0:04 This is Brent of the Brookbush 0:06 Institute bringing you a new 0:07 self-administered joint mobilization 0:09 technique. In this video we're going to 0:11 talk about sternocostal mobilizations, 0:13 or mobilizations of these tiny little 0:15 joints that you have just lateral to 0:18 your sternum where your ribs interface. 0:20 Some of you guys are thinking to 0:22 yourself well why would I want to 0:23 mobilize these tiny little joints. We 0:26 have to think a little bit bigger 0:27 picture for the broadest use of this 0:29 technique, which is those individuals who 0:31 have problems with thoracic mobility. So 0:35 your thoracic spine controls your 0:36 ribcage, and your ribcage attaches to 0:39 your sternum anteriorly. Now if you've 0:42 had long-standing thoracic mobility 0:44 issues, it would actually make sense that 0:47 we've had some sort of adaptive change 0:49 in the mobility of these joints. Maybe an 0:52 increase in stiffness that is preventing 0:55 us from getting as much results as we 0:59 could be getting from our thoracic 1:00 mobility routine. There are some other 1:02 issues where we may look at using this 1:04 technique as well, for example those 1:07 people who get a lot of trigger points 1:09 through their pectoralis major. I would 1:11 say it's worth a try to do this 1:13 technique. I have noted clinically that 1:16 there seems to be a relationship between 1:18 sternocostal mobility and pectoralis 1:20 major trigger points. There are also 1:22 those individuals who feel like these 1:24 joints need to pop, that's a potential 1:28 symptom or a potential sign that this 1:31 technique is also worth a try. Of course 1:33 if you guys are dealing with pain, make 1:36 sure you're either a licensed 1:37 professional or you refer out to a 1:39 licensed professional, to determine 1:41 whether this technique would be 1:42 appropriate. I'm going to have my friend 1:44 Melissa come out, she's going to help me 1:45 demonstrate this technique. Now let's go 1:49 over our anatomy a little bit, like the 1:51 practical part of this. You guys all know 1:54 where your sternum is. Now this is her 1:57 manubrium, the top of her sternum. I can 2:00 actually just by putting the pads of my 2:02 fingers down in the center of her 2:04 sternum, I can actually feel her sternocostal 2:05 joints at either side. So if you 2:08 thought your sternum was that wide 2:09 you're wrong, your sternum is actually 2:12 fairly thin. These sternocostal joints 2:15 are just lateral to the midline, so we're 2:18 not going to be moving a whole lot when 2:20 we do these mobilizations. We're going to 2:23 be staying pretty center, which I know 2:26 what some of you guys have already been 2:28 thinking with this technique, is this 2:30 safe for females to do, is this going to 2:32 be uncomfortable for females to do, am I 2:35 going to impinge, or bruise, or compress 2:39 breast tissue. Chances are no, we're not 2:43 moving very far and if somebody is 2:45 really rolling over their chest they're 2:46 going too far. Or they're using a 2:49 foam well that's just too wide for their 2:51 little person, but chances are they're 2:53 rolling too far and as I show you this 2:55 technique that'll make more sense. Now 2:57 what we're going to do is we're going to 2:59 adapt a manual therapy technique, which 3:01 would be anterior to posterior 3:03 mobilizations, where I would take maybe 3:05 the ulnar border of my hand and put 3:09 pressure down on those sternocostal 3:12 joints anterior to posterior. Now 3:15 obviously I can't do that with a foam roll 3:17 I guess I could have somebody hug 3:18 into themselves, but that's not going to 3:19 work out too well. What we're going to do 3:21 is we're going to start on the sternum 3:23 which is essentially the ribs being 3:25 unloaded, and then roll onto the ribs 3:28 which is going to be an anterior to 3:29 posterior force. We're then going to roll 3:31 back and forth and that's going to 3:34 create the oscillation that we'd 3:36 normally use for mobilization. So 3:39 Melissa's going to go chest down on this 3:41 foam roll and the trigger point roll 3:42 tends to work pretty well, being covered 3:45 in a little bit of foam it definitely 3:47 helps the sensitive area. She's going to 3:50 start with her hands and maybe even 3:51 elbows down to take off some of the 3:53 weight, especially when she starts 3:56 because this can be quite tender. If I 3:57 needed to I could even use a towel 3:59 underneath, to even further soften that 4:04 down. We don't want to kill the person. We 4:06 don't want them in so much pain just 4:08 trying to do the technique that they're 4:09 not going to comply, and do this with 4:11 their home exercise program. Once she's 4:14 found the center of her sternum I'm 4:15 going to have her try one side at a time. 4:17 I just want her to roll over one set of 4:20 ribs, just barely over those bumps and 4:23 then 4:23 back, and then if she can get a little 4:26 oscillation going, I'd have her do about 4:30 15 maybe 30 seconds tops on each side. 4:34 Good go ahead and switch sides. 4:42 I'm going to have her get up and go back into Child's 4:45 Pose. Nice and comfortable and then I go 4:50 ahead and retest. Be very careful how 4:52 much of this stuff you guys do, you don't 4:53 want to take a mobilization from 4:55 positive to irritating. Now there are 4:59 several progressions to this 5:01 mobilization to add force, that was our 5:03 first progression. You may need to 5:05 regress to something even softer. When 5:08 Melissa and I were experimenting before 5:10 we made this video, we actually used this 5:12 very soft squishy ball, and honestly 5:16 that's enough to load and unload the 5:18 ribs for somebody who might be really 5:20 really sensitive. Little tougher to roll 5:26 back and forth but that's okay. 5:31 Good go ahead and relax. The other thing 5:33 we talked about is if you guys have any 5:35 really soft foam rolls lying around, a 5:37 good reason to keep some of those old 5:39 beat-up spongy foam rolls, is a long foam 5:42 roll can actually be less force because 5:49 now Melissa can shift part of her body 5:52 weight, onto her inner thigh on the side 5:56 the she's is going to roll. So now 5:58 she's getting like more or less the 6:00 bottom half of her body supported by the 6:02 length of the foam roll, and then she 6:03 only has her upper body weighting down her 6:07 ribs. But as Melissa is pretty tough and 6:12 we've been working on this a little bit, 6:14 let's go ahead and show you guys the 6:15 progression. So those are some of the 6:17 regressions, how would I progress this 6:19 exercise, you want the trigger point roll 6:20 back. 6:29 So to increase the amount of weight 6:31 we're using, we could just start by going 6:34 from elbow and forearm down where we're 6:36 nice and unweighted, to arms wide and now 6:41 she can kind of roll back and forth this 6:43 way. The next progressions we 6:49 kind of start integrating this into our 6:51 trapezius activation, or those prone ITY's. 6:54 She goes on one side just over 6:58 those sternocostal joints, and she 7:00 goes down into her Cobra from floor and 7:05 then pinches your shoulder blades. Not 7:07 only is she unweighted herself by going 7:09 from floor and up, floor and up, but her 7:14 scapula having to retract and 7:16 posteriorly tip, is also forcing 7:20 mobilization of her rib cage which is 7:23 going to have an effect on our sternocostal 7:24 joints. And of course i can 7:27 increase that posterior tipping and that 7:30 retraction by going from Cobra to 7:35 abduction, abduction with external 7:37 rotation ideally. So now I'm kind of 7:41 getting a little bit more bang for my 7:42 buck if I'm writing out like an 7:44 integrated warm-up, corrective exercise 7:45 routine, home exercise program, where I'm 7:47 trying to get a lot done in a few 7:49 exercises or a short amount of time. I 7:51 might be able to use this for trap 7:54 activation knowing that I'm also getting 7:56 some sternocostal mobility, if she's 7:58 had a history of upper-body dysfunction. 8:01 You can go ahead and relax. 8:04 It has a tendency to be very tender. As 8:07 they get off that foam roll I have found 8:09 that going right into a child's pose 8:11 helps. Sometimes you even get a little 8:14 cavitation or mobilization of the 8:16 thoracic spine going back into that 8:17 lengthened position and having loosened 8:20 up all of this tissue. This is once again 8:23 a sensitive technique, you guys are going 8:26 to have to use your best judgment. You 8:28 guys are going to have to modify with 8:29 towels and softer pieces of equipment 8:32 and keep some old foam rolls around, but 8:35 this is one of those techniques if it 8:37 really is like a clinical gem. If you 8:40 have that stiff thoracic spine that just 8:43 doesn't seem to want to respond for you. 8:45 You have somebody who's several years 8:49 post sternotomy right, 8:53 that bone is healed but all these joints 8:55 are super stiff. Little stuff like this 8:58 all the sudden might open some doors and 9:01 get you a little further through your 9:03 rehabilitation, or a little further into 9:06 your intervention, or give you a little 9:08 better mobility for your performance 9:11 training, so that you can get better 9:12 results than you've had before. I look 9:15 forward to hearing how you guys use this 9:17 technique, when you guys use this 9:18 technique, and of course what results you 9:20 get. I look forward to hearing from you.
