CategoriesAssessment

Assessing Our Assessments: Shoulder Flexion

Assessment.

It’s a powerful word. A daunting word. A ten letter word. A word that means different things to different people.

But the word itself implies you’re assessing something.

So, what is it?

Well, given this is a fitness website it stands to reason that when I say the word “assessment” I’m not referring to one’s ability to color between the lines, write sick computer codes, or, I don’t know, how to say “excuse me, but can you tell me where the library is?” in Spanish1

No, in this context, when referring to the word assessment…I’m alluding to one’s ability to do “stuff.”

Particularly with their body. Most often in the weight room and/or within the confines of their respective sport(s).

But also their ability to perform every day life tasks – bending over to pick something up off the floor, reaching for something, carrying things, fighting crime, walking down a flight of stairs without snapping their hip in half – pain free.

The other day I said something halfway smart on Twitter:

I approach assessment with every person with a blank slate. While I’d be remiss not to mention we do have a “protocol” we prefer to follow at Cressey Sports Performance – namely because of the unique population we overwhelming work with on a daily basis, overhead athletes – it’s not uncommon for me to go off the beaten track when it’s called for.

Put another way…..

No two assessments are the same.

It’s outside the scope of this article to discuss the entire assessment process. Rest assured I’m asking all the pertinent questions: training history, injury history, goals, favorite Mighty Morphin Power Ranger, you know, the important stuff.

While every assessment is different, there is a go to “algorithm” that exists which helps guide the process and keeps this succinct and organized.

We generally start static to dynamic; proximal to distal; and seated/lying/ground-based to moving.

All that said, under the umbrella of assessment, there are certain protocols or screens I use with just about every client or athlete I work with – no matter what sport he or she plays or what their background is. There are some screens too valuable to omit.

Not only that, we have to be able to look at what the assessment is looking at, whether it’s looking at what we think it’s looking at, and whether or not it’s telling us as much information as we think we’re getting from it.

I don’t even know if that makes any sense, but I’m going with it.

Basically all I’m saying is that, while assessment is cool and all, a lot of fitness professionals really suck at it and have no clue what they’re looking for.

Lets take a look at the standing shoulder flexion screen.

To the casual fitness professional this screen tests one’s ability to get their arms over their head.

It goes like this:

Trainer to Client: “So, like, stand there and lift your arms over your head.”

Client to Trainer: “Like this?” [Cue picture pictured below, the one on the left].

Trainer to Client: “Yes! You did it! Well done. Lets go kip.”

Client to Trainer: “Right on. Weeeeeeeeeeee”

To the untrained eye (again, looking at the picture to the left), and to someone who doesn’t know what to look for, things look a-okay.

Arms + Overhead = Able to train.

But to me it looks like a nightmare. There’s significant forward head posture in conjunction with a massive rib flair and hyperextension through the lumbar spine.

[Not coincidentally, lack of shoulder flexion could easily explain why someone has chronic lower back issues. Look at what happens every time they do anything overhead. They crank through their lumbar spine. Just sayin…..]

When corrected – picture to the right – total ROM (shoulder flexion) is reduced because compensation patterns are corrected (no head protraction, rib flair, and pelvis is more posteriorly tilted). And this isn’t even half bad. I’ve seen way worse. Some people I’ve worked with couldn’t get their shoulders past 75 degrees of shoulder flexion when I made sure they weren’t allowed to compensate!

Candidly: if someone can’t pass this simple screen they really have no business doing anything over their head in the weight room, kipping pull-ups included.

So this begs the question: What prevents someone from getting full shoulder flexion in the first place?

It could be any number of things:

1. Shoulder Capsule, osseous changes (which, admittedly, aren’t very common).

2. Soft tissue restrictions – subscapularis, lats, teres minor, traps, etc. (much more common).

3 Lack of scapular upward rotation (instead of upwardly rotating scapulae, they shrug).

4. Thoracic spine mobility.

5. And lastly, and something Mike Reinold speaks to quite often, lack of lumbo-pelvic hip control.

I’m not going to hit on every point above today. I’d encourage you to check out Mike Reinold’s site and/or look into his and Eric Cressey’s Functional Stability Training series (which goes into the geeky stuff in MUCH more detail).

What I will delve into is how, when someone does present with a lack of shoulder flexion, you can differentiate between whether you’re dealing with a lat length/soft tissue restriction or if it’s a anterior core/pelvic control issue.

Easy – test their PASSIVE range of motion.

Like this.

Have them lie on their back (making sure to bend their knees to flatten out the lumbar spine and to account for any excessive rib flair). If their upper arms don’t touch the table….you’re most likely dealing with a soft-tissue restriction (lats, teres minor, traps, rhomboids, etc).

Hammer the lats with some t-spine mobility drills like this one:

 

And you can hit the rhomboids and traps using this drill:

 

And you can get the teres minor using this drill (thank you Mike Reinold).


If you test someone on their back and they pass with flying colors (I.e., their arms touch the table), then it stands to reason you’re probably dealing with a lumbo-pelvic control issue and a weak anterior core.

In that case my go to is coaching someone through deadbug variations.

Standard Deadbug – with emphasis on exhale

 

Note: these can be regressed to include arms only or legs only (or even legs bent so ROM is decreased).

Stability Ball Deadbug

 

Note: placing the stability ball between contralateral elbow and knee forces the trainee to squeeze the ball, thus activating the anterior core to a more effective degree.

Core Activated Deadbug w/ KB

 

People will often roll their eyes at deadbugs – deeming them too easy. That is until they do them correctly.

As well we can’t discount other exercises and drills that challenge the anterior core and pelvic control. Push-ups (and their infinite variations), birddogs, bear crawls, chops, lifts, Farmer carries, Pallof Presses, asymmetrical loaded lifts….all are fair game in my book.

The bigger picture, however, is to pay closer attention to what you’re actually assessing. Does the assessment itself assess what you think it’s assessing? Moreover, are you able to interpret what it’s telling you correctly?

If yes, awesome. You win the internet today.

If no, WTF are you doing???

CategoriesAssessment Corrective Exercise

Defending Spinal Flexion: It’s Not Always the Evil Step-Child We Make It Out to Be

No offense to my future wife (t-minus 37 days until the big day), one of the greatest days of my life was the day I got my first Atari 26002 My game of choice: Defender.

The premise was/is simple: your planet is under invasion by waves of aliens and it’s your mission to “defend” it, as well as other astronauts.

Pew pew pew

Man, I spent hours playing that game.

I really have no other reason for leading with this story other than to say 1) it was an awesome game 2) the chick on the cover was hot and 3) the theme – defender – served as a nice segue to today’s topic……

Spinal Flexion

https://www.youtube.com/watch?v=a1Y73sPHKxw

 

Like many other fitness professionals a few years back, I jumped onto the anti-flexion bandwagon.

I mean could you blame me?

Gulfs of research – in addition to anecdotal evidence – suggest that spinal flexion has its downfalls. To be more precise, however, I should state it’s repeated spinal flexion (and extension) taken into end range that’s the real culprit. Do that on a consistent basis, let it marinate with little to no strength training, and you have the perfect recipe to herniate a disc.

And as my boy, Eric Cressey, notes:

“If you want to see a population of folks with disc herniations, just look at people who sit in flexion all day; it’s a slam dunk.”

Of course, this doesn’t automatically equate to someone being in pain or complaining of back issues. There are plenty of people walking around with not one, but maybe even two, levels of herniations or disc bulges in their spine. And they’re fine.

In fact, in a landmark study published in 1994 in the New England Journal of Medicine, researchers sent MRI’s of 98 “healthy” backs to various doctors, and asked them to diagnose them.

– 80% of the MRI interpretations came back with disc herniations and bulges. in 38% of the patients, there was involvement of more than one disc.

And these were considered “healthy” backs, and those of people walking around with no symptoms what-so-ever.

Which goes to show: I’d trust an MRI about as much as I’d trust a barber with a mullet.

NOTE: this isn’t to insinuate that MRIs are a waste of time or aren’t valuable. That’s 100% false. But I’d be remiss not to state that we, sometimes, place far too much precedence in them.

Oftentimes leading to unnecessary surgery (which should be an absolute LAST resort).

Long story short: just because someone flexes their spine – and may or may not have a disc herniation – doesn’t mean their spine is going to explode.

And least we forget the Godfather of spinal mechanics and research Dr. Stuart McGill. The man has forgotten more about the spine than any of us could ever hope to remember. I’d be lying if I said his two books – Low Back Disorders and Ultimate Back Fitness and Performance – haven’t shaped most of my thinking and approach when working with clients and athletes with low back pain.

Who the hell am I to disagree with him?!?!

That would be like me starring Yoda in the face and saying something like, “Pffft, whatever dude. Force schmorce. What do you know??”

With that commentary in mind, as a fitness professional, most of the time (but not always), I’m not going to go out of my way to include more exercises or drills that place people into spinal flexion.

Particularly with the aforementioned “people who already sit a lot and live in flexion” scenario from above.

Taking it a step further (and to help appease those people who are probably hyperventilating into a brown paper bag reading this, assuming I’m saying spinal flexion is okay):

I typically avoid the following:

1. End-range lumbar flexion

2. Lumbar flexion exercises for those who are “stuck” in flexion.

3. LOADED spinal flexion

But Just to Play Devil’s Advocate For a Second

With point #3 – loaded flexion – there are some people out there who purposely train with a rounded spine and do very well.

Lets use the deadlift as a quick example.

We could make the argument – from a bio-mechanical standpoint – that a rounded back deadlift is efficacious because it’ll allow you lift more weight.

As Greg Nuckols explains in THIS amazing article:

“Rounding your back a bit shortens the length of the torso in the sagittal plane.  In non-nerd speak, it lets you keep your hips closer to the bar front-to-back so they don’t have to work as hard to lift the same amount of weight.”

Fancy chart making skills courtesy of Greg Nuckols

The picture on the right depicts a “neutral spine.” Taking natural kyphotic/lordotic curves into account, on the right, “neutral” equates to a spine that’s 15.3 inches “long” front to back.

On the left, with some significant rounding – albeit in the THORACIC spine (more on this point in a bit) – the the length of the spine is reduced to 11.7 inches. I.e., the hips are closer to the bar.

This in mind, if you watch elite level powerlifters you’ll notice that many of them do seem to “round” their back on max effort pulls.

But lets put things into context

A). It’s important to understand that for most, the rounding is happening in the t-spine and NOT the lumbar spine. The T-spine has more “wiggle room” in terms of end-range flexion compared to the lumbar spine.

B) They’re NOT rounding their lumbar spine.

C) Pulling 600+ lbs is heavy as f***. You try pulling that much without some rounding.

D) Guys (and girls) who are strong enough to be pulling 3-4x bodyweight have assuredly trained themselves to stay out of those last 2-3 degrees of end-range flexion. Moreover, they’ve also been in compromising positions enough that they’re able to stay out of the danger zone.

E) More importantly, you’re (probably) not an elite lifter, so I wouldn’t suggest you start training with a rounded back.

In the end, we could make the case for loaded spinal flexion. Just like we could make the case for Lisa and I being introduced as husband and wife for the first time with Juvenile’s Back That Ass Up playing in the background:

 

Neither are a good idea. Except for the second one.

When Is Spinal Flexion Okay?

Let me repeat, I generally avoid:

1. End-range lumbar flexion

2. Lumbar flexion exercises for those who are “stuck” in flexion.

3. Loaded spinal flexion

I BOLDED #2 because, well, I work with a lot of athletes and people who are the opposite. They live in extension and excessive anterior pelvic tilt, which can be just as deleterious for the spine as flexion.

I BOLDED “excessive” because I want to make it clear that anterior pelvic tilt is not a bad thing (it’s normal). And because some people are morons, will miss the bolded EXCESSIVE, and will still send me a note via email or social media saying how dumb I am for saying APT is bad for the spine.

People on this side of the fence face a whole host of other scenarios like Spondylolysis (referred to as an end plate fracture, most often on the pars interarticularis), Spondylolisthesis (forward disc slippage), femoral acetabular impingement, and what I like to call fake badonkadonk-itis.

In other words: some people don’t have a big butt, they’re just rockin some serious APT.

Cough, cough Jen Selter cough, cough

Kidding aside, extension-based back pain or extension-based issues are no laughing matter, and it’s in scenarios like these where spinal flexion is warranted (and encouraged).

This is where were start to dive into the PRI (Postural Restoration Institute) philosophy and discuss breathing and how it affects pretty much everything.

Many of the (breathing) drills we use at Cressey Sports Performance place people (people who are overly extended) into spinal flexion, which is a good thing.

Watch this video below and you’ll get a sense of what I’m referring to.

Lets take the regular ol’ boring prone plank/bridge.

Learning to perform this exercise correctly (getting to and maintaining neutral spine) is a game changer for anyone experiencing low-back pain regardless of whether it’s a flexion issue or extension.

However, I rarely ever see anyone perform this exercise right. Most people start in a okay position for about five seconds, but then quickly “fall into” an excessively extended posture where their head protracts towards the floor and/or their entire spine sags, essentially doing nothing but hanging onto their passive restraints and hip flexors.

The “core” isn’t doing anything.

It kind of looks like this.

Not coincidentally these are the same people who brag about being able to perform a plank for [insert pointless amount of time here].

When done correctly – I prefer an RKC style plank: feet together, palms flat, elbows being pulled towards toes (to increase tension), and fire everything (glutes, abs, quads, nostrils, everything) – the amount of time someone can perform it is drastically different.

20 seconds and you should be hating life.

You may also notice that I’m rounding my (upper) back above. This is on purpose and goes against conventional wisdom.

Here’s the deal.

I like to start people in a bit of flexion – especially those who are overly extended – because as fatigue kicks in they’ll end up in neutral (rather than past it).

And I’m done.

CategoriesAssessment personal training

What I Learned Taking the FMS

This is what I looked like last Sunday after spending three days and 20 course hours taking the Functional Movement Screen (FMS) I & II modules.

That’s my face melting.

It sounds (and looks) like a bad thing, but I assure you it’s the exact opposite.

Sitting through 20 hours of anything can be daunting.3

Sitting through 20 hours of non-stop talk on anatomy, assessment, corrective exercise, and how much I suck at the Active Straight Leg Raise can be downright overwhelming. And to be honest there were times I was overwhelmed.

But this was easily one of the best 20 hours I’ve spent doing anything not involving a book, baseball, Star Wars, or chocolate covered strawberries. BOM CHICKA BOM BOM.

Trying to overview the entire experience in one simple blog post isn’t doing it any justice. But I figured I’d try to highlight some “big rock” concepts and tidbits of information I learned while everything was still fresh in my head.

Lets Do This

I’d be remiss not to first give a shout out to both Functional Movement Systems and Perform Better for putting on and running a class-act event. The two together are like peanut butter and jelly or Jordan and Pippen or Batman and Robin (<— without the weird sexual tension).

I’d also be remiss not to lend a huge kudos to the bandleader, Brett Jones, who was the epitome of class and professionalism the entire weekend. He’s like Justin Timberlake, only with kettlebells. And a 500+ lb deadlift.

He along with Mike Perry and Diane Vives did an amazing job coaching all the attendees up and offering their expertise. A slow clap goes out to all of them.

NOTE: From here on out I’m using bullet point format because what follows is going to be a massive brain dump that may or may not make any sense. Good luck.

– The “S” is the most important letter in “FMS.” It’s a (S)creen. Nothing more, nothing less. It’s NOT an end-all-be-all assessment. I’ve always used components of the FMS when assessing my athletes and clients, but always viewed it as the outer layer of an onion. If I need to peel back more layers and dig deeper with other protocols I will.

What does the FMS accomplish? In a nutshell: it ascertains whether or not someone can “access” a pattern.

– Simplifying things even more: the FMS helps to figure out if “you move well enough to do stuff.”

– The FMS can also be seen as a litmus test to see if someone is at risk for injury. Of course a previous injury is going to be the greatest risk factor, but the FMS looks at other things such as asymmetries, mobility, stability, and neuromuscular control.

A great analogy that Brett used to describe the process was to ask the audience whether or not smoking increases the risk of cancer? Yes. Does not smoking protect you from cancer? [Interesting question, right?]

Just because you do or do not do something doesn’t mean anything. The primary goal(s) of the FMS is to set a movement baseline, identify the pain or dysfunction, and set up proper progressions and conditioning to address it.

– Fitness professionals are the worst at testing. We overthink things. There’s no such thing as a “soft” or “hard” 2. There’s no such thing as a 1+ or 1-. The screen is the screen, and it’s important (nay, crucial) to hold yourself to the standards and criteria set forth by the manual.

I’m paraphrasing here, but either shit looks good – and meets the criteria for testing – or it doesn’t.

You can’t overthink things or start doing stuff like, “well, his heel only came up a teeny tiny bit, and only rotated 8.3 degrees. I guess that’s a 3.”

– We can’t feel bad for giving people the score they present with and deserve. It’s doing them a disservice in the long run. It’s just like Brett said and made us pledge as a group before we started testing one another: “I’m still a good person and am not a failure if I score a 1.”

It’s not the end of the world and you won’t be considered the spawn of Satan if scored a “1” on your Deep Squat screen.

Life…will…go…on.

https://www.youtube.com/watch?v=Ois60CobLZM

 

– If pain is present…ALWAYS REFER OUT. If pain is present and persists, don’t just blame the hip flexors. Again, as Brett noted, there’s 32 muscles that act as hip flexors, why is the psoas always the culprit for back pain? If you do the screen, apply the correctives, and pain persists, it’s (probably) something deeper and outside your scope of practice.

Seriously, refer out.

But that doesn’t mean we still can’t train the athlete or client. As coaches we can usually train around any injury; we don’t need to keep everyone in a safe bubble where we just tell them to “rest.” To me that’s unacceptable and not an option.

– Take a gander at the Functional Performance Pyramid. Don’t worry I’ll wait.

If you decrease one’s movement capacity and increase their performance (make the movement block less wide compared to the performance block), that’s bad.

If you increase one’s movement capacity (think: yoga) and decrease their performance, that’s also bad.

We’re really good as coaches and personal trainers at building better engines (improving performance), but neglect to address the brakes and suspension (movement). Hence, people often break down sooner.

This is also another fantastic reason why the FMS is valuable. It’s helps you figure out where people need the most work/attention.

– Raise your hand if you feel the Active Straight Leg Raise is a great screen to test for hamstring length.

It’s not.

If anything it’s more of a screen for the “core,” and how well you’re able to control your pelvis. I.e., can you maintain extension on the down leg as you bring the other into hip flexion (and vice versa).

– The Deep Squat Screen (<—- bolded on purpose) takes place with the toes pointing straight a head. It’s not how we coach the squat in the long run.

1. Toes forward provides some semblance of standardization. It doesn’t make sense to allow people to externally rotate their feet (even a little bit) because that defeats the purpose. You allow someone to rotate 5 degrees, and the next person rotates 15. Like, WTF?

2. Toes forward also makes it easier to see faults and compensations in the pattern.

I literally had a “tense” exchange with a female attendee who gave me push back on making her perform the screen with her toes pointing forward.

Her: “Well I can’t squat if they’re forward!”

Me: “Then you won’t get a 3.”

Her: “Last time I went to this (she attended module I at a previous time), I was told we could point our toes out.4

[Relax, deep breaths]

Me: “Sorry but we were told otherwise yesterday. Toes forward.”

Based off her reaction you would have thought I insulted her yoga pants. With a little bit of a huffy attitude she reluctantly conceded and ended up with a 2.

I guess I’m an asshole.

– Corrective exercise is like boxing. It’s generally accepted that there are four different kinds of punches in boxing: the jab, cross, hook, and uppercut. The Five-Point-Palm-Exploding-Heart-Technique from Kill Bill didn’t make the cut.

 

You don’t need 500 different correctives to “fix” something. You only need a few and to OWN each one. Don’t overwhelm your clients with 17 different variations of glute bridges to perform before they go to bed. They’re not going to do them. Ever.

– Breathing is all the rage in fitness today. And for good reason: it’s something that needs to be addressed.

I’ve seen magical things happen when you help someone address a faulty breathing pattern. But pigging back off the previous comment about corrective exercise, you don’t need to get all fancy pants on people.

Showing your athletes and clients how to properly perform “crocodile breathing,” where they learn to get 360 degree expansion (and to not rely on their accessory muscles like the upper traps, scalenes, etc) can go a long ways in helping to set the tone on fixing stuff….even a straight leg raise or shoulder mobility.

Dumbledore can’t even do that.

 

How’s that for a super scientific explanation.

– You need to be RELAXED when you foam roll. We’re not deadifting max effort weight here. Chill out.

– Don’t underestimate the power of grip work (squeezing the handle of a dumbbell or kettlebell) to help improve rotator cuff function as well as shoulder mobility.

– You need a minimum of 30 degrees of ankle dorsiflexion to run well. Just sayin…..

– Here’s one of the best analogies I’ve ever heard with regards to overhead pressing courtesy of Brett Jones. When explaining the path of the DB or KB during an overhead press tell your client to pretend as if there’s a booster rocket underneath the elbow and that it takes the weight to space.

The path should be straight up, not to the side or in a zig-zag fashion. Straight up.

I Could Easily Keep Going

But I think that’s enough.

Needless to say I HIGHLY encourage any and all fitness professionals to attend one (or both!) of these courses if you have the opportunity to do so. I learned a ton and there’s no reason to suspect you wouldn’t either.

CategoriesAssessment Exercise Technique

What We’re Really Saying When We Discuss Breathing

I read a recent article by my good friend, Jordan Syatt, on the Personal Trainer Development Center’s website titled No One Ever Got Better Solely From Diaphragmatic Breathing Exercises and I liked it for two reasons:

Photo Credit: Shawn Rossi

1. It’s a message that needed to be said. Breathing drills (and to be more specific, diaphragmatic breathing drills) aren’t going to add 50 lbs to your deadlift, nor improve your vertical jump, and they certainly aren’t the “x-factor” when it comes to improving one’s sex appeal.

Last time I checked no one ever thought to themselves, ” Whoa, that’s one sexy Zone of Apposition goin on there. I need to get naked with that person, like, right now!”

I’m sure there’s someone out there with some sort of creepy ribcage/thorax re-setting fetish, but for the sake of argument lets just agree that breathing drills won’t land you on the cover of People Magazine anytime soon.

2. Jordan gave props to Cressey Sports Performance in the article. What what!

There’s no denying that “breathing” is all the rage right now – especially in the fitness industry. And more to the point, there’s no denying that the peeps over at the Postural Restoration Institute (PRI) are leading the charge.

Funnily enough: while the breathing hype has gained momentum in the last 2-3 years, PRI has been around for DECADES. I guess it just goes to show there’s a tipping point for everything.

I wrote a post a few months ago calling some trainers out who go a little too far down the PRI rabbit hole. I highlighted the fact that I like PRI; I use PRI; I just feel it’s crippling many fitness professionals who take it too far.

One of my biggest pet peeves is when trainers and coaches forget that they’re trainers and coaches and stop training their athletes and clients. Instead they start treating them, which isn’t their scope of practice in the first place. Worse is that their clients rarely (if ever) get a training effect!

I’m sorry but if your client is 30 lbs overweight or just interested in going to a Bootcamp class, they don’t need to be breathing into a balloon for 20 minutes.

Having Said That…..

At CSP, because we work with a lot of athletes who live in a constant state of (spinal) overextension, in addition to general fitness clients who come in with a wide variety of movement dysfunctions, we have found that these drills are a nice fit for our demographic. It’s borderline voo-doo(ish) how much improvement we can glean – both from a postural standpoint and pain reduction standpoint – from having someone focus on their quality of breathing for a few minutes.

There’s a bit of self-auditing required, though. I.e., It’s not going to be an ideal fit for some coaches and trainers.

Take for example a trainer who, while attended mine and Dean Somerset’s workshop in LA last weekend rolled his eyes and made the off-handed comment, “if I did this stuff with my clients, I’d be fired” as I was taking the attendees through a few drills.

1. No shit Sherlock! If the bulk of your clients are celebrities more interested in shadow boxing and looking good for the camera, then of course you’re not going to place a premium on alignment and how breathing mechanics play a role in improving it.

2. So, yeah, placing some emphasis on breathing and breathing mechanics isn’t a good fit depending on who you work with.

Thanks for the insight, dick.

I’ve stated this in the past, but it bears repeating here: GETTING PEOPLE STRONG IS CORRECTIVE!!!!!! This happened to be the larger point I was trying to make which said trainer seemed to overlook. Or maybe he missed it because he was too busy texting on his phone the duration of my presentation.

Okay, okay….not a big deal Tony. You know, people are busy and need to keep in touch with their clients. It’s not th end of the wor…….GODDAMMIT!!!!!! [punches wall].

Why I stress this point is important, because when I do talk about breathing drills and how we incorporate them with our athletes and clients at CSP (regardless of sports played, injury history, and postural imbalances), it’s important to understand that it takes up roughly 2-5% of the total training volume.

That’s it.

Call me crazy, but that’s a pretty awesome minimal investment of time given the profound effects it can have!

Which begs the question: What effects DOES it have?

From my perspective here are a few bullet points.

NOTE: a MAJOR shout out to Michael Mullin, ATC, PTA, PRC, Mind-Jedi Level II for much of what follows. He’s visited the facility a handful of times to enlighten the CSP staff on some PRI basics.

1. Airflow drives the nervous system. More importantly, the respiration you learned about in school is gas exchange. BREATHING is movement.

2. Taking this a step further, much of the advantage of the PRI approach – and why addressing breathing patterns is important – is that it leads to better outcomes for clients and athletes. Teaching and grooving more efficient breathing is every bit as important as teaching and grooving a proper hip hinge or squat pattern.

3. People who present with a more scissor posture will have a harder time recruiting and using their diaphragm.

In short, the diaphragm is kind of a big deal, and because many of us are locked into a scissor pattern in conjunction with a left rib flare – what PRI refers to as a Zone of Apposition – we have a hard time breathing correctly.

Ideally the diaphragm will act as a superior and inferior “canister,” descending/compressing when we inhale and elongating/doming out when we exhale….which in turn provides optimal stability up and down the kinetic chain.

Unfortunately, due to the aforementioned scissor posture (to the far right in the pic above), we tend to see more anterior translation of the diaphragm locking us into more extension, which in turn doesn’t allow it to perform optimally.

For the more visual learners out there, here’s how the diaphragm should work:

4. All of this to say: these drills help to “encourage neutral.” The body WILL NEVER by symmetrical due to our anatomy, but when someone lives in extension these drills help to get someone closer.

5. Likewise, the brain wants efficiency and will do whatever it takes to get you there. If you watch how most people stand, they’ll revert to what’s known as a Left AIC (Left Anterior Interior Chain) stance, like this….

The right side of the pelvis will be more internally rotated and ADD-ucted and the left side will be more externally rotated and AB-ucted. This, too, causes all sorts of wackiness and effects posture all up and down the kinetic chain. PRI helps to address this and tries to “encourage neutral.”

6. Lastly, if nothing else, the real benefit to all this is that it helps people to chill the eff out.

Exercise drives the sympathetic nervous system and put people on “alert.” I like to incorporate basic breathing drills to engage the parasympathetic nervous system and help people to tone it back down closer to homeostasis.

In addition, anecdotally, so many people are type-A, live in a sympathetic state, and are always “switched on” that they’re unable to relax. Breathing helps to turn on the parasympathetic nervous system and allows people to smell the roses so-to-speak.

There’s obviously A LOT more to all of this and I’m only scratching the surface with this post. It’s a topic that requires a bit more time (and I encourage you to seek other resources if it interests you). That said, everything I alluded to above hits on a few BIG ROCK points that I hope resonates with everyone.

Whether it’s a good fit for YOU and YOUR clients is a discussion that needs (and should) to be considered. In the end, like anything….it depends

CategoriesAssessment

Do Assessments “Need” to Be New and Exciting?

I’ve been doing a lot more traveling this past year.  Some for pleasure, mostly for work, but sometimes I’m fortunate and get to combine the two which is always cool.

In the past two months alone I’ve been to Cortland, NY (which doesn’t really count since that’s basically my home town), Fargo, North Dakota, and Kansas City, Missouri….all of which were for speaking engagements

Next week I’m heading to Cancun, Mexico to spend 4th of July with Lisa and some of her family. In addition I’ll also take part in a 1-day “coaching the coaches” workshop at Warrior Fitness where I’ll have the opportunity to talk shop with a dozen or so local trainers and coaches, and possibly discuss my secret fascination with Lucha libre; or Mexico’s version of “free wrestling.”

In short, I have every intention of going all Nacho Libre on their asses!

But seriously, the game plan is to break down how to coach the squat, deadlift, bench press, Turkish get-up, and, oh who am I kidding…….the piledriver, too!

Later this summer I may be doing some staff in-services for SportsClub LA, which takes us into the fall where my schedule kicks into overdrive.

Dean Somerset and I will be in London (Sept) and Washington, DC (Oct) for our Excellent Workshop High Five, and we’re also looking at adding a date in  Los Angeles in November.

And, serving as a bit of a teaser, all signs point to me (and Lisa) heading to Australia in March 2015 for two separate, 2-day workshops in both Sydney and Ballina respectively. Nothing is set in stone yet, but the prospect of being able to put some of my Crocodile Dundee quotes to good use is making me pee my pants.

After all that, what’s left is trying to set-up dates in Hoth, Minas Tirith, and Cybertron. Fingers crossed.

My point to all of this is something that came up a week or so ago. Now that I’m “in demand” and traveling more for work, it’s always interesting some of the feedback I receive from my presentations.

As an example, my use of colorful language has come up. Whereas on the east coast, and Boston in particular, talking like a sailor and peppering a few f-bombs here in there is the norm, in the mid-West it may come across as bit more juvenile and un-professional. And that makes a lot of sense.

This is something I’ve had to learn and adapt to the more and more I’ve travelled to different places. But, in general, a good rule of thumb is to not be too gratuitous with language and make references to explosive diarrhea with a bunch of doctors in the audience.

Oops. My bad.

However, on a more relevant level I’ve noticed another “theme” that’s been present the more I’ve spoken. It’s nothing glaring and it’s more the minority mindset, but it’s been brought up a handful of times.

And it’s the notion that I don’t offer anything “new or exciting.”

To be more specific, I had someone comment that I offered “nothing new or exciting” with regards to shoulder assessment as part of a presenter evaluation for a recent speaking engagement.

I’m all for constructive criticism and I appreciated the feedback, but since when did assessment or screens need to be exciting or revolutionary?

Sometimes it comes down to doing the “boring stuff” correctly, no?

I’ll be the first to admit that I’m NOT a researcher, and the likelihood I’ll ever offer anything “revolutionary” is on par with Justin Bieber not coming across somewhat douchy.

This is also the same mentality I take with program design. Boring is generally what works best for most people in most situations. Focusing on the principles – whether it be assessment or program design or “insert whatever you want here” – is what many people overlook, and why most tend to miss the forest for the trees.

How am I supposed to make shoulder assessment more glamorous?  Do I need to add some pyrotechnics?  Have them juggle a pair of chainsaws? Please, tell me!

Walk into an assessment or screen at Cressey Performance and you’re bound to see things like:

1.  Looking at standing/static posture. Posteriorly, what’s the medial border of the scapulae tell you?  Is the inferior border closer to the spine than then superior border, as shown in the pic below (which is of me by the way, taken from Eric Cressey and Mike Reinold’s Functional Stability Training of the Upper Body).

If so, the scapulae are downwardly rotated and could be the root cause of someone’s shoulder pain.

How about anteriorly?  What about clavicular angle? Drawing a line from the medial border of the sternum along the clavicle, does one present with a more horizontal angle?

NOTE:  Abs alert!!

If so, that’s not ideal.  We’d like to see a 10-15 degree upslope of the clavicle.  Again, this translates to a “depressed” shoulder girdle  and downward rotation emphasis.

2.  If someone presents with a wonky static posture (<=== how’s that for a scientific term?), you can almost guarantee they’re going to present with aberrant movement patterns with regards to standing shoulder flexion or when testing scapulohumeral rhythm.

Then again, they could “fix” things once you start adding dynamic movement, but you’re never going to know unless you screen/assess for it.

Admittedly, these tests aren’t sexy or revolutionary….but they sure as hell get the job done. And, when done right, consistently, offer more than enough feedback and information to come up with an appropriate corrective strategy and training program.

Sans fireworks or anything “new and exciting.”

CategoriesAssessment Exercise Technique Strength Training

How Deep Should I Squat?

Perusing the internet can be comical.  LOLcats, Buzzfeed, and Star Wars parodies aside, where I find the most comedy (or to be more precise, the most chest thumping, blatant lies, and fibbing) are in various training websites and forums.

It seems everyone on the internet – at least in training circles – is either some kind of unknown world-record holder or anonymous StrongMan competitor that no one’s ever heard of.  Some of the numbers tossed out by the likes of PowerPlateJumboJim or DieselJackedGunz101 are astonishing.

Ever notice how many of them claim to bench press 400+ lbs (raw) or can pull 4x bodyweight (for reps) or boast how  “they could have won State if only their high school coach didn’t have it in for them”?

It’s uncanny and makes for some quality entertainment.

In that same vein, it’s also amazing how many people on the internet squat “ass-to-grass.”  For those unaware, the term “ass-to-grass” refers to one’s ability to squat deep or to the point where their butt touches their ankles. Or very close to it.

It’s often deemed the bro-tastic or “right” way to squat.  While admirable, and in some cases an acceptable approach, I don’t agree with this mentality as it flies in the face of every individual’s own goals, needs, abilities, experience, and freakin anatomy.

In my latest article for T-Nation, I discuss the whole notion of “deep squats” and why they may not be a great fit for a large number of the population.  Furthermore, I discuss the “butt wink,” what it is, what causes it (and what doesn’t), and how to resolve it.

It’s basically the greatest article ever written give or take a few billion.  Let me know what you think!

Continue Reading…….

CategoriesAssessment Corrective Exercise

How Deep Down the Rabbit Hole Do We Really Need to Go?

Today’s topic has been something that’s been festering in my brain for a while now, and it’s only been within the last few weeks where I felt the need to put something down on paper.

Or in this case, down on keypad.

To save face, you can relax….it has nothing to do with Tracy Anderson (I’m kind of over bitching about her).  Or Paleo Nazis. Or the fact that I was never able to beat Mike Tyson in Mike Tyson’s Punch-Out back in the day.  There’s always been a void in my childhood for that fail.

Nope, it has nothing to do with any of those things.

I guess you could say the impetus or tipping point came a few weeks ago at The Fitness Summit when Harold Gibbons and Kyle Langworthy – both brilliant coaches at Mark Fisher Fitness in NYC – asked me the following question:

“Hey Tony, do you think the long-head of the tricep can act as a spinal rotator?”

[Cue crickets chirping]

Uhhhhhhhhhhhh.  Yes? No?  I mean yes. No wait, no!  What was the question again?

What made the interaction more hilarious was the fact they asked it in such a nonchalant, casual manner, as if asking me “Hey Tony, do you like food?”

To their credit, both Harold and Kyle have been immersed in the rabbit hole that is PRI (Postural Restoration Institute), and not surprisingly have been having their minds blown.

It’s very much akin to Alice’s Adventures in Wonderland, where Alice ends up following the White Rabbit down his rabbit hole.

Except in this case, instead of a mescaline induced world of hookah smoking caterpillars, Cheshire cats, and Mad Hatters, we have things like predicted (normal) asymmetries in the human body, terms like Left AIC (anterior interior chain) and PEC (posterior extension chain), and aberrant breathing patterns (we’re really good at inhaling, but poor at exhaling).

Both Harold and Kyle admitted that they’ve been exploring the rabbit hole and that they’ve been traveling deeper and deeper.

To which I say:  how deep do we as coaches and trainers need to go?

Don’t get me wrong, I think it’s fantastic that more and more trainers are educating themselves, experimenting, and digging deeper.  I wish more would follow suit and do more of it!

This phenomena is something both Harold and I discussed in our little chat last week (so for those assuming I’m tossing Harold and Kyle under the bus, think again.  I’m not).

Besides, I’d be remiss not to express my own accolades and biases towards the PRI mentality.

We’ve been using aspects of PRI at Cressey Performance for coming up on two years now. We recognize that it’s POWERFUL stuff, that it works, and it helps people feel better.

I like PRI. I use PRI. But man, I really wish some trainers and coaches would tone it down a notch and just get people strong.

The PRI 10-Second Elevator Pitch

Before we continue, I should first apologize to those reading who have no idea what the hell I’m talking about.

I’m sure some of you are sitting their scratching your head and thinking to yourself “Postural Restor……WTF are you talking about?”

Let me explain.

While trying to squeeze PRI’s philosophy into one sentence or paragraph would be doing it a huge disservice, if I had to give a quick ten second “elevator pitch” on what their schtick is and what they’re all about, I’d say:  it’s about breathing!  Or, to be more precise, it’s about how most of us suck at it.

I’m more of an analogy guy, so using one that most people can (hopefully) appreciate:  if our breathing patterns are like the worst karaoke singer we’ve ever heard, we’d sound like a whale passing a kidney stone.

Yeah, not pretty.

More to the point it’s about understanding that symmetry – as much as we try to attain it, and think that it exists – probably ain’t gonna happen.

It’s recognizing that we’re inherently designed in such a way where asymmetry is inevitable – we have a heart on one side, a liver on the other, more prominent diaphragmatic attachments on one side compared to the other – and that how we breath plays a major role in that.

PRI tries to teach people how to breath more efficiently, which in turn, in conjunction with their corrective modalities, will help attempt to bring them back to neutral.

In short, the diaphragm is kind of a big deal, and because many of us are locked into a scissor pattern in conjunction with a left rib flare – what PRI refers to as a Zone of Apposition – we have a hard time breathing correctly.

Ideally the diaphragm will act as a superior and inferior “canister,” compressing when we inhale and elongating when we exhale….which in turn provides optimal stability up and down the kinetic chain.

Unfortunately, due to the aforementioned scissor posture (to the far right in the pic above), we tend to see more anterior translation of the diaphragm locking us into more extension, which in turn doesn’t allow it to perform optimally.

For the more visual learners out there, here’s how the diaphragm should work:

So that was a little more than 10 seconds, but you get the idea. I think.

This stuff IS important, and it definitely has its place in the grand scheme of things – ESPECIALLY if someone is in pain.

But I can’t help but feel that sometimes this knowledge is crippling some trainers and that they’re missing the forest for the trees.

It’s kind of like they’re constantly operating with their emergency brakes on.  They can apply the gas, and yes, the car will move, albeit it will be at a snail’s pace.

What’s starting to become more common is that trainers and coaches are forgetting that they’re trainers and coaches and they’re not training their athletes and clients.

Where I find this becomes more dangerous/annoying is that new, more inexperienced trainers are falling into this trap.  It’s one thing for someone with years of experience to start playing around with this stuff – as is the case with myself, Harold, and Kyle (and many, many, many others).

But it’s a whole nother ball of wax when you have inexperienced trainers trying to implement this new information when they haven’t yet learned to integrate it appropriately.

Stealing a line from Michael Mullin (who’s a PRI instructor himself)…..”just like any new skill, there’s a learning curve involved.”

How can one justify using more advanced techniques like positional breathing tactics when they can’t even coach someone how to squat correctly?

More importantly:  how much are we (as coaches and trainers) allowed to teeter with our scope of practice?

There’s no doubt an overlap between the physical therapy world and the strength and conditioning world.  Where do we draw the line though?

I’m always asked my opinion on “corrective exercise,” and to be brutally honest I feel that CORRECT MOVEMENT is corrective.

Coach people to squat, hinge, lunge, push, pull, and carry correctly, and it’s amazing what can happen.

The kicker is that PRI has been around for a few decades.  It’s only been in the past 2-3 years that it’s blown up to the point where everyone – physical therapists, chiros, strength coaches, personal trainers, and your local weather man – are using it.

As my boy, Mark Fisher himself, notes:

It frankly reminds me of the FMS mania a few years back where every trainer thought they were “diagnosing dysfunction” and “correcting” shit for hours on end (which is hilariously something that drives Gray fucking NUTS)

I’m sure it will all blow over soon (these things always do) and we’ll be left with the good big rocks of knowledge that can be implemented in a fitness setting, but good loooord people.

I’m 100% on the same page as Mark, with the exception of one thing.

I don’t feel PRI is just some random thing that will blow over – I mean, come on, One Direction is a thing.

I find a lot of value in PRI, and I know it works because I’ve seen it with my own eyes.

I think it’s great that more trainers and coaches are exploring the rabbit hole. But it’s important not to get too carried away. PRI is a tool in the toolbox.  Nothing more.

Just remember that.

CategoriesAssessment personal training Program Design Strength Training

Two Dudes Talking Shop

I had the pleasure of recording an interview with Harold Gibbons, a fitness writer and trainer at Mark Fisher Fitness in NYC yesterday.

The word “interview” is used loosely here, because it wasn’t so much an interview as it was two intelligent and uncannily witty dudes sitting down to talk shop on things ranging from coaching and program design to more rabbit hole topics such as the Postural Restoration Institute and “corrective” exercise.

And, of course, there was Star Wars.

Not to mention Harold’s epic beard!

Nevertheless, if you’re sitting at work and need something to keep you occupied until lunch time or want something to listen to while you drive your car or ride the train, just press play.

Fair warning:  If you’re listening to this in a public place or work, you may want some earphones because I cuss like a sailor at several points throughout.  If, however, you have the coolest boss ever, and he or she doesn’t care, then by all means turn up the volume. It’s been said I have the voice of an angel.

CategoriesAssessment Corrective Exercise Product Review

Functional Stability Training for the Upper Body

Eric Cressey and Mike Reinold (otherwise known as Erik Cressnold) released their latest module in their Functional Stability Training series, Functional Stability Training for the Upper Body, yesterday and I’m excited for a few reasons.

1. I’m not going to sit here, blow rainbows up your ass, wax poetic, and say that this product is going to make the industry better…..except that that is exactly what I’m going to do.

This product is going to make the industry better.

I think it goes without saying – especially considering the two who are involved  – that FST for the Upper Body is a baller product that delivers on its promise to offer people a deeper look into the upper extremity and how to effectively assess dysfunction and address it through corrective exercise progressions and strength training.

It’s also gluten-free.  So there’s that.

2.  I have a unique perspective in that I see this stuff every….single…day. What you’ll watch in these videos are the exact assessment protocols and strategies we use at Cressey Performance on a daily basis with our overhead athletes and general population clientele.  It’s an inside-look, if you will.

3.  And, not to be understated, as I’m sure both Eric and Mike strategized this move to help increase their sales, you get to see me with no shirt on for 15 minutes.

I think I just broke the internet……;o)

Functional Stability Training for the Upper Body is on sale now at a low introductory price from today until this Sunday (5/18).  Click the link below for more details and to order.

—-> FST for the Upper Body <—-

CategoriesAssessment Corrective Exercise Exercise Technique Motivational personal training Rehab/Prehab Strength Training

A Response to Anyone Who Feels Deadlifts Are Destroying Everyone’s Spine

A HUGE thank-you to Bret Contreras for his contribution to this post. You’re my boy blue!

A little backstory.  A long time ago, in a galaxy far, far away A few years ago – back in 2010 – I wrote a blog post in response to someone claiming that deadlifts were “one of the worst things you could do for your spine.”

The comment was made by a TA (Teacher’s Assistant, not to be mistaken for Total Asshat) in a University setting, and the student who overheard the comment reached out to me and asked for some commentary.

I happily obliged.

You can read the original post HERE.

Even though I wrote that blog coming up on four years now, it’s still one that gets a lot of “love” and frequent comments.

Today I want to share the latest comment (another deadlift detractor) that was posted up two days ago by a physical therapist (and I assume a pilates enthusiast based off some of her wordplay), as well as mine, and subsequently, Bret Contreras’s, response.

I understand that some people will think to themselves, “What’s the point? If someone who’s clearly educated and is a practicing therapist feels deadlifts are the worst thing since Hilter (my words, not the therapist’s), do you really feel writing a response will change their mind?”

It’s a valid question, but my response is simple.

These types of posts are important for other fitness professionals since they’ll undoubtedly hear these types of arguments over time and they need to know how to respond.

So to begin lets take a gander at the therapist’s comments. Again, it may help to read the original post HERE.

I’ll preface this by saying that, giving credit where credit’s due, she kept things “civil” and refrained from using ad hominem attacks, which was refreshing to say the least.

In addition, she used her REAL name in the comments section (Meggen Lowry.  I wasn’t going to include the name here, but since people can see it in the comments section anyways, why not?), which was a nice change of pace and sure beats hearing from the likes of PowderPuffPrincess or JackedGunz84.

In doing a quick Google search, Meggen’s a well educated professional who works with a very specific population (pre-natal/post-natal clients, as well as those in a rehabilitative setting), which is relevant and gives context into her point of view.

Anyways, lets get to the meat and potatoes!

Posted on TonyGentilcore.com 4/27/14:

1) Your attitude and arrogance makes for an unpleasant reading experience.

2) Pilates uses limb loading, and can create significant loads through your spine but tends to be done in better postures and positions that support the spine and reduce downwards strain on the pelvic floor. Try it. You might find it isn’t for wussies.

3) Osteogenesis (bone adaptation by means of increased bone laydown) in response to loading is not a phenomenon unknown to researchers and physical therapists.

4) The problem with ‘educators’ like yourself is that you use the collective terms “spine” and “back” when talking about individual components of those structures. Deadlifts do not strengthen your whole spine. They are not good for your back.

The erector spinae will be strengthened (and possibly injured) with a dead lift, nobody is denying that.

The vertebral bodies themselves will experience adaptation and increase in density also. The intervertebral discs, however, will suffer. Under such huge compressive forces the nucleus pulposis will be ‘squished’ backwards and the annular fibres of the posterior portion of the disc will tear under strain. Those discs are not replaceable….

5) Intra-abdominal pressure is far far greater with a deadlift than any other exercise you mentioned, and increases even more if the person holds their breath. Intra-abdominal pressures of that magnitude cause significant detrimental strain to the abdominal wall, predisposing it to herniation. Even worse, it causes even greater strain to the pelvic floor, stretching and weakening the pelvic floor muscles and predisposing them to urinary incontinence and prolapse.

Until you show me some research (preferably not 20-30 year old research) demonstrating intervertebral disc and pelvic floor adaptations to dead lifts, proving that the annular fibres of the discs are not broken under strain and the pelvic floor is not weakened and lowered, I’m still going to advise my clients against them.

WHEW! And there you have it.

I’ll admit it:  when I first read all of that the other day my first reaction was as follows:

LOL – Just kidding.  I’m not going to kill anyone.

I was a bit “miffed,” but I think that would be anyone’s reaction whenever someone questions your training philosophy and beliefs.  Strength coaches defend deadlifts; yoga instructors defend downward dog; pilates instructors defend reformers; bodybuilders defend fanny-packs and benching with their feet up. It’s just how the world revolves.

Even so, I was bit taken aback by some of Meggen’s comments.  Sure, she brought up some valid points (addressed below), but she also seemed, in my opinion, to have a very narrow-minded mentality – especially for someone who’s a physical therapist.

I mean, in checking the Mission Statement of the establishment where she’s employed you find the following text:

In addition to home visiting, we offer exercise classes carefully designed and delivered by physiotherapists for people whose bodies are vulnerable to pain and injury because we believe movement can be the best medicine if you perform exercise tailored to the shape you are in.

How can someone who’s company’s Mission Statement says “we believe movement is the best medicine if you perform exercise tailored to the shape your are in” completely disregard a basic, human movement pattern – the deadlift – and deem it and all its iterations “dangerous” or “risky” or gloss over them because of the potential for spinal stress?

That seems a bit harsh and shortsighted if you ask me.

Isn’t that the point of exercise – to stress the body, including the spine?

Any competent coach will assess his or her client/athlete, progress them accordingly – based off their training experience, injury history, etc – and provide the minimal essential strain to stress the body so that it will come back stronger.  It’s called adaptation!

In my experience, those who disregard certain exercises or movements and/or poo-poo them altogether typically (not always) are those who’ve never performed them themselves in the first place.

Calling a spade a spade, these are also the same people who have no idea how to coach said movement(s) well.  So, as a result, the exercise becomes too “risky” and everyone else who uses it is wrong.

Meanwhile if we were to take Meggen’s company’s Mission Statement and apply it to real life, we’d realize that the deadlift, like every exercise ever invented by human beings, can be regressed and tweaked to fit the abilities and needs of each individual.

Using a quick example: Look at me hinge from the hips, load my glutes, maintain tension in the upper back and lats, keep a “neutral” spine, and reduce “stress” on my spine below.

This is a deadlift, too.  Not all deadlifts have to be max effort, full-exertion, grind it out movements. And while it (should) go without saying:  a properly executed deadlift – done with a neutral spine – is a far cry from the eye sores you see a lot of trainees performing.

The two can’t and SHOULD NOT be lumped into the same category (which is what I feel many people, not just Meggen, are doing).

Okay, so lets break down Meggen’s comments. I’ll re-post her point-by-point breakdown below followed by my response (if I have one) and Bret’s.

1) Your attitude and arrogance makes for an unpleasant reading experience.

Tony:  You know what.  You’re right.  I re-read the post again and I can see how someone would come to that conclusion having never read any of my stuff before. I did come across as a bit of an a-hole, and I apologize for that.

Not that it’s a hard defense, but it was FOUR years ago that I wrote that post, and I’d like to think that I’ve grown as a person (and writer) since then.

Having said that, I “get” that my writing style isn’t for everyone. Touche.

Bret: As somebody who is very well-versed with industry leaders in strength & conditioning, I can say with confidence that Tony might be the most humble of the bunch. 

Tony’s Response to Bret’s Response:  Awwwwwwwwwwwwwwwwwww.

2) Pilates uses limb loading, and can create significant loads through your spine but tends to be done in better postures and positions that support the spine and reduce downwards strain on the pelvic floor. Try it. You might find it isn’t for wussies. 

Tony: And, Pilates should be held under the same microscope. Just like deadlifts, Pilates, too, can add undo strain or stress on the spine when done incorrectly.

Can you honestly sit there and tell me that performing hundreds of repetitions of any Pilates exercise – even if supported and done in alignment – won’t “stress” the spine?

I actually know quite a few Pilates instructors, most of which understand the importance to strength training, who recognize that it can hurt people when done incorrectly.

The key term you use is “better postures and positions,” which I assume means alignment.

YES!!!  Alignment is key.

This is something I discuss quite often. It makes no sense to debate over which comes first or should be prioritized – mobility or stability – if someone isn’t in (optimal) alignment.

Note:  it should be highlighted that there’s no such thing as true alignment or neutral or symmetry.  It doesn’t exist, because the human body – based off our anatomy – is designed to be asymmetrical.

I 100% agree with you on this point.  So, tell me again, if a deadlift is performed correctly, with a neutral spine, it places too much stress on the spine?

And, as far as your comment “Try it (Pilates). You may find it’s not for wussies.”  I did!  

You can read about it HERE.

Funny thing:  I like to try things that I write about.  In fairness, the Pilates post was written well after the post we’re all discussing here.  But still, I feel like I should get a gold star or something.

Which begs the question, Meggen:  what’s the parallel you’re trying to make between a modality which was originally designed to treat injured dancers and……deadlifts?

More specifically: deadlifts, when performed correctly and by healthy individuals with no contraindications?  Even more specifically:  deadlifts, which have been utilized by thousands of physical therapists (past and present) to help people get stronger and move more efficiently.

Also, when was the last time you performed or even coached a deadlift?  When was the last time you ever prepared an athlete for a long, competitive season?  When was the last time you coached ANYONE interested in performance?

I hate to break the news to you, but deadlifts are kind of important in this regard.

Context is important here.  I understand – and respect – the population you work with (pre and post natal women, and those in a rehabilitative setting), and deadlifts may not be a good fit for some of YOUR clients.  I doubt that’s the case entirely, but still…….you know your clients better than me.

There are ways to regress the deadlift and to teach someone how to groove a proper hip hinge pattern.  It takes coaching, it takes times, and it also takes not deeming an exercise too “risky” because you’re not familiar with it.

Like I said above, not all deadlifts have to be loaded with 400 lbs on the bar. You can’t equate all deadlifts as being equal. What I’d do for someone who’s in pain, de-conditioned, has little to no training experience has chronic back issues, and moves like the Tin Man is COMPLETELY different compared to someone who’s healthy and otherwise “good to go.”

Take THIS post I wrote not too long ago on how to groove the hip hinge.

Lets try not to toss the baby out with the bathwater.

Bret: Most strength coaches borrow from Yoga and Pilates and incorporate various drills into their warm-ups and corrective exercise regimes. We’ll use anything that’s effective, as S&C is all-encompassing.

The same cannot be said of trendy modalities that pick and choose what’s included and what’s excluded and fail to tailor programming to the goals and needs of the individual.

Pilates can definitely be progressive in nature and isn’t always “wussy,” but if maximum power, strength, or conditioning is the goal, then you’re going to have to jump, sprint, lift heavy, and move around more. 

3) Osteogenesis (bone adaptation by means of increased bone laydown) in response to loading is not a phenomenon unknown to researchers and physical therapists. 

Tony:  Cool, we’re on same page. 

Bret: Agree! Perhaps you’d be interested to know that the highest bone densities ever recorded are in powerlifters (see HERE and HERE), and that high load exercise is more effective than low load exercise in increasing bone density (see HERE). 

4) The problem with ‘educators’ like yourself is that you use the collective terms “spine” and “back” when talking about individual components of those structures. Deadlifts do not strengthen your whole spine. They are not good for your back.

The erector spinae will be strengthened (and possibly injured) with a dead lift, nobody is denying that. 

The vertebral bodies themselves will experience adaptation and increase in density also. The intervertebral discs, however, will suffer. Under such huge compressive forces the nucleus pulposis will be ‘squished’ backwards and the annular fibres of the posterior portion of the disc will tear under strain. Those discs are not replaceable….

Tony:  Again, I think you’re equating deadlifts done incorrectly (which if that is the case, I’ll agree with you 100%) with deadlifts that are progressed appropriately and with progressive overload in mind.  They are not the same.

And, not for nothing, a 1994 study in the New England Journal of Medicine found that in a study of MRIs of 98 asymptomatic individuals, 82% of those MRIs came back as positive for a disc bulge, protrusion, or extrusion at one level.  And, 38% actually had these issues at more than one level.  You can read the free full text HERE.

I bring this up because, as this study shows, there’s a fair number of people walking around out there with disc bulges who are asymptomatic and show no signs of stress or pain.

What prevents (most) of them from reaching threshold is appropriate strength training, attention to tissue quality and movement impairments, and, yes, things like positional breathing and pelvic alignment (but that’s obvious, right?).

It’s not a death sentence, and we shouldn’t go out of our way to demonize certain exercises and to toss them aside because of personal ignorance.  

As fitness and health professionals we can’t place people in these “no stress” bubbles, cower in the corner every time we ask them to do anything challenging, and expect them to get better.

As noted earlier, any competent coach will assess their client, progress them accordingly, and provide a minimal essential strain to STRESS the body so that it comes back stronger. 

Using a population you (Meggen) may be more familiar with, HERE is an article I wrote about training women through their pregnancy.  These were HEALTHY women, with no major injuries and dysfunctions, and both of which had been training with me for a few years.

I’m not sure if you’ll read the post (don’t worry, I won’t be offended), but hopefully you won’t cringe at the thought that both women deadlifted throughout their entire pregnancies.

Here’s Whitney at 32 weeks:

Here’s Cara at 33 weeks:

NONE of these lifts were even close to what either woman could do when not pregnant. The objective was to maintain a movement pattern and training effect, do what felt comfortable, and prepare them for something a helluva lot more strenuous…..giving birth!!

In addition, because I had been training both women for two years, progressing them accordingly, I had full confidence that they would be able to deadlift up until “game time.”

And, as it happens, both had seamless births (coming from a guy, that seems a bit wonky as I recognize that giving birth is anything but “seamless”) with no complications or ramifications afterwards.  

It’s BECAUSE they strength trained (and yes, we did diaphragmatic breathing and tons of core work, too) that they were able to bounce back so quickly.  I believe both were back in the gym within a week after giving birth. 

Bret: Do you have any research to support your claim that deadlifting with a neutral posture leads to disc herniation?

I’m very well-versed in spine research, and I’m unaware of any such research.

I believe that with proper deadlifting, the erector spinae will be strengthened, the vertebrae will be strengthened, and the discs will be strengthened too, in concordance with Wolff’s law of bone and Davis’s law of soft tissue. 

Nevertheless, the spine is very good at handling compressive loads when in neutral postures, and shear loading is limited in neutral spine deadlifting as well. If you round your spine close to full flexion when deadlifting with heavy loading, then lumbar intervertebral discs can indeed herniate and ligaments can be damaged.

However, now we’re talking about a different exercise (roundback deadlifting, not neutral deadlifting). An exercise is judged based on how it’s supposed to be performed, not how jackasses screw it up.

We could also speculate about the effects of performing Pilates maneuvers with improper form, but this wouldn’t imply that the exercises should not be performed with proper form.

5) Intra-abdominal pressure is far far greater with a deadlift than any other exercise you mentioned, and increases even more if the person holds their breath. Intra-abdominal pressures of that magnitude cause significant detrimental strain to the abdominal wall, predisposing it to herniation.

Even worse, it causes even greater strain to the pelvic floor, stretching and weakening the pelvic floor muscles and predisposing them to urinary incontinence and prolapse.

Until you show me some research (preferably not 20-30 year old research) demonstrating intervertebral disc and pelvic floor adaptations to dead lifts, proving that the annular fibres of the discs are not broken under strain and the pelvic floor is not weakened and lowered, I’m still going to advise my clients against them.

Tony:  So 20-3o year old research, even if it’s applicable and still very much referenced by many other fitness professionals, isn’t relevant to the topic at hand?  Why not?  

Besides, good luck finding ANY research which states exercise doesn’t stress the spine. Walking stresses the spine.

Unless you tell someone to lie down their entire life, it’s impossible not to put the spine under some strain.

Research is more Bret’s wheelhouse, and I’m sure he’ll satiate your appetite for something more “up-to-date,” but it’s my hope that this conversation will help shed some light from our (mine and Bret’s) point of view.  Neither of us are therapists, nor claim to be. We don’t diagnose anything and we don’t “treat” our clients and athletes. That sort of stuff is reserved for the likes of you.

We do, however, both recognize the importance of bridging the gap between the strength and conditioning world and the physical therapy world.

Going out of your way to state deadlifts aren’t beneficial because of the “perceived stress” they cause not only widens that gap, but flies in the face of pretty much every physical therapist I’ve ever dealt with.

I don’t expect this to alter your mindset, and I am in no way stating that I’m completely correct and without my own biases, but I hope it challenges you to think a little more outside the box.

Bret: If you’re going to deadlift, you better hold your breath until you pass the sticking region.

Failing to do so would reduce IAP and therefore reduce spinal stability, which could compromise spinal posture and lead to injury.

I agree that IAP will be extremely high during deadlifting. However, strength coaches first introduce deadlifting to clients with light loads, ensuring proper mechanics.

Each week, loads are increased so that the body has the ability to build up in strength. This is the essence of progressive resistance training. We also program multiple exercises that will further strengthen the abdominals, the erectors, and the glutes, which will further help prevent injury. 

I’m aware of no research showing that deadlifts lead to increased incidents of hernias.

You can speculate that deadlifters might be at greater risk for experiencing hernias, but the role of exercise and occupational lifting on hernia risk has been debated, with both sides providing great arguments (see HERE for references).  In my experience as a personal trainer for well over 15 years, I would say that proper deadlifting does not significantly increase hernia injury risk. 

When you deadlift, the muscles of the TVA, multifidus, diaphragm, and pelvic floor (sometimes referred to as “inner core unit” muscles) contract to produce IAP. Essentially, a pressurized cylinder is formulated via contraction of each of these muscles (a few more assist, but this is beyond the scope of this article).

The pelvic floor muscles draw upward and inward, which increases the IAP and stabilization. As you can see, the pelvic floor muscles will be strengthened and not stretched out.

Women tend to notice improvements in incontinence after learning proper resistance training, including deadlifts.

If their pelvic floor muscles draw outwards, then they are exhibiting a dysfunctional pattern and need to be taught proper pelvic floor biomechanics.

Research shows that 78% of women who exhibit flawed pelvic floor mechanics can properly contract the pelvic floor muscles after basic instruction (click HERE for an article on this topic).

Women who properly contract their pelvic floor musculature will properly stabilize during deadlifts, Pilates, and other exercise. Women who don’t will improperly stabilize during deadlifts, Pilates, and other exercise. The IAP doesn’t blow the pelvic floor outwards during the deadlift like you propose, nor does it force the diaphragm upwards. Rather, it’s the proper mechanics of the core muscles that creates the high IAP. 

 

In summary, you have failed to issue an evidence-based response, and I believe that your unfamiliarity with the deadlift exercise is biasing your beliefs.

Just as you recommended that Tony give Pilates a try (Note from Tony:  I did! See above), I recommend that you start learning about deadlifts and experimenting with them in the gym.

From the various hip hinging drills, to single leg RDLs, to partial deadlifts such as rack pulls and block pulls, to full range deadlifts such as conventional, sumo, and trap bar deadlifts, to various variations such as Romanian deadlifts, stiff leg deadlifts, and snatch grip deadlifts. 

Since you’re making the claims that proper deadlifts damage discs, abdominal walls, and pelvic floors, the burden of proof is on you.

You can speculate all you want, but bear in mind that if this were true, all powerlifters would have wrecked spines, hernias, and incontinence. This isn’t the case at all; quite the opposite. But they’re loading the spine to the maximal limit.

Research shows that there’s a u-shaped curve with regards to low back pain and exercise. Sedentary folks and individuals who perform strenuous exercise have increased pathology and low back pain, whereas those in the middle are more healthy and comfortable (see HERE and HERE).

Therefore, a few days of strength training per week utilizing basic strength training exercises such as squats, deadlifts, hip thrusts, planks, push-ups, and rows will generally improve back health and structural integrity.