Home Posts tagged "Injury Prevention"

What Stupid Stuff Have You Seen in the Gym?

I recently came across a study in the American Journal of Sports Medicine that showed that over an 18-year period, an estimated 970,801 weight-training-related injuries presented in emergency rooms around the country.  That's an average of 53,934 injuries per year...nationwide.

Based on the market research from back when we wrote Maximum Strength, about 23 million Americans lift weights for exercise - meaning that one out of every 426 people who lifts weights actually gets jacked up enough during a training session that he/she has to to go the hospital.

Now, I'll be honest: while I have seen people do some INSANELY STUPID stuff in commercial gyms, I can't say that I've ever seen anything that warranted a trip to the hospital.  Obviously, I've lived a bit of a sheltered life in owning Cressey Performance for the past three years and working in either private training facilities or college weight rooms since 2003, but one would think that I could have come up with at least ONE gruesome story.  Alas, nothing comes to mind...not even a goofy laugh while benching.

So, I'm counting on you, my loyal and entertaining readers, to provide me with some good stories in the comment section below.  What outlandish stuff have you seen in gyms that has landed some schmuck in the emergency room?

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Cressey’s Favorite Strength Exercises

We see everything at Cressey Performance. While just about 70% of our clients are baseball players, we also have everything from Olympic bobsledders and boxers, to pro hockey players and triathletes, to 69-year-old men who bang out pull-ups like nobody's business. Obviously, certain athletic populations have specific weaknesses that need to be addressed. Soccer and hockey players and powerlifters tend to have poor hip internal rotation. Basketball players don't have enough ankle mobility. Baseball pitchers need to pay more attention to scapular stability, posterior rotator cuff strength, and glenohumeral (shoulder) internal rotation range of motion. Continue Reading...
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The Right Way to Stretch the Pecs

Stretches to maintain length of both the pectoralis major and pectoralis minor are really important — especially in the weight-training population, where Mondays, Wednesdays, and Fridays are declared national bench press holidays in all 52 weeks of the year. Simply put, everyone presses too much and pulls too little. However, what few people (including Mike and I, circa 2004) realize is that in the process of stretching out the pecs (particularly pectoralis major) in this fashion, you run the risk of irritating the anterior shoulder capsule, particularly if the shoulder blades aren't stabilized. As the picture below shows, the attachment point of the pectoralis major is further down the humerus. Continue Reading...
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Solutions to Lifting Problems

It's happened to all of us at one point or another. You show up to the gym, anticipating a great training session, or even just another solid day of lifting. However, once you start adding plates to the bar, it just isn't there. The weights feel heavy. And, you just can't find your groove. Stubborn ass that you are, you keep adding plates, looking for a PR. And, of course, you get buried under your first heavy attempt — or just fall short on the target number of reps. It might be that you didn't get enough sleep last night, or that your girlfriend broke your heart. Hell, maybe there was just a little too much gravity for you in the gym that day. Regardless, your training partners are calling for the staple removers (because you got stapled), shovels (because you got buried), and spatulas (to get your pancaked ass off the floor). Do you hammer through it and try again? Or, do you just call it a day and get out of there? Continue Reading...
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7 Tips for your Physical Therapist Visit

After two years of searching, I've established a good network. But you as a Testosterone reader don't have that luxury when your shoulder is throbbing. With that in mind, here are seven tips to help you be an advocate for your cause as you visit a physical therapist. Continue Reading...
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Fixing the Flaws: A Look at the Ten Most Common Biomechanical Weak Links in Athletes

By Eric Cressey

Originally featured at charlespoliquin.net

Even the best athletes are limited by their most significant weaknesses. For some athletes, weaknesses may be mental barriers along the lines of fear of playing in front of large crowds, or getting too fired up before a big contest. Others may find that the chink in their armor rests with some sport-specific technique, such as shooting free throws. While these two realms can best be handled by the athletes' head coaches and are therefore largely outside of the control of a strength and conditioning coach, there are several categories of weak links over which a strength and conditioning specialist can have profound impacts. These impacts can favorably influence athletes' performance while reducing the risk of injury. With that in mind, what follows is far from an exhaustive list of the weaknesses that strength and conditioning professionals may observe, especially given the wide variety of sports one encounters and the fact that the list does not delve into neural, hormonal, or metabolic factors. Nonetheless, in my experience, these are the ten most common biomechanical weak links in athletes: 1. Poor Frontal Plane Stability at the Hips: Frontal plane stability in the lower body is dependent on the interaction of several muscle groups, most notably the three gluteals, tensor fascia latae (TFL), adductors, and quadratus lumborum (QL). This weakness is particularly evident when an athlete performs a single-leg excursion and the knee falls excessively inward or (less commonly) outward. Generally speaking, weakness of the hip abductors – most notably the gluteus medius and minimus – is the primary culprit when it comes to the knee falling medially, as the adductors, QL, and TFL tend to be overactive. However, lateral deviation of the femur and knee is quite common in skating athletes, as they tend to be very abductor dominant and more susceptible to adductor strains as a result. In both cases, closed-chain exercises to stress the hip abductors or adductors are warranted; in other words, keep your athletes off those sissy obstetrician machines, as they lead to a host of dysfunction that's far worse that the weakness the athlete already demonstrates! For the abductors, I prefer mini-band sidesteps and body weight box squats with the mini-band wrapped around the knees. For the adductors, you'll have a hard time topping lunges to different angles, sumo deadlifts, wide-stance pull-throughs, and Bulgarian squats. 2. Weak Posterior Chain: Big, fluffy bodybuilder quads might be all well and good if you're into getting all oiled up and "competing" in posing trunks, but the fact of the matter is that the quadriceps take a back seat to the posterior chain (hip and lumbar extensors) when it comes to athletic performance. Compared to the quads, the glutes and hamstrings are more powerful muscles with a higher proportion of fast-twitch fibers. Nonetheless, I'm constantly amazed at how many coaches and athletes fail to tap into this strength and power potential; they seem perfectly content with just banging away with quad-dominant squats, all the while reinforcing muscular imbalances at both the knee and hip joints. The muscles of the posterior chain are not only capable of significantly improving an athlete's performance, but also of decelerating knee and hip flexion. You mustn't look any further than a coaches' athletes' history of hamstring and hip flexor strains, non-contact knee injuries, and chronic lower back pain to recognize that he probably doesn't appreciate the value of posterior chain training. Or, he may appreciate it, but have no idea how to integrate it optimally. The best remedies for this problem are deadlift variations, Olympic lifts, good mornings, glute-ham raises, reverse hypers, back extensions, and hip-dominant lunges and step-ups. Some quad work is still important, as these muscles aren't completely "all show and no go," but considering most athletes are quad-dominant in the first place, you can usually devote at least 75% of your lower body training to the aforementioned exercises (including Olympic lifts and single-leg work, which have appreciable overlap). Regarding the optimal integration of posterior chain work, I'm referring to the fact that many athletes have altered firing patterns within the posterior chain due to lower crossed syndrome. In this scenario, the hip flexors are overactive and therefore reciprocally inhibit the gluteus maximus. Without contribution of the gluteus maximus to hip extension, the hamstrings and lumbar erector spinae muscles must work overtime (synergistic dominance). There is marked anterior tilt of the pelvis and an accentuated lordotic curve at the lumbar spine. Moreover, the rectus abdominus is inhibited by the overactive erector spinae. With the gluteus maximus and rectus abdominus both at a mechanical disadvantage, one cannot optimally posteriorly tilt the pelvis (important to the completion of hip extension), so there is lumbar extension to compensate for a lack of complete hip extension. You can see this quite commonly in those who hit sticking points in their deadlifts at lockout and simply lean back to lock out the weight instead of pushing the hips forward simultaneously. Rather than firing in the order hams-glutes- contralateral erectors-ipsilateral erectors, athletes will simply jump right over the glutes in cases of lower crossed syndrome. Corrective strategies should focus on glute activation, rectus abdominus strengthening, and flexibility work for the hip flexors, hamstrings, and lumbar erector spinae. 3. Lack of Overall Core Development: If you think I'm referring to how many sit-ups an athlete can do, you should give up on the field of performance enhancement and take up Candyland. The "core" essentially consists of the interaction among all the muscles between your shoulders and your knees; if one muscle isn't doing its job, force cannot be efficiently transferred from the lower to the upper body (and vice versa). In addition to "indirectly" hammering on the core musculature with the traditional compound, multi-joint lifts, it's ideal to also include specific weighted movements for trunk rotation (e.g. Russian twists, cable woodchops, sledgehammer work), flexion (e.g. pulldown abs, Janda sit-ups, ab wheel/bar rollouts), lateral flexion (e.g. barbell and dumbbell side bends, overhead dumbbell side bends), stabilization (e.g. weighted prone and side bridges, heavy barbell walkouts), and hip flexion (e.g. hanging leg raises, dragon flags). Most athletes have deficiencies in strength and/or flexibility in one or more of these specific realms of core development; these deficiencies lead to compensation further up or down the kinetic chain, inefficient movement, and potentially injury. 4. Unilateral Discrepancies: These discrepancies are highly prevalent in sports where athletes are repetitively utilizing musculature on one side but not on the contralateral side; obvious examples include throwing and kicking sports, but you might even be surprised to find these issues in seemingly "symmetrical" sports such as swimming (breathing on one side only) and powerlifting (not varying the pronated/supinated positions when using an alternate grip on deadlifts). Obviously, excessive reliance on a single movement without any attention to the counter-movement is a significant predisposition to strength discrepancies and, in turn, injuries. While it's not a great idea from an efficiency or motor learning standpoint to attempt to exactly oppose the movement in question (e.g. having a pitcher throw with his non-dominant arm), coaches can make specific programming adjustments based on their knowledge of sport-specific biomechanics. For instance, in the aforementioned baseball pitcher example, one would be wise to implement extra work for the non-throwing arm as well as additional volume on single-leg exercises where the regular plant-leg is the limb doing the excursion (i.e. right-handed pitchers who normally land on their left foot would be lunging onto their right foot). Obviously, these modifications are just the tip of the iceberg, but simply watching the motion and "thinking in reverse" with your programming can do wonders for athletes with unilateral discrepancies. 5. Weak Grip: – Grip strength encompasses pinch, crushing, and supportive grip and, to some extent, wrist strength; each sport will have its own unique gripping demands. It's important to assess these needs before randomly prescribing grip-specific exercises, as there's very little overlap among the three types of grip. For instance, as a powerlifter, I have significantly developed my crushing and supportive grip not only for deadlifts, but also for some favorable effects on my squat and bench press. Conversely, I rarely train my pinch grip, as it's not all that important to the demands on my sport. A strong grip is the key to transferring power from the lower body, core, torso, and limbs to implements such as rackets and hockey sticks, as well as grappling maneuvers and holds in mixed martial arts. The beauty of grip training is that it allows you to improve performance while having a lot of fun; training the grip lends itself nicely to non-traditional, improvisational exercises. Score some raw materials from a Home Depot, construction site, junkyard, or quarry, and you've got dozens of exercises with hundreds of variations to improve the three realms of grip strength. Three outstanding resources for grip training information are Mastery of Hand Strength by John Brookfield, Grip Training for Strength and Power Sports by accomplished Strongman John Sullivan, and www.DieselCrew.com. 6. Weak Vastus Medialis Oblique (VMO): The VMO is important not only in contributing to knee extension (specifically, terminal knee extension), but also enhancing stability via its role in preventing excessive lateral tracking of the patella. The vast majority of patellar tracking problems are related to tight iliotibial bands and lateral retinaculum and a weak VMO. While considerable research has been devoted to finding a good "isolation" exercise for the VMO (at the expense of the overactive vastus lateralis), there has been little success on this front. However, anecdotally, many performance enhancement coaches have found that performing squats through a full range of motion will enhance knee stability, potentially through contributions from the VMO related to the position of greater knee flexion and increased involvement of the adductor magnus, a hip extensor (you can read a more detailed analysis from me here. Increased activation of the posterior chain may also be a contributing factor to this reduction in knee pain, as stronger hip musculature can take some of the load off of the knee stabilizers. As such, I make a point of including a significant amount of full range of motion squats and single-leg closed chain exercises (e.g. lunges, step-ups) year-round, and prioritize these movements even more in the early off-season for athletes (e.g. runners, hockey players) who do not get a large amount of knee-flexion in the closed-chain position in their regular sport participation. 7 & 8. Weak Rotator Cuff and/or Scapular Stabilizers: I group these two together simply because they are intimately related in terms of shoulder health and performance.

Although each of the four muscles of the rotator cuff contributes to humeral motion, their primary function is stabilization of the humeral head in the glenoid fossa of the scapula during this humeral motion. Ligaments provide the static restraints to excessive movement, while the rotator cuff provides the dynamic restraint. It's important to note, however, that even if your rotator cuff is completely healthy and functioning optimally, you may experience scapular dyskinesis, shoulder, upper back, and neck problems because of inadequate strength and poor tonus of the muscles that stabilize the scapula. After all, how can the rotator cuff be effective at stabilizing the humeral head when its foundation (the scapula) isn't stable itself? Therefore, if you're looking to eliminate weak links at the shoulder girdle, your best bet is to perform both rotator cuff and scapular stabilizer specific work. In my experience, the ideal means of ensuring long-term rotator cuff health is to incorporate two external rotation movements per week to strengthen the infraspinatus and teres minor (and the posterior deltoid, another external rotator that isn't a part of the rotator cuff). On one movement, the humerus should be abducted (e.g. elbow supported DB external rotations, Cuban presses) and on the other, the humerus should be adducted (e.g. low pulley external rotations, side-lying external rotations). Granted, these movements are quite basic, but they'll do the job if injury prevention is all you seek. Then again, I like to integrate the movements into more complex schemes (some of which are based on PNF patterns) to keep things interesting and get a little more sport-specific by involving more of the kinetic chain (i.e. leg, hip, and trunk movement). On this front, reverse cable crossovers (single-arm, usually) and dumbbell swings are good choices. Lastly, for some individuals, direct internal rotation training for the subscapularis is warranted, as it's a commonly injured muscle in bench press fanatics. Over time, the subscapularis will often become dormant – and therefore less effective as a stabilizer of the humeral head - due to all the abuse it takes.

For the scapular stabilizers, most individuals fall into the classic anteriorly tilted, winged scapulae posture (hunchback); this is commonly seen with the rounded shoulders that result from having tight internal rotators and weak external rotators. To correct the hunchback look, you need to do extra work for the scapular retractors and depressors; good choices include horizontal pulling variations (especially seated rows) and prone middle and lower trap raises. The serratus anterior is also a very important muscle in facilitating scapular posterior tilt, a must for healthy overhead humeral activity. Supine and standing single-arm dumbbell protractions are good bets for dynamically training this small yet important muscle; scap pushups, scap dips, and scap pullups in which the athlete is instructed to keep the scapulae tight to the rib cage are effective isometric challenges to the serratus anterior. Concurrently, athletes with the classic postural problems should focus on loosening up the levator scapulae, upper traps, pecs, lats, and anterior delts. One must also consider if these postural distortions are compensatory for kinetic chain dysfunction at the lumbar spine, pelvis, or lower extremities. My colleague Mike Robertson and I have written extensively on this topic here. Keep in mind that all of this advice won't make a bit of difference if you have terrible posture throughout the day, so pay as much attention to what you do outside the weight room as you do to what goes on inside it. 9. Weak Dorsiflexors: It's extremely common for athletes to perform all their movements with externally rotated feet. This positioning is a means of compensating for a lack of dorsiflexion range of motion – usually due to tight plantarflexors - during closed-chain knee flexion movements. In addition to flexibility initiatives for the calves, one should incorporate specific work for the dorsiflexors; this work may include seated dumbbell dorsiflexions, DARD work, and single-leg standing barbell dorsiflexions. These exercises will improve dynamic postural stability at the ankle joint and reduce the risk of overuse conditions such as shin splints and plantar fasciitis. 10. Weak Neck Musculature: The neck is especially important in contact sports such as football and rugby, where neck strength in all planes is highly valuable in preventing injuries that may result from collisions and violent jerking of the neck. Neck harnesses, manual resistance, and even four-way neck machines are all good bets along these lines, as training the neck can be somewhat awkward. From a postural standpoint, specific work for the neck flexors is an effective means of correcting forward head posture when paired with stretches for the levator scapulae and upper traps as well as specific interventions to reduce postural abnormalities at the scapulae, humeri, and thoracic spine. In this regard, unweighted chin tucks for high reps throughout the day are all that one really needs. This is a small training price to pay when you consider that forward head posture has been linked with chronic headaches. Closing Thoughts A good coach recognizes that although the goals of improving performance and reducing the risk of injury are always the same, there are always different means to these ends. In my experience, one or more of the aforementioned ten biomechanical weak links is present in almost all athletes you encounter. Identifying biomechanical weak links is an important prerequisite to choosing one's means to these ends. This information warrants consideration alongside neural, hormonal, and metabolic factors as one designs a comprehensive program that is suited to each athlete's unique needs.
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Bogus Biomechanics, Asinine Anatomy: Part II

By Eric Cressey

Last month, I covered the five myths that you're bound to come across in any gym during your time in the iron game. This month, five more!

Myth #6: Stance width dictates recruitment of the different muscles of the quadriceps during squats and leg presses. Contrary to what the local self-proclaimed bodybuilding guru might have told you, this is false. Recruitment is more a function of squat depth than width. McCaw and Melrose (1999) demonstrated that although a wider stance will recruit more of the adductors and glutes, it doesn't change the relative contributions of the four muscles of the quadriceps during a squat (1). In other words, the "feet together for the vastus lateralis" and "wide stance for the vastus medialis" concepts simply don't hold water. The vastus medialis is better recruited with terminal knee extension and any movements that send the knee into valgus. Likewise, anecdotally, knee extension exercises from positions of great knee flexion (e.g. deep squats, lunges, and step-ups) preferentially recruit the vastus medialis. This could result from increased activity of the adductor magnus - which also works as a hip extensor – to assist in hip extension from the low position. Research has shown that because the vastus medialis oblique originates on the adductor magnus tendon, increasing adductor magnus activity will enhance vastus medialis recruitment. This is the premise behind many physical therapists recommending straight leg raises with the knee extended and femur adducted to strengthen the vastus medialis; unfortunately, this rehabilitation model isn't functional at all, and therefore doesn't have much value beyond the initial stages of rehabilitation. The next time someone tells you that stance width is what determines quadriceps recruitment, ask him how we classify single leg movements, where there is no such thing as stance width! Myth #7: The "core" consists of just the abs, and can best be trained with crunches. This statement is accepted as gospel in most mainstream muscle magazines, but it's actually way off the mark. The core actually encompasses far more musculature than the rectus abdominus alone; broadly speaking, it extends from the upper torso and neck to the knees, serving as the link between strength and power in the lower and upper body. Clark (2001) put forth perhaps the best functional anatomy breakdown of the core when he divided it into the local (deep) and global (superficial, prominent) musculature (2). The local musculature – including most notably the transverse abdominus and multifidus – functions primarily to stabilize the spine. Much debate has arisen in the strength training and rehabilitation communities in regards to whether or not the local musculature warrants direct training in healthy individuals. Since it's my article, I'm allowed to give my opinion: in healthy individuals, spinal stabilization occurs involuntarily, so direct training is unproductive, and potentially counterproductive, as McGill has pointed out (3). I'd also like to take this opportunity to say that I think it sucks that most canned tuna has soy hidden in it. Oh yeah, this is also a good spot for my prediction of a third Patriots Super Bowl win in four years. Clark further divided the global musculature into the lateral, deep longitudinal, posterior oblique, and anterior oblique "subsystems." All of these subsystems function as a cohesive unit during complex movements (2), but they warrant mention individually to understand how training can be targeted for improving function in one or more. The lateral subsystem involves the interaction of the gluteus maximus, tensor fascia latae, adductors, and quadratus lumborum (think "inner and outer thighs and hips"). This subsystem plays an important role in stabilizing the body in the frontal plane during activities (especially single-leg work) involving the lower body (2). The deep longitudinal subsystem most notably includes the erector spinae, biceps femoris, sacrotuberous ligament, and thoracolumbar fascia; this system is a crucial component of the powerful posterior chain that you've likely heard discussed by numerous strength coaches. Essentially, this subsystem's primary function is to allow forces generated in the lower body to be carried up to the upper body (and vice versa, in less common occurrences) (2). The posterior oblique subsystem also includes the gluteus maximus and thoracolumbar fascia, but this time in collaboration with the contralateral latissimus dorsi (2). You may have heard of the "serape effect," which relates the gluteus maximus and latissimus dorsi during the gait cycle. Basically, both muscles are extensors; when the right arm is extending (thanks to the right lat) during gait, so is the left leg (thanks in part to the left gluteus maximus). By "posterior oblique," we're referring to the back and across nature of this muscular interaction. This subsystem also has implications in transverse plane stability (2). The anterior oblique subsystem consists of the adductors, internal and external obliques, and external rotators of the hips: gluteus maximus, piriformis, obturator internus and externus, gemelli superior and inferior, quadratus femoris, long head of biceps femoris, posterior fibers of the gluteus medius, sartorius, and adductor complex (at certain degrees of hip flexion). Beyond its obvious role in producing rotational motion, this final system is an important part of transverse plane stabilization (2). Myth #8: You can "isolate" muscles in a resistance training context. True muscular isolation is only possible in fine movements like blinking and twitching. In more gross movements and those involving significant external loading, numerous muscles interact as prime movers, synergists, and stabilizers. While some single-joint exercises will allow you to focus more on one muscle than others in concentric, eccentric, and isometric actions, it's simply impossible to truly isolate a muscle. In fact, the concept of isolated muscle action actually has dangerous implications, as elimination of important stabilizers would undoubtedly compromise exercise safety. If you don't believe me when I say that true isolation is impossible, you can continue to try to isolate your medial gastrocnemius while your bandana-sporting, belt wearing, pretty boy training partner screams in your ear about how badass you are. Meanwhile, those of us who know better will just keep to ourselves and do multi-joint exercises that allow for significant external loading, and we'll see who makes better progress. Myth #9: The secret to healthy shoulders is to have a big, strong chest, lats, delts, and "traps." I've heard this one on several occasions, and it never ceases to crack me up. These larger muscles are usually the problems, not the solutions! When you hammer your pecs, lats, anterior delts, and upper traps mercilessly and ignore their antagonists (external rotators, horizontal abductors, scapular retractors, and scapular depressors), unfavorable postures and movement patterns develop. Specifically, the humeri tend to assume an internally rotated resting position and the scapulae become elevated, winged and anteriorly tilted. These changes mechanically decrease the already-narrow subacromial space, increasing the likelihood that the tendons of the rotator cuff will become irritated when the arm is raised. When the rotator cuff is strong, it serves to depress the humeral head in the glenoid fossa so that this impingement doesn't occur. If the SITS muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) are weak relative to these larger muscles, the humeral head translates superiorly excessively; the pain is most prominent in bench pressing and overhead movements. Summarily, the secret to healthy shoulders is to train the antagonists to the "big dogs" in order to foster appropriate strength ratios and maintain ideal resting posture. Myth #10: Calves won't grow without calf raises. In my experience, calf development is perhaps the single-most genetically influenced aspect of weight training. Some guys are born with high calves, and some have thick ankles attached to tree trunks. That's not to say, however, that training and lifestyle factors can't markedly improve the size of one's calves. Yes, I said lifestyle factors! Take a look at any really fat person, and you'll see a great set of calves. The soleus comprises roughly 2/3 of the lower leg musculature, and since it's largely a postural muscle, it tends to hypertrophy in tubby people even if they don't exercise. It may not seem fair to those of you who are putting in the time with hours upon hours of calf raises, but that's life. Speaking of calf raises, they aren't the only way to train calves. The gastrocnemius works not only in plantarflexion, but also in knee flexion. As such, it gets hit hard with glute-ham raises and leg curls. Moreover, plantarflexion is trained heavily in a variety of more compound movements, including Olympic lifts, sprinting, sled dragging, and farmer's walks (with accentuated pushoffs). Sometimes, ignoring the calf raises altogether and focusing on these compound movements is a great way to spark growth "by accident." Or, they can serve as valuable adjuncts to your regimen of seated, standing, leg press, and donkey calf raises. Finally, the tibialis anterior (muscle on the front of the shin) can contribute to lower leg mass; dorsiflexion exercises and downhill running can be effective means of improving in this regard. Conclusion Hopefully, the past two articles have given you some intellectual firepower to call upon the next time you're confronted with these myths. Then again, old myths die hard, so sometimes it's better to just shake the "gurus" off and do your own thing. References 1. McCaw ST, Melrose DR. Stance width and bar load effects on leg muscle activity during the parallel squat. Med Sci Sports Exerc 1999 Mar;31(3):428-36. 2. Clark, M. Performance Enhancement Specialist Online Manual. National Academy of Sports Medicine, 2001.
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Bogus Biomechanics, Asinine Anatomy: Part I

Kinesiology Myths that Need to Die

By Eric Cressey

Call me anal-retentive, but when intelligent, experienced writers make incorrect statements in their publications, it makes me question their credibility. As we all know only too well, myths abound in the area of weight training ("high reps for toning") and nutrition ("protein is evil"). Since the kinesiology and biomechanics realm is my area of expertise, erroneous statements tend to get on my nerves even more. With that in mind, here's my opportunity to vent with respect to ten of those myths.

Myth #1: You can train the "medial deltoids." I always get a kick out of it when some of the most brilliant strength coaches (I can think of at least five) write about training the medial head of the deltoids with lateral raises or some other shoulder-specific exercise. These are some brilliant guys, so I never have the heart to speak up and tell them that "medial deltoids" don't even exist. Incorporating exercises for this imaginary head is not only impossible, but attempting to do so represents a fundamental lack of knowledge of anatomy. The term "medial" is a directional term that means "toward the midline" of, in this case, the body. From the anatomical position - standing, arms at sides, palms supinated (facing forward), the head of the deltoid that is sandwiched between the anterior and posterior deltoid fibers is actually the farthest away from the midline of the body of all of the heads of the deltoid. If anything, it should be called the lateral head! As such, these fibers are referred to as the "middle deltoid," a term that correctly identifies their position between the anterior and posterior deltoid. Myth #2: You can work on your left and right "bicep" and "tricep." These muscles both have more than one head, so you'd be better off saying, "You can work on your left and right biceps and triceps." Now that we've got the terminology down in a broad sense, let's look at the specific anatomy and how one can prioritize certain heads over the others. An important principle of which you should be aware is active insufficiency, a scenario that occurs when a two-joint muscle cannot contribute optimally to concentric action (i.e. shortening) at one joint because it is already shortened at another. In the case at hand, the long head of both the biceps and triceps can be preferentially recruited or excluded (for the most part) by avoiding or encouraging active insufficiency, respectively. The long (lateral) head of the biceps crosses both the elbow and shoulder joint (and the radio-ulnar joint to act as a supinator, but we won't worry about that right now), acting as an elbow and shoulder flexor. To maximally recruit the long head of the biceps, we need to eliminate one of these joint actions. As such, our options are to a) maintain shoulder extension (preferably past neutral) while flexing the elbow joint (e.g. incline curls) and b) flex the shoulder joint while maintaining elbow extension (e.g. front raise). Both scenarios avoid active insufficiency and force the long head of the biceps to bear the brunt of the load. Likewise, if we want to focus our efforts on the short (medial) head of the biceps, we simply flex the elbow with the shoulder flexed (e.g. preacher curls); because the long head of the biceps is already shortened at the shoulder, it can't contribute effectively to elbow flexion. The long head of the triceps also crosses the shoulder and elbow, but it acts in extension at both joints. If you want to overload this head of the triceps, you can a) maintain shoulder flexion while extending the elbow (e.g. overhead or lying extensions) and b) maintain elbow flexion while extending the shoulder (e.g. bent-arm pullover), although the latter option tends to recruit the lats and teres major more extensively. To reduce involvement of the long head of the triceps in favor of overloading the medial and lateral heads, simply extend the elbow with the shoulder extended (e.g. variations of pressdowns and dips). Myth #3: The traps are just the muscles between your shoulders and neck; they can be trained with just shrugs. This is an unfortunate misconception that has led to countless shoulder injuries in anatomy-ignorant lifters. The trapezius is actually a very large muscle that essentially spans from the lumbar spine all the way to the base of the skull. It can be divided into the lower, middle, and upper fibers; each of the three divisions has unique functions, so it's almost easiest to think of them as separate muscles altogether (much like the different heads of the deltoid). The lower fibers are responsible for scapular depression, retraction, and upward rotation. The middle fibers contribute to scapular retraction, elevation, and upward rotation. Finally, the upper fibers contribute to scapular elevation retraction, and upward rotation, and extension, lateral flexion, and contralateral rotation of the neck. Interestingly, as you may have inferred, the different fibers of the trapezius can act as both antagonists (elevation and depression) and synergists (retraction and upward rotation) to each other! Perhaps more importantly, you hopefully can tell that shrugs only directly train scapular elevation and the upper traps, so you need to use a wider variety of exercises to achieve complete trapezius development. If you didn't pick up on that, you're hopeless; go play in traffic. The rest of you should note that the lower and middle trapezius both play crucial roles in maintaining scapular stability and proper posture, two factors with definite implications in terms of overall shoulder health. Myth #4: Close-grip bench presses are good for the "inner" chest. I've read a lot of anatomy books, but I've never come across the inner head of the pectoralis major. There are clavicular (upper) and sternal (lower) fibers, but selective recruitment of these fibers is a function of angle of inclination of the bench and different movement patterns rather than grip width. Bringing your grip closer together will recruit more triceps, though. Myth #5: Your body doesn't know the differences between similar exercises that target similar musculature. I have been surprised to see this coming from a few prominent writers in the bodybuilding and strength and conditioning industries, so I thought this article would be a good place to air my disagreement with such a statement. Essentially (and pardon the stereotype), this is bodybuilding logic. For the most part, in the bodybuilding world, there are only muscles; in the quest to be big, and not strong or proficient at some athletic endeavor, many bodybuilders completely overlook the role of the nervous system in exercise selection. Let's start with the most basic arguments against this logic. As Mel Siff points out, "Subtle differences apparently as insignificant as a change in grip, stance or head position in regular training can cause significant neural changes which control the way in which the athlete executes a given skill (1)." When we change our grip on standing dumbbell curl variations, for instance, we can shift the emphasis within the elbow flexors among the biceps brachii, brachioradialis, and brachioradialis (among other muscles). Like I said, we're starting with the basics, but let's now make our example a bit more complex by comparing a preacher curl and a standing dumbbell curl. As I mentioned before, there are obvious muscular recruitment changes that occur due to the aforementioned active insufficiency of the long head of the biceps with the flexed-humerus position. Likewise, there are implications in terms of force production capabilities. According to Siff,

Many studies indicate that, in all of the diverse isolated single-joint movements, changes in strength apparently depend upon the role and functions of the joint mechanisms and the relative disposition of the body's links relative to one another. Changes in joint angle alter the conditions of muscular work, since muscle length and angle of pull are changed. Muscular strength and leverage change, and consequently, so does the torque (i.e. moment of force) produced by the muscles about a joint (1).

Keep in mind that the above quote only refers to single-joint movement; as I'm sure you can imagine, when multiple joints are involved, recruitment patterns can differ even more dramatically. Because joint angle affects how muscles produce force, there are clear implications in terms of the overall training effect. For instance, at joint orientations, rate of force development (RFD) will be faster than at others; when dealing with athletes, this is an important consideration. Moreover, strength increases over the entire range of motion depend to a large degree on the joint angle in training at which maximum muscular tension is attained (1). If this strongest position is avoided (via partial reps, for example), the magnitude of the strength increases may be compromised.

Now, let's go back to the preacher curl versus standing dumbbell curl example. Not only are recruitment patterns different within the elbow flexor musculature, but contributions (or lack thereof) from the rest of the kinetic chain are also altered. Far more stabilization must take place at multiple joints in the latter exercise because of the standing position and the lack of support for the upper arms. This underscores the importance of basing all training programs on core exercises; they simply involve more musculature and train recruitment patterns that are functional for our daily lives. It also demonstrates the differential training effect of, say, a floor press when compared to a 2-board press. Both have their place in training programs, but the latter involves greater muscle recruitment and loading in a fixed distance traveled by the bar. Now, let's take this a step further. Which is more neurally draining: a 1RM barbell curl or a 1RM deadlift? If you answered "the curl," it's time to start taking your lower body training more seriously. Very simply, the deadlift is more taxing because it requires more work (force times distance) to be done. Increasing both the force and distance components necessitate increased muscular recruitment via increased neural output. One step further: is a full ROM 1RM barbell curl more neurally draining than a ½ curl? Assuming the same weight it utilized, of course (force stays the same, but distance is greater). However, let's assume you can use enough additional weight on the ½ curl to offset the reduction in distance, and the overall work is the same for both exercises. Then, you certainly have a conundrum. In a broad sense, the neural demands are similar; however, differences exist in terms of rate coding and fiber recruitment, depending again on joint orientation. Here's where a lot of folks want to end the discussion (if they're even gotten this far without getting bored or confused). If we've established that subtle variations in exercises won't markedly change the overall impression left on the nervous system, then we can go ahead and bench 52 weeks per year as long as we change our rep ranges and tempo of execution, right? Yes, but since when is lifting weights about "avoiding stagnation," and not about "getting hella beeeg, fast, and strong?" That's right; I'm talking about optimization of training here. Read on… Training has a far more profound impact on the nervous system than just fiber recruitment. Most attention in the literature is focused on the efferent (motor) and not the afferent (sensory, or feedback) component on the nervous system. However, varying exercise selection – just like varying speed of execution, loading, and volume – is crucial to developing afferent pathways as well. Specifically, I'm referring to the joint receptors.

  • Pacinian corpuscles are rapidly adapting receptors that are highly sensitive to vibration frequency, acceleration, and deceleration.
  • Golgi-Mazzoni corpuscles are sensitive to compression of the joint capsule, therefore supplying crucial information to the CNS regarding how close one is to the end of the range of motion.
  • Ruffini endings are sensitive to capsular stretching with respect to speed and direction; this information complements that gathered by the Pascinian corpuscles.
  • Golgi ligament endings are sensitive to tension and stretch on ligaments, whereas free nerve endings (nociceptive and nonnociceptive) may respond to a variety of mechanical and biochemical stimuli (2,3).

The CNS cannot act without information upon which to base its actions, so efficiency of these joint receptors is of paramount importance in determining not only success, but injury prevention (e.g. knowing when to fire a muscle to decelerate a movement). For this reason, re-education of joint receptors should be an important focus in all rehabilitation and prehabilitation programs. The best way to train these receptors is to expose them to a wide variety of speeds, loads, and positions.

The last few paragraphs are just my two cents on the issue, so I suppose calling this one a "myth" is somewhat of a stretch. Conclusion Next month, I'll cover five more myths that need to be banished from weight rooms for the rest of eternity. In the meantime, be leery of everything you hear from the self-proclaimed gurus at your gym. References 1. Siff, M. Supertraining: 6th Edition. Supertraining Group, 2003. 2. Tiberio, D. Unpublished. 2004.
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Five Resistance Training Myths in the Running World

To some, resistance training is the Rodney Dangerfield of the running community; it gets no respect. To others, it’s like Tom Cruise; runners think it might be useful, but it just doesn’t make any sense to them. And then, there are those to whom resistance training is like Abraham Lincoln; it’s freed them from being slaves to ineffective programming. As a performance enhancement specialist who has a lot of “Abe” endurance athletes under my tutelage, I’d like to take this opportunity to bring the Rodney and Tom runners in the crowd up to speed. With that in mind, let’s look at the five most prominent myths present in the running community with respect to resistance training Continue Reading...
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How To Dramatically Improve Your Performance and Decrese Injuries with Dynamic Mobility

Listen to this exclusive 20 minute interrogation with Eric Cressey as he goes into great detail about what all athletes should be doing before they train! Continue Reading...
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  • 9 - minute instructional video
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