Overhead Performance and Rehab with Body Weight - KIME Physical Therapy

Overhead Performance and Rehab with Body Weight

May 24, 2019 | Aaron Crouch, DPT, CSCS, SFG1

Fitness and health can come in a variety of ways. Have you ever been challenged to develop upper body integrity, strength, and endurance outside of a facility with weights? Asked to perform your home exercise routine from your Physical Therapist while on a business trip or vacation? Or have no interest in using weight training to improve your health, and would rather spend time enjoying what mother nature has to offer (sign me up!)? To alleviate the anxiety following these questions, we have a solution.

Overhead mobility, stability, strength and endurance can be argued as the most important patterns for the upper body. We lift objects of varying size, shape, and weight with one, or both arms, daily in the home, outside, at work, and for fitness. Also, most patients in a clinical setting will be challenged to demonstrate overhead ability. Developing overhead movement proficiency is typically achieved through a compilation of stretching, band work, and weight training, which doesn’t speak to all interests. Another demonstration of overhead movement proficiency is through a handstand, which seems like a daunting tasks at first sight.

The handstand is the inverted version of a military press/overhead hold, and can be a very effective substitute for shoulder fitness and rehabilitation when weights are unavailable. Handstand holds promote high amounts of compressive activity at the shoulder joint, as well as creating the rare environment where the thoracic spine stabilizes on a fixed shoulder girdle. Unlike vertical pressing exercises, handstand hold variations naturally eliminate the opportunity to cheat through your column. Even though the complete handstand, pictured above, is the end goal, there is a clear progression for those of us that aren’t there quite yet, but want to set the personal goal!

Initial requirements do exist even for the lowest level progression of the handstand. Full active mobility reach above your head should be achieved. Use the following test if you are checking yourself at home:

Also, baseline stability requirements can be self-assessed with the following sequence.

**CLINICAL PEARL – previous elevated progression is a wonderful closed chain challenge that is safe for patients in a rehab setting for repetitive pathology or post-surgical, when appropriate. Rule of thumb for progression to a more difficult, or heavier, version is a self assessment of owning the current task.

Once initial requirements are checked, then the progression toward a handstand begins! First step is a pristine downward dog position. In this position, you can challenge your skill with weight shifting, longer holds, and eventually head taps to promote single arm hold.

**CLINICAL PEARL – Downward dog position with two hands will seem easy to most, and the transition to elevated feet seem impossible; however, we are using the single arm holds as an intermediate task to bridge the gap.


Now that you have an understanding of the progression to the handstand, the most important part is the programming. As stated earlier, progress the challenge/position ONLY when ownage is achieved at the current position. Another helpful, and safe, suggestion when developing this skill is an honest understanding of your capabilities. We don’t walk on our hands during the day, so our shoulder girdle integrity and tolerance to weight bearing is much less than our legs.

**CLINICAL PEARL: As Pavel Tsatsouline famously instructed, grease the groove when it comes to high skill and high neurologically challenging drills. Handstand progressions only need to be practiced for short periods at a time and multiple times in a day. Your initial tolerance to these drills may only start with 2-3 minutes per day for a couple days a week; however, frequent safe participation will build your tolerance to multiple bouts in a day.

Hopefully this small twist on developing shoulder girdle stability, strength and endurance was helpful for those looking for something different. Feel free to contact us for more detailed

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