CategoriesCorrective Exercise Exercise Technique

Deadlift and Grip Pain

Q: My fellow lifter in Germany has long maintained that the things that happen to me under the bar are just plain weird. As it happens, I’ve not yet seen anyone write on this (if you did and I missed it, just point me there!); I hope you’ll be able to help me figure out what on earth is going on.

I love deadlifts, but it seems they absolutely hate my right forearm. At all of 95lbs, double overhand, I start feeling a mildly painful strain at the elbow when I close my hand. As the weight goes up, the pain gets worse.

Last year, I ignored the pain thinking it was something that would get better with time. Instead, by the time I got to 190lbs, the pain was so hideous that I couldn’t even open the refrigerator door without wanting to cry. It took five months of strict rest for it to heal.

I definitely don’t want to go through that again! What annoys me even more is that 190 is well short of what I could break from the floor if whatever-this-is wasn’t doing what it’s doing (left arm has no issues at all). What on earth is going on here, and how do I make it stop???

A: Hi Jackie, thanks for writing and sorry to hear about your grip issues.  I know how frustrating it can be to be hurt and unable to train like you’d like, so hopefully I can offer some insight.

But first, given you’re writing to me all the way over from Germany, can you answer me just one minor question?

What is up with the obsession German’s have with David Hasslehoff??????

I’m not going to sit here and pretend that I didn’t idolize the guy back in his Knight Rider days, and I certainly have to give my man kudos for rocking the 80’s mullet and chest hair like a boss…….

But German’s take things to a whole different level and go bat-shit crazy for the guy.

What gives?

Please, tell me, it’s killing me.

Okay – with that out of the way, lets state the obvious:  while it’s pretty much impossible for me to make any definitive assertions over the internet without being able to observe you in person, I have a few comments/insights.

1.  It sounds like you need to get some aggressive soft tissue work done. Honestly this is the best piece of advice I can give you and takes precedence over everything else.

The forearms and by extension – the elbow – is a very “claustrophobic ” area where a lot of “stuff” converges in a small area resulting in a lot of friction that takes place amongst muscle, ligaments, facia, and other soft tissue.

On the medial side you have all the muscles in the forearm that flex the wrist (I could list them all here, but it’s early and I don’t feel like it. But trust me: they’re there) which connect to the medial epicondyle via the common flexor tendon, with the pronator teres (which I suspect is going to be a HUGE player for you) attaching nearby.

The same can be said on the lateral side:  you have all the muscles in the forearm that extend the wrist which connect to the lateral epicondyle via the common extensor tendon.

Posteriorly you have all three heads of the trciep attaching to the olecranon via another common tendon.

And lastly, anteriorly, you have the attachment points of the bicep brachii, brachioradialis, and brachialis on the elbow.

See what I mean?  There’s a lot going down in one teeny tiny area.

We call it a Zone of Convergence, and it stands to reason that if your forearm is that painful whenever you grab a pencil, let a lone a barbell, you have poor tissue quality in that area.

Just resting – while it may alleviate the symptoms temporarily – won’t get at the root of the problem.  To that end, I can’t stress enough how crucial it will be to seek out a reputable manual therapist – someone who can perform Graston or Active Release Therapy – to treat that area.

As I noted above I have my suspicions that the pronator teres (which, as the name suggests, pronates the forearm) is on fire and that you need to take a bit of a grenade approach in terms of addressing the entire spectrum.

While manual therapy takes priority, you can take the self myofascial release route and use something like The Stick on the forearms, biceps, and triceps.

2.  Another less obvious – albeit equally as important – thing to consider is something that many people overlook.  While soft tissue restrictions in the forearm and elbow area make a lot of sense and is a great place to start, it’s not uncommon for everything to manifest itself higher up the kinetic chain into the brachial plexus area – upper traps, neck, etc.

The brachial plexus is basically an area where a network of nerves start at the spine, run through the neck, and all the way down to the elbows, forearms, and to each finger

If you’re someone who spends a fair amount of time in an office staring at your computer, that area is notorious for getting gunked up (<— how’s that for a technical term?) and it may bode in your favor to have a manual therapist perform some work there as well.

Moreover, this is also an opportune time to run an audit on your breathing patterns.  If you’re someone who’s a “chest breather,” meaning whenever you take a breath you tend to rely on your accessory breathing muscles like the upper traps, levator, scalenes, etc, it’s no wonder you’re jacked up!

Think about it:  you take upwards of 20,000 breaths everyday.  Not that every breath is going to be “optimal,” but it stands to reason that if you’re a dysfunctional breather bad things may happen.

Taking the time to address something as simple as how you breath, becoming more of a “belly breather,” and learning to use your diaphragm more efficiently, can go a long ways.  More than you think.

Check out THIS post I wrote last year on the topic.

3.  As a corollary to the above, it’s also important to run a check on your technique on stuff like push-ups, rows, and chin-ups.  If you’re someone who has a tendency of shrugging everything – and relying too heavily on the upper traps to do everything – that’s just going to feed into the issue(s) at hand.

While addressing soft tissue quality and breathing patterns are high on the “to do” list, it’s going to be a waste of time if all you’re doing is heading back to the gym and shrugging everything.

So, you might as well give yourself an audit on those things too.  Just something to consider. I know everyone thinks their technique is spot on, but I can assure you that everyone needs a little tweaking.

I realize it wan’t the sexiest answer in the world, but hopefully it helps a few people out there.

But seriously, Hasslehoff……what’s the deal?

CategoriesStuff to Read While You're Pretending to Work

Stuff to Read While You’re Pretending to Work: Haters Gonna Hate

Ever notice that when it’s cold outside – for the record:  yesterday and today are the first two days of legitimate snow here in Boston – people bitch and whine about how cold it is?

By that same token, when it’s too hot – people bitch and whine about how hot it is!

I don’t get it.

Then again – these are the same people who will find any excuse to complain about something. It’s too windy; the Dew Point is f’ed up; ObamaCare is the next Death Star; the barista at StarBucks put too much cream in my latte; I can’t believe “so and so” is on the new season of Dancing With the Stars; the checkout person didn’t ask me if I wanted my receipt, bitch; that rainbow is too “raibowey;” for the love of god, people, HAN SHOT FIRST!!!!!!!!!!!!

Anyways I have no other reason behind this keen observation other than it’s something I noticed today while standing in line at Panera while someone complained that the line was moving too slow.

People complain way too much.

Now if you excuse me, someone just looked at me wrong and I have to go scissor kick them in the pancreas.

If You Are Not Sore, You Are Not Working Hard Enough…Or Are You – Kyle Arsenault

It’s a common fallacy people make.  If they’re not drowning in a pool of their own sweat or don’t feel like they’re on the verge of an epileptic seizure after a training session, it obviously was a waste of their time.

This is a battle I have fight all the time and my retort is usually saying something along the lines of “any tool with a certification can make you tired and sore.  But it takes a COACH and someone who actually know what they’re talking about to be able to tweak programming to garner a desired effect – whatever it may be.

Making someone tired for the sake of feeling tired is a pointless endeavor and rarely yields positive results in the long run. Likewise soreness doesn’t mean much either

On one hand, especially with newbies, it’s a matter of teaching them the difference between sore and hurt.

On the other, especially with those who are more advanced, it’s a matter of teaching them that fatigue will always mask one’s true level of fitness.

Yes, soreness is okay and it’s perfectly fine to want to kick yourself in the ass sometimes so that you ARE sore the next day.

But it’s certainly not the “x-factor” when it comes to long-standing results, and it’s certainly not something that should be strived for on a consistent basis.

Supple Leopard vs. The World – Dr. Quinn Henoch

It’s the fitness industry’s latest version of the classic West Side Story rivalry between the Jets and the Sharks.

On one side you have those who lean towards the CrossFit mentality – in particular, Dr. Kelly Starrett – and advocate pushing the knees out when squatting or deadlifting in an effort to create more torque and not to allow any torsion stress on the body.

On the flip side, you have those who have a little bit of an issue with this mindset.

I thought this was a fantastic (and fair) discussion which lends the opportunity for the reader to make up his or her own mind on the topic.

My thoughts?  I think much of the controversy is lost in translation.  I’ve heard Kelly talk about this and from what I can gather – and I could be wrong on this – he never really states that he wants people to excessively push their knees out.  Rather, it’s more of a cue so that people don’t go into knee valgus (which I agree with, 100%).

I know I’d never go out of my way to allow someone to squat with excessive knee valgus. And I think by that logic it makes sense that letting the pendulum glide too far to the other side – where people are going into excessive knee varus – doesn’t do them any favors either.

What are people arguing about again?

Take the Lunge – Lee Boyce

Lee’s been on a writing tear lately, and with this gem he touches on the intricacies of the one of the more overlooked movement patterns – the lunge.

CategoriesUncategorized

Miscellaneous Miscellany Monday: 12/9/13

1.  Starting things off with a bit of TG content, I had the pleasure of teaming up with the likes of other top-notch coaches like Lee Boyce, Geoff Girvitz, Jeremey DuVall, and Anthony Yeung on a tongue-in-cheek piece on www.conFitdent.com on exercise selection and programming.

It’s a running series that I participated in a few months ago where I answered a litany of questions but was told I could only use “x” number of words (which is a lot harder than it seems) to portray my thoughts.

The gist is that every few weeks they’ll release a “series” of compatible questions or just go with a running theme.

In case you missed it the first time around, here’s one that involved Cardio Tips.

Just to reiterate:  if you want to geek out and read all about supercompensation, strength deficit, periodization, or the difference between central fatigue and peripheral fatigue than I suggest opening up your copy of SuperTraining and have at it.

If, however, you don’t take yourself too seriously, and want a quick, bullet-point read…..than you can check out the latest iteration – Exercise Selection: How to Optimize Your Workout.

2.  I touched on this a few weeks ago, but I want to try to keep this fresh in people’s minds as I think it’s going to be a SICK event.

I’ll be heading back to alma mater – State University of New York at Cortland (SUNY Cortland) – on April 5th, 2014 as part of the First Annual Cortland Strength and Conditioning Symposium.

With the likes of myself, John Gaglione, Dr. Mike Roussell, Dr. Cassandra Forsythe, and Spencer Nadolsky as the slated line-up it’s going to be an unparalleled event for students and fitness professionals alike.

Registration is now open, and it’s set at a VERY reasonable price as we want to ensure that this is an event that’s accessible to everyone.

For more information you can go HERE.

3.  Part of the “charm” about this blog and what I feel makes it so successful is that I’m not afraid to go off the beaten track and let people know that I’m not just some fitness cyborg.  I don’t eat, live, and breath fitness 24/7.  I occasionally – not often – scratch a scheduled training session.

Sometimes I squat above parallel.

I eat gluten!!!

So I guess I won’t be invited to a Paleo party anytime soon.

More to the point:  sometimes I just like talking about other stuff, and I’m not shy to share more personal components of my life here on this blog.  I can’t tell you how many times people have stopped by to check out Cressey Performance and asked how my cat, Dagny, was.

At first I’m taken aback – “how the hell do you know the name of my cat?!”  But then I remember that I talk about her on this blog about once a week, and I also post pictures like this on my Facebook page:

O…..M……G.  She’s the cutest thing, like, ever.

And for the record I didn’t take a selfie of myself chilling with my cat.  Come on:  I do have some standards.  Lisa happened to snake this pic of me when I got back from Edmonton and I was a little jet lagged the following day.

Anyways, with that out of the way I wanted to share a funny story from this past weekend.

Every Saturday night Lisa and I have our weekly “date night,” where 1) I actually take a shower and wear matching socks and 2) we go out to a nice dinner somewhere in the city.

As it happened this past weekend Lisa was taking me out for my belated Birthday dinner. As we were walking from point A (super secret birthday surprise) to point B (dinner at Ruth’s Chris Steakhouse) we found ourselves on Newbury Street.

For those unfamiliar with Boston, Newbury Street can be thought of where all the upscale shops and stores are located and as such, where all the uppity people tend to spend their money

For shit and gigs we both figured, “huh, we have some time to kill, why not walk into this fancy schmancy jewelry store and peruse some rings?”

As a side note and just for the sake of clarity:  Yes, Mom, you read that correctly….Lisa and I were in a store, looking at rings. But more cogent to the point – I just want to let everyone know that I in no way would EVER buy a ring from said fancy schamancy store.

We just wanted to walk in – it was freezing outside! – and get an idea for what Lisa likes.

After about five minutes of meandering around the woman in the store approaches us and asks Lisa which one she’d like a closer look at. “That one,” Lisa said. Pointing to a 6.1 carat cushion cut diamond.

What followed was a whole diatribe about cut, quality, angles of light, and I think there may have been a Pythagorean theorem thrown in there for good measure.  The woman was very friendly and more than willing to answer our questions.

Then, the question that was on both our minds came out.  Lisa asked, “out of curiosity, how much is this one I’m wearing cost?”

$175,000.

Cue me destroying the back of my pants.

LOL – Lisa’s got good taste it seems…….;o)

4.  One of the perks of being “kind of a big deal,” (my words, no one elses) is that I get sent free stuff to try out.  Recently a Boston based company called EnergyBits sent me a sample to try out, and I just wanted to toss their name out there to my readers.

Giving the Cliff Notes version (ie: stealing from their own website):

Want more energy, more mental vitality, or a healthy high protein snack you can grab on the go? How about a quick way to boost your athletic performance, supercharge your run or crank up your endurance while working or working out?

Made from 100% organically grown spirulina algae and loaded with 40 nutrients, ENERGYbits® algae tabs have the highest concentration of protein in the world (64%) all for just one calorie per tab.

I’ve been trying to make a concerted effort to tone down my energy drink consumption, and have been using EnergyBits sporadically for the past two weeks as a way to boost my  “morale” in the late stages of the day when I’m coaching.

I have to say:  it’s working! I definitely notice a steady surge in my energy levels without the jitteriness that comes from downing a metric shit ton of caffeine.

A word of caution, though – they taste like butt-crack.

But this isn’t a slap against the company since they go out of their way themselves to tell people that the taste takes some getting used to.  In fact they encourage people to not EAT THEM, but rather to take a handful and down it with a glass of water.

Either way, for those looking to get an energy boost without feeling like their left ventricle is going to explode, I’d highly encourage checking www.EnergyBits.com (<—- no affiliate  code).

5.  Lastly, my boy Dean Somerset wrote an EXCELLENT blog post last week titled Fit/Fat Shaming, Judging, and Simply Being You.

At the end of the day, what you do with and how you feel about your body is entirely up to you.  It’s your body.  Stop allowing others to dictate your thoughts and predications.

Dean’s explanation and insight is A LOT more thorough than that…..so I’ll just defer to him. Read it!  Do it!

CategoriesSupplements

Creatine (Wait, Stop! I Promise This Post Won’t Make Your Head Hurt)

Creatine has been around for well over 20+ years and is undoubtedly one of the most researched (and popular) sports and performance supplements in human history.  Still, there’s a lot of preconceived notions and misinformation regarding creatine and its efficacy.

Some people think it’s a steroid (it’s not), some people think it will stunt growth (it doesn’t), some people think it will shut down your kidneys faster than Congress can shut down the Federal Government (it’s close, but no cigar; in fact, it’s perfectly safe), and some think creatine is part of the Periodic Table of Elements (Walter White would be disappointed in you).

And while there’s certainly no shortage of blog posts, articles, and even books written on the topic, this post written by Eric Bach of Bach Performance won’t make your head hurt with long words and overly “sciency” stuff.

In every essence of the phrase, he gets right down to the nitty gritty and tells it like it is.

Enjoy! – TG

Creatine. We’ve all heard about it, but what’s the real deal?

I get tons of questions regarding the safety and effectiveness of creatine.

Does it make me look better naked?

Will it turn me into a deadlifting Megatron?

What’s the ideal dosing?

Is it dangerous?  Are there any side-effects?

With all the products and information it’s no wonder there are questions.  I’m going to dig in and tell you what creatine is, how to use it, and what to expect.

What is it?

Creatine is a natural amino acid most commonly found in red meat, but is also produced in small amounts by the liver, kidneys, and pancreas. In the body, creatine becomes a fuel source for short duration high-intensity activities such as weight training, sprinting, and jumping where phosphocreatine is converted to ATP.

The amount of creatine consumed through the diet and produced naturally in the body are low; supplementation increases available levels.

Why It’s Important

*Warning, this gets a bit heavy.  But I promise it will be fairly painless.

The energy needs of brief and powerful movements lasting less than 10 seconds, such as a short sprint or a maximum lift, are met by the phosphagen system. This system replenishes the stores of adenosine triphosphate, or ATP, which provides energy to working cells  (Andrews).

Muscles have a small amount of ATP in the cell, but only a little bit — enough for a few seconds. ATP is broken down by removing a phosphate, which turns it into adenosine diphosphate. To generate more ATP, the muscles need to replace the third missing phosphate. AH-HA!

This is where Batman creatine saves the day. Creatine donates a phosphate for ADP to become ATP again, providing fuel to finish the sprint without a drop in performance.

Supplementing with creatine creates larger stores of creatine, allowing for more ATP for short-duration exercise performance.  Endurance athletes have also experimented with the use of creatine, but for the most part creatine is not useful in endurance sports.

Basically, more creatine let’s you go Beastmode for longer. And that’s cool.

Do You Even Lift, Bro?

A sweet side effect of creatine supplementation is weight gain. Some don’t gain any weight, and some gain 5-10 pounds, it’s highly individualized.

Here’s the deal: Creatine is osmotic, meaning it pulls water into the cells. When supplementing with creatine it’s best to drink boat-loads (this is an actual measurement, trust me bro) of water to properly hydrate the body.

When this happens your muscles pull additional water into the muscle, increasing cell volume. The additional hydration increases the speed of protein synthesis within the muscle, boosting muscle growth and recovery.

Safety Concerns

Contrary to the beliefs of its pundit’s, creatine is safe. Creatine has gone through extensive research and testing without significant findings that it’s harmful.

The biggest issues related to creatine relate to dehydration, which can lead to soft-tissue injuries such as a strain, and hypothesized kidney dysfunction at extremely high levels.

Recently, increased research and testing of creatine have analyzed the effectiveness of creatine on health related outcomes. Preliminary evidence has suggested supplementation can be beneficial in the treatment of a broad range of diseases, neurodegenerative disorders, cancer, rheumatic diseases, and type 2 diabetes.

How to Use It

The body can store only a limited amount of creatine. I don’t recommend a loading phase for my clients; rather, taking 5-10 grams per day.

On workout days dose it pre and post-workout with your beverage of choice. Taking creatine with a protein or carbohydrate beverage can increase absorption, as the increased insulin response will pull more creatine into the muscle tissue. A recovery drink works better than beer, trust me. 

On non-workout days creatine works well in the morning with a drink such as green tea. Using a warm drink helps dissolve creatine better, so the bottom of your beverage doesn’t taste like a sandbox.

Other Types of Creatine

There has been an influx of new creatine products hitting the market over the past few years. Despite the fancy marketing and price tag they aren’t better than good ole’ creatine monohydrate. In this study, creatine ethyl ester was found to not be as effective as creatine monohydrate at increasing serum and muscle creatine levels OR in improving body composition, muscle mass, strength, and power.

Sounds busted to me.

Wrap Up

Creatine is a great supplement that increases high-intensity exercise performance and boosts muscle mass. Stick with creatine monohydrate, as it’s the most tested and proven form. 5-10 grams per day should work great, especially if taken post-workout with your recovery meal or in a warm beverage on non-workout days.

To maximize creatines’ effectiveness and alleviate any safety concerns hydrate your body.

About the Author

 

Eric Bach, CSCS, PN1 is a Strength Coach in Denver, Colorado. Eric trains clients in-person at Steadman Hawkins Sports Performance and is President of Bach Performance. A writer for EliteFTS, thePTDC, and STACK, Eric has established a great reputation for his simplistic style, nutritional programming, and helping clients develop long-term lifestyle changes.

Come hang out with Eric on Facebook, twitter, or drop him a line at Bachperformance.com.

Resources:

Andrews, Ryan. “All About Creatine.” Precision Nutrition. Precision Nutrition Inc., n. d. Web. 2 Nov. 2013. <http://www.precisionnutrition.com/all-about-creatine>.

Baechle TR & Earle RW. Essentials of Strength Training and Conditioning. National Strength Training Association, 2nd ed. Human Kinetics. Champaign, IL. 2000.

Green AL, et al. Carbohydrate ingestion augments skeletal muscle creation accumulation during creatine supplementation in humans. Am J Physiol 1996;271:E821-E826.

Gualano, B., H. Roschel, A. H. Lancha Jr, C. E. Brightbill, and E. S. Rawson. “National Center for Biotechnology Information.” In Sickness and in Health: The Widespread Application of Creatine Supplementation. (2011). National Center for Biotechnology Information. U.S. National Library of Medicine. Web. 28 May 2012. http://www.ncbi.nlm.nih.gov/pubmed/22101980.

Spillane, Mike, et al. The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levels. Journal of the International Society of Sports Nutrition 2009, 6:6doi:10.1186/1550-2783-6-6.

CategoriesProgram Design Rehab/Prehab

The Lowdown on Femoral Acetabular Impingement. Trust Me: Not as Geeky as It Sounds.

When I first moved to Boston – roughly seven years ago – I was working at a swanky, fancy-pants commercial gym in the downtown area and I remember on one of my days off Eric Cressey and myself took a little road trip to Worcester, MA to take part in an impromptu and informal workshop that orthopedic surgeon, Dr. Chris Vinton, was doing at the College of the Holy Cross on Femoral Acetabular Impingement (FAI).

Like some of you seeing this for the first time and starring at the screen as if I were saying the alphabet in Klingon, at the time of Dr. Vinton’s talk I had a similar reaction:  Femoral Acetabular Say-What-Now???

Without beating around the bush, in laymen’s terms:  “FAI is a condition of too much friction in the hip joint.  Basically, the ball (femoral head) and socket (acetabulum) rub abnormally creating damage to the hip joint.  The damage can occur to the articular cartilage (smooth white surface of the ball or socket) or the labral cartilage (soft tissue bumper of the socket).”

Resultantly it sucks donkey balls.

Source:  www.hipfai.com (except for that last sentence).

FAI comes in a few flavors.  You have your Cam form which manifests itself as a bony overgrowth on the femoral head itself, and you have your Pincer form which results from a bony overgrowth on the rim of the acetabulum itself. And lastly, for those unfortunate few who can’t seem to make up their mind, you can also have a Mixed form which is a bony overgrowth of the two.

Even then, seven years ago, as I was sitting through the presentation, FAI wasn’t that prevalent in the athletic or fitness community – or, so it seemed.  I couldn’t recall one case of a current or past client who I felt fell under this FAI tree.

Fast forward to today and it seems everyone has FAI.  Hockey players, baseball players, soccer players, the mailman, the woman who does your hair, Batman.  Everyone.

Of Note:  Eric was talking the other day about this and mentioned something about a recent study that came out which showed something like 90% plus of high school hockey players have some degree of FAI.

I’ll have to see if I can ask him to find the study.  Stay tuned……

UPDATE:  Kevin Neeld discusses it HERE.

I don’t feel it’s because of some new pandemic or anything – like we’ve somehow mutated into a bunch of hip impingement ninjas.  Nah – nothing like that.

Well, maybe a little bit.  If I were speak freely I do feel that athletes today – particularly young athletes – fall into two categories:

1. Those who specialize too early and play ONE sport year round without any breaks.  It’s not rocket science to see how someone who plays a rotational sport year round, and develops pattern overload, can run into problems.

2.  Those who make the Tin Man look agile. It’s sad to say, but kids (and adults) just don’t move around as much anymore.  Texting has taken the place of riding a bike.  Call of Duty has trumped pick-up baseball games.  Escalators > stairs.

So I think we have ourselves to blame…..to a degree.  When we take people who have joint restrictions and don’t move well, and then ask them to “do stuff” they aren’t prepared to do. Well…….

But too, I just feel we’ve gotten a heckuva lot better in recent years at screening for FAI and recognizing symptoms.

Before I go on I should state the obvious:  as a strength coach I’m not diagnosing anything.  I can use some rudimentary “screens” (like the one to follow) which will better help me ascertain the situation and provide information on how I’ll go about programming for someone.  But almost always, I’ll be referring someone out to a more qualified fitness professional who can do a more thorough exam and/or possibly order an MRI.

That said if I’m working with an athlete or general population client who’s complaining of consistent and chronic hip pain – especially if they participate in a rotational sport or when squatting, I can do a quick “screen” as follows.

Here, I lie the person on their back and make sure their lumbar spine is flush against the table.  Then I’ll bring the affected limb into flexion, adduction, and internal rotation.

If the person winces or punches you in the face, it’s fair to say that that lit them up, and they may be a candidate for FAI. You can tweak the test by having them brace their abs – which will encourage more posterior pelvic tilt – and if it feels better, you know that’s it’s more of an alignment issue and not a worse case scenario.

No need to send someone for an MRI when all they had to do was posteriorly tilt their pelvis.

But it stands to reason that even with their anterior core engaged, if that still causes discomfort, it’s time to refer out and get them to see a more qualified practitioner to dig a little deeper.  Only through a combination of screens, tests, and possibly an X-ray or MRI can FAI be truly diagnosed.

But What Can You Do In the Meantime?

A lot, actually.  But lets try not to get carried away in thinking we’re going to solve the issue.  This is more about working AROUND the issue and maintaining a training effect than anything else.

FAI is a condition, not a disease. But here’s some food for thought.

1.  Rule numero uno is to nix squatting.  You’re not going to last long as a strength coach or personal trainer if you’re throwing caution to the wind and squatting those who are candidates for FAI.

I will say, though, that I say that with a grain of salt because technically you could still squat someone – albeit NOT BELOW 90 DEGREES OF HIP FLEXION.

If you look at the pictures provided above of the Cam and Pincer lesions, you can see how if someone were to squat below 90 degrees, that that would be, well, dumb.

Depending on symptoms you could get away with staying above 90 degrees, but honestly my rule of thumb is to wait six months before playing with fire.

2.  The good news is that you can still hit the lower body fairly hard.  Things like rack pulls, trap bar deadlifts, or even conventional deadlifts would be fair game given that neither require significant hip flexion.  In addition barbell glute bridges would be a viable option as well.

3.  Surprisingly, single leg work is fair game.  Even things like Bulgarian split squats – as counterintuitive as it sounds given they require deep hip flexion – would be okay.

The thing with single leg work is that the trainee can sort of find his or her “groove” with regards to hip internal and external rotation and be able to find a pain free ROM.

To that end I wouldn’t be apprehensive to crush single-leg training with someone with FAI – although certain things like femoral glide syndrome should be on the radar and may lend itself to making appropriate modifications.

4.  Go read anything and everything by Kevin Neeld on the topic. THIS and THIS would be good starts.

And that’s about it really. I think as strength coaches and personal trainers it IS in our best interests to know when to refer out and understand scope of practice.  But just as equally (if not more) important is to have the ability to assess and screen clients for certain conditions and be able to still garner a training effect and not make them feel like a patient.

Of course there is still a lot that’s unknown about FAI (s0me doctors still fail to admit that it exists!), and this post isn’t meant to serve as a definitive path to address the issue.  If anything I just wanted to throw it out there and hopefully bring forth a little more awareness on the topic.

CategoriesMotivational

3 Not-So-Common Mistakes Athletes Make

It’s a fairly self-explanatory title, with a fairly self-explanatory premise:  Athletes, like everyone else, make mistakes.  However, in giving a bit of a spoiler alert (and what I hope will be an enticing attempt for you to click on the link), I don’t cover your run-of-the-mill mistakes in this most recent article I wrote for Stack Magazine.

I don’t discuss set and rep schemes, nor do I discuss exercise technique. I don’t touch on the importance of making better food choices, and while it’s arguably the most important factor (and most overlooked), I don’t belabor how crucial it is to instill appropriate recovery methods (hydration, sleep, soft tissue work, puppy dog kisses, etc).

All that stuff – while important – are always talked about and debated and written about ad nauseam. I wanted to take a different route – you could say “the road less travelled” – and bring to light some other things that come into play when broaching the topic of mistakes (young) athletes make.

You know, stuff like not instilling a sense of work ethic, battling entitlement, or going waaaaaaaay too long before washing their jock strap.

Okay maybe not the last one, but I do feel that my soap box rant may strike a chord with some athletes and parents of athletes. At least that’s my goal.

It’s a quick read, but I’d love to hear some feedback to see if anyone else agrees with my thought process.

Thanks!

3 Not-So-Common Mistakes Athletes Make (<—Click Me)

CategoriesUncategorized

Exercises You Should Be Doing: Prone Kettlebell Drag

Raise your hand if you’re kinda still feeling out of sorts from all the apple pie you ate over the weekend. Don’t be bashful – there’s nothing to be ashamed about.

*Raises hand*

For those who celebrated it, I hope you had an amazing Thanksgiving weekend.  Despite not going back to my hometown and being around family for the first time ever, my Holiday was pretty spectacular.

Rather than risk me burning our apartment down attempting to help with cooking, Lisa and I opted to order Thanksgiving “to go” from one of our favorite restaurant here in Boston and had a lovely catered dinner.

It wasn’t quite the same as mamma Gentilcore’s home cooking, but it was scrumptious nonetheless….complete with turkey, stuffing, mashed sweet potatoes, kale, some roasted mixed veggies, and gravy!  SHA-ZAM!

The following morning we had a wicked early flight to Virginia for a friend’s wedding.  Trust me:  getting up at 4:15 AM after eating what mounts to a crap-ton of food less than eight hours earlier isn’t fun. I’d liken it to being forced to watch a Jillian Michaels video on repeat.

But both Lisa and I persevered and met the rest of the Cressey Performance crew at Logan Airport for the weekend of festivities. I won’t bore all of you with the details, but taking a few moments to highlight some of the weekend’s shenanigans:

1.  I’m pretty much the best minivan driver in the history of the world. I was somehow knighted as the weekend’s version of a “soccer mom” and was responsible for all the driving.  I rocked that shit.

Seat belts on or so help me god I’ll turn this van around and give you something to cry about!

2.  Virginians love them some pancakes.  I’ve never seen so many pancake houses in my life.

3.  We visited Colonial Williamsburg and I couldn’t help myself from having a little fun and yelling out, NO TAXATION WITHOUT REPRESENTATION.  NO TAXATION WITHOUT REPRESENTATION.

No one joined me. Jerks.

4.  Since last weekend was also my birthday weekend, I enjoyed myself by having four pieces of apple pie on Saturday night.  In case you haven’t figured it out by now: I kinda like apple pie.

5. By the way:  thank you to everyone who sent me B-day wishes on Facebook!

6.  If there’s one song that will get the entire CP crew on the dance floor and act like a bunch of idiots it’s this:

On the return trip back we had some time to kill and had the opportunity to walk around and see the sights and sounds in Washington, DC.

I had never been to DC before, and definitely plan on making a trip back so that I can spend more time in the museums.

One my favorite stops, though, was the World War II Memorial.  My grandfather was at Pearl Harbor when it was bombed in 1941 and I have always had a fascination with that era and how the people during that time came together, stepped up, demonstrated courage beyond measure, and did what had to be done.

In any case, enough about that.  I know the majority of people didn’t log on today to hear all about my weekend.

Oh, did I mention I crushed some leg extensions!

Eric Cressey, Matt Blake and myself made a cameo appearance at a local gym in Williamsburg and basically took ourselves through the most meat-headed of meathead workouts.

Yep, that happened.

Okay, lets get to the meat of this post.

Prone Kettlebell Drag

Who Did I Steal it From:  As with the Supine Band Pallof Press, I stole this gem from Providence, RI based strength coach, Sean St. Onge.

What Does It Do:  Rather than come across as a broken record, I’ll just defer to THIS post as to why I like plank variations, as well as delve into a minor rant as to why I could care less if someone can hold that position for the duration of a Katy Perry song.

It really doesn’t mean jack squat if you’re someone who looks like this and is just hanging on your passive restraints in your lower back.

What I love about this variation is that not only are you going to get a killer oblique workout, but with the drag (and grab) of the kettlebell you’ll also get a fair amount of shoulder internal and external rotation, too.

Key Coaching Cues: Playing the Captain Obvious card, it stands to reason you should first MASTER the regular (low) plank before attempting this variation.

Assuming this is the case, all you’re going to do is get in the “set” position (eyes in line with your fists, backside should be neutral, abs and glutes engaged, pull elbows towards toes to garner more tension) then reach over and grab the handle of the KB.

Pinch your shoulder blades together and drag the bell to the opposing side. When there, flare the elbow in towards your ribcage, and place the bell down.

Then all you’re going to do is repeat the same process of “x” amount of repetitions per side.  I like to shoot for 5-6 reps per side.

Of note, for those who need to REGRESS this exercise (particularly for those with limited shoulder IR or ER), you can perform the same movement in the standard push-up position – with both arms fully extended – which will allow a little more wiggle room.

And that’s that.  Give it a try today and let me know what you think!