I first met Neil Rampe when I was looking for someone to help me work through some nagging injuries. My chiropractor told me to refrain from some really basic movements for the rest of my life, and had provided me with a handy booklet of exercises I could do a million reps of quite easily. I felt these weren't really helping me get stronger and work through some muscular imbalances.

At the time, Rampe was a strength and conditioning coach working for the University of Arizona basketball team. I was searching for a midway point between what my chiropractor told me (which was way too easy) and the seemingly easy core-strengthening exercises that left me in agonizing pain. I thought Neil Rampe really helped bridge the gap. Apparently the Diamondbacks thought so too, because they stole him from us. So here's a bit about Neil Rampe and what he's about.


Q: So you used to be the strength & conditioning coach for the U of A basketball team and now you work for the Diamondbacks... what exactly do you do?

A: My official title within the Arizona Diamondbacks organization is Major League Manual Therapist. My primary responsibility is to provide soft tissue work and massage/manual therapy services to the Diamondback players at the Major League level. I also work in close collaboration with the head athletic trainer, assistant athletic trainer and strength & conditioning coach in the assessment, design and implementation of rehabilitative and corrective exercises for the athletes.

Q: What are some of the most common dysfunctional movement patterns you come across in your work, and how do you go about treating them?

A: I think the first thing that I would like to explain is that movement is based on the interaction between structure and function. There is a very fluid and reciprocal interplay where structure governs function as well as function governing structure. With that being said, I see a lot of the Janda’s classic lower crossed syndrome. Lower crossed syndrome presents itself as seeing someone in a hyperlordotic posture. What tends to happen is that a person begins to deviate from a neutral posture and there then becomes an interplay between muscle groups that will have a tendency toward becoming either inhibited (phasic) or overfacilitated (tonic). For example, there will be a bilateral tendency for overfaciliation from the erector group, QL, psoas, iliacus, rectus femoris, and TFL muscle groups just to name a few. Opposing this is a bilateral tendency for inhibition from the gluteals collectively and the abdominals collectively. This pattern creates an anteriorly rotated or anteverted pelvis.

How I explain this to athletes is that if you think of your pelvis as a bowl of water, a neutral pelvis should not spill any water. However, in lower crossed syndrome, an anteriorly rotated pelvis (bowl) will spill/leak water anteriorly. I then explain to them that “water” is the equivalent to energy and that this anteriorly rotated pelvis creates energy leaks in the kinetic chain.

With that being said, addressing this issue comes in the form of a multidisciplinary approach. As a gross simplification, I think of the human body as a puppet (skeleton) whose movement is dictated by the tension on its strings (muscles). Through soft tissue work, stretching and activation exercises, I am able to help correct and retension the “strings” so that the “puppet” is in a better neutral posture both statically and dynamically.



Q: How do you bridge the gap between rehabilitating athletes and getting them back in the gym (or on the field)?

A: QUALITY, QUALITY, QUALITY!!!!! My biggest focus when rehabilitating and transitioning an athlete back to unrestricted activity is quality of movement. I look at this period as an opportunity to re-groove faulty movement patterns, which may have actually had something to do with the initial injury anyway, into ideal ones. I think when an athlete is injured, there is a window of opportunity that forces the athlete to slow down and be broken down a bit into his/her basic parts before being built back up. This is also where I explain to some athletes that if their timeframe for return cannot be rushed or expedited, their goal should be to be the best anyone has ever been in whatever phase of rehabilitation/return to play they are currently in.

Secondly, PROGRESSION, PROGRESSION, PROGRESSION!!!!! There is a very important interplay between properly progressing an athlete so that they can prove to me and to themselves that they have gone through the proper channels to feel confident that they are ready to get back into the gym or back onto the field. The fine line lies in your ability to progress incrementally so that you can have a tight reign on where they are in their progress, yet have it be challenging enough so that they feel as though they are moving forward toward their goal of unrestricted activity. For example, if you progress an athlete from step A to step F and there is a setback, you don’t know if things went wrong at step B,C,D, or E. Spend the time to create a proper foundation and move incrementally forward from there. You must do this because sport/athletics is a numbers game. Every game, match, meet, set, repetition, etc. is an opportunity for an incidence of injury. If you cheat the process, it is only a matter of time before your weakness is exposed, whether it be through detrimental performance or an injury.



Q: What can athletes do on a regular basis that will help them improve functional movement and mobility and prevent injury?

A: I think the beautiful thing is that there are a number of things athletes can do to be proactive in improving their mobility, movement skills and injury prevention. The other beautiful thing is that it can be done very effectively without needing a lot of money, equipment or space. Obviously I am very biased to receiving some form of massage or soft tissue work. However, if funds are limited, there are a number of different ways to go through a very extensive, thorough and effective self soft tissue routine using simple implements such as golf balls, tennis balls, lacrosse balls, massage sticks, foam rollers/balls. Pool workouts are also a favorite activity of mine. I like to take athletes through different dynamic movements and ROM activities in water. To me, this is valuable as it allows you to go through different ROM’s in an assisted/gravity-eliminated environment. However, you can also modify the resistance based on the speed of movement in water. This allows for a wide array of controllable variables to help cater to the athlete’s individual needs. I am also a fan of using yoga and different meditation exercises/routines as a vehicle for people to create self-awareness within their body. In my opinion, probably the most overlooked aspect that people could definitely stand to improve in is their breathing. This is the most primitive “homebase” that the majority of people are lacking in. Proper breathing is really the base and source of everything. Improper breathing can lead to conditions such as asthma, headaches, lethargy, hypochondria, and respiratory alkalosis just to name a few. All in all, I really encourage people to become “informed consumers” when it comes to their own bodies.

Q: What about trainers or coaches? What should they incorporate into their clients' routines on a regular basis that will help prevent injury and improve functional movement (and maybe even speed up recovery)?

A: My biggest piece of advice here is that a great trainer and coach will have the “know how” to be able to write and implement a program reactively to what he/she finds in the assessment of an athlete/client. Too often a trainer/coach will write a program and have the athlete come to “their world” as opposed to assessing, troubleshooting, and identifying potential problems for that specific athlete/client and creating a comprehensive program to address that specific athlete’s/client’s needs. After all, you are only as strong as your weakest link. Very simply, I look at it this way: If I am going to take a road trip, I am not just going to start driving. I am going to assess where I am starting from, any potential detours, and where exactly is my final destination. The other thing that I really push is for my athletes/clients to “own their own experience” and to be accountable for themselves and their actions. I explain to them that we may only spend 1-8 hours together in a day, which leaves them 16-23 hours on their own to make decisions for themselves. Are they going to make good decisions or are they going to make bad decisions? All you can do is education them to the best of your ability so that they have the tools to make good decisions. The rest is on them.

Q: What common mistakes or problematic movements do you see all the time? What are some things to eliminate that would improve wellness?

Too often I see people who can’t appreciate that every muscle has a specific and intended job and it is an important cog in this beautifully complex organism we call the human body. Prime movers are meant to initiate and create movement. Synergists and stabilizers are there to help and provide a supporting cast. However, peoples’ training regimens, often times, force prime movers to do all of the above, thus creating dysfunction. People want to do what they are good at. People do not want to do things that they are not good at. It’s human nature. The problem is that this creates a disparity in balance of muscle tensions and joint positions. It’s like the old saying, “the rich get richer and the poor get poorer.” Often times, people are simply not in a position to become stronger. An example of this would be people who bench press until they’re blue in the face, yet do no accessory rotator cuff or posterior chain exercises to counter and/or compliment it. You are asking your prime movers to become stronger, but your stabilizers are unable to keep up with this demand, thus compromising the position of the joint... And over time, something has to give, usually your rotator cuff or labrum. To me this is the equivalent of putting more horsepower into a car and never addressing the wheels’ lugnuts, which may be loose. At some point, disaster is sure to ensue. Again, it’s a numbers game and only a matter of time before these imbalances and disparities manifest themselves as injuries.

Q: What are the biggest similarities and differences you see between run o' the mill clients and dedicated athletes?

I would say that the biggest similarity between elite athletes and general population clients is that they all have external stressors that affect them on a daily basis and may manifest in different ways. As human organisms, whether an elite athlete or general population client, our bodies are always seeking equilibrium/homeostasis as well as constantly combating inflammation in all of it’s forms and manifestations. Bottom line: whether you are an elite athlete or part of the general population, a “happy” body wants to perform optimally and an “unhappy” body doesn’t want to perform optimally. I would say that the biggest difference is that most elite athletes are in a position to have the time, money, coaching and other resources to dedicate to their training and performance goals and to have them be a top priority because it is their livelihood, whereas a general population client may have other obligations to tend to such as their jobs and careers which can deter from there performance goals due to having to wear more hats out of necessity.