Shoulder Internal Rotator (Subscapularis) Isolated Activation

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Shoulder internal rotator (subscapularis) isolated activation is an exercise designed to develop strength and stability in the shoulder girdle muscles that are responsible for shoulder internal rotation. This exercise focuses specifically on training the subscapularis muscle, which is one of the four rotator cuff muscles, to help create a stronger, more stable joint. It works to counteract the common postural dysfunction of excessive shoulder external rotation, which can lead to shoulder impingement, rotator

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Transcript

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This is Brent president of the Brookbush Institute bringing
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...blank
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you guys a technique that you may not
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use as often as some of the other
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techniques we've demonstrated in
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previous videos, and that's because we're
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going to demonstrate internal rotator
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activation. Now why you wouldn't use
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internal rotator activation is because
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most individuals have a propensity
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towards excessive glenohumeral or
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shoulder internal rotation during both
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static and dynamic postures, however
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there is also a group of individuals who
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are affected by shoulder hypermobility
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or glenohumeral laxity. Now
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in those individuals we have a
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propensity towards excessive anterior
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glide, and now we see where the
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subscapularis lying in front of the
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humerus, if it increases in activity may
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actually have a good fiber arrangement
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to help block excessive anterior glide.
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So I'm going to have my friend Melissa
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come out, she's going to help me
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demonstrate this exercise that actually
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took me quite a while to come up with
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because we have this problem when we try
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to do internal rotator activation. I'm
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sure some of you have seen internal
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rotator activation this way which is a
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good general idea it is internal
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rotation, other than we have two or three
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larger internal
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rotators being our pectoralis major,
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latissimus dorsi and teres
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major. So now the question becomes well
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how do I target my subscapularis because
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chances are my pectoralis major, my
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latissimus dorsi and my teres major
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aren't going to help me with this
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anterior shoulder laxity. So Melissa I'm
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going to have you take the band and do
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this, so it's across your back and
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you're going to put it right underneath
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the border of your deltoid so that it's
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literally wrapped around you.
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Alright so as she does that I know some of
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you guys are already thinking well he
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said he wants to hit the subscapularis and we basically
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have pectoralis major and latissimus dorsi
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that I need to reciprocally inhibit,
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If you are thinking toward some of
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the other activation videos we did. And
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pectoralis major I could
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probably reciprocally inhibit using
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horizontal abduction, and then my
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latissimus dorsi I probably can inhibit
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using flexion. So what would it look like
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to do horizontal abduction, flexion and
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internal rotation all at the same time,
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and how do I resist that. Now you know
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why this took me a few months to come up
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with. What you're going to
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do Melissa is go ahead and lie on your
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side. Now since the band is wrapped
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around her back
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I already have internal rotation
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resisted on this bottom arm. Just if
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she goes, so just take this out away for
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a second. If she goes like this, the band
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gets stretched around her arm, that'll
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resist my internal rotation. Now to
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inhibit my pectoralis major with
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horizontal abduction all I have to do
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is cue Melissa to take the shoulder and
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press it back into the wall. So we're
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using a plyo box just for video purposes, but
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you could just do this against
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any blank wall. Now to get the latissimus
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dorsi out I'm going to go ahead and use
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a little shoulder flexion, and the way
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I'm going to do that is i'm going to
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have Melissa take this hand and put it
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on top of the bicep. Alright so now she's
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she's getting pretty close to to what's
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going to end up being this kind of cross
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arm pose which is our goal. The only
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difference is I'm going to actually have
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her kind of cue this chicken wing
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maneuver where I have her think about
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going elbow up and hand down so that our
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hand just passes this elbow. So she's kind
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of grinding her elbow into the turf here
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going this way, while bringing her hand
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down this way, good and back up. So she
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started with her elbow kind of low, you
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guys don't have to be at 90 degrees of
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flexion necessarily. It may be more
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comfortable for somebody
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to come down to like 45 degrees of
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flexion, if she wanted to she could
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definitely go higher. Lets see can
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you go all the way up. Let's try this,
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how does that feel? A little tougher up there
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which you'll find unfortunately is
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although it's tougher to do it 90
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degrees of flexion, some individuals who
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have some shoulder pain already, they're
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already showing symptoms of inflammation,
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they may not like doing internal
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rotation at 90 degrees it just doesn't
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feel comfortable for them. Alright you
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just have them like I said keep trying to
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get this hand past this elbow. If you
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know how much internal rotation
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somebody is supposed to have in this
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position it should be between 50 and 70
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degrees, they should actually be able to
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get their fingertips
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pretty close to the floor, assuming
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they're going to do a little wrist
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flexion too. We can see Melissa is
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missing a few degrees there. Under
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normal circumstances we would have done
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some mobility techniques first. Alright Melissa
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do you want to try the other side see
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if you can get set up on your own. Good
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thing to work through with people is
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usually I'll show them one side and then
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I'll see how far they can get on their
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own without any cueing to set up the
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other side, just to make sure they're
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going to be able to do this in a home
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exercise program without my supervision.
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Make sure you're leaning back into the
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wall, there i go cueing again. Alright
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good how does that feel. A lot of people
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won't feel much, if they do feel
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something they might feel it deep in
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their armpit. If they start feeling a
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burn in their pectoralis major you know
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you're going to have to work a little
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harder to try to get them to inhibit
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their pectoralis major, and that might be
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leaning back into the wall a little bit
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harder, or messing around with how much
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flexion they had in the arm that they're
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working. From an assessment standpoint
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guys you're probably going to see
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something like excessive external
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rotation, maybe a hundred degrees of
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external rotation before implementing
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this technique; and oddly when compared
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to some of our other case studies that
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you might have gone through before, we're
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actually looking for a decrease in
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mobility after this technique has been
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performed like I said if we're using it
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for anterior shoulder laxity. Now I know
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some of you guys are going to use this
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potentially for individuals who have a
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decreased internal rotation range of
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motion which is okay. I might not use it
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for that based on some of the
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arthrokinematic dysfunction that's happening
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around that, but if that were the case
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then you would use internal rotation
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goniometry and actually expect an
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increase in internal rotation range of
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motion after doing this technique. So
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there you guys have it we have monster
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band resisted internal rotation,
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resistance is coming from the band being
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wrapped around their arm. So it's not
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like they're pulling on the band, the
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band is getting stretched around their
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arm as they're rotating inward. You're
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reciprocally inhibiting the
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pectoralis major through horizontal
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abduction, and you're resisting the
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latissimus dorsi be a little shoulder
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flexion. Ideal number of reps for all of
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our activation techniques is 12 to 20
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repetitions. Our tempo for something
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like this although I haven;t cued Melissa
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too harshly as you're just trying to get
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this set up, would be something like a
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2-4-2, where I have her hold for four
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second at the bottom if I really want to
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work on that range of motion. Or a 4-2-2,
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where she would go through, hold and then
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back nice and slow working on eccentric
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control, and all we need is one, maybe two
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sets of these activation techniques
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before we start moving into our other
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more complicated resistance training
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based movement patterns. I look forward
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to hearing your questions and i hope you
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enjoyed this video, and enjoy using this