Accessory Work- Train Smarter

Accessory work

AmazonBasics Cast Iron Kettlebell, 35 lb

What is accessory work? and why is it important?
Accessory work in summary is the small, tedious movements that most athletes do not like to take the time to do but are extremely important for complex movements. Online definitions in the athletic world suggest that accessory work is defined as exercises that compliment larger, more complex movements like a squat.

Within the therapy world accessory work means a couple different things including “accessory movement” which relates to the specific joint mechanics and also accessory exercises that compliment the larger movements as well. I often call accessory work also “prehab”

Why is it important?

It is important to “activate”/ warm up the muscle tissues correctly before you work out. I use the term activate in quotes because the muscles are only truly fully inactive in someone with a spinal cord injury or neurological damage. So really with are warming up the specific muscles and increasing blood flow to them.

It’s not just about everything feeling “warm” but your about your brain connecting with the specific muscles you are asking to work through movements. It’s about creating more neural pathways to those muscles to help you better recruit them.

The accessory work along with prehab exercises can be done on days of working out as well as on days of rest depending on how heavy you are doing loaded accessory work.

For example, your program might call for accessory work of single arm dumbbell overhead press building to heavier weight. As a Physical Therapist, I break that down even more for someone with hx of or current elbow pain and they might do light weight skull crushers to “activate” the tricep muscle as prehab/accessory work before the heavier accessory work.

For the lower body, a great “accessory exercise” is doing single leg deadlifts to improve blood flow to the hamstrings and glutes while the brain is connecting with these muscles knowing it should utilize them more when doing squats or deadlifts. This also helps improve motor control and balance. You could also do them heavier to build strength as well.

The goal is that your choice of exercise compliments your other movements planned.

Train Smarter. Train specific

If you want to HEAR me talk a little bit about this. Head over to the Ultimate Athlete Podcast. Straight about it. Episode 10. “Train Smart and avoid injuries”

#trainsmart #athletes #ultimateathlete #dpt #sleep #accessorywork #recovery #singlelegdeadlifts #RDL #SLDL #prehab #kettlebellwork

Postpartum Restrictions…What should I do and not do Dr. Jenn??

Postpartum Restrictions…What should I do and not do Dr. Jenn??

I have so many questions about postpartum rehab and postpartum care from patients, friends, family members, acquaintances, personal trainers, Instagram and facebook followers and the list goes on. I wish I could say it’s clear cut A, B, C but it’s not. Everyone is different. Every woman’s delivery is different as well as her health and fitness and strength levels are prior to pregnancy and during no matter what sports area they are in. Genetics play a factor as well, as do prior birth histories, and other medical histories including a person’s pelvic health even prior to pregnancy. Really?? That matters prior to pregnancy..YEP.

The best tool for EACH PERSON is individualized care including individualized evaluation from and Pelvic Floor Physical Therapist that includes a thorough history on past medical information. I am very bias in that I think it is crucial that the pelvic floor therapist is active herself and understands physical activity and fitness as well to truly understand the patient and the demands they place on their body. I truly believe every woman should have at least one pelvic floor Physical Therapy Evaluation from a licensed Physical Therapist whether you are postpartum or not. It just gives a woman so much information on how this area, that has 5 huge daily functions, should be working and coordinated and communicating properly do the brain.

One of the BEST things a pregnant or woman thinking about becoming pregnant can do, is see and pelvic floor PT. It can help you understand how your pelvic floor is currently functioning but also ways to help you with safety during your pregnancy, modifications for your workout routine, preparation for your delivery as well as immediate plans for you to do as soon as you return home with a brand new baby for those 1st 6 weeks until cleared by MD to return to the pelvic floor physical therapist. It is then, she can guide you even more specifically for YOUR needs, goals and recovery based on your findings postpartum and the affects your pregnancy had on your body. Everyone can be similar in some ways, but also very different in others.

Depending on a patient’s pelvic floor strength, core strength pain, hip strength, knee strength, back strength, awareness, posture, weaknesses as well as their degree of ab separation (diastasis recti) , their plan and full return to physical activity WILL ALL look a little different.

However, I will share some general guidelines and restrictions for those active women that want to get back to doing everything they love ASAP. What you need to understand and I must highlight is the importance of proper tissue healing and why these restrictions should be in place. There is ALWAYS a reason.  Pregnancy places a lot of stress on the human body in many ways unlike other events or injuries. On top of that, a childbirth is a traumatic event in so many ways that deeply affects the nerves, muscles, ligaments, and fascia in and around the pelvic floor. The muscles, nervous tissue, and connective tissue can all be damaged which changes the sensation, support and stability of the pelvis. Ligament laxity is also present still when a woman is breastfeeding. When stability is lost, more stress is placed in other areas including down on the pelvic floor increasing risk for prolapse, pelvic floor dysfunction, low back pain, hip pain, groin pain and even neck pain.

In general muscle tissue strains can take 3 weeks to 6 months and ligamentous strains (depending on the grade) take 3 weeks to 1 year (if a grade 3 strain) in order to heal so a lot of postpartum restrictions are most limited in the first 3-4 MONTHS with GRADUAL return to be safe, careful and allow the tissues time to heal. To be safe, gradual return should occur with test and retesting for the first 6 months at a minimum. I say 3-4 months meaning at that marker a woman could try a 200 meter run for example and see how she feels the next day. It also does not mean at 3-4 months the woman should now go as hard as she would like in a workout like she was before she was pregnant and go run 4 miles.  These first 6 months should be focused more on strengthening, mobility and correcting posture with a gradual return in the 3-6 month window up to a year depending on pelvic floor strength, diagnosis or prolapse or nerve injury.

Exercises I recommend NOT to do before 2 months postpartum:



-includes box jumps, jumping rope, jumping jacks..ANY jumping

-kipping or butterfly pull ups

-sit ups

-GHD sit ups

-ski erg- wait at least 4-6 weeks possibly more especially if prolapse symptoms

-kipping Handstand push ups

-toes to bar

-heavy lifting

-front planks (depending on the patient)

-handstand push ups without controlled descent


-muscle ups


Please understand this list is not all inclusive and each person may have greater restrictions.

Be safe. Train Smart. It will be worth it

-Dr. Jenn

#postpartumfitnesss #postpartumrecovery #diastasisrecti #postpartumrestrictions #postpartumrehab #pelvicfloor #pelvicfloorPT #PFPT #concord #charlotte


Just Stop Doing That

Just stop doing that…😒🤔

Have you ever gone to see a healthcare provider looking for answer to your pain and been told ” Just stop doing that”, “just stop doing what causes you pain or your symptoms” ??🙄

The immediate response in your head is often…

“Is that really the answer I just paid you to hear?”


“If I knew what caused it, I could.”


“So pretty much you’re asking me to not reach for anything, bend over, get dressed, sleep, sit, stand, run, lift, exercise…everything”

Oh that’s right, it’s so simple.

I was one of these patients at age 15 that listened. I was told by an orthopedic specialist after X-rays and an MRI of my low back that I had 2 bulging disks and I needed to “retire” from gymnastics forever. So initially I did, but I continued to coach because I couldn’t fully give up the sport I loved so much. I later went on to run track and I continued to be a cheerleader so I could still tumble all through high school. My back pain eased but actually bothered me more with standing still than anything else. It always felt better with exercise but I never questioned anyone, and just thought overall I’d be limited with lots of things forever because that is was I was told.😡

How sad is that, that it was ingrained in me at a young age, that I’d have back pain forever and not be able to do a lot of things I loved.

I went on to PT school and we studied orthopedics including units on the hips and low back and then later studied imaging as well. I quickly learned that my MRI reports stated the bulging disks in my back were actually protruding to the left and all my back pain was on the R near my SI joint. 🤔🤔🤔😲Something now is not adding up.

Fast forward another year, at age 22, I did finally have back pain on the left after lifting a patient which did cause symptoms consistent with bulging disks with some radicular symptoms (radiating symptoms into my butt and later on, down my leg). What I was so thankful for was that I was in PT school at the time and we were able to treat me👏#Conservatively . Since then I have always been treated by a PT, or I have seen my friend that is a Physician’s assistant because I know she will not be one of those healthcare providers to just tell me to stop doing what I love.

I started #Crossfit in 2014 and that too has helped my back tremendously especially because I gained strength. I have also learned to change some of my movement patterns that contributed to the symptoms and continue to work towards correct movement patterns, NOT just stopping what I love.

So, if you have had someone tell you to stop doing that exercise, or stop bending, or stop reaching, please DO NOT GIVE UP. Find the RIGHT provider willing to find the source, and correct the movement or imbalance that is causing you to have abnormal pain in normal tissue. You CAN heal. The body WILL adapt and can change when we teach it how.

#qualityoflife #dontgiveup #juststopdoingthat #dontlisten #stillhope #doctorofphysicaltherapy #PT #DPT #womenshealth #athletes #athletesminds #dowhatyoulove #dontstop


— Dr. Jennifer Iskat Frankoski, PT, DPT

Owner of Be the Change Physiotherapy

Powered by

Up ↑