Categoriescoaching Corrective Exercise Exercise Technique Program Design Strength Training

How Unilateral Strength Training Can Improve Your Squat, Bench, and Deadlift

Another fantastic guest post today from Shane McLean. This time he tackles the importance of unilateral strength training and offers some neat ideas as to the best accessory movements to compliment the “big 3.”

Copyright: vadymvdrobot / 123RF Stock Photo

 

Don’t you love “that” guy who always stands between you and the dumbbells while doing single arm curls and making faces only his mother could love? What if I told you that he’s actually on to something, minus the faces and grunting?

Bilateral exercises (not biceps curls) should form the foundation of your strength program because this is where you’ll get most of your gains. However, unilateral training often gets neglected in the quest to get bigger and stronger because it’s just not as sexy (or cool) as a big squat, deadlift or overhead press.

However, unilateral training will help you get stronger, improve the big lifts (by shoring up weakness) and provide the following benefits.

Reduce Muscle Imbalances

Due to activities of daily living almost everybody has a dominant and non-dominant side. For instance, carrying more groceries on one side over the other over time may get one arm stronger.

During bilateral exercises such as a press or squat variation, your dominant side can pick up the slack for the weaker side.

Have you ever seen a lifter struggle to lock out one side over the other during a barbell bench press? I rest my case. Improving your “weaker” side will reduce your injury risk and help increase overall lifting numbers.

Improved Muscle Recruitment

Unilateral training makes you work harder and recruit more muscle fibers to perform the exact same movement, such as a split squat.

Taking one leg out of the equation forces your abductors and core to stabilize your pelvis while the working leg performs a split squat. Working more muscle with less weight will help correct strength imbalances between sides, also.

Core Work Without Crunches

When training unilaterally, you automatically throw your body off balance, forcing your core muscles to engage in order to keep yourself upright.

Trust me when I say that’s a good thing.

And we can double-down on the core training ante by utilizing offset loading:

 

Programming Guidelines

Unilateral exercises are best performed as an accessory movement after your big lift for the day.

Choose one or two single limb movements per session and perform three to four sets on both sides. The repetitions performed will depend on your goal.

For example:

  • Strength: 4 – 6 reps
  • Hypertrophy/Fat Loss: 8 – 15 reps

If you have a strength or muscle size imbalance always start with the weaker/smaller side first and let the weaker side determine the weight/reps you do on the stronger side.

Without further ado, here are my top two accessory exercises you should be doing to improve your squat, dead lift and press numbers. Sorry, this is a biceps curl free zone.

1) Deadlift

 Suitcase Carries

 

Not only will carries change your life in three weeks, according to Dan ‘the man’ John, they can strengthen grip imbalances between hands which can be a limiting factor when pulling heavy from the floor or opening the pickle jar.

When you’re doing carries (you do, right?), pair them with a movement that doesn’t demand a lot of grip strength, so you can get more out of it. For example:

1A. Goblet squat/press variation.

1B. Suitcase carry- (25-50% of your bodyweight) 30 steps one hand then 30 steps with the opposite hand.

Form considerations – cues “shoulders down and back” or “chest up” work well here. Checking your form in a mirror will help if you having trouble knowing if you’re overcompensating or not.

Front Racked Kettlebell Bulgarian Split Squat

These were first introduced to me by Anthony Dexmier to improve my pulling ability from the floor. Let’s just say after doing them, we weren’t the best of friends.

Hardcore dead lifters knows that hip mobility, upper back strength and leg drive are essential elements for pulling heavy, and this exercise covers all those bases, if somewhat brutally.

 

Pairing this exercise with a single arm row variation is a real upper back whammy that you’re sure to enjoy. For example

1A. Front racked kettle bell elevated split squat – 12 reps on each leg

1B. 3 point dumbbell row – 12 reps on each arm

 

Form considerations – Perform a bodyweight elevated split squat and notice where your big toe is, and then place weight plate in front of it. This will give you a reference point and shorten your set up time between sets. This is courtesy of the one and only Jordan Syatt.

Keep a nice tall chest and your wrists in neutral during this entire movement and smile through the pain.

2) Bench Press

Landmine Press

The single arm landmine press is a mix between a vertical and horizontal movement which makes this great for individuals who lack the shoulder mobility for overhead pressing and for those looking to improve their press numbers.

Note From TG (to Shane): How could you not include a link to THIS article I wrote discussing how to assess overhead mobility and drills to help improve it?

Why Shane…….WHY?!?!?

The beginning of this exercise (initial push of the shoulders) is the hardest part of the movement. This will assist you with pushing the bar off your chest during the bench press or pushing the barbell overhead from a dead stop. The extra core work doesn’t go astray either.

This press can be done from a variety of positions. For example, it can be done standing, tall kneeling and this half kneeling variation courtesy of Eric Cressey:

 

Pairing this landmine variation with a hip flexor stretch works well and provides an active rest between sides and sets. For example

1A. Half kneeling landmine press (right hand)

1B. Half kneeling hip flexor stretch (right knee down) – 30 seconds

1C. Half kneeling landmine press (left hand)

1D. Half kneeling hip flexor stretch (left knee down) – 30 seconds

Form considerations- Make sure the barbell is close to the front of your shoulder and actively squeeze the barbell. This provides Irradiation, allowing you to produce more force and lift more weight. This also turns on the rotator cuff, which helps with shoulder stability.

Single Arm Dumbbell Floor Press

The reduced range of motion of the floor press makes this a great triceps builder (when the elbows are close to your side) and will assist you in getting stronger with the lockout part of any press variation.

The single arm variation will turn on your core and shoulder stabilizers due to the offset load that can get neglected during bench/overhead pressing. It’s a shoulder saver because it eliminates the lower half of the press where the shoulder is externally rotated and nasty things like shoulder impingements can happen.

 

Pairing this with a side plank or a suitcase carry gives your shoulders and core the extra work they deserve. For example

1A. Floor press

1B. Side plank variation 30 sec/ Suitcase carry – (25-50% of your bodyweight) 30 steps one hand then 30 steps in the opposite hand.

Form considerations- Grip the dumbbell tight or strangle the handle and keep the elbow close to your side but not touching. Touch the entire upper arm to the ground at the start of each rep.

3) Squat

Single Leg Negative Calf Raise

It’s a common issue to lack ankle mobility as we wear shoes that inhibit the movement of the ankles, like wearing high heels, for example. The ability to dorsiflex the ankle (how far the knees can go over the toes without raising the heel) can get compromised and this can show up in the squat.

As the squat movement has to come from somewhere, lacking dorsiflexion can negatively affect the joints further up the kinetic chain especially the knee, and who hasn’t had sore knees (and everything else) at the end of an intense squat session?

If hammering away at ankle mobility isn’t working for you, try this single leg negative calf raise drill from Dr. Ryan DeBell before your squat session. This will help with ankle dorsiflexion under load.

 

Form considerations- Having something solid to hold on to is a must. If you have pain bending the knee during this drill, please use a pain free range of motion. Do 5-10 reps on each leg before you squat. Your knees will thank you.

Barbell Reverse Lunge- Front Squat Grip

Most lunge variations are interchangeable because they work on knee stability (knees that go out instead of in) and core (reduced base of support) hip mobility (active stretch of the hip flexors) and help build your quad strength and size. Sounds like everything a good squat needs, right?

This variation does this and more. The front squat grip works on your anterior core upper back strength and thoracic mobility which are also needed for a strong squat.

 

Pairing this with an upper back or anterior core exercise in a superset works well. For example

1A. Barbell Reverse Lunge – Front Squat Grip – 8-12 reps on both legs

1B. Chin up

Or

1A. Barbell reverse lunge- Front squat grip 8-12 reps on both legs

1B. RKC Front Plank

Form considerations- Start on the light side until you nail the technique and feel confident that you’re not going to bite the floor. Keep the ears away from the shoulders and maintain an upright torso during this exercise.

Wrapping Up

Don’t forget about unilateral training when it comes to getting bigger, stronger and more awesome. Including these exercises into your routine will improve your lifting numbers and overall balance and will help keep you off the lifting DL.

You can throw in some single arm curls (for the girls) to keep Ron happy, if you must. J

Author’s Bio

 Shane “The Balance Guy” McLean, is an A.C.E Certified Personal Trainer working deep in the heart of Dallas, Texas.

No, Shane doesn’t wear a cowboy hat or boots.  After being told that his posture blows by Eric Cressey, he has made it his mission to rid the world of desk jockeys and have fun while doing so.

After all exercise is fun and never a “work” out.

You can follow Shane on Twitter HERE, and Facebook HERE.

CategoriesCorrective Exercise Exercise Technique Exercises You Should Be Doing

Exercises You Should Be Doing: Supine Straight Leg Hip Extension with Alternate Hip Flexion

Admittedly, today’s “Exercise You Should Be Doing” doesn’t highlight anything visually badass like, say, deadlifts vs. chains, recoiled sled high pulls (<– seriously, check that out), or, I don’t know, juggling chainsaws while balancing on a BOSU ball.1

25682290 - detail of the chainsaw isolated on the white background

Copyright: photozi / 123RF Stock Photo

Nope, today’s exercise recommendation is very plain looking and is about as vanilla as they come. It’s not flashy and it (probably) won’t win anyone any additional Instagram followers. But oh is it a doozy and one I feel is going to raise some eyebrows and surprise people at how challenging it really is.

Supine Straight Leg Hip Extension with Alternate Hip Flexion

 

Who Did I Steal It From: NYC based coach and AMP Training Active Movement & Performance owner, Chris Cooper.

What Does It Do: Not only is this great for glute activation, but because of the alternating nature of this drill (bringing one leg towards you chest at a time) it also serves as a fantastic core exercise as you must resist the hips from rotating to any one side. In fancy schmancy technical terms: you’re working on rotary pelvic control, or rotary stability.

Many people are incapable of controlling their lumbo-pelvic region and it’s no surprise we see a high incidence of SI joint issues, chronic low-back pain, and many other dysfunctions up and down the kinetic chain within this population.

Drills such as deadbugs, birddogs, Pallof presses, and planks are all exercises that tackle this head on. However, I hope this quick post will encourage people to add this exercise to their repertoire as well.

Key Coaching Cues: Place your feet (heels) on an elevated platform (no higher than 12″) and extend (elevate) your hips off the floor. From there place your fingers on the front of  your pelvis (ASIS) and slowly flex on hip, bringing your knee towards your chest. The idea is to use the kinesthetic feedback of fingers on the ASIS to keep your pelvis level throughout the duration of the exercise.

For added badassery, you can progress things by place a light band around your toes.

Give it a try and let me know what you think.

CategoriesAssessment Corrective Exercise Strength Training

Strong Traps, Healthy Shoulders

A funny thing happens whenever I inform someone (namely, guys) they need to hit their upper traps more. The immediately go into Bane mode:

Visions of heavy barbell shrugs, breaking Batman’s back, and walking around asking people “do you feel in charge?” run rampant.

It’s all well and good, I have nothing against shrugs. I draw the line against breaking people’s backs though. BAD BANE, NO!

Shrugs are undoubtedly a great exercise to build the upper traps. And the upper traps are kind of important when it comes to the ability to bring one’s arms overhead – they’re one of three muscles that help to upwardly rotate the scapula.

Via my time as a coach at Cressey Sports Performance (and even now) I work with a lot of people with shoulder issues. Training the upper traps directly has gotten a bad rap in recent years. But for athletes and lifters who are stuck in spine-extension based postures and can’t raise their arms overhead, training the upper traps can be a game changer for overall shoulder health and performance.

The key? Ensure they’re trained with upward rotation.

Continue reading my latest article on T-Nation.com HERE.

CategoriesAssessment Corrective Exercise Program Design

It’s Coming: The Complete Shoulder and Hip Blueprint

Much like Winter in Game of Thrones……It’s coming.

Hip&Shoulder-Landscape

Except, you know, in this case “it” has less to do with the Night King, White Walkers, and the impending doom of man, and more to do with shoulder and hip assessment, corrective exercise, strength & conditioning, and programming strategies to optimize performance in the weight room.

Dean Somerset and I filmed our Complete Shoulder & Hip Workshop in Oslo, Norway this past spring and we’re excited to give everyone a sneak peak on what to expect:

 

Yes, the music is a bit dramatic. We were originally gonna go with “Wu-Tang Clan Ain’t Nuthin to F*** Wit” or “You’re the Best Around” from the Karate Kid soundtrack, but figured both were a bit more dramatic.2

In any case, we’d be honored for you to take a look. And stay tuned for a release date in the very near future.

Seriously, it’s coming…..

CategoriesAssessment Corrective Exercise Program Design Rehab/Prehab

The Forgotten, Often Overlooked Cause of Low Back Pain

There are many root causes of low back pain and discomfort, and there are many people who’s day to day lives are affected by it.

In my neck of the woods – Strength & Conditioning – the culprit(s) can often be displayed on the weight room floor. Lifters who routinely default into movement patterns that place them in (end-range) LOADED spinal flexion or extension are often playing with fire when it comes to their low back health and performance.

NOTE: this isn’t to say that repeated flexion/extension is always the root cause.

1) There’s a stark contrast between flexion/extension and LOADED flexion/extension. Many people have been programmed to think that all flexion/extension of the spine is bad. It’s not. The spine is meant to move, albeit under the assumption that one can do so without significant compensation patterns (relative stiffness), limitations in mobility, and with appropriate use of both passive (ligaments, labrums, and tendons, oh my) and active (muscles) restraints.

It’s when people start placing the spine under load in ranges of motion they can’t control – often in the name of social media glory – that bad things end up happening. 

2) However, there are plenty of examples of lifters (mostly elite level, which is an important point) who have been utilizing techniques many fitness pros would deem incendiary with regards to the increased likelihood of spines all over the world resembling a game of Jenga.

A great example is a piece Greg Nuckols wrote HERE, explaining the benefits – biomechanically speaking – of a rounded back deadlift.

But back pain – specifically low back pain – can strike at any moment. I’ve heard stories of people hurting their back during training of course. But I have also, and I think many of you reading will nod your head in agreement, have heard stories of people messing up their back while bending over to pick up a pencil or to tie their shoes.

Or while fighting a pack of ninjas (hey, it can happen).

In pretty much all cases it comes down to one of two scenarios going down:

1. Ninjas attack.A one-time blunt trauma. Think: spine buckling under load, car accident, falling off a ladder.

2. A repetitive aberrant motor pattern. Think: tissue creep into sustained spinal flexion for hours on end at work.

Dr. Stuart McGill and his extensive research on spinal biomechanics has been the “go to” resource for many people – including myself – to help guide the assessment process and to attempt to figure out the root cause of most people’s low back pain.

A term he uses often is “Spinal Hygiene.”

It behooves us as health and fitness professionals to use the assessment as a window or opportunity to “audit” our client’s and athlete’s movement and to see what exacerbates their low back pain.

From McGill’s book Back Mechanic:

“Our approach in identifying the cause of pain during an assessment is to intentionally provoke it. Provocative pain testing is essential and irreplaceable when it comes to determining which postures, motions, and loads trigger and amplify pain and which ones offer pain-free movement alternatives.”

People who have more pain and discomfort in flexion (slouching, sitting, bending over to tie shoes) are often deemed as flexion intolerant. Moreover, people who have more pain and discomfort in extension (standing for long periods of time, bending backwards, excessive “arching” in training), are often deemed as extension intolerant.

Ironically, in both scenarios, people will find relief in the same postures that are “feeding” the dysfunction and their symptoms.

What’s the Fix?

Funnily enough, pretty much everything works. There are any number of methodologies and protocols in the physical therapy world that have worked and have helped get people out of low back pain.

It’s almost as if the appropriate response to “how do you fix low back pain?” is “the shit if I know? Everything has been shown to work at some point or another.”

Active Release Therapy, Graston, positional breathing, stretching, mobility work, rest, sticking needles in whereeverthefuck….it’s all been shown to work.

I’ve had numerous conversations with manual therapists on the topic and the ones who tend to “get it” and elicit the best results are the ones who take a more diverse or eclectic approach.

They’ll use a variety of modalities to best fit the needs of the individual.

That said, I’m a fan of directing people towards therapists who take a more “active” approach as opposed to a “passive” approach.

Both can work and both have a time and place. However one approach is less apt to make me want to toss my face into an ax.

Passive Approach = Ultra sound, electric stimulation, etc. This approach treats the symptoms, focuses on instant relief, and not necessarily addresses the root cause(s).

Active Approach = Is more hands on and more “stuff” is happening. Practitioners who fall on this side of the fence tend to focus more on the root cause – poor movement quality, positioning, muscle weakness, mobility restrictions – and work in concert with the patient/athlete to educate them on how to prevent future setbacks.

Above all, an active approach is about finding and engraining a neutral spinal position, and finding pain-free movement.

I think by now you know my preference.

 

Tony, Shut-Up, What’s the “Forgotten” Cause of Low Back Pain?

Well, to say it’s “forgotten” is a bit sensationalistic. My bad.

We tend to solely focus on either flexion or extension intolerance…and granted those are the two biggies.

However, have you ever had someone come in and pass those “screens” with flying colors only to complain of back pain or discomfort when he or she rolls over in bed, rotates, or maybe experiences an ouchie when they sneeze?

What’s up with that? And bless you.

Spinal Instability – That’s What’s Up.

Instability can rear it’s ugly head with flexion/extension based issues too, but it becomes more prevalent when rotation is added to the mix.

The body doesn’t operate in one plane of motion, and it’s when people meander out of the sagittal plane and venture into frontal and/or transverse plane movements, when they begin to get into trouble.3

The muscles that provide intersegmental stability to the spine may be under-active and may need some extra TLC.

I’ve worked with people who could crush a set of barbell squats (they handle compression and shear loading well), but would complain of l0w-back pain whenever they did anything that required rotation.

 

The fix is still going to be helping them find and maintain spinal neutral – I don’t feel this is ever not going to be a thing. Kind of like too much money in politics or LOLcats.

In addition, gaining motion from the right areas – hips, t-spine, for example – will also bode well.

However, I’d like to offer some insight on what exercises might be part of the repertoire in terms of “pain free movement” when spine instability is a factor.4

The Stuff Most People Will Skip (It’s Okay, I Won’t Judge You)

One word: planks.

Dr. McGill has stressed time and time again that improving spinal endurance (and hence, stability) is paramount when dealing with back pain. They key, though, is performing them in ideal positions.

I chuckle whenever someone brags about holding a 5-minute plank. When in fact all they’re really doing is hanging onto their spine….literally.

This does no one any favors.5

RKC Plank.

1. It’s a bonafide way to help people gain a better understanding and appreciation for creating full-body tension.

2. I like cueing people to start in a little more (unloaded) flexion, so that by the end they’re residing  in a neutral position anyways.

3. When performed as described in the video below, 10s will make you hate life.

To up the ante you can also incorporate 3-Point Planks (where you take away a base of support, either an arm or a leg, and hold for time) or Prone Plank Arm Marches:

 

NOTE TO SELF: do more of these.6

You can also incorporate Wall (Plank) Transitions where the objective is to cue people to keep the torso locked in place. Motion shouldn’t come from the lumbar spine then mid-back. Everything should move simultaneously, as follows:

Deadbugs

I’m a huge fan of deadbugs. When performed RIGHT, they’re an amazing exercise that will undoubtedly help build core and spine strength/stability.

A key component to the effectiveness of a deadbug is the FULL-EXHALE (check out link above). However, one variation I’ve been using lately is the Wall Press Deadbug (for higher reps).

https://www.youtube.com/watch?v=gmtsGHk34C0

 

Here the objective is to engage anterior core (pressing into the wall), to breath normally, and then to perform a high(er) rep set (10-15/leg) making sure motion comes from the hips and NOT the lower back.

If you want to build stability (and endurance) this is a doozy.

Stuff People Are More Likely To Do (Because It Involves Lifting Things)

1. Offset Loaded Lifts

This is an untapped, often overlooked component to back health and performance. Offset or asymmetrical loaded exercises are a fantastic way to train spinal stability and challenge the core musculature.

By holding a dumbbell on one side, for example, you have work that much harder to maintain an upright posture and resist rotary force:

 

Likewise, with offset presses, the core must fire to prevent you from falling off the bench. Unless you fall off because you’re drunk. If that’s the case, go home.

 

And we don’t have to limit ourselves to dumbbells, either. We can use barbells too.

2. Shovel Deadlift

3. Farmer Carries

Farmer carries – especially 1-arm variations – can be seen in the same light. The offset nature is a wonderful way to challenge the body to resist rotation (rotary force) and to help build more spinal stability.

 

4. 1-Legged Anti-Rotation Scoop Toss

Another option is to perform anti-rotation drills such as the 1-Legged Anti-Rotation Scoop Toss. As you can see from my un-edited video below….it’s tougher than it sounds.

 

5. Anti-Rotation Press

 

A bit higher on the advanced exercise ladder, the Anti-Rotation Press is another great drill to help hone in on increased core strength and spinal stability. To make it easier, use a longer stride stance; to make it harder go narrower.

This Is Not an End-All-Be-All List

But a good conversation stimulator for many people dealing with low-back pain nonetheless. Have you got own ideas or approaches to share? Please chime in below or on Facebook!

CategoriesCorrective Exercise personal training Rehab/Prehab Strength Training

Bridging the Gap Between Physical Therapy and Strength and Conditioning. How Much of a Gap Is There?

Today’s guest post comes courtesy of Andrew Millett – a good friend of mine and brilliant physical therapist outside of Boston.

The term “bridging the gap” is always brought up when the discussion of physical therapy and strength and conditioning comes up. There’s no doubt a melding of the two when discussing the most successful outcomes for patients and athletes. However, in a day and age where more and more personal trainers are taking it upon themselves to play the role of “therapist” (and vice versa), it’s important to note that, while it behooves us to dip our toes in both ponds, there IS a distinction between the two.

And we need to respect that.

Enjoy.

Bridging the Gap Between Physical Therapy and Strength and Conditioning

In the fields of strength and conditioning, human performance, physical therapy, etc., we interact with people on a daily basis.  We learn about their family, their job, their goals, and what they want to get out of their training or rehab.  The majority of the people in this field did not get into their respective field for the money.

I am not saying that any of these fields can’t be lucrative.  The majority of us share a common bond:  the desire to help people.

Whether you are a physical therapist trying to help someone get rid of their pain and get back to doing what they want to be doing or a personal trainer trying to help someone lose some weight, most of us want to help people.

When we see a client who is in pain or has some type of movement dysfunction, most of us want to help them get out of pain, whether or not we are a healthcare practitioner.  Personal trainers, strength and conditioning coaches, etc. are well-qualified to assess and correct movement.

There are many schools of thought such as the Functional Movement Screen (FMS), Selective Functional Movement Assessment (SFMA), and Functional Range Conditioning (FRC) – to name a few – that teach trainers and coaches how to assess movement so that they can make their programming more effective based off of how their client presents on their assessment.

 

More often than not, a strength coach or trainer will see a movement fault they would like to fix in order to optimize their client’s training in order for their client’s to succeed.  There is nothing wrong with wanting more for your client and for your client to achieve their goals.  When assessing a client, if some type of movement limitation is present (I.e., decreased joint mobility and range of motion), then by all means, use the tools in your toolbox to attempt to correct it.

Tools such as a foam roller, lacrosse ball, or other self-myofascial release device, can be beneficial in attempting to increase soft tissue flexibility that could be limiting a client’s movement pattern.

 

Self-myofascial release can be very effective for improving movement quality and at reducing pain.  By doing something such as this, you are doing your due diligence in trying to help your client to the best of your abilities.

If you use an implement suggested above and someone moves or feels better, GREAT!

If someone doesn’t move or feel any better after something like that, then as Charlie Weingroff has said,

“4th and 10, you have to punt.”

As he described in his DVD, Training = Rehab, if you have a client who has some type of mobility limitation and they aren’t improving, “punt” them, not literally, to another provider…I.e., physical therapist, sports chiropractor, or a massage therapist.

If someone has pain, punt!  Per the Functional Movement Screen (FMS), if someone presents with pain, the test is over and they should be referred to a healthcare practitioner.

Now, if you referred all of your clients who are in pain to another healthcare practitioner, you would probably have a lot of free time on your hands.

Most clients have some type of ache or pain they are dealing with.

By “punting” them, this does not mean you have to get rid of them.  You can use a multi-disciplinary approach and continue to train them without worsening their pain or dysfunction while they are treated for whatever ails them.

Don’t try to be a jack of all trades and a master of none.  Don’t try to be the strength coach or personal trainer who trains their clients, but also attempts to treat their pain or soft tissue dysfunction by performing some form of manual therapy.

This is where you need to know what you are good at and what someone else may be able to do better.  If a patient or client presents to me and I know another practitioner that is better at it than me, they are definitely going to continue their care with that better clinician.

Keep the manual therapy to the physical therapists, sports chiropractors, etc.  These clinicians have hours upon hours of training on various manual therapy techniques to assist in improving movement, pain, and dysfunction.

By meeting with local PTs and chiropractors in your area and developing a network of providers you can refer to, you should have no problem sending a client to a colleague who can help improve their current state.  Your client will think the world of you for having the humility to refer them out to someone who can help them properly.

Even if the physical therapist helps decrease their pain, that client will always remember that you had their best interests at heart and you were thinking of them first.

Think of your client’s needs first, not your ego!

Now, just because I am a physical therapist, doesn’t mean I am not going to “bash” on personal trainers and strength coaches.  I have a background in physical therapy and strength and conditioning.  I consider myself a hybrid physical therapist, bridging the gap between rehab and strength training.

I know that I am not the smartest trainer or coach out there.  I have the confidence in my skill-set to start the programming process and teach and help clients squat, deadlift, lunge, carry, push/pull, etc.

There eventually comes a time where I can have a personal trainer or strength coach take over and continue the process.  My goal for my clients when they leave me is that they have some type of basic foundation of the various movements just mentioned so they can effectively and safely progress towards their health and fitness goals.

If you are a physical therapist, sports chiropractor, etc. and you either do not have the confidence in how to teach basic movements and program them OR you have not educated yourself on how to program and teach basic movements, then leave that to the strength and conditioning or personal training professionals.

The message goes both ways: as much as we encourage personal trainers not to be too “bridge gappy,” the same goes for physical therapists.

The major point of this post is not to bash either side of the health and performance spectrum.  The point is that we need to coexist and develop connections with various healthcare and performance disciplines so that we are in the position to help the most important person in this process:  the client or patient.

About the Author

 

Andrew Millett is a Metro-West (Boston) based physical therapist

Facebook: From The Ground Up

Twitter: @andrewmillettpt

Instagram: andrewmillettpt
CategoriesAssessment coaching Corrective Exercise Exercise Technique

A Common Mistake People Make With Thoracic Extension

Thoracic (mid-back) extension is kind of a big deal.

Without turning this into an anatomy lesson, t-spine extension is important for a variety of reasons. In no particular order:

  • It’s what the mid-back (T1-T12) is designed to do.  However, due to the long hours many of us tend to accumulate at work and at home in excessive flexion (hunched over, rounded upper back), we lose the ability to get into and maintain extension.
  • In short: “good” posture can become compromised.
  • T-spine extension allows us to get into proper positions to lift things – it’s crucial for overhead activities (or elevating the arms overhead in general), deadlifting, squatting, and helping to offset “sheer forces” on the spine.
  • Lack of t-spine extension means you can never be Batman.7
  • Our scapulae (shoulder blades) are more or mess at the mercy of thorax position. For those who present with a more kyphotic/computer guy posture, the “resting” position of our scapulae can be affected (abducted, anteriorly tilted) which can (not always) lead to shoulder ouchies in addition to scapular dyskinesis.

There are numerous ways to address lack of thoracic extension, the most common being foam rolling the mid-back followed by corrective modalities such as:

Bench T-Spine Mobilizations

 

Rocked Back Extension-Rotations

 

Side Lying Windmill

 

We’d then follow all of that with strength-based exercises – cued well – to help “cement” things. Front squats, for example, would be a great fit here. The anterior placement of the barbell forces the upper back musculature to counteract the forward pull to keep the torso upright; in effect nudging trainees into more t-spine extension.

Another popular approach is to use the foam roller in a different way and pepper in some additional t-spine extension patterning.

You all know the drill: take a foam roller, lie on it, and lean back, waaaaaaay back.

Like this:

While intentions are good in this scenario and there is some mid-back extension happening, it arrives at the expense of movement coming from elsewhere…the lumbar spine (often times with the hips coming off the ground) in conjunction with a massive rib flair.

Thoracic movement is much more subtle than people think. I fear this is one of those cases where many people – fitness industry pros included – have grown infatuated with the notion more ROM (Range of Motion) is better ROM.

Not the case.

What T-Spine Extension on Foam Roller Really Looks Like

CategoriesAssessment Corrective Exercise Product Review

Stretch the Tight?

Note From TG: It’s July 4th. I’m in Maine. There’s no way I was writing a new post today, so I decided to repurpose the post below.

It coincides with Dean Somerset’s Ruthless Mobility, which is currently on sale at half-off the regular price. The sale ends TODAY.

Toodles! 

I started with a new client yesterday. As is the case every time I work with someone new I’ll sit down with him or her (in this case her) and attempt to get all the pertinent information I’ll need to help them achieve their goals and to write an effective training program. Things like injury history, what their training has looked like previously, training preferences, perceived barriers on what’s limited them in the past, favorite 80’s cartoon, you know, all the important stuff.

Please tell me someone out there remembers Disney’s Adventures of the Gummi Bears!?!?! And please tell me someone else out there tried to make their own version of Gummiberry Juice (which, when drunk by humans, gave them superhuman strength) as a kid by combining Mountain Berry Punch Kool-Aid with actual gummy bears???

No? Hahahaha. Well, uh, me neither. That’s just stupid talk!  Yeah, that’s what it is……stupid.

So anyways, along with the brief Q&A I’ll also perform an extensive movement screen so I can gain a better understanding of how someone moves and whether or not they present with any distinct compensation patterns which may (or may not) be “feeding” into their dysfunction or pain.

Many people have been programmed to think that increased range of motion is good – and that the more we have of it, the better off we are.

Yes and no.

For those who are stuck starring at a computer for ten hours a day and have little to no amplitude (ROM) in their daily lives (and as a result have the movement quality of a hipster wearing a pair of jeans 3 sizes too small), working on improving their mobility would absolutely be a priority and help to improve performance in the gym and their quality of life.

For someone like the individual I was working with yesterday, however – who had plenty of ROM, to the point where she was borderline hypermobile, yet still was under the impression she had “tight” hips – going out of our way to “stretch the tight” and work on improving mobility could have more deleterious effects than good.

She came in with a history of left hip/ITB pain, and upon testing her hip internal range of motion on that side, it was limited.

Pretty strange for someone with plenty of laxity, right?

As is par for the course, she has spent years stretching her hip in hopes of improving her mobility in an effort to get better.

It hasn’t worked.  Yet, I was able to improve her hip IR by a good 10-15 degrees in a matter of 30 seconds without “stretching” her hip. It was priceless to see her reaction when it happened.

So, how did I do it?

I’m Gandalf, duh!

Okay, in all seriousness what I did was work on her REACTIVE STABILITY, which is a term that Dean Somerset has tossed around for a while now.

The Cliff Notes Version: the body will limit a movement into ranges of motion it deems to be either risky, pain producing, or “un-known.”

This is often referred to as PROTECTIVE TENSION, which is what the body creates to help support an injured area.

If I test someone’s hip IR and it’s limited I can’t just assume it’s due to shortness or stiffness of specific muscles. It can definitely be a factor and the main culprit for some people, but it’s something I feel far too many fitness professionals gravitate towards because of an archaic mindset or because it’s “what’s always been perceived as the problem.”

As many of you know Dean (Somerset) and I are good friends. If you ever hear a joke that starts with an American strength coach and a Canadian exercise physiologist walk into a bar……

…..it’s probably us.

He and I have done several workshops together and I’ve had the opportunity to see Dean perform his voodoo assessment stuff each and every time. And it never ceases to amaze me.

One of the best “party tricks” he’ll use in our workshops is exactly the protocol I described above. In short, what he’s found (and I can confirm) is that reduced hip internal rotation is often a symptom of something not working and the body will compensate by forcing surrounding musculature to chronically fire and “tense,” impairing ROM, and thus mobility.

To be more succinct:  lack of hip IR = reduced lateral stabilization.

Have someone do a (correct) side plank, have him or her focus on deep, forceful breathing and watch what happens.

Awesomesauce, right?

The side plank helps work on lateral stabilization, which in turn tells the over tensed muscles to chill out, improves reactive stability, which then in turn takes away the “perceived threat” and ROM improves.

It’s not a catch-all for everyone, but you’ll be surprised as to how often it works. I should also note that it’s not something that will stick long-term. Typically the increased ROM will last a few hours, maybe a day. But for something like this to last at least now we know that it’s not a situation where we’re going to tell someone to “just go stretch.” We need to work on improving (lateral) stabilization.

And this is the type of stuff that Dean covers in Ruthless Mobility.

To reiterate, there are PLENTY of people who need to work on improving their mobility in the traditional sense – mobility drills, stretching, etc – and Dean covers that in droves here. So whether you or some of your clients need to work on mobility in specific areas (t-spine, hips, etc), this resource provides a TON of options.

Dean’s not a small human being. He practices what he preaches, and it’s amazing to see how supple he is in his own right! Trust me: you’re going to be watching the videos and think to yourself, “is that Dean Somerset or Houdini?”

But of more value, and more germane to the point(s) I made above, Dean covers stuff that most fitness peeps gloss over or fail to understand altogether. And that’s why I wholeheartedly feel this is THE next “go to” resource on the topic.

Not only do you get 4-5 hours of brilliant content, but you also earn valuable CEUs to boot. So there’s that to consider as well.

Ruthless Mobility is currently on sale at a heavily discounted price, but the sale ends tonight (July 4th). Get on it people. You won’t be disappointed.

—> Ruthless Mobility <—

CategoriesAssessment coaching Corrective Exercise mobility

3 Unconventional Ways to Move Better

Counting today’s post, four out of my last five entries have had a number included in the title. That’s never happened before.

Wanna know what else I’ve never done?

  • Gotten a speeding ticket.
  • Tried calamari.
  • Deadlifted 2000 lbs.
  • Cried to the movie Notting Hill.8

Nevertheless, in conjunction with Dean Somerset putting his Ruthless Mobility resource I sale TODAY (through July 4th) I wanted to share a few thoughts on the topic (mobility/movement/general badassery) that maybe some of you reading would find useful or interesting or mildly captivating.

Captivating like this picture of a kangaroo punching someone in the face:

1. Anterior Pelvic Tilt Doesn’t Always Have to be Fixed, Nor Is It Bad. Everything Will Be Okay. Seriously.

New Client: “I’m so excited to work with you. I was told by my previous trainer I had anterior pelvic tilt.”

Me: “Okay, explain.”

New Client: “Well, I went in for my assessment and he told me I had anterior pelvic tilt and that it needed to be addressed and that he’d write me a program to fix it.”

Me: “I see. How long did you do the program for? And, was it fixed?”

New Client: “I worked with him for eight months, and I don’t know if it was fixed. All I know is that we did a metric shit-ton of stretching, corrective exercise, and very little strength training.”

Me: “Well, that’s unfortunate. Excuse me while I go toss my face into a brick wall.”

Okay, the brick wall comment didn’t really happen…but everything else stated above was said verbatim as I sat down with a new client recently.

Without going into the particulars I went on to state that roughly 7 billion other people in the world “suffer” from anterior pelvic tilt, and that it’s truly reached pandemic levels of clusterfuckedness.

In short: I explained that, aside from scenarios where excessive anterior pelvic tilt may be causing pain or movement dysfunction, having it was not a disease or a scenario which always required intervention.

In fact, APT is considered anatomically neutral. I.e., Your lumbar spine has a natural lordotic curve.

To quote Bret Contreras:

“Is APT abnormal?

No, it’s not. According to a published study by Herrington 2011, 85% of males and 75% of females presented with an anterior pelvic tilt, 6% of males and 7% of females with a posterior pelvic tilt, and 9% of males and 18% of females presented as neutral. Anterior pelvic tilt is also the most common postural adaptation in athletes according to Kritz and Cronin 2008, and it seems to naturally occur with athletes that do a lot of sprinting. Therefore, it’s actually normal for healthy individuals to possess APT, and the average angle of anterior pelvic tilt ranges from 6-18° depending on the study and methods used to determine the angle, with around 12° appearing as the norm (ex:Youdas et al. 1996, Youdas et al. 2000, Christie et al. 1995, Day et al. 1984).”

As I recall, there’s no definitive test or “screen” which can correlate “x-degrees” of APT and one’s vulnerability to pain and dysfunction.

Some people have APT and walk around in considerable pain, while others have APT (even excessive APT) and have no issues what-so-ever.

However, those coaches with an acute eye for assessment and movement can often use a plethora of screens and tests to ascertain whether or not APT may be something that’s needs to be addressed.

To reiterate, APT is not always wrong (or bad)…but it can be problematic once we start allowing ill-prepared people to load the pattern and not only that…begin to add repetitions and/or speed.

Often, it’s the LACK of ability (or our proclivity to refrain from) posteriorly tilting the pelvis when bad things start to happen.9

As Tony B mentions above: There’s a big difference between cueing someone to arch like crazy (and thus encouraging excessive APT, resulting in poor positioning and increased instability) and cueing someone to posteriorly tilt the pelvis to nudge them into a more neutral spinal position.

 

NOTE: As Mike Robertson notes in THIS article, there is no such thing as a bad cue. However, there does exist poor cues when they’re not applicable to the individual or are used haphazardly (because you heard someone else use it).

2. Thoracic Spine Endurance is Often Overlooked

A huge shout-out to Mike Reinold for hammering this point home in a recent Inner Circle I watched on How to Improve Thoracic Extension.

Mike noted that in order to improve t-spine extension it is important to work on mobility (Windmills, Bench T-Spine Mobilizations, Quadruped Extension-Rotations, etc), however we can’t dismiss the importance of ENDURANCE in order to maintain it.

 

Mike also noted that with regards to posture, “sitting upright is fictitious.” The amount of hours many of us spend in a flexed position far out-weigh the number or hours we’re upright. As such, keeping an upright posture is freakin exhausting.

My words, not his.

Building spinal endurance (not strength) is key here.

Don’t get me wrong: strength is (and always will be) important. A healthy dose of horizontal rowing (DB rows, seated rows, chest supported rows, Seal rows) is never a bad thing.

However, when we’re talking about our “posture muscles” – the muscles that need to be on all day in order to keep us upright – endurance is the name of the game.

3. Lack of ROM Isn’t Always Because You Need to Stretch More

The second someone is told that they lack range of motion (ROM) in any part of their body, they’re immediately shown 37 different stretches and ways to “smash” their tissue.

Many end up cranking this joint and yanking that joint till their blue in the face.

One of the more common examples I like to use here is lack of shoulder flexion (or ability to elevate the arms above one’s head).

Many people are unable to do so without some form of compensation via forward head posture, rib flair, and/or excessive lumbar extension. Picture on the left.

The fix can be any number of things: addressing lat length, fighting a zombie, poor anterior core control, poor tissue quality in the pecs/pec minor, you name it.

And none of those approaches would be wrong. Fighting zombies is awesome.

However, stretching tends to be the “go to” modality for many fitness professionals, and frankly it isn’t always the answer.

Oftentimes, taking the time to teach people to get 3D expansion of the rib cage with their breath (front, side, and into the back) and then learning to fully exhale (to get rib cage down and promote better engagement of anterior core) will help to “open up” the thorax.

I can’t tell you how many times I’ve tested someone’s shoulder flexion and saw an immediate 10-20 degree improvement after having them perform ten good breaths.

I call it my Gandalf moment.

Except, you know, I’m not a wizard.

Did Someone Say Gandalf?

For more insights on the topic and wizard-like shenanigans I’d recommend checking out Dean’s Ruthless Mobility.

You get FIVE hours of content (digital or DVD) from one of the smartest coaches I know on assessment, corrective exercise, and how to get people moving better.

What’s more, CEUs are available AND it’s on SALE at close to 50% off the regular price.

Go HERE and thank me later.

CategoriesCorrective Exercise Program Design Strength Training

The Pendulum Swing

I’m still in Europe. Thankfully I have some coaches pinch-hitting for me while I’m away providing some awesome content. 

Today I have a great post from Pittsburgh based strength coach and physical therapy student, Michael Mash.

Užívat si (<— Enjoy in Czech)10

What You Need to Know

  1. With the popularization of core stability training, true rotational movements have erroneously gotten a bad rap.
  2. Mobility and soft tissue work have done wonders for various populations, but if you’re stretching and mobilizing for an hour before you even start your workout, something’s wrong.
  3. Squats and deadlifts are fantastic foundational exercises, but they are simply not enough to effectively train the core.
  4. While it has good intentions, the term “functional training” has recently been abused. Real functional training is actually quite simplistic.
  5. Evidence-based practice has enhanced the way we view clinical practice and strength training, but it is simply a tool in the toolbox.

Fitness trends act like a pendulum. As soon as the newest idea hits the mainstream and peaks, a group of people who adamantly oppose it return it to the other end of the spectrum. What we can learn from this phenomenon is this: the answer often lies right in the middle.

Core Stability Training

Quite possibly one of the most popular fitness buzz words of the last decade, core stability training has made a huge impact on how we train our midsection for health and performance.

Characterized by learning to properly move at the hips and upper extremities while keeping the spine stable, core stability training can be categorized into different planes of movement.

For example, anti-extension exercises such as the RKC plank, challenge the core’s ability to resist extension, whereas the barbell torque, an anti-rotation exercise, involves moving a barbell from side-to-side while maintaining a rigid core.

The barbell torque, performed with arm movement and a rigid core, is a fantastic anti-rotation exercise.

Popularized by Dr. Stuart McGill, while anti-rotation exercises are fantastic for those in both the rehabilitation and performance worlds, they seem to have been associated with the trend to completely STOP doing rotational core exercises.

What gives?

The last time I checked, the torso does actually have the capability to rotate and does so quite frequently on the field. Although, solely training core stability might not directly encourage an athlete to run around the field like a stiff board, promoting movement fluidity and rotational power with TRUE rotational core exercises does have merit.

Barring any contraindications such as previous or current hip/lumbar pathologies, rotation at the core is pivotal for successful sports performance, so let’s train it!

Exercises such as cable chops and medicine ball throws will train core rotation in the standing posture to promote both movement fluidity and increase performance!

 

Mobility and Soft Tissue Work

Oh mobility and soft tissue work!

Can’t live with it, can’t live without it!

The rise of mobility and soft tissue work has done wonders for both the banged-up lifter population and the elite athlete. Mobility and soft tissue work are paramount for success and have helped extend careers and led to more pounds lifted on the platform.

Once again, like core stability training, what started as a great idea to reduce pain and increase performance, now has turned into people flopping around on foam rollers, smashing and flossing each and every muscle, and twisting themselves up into a pretzel for 45-minutes before they even begin their workout!

This is a major problem.

I emphasize, do not take this babble to be anti-mobility work rhetoric, quite the contrary.

In order to set yourself up for success and time efficiency, your mobility and soft tissue work needs to be succinct, effective, and goal driven. Often times, what happens is the complete opposite.

Let me propose to you an example.

You are someone who has “tight” hamstrings. You spend the first 5 minutes of your routine foam rolling.

Next, you get out your spikey ball, because the roller wasn’t good enough, and you start rolling with that. Then you perform some mobility work such as single-leg toe touches, walking kicks, yoga push-ups, and finish off with a healthy dose of static stretching from 5 different angles. Fast-forward 6-months, and guess what? You STILL have “tight” (and I use that word loosely…no pun intended) hamstrings.

My point is this: It is IMPERATIVE that you monitor for results with your targeted mobility and soft-tissue work. Your warmup should be no more than 10 minutes at most, and if you are not seeing the results you want, reassess, or see a qualified professional for some advice instead of endlessly spinning your wheels.

Squats and Deadlifts Only for Core

With the popularization in core training, came a concurrent rise in the notion that it’s all a pile of bologna.

Yep. You heard me right.

“Look at all these wacky core exercises. You don’t need those. Just squat and deadlift. That’s all you need!”

Going along with our pendulum analogy, with the rise of core stability training, came the rise of those who said all you need to do is squat and deadlift.

Again, the answer lies in the middle.

Here’s the bottom line: although you don’t need to perform a million different core exercises, squats and deadlifts alone are NOT enough. I’ve worked with clients capable of squatting and deadlifting a brick house but the second you challenge them in with dead-bug progressions such as the hollow-body hold, they can’t maintain proper positioning without holding their breath or slipping into anterior pelvic tilt.

 

Although you must brace the core in a 360⁰ manner to encourage maximal stability during squats and deadlifts, they essentially only train the in an anti-flexion manner, a.k.a preventing your spine from crumbling into a pile of Lego blocks during the lift.

While the barbell lifts with ALWAYS serve as the pivotal foundation of exercise prescription, adding in a few extra rotary, lateral flexion, and flexion (or “anti” movements, again BOTH have their place), will take minimal time and promote a more complete core training experience to enhance performance and reduce the risk of injury.

Functional Training

What once started as a great idea to promote enhanced daily function, has turned into people single-leg squatting on a Bosu ball while juggling in one hand and reading a book in their other hand to their imaginary friend.

Functional right?

So let me ask you this. What does functional training mean to you?

From what I understand, the premises of functional training is utilizing exercise techniques to promote function in ever day life and sports performance. In life we bend down to pick things up off the ground, reach overhead to reach and cupboards, and carry things around, do we not?

Progressively loading human patterns IS FUNCTIONAL. It literally doesn’t get more “functional” than loading squats, deadlifts, carries, and presses. Barbell training IS functional training.

Teach grandma how to pick a barbell off the ground with a correct hip-hinge pattern and suddenly she has more ease playing with her grandchild who’s sitting on the floor…funny how that works.

Training the Farmer’s Walk suddenly makes carrying groceries in from the car that much easier.

 

I’m not against functional training, I’m against what functional training has become. True functional training entails progressively loading basic human movement patterns to increase quality of life, rehabilitate from injury, and increase sports performance.

Evidence-Based Practice

The rise of evidence-based practice (EBP) has drastically improved the practices of physical therapy and strength & conditioning.

Constantly questioning the methods we employ is paramount to ensure practitioners are constantly learning and providing the best possible care for their patients and clients.

With that being said, we must view EBP for what is it, an important tool in the clinical toolbox, not the end-all be-all solution for everything.

Solely relying on EBP can limit creativity. Suddenly clinicians and strength coaches become hesitant to employ a technique or exercise because there’s insufficient evidence to support its use.

Here’s the truth: strength coaches and rehab professionals in the trenches DRIVE evidence-based practice.

In order for there to BE evidence, someone has to be grinding away utilizing innovative techniques and seeing results beforehand.

Do you think evidence-based practice was a part of King Arnold’s success back in the ‘70s? I don’t think so, but if he had it on his side, he may be done even better (if that’s even possible)!

Incorporate a healthy mixture of your experience, the latest evidence, and your patient/client’s values to maximize outcomes.

Conclusion

The pendulum often swings from both ends of the extremes in the fitness industry, but it ALWAYS finds its way back to the center. When new ideas rise to the mainstream, it is often associated with major backlash by a group of those who believe the complete opposite! Always question the latest and greatest fitness trends, because the REAL answer always lies somewhere in the middle!

About the Author

Michael Mash, SPT, CSCS, FMSC is a physical therapy student and strength coach located in Pittsburgh, PA. He started his company, Barbell Rehab and Performance, with the mission to bridge the gap between physical therapy and strength & conditioning by implementing barbell lifts into clinical practice.

Follow Michael at his website BarbellRehabandPerformance.com and on Facebook and Instagram (@barbellrehab))