Home Posts tagged "poor posture"

Progress Doesn’t Happen in Isolation

I've got an important point to make today, and I think it's best illustrated with a hypothetical story.

Let's say that a 14-year-old, 6-0, 140-pound kid - we'll call him Joey - comes in to Cressey Sports Performance and does an evaluation with me in September. He says that he currently throws 70-72mph, but wants to hit 80mph by the start of the upcoming spring baseball season - and that he's willing to do anything to reach that goal.

We put Joey on a great strength and conditioning program - lifting, sprint/agility/jumping challenges, medicine ball drills, arm care exercises, self-myofascial release, and mobility work - and he crushes it with his nutrition. Joey gets on a solid throwing program, and fine-tunes his grip on the baseball and some mechanical flaws with our pitching coordinator.

Joey gets manual therapy with our massage therapist, and also makes a dedicated effort to improve his sleep quality and quantity. He hangs out with a bunch of professional baseball players in a motivating environment, and even reads some sports psychology books to prepare himself mentally. Joey crushes his offseason with us - and puberty is still kicking in to help the cause.

And, the results show up in the spring: Joey is consistently pitching harder than 80mph, surpassing his goal.

It must have been the lifting, right? Or the medicine ball work? Or the arm care? Or the nutrition improvements and weight gain? Or the mechanical changes? Or a simple grip adjustment on his fastball? Or better sleep? Or just the gains associated with puberty?

What I also failed to mention is that Joey was taking algebra in school. He also shoveled his driveway whenever it snowed. And he stopped eating gluten because he felt like it made him bloated. And he got a new pair of sneakers. And his mother switched from a minivan to a SUV. Joey even developed a weird ritual of half-naked shadow boxing in the mirror every night with the Spice Girls playing in the background. You've got to have a routine, right?

Of course, everyone takes note of Joey's crazy progress and asks him what the "secret" was. How does Joey respond? Puberty, gluten, the minivan, and his Spice Girls infatuation are all sensitive subjects he doesn't want to publicly discuss, so those are off the table. Nobody gets excited hearing about algebra, sneakers, grip adjustments, or mobility work, so those are lame discussion points for the local newspaper interview. Hanging out with professional baseball players seems like a cooler story line, though, so that's what he goes with: his progress all had to do with environment.

Nevermind the fact that Joey gained 30 pounds and started sleeping more than six hours per night. And, forget that he can actually touch his toes and do a body weight lunge without tipping over. And, overlook the fact that he is no longer throwing accidental cutters on every pitch because his delivery was so out of whack. Heck, those old shoes may have been terribly constructed and put Joey into horrible positions in his pitching delivery. 

 

If you want to throw hard, you have to firm up on the lead leg...and at the right time and in the right direction. Cleats can definitely help athletes "get away" with a bit more in this regard, as they guarantee a larger base of support (foot stays on the ground) and generally have a lot more medial/lateral support than normal sneakers. It's one reason why many pitchers throw considerably harder outside than they do off indoor (turf) mounds. That said, if you're going to pitch off a turf mound, do yourself a favor and make sure that you've got a sneaker that isn't too flimsy - especially side to side. You shouldn't roll out of the shoe (which we see in the right video). Take note of the same pitcher on the left in the @newbalance #mx20v6, a minimalist sneaker that is lightweight but still provides adequate medial/lateral support. Exact same delivery, but markedly different outcomes. Full disclosure: I helped design this shoe - but the lessons are the same regardless of what you're wearing. Thanks for the demos, @joeryan34! #cspfamily #pitching #pitchingdrills #minimalistshoes

A post shared by Eric Cressey (@ericcressey) on

I know what you're saying: this is an extreme example - and you're right. However, we see a modified version of it all the time. Tom Brady refuses to eat tomatoes. Marshawn Lynch eats Skittles during games. Chris Sale needs to eat fast food to keep his weight up.

Usually, progress is incredibly multi-factorial. The results come not just from a lot of different directions, but from the synergistic interaction of many factors. And, sometimes there are other factors that may confound how we evaluate the path to success.

Tom Brady is still going to be an elite NFL quarterback if he has tomatoes for dinner the night before a game.

The 40 calories worth of Skittles Marshawn Lynch eats on gameday probably have zero impact on his performance.

Chris Sale's slider is going to be absolutely filthy even if he chooses pizza over chicken, broccoli, and rice.

And, in our example above, Joey's progress was completely unrelated to a myriad of things that took place. But, that doesn't mean we can ever really know what percentage was related to strength and conditioning vs. pitching instruction vs. nutrition vs. a host of other factors. We just know that success comes for a variety of reasons, so you have to check a lot of boxes to determine what contributed to that success. And, you have to recognize that unless you have perfectly controlled research studies, you'll likely have a very hard time isolating where the success really originated.

A perfect example of this is the debate on posture's impacts on pain and performance. Anecdotal evidence tells us that it does make a difference, but the research is actually shockingly inconclusive in this regard; we just don't know exactly how big a role (if any) that it plays in one's ability to stay healthy.

If you're looking to learn more about the controversial link between posture and performance, I'd encourage you to check out my popular resource, Sturdy Shoulder Solutions. I delve into this subject - along with many others - in great detail.

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How Chronic, Prolonged Sitting Impacts Your Body – and What to Do About It

Last week, over the course of two days, I made the long drive from Hudson, MA to Jupiter, FL. Suffice it to say that all those hours in the car gave me a newfound appreciation (or distaste?) for just how hard sitting is on the body. As such, it was really timely when my friend Michael Mullin emailed along this guest post on the subject. Enjoy! -EC

Disclaimer:

In this article, the author describes a fictional scenario in order to demonstrate a point related to the degree of information and misinformation there is in the layman and professional literature. It is in no way an attempt to create alarm that these facts apply to every person and every situation. While this article is not scientifically based, the published references are meant as an example of what some studies have found of the impact prolonged sitting and being in a stressful environment has on the body. Please read this article with the intent with which it was written—to provide concrete tools to use if you have to sit for extended periods of time.

I would like to have you read the scenario below and let me know if you would want this job.

“Congratulations on being selected for the position of top minion here at Do Everything Against Design, Inc. (DEAD).  Our company is a prestigious purveyors of thneeds—and a thneed is a thing that everyone needs (5). We pride ourselves on our commitment to being on the cutting edge of business and we use only the best, most up-to-date information possible to dictate how we run our business.”

“Let me start off by saying that this job will provide all kinds of potential benefits. It is up to you to decide how committed you are. The potentials are endless—overuse injury, chronic pain, depression, increased alcohol use, drug or medication use, cancer, increased general mortality, even bullying—that’s right, just like when you were a kid—are all very real possibilities here at DEAD, Inc.”

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“So first thing we will do is get you set up with your work area and station. Here is your cubicle which studies have shown are detrimental to not only work life but also your personal life (1). And here is your ergonomically correct chair so that your body doesn’t have to move, because research has shown that sitting 90% of your day, will almost double your risk of developing neck pain (2). We are also well aware of the fact that this increased time sitting will ultimately yield to a higher mortality rate for you (3), and make you feel generally crummy, but we are willing to take your chances. In fact, don’t even bother trying to counter all this sitting with exercise, because it will increase your risk for certain cancers by up to 66% regardless of how active you are when not sitting! (4)”

“However, placing this degree of stress and strain on your body is mainly so that we can reduce the organization’s costs and increase productivity (5), which is what is most important to us. Because ‘business is business and business must grow, regardless of crummies in tummies you know’ (6). And you do want to be a team player, don’t you?”

“In fact if you do end up having any physical problems, there is a greater than 63% chance that it is actually due to work (7). And if it isn’t from sitting too much (8), then it is due to the psychological stress that this position places on you. Heck, it might even be due to me and the stress I place on you! I will give you an 80% chance that our workplace stress will be the most important factor you will have to deal with here (9).”

forward head posture man

“We have also found that this job can also really give you a great chance on becoming an alcoholic or binge drinker (10), so you have that going for you as well.”

“If stress does become greater than you can learn how to cope with, which is apparently one important part of your employment here (11), then rest assured that we don’t really have a plan in place, because 80% of facilities do not have formal programs in place to deal with workplace stress, and of those that do, only about 14% say it is effective (12). Since that’s what the research suggests, then I mean, how important can establishing a plan be?”

“The single greatest thing about this whole situation is that I will actually pay you to let me break you down, little by little, bit by bit, until you feel beaten and broken. Don’t you see? It’s a win-win situation for both of us here at DEAD, Inc!”

I decided to title this article differently from my original title, “Your Employer Is Trying to Kill You” because I thought it might be a little less inflammatory. But, if you think about it, if data were used to truly guide what we should be doing, than many jobs where employees have to sit the better part of the day are truly a form of abuse. OSHA should be having a field day with these kinds of stats!

This is not about trying to bash many of the companies that have these incredibly sedentary work environments, though. Moreover, it's also not about the fact that I disagree with how our ergonomic evaluations and standards currently are. This is more about trying to create a "Movement/Movement."

Michael Mullin

Our bodies are designed for movement. Period. Our brains are designed for processing and trying to create efficiency so that we can process more. Now that’s pretty smart, however, highly detrimental when it comes to the importance of movement. Because if we continue to listen to what our brain is telling many of us, then it will constantly suggest that we just continue to sit to conserve energy.

So what to do for those of us who have to sit regularly during the day?

  • Get up regularly, even if it means setting a timer at your desk to walk down the hall a couple of times. Not only good for the body, but also good for the brain.
  • Stand every time the phone rings in your office, even if it means you have to sit back down to do something at your computer for the call.
  • Every hour, independent of getting up for regular walks:
    • Sit at the front edge of the chair, hands resting on thighs and body in a relaxed position—not too slouched or sitting up too straight. Take a slow breath in through your nose, feeling your ribs expand circumferentially. Then slowly, fully exhale as if you are sighing out and exhale more than you typically would, without forcing or straining. Inhale on a 3-4 count, exhale on a 6-8 count, then pause for a couple of seconds. Re-inhale and repeat for 4-5 breaths.
    • Staying in this position at the front edge of the chair, reach one arm forward, alternating between sides, allowing your trunk and torso to rotate as well. Your hips and pelvis should also shift such that your thighs are alternately sliding forward and back. Perform 10 times on each side, slowly and deliberately and while taking slow, full breaths.
  • Consider using your chair differently, depending on the task:
    • When doing work on the computer, sit with the lowest part of your low back (i.e. sacrum) against the seat back, but don’t lean your upper body back. This will give the base of your spine some support, but also allow for good trunk muscle activity as well as proper thoracic circumferential breathing.
    • When doing general work such as going through papers, moving things around your desk, filing, etc., sit forward on your chair so that you are more at the edge of the chair. This will allow your legs to take more load and your trunk muscles better able to aid in support, reaching and rotating tasks.
    • When reading items or reviewing paperwork, recline back with full back contact to give your muscles, joints and discs a rest. Make sure to hold the items up at roughly shoulder height—even if you support your arms on armrests or desk.

Remember, chairs and sitting is something that WE as humans created and the current norm is in no way optimal. We were not put on this planet to sit on chairs, and in particular not ones which shut our system off and limit our movement and ability to breathe normally. Until organizations and the general mindset changes to balance work requirements, work efficiency and human health, then we will be constantly be dealing with companies such as DEAD, Inc.

Note: the references to this article are posted as the first comment below.

About the Author

Michael J. Mullin, ATC, PTA, PRC: Michael is a rehabilitation specialist with almost 25 years of experience in the assessment and treatment of orthopaedic injuries. He has published and lectured extensively on topics related to prevention and rehabilitation of athletic injuries, biomechanics and integrating Postural Restoration Institute® (PRI) principles into rehabilitation and training. He has a strong interest in system asymmetry, movement, rehabilitation and respiratory influences on training and their effect on athletics. He has extensive experience with dancers, skiers, and professional and recreational athletes of all interests. You can find him on Twitter: @MJMATC

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Assessments You Might Be Overlooking: Installment 1

I generally perform 8-10 new evaluations per week.  They may be individuals who plan to train with us at Cressey Performance for the long haul, or they may just be popping in for a one-time consultation regarding a particular issue or training technique concern.  Sometimes, they'll be rehabbing with one of the physical therapists with whom we work closely, and seeking us out to maintain a training effect in spite of their injury. 

Regardless of the scenario, I'm fortunate to see a lot of variety in a typical week of evaluations, and it has led to me thinking outside the box and appreciating a few things that are commonly overlooked by trainers and rehabilitation specialists.  With that in mind, today, I wanted to kick off a new series about these under-appreciated observations that can really make a difference in your takeaways from an evaluation.

1. Standing/Sitting Posture

There are a lot of trainers who'll observe this in passing, but in many cases, they'll only note something if it's something really dramatic.  My suggestion along these lines would be to note not just what's going on in the sagittal plane (kyphosis, lordosis, forward head posture), but also what's happening in the frontal and transverse plan.  Do they always cross one leg over the other?  Does one shoulder sit markedly lower than the other? Do they sink into one hip and carry more weight on that side?

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As an aside, Greg Robins recently wrote up a great posture blog about some of the most common aberrant patterns we see.

2. Handshake

Believe it or not, a handshake can tell you a ton.  If it goes like this, it's safe to say that you probably won't need to do any direct arm work with this individual, who'll quickly become either the coolest (or most awkward) client of all time. 

Joking aside, handshakes can tell you a lot, particularly with respect to joint hypermobility.  First off, what's the feeling of the fingers?  Are they more rigid or "pliable?" If they're more pliable, chances are that you're going to be dealing with someone who has considerable congenital laxity (loose joints).  Second, are the hands cold, even in the middle of the summer?  Chances are their circulation is poor - another common symptoms of those with considerable joint hypermobility.

To test these theories, here's a challenge for you.  Go shake the hands of ten of your friends/colleagues today. Note the feel of the hands, and then follow up the handshake with a Beighton Hypermobility Test. The screen consists of five tests (four of which are unilateral), and is scored out of 9:

1. Elbow hyperextension > 10° (left and right sides)
2. Knee hyperextension > 10° (left and right sides)
3. Flex the thumb to contact with the forearm (left and right sides)
4. Extend the pinky to >90° angle with the rest of the hand (left and right sides)
5. Place both palms flat on the floor without flexing the knees

I'm sure you'll find that the coldest hands with the most pliable fingers are the ones who have high scores on the Beighton test.  When you have folks like this, they need more stability work than mobility training.  And, if an individual has a noteworthy injury history, you need to ask if he/she has been stretched aggressively in previous training or rehabilitation scenarios - particularly if he/she had negative outcomes with those experiences.

Also, if a young athlete gives you a lame, limp-wristed handshake, it's a sign that he's going to need to step up his game if he doesn't want to live in his parents' basement for the rest of this life.  I recommend introducing him to the foundation of the Ron Swanson Pyramid of Greatness to get the ball rolling (definitely worth a zoom-in):

rspyramid_1500

3. Medications

It is absolutely shocking to me how many people in the fitness industry overlook medications on an initial evaluation.  Perhaps it is the new era of bootcamps and semi-private training leading to a less individualized approach (particularly with respect to assessment), but you can learn so much about what a client needs by reviewing medications.  And, it's one reason why we have an initial one-on-one assessment with every new client at Cressey Performance.

Of course, you're looking for the obvious stuff - beta-blockers, prescription inhalers, etc. - that have definite impacts on how someone will respond to exercise.  Taking it a step further, though, there are hundreds of other medications that can impact how you program for and coach a client.  The problem is that not everyone views the term "medication" the same - so people will generally underreport on their health histories. In other words, you need to "pry" and ask if there really aren't any pills they take.  Recently, there was even an instance when I was able to guess a medication a kid was on just by asking his mom after observing his habits during the evaluation.

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As an obvious example, there are loads of people out there who pop non-steroidal anti-inflammatory (NSAID) pills like candy because they've got chronic low back, shoulder problems, or any of a number of other issues.  In their eyes, though, these "get-me-by" pills don't count as drugs because they can be bought over the counter.  They can mask pain during exercises, and obviously have significant side effects. It's a trainer's responsibility to be "in the loop" with a client, his doctor, and a rehabilitation specialist to determine what the right course of action is to get this individual off those NSAIDs over time.

In a youth athlete population, we've had three kids who have had extensive and prolonged negative reactions to the Isotretinoin (Accutane) that was prescribed to treat acne. In two of these cases, the kids were excellent D1-caliber athletes who gradually felt worse and worse over the course of months in spite of no change to training volume or lifestyle factors.  We were all stumped because they had never reported that they'd started taking the medication.

Once we found out the cause, their parents got them off the Accutate right away, and symptoms resolved over the course of a month. However, these experiences led me to look further into the side effects of this prescription medication. I was astounded.  There are reports of depression, muscle weakness, joint pain, vision problems, dry skin skin dryness, and several other side effects. The FDA even warns, "Accutane may stop long bone growth in teenagers who are still growing." I'm not a dermatologist, so it's not my place to say that it's right or wrong.  However, it absolutely, positively is something you need to inquire about on a health history if you see it listed - or even if you suspect that a kid might be a candidate for it.  That said, I've known a lot of kids whose acne has improved considerably once they've gotten all the crap out of their diet, but that's a conversation for another day!

If you see a sleep aid listed on a health history, you may need to think twice about programming high-volume training for an client, and spend some extra time discussing recovery methods.  If you see anti-depressants, anti-anxiety, or ADHD medications on a health history, it may change the way you approach coaching this individual.  These are really just the tip of the iceberg; you have to keep your eyes open and consider/discuss the implications when appropriate.

I'll be back soon with more assessments you might be overlooking.  In the meantime, if you'd like to learn more about some of our approaches to assessment, I'd encourage you to check out Assess and Correct: Breaking Barriers to Unlock Performance.

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Quick and Easy Ways to Feel and Move Better: Installment 41 (Posture Edition)

Thanks to Greg Robins, here are five tips for the week, with a focus on postural awareness.

1. Monitor head positioning during supine bridge and hip thrust variations.

2. Consider this routine to taking your breath before lifts.

Breathing is a big part of postural awareness.  Check out this video for ensuring that you're locking things in correctly before big lifts:

3-5. Avoid parafunctional habits.

The following three points will be based on a common theme: “Parafunctional Habits.”

A parafunctional habit is a habitual movement, or positioning that differs from the most common, or ideal movement and / or positioning of the body. It can also be a habitual positioning or movement of the body that’s continuous exposure (repetitive practice of) leads to certain asymmetries or dysfunctions.

When I think about how to attack posture changes both with my clients and myself, I look for the most efficient ways to change daily habits. In other words, I look at how we can disrupt parafunctional habits.

“Posture is a composite of the positions of the positions of all the joints of the body at any given moment. If a position is habitual, there will be a correlation between alignment and muscle test findings.” – Florence Kendall (Adapted from PRI’s Postural Respiration)

Many of us tend to default to the same habitual movements and positions. Here are three examples, and three quick fixes. Making a point to apply these corrections will have a tremendously positive outcome in helping you "feel and move better.”

3. Don’t stand on the same leg all the time.

For a variety of reasons, many of us will tend to shift onto one leg when standing in place for a period of time. Our body is always looking for the most efficient way to “survive.” Shifting onto one leg is any easy way to gain passive stability, via our positioning.

Many of us will tend to shift onto the right leg. Why? In short, it’s easier for us to pull air into our left side, in light of the normal structural asymmetries you see with human anatomy. Breathing is kind of important. It’s also not fun to rob ourselves of air. Enter the “right stance," an aberrant posture you'll see all too often.

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Start paying attention to how you stand at rest. Additionally, look around and notice how others stand at rest. I bet it looks a lot like the picture above. This is something we see on extreme levels in some of our right-handed throwing athletes; they're right handed people, in a unilateral sport, in a right-handed world!

Now, let’s make a change. For now on, use the picture below as a guide for how to stand when you shift onto one leg. Place the right leg in front of the left, and shift your weight into the left hip. If you are doing it correctly, your left hip will sit just below the right. Give it a try!

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4. Cross your right leg over the left, and cross your right arm over your left.

In a similar fashion to your default standing position, those who tend to cross their legs will generally go left over right. Why? Same reason: it’s easier to sit into the right hip, and breathe into the left side. Instead, start doing the opposite. From now on cross the right over the left, and feel the left hip dig into your seat.

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Do the same with your arms. Instead of crossing left over right, cross right over left. Close down the left side, and open up the right.

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5. Change the way you sit while driving.

Driving is a GREAT place to work on positioning. Notice that your default is to slump over to the right side, opening the left leg and possibly resting it against the door. Instead, try this:

As you sit reading this, pretend like you’re in your car. First, even up your thighs and feet. Keep a space about the size of your fist between your two knees. At this point, your knees and feet should be even, or you might find the right slightly behind the left. Move the right foot into a position as if it was working the gas and brake pedal. You should look like this:

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Now, pull your left hip back and push your right hip forward. This will leave the left knee behind the right.

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You will notice the upper, inner thigh of your left leg “turning on.” Reach for the steering wheel with both hands. Consider this your new driving position. If you tend to drive with one arm, start making it your right arm. Leave the left arm hanging down to the side, causing a slight side bend to the left.

All of these positions will seem uncomfortable at first. That’s okay! Use them as much as possible, but allow yourself to just “chill” sometimes. Making these small changes is a fantastic way to better your posture and change your habits. Working on them will pay off in the long run, and you may even find your nagging aches and pains disappearing.

For more information on these postural approaches, check out www.PosturalRestoration.com.

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Quick and Easy Ways to Feel and Move Better: Installment 21

Here's this week's list of strategies to get your nutrition and strength and conditioning programs headed in the right direction.  This is a collaborative effort between Greg Robins and me.

1. Add amplitude to your conditioning.

Let's face it: jogging on the treadmill and riding the elliptical or recumbent bike is about as fun as watching paint dry.  While an exercise causing boredom doesn't mandate that it be thrown by the wayside immediately, it does become concerning with this exercise modality doesn't broaden the amplitude - or range of motion - that you encounter in your daily life.  Moving better is about improving mobility, which is defined as one's ability to reach a certain posture or position.  For some folks, this means actually lengthening short tissues or reducing tension in overly stiff tissues, while for others, it's about establishing stability in the range of motion that one already possesses.  Unfortunately, while you're burn some calories on these cardio machines, you aren't going to do much to improve your mobility.

The solution is to implement variety in your conditioning, whether it means taking a bunch of mobility exercises and doing them right after another, or integrating several strength training exercises with lighter loads.  Step-ups, sled pushing/dragging, side shuffles, lateral lunges are all ways to get your hips moving in ways they normally don't.

In the upper body, innovative rowing and push-up variations can keep things fun while improving your movement quality.

The next time you're planning to do some interval training on the bike, try substituting some wider-amplitude movements and see how you like it.

2. Get your Vitamin D right.

I've seen studies that have shown great benefits from getting vitamin D levels up to normal, but to my knowledge, those effects were most observed with respect to body composition, hormonal levels, and tissue quality.  Interestingly, I just came across this study that showed a significant improvement in power production over four weeks in the vitamin D supplementation group, as compared to the controls. These results are tough to interpret, as the subjects were overweight/obese adults; ideally, we'd study trained athletes with smaller windows of adaptation ahead of them to see just how beneficial vitamin D supplementation is on performance. However, it certainly makes sense that if we're improving body composition, endocrine status, and tissue quality, folks are going to get more out of their training and make faster progress.

Vitamin D is one of very few supplements that I view as "must-haves' for the majority of the population.  I'd pair it up with a good fish oil and greens supplement to cover one's nutritional foundation. This is one reason why I'm a big fan of the Athletic Greens Trinity Stack; you can a high quality version of all three in one place.

 

3. Plan out regressions and progressions.

People like to be good at things. This is especially the case when they are surrounded by a bunch of other people. In the case of group exercise, your attendees are going to have a much better time, get better results, and stay safer if they are performing movements correctly. Group settings aren't ideal from a coaching standpoint, though, as you can't spend as much individualized time coaching technique. Therefore, exercise selection becomes paramount to these classes' success.  In other words, you need to have both progressions and regressions in your exercise library.

A common flaw in group classes is that each week, there are 15 new exercise variations on the agenda. The week before, it was 15 other ones, and the following week, it will be 15 more. I know, I know; people want you to "keep it fresh." In my mind, by changing the exercises so often you are taking the easy way out.

Instead, have people become incredible at the basics. Have them squat, swing, push up, row - all basic movements. From there, set up progressions and regressions. This is much easier to do when you keep the original exercises basic.

Here are a few examples:

TRX Supported Squat > Counter Balanced Squat To Box > Goblet Squat > Double KB Front Squat > Offset KB Front Squat

Hands-Elevated Push-up > TRX Chest Press > Push-up > Feet Elevated Push-up > Push-up vs. Band

This is mostly for teaching purposes, as an example. The goblet squat is accessible to most people, and it falls in the middle, with two levels of regression and progression built in.

I'm a big fan of more work up front and easy sailing there out. You might need to take some time to develop your class program, but it will make for a better product and better results thereafter.

4. Use leftover vegetables in your omelet.

I don't know about you, but leftover vegetables never taste quite as good as they do when they've just been cooked.  They're cold, and often soggy to the point that even heating them up in the microwave doesn't really make them sound appetizing.  Rather than throw them out and skip on your veggies for a meal, try adding them to your omelet the following morning, as the other ingredients - eggs, spices, oils, cheese (if that's your thing), salsa, and ketchup - can help to liven up their taste.  I've done this with previously cooked asparagus, broccoli, peppers, onions, spinach, kale, mushrooms, cauliflower, green beans, and tomatoes.  Some vegetables - squash and turnip, for instance - don't have the right consistency to make for a good omelet ingredient, though, so experiment carefully!

5. Learn to stand correctly before you even try to train correctly.

Many people think moving well is all about picking the right corrective exercises to get the job done. While that's certainly part of the equation, the truth is that before you even talk about exercising, you have to educate yourself about how to simply stand with good posture.  As an example, if you have an excessive anterior pelvic tilt and lordosis, you need to learn how to engage your anterior core, activate your glutes, and prevent your rib cage from flaring up up when you're standing around. Conversely, if you do all your exercises in this aberrant posture, you just get good at sucking!

Have a great week!

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Strategies for Correcting Bad Posture: Part 3

This is the third installment of my Correcting Bad Posture series.  In case you missed the first two installments, you can check them out here: Strategies for Correcting Bad Posture: Part 1 Strategies for Correcting Bad Posture: Part 2 Today, we pick up with tip #9... 9. It's not just the strength exercises you perform; it's how you perform them. Often, people think that they just need to pick a bunch of "posture correction" exercises and they'll magically be fixed.  Unfortunately, it's not that simple, as making corrections takes time, patience, consistency, and perfect technique.  As an example, check out the following video of what some bad rows often look like in someone with a short pec minor, which pulls the coracoid process down and makes it tough to posteriorly tilt and retract the scapula.  The first substitution pattern you'll see (first three reps) is forward head posture replacing scapular retraction, and the second one (reps 4-6) is humeral (hyper)extension replacing scapular retraction.

Ideally, the chin/neck/head should remain in neutral and the scapula should retract and depress in sync with humeral movement.

Of course, these problems don't just occur with rowing motions; they may be seen with everything from deadlifts, to push-ups, to chin-ups.  So, be cognizant of how you're doing these strength exercises; you may just be making bad posture worse!

10. Get regular soft tissue work. I don't care whether it's a focal modality like Active Release, a mid-range modality like Graston Technique, or a more diffuse approach like general massage; just make sure that you get some sort of soft tissue work!  A foam roller is a good start and something that you can use between more targeted treatments with a qualified professional.  A lot of people really think that they are "breaking up scar tissue" with these modalities, and they certainly might be, but the truth is that I think more of the benefits come from altering fluid balance in the tissues, stimulating the autonomic nervous system, and "turning on" the sensory receptors in the fascia.

For more thoughts along these lines, check out my recap of a Thomas Myers presentation: The Fascial Knock on Distance Running for Pitchers.

11. Recognize that lower body postural improvements will be a lot more stubborn than upper body postural improvements. Most of this series has been dedicated to improving upper body postural distortions (forward head posture and kyphosis).  The truth is that they are always intimately linked (as the next installment will show) - however, in the upper body, bad posture "comes around" a bit sooner.  Why?

We don't walk on our hands (well, at least not the majority of the time).

Joking aside, though, the fact that we bear weight on our lower body and core means that it's going to take a ton of time to see changes in anterior pelvic tilt and overpronation, as we're talking about fundamentally changing the people have walked for decades by attempting to reposition their center of gravity.  That's not easy.

So why, then, do a lot of people get relief with "corrective exercises" aimed at bad posture?  Very simply, they're creating better stability in the range of motion they already have; an example would be strengthening the anterior core (with prone bridges, rollouts, etc.) in someone who has a big anterior pelvic tilt and lordosis.  You're only realigning the pelvis and spine temporarily, but you're giving them enough time and stability near their end range to give them some transient changes.  The same would be true of targeted mobility and soft tissue work; it acutely changes ROM and tissue density to make movement easier.

Long-term success, of course, comes when you are consistent with these initiatives and don't allow yourself to fall into bad posture habits in your daily life.  In fact, I have actually joked that we could probably improve posture the quickest if we just had people lie down between training sessions!

12. Add "fillers" to your weight training program. Mobility drills aimed at correcting bad posture are often viewed as boring, and in today's busy world, they are often the first thing removed when people need to get in and out of the gym quickly.  To keep folks from skipping these important exercises, I recommend they include them as "fillers."  Maybe you do a set each of ankle and thoracic spine mobility drills between each set of deadlifts (or any strength exercise, for that matter) - because you'd be resting for a couple of minutes and doing nothing, anyway.  These little additions go a long way in the big picture as long as you're consistent with them.

I'll be back next week with Part 4 of the Correcting Bad Posture series.

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Strategies for Correcting Bad Posture – Part 2

Today, we move forward with more strategies for correcting bad posture. In case you missed it, be sure to check out Strategies for Correcting Bad Posture: Part 1.  We pick up with tip #5... 5. Don't overlook a lack of glenohumeral (shoulder) joint internal rotation. When it comes to bad posture, everyone thinks that the glenohumeral joint is only a "player" when it's stuck in internal rotation; that is, the ball - or humeral head - is rotated too far forward on the socket - or glenoid fossa - meaning that the individual just doesn't have adequate external rotation.  And, this is often true - especially in non-athletic populations. However, you'll also very commonly see poor posture folks who present with big glenohumeral internal rotation deficits (GIRD), particularly on the right side (for very legitimate reasons that go well beyond the scope of this article).  This is much more common in athletes, particularly overhead throwers (read more: Static Posture Assessment Mistakes).  When the posterior rotator cuff is stiff/short and there is an internal rotation deficit, we have to substitute excessive scapular protraction (winging) or thoracic flexion/rotation each time we reach for something. So, for many folks, posterior shoulder mobility and soft tissue work is an important inclusion in cleaning things up in terms of appearance, function, and shoulder health.  If - and only if - you've been assessed and it's been determined that you have an internal rotation deficit that compromises your total motion at the glenohumeral joint, you can integrate some gentle sleeper stretches (scapula stabilized!) to get a bit more ROM in the posterior cuff.

6. Don't overlook a lack of glenohumeral (shoulder) joint flexion. The shoulder is a tremendously mobile joint, so we need to appreciate what goes on outside the transverse plane as well. In particular, I see shoulder flexion limitations as a big problem. These limitations may come from the lat, teres major, long head of the triceps, or inferior capsule.  Another overlooked cause can be posterior cuff restrictions; it's not uncommon to see both GIRD and major shoulder flexion limitations on the same side.  As the picture below shows, the infraspinatus and teres minor run almost vertically when the arm is abducted a mere 90 degrees - which means that they're struggling to lengthen fully to allow full shoulder flexion (and abduction, for that matter).

These restrictions that can contribute to both faulty compensation patterns in certain positions, as well as overall bad posture chronically.  Let's have a look at what these issues look like in the real world. First, in someone with a shoulder flexion limitation, you'd first want to check them in the supine position, with the knees flexed and back flat (to avoid substituting lumbar extension for shoulder flexion).  Ideally, the arms should rest flat on the table - so this would be a "not-so-hot" result (especially since the arms "fall" to the sides a bit instead of staying in "attempted flexion"):

Next, let's take this same shoulder flexion limitation, and look at what would happen actively.  In the first three reps of the video below, take note of the position of our subject's head at the start and finish of each rep; you'll see that as he "runs out" of shoulder flexion, he substitutes forward head posture.  On the next three reps, after I cue him to keep his cervical spine in a more neutral posture, he has to arch his back excessively (lumbar hyperextension) to complete the movement.

Now, imagine taking this walking disaster (only kidding; I had Dave fake it for the video, as he's actually a finely tuned trained killing machine who can't be stopped by conventional weapons - and he's single, ladies) taking up overhead pressing, Olympic lifting, or just reaching for a glass on the top shelf.  Then, imagine him doing those tasks over and over again. Obviously, the posture will get worse as he reinforces these compensation schemes - but something is going to surely break down along the way; it's just a question of whether it's his low back, shoulder, or neck!

Correcting these issues is easier said than done; as I noted, there are several structures that could be the limiting factor.  However, for those looking for a relatively universal stretch they can use to get a bit of everything, I like the wall lat stretch with stabilization, one piece of a comprehensive (but not excessive and boring) static stretching program included in Show and Go.

7. Don't ignore the thoracic spine. The previous two examples focused exclusively on the glenohumeral joint, but the truth is that it is tremendously dependent on thoracic spine positioning.  Ask any physical therapist, and they'll tell you that if they can get the thoracic spine moving, they can instantly improve glenohumeral joint range-of-motion without even touching the shoulder (this is incredibly valuable with folks who may have stiff glenohumeral joints that can't be mobilized aggressively following shoulder surgery; they need ROM in any way possible).  And, truthfully, you can substitute a lack of thoracic spine extension for the shoulder flexion problems and compensation schemes above, and a lack of thoracic spine rotation can work in much the same way as a GIRD (substitute excessive scapular protraction with reaching tasks).

If you ever want to quickly check to see what limiting thoracic extension does to someone's upper body posture, just put them in supine position and push the sternum/rib cage down - which will bring the thoracic spine into flexion. Watch what happens to the position of his chin, and the size of the "gap" between his neck and the table:

Now, just consider what kind of "yank" this puts on the sternocleidomastoid chronically...

...and you'll understand why a lack of thoracic spine mobility can give people enough neck pain and tension headaches to make Lindsay Lohan's hangovers look like a walk in the park.  And this doesn't even consider what's going on with scalenes, suboccipitals, levator scapulae, subclavius, and a host of other muscles that are royally pissed off!  Also, think about all those folks in your gym doing hours and hours of crunches (especially while tugging on the neck).  Ouch.

For that reason, we need to get our thoracic spine moving - and more specifically, we need to get it moving in both extension and rotation.  I've mentioned in the past that the side-lying extension-rotation is one of my favorites (assuming no symptoms); remember that the overwhelming majority of the range-of-motion is coming from the upper back, not just the shoulder:

Here's another we're using quite a bit nowadays in our folks who have good internal rotation (which we want to keep!):

8. Watch your daily habits and get up more frequently. I'm at 1,140 words for this post right now - plus several pictures and videos.  In other words, some of you might have been hunched over your computer screens trying to figure out what I'm saying for over 20 minutes now - and that's when "creep" starts to set in an postural changes become more and more harmful (both aesthetically and functionally).

With that in mind, make a point of getting up more frequently throughout the day if you have to be sitting a ton.  Likewise, "shuffle" or "fidget" in your chair; as Dr. Stuart McGill once said, "The best posture is the one that is constantly changing."  Now, shouldn't you get up and walk around for a few minutes?

I'll be back soon with Part 3 of this series, but in the meantime, I'd encourage you to check out Show and Go: High Performance Training to Look, Feel, and Move Better, a comprehensive program that includes many of the principles I have outlined in this series.

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Strategies for Correcting Bad Posture: Part 1

This week, I'll feature several strategies for correcting bad posture; you should be able to insert these into your weight training programs quickly and easily for immediate results. Here we go...

1. Train more frequently.

Obviously, in many cases, those with bad posture often simply don't exercise enough, so any motion is good motion.  However, this also applies to regular exercisers who hit the gym 3-4 times per week as well.  Why?

Well, I do a lot of my "corrective" work in my warm-up programming - and the more often you train, the more often you'll have to do your foam rolling and mobility warm-ups.  So, breaking your training program up into smaller components on more frequent days might be the best way to force yourself to do the things that you need the most to correct bad posture.

2. Use daily mobility circuits.

Along the same lines as the "increase training frequency" recommendation, it'll never hurt to repeat your mobility warm-ups during your daily life. If you are someone who is really in need of drastic changes, do your warm-ups twice a day, seven days a week (on top of any static stretching you do).

3. Strengthen the deep neck flexors.

When you get stuck in a forward head posture, the deep neck flexors (muscles on the anterior portion of your neck) really shut down as the sternocleidomastoid, suboccipitals, levator scapulae, scalenes, and upper traps get dense, fibrotic, and nasty.

You can start off by simply doing chin tucks against the wall (put the back of your head up against a wall, then make a double chin without the back of your head losing contact with the wall). Then, you can progress to quadruped chin tucks, a drill I learned from Dr. William Brady.  In this drill, you'll work against gravity as you pull your head into a more neutral cervical spine posture.  Most people will butcher this on their first try by going into hyperextension as they get to the "top" of the movement.

When you get the technique down, you'll actually notice some crazy soreness along the anterior aspect of your neck in the days that following. We usually go with sets of 5-6 reps and a 2-3 second hold at the top of each rep.

4. Go with a 2:1 pulling-to-pushing ratio.

This is a recommendation you see quite a bit, but nobody really talks about how to "smoothly" apply it to a weight training program.  Here are a few approaches I've used in the past:

a. Simply add an extra pulling exercise on the end of a day's session.

b. Pair a bilateral pulling exercise with a unilateral pressing exercise - and do "halves" on each pressing set.  In other words, if I was doing 6x6 chest-supported rows (CSR) with 3x6/side 1-arm incline DB presses (IDP), here's how I'd set it up: CSR, IDP-right, CSR, IDP-left, CSR, IDP-right, CSR, IDP-left, CSR, IDP-right, CSR, IDP-left.

c. Make the pulling exercises in your program the A1, B1, and C1 options, with the pressing as the A2, B2, C2.  And, simply have an extra set of each of the pulling exercises - meaning you just don't return to the pressing exercise for a last set.  This might work out as more of a 3:2 pulling-to-pushing ratio, but you can always tack an extra set or two on at the end to make it work.

I'll be back soon with more strategies for correcting bad posture, but in the meantime, I'd encourage you to check out Optimal Shoulder Performance at www.ShoulderPerformance.com, as this resource features loads of postural correction strategies to complement the ones featured in this series.

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