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You've mentioned to me in the past the issues with the ever popular Nike Shox training shoe as well as high heels in women. What's are the potential problems?
When you elevate the heels chronically - via certain sneakers, high-heels, or any other footwear - you lose range of motion in dorsiflexion (think toe-to-shin range of motion). When you lack mobility at a joint, your body tries to compensate by looking anywhere it can to find range of motion. In the case of restricted ankle mobility, you turn the foot outward and internally rotate your lower and upper legs to make up for the deficit. This occurs as torque is "converted" through subtalar joint pronation.
As the leg rotates inward (think of the upper leg swiveling in your hip joint socket), you lose range of motion in external rotation at your hip. This is one of several reasons why females have a tendency to let their knees fall inward when they squat, lunge, deadlift, etc. And, it can relate to anterior/lateral knee pain (think of the term patellofemoral pain ... you've got restriction on things pulling on the patella, and on the things controlling the femur ... it's no wonder that they're out of whack relative to one another). And, by tightening up at the ankle and the hip, you've taken a joint (knee) that should be stable (it's just a hinge) and made it mobile/unstable. You can also get problems at the hip and lower back because ...
Just as losing range of motion at the ankle messes with how your leg is aligned, losing range of motion at your hip - both in external rotation and hip extension - leads to extra range of motion at your lumbar spine (lower back). We want our lower back to be completely stable so that it can transfer force from our lower body to our upper body and vice versa; if you have a lot of range of motion at your lower back, you don't transfer force effectively, and the vertebrae themselves can get irritated. This can lead to bone problems (think stress fractures in gymnasts), nerve issues (vertebrae impinge on discs/nerve roots), or muscular troubles (basic strains).
So, the take-home message is that crappy ankle mobility - as caused by high-top shoes, excessive ankle taping, poor footwear (heel lifts) - can cause any of a number of problems further up the kinetic chain. Sure, we see plantar fasciitis, Achilles tendinosis, and shin splints, but that's just the tip of the iceberg in terms of what can happen.
How do we fix the problems? First, get out of the bad footwear and pick up a shoe that puts you closer in contact with the ground. Second, go barefoot more often (we do it for all our dynamic flexibility warm-ups and about 50% of the volume of our lifting sessions). Third, incorporate specific ankle (and hip) mobility drills - as featured in our Magnificent Mobility DVD.
Oh, I should mention that elevating the heels in women is also problematic simply because it shifts the weight so far forward. If we're dealing with a population that needs to increase recruitment of the glutes and hamstrings, why are we throwing more stress on the quads?
Eric Cressey
www.EricCressey.com
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Eric,
My SI joint have given me major problems for the last 3-4months. I have received some fairly effective treatment from my Chiro but need to get some tips on corrective exercise. I own your Magnificent Mobility DVD. What movements should I avoid/focus on?
Try this:
Foam Rolling, then
X-band Walks
Supine Bridges
Birddogs
Warrior Lunge Stretch Static - 15s/side
IT Band Stretch Static - 15s/side
Calf Mobilizations
High Knee Walks
Pull-Back Butt Kicks
Cradle Walks
Overhead Lunge Walk
Walking Spidermans
Scap Pushups
There are a lot more I'd use with you, but these are the ones on the DVD. Stay away from anything that involved twisting/rotation.
As far as rehab is concerned I understand i have to:
Go for walks.
Activation work for abs/glutes.
Improve length/tension relationship of hip related musculature.
Strengthen multifidi
ETC
Etc? Yikes. Don't worry about isolating multifidi; you can't do it.
I would recommend you do the following daily:
Side bridges
Supine bridges
Birddogs
Avoid Crunches.
Start with Isometrics for abs/lower back and slowly progress and avoid hyperextension at all costs.
With regards to weight training I am thinking:
Now machine work. Leg ext/curls/GHR
light front squats.
=> BW one legged movements
Dynamic Sumo deads
Oly squats
power squats
Any tips for me?
A lot of single-leg movements, and glute-emphasis pull-throughs are good. Can't really say much about squats and deadlifts without seeing your form.
Eric Cressey
10 Minutes to Better Flexibility, Performance, and Health |
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With the NCAA tournament final on Monday night, I thought this email exchange I had Sunday morning might be of interest. As a little background, I was recently contacted by a local D3 basketball coach to help with his team’s off-season conditioning. As a little background, this team is a solid D3 program that generally loses in the first round of the NCAA tournament after winning its conference regular season title. I gathered some background information on the team, and even went up to check out a game a few weeks ago. Following the game, we met up, talked shop, and worked out some of the details on what I’d be doing to help them out; it was a go.
Then, I got an email that included the following:
We just met as a staff and when they were down in Atlanta they met with the a couple of coaches from the NYC area and decided to do a three day trip in mid December. Obviously this is a great experience for our players, but this trip cripples our budget. After punchig the numbers we literally have just under $400 dollars so now we have to adjust everything, including working with you. I appreciate the effort you have devoted to us since I first contacted you and I hope we are able to work something out, if not this year, certainly in years to come. When you find the time let me know what you think about situation.”
Honestly, I don’t really need the money, so doing this was going to be more for my own fun – and I liked the idea of helping out some coaches that were enthusiastic and open-minded (or at least I thought they were).
Here was my response:
Thanks for the update.
I have to be very honest with you: you guys are falling in to the trap that a lot of coaches fall into.
When my buddy and I left your game a few weeks ago, we remarked about how your team basically looked like a "good" high school team in New England. The thing is that neither of us really know a damn thing about the tactical aspect of basketball; we were referring to the speed of play, level of aggressiveness, and utter lack of athleticism. Your players were no different from their competition in terms of memorizing plays/defense, shooting, or anything tactically that could potentially differentiate them. They were just slower, fatter, and weaker - poor relative strength with reactive ability that was mediocre at best. Do you think that they remember plays any worse than the guys at Florida or Ohio St? Trust me, tactically, your guys are probably AHEAD of what you see in D1 ball (as evidenced by average scholastic achievement); they just aren't as physically gifted.
These deficiencies are readily trainable - and you get the added bonus of increased team camaraderie and attitude in the process.
Instead, you guys are going to spend more time on the tactical side of things - basically changing the engine on a car with square wheels. And, you're going to do it over three days while ignoring something more valuable that could span 16-20 weeks. Motor learning doesn't happen in three days.
The guys don't need a three-day vacation mid-season. They need to can the permanent vacation they've been on with respect to off-season conditioning and diet and get their act together. I would encourage you to think "different" instead of thinking "better" - otherwise you're just going to be waiting around until someone tells you what you want to hear.
Hope this wasn't too blunt.
Last night, the commentators noted that it would be very interested to see if Greg Oden of Ohio State – likely the most important man on the team – would be able to withstand the outstanding mobility of Florida’s big men. Mobility is a quality that is very easily trained.
Conversely, I didn’t hear anyone questioning whether Florida or Ohio State’s players could remember their defensive schemes or in-bounding plays.
Tomorrow night, when you’re watching the NCAA tournament final, consider who would be better off: the team that did a three-day crash course on the court in-season, or a team that worked the hardest and smartest in the off-season to prepare for the grueling in-season period.
For more information, check out UltimateOffSeason.com
Eric Cressey
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| Q: I just read your article on leg extensions, and I'm wondering if leg curls are bad, too. I'm rehabbing a mild hamstring pull, and I’m wondering if light-weight leg curls are okay.
A: I'm not a fan of leg curls at all. Your hamstrings will never work in isolation like that; they'll always be co-contracting with the glutes, adductor magnus, and smaller hip extensors. When you do a leg curl, you really just encourage an overactive muscle to tighten up even more than it already has.
In our Building the Efficient Athlete DVD set, Mike Robertson and I go into great detail on how when you see a muscle strain, you should always look for a dysfunctional synergist. Think about the functions of the gluteus maximus: hip extension, abduction, and lateral rotation.
If it shuts down, you can get hamstrings or adductor magnus strains (synergists in hip extension), piriformis issues (synergist in lateral rotation), tensor fascia latae (TFL) strains (synergist in hip abduction) or even quadratus lumborum tightness/strains (hip-hiking/lateral flexion to compensate for lack of hip abduction). You also might get lower back tightness or lumbar erector strains from lumbar hyperextension to compensate for a lack of hip extension range of motion (secondary to glute weakness not being able to finish hip extension). Finally, you might experience hip joint capsule irritation anteriorly because your glutes aren't providing enough posterior pull to counteract the tendency of the hamstrings to allow the femoral head to glide forward during hip extension.
Yes, I know I'm a longwinded geek, but I do have a point. That is, always look for inefficiencies and dysfunction; don't be lazy and just stop at pathology. Several pathologies can result from a single inefficiency/dysfunction/syndrome. If you understand how to identify and correct these inefficiencies, you can use comparable protocols to fix a lot of problems.
They say that one of the best ways to win people over is to take their pain away. If you're a trainer or therapist whose income depends on getting people healthy, you NEED to know this stuff.
Oh, and as for your hamstrings issue, get the glutes firing with various activation exercises and stick to hip extension movements such as pull-throughs, deadlifts, forward sled dragging, box squats, and back extensions to get co-contraction of the glutes. It goes without saying that I would also include plenty of single-leg exercises. If you want to start training knee flexion, when the time is right, incorporate some glute-ham raises.
www.BuildingTheEfficientAthlete.com
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| I just got this in the mail today; it’s yet another study to show that static stretching pre-training is (with a few minor exceptions) a big no-no!
Bradley, P.S., P.D. Olsen, and M.D. Portas. The effect of static, ballistic, and proprioceptive neuromuscular facilitation stretching on vertical jump performance. J. Strength Cond. Res. 21(1):223-226. 2007.
The purpose of this study was to compare the acute effects of different modes of stretching on vertical jump performance. Eighteen male university students (age, 24.3 +/- 3.2 years; height, 181.5 +/- 11.4 cm; body mass, 78.1 +/- 6.4 kg; mean +/- SD) completed 4 different conditions in a randomized order, on different days, interspersed by a minimum of 72 hours of rest. Each session consisted of a standard 5-minute cycle warm-up, accompanied by one of the subsequent conditions: (a) control, (b) 10-minute static stretching, (c) 10-minute ballistic stretching, or (d) 10-minute proprioceptive neuromuscular facilitation (PNF) stretching. The subjects performed 3 trials of static and countermovement jumps prior to stretching and poststretching at 5, 15, 30, 45, and 60 minutes. Vertical jump height decreased after static and PNF stretching (4.0% and 5.1%, p <> 0.05). However, jumping performance had fully recovered 15 minutes after all stretching conditions. In conclusion, vertical jump performance is diminished for 15 minutes if performed after static or PNF stretching, whereas ballistic stretching has little effect on jumping performance. Consequently, PNF or static stretching should not be performed immediately prior to an explosive athletic movement.
Okay, so we know that static and PNF stretching are bogus, and it looks like ballistic stretching doesn’t do much for us, either. So what can we do to warm up for effective performance?
Fletcher IM, Jones B. The effect of different warm-up stretch protocols on 20 meter sprint performance in trained rugby union players. J Strength Cond Res. 2004 Nov;18(4):885-8.
The purpose of this study was to determine the effect of different static and dynamic stretch protocols on 20-m sprint performance. The 97 male rugby union players were assigned randomly to 4 groups: passive static stretch (PSS; n = 28), active dynamic stretch (ADS; n = 22), active static stretch (ASST; n = 24), and static dynamic stretch (SDS; n = 23). All groups performed a standard 10-minute jog warm-up, followed by two 20-m sprints. The 20-m sprints were then repeated after subjects had performed different stretch protocols. The PSS and ASST groups had a significant increase in sprint time (p < or =" 0.05)," or =" 0.05)."> or = 0.05). The decrease in performance for the 2 static stretch groups was attributed to an increase in the musculotendinous unit (MTU) compliance, leading to a decrease in the MTU ability to store elastic energy in its eccentric phase. The reason why the ADS group improved performance is less clear, but could be linked to the rehearsal of specific movement patterns, which may help increase coordination of subsequent movement. It was concluded that static stretching as part of a warm-up may decrease short sprint performance, whereas active dynamic stretching seems to increase 20-m sprint performance.
Dynamic stretching, huh? Maybe these Cressey and Robertson guys are on to something with that DVD of theirs…
www.MagnificentMobility.com
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| Last week, sports fans witnessed arguably the most gruesome knee injury – both visually and medically – in recent history when the Clippers’ Shaun Livingston’s knee folded up like a lawn chair on a seemingly harmless play (be forewarned; this video is not for those with uneasy stomachs). Given Livingston’s age (21) and “fragile” 6-7 frame, many supporters of the NBA’s new age minimum restrictions are quick to assert that this injury would not have happened if Livingston had been forced to wait longer to enter the NBA. Dan Wetzel of Yahoo Sports wrote a detailed piece on the topic.
As a strength coach who has worked extensively with basketball players, I can say without wavering that this couldn’t be further from the truth; chronological age had nothing to do with Livingston’s injury. Physical maturity, training experience, and – presumably – ignorance of previous injuries and imbalances did. What seems to be lost in the details is that the Clippers guard also had a stress reaction in his lower back and pre-existing ankle problems; any of the best coaches and physical therapists in the business will all tell you that dysfunctions are almost never isolated.
Stress reactions are commonly the result of repeated hyperextension of the lumbar spine secondary to poor core stability and hip mobility (not to mention that the typical NBA spine is a LOT longer than that of the Average Joe). As part of this dysfunction, the gluteal muscles fail to fire sufficiently, and they lack the strength and activation level to decelerate “knock-knee,” internal rotation forces in landing – just like the one that ended Livingston’s season. When you lack mobility at the hips and ankles (most basketball players have terrible ankle mobility due to high-top sneakers and ankle taping), the knee (a joint that should just be a stable hinge) develops instability to create mobility. He could easily have developed chronic hip or knee pain; a traumatic injury got him first. Put a 1983 Buick engine in a 2007 Ferrari body, and you’ve got the typical NBA athlete.
When it comes to injuries, the basketball culture is reactive, not proactive. Unlike sports like football, hockey, and baseball that have embraced dedicated off-season conditioning programs (not to mention resistance-training from an early age), the basketball community – from the youth leagues right up to the NBA – has yet to appreciate how valuable a role strength and conditioning can play in preventing injuries like Livingston’s.
Rather than preventing the injuries by participating in dedicated off-court off-season training programs, most basketball players go right back to playing street ball, AAU hoops, or NBA summer leagues – all the while reinforcing the imbalances they’ve developed. Everyone wants to compete, but nobody wants to train or even rehab. Apparently, alley-oops and crossover dribbles are a lot more “sexy” than lifting weights and doing flexibility drills – at least until you rupture an ACL, MCL, PCL, patellar tendon, and lateral meniscus on a lay-up.
Karl Malone was notorious for his rigorous off-season lifting regimen, and he was quite possibly the most durable player in the history of the league. Entering the NBA at a young age wasn’t a problem for Lebron James – and it should come as no coincidence that he was resistance training for years before his arrival to the NBA at age 18. I had a 15 year-old, 192-pound high school shortstop front squat 300 for an easy single on Friday, then vertical jump 28.5 inches and box squat 355 today with a bit left in the tank. Do you mean to tell me that he won’t be ready for professional sports physically in three years? Please!
The NBA doesn’t need to institute age restrictions; it needs to take the initiative to develop a culture – independent of age – where players start training smart and taking care of their bodies.
Want to learn more? Check out The Ultimate Off-Season Training Manual.
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| We need an appropriate balance between strength and mobility in our hips. This is true if we want to squat or deadlift more weight, jump higher or sprint faster. A world-renowned philosopher by the name of Coolio may have said it best: "You can't have da' hop if ya don't have da' hip!" It’s no surprise that athletes in sports like Olympic lifting, powerlifting and sprinting have amazing overall development in both flexibility and strength of the hip musculature.
We see tons of injuries to the hamstrings and lower back, but rarely encounter any sort of injury to the glutes. The fact of the matter is that most athletes are tight in the hamstrings, lower back and hip flexors. This collection of problems is related to a lack of strength and motor control in the gluteal muscles. When the hip flexors (antagonists to the gluteus maximus) are overactive, the gluteus maximus becomes weak via a mechanism known as reciprocal inhibition.
Furthermore, when our "butt" muscles aren’t up to the task, the hamstrings and erector spinae muscles are forced to work overtime to compensate. This is known as synergistic dominance. This unfortunate cycle often results in injury, or at the very least, sub-optimal levels of performance.
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