Recent E-mails

On the Progression of Right BC Activity…

The main difficulty I have with BC patients and specifically T4 patients is the “when” for progression of activity. I sometimes feel I progress too quickly to upright activity or not quickly enough into serratus work, and now I really feel I have missed some left low trap work with patients. Do you have anything objectively that you look at for progression of patients?

You asked about an objective test for the upper half progressions.  The answer is pretty simple: The Hruska Adduction Lift Test.  From 0-2 we are doing a lot of focal left AF and FA testing, but when we move on to levels 3-5, we are really assessing the ability to get a full and well supported left ZOA with proper integrated trunk rotation.  When you can’t get further than a 2 or a 3, then you have BC position and TS strength (including abdominals) problems.  If you are having problems understanding the proper progression of patients, then you may be misunderstanding the following:
1) what the Hruska Adduction Lift Test is really for.  Its a gait performance test; with left AF IR and left ZOA isolation tested out for each phase of gait.
2) you are focusing on ST upper half work and overlooking the much more important TS training with all upper half muscles to complement and support left AF IR and left ZOA.
3) you are overlooking the tri-planer position and function of the diaphragm and all of what must occur for balanced breathing across the trunk.