Last night, I was on my laptop searching for an old weight training program I’d written up a while back, and I accidentally stumbled upon some written goals of mine from back in 2003. Based on the “Created on” date in Microsoft Excel, I had written them up in the spring of my senior year of college.
On one hand, I was proud of myself for – at age 22 – knowing enough to write down the goals that I wanted to achieve. On the other hand, I have to laugh about just how out-of-whack my priorities were.
You see, I’d listed loads of strength, body weight, and body fat percentage goals first and foremost. In fact, there were 41 rows worth of performance and physique goals; hard to believe that ladies weren’t lining up to date this Type A stallion, huh? Can you say neurotic? I was like this guy, but with better eyesight and a decent deadlift.
That’s just self-deprecating humor, though. What was actually really sad was how distorted my perception of reality really was, as rows 42-46 consisted of the following:
42. Resolve shoulder pain.
43. Get rid of lower back tightness.
44. Get accepted to graduate school.
45. Get a graduate assistantship in research or coaching.
46. Have 3-4 articles published.
At the time, I was coming off a lower back “tweak” while deadlifting, but more problematic was my right shoulder, which hurt so much that it kept me up at night and negatively affected not only my training, but my everyday life. It was an old tennis injury from high school that just kept getting worse and worse.
Likewise, I hadn’t gotten word on whether or not I’d been accepted to graduate school, so I was up in the air on whether I needed to start looking for jobs for after graduation, or whether I’d end up moving south to enroll at the University of Connecticut.
Finally, I’d just had my first article published, and there was some momentum in place on which I could build a successful writing career.
In other words, I was in pain, unsure about where I’d be living in two months, potentially without a job, and all but ignoring a potentially career-changing opportunity – yet I managed to list 41 performance and physique goals more important than any of these concerns. Maslow’s Hierarchy of Needs was clearly buried under all the bullshit I had convinced myself was important. They made signs like this for guys like me.
Maybe it was the acceptance phone call from my future advisor at the UCONN; the experience of moving to a new area and being out on my own; interaction with a lot of highly-motivated, career-oriented people and successful athletes; the natural maturation process; or a combination of all these factors, but I got my act together that fall and figured out my priorities. That fall, I read everything I could get my hands on to get rid of the pain in my shoulder (canceled an impending surgery) and lower back. I put in 70 hour weeks among classes, volunteering in the varsity weight rooms and human performance lab, and personal training and bartending on the side. I published my first article at T-Nation and in Men’s Fitness. In short, I grew the hell up and stopped losing sleep over whether I’d remembered to take my forearm circumference measurements on the third Tuesday of the month.
Some folks might think that this shift in my priorities interfered with my training progress, but in reality, the opposite was true. In that first year of graduate school, I put over 100 pounds on both my squat and deadlift and 40 pounds on my bench press – and did so pain-free, which made training even more enjoyable. I learned a ton about the importance of training environment as I lifted around athletes and other coaches in the varsity weight rooms, and even caught the powerlifting bug, competing for the first time in June of 2004. I even won a few trophies absurdly large trophies that wildly overstated my accomplishments.
In short, when I stopped majoring in the minutia and clearly defined the priorities that were important to me – being pain-free, enjoying training, and seeing it as a means of becoming better in a profession that I loved – a world of opportunities opened up for me. And, surprisingly, some of the “old” priority goals were easier to attain because I didn’t force them or put as much pressure on myself.
That was almost a decade years ago, and I’ve had to make similar reevaluations of my priorities since that time, from opening a business, to proposing to my wife, to buying a house, to getting a puppy, to hiring employees, to working with charities. There are some priorities that will always remain for me, though; strength and conditioning has to be fun, and it has to improve my quality of life, not take away from it. These are values that are reflected in the weight training programs that I write, too.
To that end, how have your priorities changed over your training career? And, how have these changes impacted your progress in the gym?
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Today's guest blog comes from former Cressey Performance intern Eric Oetter. Eric was one of the best interns we've ever had, and writing like this is just one example of why.
In Thomas Myers’ groundbreaking work Anatomy Trains, several “lines” of fascially connected muscles are presented. Myers denoted these lines as “anatomy trains” (thus giving rise to the title of his now famous book). For those unfamiliar, fascia is a seemingly endless web of connective tissue, which envelops and unites the musculoskeletal, nervous, and circulatory systems of the body. Though manual therapists have treated the fascial system for centuries, Myers has played a pivotal role in introducing the concepts fascia and musculoskeletal tensegrity to the strength and conditioning community.
Tying the bottom of the foot to the scalp through fascial connections up the posterior surface of the body, the superficial back line remains the most referenced of Myers’ anatomy trains. While this line certainly has implications in extension (above the knee), propulsion, and full-body pronation, it’s far from being the only line yielding practical application and solutions for strength and conditioning coaches and movement therapists.
Patrick Ward wrote an excellent guest piece on Mike Robertson’s blog last year concerning the deep front line and its effect on diaphragm functionality. I’ll follow suit with some examples of how the functional back line can produce stability across the posterior lumbo-pelvic-femoral complex.
Functional Back Line Anatomy
Tying one humerus to the contralateral tibia, the two functional back lines take the following path across the dorsal surface of the body:
Shaft of humerus --> Latissimus dorsi --> Lumbodorsal fascia --> Sacral fascia --> Sacrum --> Gluteus maximus --> Shaft of femur --> Vastus lateralis --> Patella --> Subpatellar tendon --> Tuberosity of tibia
From behind, the lines look like a giant “X”, intersecting at the pelvis. The two key components in this discussion will be the latissimus dorsi and the glute max, as well as how their muscular actions can affect the sacro-illiac joint.
Sacro-Iliac Joint Stability: Form Closure vs. Force Closure
The sacro-illiac (SI) joint is comprised of the articulation between the illium and the sacrum and lies right in the middle of both functional back lines, deep to the lumbosacral fascia. Much like a crack in the sidewalk, the joint acts as a predetermined fracture to defer stress across the pelvis.
Viewed from the back, the SI joint resembles a key fitting into a lock– the grooves on either side of the posterior illium are congruous with the lateral sacrum. This “lock-and-key” structure can be described as an instance of form closure. Essentially, the innate stability of the joint is provided by bony approximation.
While form closure can create stability, it’s not truly authentic. For example, we can create stability in the lumbar spine by shearing it into extension and using bony approximation to prevent movement. I hope all reading agree that such a situation is less than ideal.
A superior option would be the force closure of a joint system. As opposed to form closure, where the morphology of the joint system creates stability, force closure entails the surrounding musculature dynamically stabilizing a joint by “pulling it tight”.
Relating to our previous example of the SI joint, imagine how much better it would be to stop relying solely on the ligaments that cross the joint andinstead employ the powerful glute max and lat, which cross superficially as part of the functional back line, as both become continuous with the lumbosacral fascia.
While using the functional back line to create force closure is useful in cases of general instability, it can be especially valuable in the instance of sacral torsion, where, as shown in the CT scan below, the sacrum rotates one way and creates strain on the contralateral tissues/ligaments as they are pulled taught.
Training this line in isolation can certainly provide benefit, but why not implement a big-bang strength exercise that integrates the entire line at once?
Here are two great examples of how to train the functional back line in a more dynamic fashion.
Split-Stance Low Cable Row
The split-stance low cable row provides an excellent presentation of shortening the functional line from both ends, thus force closing the SI joint. The latissimus dorsi aids in the horizontal pull while the contralateral glute max stabilizes the pelvis in the transverse plane to fight rotation. (Remember, any unilateral movement is inherently rotational.)
Coaching Cues:
Place the cable stack with a D-handle attachment at its lowest height.
Set up facing the stack with feet about hip width apart. Imagine that you’re standing on railroad tracks – when you take the step back to set up, the only movement should be in the sagittal plane.
Pack the chin, brace the core, and then flex the hips to the point that the torso is angled at about 45°. Put most of your weight through the outside of your up-foot heel.
Perform a row, holding at the top for a one count.
Potential Corrections:
Look for lumbar extension in two places – the initial set-up and as a substitution for scapular retraction. Think “neutral spine” throughout.
Scapular elevation and shoulder hyperextension are common compensation patterns during horizontal pulling. Think of rowing “back-and-down” and only to the point that the scapula gets to the thoracic spine.
Make sure that you or your client feels the front-leg hip musculature kick on to stabilize – if not, play with the set-up a little until those external rotators are contracted.
The split-stance low cable row can be a great horizontal-pull variation for any client, but especially for those experiencing lumbosacral instability. I’d recommend placing it as an accessory exercise on upper body days – 3-4 sets of 8-10 reps.
1-arm Cable Rotational Row
Serving as a progression to the split-stance low cable row described above, the cable rotational row is a fantastic movement to dynamically integrate the functional back line into a more advanced pulling variation with much greater demand placed on the glute max. I view this movement much like the horizontal pull version of a push-press – the lower body drives the action with the upper body coming along for the ride.
Coaching Cues:
Set up a few feet away and perpendicular to a cable stack with feet about a step outside of hip width. The D-handle should be about waste height.
Offset the feet so that the toes of the inside foot (closest to the stack) line up with the middle of the arch on the back foot. This positioning is crucial to maximize external rotation/abduction of the front hip.
Grab the D-handle and allow the load to pull you toward the cable stack. Maintain an erect torso and packed chin throughout. You’re allowed to let the back foot toes come up, but keep the front planted in position.
Once you’re facing the cable stack with arm outstretched, drive hard through the front heelto extend the front hip/knee while simultaneously pulling the D-handle across your torso.
Hold the end position – hip extended/abducted, scapula retracted, and eyes straight ahead – for a count of one before reversing the movement.
Potential Corrections:
I find some clients tend to lead the row with cervical rotation, finishing the movement looking away from the cable stack. These biomechanics are sub-optimal, so make sure to cue a packed chin.
Rowing from this position can prove awkward, as there is a tendency to try and row around your torso. Fight this urge by keeping the cable close to your body – it should be in contact with your shirt as you finish the row.
Achieving full hip extension on the front leg is a must – make sure the movement is initiated by driving the lateral heel into the ground almost as if you were going to step away from the stack.
The benefits of the rotational cable row are numerous, but two stick out in my mind. First, it drives a powerful and dynamic contraction of the functional back line, which as we’ve seen can have ramifications for pelvic/SI stability. Secondly, this variation has huge carryover for some of our rotary sport athletes who rely on the connection between shoulder and contralateral hip to develop force.
As mentioned above, use this as a progression to the split-stance low cable row or with some of your athletic clientele – think in the range of 3-4 sets of 6-8 reps per side.
Conclusion
The functional back lines can be powerful players in creating stability across a region of the body that demands it. In cases of lumbo-pelvic-femoral instability, utilization of these lines can be as crucial for correction as they are for performance enhancement.
I hope the two exercises described above help give some practical application for the functional back lines in action – let me know in the comments!
About the Author
Eric is currently a senior at the University of Georgia majoring in Exercise and Sport Science, with plans to pursue a Doctorate of Physical Therapy. After concluding a Division-1 football career at the Georgia Institute of Technology, Eric has ardently pursued his passion for coaching, garnering experience with clients of all ages and ability levels through internships at both Indianapolis Fitness & Sports Training and Cressey Performance. He can be reached at ecoetter@gmail.com.
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Here's this week's list of recommended strength and conditioning reading:
Thoracolumbar Fascia: An Area Rich with Activity - This was an outstanding guest blog from Patrick Ward on Mike Reinold's site. I'm a big fan of Patrick's writing; he really does an excellent job of blending manual therapy with corrective exercise.
Why Finger Pointing at Carbs is Missing the Point - Brian St. Pierre kicks off what is sure to be a great series by focusing on yet another area in which we overreact on the nutrition side of things.
Why You Need More Strength - In my eyes, this is one of the best things Chad Waterbury has ever written - and Chad is a super-bright guy who has written a lot of excellent stuff.
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Today marks Part 2 of this mini-series covering just how much you can learn from looking at an elbow before writing up a strength and conditioning program. In Part 1, we talked about what can be learned from our first potential scenario, elbow hyperextension. Today, we'll focus on the lessons to be learned from three more scenarios.
Full Elbow Extension, Muscular End-Feel - This simply means that you have all your extension and no "empty" end feel; it eases to muscular stretch (of the elbow flexors).
This is probably the most common presentation pattern in the general population, and you can generally expect these folks to respond to need equal amounts of mobility and stability training. More thorough assessments will give you more information on where to focus your efforts.
Incomplete Elbow Extension, Bony End-Feel - These are, in many cases, guys who did not get full elbow extension back following a surgical procedure. Or, it may just be someone with bone spurs on the underside of the joint that interferes with elbow extension.
It's a bold assumption to make, but these individuals are almost always (in my experience) athletes who have profound limitations in other regions, as poor glenohumeral mobility, rotator cuff function, scapular stabilization, thoracic spine mobility, and terrible tissue quality can all contribute to these kind of issues presenting at the elbow. So, when I see and feel an elbow this "gross," I usually know that I have my work cut out for me. Generally, these guys wind up needing a hearty dose of mobility training, soft tissue work, breathing drills, and longer duration static stretching.
That said, with respect to the elbow itself, these guys need to be cognizant of maintaining every little bit they have. If you've got a 10° elbow extension deficit because of bony changes, you can probably get by. However, if you allow that 10° to become 30° because you pile soft tissue shortness/stiffness on top of it, you could be waiting for some serious problems to come around. To that end, I always encourage these guys to get routine soft tissue work and plenty of static stretching in to maintain whatever elbow extension they still have.
Incomplete Elbow Extension, Muscular End-Feel - These guys look very much like our previous category, but the end-feel has much more "give" to it; it's not a "concrete-on-concrete" end-feel. This is a very good thing, as you know you can work to get it back. This athlete, for instance, got 15° of elbow extension back in a matter of a few minutes following a Graston treatment with our manual therapist and some follow-up stretching.
I wouldn't expect him to maintain 100% of those improvements from treatment to treatment, but over the course of 3-4 bouts, he should get to where he needs to be.
Expect to see some of the same things with the rest of the body, as elbow extension deficits rarely occur in isolation. In throwers, they're usually accompanied by poor glenohumeral internal rotation on the throwing side, poor hip internal rotation on the front leg, and a host of other stiffness/shortness issues. In the general population, you see them in people who are locked up all over - especially in people who sit at computers all day long.
That wraps up our look at four elbow presentation patterns and what they may mean for your strength and conditioning programs and corrective exercise approaches. For more information, check out the Everything Elbow In-Service, an affordably priced 32-minute in-service where half of all proceeds go to charity.
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This marks the third and final installment of my review of Muscle Imbalances Revealed - Upper Body. In case you missed the first two parts, be sure to check out Part 1 (Dean Somerset) and Part 2 (Jeff Cubos). In this third installment, I'll cover the contributions from Tony Gentilcore and Rick Kaselj. For the record, me combining these two into one installment in no way reflects how I felt about their presentations; I am just getting ready to leave for my anniversary this weekend, and need to cover them both quickly before I head out!
Tony, as many of you know, is a long-time friend of mine and works with me at Cressey Performance - and I've been harassing him for years now to put out a product. He's a great coach whose ideas and skills deserve to be showcased to a larger audience, and I'm glad that he finally got around to putting his name on something!
That said, it was a little tougher to evaluate Tony because we literally spend so much time together that our brains are very "synced up" - meaning that it'd tough for him to throw something new at me that we haven't already integrated at CP. That said, some highlights of Tony's presentation:
1. I think he did a good job of distinguishing between how we program both reactively and proactively for upper extremity issues at Cressey Performance. How one trains someone with symptoms is, in many cases, remarkably different from that same individual would be trained in the absence of those symptoms - even if the same movement impairments are present. This is a crucial area of understanding for trainers who may want to get more involved on the corrective exercise side of things.
2. Tony outlines some of our horizontal pulling and scapular stabilization progressions. I think the biggest take home is understanding that different people need different progressions. Some folks with completely imbalanced programs can thrive simply from going to loads more horizontal pulling. Others may be doing plenty of horizontal pulling, but doing it incorrectly because they lack the appropriate recruitment patterns. These folks need very targeted scapular stabilization drills to get the ideal "big bang" effect of rowing variations. The low-level activation drills become the warm-ups to groove the movement patterns, and the horizontal (and vertical) pulling helps to make those patterns part of the bigger picture.
3. Above all else, I feel that the strongest value of Tony's presentation is in the cues. If you're an up-and-coming coach and need to learn some excellent cues to get your clients/athletes to not just pick up movements, but pick them up optimally, then this is a great purchase for you.
4. Last, but certainly not least, Tony provides some sample programming templates to demonstrate how everything fits together in a comprehensive strength training program. It's one thing to hear about principles and theories, but another thing altogether to appreciate how they all fit together in a comprehensive strength and conditioning program. He provides several examples in this regard that'll help you get comfortable with piecing everything together.
Next up was Rick Kaselj, the man responsible for bringing all these minds together.
Here were some of my favorite points from Rick's presentations:
1. People seem to think of clavicle as motionless. In reality, from 0-90° abduction, you only need 5-10° of clavicular upward rotation. From 90-180° of abduction, you need 20-25° of clavicular upward rotation. This clavicular movement can be affected by the muscles that attach directly to it (pectoralis major) or by those that indirectly impact it (muscles attaching to the scapula and/or humerus).
Now, think about where most people with acromioclavicular joint pain wind up with symptoms during abduction: the final 30° - which is known as the painful arc. Any surprise that the symptoms occur at the point where the most amount of clavicular upward rotation is needed? Nope.
Keep in mind that poor clavicular positioning can also impact sternoclavicular joint function, too. Double whammy, if you're "stuck."
2. Rick did a good job of showing the checks and balances that occur within the rotator cuff musculature. Shirley Sahrmann has pointed it out in her work, but I think it gets overlooked.
The supraspinatus creates a compression force into glenoid fossa. The subscapularis, teres minor, and infraspinatus produce an inferior directed translation force on the humeral head. The infraspinatus and teres minor also externally rotate the humeral head in frontal plane so that the greater tubercle doesn’t clog up the subacromial space.
In other words, you get a pull in, down, and into the “right kind of rotation (external rotation increases the subacromial space, whereas internal rotation closes it down).
One point I’d add to strengthen Rick’s case even further is that the subscapularis also has a posterior pull on the humeral head. Without adequate subscapularis function during internal rotation, the pectoralis major can take over and draw the humeral head forward, causing anterior joint capsule irritation.
3. Rick's last presentation focused on the neck, a complex area to understand for most fitness professionals. He started off by emphasizing to get neck issues checked out, as they can be very serious. His presentation then emphasized training strategies to prevent neck pain and work around it if it's present. Accurately, Rick noted that some of the big players on this front were:
a) breathing - diaphragmatic or overuse of accessory respiratory muscles?
b) posture - forward head posture or neutral spine?
c) tissue quality
d) range of motion (particularly the thoracic spine)
e) strength (particularly the deep neck flexors)
f) scapular stability
g) rotator cuff function
Sometimes, the easiest way to address an issue (or prevent it) is to look at what happens a joint below (or above). Of course, when you're dealing with neck issues, always refer out to a qualified professional first.
This wraps up my three-part review of Muscle Imbalances Revealed - Upper Body. As I'm sure you can tell by now, I'm a big fan of this resource and highly suggest you add it to your library. It's on sale at a great price, so don't delay in picking up a copy if this is up your alley. With the money-back guarantee Rick's made available, you can't go wrong.
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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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Last summer, Rick Kaselj sent me the eight webinars from his new collaborative product, Muscle Imbalances Revealed - Upper Body, to review. I was really excited to check them out, as I'd enjoyed the initial version of the Muscle Imbalanced Revealed (MIR) series.
Unfortunately, my enthusiasm to watch it was overtaken by a crazy busy summer schedule and I only got around to looking it over a few months later. I regretted that it took me so long, as I really enjoyed what I viewed. That said, I thought I'd use today's piece to comment on my favorite take-homes from one presenter, Dean Somerset, who I thought did an exceptional job. Be sure to read through to the end, as Rick has a great discount on the entire Muscle Imbalances Revealed series in play this week.
Anyway, Dean's presentation was a pleasant surprise for me in the initial Muscle Imbalances Revealed collection, as I had not been familiar with his work prior to the product. As it turned out, he did a great job of delving into the fascial system, which is no easy task, considering that even the foremost experts on "fascial fitness" recognize that we still have a tremendous amount to learn in this regard.
His presentations this time around didn't deviate from that initial trend, either; I really enjoyed them for a number of reasons; here are my top seven:
1. Dean did the best job of outlining a clear rationale for foam rolling that I've seen in the industry thus far - and did so in a very layman-friendly format. In highlighting the role of Ruffini endings - which are slow adapting, low threshold mechanoreceptors that respond to direct pressure (like foam rolling) - Dean showed that they can decrease tone of tissues in the presence of stretch and inhibit sympathetic nervous system activity.
2. Another way he made his point was with a great analogy. Much like we have fast-twitch and slow-switch muscles, we have receptors that may act in similar ways. On one hand, we have "fast twitch" receptors like golgi tendon organs and muscle spindles that function with the musculotendinous units. On the other hand, we have "slow twitch" receptors like Ruffini endings and Pacini fibers that exist in the fascial tissues. Because the muscules, tendons, ligaments, and fascial tissues are really all continuous with each other, there exists a great amount of interaction between these slow and fast twitch receptors - much like the interaction of different muscle fiber types. They are all responsive - in both positive and negative directions - to chronic training stimuli - and sitting on your arse in front of a computer screen for years on-end.
3. Dean noted that fascia carries an electrical charge that is never off; it’s just "on" at different levels. Certainly, it's far more "on" with exercise than at rest - and it's the reason that contractions can last for hours post-exercise. If you have an individual who isn't able to tone down (pun intended) that contraction in the post-exercise period, you're likely dealing with someone who'll have chronic movement impairments. If this electrical charge is always present, it can ultimately alter movement to the point that joint structure can actually change (think of the reactive changes in an acromion process, as an example). Appropriate training enables one to get the benefits of exercise without creating negative long-term adaptation in this regard.
4. What is appropriate training for fascial fitness, though? Dean cites the same seven components to an appropriate program that I outlined here, but he does so with a very valuable qualifications: adequate hydration status is absolutely crucial to making the most of any training status. Repeated stretch bouts during the warm-up period allows for more water content for the fascia; each successive stretch improves hydration to allows for better elasticity and tensile strength, which in turn provides better joint stability and force production.
5. I like guys who solve problems. I love using spiderman variations in our warm-ups, as they are great hip mobility drills. Unfortunately, though, they don't always look so hot when you have someone with poor thoracic mobility trying to get their elbow down to the inside of their thighs. Many folks will wind up rounding over - which is certainly not ideal. Imagine Quasimodo doing this drill and you'll get what I mean.
Dean's solution - which provided me with a "why didn't I think of that?" moment - was to bring the thigh up to the torso. In other words, do the forward lunge component onto a 12-inch plyo box so that folks can get the hip mobility benefits without compromising thoracic positioning. Sweet.
6. I thought Dean did an excellent job of highlighting that it can take years to improve fascial fitness substantially. Super-immobile individuals usually take years and years of either sedentary lifestyles or terrible training habits to get to that point, and unless they're ready to dramatically overhaul their mindsets and daily habits, it can be like swimming upstream when correcting bad posture. Be consistent when addressing these limitations, but also be patient.
7. I love the fact that he commented on all the normal roles of the core - force transfer, resisting movement, returning from a position outside of neutral - but also highlighted that optimal core function is essential for optimal respiratory function. Anyone who reads this blog regularly knows that we use a lot of specific breathing drills, so I was glad to see a bright dude in the industry backing me up on this one!
This is really just the tip of the iceberg with respect to not only Dean's two presentations, but the entire Muscle Imbalances Revealed - Upper Body package, which also includes webinars from Rick Kaselj, Jeff Cubos, and my business partner, Tony Gentilcore. I'll highlight a few more of my favorite takeaways in my next post, but in the meantime, I'd strongly encourage you to check this great resource out for yourself.
To sweeten the deal, Rick has put the entire Muscle Imbalances Revealed product on sale for $210 off the normal price through tomorrow (Friday) at midnight. It's a fantastic deal on a product that I highly recommend - and one that comes with a 60-day money-back guarantee, plus several cool bonus features (including two interviews Rick did with me). Click here to check it out.
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When it comes to corrective exercise programs, everyone simply wants to know "what" is and isn't included - and rightfully so. Picking the right strength exercises and mobility drills - and contraindicating others - is absolutely crucial to making sure you get folks to where they want to be.
However, very rarely will you hear anyone specifically discuss the "when" in these scenarios, and as I'll demonstrate in today's piece, it's likely just as crucial to get this aspect correct.
To begin to illustrate my point, I'm going to reuse a quote from an article I wrote a few weeks ago, Correcting Bad Posture: Are Deadlifts Enough?, on the Law of Repetitive Motion :
Consider the law of repetitive motion, where “I” is injury to the tissues, “N” is the number of repetitions, “F” is the force of each repetition as a percentage of maximal strength, “A” is the amplitude (range of motion) of each repetition, and “R” is rest. To reduce injury to tissues (which negative postural adaptations can be considered), you have to work on each of the five factors in this equation.
You perform soft tissue work – whether it’s foam rolling or targeted manual therapy – on the excessively short or stiff tissues (I). You reduce the number of repetitions (length of time in poor posture: R), and in certain cases, you may work to strengthen an injured tissue (reduce F). You incorporate mobility drills (increase A) and avoid bad postures (increase R).
What I failed to mention a few weeks ago, though, was that the sequencing of these corrective modalities must be perfect in order to optimize the training/corrective effect and avoid exacerbating symptoms. Case in point, we recently had a client come to us as a last resort with chronic shoulder issues, as he was hoping to avoid surgery. Physical therapy had made no difference for him (aside from shrinking his wallet with co-pays), and following that poor outcome, he'd had a similar result with soft tissue treatments twice a week for six weeks. In a single four-week program, we had him back to playing golf pain free. What was the difference?
In the first physical therapy experience, he'd been given a bunch of traditional rotator cuff and scapular stabilization exercises. There had been absolutely no focus on soft tissue work or targeted mobility drills to get the ball rolling. In other words, all he did was improve stability within the range of motion he already had. In the equation above, all he really worked on was reducing the "F" by getting a bit stronger.
In his soft tissue treatment experiences, he felt a bit better walking out of the office, but ran into a world of hurt when his provider encouraged him to "just do triceps pressdowns and lat pulldowns" for strength training. In other words, this practitioner worked on reducing "I" and increasing "A," but totally missed the boat with respect to enhancing strength (reducing "F") and increasing rest ("R") because of the inappropriate follow-up strength exercise prescription. Doh!
What did we do differently to get him to where he needed to be? For starters, he saw Dr. Nate Tiplady, a manual therapist at CP, twice a week for combination Graston Technique and Active Release treatments (reducing "I") at the start of his training sessions. He followed that up with a specific manual stretching, positional breathing, and mobility exercise warm-up program (increase "A") that was designed uniquely for him. Then, he performed strength training to establish stability (decrease "F") within the new ranges of motion (ROM) attained without reproducing his symptoms (decreasing "N" and increasing "R).
The sequencing was key, as we couldn't have done some of the strength exercises we used if we hadn't first gotten the soft tissue work and improved his ROM. He may have had valuable inclusions in his previous rehabilitation efforts, but he never had them at the same time, in the correct sequence.
This thought process actually closely parallels a corrective exercise approach Charlie Weingroff put out there much more succinctly in his Rehab = Training, Training = Rehab DVD set:
Get Long. Get Strong. Train Hard.
Keep in mind that there are loads of different ways that you can "get long." You might use soft tissue work (Active Release, Graston Technique, Traditional Massage, etc.), positional breathing (Postural Respiration Institute), mobility drills (Assess and Correct), manual stretching, or any of a host of other approaches (Mulligan, DNS, Maitland, McKenzie, etc). You use whatever you are comfortable using within your scope of practice.
When it's time to "get strong," you can do so via several schools of thought as well - but the important thing is that the strength exercises you choose don't provoke any symptoms.
It's interesting to note that this corrective exercise approach actually parallels what we do with our everyday strength and conditioning programs at Cressey Performance - and what I put forth in Show and Go: High Performance Training to Look, Feel, and Move Better. We foam roll, do mobility warm-ups, and then get cracking on strength and stability within these "acutely" optimized ranges of motion to make them more permanent.
Earlier this week, I received an email from a reader who was wondering whether deadlifts executed in perfect technique could be all one needs for correcting “bad posture.” It got me to thinking about just how ideal the deadlift really is. Working from the ground up: 1.You’re teaching folks to keep their weight back on their heels, and (ideally) executing the lift in minimalist or no footwear – thereby increasing dorsiflexion range-of-motion. 2. You increase stiffness in the hamstrings and glutes, which extend the hip and posteriorly tilt the pelvis.
3. You get a great co-contraction of all the muscles of the core to effectively handle all shear and compressive forces on the spine. In the process, you lock the rib cage to the pelvis and establish a solid zone of apposition (learn more here) for the diaphragm to function optimally. 4. You establish stiffness in the thoracic erectors, thereby minimizing a thoracic kyphosis. As I noted a few weeks ago, stiffness can be a great thing. 5. You pull the scapulae into retraction and depression, thereby increasing stiffness in the lower trapezius. 6. You pack the neck, ingraining the ideal cervical posture.
It’s no surprise that the deadlift is an outstanding strength exercise when it comes to correcting bad posture. However, is it enough? I don’t think so. Why? Well, first, you have to remember that postural considerations must be multiplanar. Just because we’re moving in the right direction in a bilateral, sagittal plane motion doesn’t mean that we’re ironing out issues in the frontal and transverse planes. Is there adequate control of femoral internal rotation and adduction by the hip external rotators/abductors? Do you see a big rib flair on the left side and a low shoulder on the right? Does an individual have adequate thoracic rotation to match up with the thoracic extension that’s been improved?
We really never work in a single plane during functional activities; life is a combination of many movements. Bad posture – to me at least – isn’t just characterized by how someone stands in the anatomical position, but how he or she is gets into specific positions. In other words, “posture” isn’t much different than “mobility.” Very simply, these terms imply stability within a given range-of-motion. Second, consider the law of repetitive motion, where “I” is injury to the tissues, “N” is the number of repetitions, “F” is the force of each repetition as a percentage of maximal strength, “A” is the amplitude (range of motion) of each repetition, and “R” is rest. To reduce injury to tissues (which negative postural adaptations can be considered), you have to work on each of the five factors in this equation.
You perform soft tissue work – whether it’s foam rolling or targeted manual therapy – on the excessively short or stiff tissues (I). You reduce the number of repetitions (length of time in poor posture: R), and in certain cases, you may work to strengthen an injured tissue (reduce F). You incorporate mobility drills (increase A) and avoid bad postures (increase R). Deadlifts certainly work in some of these capacities, but to say that they alone are enough overlooks the fact that adequate “abstinence” from poor postures is essential to making things work. To easily appreciate this, just ask: “Which is easier to address, an anterior pelvic tilt or a thoracic kyphosis?” The answer is unquestionably “thoracic kyphosis.” Why? It’s a lot easier to adjust your upper extremity posture than it to change the way your pelvis is positioned during weight-bearing. Every step re-ingrains faulty posture and “cancels out” your deadlifts unless you’re really careful. At the end of the day, deadlifts are arguably the single-most effective out there for correcting bad posture. However, in isolation, they simply aren’t enough, as you need everything from multiplanar mobilizations and strength exercises, to manual therapy, to breathing drills in combination with avoidance of bad posture during your daily life. These additions take “effective” and make it “optimal.”
