The Dr. JJ Thomas Podcast

How can better exercise prescription transform your patient outcomes? In this episode, I share live footage from our Primal Integration course, focusing on exercise integration and practical strategies for prescribing movement to patients. I demonstrate techniques like developmental movement patterns, functional exercise progressions, and ways to address patient-specific deficits. You’ll learn how these methods can help your patients recover faster, stay independent, and maintain long-term progress. Tune in to see Primal Integration in action and learn how to elevate your approach to exercise prescription!

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With over 20 years as a physical therapist, JJ’s passion for movement along with her unique experiences and training have shaped her into the successful clinician and educator she is.

JJ graduated from the University of Delaware in 2000, which is now ranked as the #1 physical therapy school in the nation. She holds multiple certifications in a variety of advanced specialty techniques and methods, all of which complement her role as an expert clinician and educator. JJ has been certified in dry needling since 2009, and began instructing dry needling in 2012. She currently teaches for Evidence in Motion (EIM), and also independently lectures and trains other clinicians throughout the country in the fields of physical therapy, chiropractic, and sports medicine. She uses her expertise to help other professionals advance their skills and outcomes, either through manual interventions or specialized movement analysis.

JJ Thomas also has certifications in Gray Cook’s Selective Functional Movement Assessment (SFMA), ACE Gait Analysis, Functional Range Conditioning (FRC), The Raggi Method of Postural Evaluation (based out of Italy), and many other joint, soft tissue, and neural mobilization techniques. In addition to these accomplishments, JJ is also a trainer for GMB Fitness, where building a solid foundation fosters restoring functional, pain-free movement.

JJ’s expertise in the area of movement analysis and in dry needling has played a large part in success in the field of sports medicine. JJ has had the honor to work with the US Field Hockey Team, and with individual professional athletes from NFL, MLB, NBA, USATF, PGA, US Squash, USPA (polo), and more.

As a recognized expert in dry needling and consultant for organizations such as the Federation of State Boards of Physical Therapy (FSBPT) and the American Physical Therapy Association (APTA), JJ has contributed to national legislative advancements in dry needling. Her work with these organizations includes establishing national education standards for dry needling competence and successfully adding a Trigger Point Dry Needling CPT code for insurance and billing coverage. JJ assisted the APTA in successfully adding a specific CPT code for trigger point dry needling in CPT 2020.

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Creators and Guests

Host
Dr. JJ Thomas
Master of Movement With over 20 years of experience, Dr. JJ Thomas has established herself as a highly successful clinician and educator. Her unique experiences and training have shaped her into a passionate advocate for movement and patient care. Graduated from the renowned University of Delaware, the #1 ranked physical therapy school in the nation. Holds multiple certifications in advanced specialty techniques, including dry needling, SFMA, FRC, and more. Instructs and trains clinicians nationwide in physical therapy, chiropractic, and sports medicine, both through Evidence in Motion (EIM) and independently. Expertise in movement analysis and dry needling has made her a sought-after professional in the field of sports medicine. Worked with notable organizations and athletes, including the US Field Hockey Team and professional athletes from NFL, MLB, NBA, USATF, PGA, US Squash, USPA (polo), and more. Recognized as an expert and consultant in dry needling, contributing to national legislative advancements and education standards in the field. Lives an active lifestyle, engaging in various activities like running, weight lifting, Jiu Jitsu, hiking, skiing, and more.

What is The Dr. JJ Thomas Podcast?

Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.

Dr JJ Thomas:

Another box to check is can we stretch and strengthen together whenever possible? People are busy. They don't want to do 5 stretches for their pecs, and then 6 exercises for their glutes, and then this for lateral. Like, we can't get there's no way we can actually get them all of these things if we're not combining things.

Dr JJ Thomas:

Welcome to the Doctor. JJ Thomas podcast. Hey everybody. Welcome to the Doctor. JJ Thomas podcast.

Dr JJ Thomas:

I'm JJ Thomas. So one of the things clinicians often come to me for is help with exercise integration and especially exercise prescription for their patients. So in this episode, we took live footage from our primal integrations course. And in this course, what we do is we teach clinicians how to look at a comprehensive program, look at your patient specific deficits and their needs, and figure out how to design a program for them that gives them everything they need to recover faster. But more importantly also give them the tools to stay that way.

Dr JJ Thomas:

So that they maintain the gains that they've made with you in physical therapy and they need us less. That's the ultimate goal. Right? So if you're interested, if you've been one of those people reaching out to me and saying, JJ, how do you guys do all these cool exercise things and how do you know when to use what? If you haven't subscribed yet, make sure you subscribe so you don't miss out on future episodes like this one.

Dr JJ Thomas:

Take care. This is the part that I was saying is gonna feel like this is what mentally, as a clinician, is going to feel overwhelming a little bit. Like, when I first started talking about analyzing the movement as a whole. This is going to feel a little bit like, JJ, how are we supposed to do all these things? But you realize that a lot of them are going to check multiple boxes at once.

Dr JJ Thomas:

But let's just talk about, you know, what does a healthy movement profile look like? Go back to developmental postures. What are we learning? When were babies and starting to developmentally earn the right to run and walk and jump and run? And we're developing posterior chain.

Dr JJ Thomas:

We're developing anterior chain. We're developing lateral stability all the way in rotational control even from when babies are on tummy time and they're starting to look for their mother, right? Or they're starting to respond in noises or visual stimulation. They're getting that SCM. They're getting lateral and rotational control already there.

Dr JJ Thomas:

Overhead work becomes really important. That's where in babies we see it as like they start to do that rocking thing. Like they're here and they start to like they start to rock before they start to catapult themselves and start to try to crawl. So they're starting to get a little bit of overhead shoulder flexion, stability work there. And then they'll push up to that, like, bear crawl position.

Dr JJ Thomas:

And so we have to remember that that's also important for our, for our for our patients. For all of our patients. Deep hip access. Like, if you remember from Primal Foundation's lecture, the the joints get nourished by the synovial fluid which happens in a closed pack position. So our patients that have decided that they don't need these closed pack positions anymore, it's not going to end well for them.

Dr JJ Thomas:

You know, we have to in some way, shape, or form Now if they can't do a deep squat like this, that's fine. But let's get them to a point where they can at least get, like, quadruped You know, let's get them to a point where they can work towards now this is I do have platforms on. But like work towards closed chain something and getting into that deep hip access a little bit more. Right. And then progressing them towards something like a frogger.

Dr JJ Thomas:

And working on all of those positions. Early on, we're going to try to bring it back to developmental stages and make sure that we're kind of honoring the rules of development and archetypal pastures which is getting the shoulder stabilizers, and the deep neck flexors, and the thoracic spine to stabilize first, and then allow the hips to move on top of that. On top of that, we have to also give them a movement profile that gives them Fast Twitch and Slow Twitch muscle fibers. Right? No matter how old you are, you need Fast Twitch like even our, you know, especially actually our older population of patients who need to be able to respond to a divot in the grass.

Dr JJ Thomas:

Like, they have to respond to a divot. That's a fast twitch fiber. If you don't have it you're going to fracture your fibula, or you're gonna have a really bad ankle sprain, or or you're gonna fall. Even worse, you maybe fracture your hips. So we all need fast twitch and slow twitch fibers.

Dr JJ Thomas:

Right? For a for a young mother who's how many of you have kids and like your 2 year old they think you're invincible and they think they're invincible, and they all of a sudden, like, freak, mama, look at me, and they jump at you and you're like, oh, crap. I got to catch you. And, like, all of a sudden my fast twitch fibers have to catch and stabilize. So no matter what age you are, we need both of those.

Dr JJ Thomas:

We also need to be slow twitch. We also, as a mother, need to hold a child for a long time asymmetrically and stabilize our trunk for that. And fathers too. Like, I don't know why I didn't let fathers in on that. Fathers have to do that too.

Dr JJ Thomas:

We also, if we're going to continue to treat the body as a system, we have to see what the feet and hands are doing at all times. I love that like when we were playing around with Brian's motion earlier and Brianne was like, Brian, can you ground through your feet better? That was perfect. Because if we're going to integrate the body and treat it as a whole, we do need to honor that. That's why the email said bring your bare feet and brains is like, whenever possible, we want to have the bare feet so that we can give that somatosensory input to our brains and our bodies and also integrate the musculature in a way that honors the fascial lines and the neurological system and all of that.

Dr JJ Thomas:

Yes. Unless you're striking a pose.

Dr JJ Thomas:

It's true.

Dr JJ Thomas:

And then, so we need all these things, and we need them in all positions and all ranges. I have a slide. I forgot to put it on. I showed Brian yesterday. But I'll put it on for tomorrow.

Dr JJ Thomas:

But it if you think about what the slide shows, it's like if you think about all the things we do in life, there's like a bazillion you know, you talk about the shoulder being highly mobile. Like, the planes of motion that we have to be able to do, you know, from from, like, screwing a light bulb into an under a cabinet to, like I said, catching our kids or or, you know, reaching up in certain things. Like, there's so many different planes of motion that we have to be able to both stabilize and mobilize through in order to have a long healthy life. So we want to try to have our exercise prescription honor all of that. In order to do that, there's going to be these we're going to do it these ways.

Dr JJ Thomas:

We're going to just like we did with Brian, we're going to find kind of pseudo isometric stability first. Like, in everything we're treating, if they're coming to us because they're dysfunctional, our first goals for them are to make sure that they can stabilize a position first. If they can then stabilize position, their brain and body is going to give them permission to pass. Then we can start to mobilize well actually I should say, then the next step from that is going to be stabilize with a dynamic system around it. So let's take the upper extremity for example.

Dr JJ Thomas:

We're going to get into this a little bit more in a minute but I think when we say things multiple times it's easier to process. So we're going to say it here anyway. So let's just take a front rack position. Let's take Brian. His pec was tight.

Dr JJ Thomas:

His shoulder was reflective of that. I would still do even a front rack hold on him and have him do, like, squat patterns. K? The progression of that, eventually, is to work him maybe to 90 90 or maybe to straight up. And then still do a squat.

Dr JJ Thomas:

Right? But in order to get there, I may go front rack hold, step back launch. Now I've changed the asymmetrical stability need at the right arm. So I went from symmetrical lower extremity, asymmetrical core. Now I'm like asymmetrical lower extremity, asymmetrical core.

Dr JJ Thomas:

So I just increased the challenge twofold. I don't know if that's true or not, but you know what I mean. I increased the challenge by just changing the ground the the the stability need underneath. Right? Then I can go maybe lateral.

Dr JJ Thomas:

His body is like, oh, crap. That's a new move. I run and it's not a new move for him because he's a snowboarder. But Brianne's runners, you put them in a lateral, and they're gonna be like, woah. I don't know how to do that.

Dr JJ Thomas:

They're that's why their adductors are so tight. They don't go into that plane. Then put them to here. Now when we get to here, they may not be able to squatting, a single arm overhead squat is, like, one of the hardest things on the planet. I I swear.

Dr JJ Thomas:

Right? I don't know if you guys have ever tried it. It's so hard. But a good way to so now when we go overhead, we probably need to regress again in order to make them be able to do it. So a good place to do that might be half kneel.

Dr JJ Thomas:

So now we put them in half kneel overhead. Right? From there we could rotate. Rotate and side bend. We could press and then we could just clean it to an overhead.

Dr JJ Thomas:

So now but now I'm going from just stability with movement underneath to the arm as a primary mover. You see what I mean? So we're still by doing all those things, we're checking all these boxes at once. And then remembering that as functioning human beings, we need we also need pushing and pulling patterns because we're going to push a heavy door. We're going to pull a heavy door.

Dr JJ Thomas:

We're going to push, you know, a grocery cart. We're going to pull our child up from whatever, the floor. So this is how I'm suggesting we try to do this. I tried to make boxes. And I think this is something the strength and conditioning world does really well.

Dr JJ Thomas:

It's like when they're writing a program, I think they take a multi week process and they have their goals at the end. And then they have components of that goal that they want to meet. And a lot of times it's things like this. And I think, we want to emulate that in a lot of ways, but do it in a way that's also giving them what they need rehab wise. And so this is just what we said.

Dr JJ Thomas:

1st, we're going to try to get mobility and stability through closed chain upper extremity and that's because that's honoring the developmental postures essentially. So whether they're coming for a shoulder or they're coming for hip, I want to try to restore their movement patterns in a way that's developmentally sound. And so, oftentimes, that means stabilizing their upper trunk and mobilizing their lower trunk. So let's actually I'm going to finish this slide and then we'll go through an example of each of these. Because we haven't done the 3 months posture in a long time.

Dr JJ Thomas:

So I want to go through the cues of that again, so you guys can feel exactly what I'm saying on that on that front. But so we'll go from that to open chain stability at the upper this is what I was saying with like so now I'm open chain stability here, either squatting around it or lunging or lateral lunging around it, or you could do the same thing in half kneel even here, and then progressing to open chain stability at a higher level. And then this is what I was talking about earlier with Brian where I was like, another box to check is can we stretch and strengthen together whenever possible? People are busy. They don't want to do 5 stretches for their pecs and then 6 exercises for their glutes, and then this for lateral.

Dr JJ Thomas:

Like, we can't get there's no way we can actually get them all of these things if we're not combining things. So stretch and strengthen again whenever possible, and then stretch across as many joints as possible, whenever, like, whenever we're able. So what we'll do, I think we'll go through, let's go through like 4 examples of, one example of each of these right now, so you guys can so we can just highlight what I'm talking about. Yeah.

Dr JJ Thomas:

Because some of these, like, holding hard

Dr JJ Thomas:

with that Yeah.

Dr JJ Thomas:

Are really hard for people to get correct. Like, even for me, when I hear it, you do it again. I'm

Dr JJ Thomas:

like, oh, yeah. Yeah. Yeah.

Dr JJ Thomas:

I'm thinking about, like, some of the videos that I have taken for patients, like, is it better for them to do these big movements and not do it, like, perfect rather than

Dr JJ Thomas:

I'm so glad you're asking this. No. I I'm so glad you asked that. No. I would say find a level that they can succeed at and have them own that.

Dr JJ Thomas:

Yeah. And you'll find it.

Dr JJ Thomas:

Like, also you're saying, like, also succeed with remembering the cues for them.

Dr JJ Thomas:

Exactly. Yeah. Yeah. And so this is where but again, if you're giving them one exercise, this is also where, like, the actual dosage of what you're giving them is helpful to less is more. Because if you can give them one exercise, and this is different for you because you're gonna have time with them.

Dr JJ Thomas:

Like we're doing manuals with them and doing exercises. But we're trying to send them home with exercises they're doing on their own. So it may be a little different for you with your practice. But if I can check lots of boxes with one exercise, and then I can say to them, I want you to work on just this exercise this week. And then they'll get greater gains, and then they'll actually have better body awareness.

Dr JJ Thomas:

Like, that's the other thing I think is when we actually reel them back to developmental patterns to reestablish not compensating and instead owning developmental postures and patterns, then they have better body awareness. And then later on when you go to give them a more complicated exercise, they they're able to do it because they have that somatosensory input. Yes. I think we do it a lot. I don't know how my phone isn't exploded.

Dr JJ Thomas:

I'm not kidding. That's good. I do it on mine now often because I want to use it for social media too, to be honest. Yeah. But sometimes I just grab their phone if I don't know where mine is.

Dr JJ Thomas:

I like sending it to my phone too because then I can use it as a reference. Yeah.

Dr JJ Thomas:

What did I give? That's right.

Dr JJ Thomas:

How do you prepare to

Dr JJ Thomas:

send that? No, it's true.

Dr JJ Thomas:

Then you already have it too to send it to somebody else

Dr JJ Thomas:

as well. Yeah.

Dr JJ Thomas:

Yeah. You said something earlier, a while ago, that you just said that and then prompted me with this is that, like, the compensations, once you start doing them, they're so hard to kind of come back from them. Mhmm. So I guess that kind of goes in the same. Is that

Dr JJ Thomas:

I

Dr JJ Thomas:

quickly heard you say that.

Dr JJ Thomas:

Yeah.

Dr JJ Thomas:

And, like, treating them where they are then.

Dr JJ Thomas:

Yeah. It's true. And I think the other piece to this is allow yourself to be creative with like like one of the hardest things I find to teach, I'm sure you agree, Jo, is like, and most of you guys too, is like a hip hinge, like an explosive hip hinge. And so what I find though is I've had to get creative with how to like, there's no way some of these people can do a kettlebell swing when I first try. And then even sometimes when I try So then that led me to sometimes doing like the, like the band or the pulley through.

Dr JJ Thomas:

You know, like the pulley's here and they pull through, which is successful sometimes. But some people need the explosion in order to trigger it. So then I found if I take a medicine ball and I have them fire it up, like throw the medicine ball from the ground, boom, then they have to do it. So I guess what I'm saying is like, also allowing ourselves, like the time to to like, okay, my goal for this person is s. I'm going to get I'm going to accomplish this goal with them today.

Dr JJ Thomas:

Rather than, like, be like, okay, I would love to get these three things and I just think sometimes less is more. You know what I mean? And I know earlier on, maybe I didn't want to spend the time or I was afraid to spend the time just on one thing. But I realized that if we take our time and really, like, conquer one component, bye, then it manifests into it's just like treating a more relevant area and then other areas get better. Like, when we really help them own one position or one goal, then oftentimes the other stuff gets better because their whole awareness starts to change.

Dr JJ Thomas:

Yeah. Good questions. You guys want to try some? Okay. So let's go to, let's go to the mat and do the 3 I want to revisit the 3 months posture position.

Dr JJ Thomas:

I usually describe this the arm position that I'm looking for from north to south or front to back, the elbow should be in line with the shoulder. And then from left to right or east to west, it should be essentially like a 30 ish degree angle. It's essentially playing a scap is what I'm looking for. Yeah, that looks good. And then so we definitely want the elbows under the shoulders is kind of the goal there.

Dr JJ Thomas:

I want your pelvis like I don't a lot of times people do this and they especially if they're fitness people, they like end up lifting to their knees right away. I don't want that. I want to really focus on reorganizing the way our body's contracting. And so what I usually tell people is eyes kind of just either between the fingers, not a super chin tuck, but like eyes forward. And then push the floor away.

Dr JJ Thomas:

Oh, I forgot to cue you to spread fingers. Everybody did that automatically though. Good job. So push the floor away to cave your sternum. And what you guys will probably notice when you do this is that your weight now shifts to your pubic bone.

Dr JJ Thomas:

I think that's great. Like, I think part of that is what makes this such a great posture is that now you're giving input to your lower to your pelvis through that sequencing of muscle firing initiating from shoulder blades. Right? Now from here, I would say the next step that I want people to do this is that foundational close chain stability with hip mobility on top of it is slide one knee up towards the elbow without letting your shoulders cave. Yeah, that's the hardest part is everyone pretty much ends up letting their shoulders cave.

Dr JJ Thomas:

So come out of it. Push the floor away. Make sure your sternum is caved in. Eyes are kind of forward. Head is neutral.

Dr JJ Thomas:

And then let your hips slide up toward yep. And then you'll feel your pelvis kind of rotate and then come back. Now don't even look for the knee yet. Still just see what it feels like to have foundational core stability. So it's essentially isometric.

Dr JJ Thomas:

Yeah. And then alternate sides. And only go what I tell patients is only go as far as you can. That left side is so hard for Brian. Only go as far as you can without oh, Terry, you want to go here?

Dr JJ Thomas:

Go here. Only go as far as you can without letting the shoulders cave. This is exactly what you were talking about, Brie. Like, we could let people compensate maybe and and let their shoulders but then we're not reestablishing the patterns. We're just feeding the compensation.

Dr JJ Thomas:

So ideally, we're only gonna go as far as they can comfortably. And usually, I'll start these people again, no matter what they're coming for, I'll usually start them without moving the head first Because I just want to establish that foundational neck and shoulder stability first. Then if they own that posture, then I might say, okay. Now I want you to look for the look for the knee. As you bring that knee up, look for it.

Dr JJ Thomas:

So now we're gonna get neck rotation and neck stabilizers in a more dynamic way. Good. And just make sure you're being really honest, not letting the shoulders cave in. Good, Brian. How's it do you guys feel, like, a stretch in your obliques on that one?

Dr JJ Thomas:

That's funny. I always do. Yeah. Mostly I mean, I think you could probably have more sternal like, see how your shoulders are caving in? So come out of it a little bit.

Dr JJ Thomas:

So oh, oh, I'm so glad you did this. I I should've done a better job. So see how Max is like extended here? We don't want I want I actually want almost kyphosis in the thoracic spine, but I don't want it to be initiated from your abs. I want So relax a second.

Dr JJ Thomas:

Eyes right here. And this is why the eyes are important. If patients look up, they're going to go into an extension pattern. And then it's and then it's different. Right?

Dr JJ Thomas:

Like, now we're not getting that rib to pelvic connection anymore. Now we're getting spinal erectors, which maybe we want later, which we'll talk about. But so, Max, eyes right here. Push the floor away to just mhmm. And come back down.

Dr JJ Thomas:

This time, I want you to

Dr JJ Thomas:

what's that? That one elbow is like

Dr JJ Thomas:

Too far out? Yeah. Right. Good. So push the floor away to cave in the sternum.

Dr JJ Thomas:

Sorry. Right there. So we get scap protraction. So I hold that now and slide your right knee towards your elbow. Don't let your shoulder cave at all.

Dr JJ Thomas:

And then come back. And then do the opposite side. Get it up there as high as you can. Yes. That's better.

Dr JJ Thomas:

And then do the other side again. And then back. And I do one more and good. And then what's happening is his arms are he's losing a little stability because his arm this happens sometimes. They're, like, pushing so hard but they don't push they don't compress well.

Dr JJ Thomas:

So they end up, like like, even babies do this too. Like, they end up, like, scooting backwards. So move your arms back a little bit, and now try to push the floor away again. That's better. Now try to so his arms are in a little better under the shoulders, and then do the other side.

Dr JJ Thomas:

And try to relax the feet when you do it, like yeah. But pull this up so much that you feel the, pelvis kind of yes. So now we're getting, like, yes. Now we're getting an oblique stretch on the opposite side, and we're getting abdominal stability on this well, really on both sides, but we're essentially shortening. That looks good.

Dr JJ Thomas:

And now that looks easy for you. But it you feel it fatiguing. Yeah. Yeah. But you got it.

Dr JJ Thomas:

It is fatiguing, right? It's surprising that such a fundamental posture can be so fatiguing. But, let's do it one more time and see if we can coordinate the neck with it without losing. Good. So now slide one knee up first, making sure that the shoulders don't yep.

Dr JJ Thomas:

And now from there, look for the knee, but don't let the shoulders cave. And then come back to center, and then bring this knee up. Don't look yet. Come up as high as you can. There it is.

Dr JJ Thomas:

And now look. And come back to center. And so now we're getting like a little bit of a different we're getting a little bit of a different, now the neck is a primary mover, but it's all under stability. It's more like, if I were to compare this to anything, it would be like, like going from, like a front rack, single arm front rack hold with a squat and then pushing up into a press. So we're getting a combination of, like, stability and mobility at the same time, but all at once.

Dr JJ Thomas:

So now instead of giving him a hip stretch and giving him a neck stretch and giving him, you know, like an oblique exercise, we're giving him all of it at once. So the next,

Dr JJ Thomas:

What would you do with, like, a 80 year old?

Dr JJ Thomas:

Same thing. Or I would have them put their arms on the, on the counter. Okay. And then still lifting the knee

Dr JJ Thomas:

up? Lifting the knee up?

Dr JJ Thomas:

It's funny because it's harder to, like, get that yeah. Either marching or or hip extension. I do go to hip extension for that more, but also a lot of those guys tend to be, like, like forward bent. So I'm trying to get them their spinal erectors to fire. So that particular patient population, I do feel like I tend to try to pull them out and to, like, get their spinal erectors to wake up.

Dr JJ Thomas:

Because usually, they're sitting too much at home, not being active enough. So I still will give them that foundational on the, sorry, my neck, my back, on the countertop, but then I'll give them back extension. And then the other one that I thought I might as well just give it is that draw the sun one in this position, which is more of a posterior chain. So in this one, yeah, elbows. So this one, you're not going to maintain that rib compression with.

Dr JJ Thomas:

This is more of an extension rotation pattern. So your arms can come in a little bit more. And then the key I give for this is to reach. Reach 1 arm. You essentially want to reach.

Dr JJ Thomas:

You're going to shift, kind of like we did with crab toe touches. Shift to one side and reach across. So that now you're activating like this diagonal sling line. Right? And then you're going to push down through this arm and try to draw the sun into an arc.

Dr JJ Thomas:

Right. If you feel yourself lifting your hip and pushing up, stop wherever you can. This would be a perfect example, Brie, of where I'm telling my patients, like, only go where you can go, like comfortably and without pulling your hips up. So you might just go there. But I do think it's also important to like I usually have them do it like, alternating because I think it's more relevant to developmental sequencing.

Dr JJ Thomas:

So if we think about reciprocating gait and everything like that, so we're reciprocating spinal extension, It's really important that we let our eyes follow the motion, again, to get proper neck stability muscles engaged correctly. That looks good. How's that feel? I know. And hard, right?

Dr JJ Thomas:

Yeah. So but again, we're stretching and strengthening. So we're stretching oblique sling, and we're strengthening posterior sling all at once. So it's, these are definitely on the favorites list of

Dr JJ Thomas:

Does it matter if they're tozer?

Dr JJ Thomas:

Good question. I prefer it to be flat. I really want like I want to rewire. And if they have a lot going if they're tightening here, then they may be inhibiting. Similar to how I was saying with, like, our Rich Hitter Cuff Girl, who the hand was neurologically inhibiting the shoulder from moving up.

Dr JJ Thomas:

Like, you can have the same thing if their feet are engaged too much, then they're going to over basically their posterior chain will be like preemptively firing from bottom up rather than what we really want is top down. Yeah. If we're going to reestablish those patterns. That looks good, Tara. Good.

Dr JJ Thomas:

Let me see. I forget what was, so let's go to let's go to the gym for the next. So that was so that was mobility and stability through closed chain upper extremity. And now we're gonna go to open chain stability at the upper extremity, we talked about this, while moving the rest of the body around it. So I want you guys to just feel come on in here in the gym area, and we'll grab some weights.

Dr JJ Thomas:

Like twenties. Here. Just bring them all up?

Dr JJ Thomas:

Yeah. I thought you're saying that like just

Dr JJ Thomas:

That might be one of those is fine. I think that's good. And then here's a 15 of I'll take a 15. Really?

Dr JJ Thomas:

I feel

Dr JJ Thomas:

like you need a heavier one, Max. A

Dr JJ Thomas:

heavier one.

Dr JJ Thomas:

Yeah.

Dr JJ Thomas:

Should I take a 60?

Dr JJ Thomas:

Do the, Jesus. Well maybe we'll just start with that one and then here's a 20. Do the 20.

Dr JJ Thomas:

Lift the rack.

Dr JJ Thomas:

Do the 20 Max right now. So grab and then here's 25 actually Max, but so hold so let's do hold the weight. If you have a dumbbell hold it like this. You can let the dumbbell rest on your shoulder, but what I want you to focus to get the core the upper trunk integrated to the lower trunk, I want you to think about elbow being in and up. So if you're out here, you're not going to integrate your abs and your core with your cuff as much.

Dr JJ Thomas:

So yeah. Sorry. I'm talking too much again. Sorry, Jess. So elbows in and up.

Dr JJ Thomas:

Other arm is active so that it's connected. And then, and bring it in a little bit more, Brian. Like, so let it rest here.

Dr JJ Thomas:

Oh.

Dr JJ Thomas:

Yeah. Right there. Okay. Active here, and then squat as low as you can. And then stand.

Dr JJ Thomas:

And then just do do like a couple of those. Yep. Elbows in and up. Good. And the other thing that I'll say, elbow in a little bit more Lauren, if you can.

Dr JJ Thomas:

Like I'd rather you go not down as far, but have the core integrated all the way. Great. So take a break if you need it. The other thing that I wanna mention if we're really gonna emphasize, like, treating the body as a system, something that I see a lot is people will have their wrist disengaged. Like they'll have they'll give me what I want in terms of elbows in and up, but their wrist will be like out like this.

Dr JJ Thomas:

And then that's not integrating their essentially your core isn't your your wrist is part of your anterior chain, essentially. Right? So like your wrist flexors, I'll say. So you want the wrist to be in line as well, if at all possible. And then squat.

Dr JJ Thomas:

Okay? So asymmetrical stability. So this is an example of where open chain, single arm stability with moving everything around it. So this would be a great this is perfect for someone like Brian where I wanna get I wanna get stability to that right shoulder because regardless of what happened, why that right pec is tight, it's tight and it probably needs to be stable somewhere. So I'm gonna activate it single arm, and I'll do it on both sides, and then squat around it so we integrate it to the lower trunk.

Dr JJ Thomas:

And then the progression of that, that was pretty heavy. Do you wanna try let's do a different one because is this 25? Because it's gonna be harder when we go to the lunge. So put this on your right. So the minute we change it from double from symmetrical lower extremity here, come in the center here.

Dr JJ Thomas:

The minute we change it from symmetrical lower extremity to asymmetrical lower extremity, the core stability needs are gonna be so much more. So I went down on weight for that. So hold this more like that. Yeah. And engage the wrist like yes.

Dr JJ Thomas:

Different. Right? Feel how that's a little different. Elbow in and up. There we go.

Dr JJ Thomas:

Right there. Okay. Hold that and then do a step back lunge. So other arm active. Yep.

Dr JJ Thomas:

And then step back. And then up. And then step back. Other side. So alternate sides.

Dr JJ Thomas:

So then we're really going to change rotational knee. Great. Okay? Good. So that would be the progression there.

Dr JJ Thomas:

And then even same thing you could do with lateral.