How to Avoid the Biggest Quadruped Mistake

Introduction:

Quadruped exercises are a common choice in physical therapy and are gaining popularity in personal training. This versatile position can be beneficially utilized for various populations and outcomes. As a result, a wide variety of compensations usually ensue. More specifically, one common mistake tends to happen in a quadruped position. To accurately understand this specific compensation, the intent of the exercise needs to be clarified. In this article, I'll discuss the following topics:

• Quadruped Intention
• The Biggest Problem
• Scapular Biomechanics
• The Role of the Serratus Anterior 
• Coaching Checklist

 Are you a visual learner? Click the video below to watch the same concepts.

Quadruped Intent:

 Remember, your intent needs to align with your execution.

When these two align, you ultimately coach the movement "correctly." When there's a disconnect, there's compensation. That means the first step is to understand why you're having your patient perform a quadruped exercise. There are many reasons to prescribe this position, but for this article, we will consider two different intentions.

Example #1 - Quadruped to improve posterior chain mobility:

When performing a quadruped exercise to improve mobility, the range of motion is less of a concern. Spinal flexion and extension are encouraged to move the spine through its available range of motion (Think cat-cow or yoga poses).

Example #2 - Quadruped to improve pump-handle dynamics (anterior expansion)

When performing a quadruped exercise to improve respiration mechanics and anterior expansion, the range of motion needs to be more specific. Too much movement, and you won't achieve the desired outcome.

Moving forward, we will discuss the biggest mistake in quadruped as it's related to example #2.

The Biggest Problem:

The biggest problem with quadruped positioned exercises with the intent of anterior expansion is over-rounding (excessive spinal flexion). Unfortunately, this compensation often goes undetected when in reality, it makes or breaks your quadruped outcomes. To understand why over-rounding produces suboptimal results, we need to understand scapular and serratus anatomy and biomechanics.

Scapular Biomechanics:

If I say upward scapular rotation, downward rotation, anterior tilt, and posterior tilt, it's quickly understood how those movements look. But, if I say external scapular rotation and internal rotation, do you have to stop and think? It's not uncommon to forget the importance of those two motions, but now is the time to bring them back into your physical therapy knowledge!

Scapular Internal Rotation (Gates Open): When visualizing internal scapular rotation, think of two gates opening. In this position, the medial border of the scapula is pushed away from the spine. The most common dysfunction this is associated with is scapular winging. So, every time you see a scapula that is "winging," you're looking at an internally rotated scapula.

Scapular External Rotation (Gates Closed): When visualizing external scapular rotation, think of two gates closed. In this position, the medial border of the scapula is "pinned" down to the rib cage. The most common dysfunction this is associated with is a flat thoracic spine.

The Role of The Serratus Anterior:

The serratus anterior is most commonly remembered as a protractor of the scapula. While the serratus fibers that wrap around the rib cage are essential, the fibers on the anterior medial aspect of the scapula are more important for our conversation. When protraction occurs correctly, the medial scapula fibers are beneficially contracted, which closes the gates (external scapular rotation) and increases congruency with the rib cage. This is the desired position when seeking to improve anterior expansion. 

Since we are looking to achieve protraction coupled with external rotation of the scapula — the amount of movement is crucial. When we excessively protract (over-rounding), we essential are going to "blow through the gates" (internal scapular rotation). When this occurs, we will have more expansion posteriorly and compression anteriorly.

If you're confused about how that happens, remember that air moves from concentrations of high to low. So when we over-round, the eccentric length of the tissues expand (creating a low concentration) posteriorly and compress (creating a high concentration) anteriorly. So when we cue the patient to breathe, they'll be biased towards moving air more posterior (from the low concentration) than the desired anterior direction.

Coaching Checklist

•  Quadruped - Elbows above wrists, Hips above knees
• Chin down
• Press the chest towards the ceiling 
  • Find 0% and 100% protraction
  • Ideal protraction is between 25-50% depending on the patients structure
• Lift Belly Button Slightly Up
• Slightly Tuck the belt buckle towards the chin
• Maintain Above steps and breath for anterior expansion

Conclusion:

How you coach a quadruped exercise needs to change based on the intent. So, the next time you're prescribing this, first understand the purpose. Once established, you'll know exactly how to coach it and how much motion is required to get the benefits of the exercise.