hands on and that lecture based seminars will be much more effective online.


4. Attitude is Often Your Most Important Quality

imageI don’t want to come across as a self-help guru with this last one, but I always try to save the last “thing I learned” for something personal, but that has direct impact on our professional development.  This year I was all about attitude.  Attitude can really make the difference between everything, and I can’t help thinking that this is the last place we all look when trying to make changes.  I had a challenging year but got through it because of my attitude.

What can you do to get better?

Alright, I’ll stop on that note and just direct you to the great John Maxwell and his book The Difference Maker (it is under $3 currently on Amazon).

Would love to hear from others on what they learned in 2010!  Please reply and Happy Holidays!



4 replies
  1. Mark Young
    Mark Young says:

    Great summary Mike!

    In line with your point about assymetry, I have a good friend who worked extensively with Olympic level speed skaters and he mentioned that they had a large number of them as a result of the position in which they leaned while skating. While some would strive to "correct" these he reinforced that these adaptations were probably useful to them.

  2. Christie Downing, PT, DPT, Dip. MDT
    Christie Downing, PT, DPT, Dip. MDT says:

    Completely agree about assymmetries. I have to spend way too much time deprogramming patients who've been told by their chiropractor (or previous PT's) that something is "wrong with them" because their left shoulder is higher than their right….

    Assessing is the whole key. It's similar to someone who has a "disc bulge" or "stenosis" or any other radiographic finding that may or may not be relevant. Tying it to the clinical picture is imperative. Otherwise we are treating red herrings.

  3. Leon Chaitow - www.leonchaitow.com
    Leon Chaitow - www.leonchaitow.com says:

    Back in the late 70s Zink & Lawson published research that pointed to a common compensatory pattern (CCP) in everyone (80% or so well compensated….the rest not).
    In other words, no-one is symmetrical, from birth onwards.
    Understanding the CCP and its implications is the real issue…..and certainly not trying to reestablish mythological symmetry.

    Zink G, Lawson W: An osteopathic structural examination and functional interpretation of the soma, Osteopathic Annals 12(7):433–440, 1979.

  4. Nick
    Nick says:


    I agree with the first idea of asymetries throughout the body. Hand dominance is the most obvious follwed next by eye dominance. When you look deeper, you see the diaphragm asymmetry which affects the rib cage and thoracic spine through breathing pattern, the low back through lumbar attachment, and thus the rest of the body. These aren't necessarily pathological until they cause some sort of pathology.

    For anyone that hasn't yet checked out the Postural Restoration Institute, I highly recommend it. It will give you a whole new outlook on physical therapy treatment in regard to these asymmetries. You have to think outside the box and have a bit of faith, but they have credible published research to support the philosophy.

    Thanks again for a great year of posts, Mike!

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