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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.

HPH-main

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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