This marks Part 2 of my write-up on Muscle Imbalances Revealed – Upper Body, a product that really impressed me.  In my first post, I highlighted some of Dean Somerset’s great contributions to the project, and today, I thought I’d bring to light seven more great corrective exercise lessons from another excellent presenter on this resource.

Dr. Jeff Cubos is an Alberta-based chiropractor with an outstanding skill set that not only encompasses his clinical work, but also an excellent ability to relate how what he does in the clinic applies to those in the strength and conditioning field.  This “dual proficiency” was readily apparent in his presentations, too.

Here were a few highlights:

1. From an alignment standpoint, you can envision the core like a house – where the diaphragm is the ceiling, and the pelvic floor is the floor.  Just like with the house, too, the ceiling and floor should be parallel.  Having an anterior pelvic tilt and rib flair dramatically alters this:

2. Good training to address this issue isn’t just about stretching hip flexors and activating glutes, though; it’s about retraining breathing, “owning” one’s breathing in various positions, and progressing that respiratory function (and, in turn, rib positioning) into more comprehensive strength exercises.

3. Jeff does the best job I’ve seen of discussing breathing drill progression – and how to sync them up with progressive strength training programs.  Just as importantly, though, he does a great job discussing the role of the diaphragm, utilizing an excellent video to show exactly how it works (as you watch it, be sure to check out how the right diaphragm attachment point is more prominent on the spine).  I’ve mentioned many times in the past in the blog about how we utilize breathing drills, and folks always want to know what they are.  Unfortunately, you can’t really just describe a breathing drill; you need to show it and add specific cues.  Jeff does exactly that.  Here’s a good excerpt on the assessment side of things, too:

4.  Dr. Cubos also discusses bits and pieces of both the Dynamic Neuromuscular Stability (DNS) and Postural Restoration Institute (PRI) philosophies.  Having been to seminars for both disciplines, I can tell you that Jeff does a great job of presenting this valuable, but sometimes confusing information in as user-friendly a format as one possibly can.  It’s a cursory overview, but enough to give you an introduction to these philosophies to find out if they’re right for you.

5. Even if you aren’t planning to delve deeply into these disciplines, Jeff covers a few specific cues that you can apply to breathing correctly on every exercise you do – especially if you (or your clients) are stuck in anterior pelvic tilt, lordosis, and an elevated ribs posture.  For instance, Jeff uses the cue of performing a few diaphragmatic breaths at the point of greatest tension in a movement; this will enable an athlete to “own” that position more quickly.  He uses the example of holding for a count of “one-one-thousand” at the top position of the quadruped extension-rotation:

6. I’ve got to great lengths in several previous blog posts to distinguish between tendinitis (inflammatory) and tendinosis (degenerative) – and Dr. Cubos did a good job of reaffirming things on that front (tendinosis is much more common than tendinitis).  However, he took it even further with some excellent information on the “continuum” of tendinopathies.  I’ve spoken about how we’re all waiting to reach “threshold” (presentation of symptoms), but haven’t paid a lot of attention to sub-clinical tendinopathies.  Here’s how Jeff portrayed the continuum:

Reactive Tendinopathy – This is acute overload (too much, too soon).  Soft tissue treatments are beneficial, but not locally to the tissue in question.  An example that immediately comes to my mind is a supraspinatus tendinosis; manual therapy to the pec minor, posterior rotator cuff, etc. would be very helpful, but working directly on the supraspinatus could exacerbate the problem significantly.

Tendon Dysrepair – Dr. Cubos referred to this as “a failed attempt at healing, and a disorganization of the connective tissue matrix.”  Immediately, I thought of someone with chronically crank hamstrings following a previous strain.  Direct soft tissue work has much more immediate and profound benefits.

Degenerative Tendinopathy – This is the obnoxious, long-term tendinosis we’ve come to know – whether it’s an Achilles tendon or common extensor tendon (Tennis Elbow).  Here we have cell death, disorganization of the connective tissues, and less collagen.  Unfortunately, full resolution isn’t that common – but most people can respond over time to the right kind of rehabilitation programs.

7. Last, but certainly not least, Jeff introduces his audience to several common soft tissue treatment approaches, including Active Release Technique, Fascial Manipulation, Functional Range Release, and the various modalities of Instrument Assisted Soft Tissue Mobilization.  In describing each, he outlines why some may be better for others in certain instances, as well as the differences between approaches.  I think this is a “must-watch” for trainers to understand the skills of the manual therapists to whom they refer, and also up-and-coming rehabilitation specialists to decide which approaches they’ll utilize in their professional careers.

All in all, Dr. Cubos was another new name (for me, at least) that I was glad to come across – and I’ll definitely be following him more moving forward.  And, in addition to Cubos and Somerset’s contributions, there are a host of other great professionals who have contributed to the entire Muscle Imbalances Revealed – Upper series, which is currently on sale with a 60-day money back guarantee, too, so check it out here.

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