CategoriesCorrective Exercise Program Design Rehab/Prehab

Measures to Strengthen and Prevent Achilles Injuries

Hi, my name is Tony and I ruptured my Achilles tendon earlier this year. 

It was the first significant injury of my life and one that, as it happens, happens often (and without warning). Since my injury six months ago I’ve met numerous people who have gone through the same dumpster fire of an experience.1.And as a result I’ve documented my rehab and post-surgery training via my IG account using the hashtags #findyourtrainablemenu and #achillesgate2020.

However, I figured something more in depth and robust with regards to explaining the mechanism of Achilles rupture (as well discussing prevention) could be of benefit to the masses. To that end, my fellow coaches and colleagues – Dr. Bo Bobenko and Shane McLean – offered to write something for the site to cover exactly that.

For what it’s worth: I peppered in a few comments myself along the way.

I hope it helps and enjoy.

Copyright: lassedesignen / 123RF Stock Photo

Measures to Strengthen & Prevent Achilles Injuries

When admiring yourself, flexing away, do you ever give thought to the unsung hero of muscle? You know, the things that attach the muscles to your bones: the tendons. You probably don’t give much thought, until it’s too late.

Unless you’ve had your head in the sand, you know our resident funny man and light saber fighter extraordinaire, Tony Gentilcore tore his Achilles tendon while hanging out with the in-laws in Florida six months ago

NOTE FROM TG: It’s important to remember that correlation doesn’t equal causation here. My in-laws didn’t cause my Achilles rupture…;o)2

Tony, a big strong guy with no history of serious injury performs a drill he has done before and boom, suddenly it’s not his day, week, month or even his year….

NOTE FROM TG: For those interested, HERE is a great depiction of the exercise (and mechanism) that served as the impetus to my injury.

The “Jump Back” Start

This video almost exactly showcases what happened. The only difference is that I didn’t preload my sprint with a three-hop thingamajig (just one), and in my case, once my back leg planted, I fell immediately to the ground.

Plus I may or not have been wearing a cape.

A Little Background On The Achilles Tendon

The tendon is named after the ancient Greek mythological figure Achilles (and not Brad Pitt) as it was the only part of his body that was still vulnerable after his mother had dipped him into the River Styx. Plus,  we all know where he got shot with an arrow, at least in the movie. 

The Achilles tendon is the thickest and strongest tendon in the human body. It’s the tendinous extension of the three-headed calf muscle soleus and the two-headed gastrocnemius and it inserts on the calcaneus (heel). 

The contraction of the calf muscles transfers a force through the Achilles tendon, which enables plantar flexion of the foot and allows for actions such as walking, running, jumping, bounding, sprinting, and skipping.

During these movements, the Achilles tendon is subject to the highest loads in the body, with tensile loads up to 10 times the body’s weight.

The reasons for this are twofold: First, the Achilles consists of type II fast-twitch fibers, and this elasticity allows for rapid forward and backwards movement. Secondly, the tendon type I fibers of collagen and elastin which are lined up parallel from calf to heel, are responsible for the Achilles tendon strength. (1) 

The Achilles due to its strength and its ability to handle high loads makes it a resilient tendon, which is good and bad. Good because it can handle lots of load and bad because it’s not always going to send pain signals to the brain every time something goes wrong. 

This is one reason why Achilles tears can happen without warning. 

 

Types Of Achilles Injuries

When your achilles hurts or you feel pain you’ll often be told ‘You got tendonitis bro’ But there are few different types of Achilles injuries besides tendonitis. 

1. Achilles Tendon Tears

This is the mack daddy of all tendon injuries and like with Tony, it often happens without warning. If you hear a pop and a pain that radiates up your lower leg, there’s no second guessing what you’ve done. 

NOTE FROM TG: The best way I can explain the sensation is that it feels like someone taking a sledgehammer right to your ankle. It doesn’t tickle.

2. Achilles Tendinopathy

Tendinopathy is a degeneration of the collagen protein fibers that form the Achilles.  Its symptoms include increasing pain at the heel, stiffness, swelling at the back of your ankle, and a grating noise or creaking feeling when moving your ankle. 

3. Achilles Tendonitis

Tendonitis is acute inflammation of the tendon and its symptoms include pain and stiffness in the morning, pain that worsens with activity, extreme pain the day after exercise. 

There are two types of Achilles tendonitis: insertional and noninsertional.

  • Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone often caused by bone spurs. 
  • Noninsertional Achilles tendonitis involves fibers in the middle portion of the tendon. 

4. Achilles Tendinosis

Tendinosis is the non-inflammatory degeneration of the collagen fibers of the tendon. This includes changes to the structure or composition of the tendon that results from repetitive strains without proper healing. 

Achilles and calf tightness are common causes of Achilles tendinosis. Plus insertional Achilles tendinosis is often associated with heel spurs as it rubs against the achilles causing small tears.  

Activities That Cause Achilles Tears

Achilles tendon tears happen to people who do things where they quickly speed up, slow down, or pivot, such as:

  • Running
  • Gymnastics
  • Dance
  • Football
  • Baseball
  • Softball
  • Basketball
  • Tennis
  • Fighting Zombies, Salsa Dancing, Talking About Feelings (<— things added by Tony)

Achilles tears tend to happen when you start moving suddenly as you push off and lift rather than land. Sometimes these abrupt actions can be too much for the tendon to handle. 

Here is the statistical lowdown on how tears happen. 

  • 90% of injuries occur with an acceleration/deceleration movements mentioned above
  • Only 15-20% of men reported any sort of heel pain/tendinosis before the injury
  • 50% of men who have an Achilles Rupture had tissue degeneration before the injury
  • Typically occurs 30 minutes after moving around 

Research has shown Achilles tears include clear degenerative changes before the rupture but many of the Achilles tendon ruptures occur suddenly without any preceding signs or symptoms. (2)

For instance, Tony’s tear was caused by aggressive eccentric load (jump back start) combined with poor load management  and then “jumping” right back into sprinting. 

NOTE FROM TG: Exactly. Part of the problem was sheer bad luck. But too, up until that point – eight or so weeks into pandemic quarantine – I hadn’t been doing much (if any) plyometric activity.

Unfortunately, this doesn’t count.

👇👇👇👇

 

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But he wasn’t in any pain.

In his mind it was all systems go. The main point here is there’s not one definitive “cause.” of Achillies tears.  It’s equal parts shit-happens and bad luck. 

Big Picture With Tendon Pain Modulation

1. CNS Response

The CNS is incredible at responding to and adapting to pain modulation. This is a good thing to keep going and for our survival but makes understanding our tendon health much trickier because damage can exist without pain. 

2. Load Management and Exposure

This is probably the single most important component to tendon health that we should seek to understand and pay attention to. It can be intimidating to truly track your loads/exposure, but the better we get at it, the more we increase our chance of avoiding injury.

All of the research continues to bear out controlling the load on tendons is the best way to make any kind of change. The analogy I often use when explaining this to patients is the comparison to a wall that continues to take damage or have a crack and we need to keep adding spackle to it every 48 hours to reinforce it and strengthen the overall structure.

How To Prevent Achilles Tears

The experts and research are a bit mixed on this therefore the safest approach in my mind is to increase the variety of loads you place on the tendons. 

Unless training for a specific sport or activity, then we should focus on preserving the natural capacity of what the tendon is meant to do, which is to absorb and transfer forces effectively in the simplest of terms.

Pogo Jumps

 

Heel Taps

 

A Daily Routine to Incorporate Into Your Movement Prep

 

You need tendon loading with multiple angles and a plan for tempo for the long term. My go to is often for heavy slow resistance, four seconds eccentric, three seconds concentric, carefully plotted over 12 weeks.  There is strong research to support this concept.

A quote I really like about this:

“We start dying when we stop jumping.”

Assessment can be vital, but there is no Gold standard. Personally, I use my hands to assess pain tolerance to pressure at the tendon as one way to track progress of tendon health, but this is not well supported by research and requires me to have physical access to you which can be limiting indeed.

If you haven’t loaded the tendon recently, some easy options are 

  1. Calf raises with full range of motion, faster up slower down, aiming for 20 reps per leg as a baseline for tendon health. This allows us to look for asymmetries as well as an overall deficit based on training age.

 

In terms of a plan to increase your activity tolerance:

Firstly, I like to think of the principle of 10% per session as a safe progression. Meaning, in terms of a weekly volume a  nice progression is to add 10% to the previous week.

Secondly, the quote that drives me here is:

“We tend to overestimate what we can accomplish in a month and underestimate what we can accomplish in a year.”

Therefore, a long term strategy for tendon health should be implemented.

Exercise Is Important But So Is Diet

It goes without saying reducing stress, sleeping soundly, and eating nutritious foods not only helps you…

…but your tendons specifically.

But I said it anyway. 

However, there are a few supplements on top of eating and sleeping well, reducing stress and moving better which help heal and keep tendons resilient.  Notice the word supplement. These should NOT be your priority to help your tendons stay healthy or heal after an injury.

Primary should always be eating real high quality foods.

The first and most obvious supplement is Vitamin C.

Vitamin C is absolutely essential for synthesis of collagen which makes the tendons type 1 slow twitch fibers strong. Pre clinical studies have shown vitamin C has the potential to accelerate bone healing after a fracture, increase type I collagen synthesis, and reduce oxidative stress after a tendon injury. (3)

Supplementing with Vitamin A helps the process of forming new tissue (collagen) and your immune system. A stronger immune system can prevent microorganisms from further damaging your tendons. 

Vitamin E has anti-inflammatory properties which helps reduce tendon inflammation, and helps the healing of damaged tendons which can lead to a reduction of tendon pain. (4)

The science and research is limited on diet and tendon health and there are probably other things out there that can help. It is an ever expanding field so stay tuned. 

NOTE FROM TG: At the moment, I like the Collagen Peptides from Momentous because they use Vitamin C, and FORTIGEL® , which is a formula designed and tested to promote collagen synthesis in tendons and ligaments. 

(👆👆👆 Discount:  GENTILCORE25 gets you 25% off your first order when you sign up for a subscription 👆👆👆)

Most collagen out there is basically like buying a pack of J-E-L-L-O, focusing on hair, skin and nails, but this stuff is solid and provides a bit more heft. 

Here’s the daily “Wolverine Cocktail” I’ve taken every day since my surgery on June 1, 2020:

I’d like to think the cocktail added an extra “x-factor” toward my recovery.

I mean, here’s me hitting a relatively easy 500×3 on my deadlifts six months later:

 

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A post shared by Tony Gentilcore (@tonygentilcore)

Wrapping Up

Tendon tears often happen without warning and it doesn’t discriminate on whether you’re fit or not. One moment you’re about to move quick and the next you’re on the ground. 

The best things you can do before engaging in risky tendon activities:

  1. Warm up properly
  2. Load the tendon appropriately
  3. Reduce stress, eat and sleep better. 

But as you’ve seen by Tony’s experience, there are no guarantees. Please do your best so you don’t hear the pop from hell. 

Authors’ Bios

Shane “Balance Guy” McLean, is an A.C.E Certified Personal Trainer working deep in the heart of Louisiana with the gators.

Dr. Bo Babenko is the owner of FitCare Physio focusing on virtual health coaching and helping people attack the 5 pillars of health: movement, nutrition, recovery, mindset, connection.

References

  1. Michael Wong; Achraf H. Jardaly; John Kiel.Anatomy, Bony Pelvis and Lower Limb, Achilles Tendon.
  2. . T A Järvinen et al. Achilles tendon injuries. Curr Opin Rheumatol 2001 Mar;13(2):150-5
  3. Nicholas N DePhillipo et al. Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review. Orthop J Sports Med 2018 Oct 25;6(10)
  4. Christopher Tack ,Faye Shorthouse Lindsy Kass. The Physiological Mechanisms of Effect of Vitamins and Amino Acids on Tendon and Muscle Healing: A Systematic Review. Int J Sport Nutr Exerc Metab 2018 May 1;28(3):294-311.
CategoriesStuff to Read While You're Pretending to Work

Stuff to Read While You’re Pretending to Work: 11/20/20

Copyright: neirfy / 123RF Stock Photo

THE WEEKLY BRIEF UPDATE

1. You can now purchase CORE @ Home for whatever it is you want to pay.

During the first quarantine I started a platform where I’d deliver 20-40 minute workouts that could be performed in everyone’s living room using minimal equipment.

In all I curated 36 workouts using nothing but bodyweight, bands, and kettlebells and/or dumbbells. With many people still reticent to head back to their regular gyms (not to mention the scarcity of gym equipment out there to purchase) I figured this would be a nice opportunity to help.

Too, now that many parts of the US (and world) have started to implement a second wave of shut-downs, this resource  is timely.

Whether you want to spend $1 or $100 (if the latter, we’ll be BFFs forever), the workouts are ready and available to start.

For more information go HERE.

SOCIAL MEDIA SHENANIGANS

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STUFF TO READ WHILE YOU’RE PRETENDING TO WORK

Barbell Rehab – Dr. Michael Mash

This resource is designed for serious gym rats (or for those who’s livelihood is to breed competent gym rats) on how to use the barbell – and not an endless parade of corrective exercises – to prevent/reduce pain & to improve performance.

Dr. Mash goes out of his way to cover everything, from assessment to troubleshooting the most popular lifts, with pristine precision. It’s undoubtedly a wonderful resource for anyone interested in lifting heavy things.

He’s offering my readers a $50 discount off the regular price this week only.

And the offer ends TOMORROW (11/21).

Go HERE and enter the coupon code TONYG50 when prompted.

Why Soreness Isn’t the Goal of Working Out – Tommy Royer

It’s to get big biceps, duh…;o)

Your First Baby Photos – Robert Aguero-Hoffman

Heads up: make sure a box of Kleenex is near.

Graceful words from an acquaintance/colleague of mine who went through something I wouldn’t wish on anyone.

CategoriesProgram Design

Stuff I Struggle With: Installment 1

No need for a witty introduction here.

The title says it all.

Copyright: photosky99 / 123RF Stock Photo

Stuff I Struggle With

1. Writing Periodized Programs for Gen Pop Clients

I know this may ruffle a few feathers out there, but I really struggle with the idea of writing periodized (meaning, several weeks or months in advance) training programs for the general population.

When working with a competitive athlete who has their year broken up between an “off-season” and “in-season” as it relates to their respective sport…

…yes, it makes sense to write a more detailed, thorough, and robust plan to prepare them for those rigors

Being more meticulous with managing stress, ascertaining precise volumes & loads, managing rest periods, and possibly even going so far as to measuring things like bar speed are all appropriate when preparing an athlete for a competitive season.

Tom, who’s 49 and works in Human Resources, has two kids at home, a cranky left shoulder, and is just looking to lose a little fat and maybe match his squatting numbers from college isn’t Bo Jackson.

He doesn’t need to prepare for Sunday or hit a 400 ft home runs.3

This is NOT to insinuate I don’t feel general pop clients don’t require planning or structure within their programming. I just don’t feel having them follow a Block Periodized program so that their bench press peaks to coincide with their kids clarinet recital in the Spring is really the panacea for progress.

What’s more, “life” just has a knack for getting in the way:

  • Kids get sick
  • Work piles up
  • Vacations get planned
  • Fucking global pandemics happen

Certainly, I’m not suggesting to take a haphazard (or “winging it”) approach, but writing training programs several weeks – or more aggressively: months – in advance, while well-intentioned, is rarely going to “stick” with most gen pop clients.

The more cogent approach will almost always be to write 2-4 week micro-cycle programs, but under the assumption that on any given day “Tom” is going to show up for a session and need some tweaking done.

2. Speaking of Athletes Though

My friend Mike Perry, owner of Skill of Strength here in Massachusetts, posted this hilarious (albeit 100% appropriate) meme on his feed today:

I see this happen often: Someone will go on and wax poetic about how “so and so” does “such and such” in the weight room so why can’t I?

To steal a few examples from Mike:

1️⃣ A loaded valgus knee is not dangerous, just look at Chinese weightlifters!

2️⃣ GSP does a ton of gymnastics, that’s what I should be doing!!

3️⃣ Tom Brady only uses bands and look at his success.

4️⃣ Lebron has amazing balance from standing and kneeling on stability balls

There’s one thing that all high-level athletes have that you don’t.

And it’s untrainable.

Natural selection.

Nature picked for them their parents and not yours.

They have superior genetics and would be elite at their sport despite some of the questionable things they do in the weight room.

One athlete may post something on social media where they’re performing some circus-trick exercise and another may post something about how they avoid foods that are colored red.

Don’t do it.

Stop it.

STOP.

You’re not them.

So I guess what I’m struggling with here is resisting the urge to jump into a shark’s mouth every time I see someone – whether a coach or just some rando – attempting to make this borderline moronic argument.4

3. Spelling Calander Calendar Correctly the First Time

Dammit!

Every…single…time.

4. Convincing Fit Pros That Rotator Cuff Training Is So Much More Than Band Exercises

I know some will see this and read the following:

“Tony Gentilcore hates band work for rotator cuff exercises. He also hates bacon, oxygen, and kitty cuddles.”

To set the record straight: I have nothing against band work for the rotator cuff.

They’re splendid (when performed correctly, of course).

In terms of EMG activation, band work (as well as Side Lying External Rotations) have been shown to be top dog.

 

That said, there’s so much more to rotator cuff training and shoulder health in general than just standing (or lying) in-place performing endless repetitions of external rotations.

The shoulder is a dynamic joint and if we wanted to be nit-picky it’s main job is to maintain joint centration where the humeral head stays “centered” within the glenoid fossa.

I’ve long championed the efficacy of implementing rhythmic stabilizations as part of a rotator cuff training strategy.

Note to Self: This video is a decade old for crying out loud; update it.

However, taking things to the next level, my friends at Back Bay Health – Laura & Tim Latham – posted this fantastic idea on their IG today:

OMG – so good and I’m stealing right away.

Although, to spice it up I’d recommend lighting the stick on fire or something.

Seems reasonable.

CategoriesCorrective Exercise Exercises You Should Be Doing

Exercises You Should Be Doing: Wall Press Rotation

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Exercises You Should Be Doing: Wall Press Rotation

When it comes to dealing with hip shenanigans5 I think we’ve done a pretty solid job as an industry at prioritizing OPEN chain exercises.

For those not in the know, open-chain exercises are where…

“…the segment furthest away from the body – known as the distal aspect, usually the hand or foot – is free and not fixed to an object.”

This would make a lot sense given the hip joint – which is a ball and socket joint – is an area designed to be mobile. I don’t need to belabor the point here as there’s an abyss of exercises & drills to choose from.

HERE‘s an example.

But you can also peruse Instagram and it won’t take long before you find someone contorting themselves like a pretzel in the name of likes and five seconds of fame.

Which leads to a not-so-obvious digression.

Lately, after having listened to and corresponded with a few of my colleagues, I’m beginning to realize that open-chain exercises are just HALF the answer.

Closed-chain drills need some love too.

Wall Press Rotation

 

Who Did I Steal It From? – A rockstar (metaphorically speaking): Katie St. Claire. You should give her a follow. She’s legit.

What Does It Do? –

1️⃣ This drill works on pelvic range of motion, but as the preface implies…in a closed chain fashion. The advantage here is that it emphasizes acetabulum motion over a fixed femur.

It feels amazing and serves as a nice drill to implement before some squats or deadlifts.

2️⃣ Too, and as Katie has pointed out, this drill also hammers home foot mechanics. As I flex into hip internal rotation I drive more foot pronation. Conversely, as I extend into hip external rotation I drive more foot supination.

A splendid drill that marries together hip-foot mechanics.

Key Coaching Cues – I’m holding onto an EZ-curl bar, but anything similar – PVC pipe, light barbell, Nimbus 2000 – will do. Be sure to press the rear foot into the wall. You’ll then flex/rotate into hip IR on the standing leg while also accentuating a full exhale.

Exhale into the stretch.

Reverse your action, rotating back/extending as you inhale.

Easy as that.

And, bonus points if you include a bicep curl.

Kidding.

But not really.

Okay, kidding.6

CategoriesAssessment continuing education Strength Training

How to Effectively Screen the Squat

Today’s guest post comes courtesy of Dr. Michael Mash.

I have a legit man-crush on him ever since I’ve started diving into his online resource Barbell Rehab. As the name implies: Its mission is to help barbell athletes (and aficionados) overcome pain and improve performance WITHOUT being forced into “corrective exercise” purgatory.

In a sense, it’s designed to use barbells (and lifting stuff) to help fix shit. What’s more Tony G than that? Okay, maybe Jason Bourne fight scenes.

Or dragons.

Or an endless cheese plate.

Regardless, Barbell Rehab speaks to my strength coach love language, and as it happens Michael is offering his course to all my readers at $50 off the regular price for this week only.

All you have to do is click THIS link and enter the coupon code TONYG50 to receive your $50 credit.

And even if you’re not keen to saving money (weirdo) you should still give his blog post below a read because it’s riddled with common sense and practical applications you can use TODAY to improve your squat screen or assessment.

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Do You Really Need to “Screen” the Squat?

When it comes to effectively screening the squat, many personal trainers and strength coaches have different approaches. From not utilizing a screen at all, to performing dozens of assessments prior to implementing a bodyweight squat, what is the best way to screen the squat?

Before we answer this question, let’s first talk about the function of a “screen” in general.

What is a Screen and Should We Use it?

According to John Hopkins…

“…a screening test is done to detect potential health disorders or diseases in people who do not have any symptoms of disease.”

If we apply this definition to the squat, one could say that a squat “screen” is a test performed to detect potential joint, muscle, or movement impairments in those who don’t have any pain.

In order for a screen to be effective, a “failed” test must be highly predictive of future injury or pain. If it’s not, this could create a lot of false positives results (a.k.a telling someone they’re doomed for injury if they really aren’t). So on one side, you want to make sure your client is “safe” to squat before loading them up, but you also don’t want to prevent them from squatting if they don’t really need to.

Oh the dilemma!

It’s Tough to Really “Predict” Pain and Injury

As mentioned, in order to analyze the efficacy of a screen, we need to know if it can indeed accurately predict injury. As it turns out, the research isn’t so sure about this.

In fact, it has been shown that one of the most common movement screens, the FMS, is only slightly better than a 50/50 coin flip at predicting injuries. This doesn’t mean, however, that you need to throw the baby out with the bathwater. While both myself and the authors of this paper note that the FMS can be used to see HOW a person moves, it shouldn’t be used as a way to predict injury.

If the FMS can’t reliably predict injury or pain….what can?

Because pain is a multidimensional experience driven by biological, psychological, and sociological factors, it is really a reductionist mindset to blame pain solely on “tight hamstrings” or “poor form” in general.

 

In fact, factors such as stress, anxiety, depression, lack of social support, job dissatisfaction, and poor sleep and nutrition can ALL affect a person’s pain experience. This is why we need to zone OUT when it comes to “predicting” injury and really take a comprehensive approach. The WAY someone moves is certainly important, but it’s just one tiny piece of a much larger puzzle.

What is an Effective Movement Screen?

So how should you effectively screen the squat? In order for a screen to be effective, it needs to be SPECIFIC, and there’s no better way to be specific than to actually perform the movement itself. Yep, that’s right. The best way to “screen” the squat, is to actually have the client perform a squat.

 

This process will give you ALL of the information you need in order to make a decision on whether or not they are “safe” to proceed forward with loading the squat.

And guess what?

It doesn’t involve any kind of joint-by-joint assessment, specific muscle flexibility testing, or any other long drawn out processes either.

While the aforementioned approaches can be beneficial to “dig deeper” if someone already has pain, they’re rather unnecessary as part of a screening process in asymptomatic individuals.

For those without pain, here’s a simple process I recommend in order to determine if they are safe to squat.

Step 1: Show Me Your Squat

The first step of our world’s simplest squat screen is to simply ask the client to “show me a squat.” I like to do this for a few reasons. First, it will give you an idea of what they “think” a squat is and how they move in general. Two, it will also give you an idea of how hesitant they are to move.

Some will just drop it low into a perfect squat and others will hesitate to start and move really slowly. You may see the latter example if someone has a history of pain or has fear with movement in general.

This is all useful data to collect on this important first step. If the squat  looks good, congratulations!

Your job is easy today, and it’s time to load them up!

If it needs some work, it’s on to the next step.

Step 2: Coach the Squat

After asking the client to show you their squat, it’s time to coach it. While everyone is going to squat with a different stance width, degree of toe out, and torso angle, it helps to at least have a frame of reference to start from.

I recommend cueing them into a heels shoulder-width stance with a moderate 20-30° toe out, and then asking them to squat as far down as they comfortably can. While this foot placement won’t work for everyone, it’ll work for the majority of people. In this initial bodyweight squat coaching phase, some people may have discomfort or won’t be able to quite get to parallel…and that’s ok.

That’s why we have Step 3.

Step 3: Modify Stance and Depth if Needed

If you coach the client into a shoulder-width slightly toed out stance, and they have pain with this, or they can’t squat very deep, all is not lost yet. Two of the most common pains you’ll see with a bodyweight squat are hip and knee pain. And just because they have pain, doesn’t mean they are injured or need to be referred out to a rehab professional.  It may simply just be the way they are built.

For example, if you take someone with highly retroverted hips, and have them try to squat with a narrow stance with minimal toe out, they may get a “pinch” in the front of their hips at the bottom. This can usually be remedied by widening the stance a bit and turning the toes out more. This doesn’t mean anything is wrong with them…it’s simply the way they are built!

Tying it all together, if someone has pain when you coach them into a bodyweight squat, see if it’s relieved with a simple stance adjustment. This is 100% within your scope to do as a personal trainer or strength coach, as you’re not diagnosing, assessing, or putting your hands on the client at all.

Step 4: Change the Exercise and/or Refer Out

Sometimes the squat pattern itself is so sensitized, that a stance or form adjustment isn’t enough to eradicate pain. If this is the case, I’d recommend NOT proceeding forward with having the client squat, and instead, finding a similar exercise like a rear foot elevated split squat or a lunge variation that they can tolerate.

If the client’s goal is to squat, it would also be best at this point to refer out to a qualified rehab professional as well. This is why interdisciplinary care is so important in the health and fitness world. At this point, as the personal trainer or strength coach, you can continue to train your client with what they can tolerate (full upper body workouts and modified lower body exercises) while the rehab professional addresses the pain itself.

A Quick Note on Squat Depth

Sometimes no matter how much you modify stance, degree of toe out, or hip position, your client won’t be able to squat to “depth.” Depth is defined as when the greater trochanter of the hip goes below the top of the patella from a side view.

In this case, you need to find out if it’s simply because they feel “tight” or if it’s limited by pain.

If it’s limited by pain (even after stance adjustments) then you may want to refer out. If they just feel “tight,” then you can proceed forward with loading them up to tolerance….even if it’s not quite to depth. That’s right. There is no evidence to suggest that squatting above parallel is inherently dangerous.

Rather than spending six months working solely on mobility to increase squat depth, you can work on BOTH simultaneously. Train the squat to the depth the client is comfortable with and tease in mobility drills at the same time.

This one-two punch of increasing mobility and loading through it, will help your clients squat deeper (if that’s their goal) much quicker than not squatting at all.

Tying it All Together

The squat is one of the most beneficial lower body movement patterns to coach your clients through. While everyone will squat with a different stance, degree of toe out, and variation, there’s no need to take clients through an extensive “screening” process prior to loading them up.

Instead:

1️⃣ Ask them to “show me a squat” to get an idea of how they move to begin with

2️⃣ Coach the squat. Cue them into a moderate stance with slight toe out and ask them to squat as deep as they can

3️⃣ If they have pain, see if you can find a stance width, degree of toe out, and depth that is tolerable for them. If so…it’s time to load them up!

4️⃣ If they still have pain after a stance adjustment, it’s probably best to hold on squatting for now and to refer out to a rehab professional for further assessment.

About the Author

Dr. Michael Mash is the owner and founder of Barbell Rehab, a continuing education company dedicated to helping fitness and rehab professionals improve the management of barbell athletes. Check out his CEU approved online course, The Barbell Rehab Workshop at this link and use coupon code TONYG50 for $50 off.

Categoriespodcast

Appearance on The Performance Hub Podcast

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Episode 4: You’re Not Broken, Find Your Trainable Menu

I had the pleasure of being invited onto the brand spankin new Performance Hub Podcast hosted by Max Gedge and Coach Karl.

These two guys had the lovely timing of opening up a gym in Melbourne, Australia right as COVID-19 was turning all our lives into a raging dumpster fire.

But I have to say: They’ve kept a positive attitude and have done their best to turn lemons into lemonade. Case in point: They started this splendid podcast…

…and, as it happens, the release of this episode coincides with gyms opening back up in Melbourne!

In this episode we discuss a number of things. Everything from the soul-sucking sucktitude of gym ownership during COVID to the idea of the “trainable menu” to 90’s hip-hop to not my biceps.

Nope I’d never do that…;o)

You can give it a listen on iTunes HERE or on Spotify HERE.

CategoriesStuff to Read While You're Pretending to Work

Stuff to Read While You’re Pretending to Work: 11/6/20

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I think a more appropriate title for this week’s iteration would have been…

“Stuff to Read While Trying to Unclench Your Sphincter From Watching the Election Results.”

I need a break, you need a break, everyone needs a break.

THE WEEKLY BRIEF UPDATE

1. You can now purchase CORE @ Home for whatever it is you want to pay.

During quarantine I started a platform where I’d deliver 20-40 minute workouts that could be performed in everyone’s living room using minimal equipment.

In all I curated 36 workouts using nothing but bodyweight, bands, and kettlebells and/or dumbbells. With many people still reticent to head back to their regular gyms (not to mention the scarcity of gym equipment out there to purchase) I figured this would be a nice opportunity to help.

Whether you want to spend $1 or $100 (if the latter, we’ll be BFFs forever), the workouts are ready and available to start.

For more information go HERE.

SOCIAL MEDIA SHENANIGANS

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To expound on my post from a few days ago on why I feel VOLUME is the key to conquering your first pull-up… . …and NOT just a few repetitions of shady looking eccentric and band assisted variations performed 1x per week… . Here’s my client @therealalexandrashow performing a Hollow Position Pull-Up pattern (vs a band). . When pull-up badassery is the goal I like to train the pull-up (or it’s derivatives) 4-5x per week and this variation, picked up from @meghancallaway , is an excellent drill to hammer home full body tension and build confidence in the lift. . Again, the key to success is FREQUENCY and implementing drills that build components of the pull-up . . Sick beats help too…😉 . . #pullup #pullupprogression #pulluptraining #bostonpersonaltrainer #bostonstrengthtraining

A post shared by Tony Gentilcore (@tonygentilcore) on

STUFF TO READ WHILE YOU’RE PRETENDING TO WORK

A bit of a curve ball this week.

The world is currently balls deep in a dumpster fire of an election and has the bulk of everyone’s attention. The last thing on most people’s “to do” list is to think to themselves “hey, you know what? I think I’ll write an article on squats or how to improve scapular upward rotation and it’s implications on overall shoulder health.

Or, I don’t know, ear wax.”

Most fitness peeps aren’t in the mood to write this week and there is a dearth of content out there.

That, and I was just too lazy (I.e., balls deep in the aforementioned dumpster fire) to do any reading.

To that end I figured I’d re-share some of my ALL-TIME favorite articles that either gave me a major ah-HA moment OR made me feel more like an idiot.

Either way, I learned something cool.

Push-Ups, Face Pulls and Shrugs – Mike Robertson & Bill Hartman

One of the first articles that really helped me to better understand that rotator cuff training (and shoulder health in general) isn’t necessarily endless repetitions of band external rotations.

The Hierarchy of Fat Loss – Alwyn Cosgrove

I still reference this article repeatedly and send out to clients who end up stuck with their fat-loss endeavors and feel endless steady state cardio and cheat meals are the key.

Cardio Confusion – Eric Cressey

Sure we were roommates for two years and we started a business together, but Eric was (and still is) a mentor of mine and someone who has had a massive influence on my career.

This was one of the first articles that made me re-think my stance on steady-state cardio and it’s importance for not only overall health, but also how it can have positive implications toward lifting heavy things too.

Categoriespersonal training Program Design Strength Training

1-Minute Deadlift Tip: The Power of the Slow Start

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Slow Start Deadlift

Whenever someone rounds their back on a deadlift two things happen:

  1. A baby seal dies.
  2. I have to fight off the urge to throw my face into a fire.

Caveats exist, however.

Everyone at some point will round their back.

Elite lifters will do it – sometimes on purpose – to lock out a max effort lift.

Newbie and intermediate lifters will do it – almost always not on purpose – to lock out any lift…🤪

The difference is that elite lifters are strong (and knowledgable) enough to know how to self-correct when teetering with a precarious position (end-range spinal flexion), and mostly everyone else is not an elite lifter.

As I’ve noted repeatedly, if your goal is to become a deadlifting Terminator then the bulk of your accessory work should address either a weakness or technique flaw.

The SLOW START deadlift is a superb choice for those lifters who have trouble with their hips coming up too early and/or have a difficult time with maintaining upper back tension. I’ve been using this with a my clients and it’s been magical to see the progress they’ve made with their technique.

Performing 3-5 sets of 3-5 reps using 50-70% of 1-rep max should do the trick.

Categoriesfitness business

Coach and Grow Rich

Fitness professionals are reticent to talk about money.

Part of this is because it’s a topic we’re not taught.

Ever.

I don’t recall the “Financial Savviness” or “SEP IRA” chapter in my NSCA textbook.

Too, partly, I think we’ve been programmed to think that we’re “selling out” if we bring up money or that we’d like to make more of it. Fit pros are just supposed to shut-up, work long hours, and take pride in the grind.

That and apparently create the facade of wealth by posting lots of shirtless or arms crossed pictures next to sports cars on Instagram…😉

Nevertheless, finances is a dearth topic in the fitness industry and something that should garner more of our attention. To that end, I’ll hand things over to fitness financial expert, Billy Hofacker, who chimes in today with the first of THREE installments of a series I believe will help a lot of people.

Enjoy!

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Coach and Grow Rich

If you’re like me, you got into the fitness industry because you had a passion for fitness and/or helping people.  You probably realized you needed an understanding of anatomy as well as how to relate with different kinds of people.

However, what often catches us off guard and derails us is managing money. In my case, the realization wasn’t subtle. I was surprised to hear a knock on the door at the crack of dawn one spring morning about 10 years ago. I opened the door to see a guy standing there with no shortage of tattoos, muscles, and piercings.

Confused, I looked past him and saw my new white Honda Accord hooked up to his tow truck.

My car had been repossessed.

The craziest thing about this is that I was actually surprised. In other words, I was so far behind on payments that the repo man had to come and I didn’t even see it coming. That’s how off track I was.

This was a major wake up call for me to say the least. Thankfully, it has a happy ending.

My wife and I went on to pay down over 130K in non-mortgage debt in 5 years. Yes, we had that much debt. We owed money to everybody!

Not only did we pay off all the debt but we went on to create a nice life for ourselves. More importantly, I discovered my mission for helping fit pros achieve financial freedom .

As fitness professionals, we’re some of the hardest working people I know and unfortunately many have little to nothing to show for it.

As Tony says, “It’s just not a topic we’re taught, ever.”

The good news is that regardless of your situation, there is hope. You can absolutely get to the next level. To make this happen, three of the most important areas we need to address are:

  • Money Mindset
  • Destroying Debt
  • Building Wealth

In the first of this three-part series. I’ll be diving into Money Mindset.

Marching orders will be included as knowledge is useless until it’s applied.

Money Mindset

This is a broad area and a topic that comes up a lot in my Fitness Profit Coaching Group.

One thing I’m certain of after being on this journey for 10+ years, is that we are affected by our upbringing and experiences.

All of our actions are based on emotions which stem from thoughts which are completely shaped by our backgrounds.

This is why we can learn all of the techniques but still find success to be elusive. We are limited by our own beliefs which aren’t necessarily true. They are simply what we learned and don’t have to define us.

After countless hours of study, I’ve come to realize that financially successful people and those who struggle think completely differently.

There are many examples of this.

Some are obvious.

For instance, most of us agree that financially successful people are more likely to take control of their destiny. They don’t simply hope for the best. They make it happen.

Additionally, you’ll rarely hear a financially successful individual complain about their circumstances. Those who struggle often play the blame game. They seem to always have a reason for where they are in life. Whether it’s the economy, their age, their boss, their spouse, their kids, or most commonly their parents, they find something or someone to justify their lack of success. It provides some short term benefit. If the reason for their position is outside their control, they don’t have to take responsibility or change.

Change is uncomfortable.

Here is a common but not as often recognized self defeating belief. It’s one that I believe has affected me negatively. It’s the belief that money isn’t important.

Perhaps someone told you that there are more important things than money – things like relationships or time to enjoy life. This belief is commonly taught in religious circles. It’s almost as if having money makes you less spiritual.

Here’s what I now know to be true:

👉 None of those things I mentioned are mutually exclusive. It doesn’t make any sense to compare them. My relationships are extremely important but so is money. The fact that my relationships are important doesn’t negate the fact that money is too.

👉 Whoever says money isn’t important doesn’t have any. The belief that money isn’t important causes people to do things that are destructive to their financial health. They don’t pay attention to it. When you don’t pay attention to it you wind up in trouble.

👉 They don’t talk about it. When you don’t talk about it to those close to you, relationships are strained. We know it’s the biggest cause for marital problems.

👉 It doesn’t make anyone less spiritual. People can’t be fed and religious buildings can’t be built without money.

Money really magnifies character or lack thereof. When a generous person becomes wealthy, they become more generous and make the world a better place. When a greedy or dishonest person gets money, it magnifies these traits.

It wasn’t caused by the money.

The key is uncovering these beliefs, recognizing them for what they are, and working hard to develop new and more productive beliefs. This is hard work but one of the most valuable things you can do for your finances and your life.

Here are your action steps:

1️⃣ Think about an emotional experience you had around money when you were young.

2️⃣ Write down all of the thoughts, statements, and feelings you had around money, rich people, wealth, etc. when you were young.

3️⃣ Write down the habits and thoughts around money that your parents or caregivers had.

4️⃣ Write down the effect all these things had on your finances and life thus far.

Hopefully after spending some time in this area, you can acknowledge that not all of those things are necessarily true. They just represent your experience. Someone with a different background and experiences would have a completely different set of beliefs and values. Now it’s time to decide that moving forward you will adopt a new set of beliefs.

About the Author

Many fitness professionals get stuck in the day to day and have little to show for their hard work. Billy Hofacker helps them get on a plan to achieve financial freedom. You can learn more by listening to the Your Fitness Money Coach podcast or visiting www.yourfitnessmoneycoach.com.

Categoriespersonal training Program Design Strength Training

The Missing Key to Conquering Your First Pullup: Stop Focusing on Eccentrics and Do This Instead

Shots have been fired.

Shots have been fired.

Some people will read the title of this post and see what they want to see…

“…Tony G has lost his mind. He’s telling people that doing eccentric only pull-ups to help build their actual pull-up is wrong. He also hates kittens.”

Others will know better and actually continue reading.

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The Missing Ingredient to Conquering Your First Pull-Up

I’d be remiss not to note that most competent programs designed to help people become pull-up badasses either emphasize or incorporate eccentric only variations.

Hell, one of the most baller programs out there (and one I reference often myself) – Meghan Callaway’s Ultimate Pull-Up Program (ahem, it’s its 3-year anniversary this week and it’s on sale for 50% OFF the regular price hint, hint, nudge, nudge) – incorporates a bevy of eccentric only pull-ups…

…among many, many other things.

I mean, it’s well established that the eccentric (or lowering) portion of any exercise is generally where a trainee is strongest, can handle the most load, and, potentially, leads to the most muscle growth.

 

All the above being the case, when it comes to BUILDING the pull-up, I still feel too many trainees (women AND men, mind you) miss the forest for the trees.

Despite it being an excellent choice, performing 5 to 10 lackluster eccentric only pull-ups week in and week out does not a pull-up make.

It’s akin to me posting a shirtless pic on my Match.com profile – and only a shirtless pic – and then underneath that pic typing…

…”come get it ladies.”

Sure, it may work in netting me a few dates.

But I doubt it.7

First of all: I’m a happily married man and don’t have a Match.com profile. It’s just a metaphor. But, coincidentally enough, I did meet my wife there…;o)

Second: I’d like to think my superior writing skills and uncanny wit was what won her over and led to us meeting for our first date four days after crossing paths digitally.

Third: In the age of Tinder, Bumble, and the litany of other dating apps at society’s disposal, do people even use Match.com anymore?

Where was I?

Right, what else to focus on other than eccentric only pull-ups.

Do More

I think one of the biggest mistakes I see most people make with their pull-up/chin-up programming is that they simply don’t train the pattern enough.

Most people will train their pull-up once, maybe twice per week.

This isn’t enough.

Pull-up badass, Artemis Scantalides, will often advocate a frequency of 4-5x per week.

However, this approach only works well for those who can already perform 3-5 pull-ups and are looking to level up that number.

If you can’t even perform one this would be a daunting prospect to say the least.

That said, I think staying cognizant of total VOLUME is an often overlooked component of pull-up progress.

As in: A metric fuck ton (which is just a tad below a metric boat load) of pulling volume is undoubtedly going to result in some cool things happening.

I like to incorporate the following (hybrid) vertical pulling progressions when working with an individual working toward their first pull-up

1️⃣ Suspension Trainer Vertical Row Thingamabobber – Level 1

Trainee is allowed to use his or her’s feet to help push off the floor and to assist as much as needed.

2️⃣ Suspension Trainer Vertical Row Thingamabobber – Level 2

 

Legs straight (less help)

3️⃣ Suspension Trainer Vertical Row Thingamabobber – Level 3

 

Feet Elevated – more ROM.

4️⃣ BONUS: Rack Pull-Up

 

This is hands down one of my favorite accessory “pull-up builder” exercises (and upper back exercises in general).

I LOVE the lat stretch in the bottom position.

If someone is looking to conquer their first pull-up I’d be more inclined to include one of these exercises as part of EVERY training session aiming for 2-4 sets of 5-15 repetitions

  • The “easier” drills are assigned more sets and reps.
  • The “harder” drills are assigned less sets and reps.
  • Sick beats optional.

Ultimate Pull-Up Program & Ultimate Push-Up Program

All this week you can purchase Meghan Callaway’s Ultimate Pull-Up Program at 50% off the regular price. Meghan is one of the best coaches I know and this program is without hesitation THE “go-t0” program if you’re looking to take your pull-up game to the next level.

Moreover, you also have the option of purchasing both the Ultimate Pull-Up Program & the Ultimate Push-Up Program at a heavily discounted price.

You can check out that link HERE.

Nevertheless, given many people have lost access to their regular gyms due to COVID-19 and have been regulated to training mostly at home these two programs couldn’t come at a better time.

Act fast, the offer ends this week!