Exercise

Tune-Up Tuesday Episode 22: Preventing the Rib Flare Part 2

Last week I discussed how to prevent our ribs from flaring when moving our upper bodies. Today, we will continue these series and focus on the lower body. 

As a recap, when we flare our ribs, it causes us to extend our spines.  When we extend our spines we put excess forces on our spine due to overactive lower back muscles and an underactive core. This lack of control over thousands of reps is what causes lower back pain. 

For the lower body, the rib flare most frequently happens when we try to extend our hips.  This could be at the top of your deadlift when running or swinging a golf club.  Check out the video below to learn how to decrease your rib flare. 

If you have any questions, comments or concerns, let me know!

Move Well, Stay Strong.

Clutter: Is It Bogging Down Your Exercise Program

Clutter: Is It Bogging Down Your Exercise Program

After reading the book "On Writing Well" by William Zinsser, I realized that writing and program design have a lot of similarities.  An example of this is clutter.  Clutter is an easy way to decrease the effectiveness of one's writing and one's program.  

Course Review: Optimizing the Big 3

A few weeks ago, I attended a seminar on optimizing the big three (bench press, squat and deadlift) at Cressey Sports Performance in Hudson, Massachusetts.  Greg Robins and Tony Bonvechhio are two smart dudes and offered a ton of value. 

Greg and Tony's seminar is geared towards the powerlifter but did a great job making this applicable to all walks of life.  I am by no means a powerlifter, yet I love to use the big three in my workouts and in my clients programming.  

The information provided gave me greater insight into the programming and cueing of these exercises.  The best part of the seminar is the hands on portion - in which we actually got to lift and get coached by both Greg, Tony and Miguel.  Getting insight into your bad habits as a lifter, as well as watching them coach several others gives you invaluable education you can't get elsewhere. 

I highly recommend anyone interested in powerlifting or weight training, whether a trainer or someone who is an avid fan of exercises - this is a must course.

Here are some take aways from the seminar:

When it comes to program design for any client, powerlifter or not, you must address the needs of the lifter.  What are the prerequisite movements to be successful at the exercise?  What limitations do the currently have?  What's their training age? etc..

Secondly, when it comes to programming the big three, there are three things we must take into consideration.

  1. They are all saggital plane movements
  2. They are all bilateral movements
  3. They are all extension based movements

Therefore, constant programming of these lifts will create postural and movement changes due to the repetitive nature and loading of these patterns

Greg and Tony talk about a great concept called "covering your basis". Due to the facts above, we address the repetitive nature of these exercises through corrective exercises and our warm-ups.

I have already been a proponent of using the warm-up to address movement concerns of the athlete at hand so this was music to my ears. Having a warm-up designed to prepare the body for the demands of that day is key to owning that session. 

Start from the ground up using a few drills to address movement concerns and prep for the major workouts of the day.  For example, work on scap stability or thoracic extension before bench press.  

Technique is the one thing as coaches that we have control over.  So not learning how to coach and cue is doing a disservice to your clients or yourself. They mention that "crappy technique puts a ceiling on your training."  This is absolutely vital. Poor technique not only puts a ceiling on training, but causes bad habits and increases chance for injury.  Learn how to coach these well, so you can set your clients and yourself up for success in the future. 

  1. Bench 
    • Bar and wrist over elbows 
    • Leg Drive 
      • If you use a flat footed stance, your leg drive is similar to pushing yourself up the bench.
      • If you prefer heels up, then your leg drive is trying to drive your feet into the ground and squeezing the bench with your thighs.
      • The leg drive serves a couple of purposes.  One, to develop more power throughout the entire body.  Two, to assist in maintaining your bar path.
    • Pull your shoulder blades into your back pockets.  This will add more passive stability to the shoulders, but also will help you maintain your thoracic extension - which is crucial to shortening the motion and maintaining bar path. 
  2. Deadlift 
    • Bar lined up over shoe strings
    • Arm pits in front of bar
    • Wedge yourself into the bar
      • What this means is that you are trying to take tension out of bar.  In order to do so you pull the weight of the bar off the floor by dropping your butt and raising your chest.  Once you feel the bars weight in your back, you know you're ready to drive through the floor.  
  3. Squat
    • Greg and Tony used two terms to describe your squat technique:
      • Don't be a stripper
      • And Don't Pop-Lock and Drop - but rather Lock, Drop and Pop
    • What this means is you don't want to arch your back on the decent.  You want to maintain a belt buckle up, ribs down posture throughout the entire set.  So, A - lock in the torso position, B - drop into the bottom of the squat and C - pop back to the top.

Another thing they mention, and I think we all forget this often, is fitness is dependent on the goal/sport at hand.  A golfer and a Cross-fitter require two very different training stimuli to reach their goal.  But does a golfer need to be crushed by a Workout of the Day (WOD) everyday in order to effectively hit a ball 300 yards down a fairway?  No, it can actually hinder their performance.  Point being, know your athlete and find their goals, and as Dan John says "keep the goal the goal."

All in all, this seminar blew away my expectations and I highly recommend you attend.  The work done at CSP is top notch and you can learn a lot from these fine gentlemen. 

Move Well, Stay Strong

 

How to Get the Most Out of Your Rehab

Just to be clear, Physical Therapists do not fix people.

Um what!?

You read that correctly, physical therapists (myself included) do not fix injuries.  I know you are thinking 'well why do I spend all my time and money on co-payments and deductibles if no one can fix me?'

In an outpatient setting, a PT is able to determine the root cause of your pain through the evaluation process.  By understanding your mechanism of injury, current symptomology, and examination of movement a PT can give you a movement diagnosis that allows them to address any pain, tissue extensibility, mobility or motor control issue that might be present. 

You are probably thinking now, 'hey you just said PTs can't fix me, but they can put me on the road to recovery?'

Exactly! Physical therapists put you on the ROAD TO RECOVERY.  This does not mean we fix you; the hones truth is the only person who can fix you is... YOU.  The bottom line being that a PT alone cannot ¨fix¨ your ailments all by him/herself, the other person in the equation of recovery is YOU. 

Every time I see a patient, any benefit they get from seeing me I call “the window of opportunity.” All tissues in the body have a threshold level that once met, pain settles in.  The benefit you get from PT is increasing your threshold, which improves your pain tolerance.  

So if you see a PT for 20 minutes to an hour twice a week and have your window of opportunity opened, what you do with the remaining 23 hours will have an even greater impact on your window as well. 

What I often see is a person feels much better after leaving PT. These effects lasts roughly a day or two and by the time they return for their next visit their pain has returned.  

 

SO WHAT IS THE BEST WAY TO GET THE MOST OUT OF YOUR REHAB!?

The number one tool a patient has for recovery is their home exercise program (HEP).  Your PT should be giving you, the patient, 2-4 corrective exercises that will maximize your window of opportunity between visits. But more often than not my patients have all the excuses in the world why they can do their home exercises, which on average takes under 10 minutes to complete. 

This boggles my mind because if I told you in 10 minutes a day you can be pain free, would you say yes, I will do whatever it is?  You may be nodding your head yes, but my experience begs to differ.

If you do your exercises as prescribed, you keep the window of opportunity open a little longer, so the next time your PT sees you they can continue to make it larger until your threshold of pain returns to normal. 

Even after being pain free, you must remain pain free for six months before you decide to cut back on frequency of HEP.  Would you rather spend 10 minutes a day now however it fits your schedule for the next 6-8 months or continue to have pain and see PTs for the same problems over and over again. 

HERE ARE A FEW TIPS

  • Do your exercises at a set time every day.  This will help you to develop habits.

    •  For example after you brush your teeth in the morning you do 5 minutes of exercises.  

  • Break up your exercises throughout the day.  

    • If your PT gives you 10 minutes of exercises but between life, kids, relationships, work etc some days you just can find 10 minutes.  No problem.

    • Break up the exercises into smaller time slots.  Do 2 minutes of exercises sprinkled throughout the day on 5 separate occasions.  No one ever said you HAVE to do them all at the same time. 

Hope this helps! Take advantage of this tool and feel better faster!

Four Hacks to the Turkish Get Up

The Turkish Get Up (TGU) is a highly technical exercise that requires attention to detail for proper execution.  Last week I wrote about how to properly perform the TGU, you can read that here.  This week I will take this a step further and discuss 4 common technique flaws and how you can fix them. 

 

1) Set Up -

During the set up, we want to have enough space to work with.  I often see people set up with their legs too close together.  This decreases your base of support, making you less stable and increases the difficulty of the first step (see number 2 below). 

2) Leg Kicks Up -

This happens when we do not produce enough tension during the initial step or if you are using too much weight.

3) Misplacing the Moving Leg -

During each stage of the get up, there are optimal places to put your extremities so all your joints are properly aligned.  Often times people put their legs in places that decrease their base of support which makes this exercise harder.

4) Not Hinging From the Hips -

When people are reversing their get up, people often have difficulty with the transition from 1/2 kneeling position to placing the hand on the floor.  People like to bend from their spine and flop to the floor.  You must maintain your core stiffness and push your hips out to the side.  This keeps the spine in a strong position and trains hip mobility in the frontal plane.

Try some of these quick fixes and let me know in the comments section below if they were helpful.   

 

Hinge Your Way Free of Back Pain

What's your plan of attack when your back aches? Painkillers? Stretching? Ice and heat? While these might provide temporary relief, we're missing the bigger picture if we don't address the way we move through our hips.

Often times when your back hurts it is often due to lack of stability and/or mobility at joints.  This makes sense when we review Gray Cook and Mike Boyle's joint-by-joint approach to the body.

When we look at this model we see that the body alternates segments of stability and segments of mobility.  These areas align themselves so that we can stabilize in certain areas in order to move freely in others. An example of this (not on the chart above) is learning proper scapula stability so we can enjoy all the range of motion the shoulder provides.  If the scapulae aren't stable, compensation patterns inhibit optimal movement of the shoulder joint.  

IMG_0037.JPG

With repetitive stresses or lack of movement over time, bodily joints have the potential to lose their inherent mobility. Once this happens the body has to compensate for this lack of motion by creating motion at the segment directly above or below.  What this ultimately does is flip-flop the order of mobility and stability.  One of the most common examples I see of this is through the loss of hip mobility.  Most people, especially those who sit at work all day lose the ability to hinge at the hips.  This loss of hip mobility causes either the lumbar spine or the knees to move excessively while moving. Whether bending over, squatting, deadlifting, or picking up your child to name a few examples, the ability for your body to maintain the joint-by-joint approach is imperative in order to prevent muscle tightness, stiffness, weakness and pain.  

Based off this information, one of the first things I assess when having a patient with low back pain is their ability to hinge.  Most often than not, their hip hinge is not up to par... and that's putting it nicely.  Even if you don't have pain, the inability to hinge from the hips will rob you of strength, power, mobility, and overall quality of life.  

Check out the video below to see some hip hinge hacks.  They will make you a better person.  

If these helpful tips helped you out, or if you just plain hated them leave me a comment below and tell me all about it!