Course Review: Mark Cheng's Prehab-Rehab 201

If you want to try to be the best you must learn from the best, and surround yourself with people who will push you to your limits and challenge your thought processes every day.  Fortunately in the last 8 months at Perfect Stride PT I can say that we have had that opportunity while learning from the minds of Erson Religioso, Dr. Andreo Spina and now Mark Cheng.  Furthermore the quality of clinicians, trainers and healthcare professionals who have attended these courses have only solidified that notion even more.  

This June Mark Cheng returned to PSPT to progress our understanding of "Prehab-Rehab" with deeper break outs, manual interventions and clinical insight.  Dr. Cheng breaks down his course beautifully with the 5, 4, 3, 2, 1 Concept.  It goes as follows:

5 Positions: Supine, Periscope, Sphinx, Quadruped and 1/2 Kneeling (The major 3 being Periscope, Spinx and 1/2 Kneeling for Rehab progressions/regressions)

4 Knots:  Where the trunk meets the hips and shoulders

3 Kings: Vision, Breathing, Cervical Range of Motion / Squat, Deadlift and Turkish Get Up

2 Approaches:  Open vs Closed Chain

1 System/Organism

Breathing is so important for rehab and performance progressions.  Here we are learning how to "breathe through the pelvis".  

Breathing is so important for rehab and performance progressions.  Here we are learning how to "breathe through the pelvis".  

We all look for progressions and the next best exercise for the population we are working with, regardless of whether it is for rehab or performance.  However, after learning from Mark Cheng, we experienced the power of simplicity and controlled movements.  By utilizing regressions and lateralizations we can hack in to movement patterns and identify entry points for treatments.  This works beautifully with the FMS and SFMA framework.  In earlier blog posts we have discussed knowing and owning your WHY, well after this past weekend we now have a better idea of WHY we would prescribe exercises, and how to make them fun while reinforcing movement patterns no matter what type of population we are working with.  

Think you have to perform high intensity exercises to break a sweat?  Well what about performing high threshold correctives that challenge breathing and the central nervous system?  As Mark points out, in looking at outcomes of people who perform "corrective exercise" (such as breathing/positioning/balance)  with their work outs, and comparing them to those who perform activities such as jumping rope/burpees etc, the people who did the simplistic movements at the edge of their ability not only lose weight faster, but also hit performance goals with improved efficiency.  How can this be?  Well the tissue that utilizes the most calories and glucose is the brain - so working the brain into your workouts by learning new movements can go along way! As one cross fit athlete we were rehabbing this week pointed out, "I did my breathing exercises and neck movements that you prescribed and after I felt my overhead press was stronger and I was able to increase weight without the same pain in my mid back."  That is not only great to hear as a clinician but empowering to patients.  In addition to this point Mark demonstrates superior control of body movements both with and without load - his experience in martial arts has allowed him to understand the concept of "slow makes fast" and be able to share that with the population he works with and courses he teaches.  By emphasizing slow and controlled movements you can incorporate the 3 Kings into any exercise (Breathing, Visual Field, and Cervical ROM) to make these positions more beneficial and challenging without adding movements or weights that clients may not be ready for or just simply fearful of.  

It is good to have fun!  Here we demonstrate how to incorporate "play" into rehab progressions.  Using a partner try to mirror the other or provide "targets" with your hand that the other has to reach to.

It is good to have fun!  Here we demonstrate how to incorporate "play" into rehab progressions.  Using a partner try to mirror the other or provide "targets" with your hand that the other has to reach to.

The added clinical insight and manual work has also progressed our treatments and home exercises with patients.  In considering that healthy tissue should be able to accept load, and combining this concept with the idea of tone and that muscle tightness is largely due to neurological tension, has resulted in significant improvements in pain and movement in patients now performing self soft tissue release techniques utilizing foam rollers and lacrosse balls with purpose, rather then simply "smashing your tissues".  It has also allowed our touch which was previously enhanced with Dr Andreo Spina and the FRR system to become even further trained.  

All in all it was an awesome weekend learning from one of the greatest minds in the movement and training world.  It will be exciting to continue to work the systems together through practice and repetition because clinical skills, like anything else take time to perfect and understand but we are already looking forward to the positive outcomes in not only our treatments but in our own bodies as well.  Thank you Mark Cheng!  

Until next time Happy Rehabbing!