A conversation over on Facebook about warming up had me reviewing my post from waaaay back in February on warm ups. It reminded me that I was remiss in not emphasizing my love of working oppositional muscles to improve the balance of muscle pull on a joint. That means more pushing for all aerialists! Anyone who does that much pulling / hanging really should be doing some overhead pushing to balance out the muscles of the shoulder and surprise the stabilizers with forces in new directions. Acro / handbalancing / tumbler folks I recommend the exact opposite for you. How about giving hanging a try (with good form, please)? Overhead pulling is the answer for you.

How should an aerialist get pushing? I'm a fan of training functional movements. So, how about a handstand (with good form, please)! Too hard? Try a downward dog. Somewhere between? Put your feet up on a increasingly higher supports, as you can maintain your shoulder control, until you are stacked and in an upside-down L shape with your hips over your hands.

Don't forget! This is all about pushing, for you (wonderful) body nerds this is coming primarily from the serratus anterior. Keep your shoulder blades actively reaching away from your hips and your elbows feeling like they are rotating towards each other (as if you were trying to turn you thumbs to point forward from the shoulder). 

If you are a handbalancer working on pulling, hanging is all about proper form and getting the shoulder blades and humerus in the proper position. Your shoulder blade needs to rotate upward a full 60 degrees. Your serratus anterior is already super strong from all of your pushing. You'll be relying more on your lower trapezius to keep your scapula down on your back while helping with your scapula's upward rotation.

Note the distinctions that these things should be done overhead. Our shoulder is a complex joint and the intricacies of the motion and stabilization of full shoulder flexion deserve and need extra love. 
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For you body nerds check out this video, with a more full description of the movement and the movers at play coming soon.

Check out our new sister website, The Circus Doc. It's a circus medicine website just for you!

Dr. Emily Scherb will present the latest research, trusted links to helpful information, new blog posts, training tips, information on upcoming workshops, and answers to all of your circus and movement questions. You can find the latest information available about your body in motion while in the air and on the ground vetted by a medical professional. 

However, if you are fully recovering., you will be undergoing adaptations that will allow your body to handle that same load more easily in the future, increasing your baseline, and decreasing recovery time. You will be in a great position to increase your capacity for whatever your goals may be (strength, endurance, flexibility, etc). 

So what does this mean for you? Your training regimen, and non-circus related stressors, are something you should closely monitor and increase or change in a controlled manner. Your sleep (or lack there of), stress, nutrition, or mental state could put you at higher risk of injury or decreased ability to recover. You need to pay attention to the intensity, duration, and frequency of your training (or performing). For example, if you are getting ready for a performance, now is not the time to go from training three times a week to training daily, or up the intensity by trying to learn that last new trick, or to stay at the gym for hours. What I recommend is only changing one factor at a time, giving your body time to adjust to the new load before changing the next. 

What the IOC found in its review of the literature is that small increases (and decreases) are significantly better than large fluctuations in loading. Through small changes and gradual controlled loading, you can reach high loads of physically hard training and it will have a protective effect from injuries. The sustained loads over time allow you body to adapt to performing incredible feats! 

Get out there and get on a training plan. You will be incredible.

For more information and resources check out the full articles below from the British Journal of Sports Medicine
Part One
Part Two 

f when you grab your aerial silks, trapeze, or rope and the inside of your elbow shouts with sharp pain, you could be suffering from “climber's elbow” otherwise known as medial epicondylosis. But, what exactly is going on and what can you do about it?

That super tender spot on the inside of your elbow is the medial epicondyle. This knobby bump on the ulnar (pinky side) of the elbow where the common flexor tendon attaches the wrist and finger flexor muscles, and the pronantor teres to the bone. These are the muscles that you use to flex your fingers and grasp your apparatus, to turn your palms facing outward, like to grip a trapeze, and to bend your wrist toward the pinky side of the hand, as with vertical apparatus. So, basically, all the muscles we hang our entire body weight from.

Often injury to this tendon is due to overuse, either from over training with too little rest, or from muscle imbalances in the body that make these muscles work overtime. Overuse and muscular imbalance is incredibly common due to how our lives revolve around finger flexion. These are the same muscles we use to type and use those '”wonderful” track pads on our laptops. Considering that not only are we aerialists, but also participants in the digital age, this gets tricky.

It is hopefully becoming clearer why the tendons attaching to the medial epicondyle are constantly subjected to sustained stress and are vulnerable to microtauma. Microtauma is normal and given adequate rest the body can repair the tendons to a higher level of capability to endure the stresses we put on it. However, without that rest the strong repeated muscle contractions can result in injury.

If you find yourself rubbing your elbows while training or having lingering pain there is hope. Find yourself a great physical therapist and get guidance on the rehab pathyway to pain free aerial practice. Tendons respond best when you load them properly and give them rest to rebuild.

If your pain is due to muscle imbalance and poor function, then your movement patterns are what need to change first. To quote a leading researcher in the field, Dr. Jill Cook, “With poor function you will never be out of pain. To get out of pain, improve function.” Having someone take a look at how the whole body, shoulder, and wrist are working can be the key to being pain-free and will get you prepared to rehab the tendon itself. For more info and links to relevant articles click here.

There are four phases to tendon treatment: isometrics to reduce pain, isotonics for strengthening, fast eccentrics to improve energy storage, and sport specific training and loading.

Phase 1: Isometrics to Reduce Pain
The first step in healing is stopping the cycle of pain and teaching the brain that though the muscles are firing, your elbow does NOT have to hurt. In isometric contractions, the muscle length and joint angle do not change. To do this, hold a heavy load (~75% max) for 45 seconds with the wrist and/ or fingers (depending on which tissues are most irritated) in a mid range position with the forearm supported on a table 5 times. By the second or third repetition this should be pain free, and without pain your strength will already be about 19% increased!

Phase 2: Isotonics for Strengthening
Once you are pain free, the next step is to strengthen the muscles and load the tendons slowly and avoiding fatigue. Begining with eccentric (lengthening) and moving toward concentric (shortening) contractions with an even amount of weight throughout the movement. As you are loading the tissue it is important that you have no pain for a full 24 hours after each session before you increase weight or resistance.

Phase 3: Energy Storage
Tendons are the springs in our system and need to be able store energy without pain. At this phase you will begin to perform fast eccentric contractions to mimic the loads that your tendons go through in daily life with about 48 hours of rest to allow for remodeling.

Phase 4: Sport Specific
Congratulations!!! You are back to (less modified) training and feeling pretty great. Now is the time to work on your grip endurance and your ability to absorb the force of doing smaller to larger release moves and re-grips.


Tendons may take a while to heal, but they will heal. The earlier you recognize your symptoms and get help, the sooner you will be back in the air and feeling great.


Some final thoughts:

I know we all love to stretch, but please AVOID stretching your flexor tendons. I know, everyone tells you to stretch, but here's why you shouldn't. The mechanism of injury to the tendon is excessive load that increases the tensive and compressive forces on the tendon. So, when you think about what stretching does, it INCREASES the tension and therefore the load on the tendon pressing it against the epicondyle and irritating the tissue further.

As far as technology goes,  track pads can be killer on the flexor tendons. GET a MOUSE. It can be a cheap and very effective way to decrease your daily symptoms and help you feel more comfortable throughout your day and in the air. Also, try to limit phone time in general. Just holding those little buggers and swiping can get irritating after a while.

Modify your TRAINING, but DON'T STOP fully. Give your elbows a bit of a rest, you may need to take a small break. In the meantime, work on your form, general strength, conditioning, and anything else you can do without increasing your symptoms. Your body and mind will thank you. :)



This blog post is for information only and is not meant to replace proper medical care and diagnosis. If you have any new pains or concerns about your body and its funciton please set up an appointment with a provider you trust.  ​

When (and when not): Hollow body is a great position for those who are not yet strong enough to stabilize their spine in neutral. For many aerialists, this is how they were taught to always move and they will continue to use a hollow body position as a basis of movement. However, advanced aerialists can learn to move beyond the hollow body and create a solid base for movement in a neutral spinal alignment displaying a mastery of core control.

Where: The core, the abdominal canister, the abdominals and friends, whatever you like to call the muscles that make up the whole middle of your body. In a hollow body position it is alive with muscular firing . Aerialists will feel muscular recruitment in their internal and external obliques, transversus abdominus, rectus femoris (the 6-pack muscle), and even through the deep gluteal muscles that make up the pelvic floor.
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Why: A hollow body position is a tool to ensure aerialists are engaged through their core and gives them a solid base from which to move their arms and legs. A properly performed hollow body allows an aerialist to more freely move their limbs by ensuring that the spine is stabilized by their core. An improperly performed position may mean that you are either loose all over or endeavoring to use you hip flexors and/or your lats to stabilize your core, and they do not do a very good job of it! In a poorly controlled position when you try to move your arms or legs you will be asking those muscles to do double duty as they try to stabilize the spine while moving the limbs. An imperfect hollow body is a risk for injury or the spine, hip, or shoulder.

How: How to recognize if you are actually using your abdominals and not your hip flexors or lats to create the illusion of a hollow body position. Most commonly you can see that the low back is slightly (or significantly) extended (arched) due to the extra stresses on the spine or that the spine goes into extension when the aerialist begins to move her legs or to press with her arms to invert.
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