Home Posts tagged "Increase Strength" (Page 2)

How I’m Breaking Out of My Training Rut: The Lean Hybrid Muscle Strength and Conditioning Program

The baseball off-season is a lot of fun for me, but it also means crazy long hours, loads of competing demands, and quite a bit of stress.  To take it a step further, though, most of my long hours are spent on my feet on the floor at Cressey Performance, which isn’t exactly conducive to making progress in a training program.  Topping it off, we've gotten about 470 feet of snow in the Northeast this winter, which makes us all want to simply go into hibernation!

While I’ve gotten all my gym sessions in during this time, the reality is that in many cases, they were a lot more like “working out” than they were “training.”  And, although I haven’t wasted away, it’s never a good sign when someone you haven’t seen for a few months asks you if you’ve lost weight when you haven’t been trying to do so – and that happened a few weeks ago. The end result?  I’m under 190 for the first time in over two years – and sadly, I’m not really any leaner (or stronger, for that matter). Something clicked two weekends ago, though.  Since the gym is closed on Sundays, I find it’s the best day for me to go in refreshed and get in a good lift.  Thanks to a little rest, loud music, and a good training partner, I sumo deadlifted 500 for a set of five.  And, it felt damn good! It also made me realize how much of a pansy I’d been in the gym for the two months prior.  With that realization, I headed home to put a program for myself on my to-do list. The next morning, I woke up anticipating writing that strength and conditioning program (along with about a dozen others!), but before I could get to it, I found an email from Mike Westerdal waiting for me.  And that email included an advanced copy of the new product he created with Elliott Hulse: Lean Hybrid Muscle.

For those who don’t know of Mike, he’s a strong dude, with competition bests of 640 squat, 630 bench, and 600 deadlift at a body weight of 242.  And, through his website, criticalbench.com, he’s helped thousands of guys bust through their bench press plateaus, not to mention interacted with and programmed for a lot of experienced lifters.  Elliott is no quack, either; he is a professional strongman and runs a hardcore gym in Tampa, FL. I’ve often reminded my readers that that if you need a contract written, you’d go to a lawyer.  If you needed your taxes done, you’d go to an accountant. Well, I’m also here to say that if you need a program to kick you in the arse when you’ve been training like a sissy, you go to qualified lifters and coaches who have consistently helped people get strong, burn fat fast, and put on muscle.  And that’s what I did.

And, I’ve definitely received that kick in the arse.  The past 10 days of training have been some of the more challenging I’ve encountered in over a decade of lifting.  And, just as Westerdal assured me, it has been a nice change of pace from the powerlifting-oriented work I’ve done in the past.  Here’s what I like about the program: 1. Concurrent Periodization – it might be high volume, but that doesn’t mean that you won't be able to increase strength.  If your goal is changing body composition – and not just dropping fat or building muscle exclusively – it’s a great resource.  Anybody can get you to lose weight with a high volume program, but not everyone can help you maintain or even increase strength and build muscle mass in the process. 2. Video Demonstrations – Mike and Elliott have links to every exercise featured in this strength and conditioning program, so if you don’t recognize one, you can quickly and easily check it out.  I know my stuff in this regard, but it was helpful when I came across a few new ones that these guys must have invented themselves. 3. Versatility – I’m fortunate to have quite a few extra goodies – sledgehammers, farmer's walks handles, tires, turf, kettlebells, sleds, slideboards, kegs – at my fingertips, and Mike and Elliott are all about incorporating what you’ve got into the strength training program.  I’ve used it to modify the interval work included in the program.  They also give you a wide variety of strength exercises from which to choose so that you can work around injuries or specialize on your weak areas. The benefits certainly go well beyond these three points (the nutrition component/meal plans are excellent, for instance), but in the interest of brevity, I’d highly encourage you to check out Lean Hybrid Muscle.  It actually makes for a great follow-up to Show and Go, for those of you who are just wrapping up that program. For more information, head over to the Lean Hybrid Muscle Website. Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
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Weight Training Programs: You Can’t Just Keep Adding

Can I just add some sets and reps of direct arm work?

How about cardio?  Would a few 30 minutes interval training sessions work?

What if I did extra rotator cuff stuff every day?  Just a little tubing, you know?

I’m going to add two extra days of calves, abs, and forearms.  It shouldn’t be a problem, right?

These are just a few of the common questions I receive from people for whom I write strength training programs (plus all the other components of a comprehensive program).  And, it's these kind of questions that make me appreciate just how challenging it is to teach someone how to effectively write strength and conditioning programs - and why everyone gets all flustered when they first start writing training plans.

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Very simply, most people don't understand the concept of competing demands.  Everybody wants to add something to their weight training program - but not everyone is willing to take something away in order to do so.

How many elite powerlifters or Olympic lifters do you know who regularly do interval training as part of their quest to get strong?

How many elite triathletes do you know who just want to add a few sets of biceps curls along the road to improving endurance performance?

The answer is, of course, none.  And, it's because - whether they appreciated it or not - these high-level athletes were effectively managing competing demands.

In some cases, different fitness qualities compete with one another; an example would be extensive aerobic training while trying to increase strength.  You can't get strong quickly if you're doing hours of cardio each week.  Somewhat similarly, in an overhead throwing population, it's challenging to regain shoulder internal rotation and flexion range of motion (ROM) and pec minor length when an athlete is throwing - so you have to do your best to get the ROM during down-time in their training year.

In other cases, you may have multiple qualities that contribute to an overall training effect, but you can't prioritize all of them at once.  For example, my professional baseball clients need a host of different qualities to be successful, but the body has limited recovery capacity, so their training programs have to target their most readily apparent weaknesses - and do so at the right time of year.  We cut back on the medicine ball and upper body strength exercises and volume when their throwing volume increases.

And, we can't do as much lower body strength exercises when guys are doing more sprinting and change-of-direction work.  Stress is stress, so you have to apply it judiciously.

Taking this into consideration, I think that one of the best drills for someone looking to get better at writing programs is to take a full-on comprehensive weight training program with supplemental conditioning/movement training where someone is training 6x/week - and then cut it back to 3x/week.  Assume that there is a whole lot of of "other" stress in this athlete/client's life - whether it's work, illness, family issues, or just being an in-season athlete - and figure out how to scale a program back in order to make it productive and safe for that individual.

Lots of factors have to be taken into account: the volume and intensity that individual can handle, how long each session can last, and what specific factors one needs to address most.  A good example to check out would be the differences between the 4x/week, 3x/week, and 2x/week weight training programs (and accompanying optional supplemental sessions) in The High Performance Handbook.

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There are loads of factors you have to take into account when you write a comprehensive training plan - from the weight training program, to soft tissue work, to mobility work, to movement training, to energy systems training.  The most important consideration, though, is how they all fit together synergistically to make the program as a whole effective.

So, try the challenge I listed above and see how you do; I think you'll find that it's a lot harder to subtract than it is to add to your weight training programs.

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Lose Fat, Gain Muscle, Get Strong: Eric Cressey’s Best Articles of 2010

Show and Go: High Performance Training to Look, Feel, and Move Better - This was obviously my biggest project of 2010.  I actually began writing the strength and conditioning programs and filming the exercise demonstration videos in 2009, and put all the "guinea pigs" through the four-month program beginning in February.  When they completed it as the start of the summer rolled around, I made some modifications based on their feedback and then got cracking on writing up all the tag along resources.  Finally, in September, Show and Go was ready to roll.  So, in effect, it took 10-11 months to take this product from start to finish - a lot of hard work, to say the least.  My reward has been well worth it, though, as the feedback has been awesome.  Thanks so much to everyone who has picked up a copy.

Optimal Shoulder Performance - This was a seminar that Mike Reinold and I filmed in November of 2009, and our goal was to create a resource that brought together concepts from both the shoulder rehabilitation and shoulder performance training fields to effectively bridge the gap for those looking to prevent and/or treat shoulder pain.  In the process, I learned a lot from Mike, and I think that together, we brought rehabilitation specialists and fitness professionals closer to being on the same page.

Why President Obama Throws Like a Girl - A lot of people took this as a political commentary, but to be honest, it was really just me talking about the concept of retroversion as it applies to a throwing shoulder - with a little humor thrown in, of course!

Overbearing Dads and Kids Who Throw Cheddar - This one was remarkably easy to write because I've received a lot of emails from overbearing Dads asking about increasing throwing velocity in their kids.

What I Learned in 2009 - I wrote this article for T-Nation back at the beginning of the year, and always enjoy these yearly pieces.  In fact, I'm working on my 2010 one for them now!

What a Stressed Out Bride Can Teach You About Training Success - I wrote this less than a month out from my wedding, so you could say that I had a good frame of reference.

Baseball Showcases: A Great Way to Waste Money and Get Injured - In case the title didn't tip you off, I'm not much of a fan of baseball showcases.

Cueing: Just One Piece of Semi-Private Training Success - Part 1 and Part 2 - These articles were featured at fitbusinessinsider.com.  I enjoy writing about not only the training side of things, but some of the things we've done well to build up our business.

Three Years of Cressey Performance: The Right Reasons and the Right Way - This might have been the top post of the year, in my eyes. My job is very cool.

How to Attack Continuing Education in the Fitness Industry - Here's another fitness business post.

Want to Be a Personal Trainer or Strength Coach?  Start Here. - And another!

The Skinny on Strasburg's Injury - I hate to make blog content out of someone else's misfortune, but it was a good opportunity to make some points that I think are very valid to the discussion of not only Stephen Strasburg's elbow injury, but a lot of the pitching injuries we see in youth baseball.

Surely, there are many more to list, but I don't want this to run too long!  Have a safe and happy new year, and keep an eye out for the first content of 2011, which is coming very soon!

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Weight Training Programs: Product Reviews

As you probably know, when I come across high-quality products that I really enjoy that I think will be a good fit for my audience, I am thrilled to be able to write up thorough reviews for you.  This way, it not only gives some love to these products’ deserving creators (and learn myself!), but also gives you more background to make sure that it’s a good fit for you if you opt to purchase it. To that end, I wanted to use today's post to highlight the top seven products I reviewed in 2010.  Considering that I receive literally dozens of products in the mail each year to review (I still have a stack left to cover), these represent not just the cream of the crop, but the ones where I actually had the time and inclination to write something up.  Check them out by category: For the Fitness Professionals: Muscle Imbalances Revealed - This set of six webinars can be viewed conveniently from the comforts of your own home.  No travel or shipping charges to ruin your day!  Check out my review Product Review: Muscle Imbalances Revealed.

The Single-Leg Solution - Mike Robertson is a great friend of mine - but that's not the only reason I liked this product.  It was very thorough, well-researched and written, and offered some excellent coaching cues that any fitness professional would be wise to study up on.  My review is The Single-leg Solution: Detailed Product Review.

Rehab=Training, Training=Rehab - This long-awaited debut product from Charlie Weingroff was just released in the last few weeks, and it certainly didn't disappoint.  Even if you don't pick up a copy, you'll learn quite a bit from my two-part review: Rehab=Training, Training=Rehab: Top 10 Takeaways - Part 1 and Rehab=Training, Training=Rehab, Top 10 Takeaways - Part 2.

Movement - I just realized that I never got around to writing up a review of this great book from Gray Cook, but that doesn't mean that it wasn't an excellent read.  I HIGHLY recommend it.

For the Fat Loss Enthusiasts (then again, can you really be enthusiastic about having to lose fat?): Body of Fire - This fat loss resource from Chad Waterbury was great for the masses - especially if you only have minimal equipment at your fingertips.  I loved the focus on movement rather than just crazy high volume training.  Check out my interview with him: Waterbury on Why Most Fat Loss Plans Fail Miserably - and a Better Approach.

Final Phase Fat Loss - John Romaniello's first product is a great fit for those trying to lose those stubborn last few pounds of body fat, especially if they are masochists who enjoy a very challenging program!  For more information, check out Final Phase Fat Loss: An Interview with John Romaniello.

For the Athletes: The Truth About Quickness - I'm a big fan of Kelly Baggett, and he collaborated with Alex Maroko to create an excellent resource for up-and-coming athletes.  I gave Kelly the spotlight with three pieces: How to Get Quick...Quickly: An Interview with Kelly Baggett, and The 5 Most Common Speed, Quickness, and Explosiveness Problems in Athletes Part 1 and Part 2.

That wraps it up for the best of 2010 product reviews; hopefully you can reward yourself with some late holiday shopping by picking up one or more of these items; you won't regret it.  I'll be back tomorrow with the best videos of 2010.

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Weight Training Programs: 5 Reasons You Aren’t Getting Stronger

Like just about all lifters, I got a lot bigger and stronger in my first 1-2 years of training in spite of the moronic stuff that I did in my weight training programs.  In hindsight, I was about as informed as a chimp with a barbell – but things worked out nonetheless.  That is, at least, until I hit a big fat plateau where things didn’t budge.

Think I’m joking?  Sadly, I’m not; otherwise, I wouldn’t have spent about 14 months trying to go from a 225-pound bench to 230.  When you’re finished laughing at my past futility (or about how similar it sounds to your own plight), we’ll continue.

Ready?  Good – because self-deprecating writing was never a strong suit of mine.  I have, however, become quite good at picking heavy stuff off the floor – to the tune of a personal-best 660-pound deadlift at a body weight of 188.

My other numbers aren't too shabby, either, but this article isn't about me; it's about why YOU can't necessarily get strong as fast as you'd like.  Let's look at a few mistakes many people make in their quest to increase strength.  Sadly, I made most of these myself along the way, so hopefully I can save you some frustration.

Reason #1: You're only doing what's fun - and not what you need.

As you could probably tell, deadlifting is a strength of mine - and I enjoy it.  Squatting, on the other hand, never came naturally to me.  I always squatted, but I'd be lying if I didn't say that it took the back seat to pulling heavy.

Eventually, though, I smartened up and took care of the issue - by always putting squatting before deadlifting in all my lower-body weight training sessions (twice a week).

In addition to me dramatically improving my squat, a funny thing happened: I actually started to love to squat.  Whoever said that you can't teach an old dog (or deadlifter) new tricks didn't have the real scoop.

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Reason #2: You're not taking deload periods.

One phrase of which I've grown quite fond is "fatigue masks fitness."  As a little frame of reference, my best vertical jump is 37" - but on most days, I won't give you anything over 34.5" or so.  The reason is very simple: most of your training career is going to be spent in some degree of fatigue.  How you manage that fatigue is what's going to dictate your adaptation over the long-term.

On one hand, you want to impose enough fatigue to create supercompensation - so that you'll adapt and come back at a higher level of fitness.  On the other hand, you don't want to impose so much fatigue that you dig yourself a hole you can't get out of without a significant amount of time off.

Good weight training programs implement strategic overreaching follows by deloads - periods of lower training stress - to allow for adaptation to occur.  You can't just go in and hit personal bests in every single training session - and if you try, you're going to wind up exhausted.

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Reason #3: You’re not rotating movements.

It never ceases to amaze me when a guy claims that he just can’t seem to increase strength on his bench press (or any lift, for that matter), and when you ask him what he’s done to work on it of late, and he tells you “bench press.” Specificity is important, folks, but if you aren’t rotating exercises in your strength training program, you’re missing out on a wildly valuable training stimulus: rotating strength exercises.

While there is certainly a place for extended periods of specificity (Smolov squat cycles, for instance), you can’t push this approach indefinitely.  Rotating my heaviest strength exercises was one of the most important lessons I learned along my journey.  In addition to helping to create adaptation, you’re also expanding your “motor program” and avoiding overuse injuries via pattern overload.

I’m not saying that you have to overhaul your entire strength and conditioning program each time you walk into the gym, but there should be some semi-regular fluctuation in exercise selection.  The more experienced you get, the more often you’ll want to rotate your strength exercises (I do it weekly).  We generally rotate assistance exercises every four weeks, though.

Reason #4: You’re inconsistent with your training.

I always tell our clients from all walks of life that the best strength and conditioning programs are ones that are sustainable.  I’ll take a crappy strength training program executed with consistency over a great program that’s only done sporadically.  In my daily practice, this is absolutely huge for professional athletes who need to maximize progress in the off-season; they just can’t afford to have unplanned breaks in training if they want to improve from year to year.

If a strength and conditioning program isn’t conducive to your goals and lifestyle, then it isn’t a good program.  That’s why I went out of my way to create 2x/week, 3x/week, and 4x/week strength training options – plus various supplemental conditioning options and a host of exercise modifications – when I pulled The High Performance Handbook together; I wanted it to be a very versatile resource.

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Likewise, I wanted it to be safe; a program isn’t good if it injures you and prevents you from exercising.  Solid programs include targeted efforts to reduce the likelihood of injury via means like mobility warm-ups, supplemental stretching recommendations, specific progressions, fluctuations in training stress, and alternative strength exercises (“plan B”) in case you aren’t quite ready to execute “Plan A.”

For me personally, I attribute a lot of my progress to the fact that at one point, I actually went over eight years without missing a planned lift.  It’s a bit extreme, I know, but there’s a lesson to be learned.

Reason #5: You’re using the wrong rep schemes.

Beginners can make strength gains on as little as 40% of their one-rep max.  Past that initial period, the number moves to 70% – which is roughly a 12-rep max for most folks.  Later, I’d say that the number creeps up to about 85% – which would be about a 5-rep max for an intermediate lifter.  This last range is where you’ll find most people who head to the internet for strength training information.

What they don’t realize is that 85% isn’t going to get the job done for very long, either.  My experience is that in advanced lifters, the fastest way to build strength is to perform singles at or above 90% of one-rep max with regularity.  As long as exercises are rotated and deloading periods are included, this is a strategy that can be employed for an extended period of time.  In fact, it was probably the single (no pun intended) most valuable discovery I made in my quest to get strong.

I’m not saying that you should be attempting one-rep maxes each time you enter the gym, but I do think they’ll “just happen” if you employ this technique.

To take the guesswork out of all this and try some programming that considers all these crucial factors (and a whole lot more), check out my resource, The High Performance Handbook.

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To Squat or Not to Squat

To Squat or Not to Squat?

I’m going to let you in on a little secret: not all our athletes squat, and the older and more banged up they get, the less they squat.

We’ve all been told that “squats are king” when it comes to leg development, and the carryover of squat variations to athletic performance cannot be overstated. Squats even have a place in corrective exercise settings; I’ve frequently used box squats to help iron out quad-dominant vs. hip dominant imbalances. And, the eccentric strength attained from squatting is of undeniable importance in active deceleration in sports – thus taking the stress off of the passive restraints like menisci, ligaments, and discs. The list of benefits goes on and on.

As with anything in life, though, there’s a downside: you get some pretty crazy compressive loads on the spine when you get stronger:

Cappozzo et al. found that squatting to parallel with 1.6 times body weight (what I’d call “average” for an ordinary weekend warrior who lifts recreationally) led to compressive loads of ten times body weight at L3-L4 (1). That’s 7000N for a guy who weighs about about 150.

Meanwhile, in a study of 57 Olympic lifters, Cholewicki et al. found that L4-L5 compressive loads were greater than 17,000N (2). It’s no wonder that retired weightlifters have reduced intervertebral disc heights under MRI.

The spine doesn’t buckle until 12,000-15,000N of pressure is applied in compression (or 1,800-2,800N in shear) – so it goes without saying that we’re playing with fire, to a degree.

Fortunately, our body can adapt reasonable well – but not if you train like an idiot and ignore marked inefficiencies. Think of it this way:

Roughly 3/4 of all athletes have disc bulges/herniations that go completely undiagnosed.

It’s estimated that 4.4% of six-year olds have spondylolysis (lumbar fracture[s] (3)).

Presence of spondylolyis is estimated at 15-63% in ordinary athletes (highest is among weightlifters) – yet only 50-60% of those diagnosed under imaging actually report lower back pain (4).

This isn’t the only place in the body where this happens. If you’re a pitcher, you’re going to have a ripped up shoulder labrum – but that doesn’t mean that you’re symptomatic. If you’re a pitcher with a junk labrum AND a lack of internal rotation range-of-motion, though, chances are that you’re hurtin’.

What does this tell us? Inefficiency is as important – and possibly MORE important – than pathology.

So, let’s assume for a second that everyone in the world had spondylolysis, disc bulges, and explosive diarrhea (just for shits and giggles – pun intended, if you’d like). To take it a step further, though, let’s say that everyone insisted that they squat and we didn’t have the option of saying “no.” What would I do, in this instance?

1. Avoid Lumbar Flexion. The aforementioned Cappozzo et al. study demonstrated that as lumbar flexion increased under load, compressive load also increased (1). In other words, if you aren’t mobile enough to squat deep, you need to squat a little higher. I’ll use light “tap and go” (to a box) variations in my strength training programs to teach proper depth to those who lack flexibility.

2. Optimize hip range-of-motion. If your hips are stiffer than your lumbar spine, you’ll move at your spine first. Those who move at the lumbar spine get hurt; spine range of motion and power are highly correlated with injury risk. Some schmucks named Cressey and Robertson made a DVD called Assess and Correct that seems to help on this front… I incorporate these in all of my weight lifting programs.

3. Optimize ankle range-of-motion. Those with poor ankle mobility will turn the toes out considerable when they squat in order to make up for a lack of dorsiflexion ROM. When they can’t externally rotate any more, they’ll start to flex at the lumbar spine (mostly because their hip mobility is also atrocious).

4. Optimize thoracic spine range-of-motion. Look at the guys who are lifting the biggest weights injury-free, and examine the way their erector musculature is “allocated.” You’ll notice that the meat is in the upper lumbar and thoracic regions – not the “true” lower back.  Why?  They subconsciously know to avoid motion in those segments most predisposed to injury, and the extra meat a bit higher up works to buttress the shearing stress that may come from any flexion that might occur higher up.  Novice lifters, on the other hand, tend to get flexion at those segments – L5-S1, L4-L5, L3-L4, L2-L3 – at which you want to avoid flexion at all costs.  Our body is great at adapting to protect itself - especially as we become better athletes and can impose that much more loading on our bodies. Just ask Olexsandr Kutcher, who’s pulling close to 800 and squatting close to 900 at sub-200 body weights.

5. Stabilize the @#*$_@^ out of your lumbar spine. This does not mean sit-ups, crunches, sidebends, hyperextensions, or the majority of what you’ll encounter in yoga (although some variations are sufficient). Lumbar rotation, flexion, and hyperextension serve to make the spine less stiff relative to the hips. Your back may feel tight, but stretching it is quite possibly the silliest thing you can do, as you’d be encouraging more problems long-term in the process. Tony Gentilcore likes to talk about how it’s like picking a scab; it feels good in the meantime, but only hurts you in the long-run. Yeah, I think Tony is odd, too.

If I can get my act together, I’ll have a full detailed progression ready for you in a few weeks.

6. Deload the spine once-a-month if you’ve been at this a while. There’s nothing wrong with dropping squatting for a week each month to focus on extra single-leg work, movement training, pull-throughs…you name it. I know of a lot of powerlifters who do it for 3-4 weeks at a time, so one week won’t kill you. Having a balanced workout routine is key to healthy lifting.

7. Avoid training first thing in the morning. Because we’ve decompressed overnight, our spines are “superhydrated” when we first wake up in the morning; this places more stress on the ligaments and discs and less on the supporting musculature. As a little frame of reference, full flexion reduces buttressing strength against shear by 23-43% depending on the time of day – meaning that your spine might be 20% safer later in the day even if exercise selection is held constant. Give the spine a bit of time to “dehydrate” and you’ll be much better off.

8. Get Lean. Ever wonder why pregnant women are always having lower back pain?  Could it be that they're hyperextending (overusing the lumbar erectors) to offset the new weight they're carrying in the abdomen?  Beer bellies work the same way.

9. Keep moving throughout the day. It takes about 20 minutes for "creep" to kick in with your muscles - and the less you let that happen, the better.  The best posture is the one that is constantly changing.

10. Fix asymmetries. Okay, so we know that compression is probably a necessary evil. And, we know that flexion + compression is even worse. And, wouldn’t you know? We can actually make things worse by adding in an element of lumbar rotation. Who rotates at the lumbar spine? Usually, it’s those with asymmetries in mobility or strength at the ankle, hip, or thoracic spine. Compare ROM side-to-side and check side bridge endurance time; fix what’s out of whack.

Obviously, a lot of this requires some more involved functional tests, a solid background in functional anatomy, and an understanding of how to fix what’s wrong. In my most recent product, The High Performance Handbook, I've outlined a Four Phase System that incorporates a self-assessment, proper strength routine, mobility exercises, and de-loading phases for healthy, rapid results. If you're ready to take a good hard look at your routine, you can find more information here.

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References:

1. Cappozzo A, Felici F, Figura F, Gazzani F. Lumbar spine loading during half-squat exercises. Med Sci Sports Exerc.1985; 17:613 -20.

2. Cholewicki J, McGill SM, Norman RW. Lumbar spine loads during the lifting of extremely heavy weights. Med Sci Sports Exerc.1991; 23:1179 -86.

3. Morita T, Ikata T, Katoh S, Miyake R. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg Br. Jul 1995;77(4):620-5.

4. Soler T, Calderon C: The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med 2000 Jan-Feb; 28(1):57-62.

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