CategoriesRehab/Prehab

How to Learn Functional Anatomy

Q: I need to improve my knowledge of functional anatomy (who doesn’t?). I know Cressey took a very comprehensive gross anatomy course down at UCONN as a grad student, but I was wondering how you approached improving this area in your based of knowledge?

Was there a specific text that you used? Did you go to town on memorizing points of origin, insertion, and anatomical structures in a musculoskeletal anatomy index? There’s a ton of information out there for me to access, but I’m trying to get a handle on what the best approach to take is to avoid spinning my wheels.

Thanks in advance for any help you might be able to offer.

A: This is actually a really good question, and something I feel is a monkey wrench for a lot of new and upcoming trainers out there.

Functional anatomy is STILL something I’m trying to get a good handle on, and by far is one of my weaker areas. Well, that, and the bench press. God, I suck at that.

Anyways, while I DO feel I can hold my own with regards to anatomy – boys have boy down there parts, and girls have girl down there parts – I’d be lying if I said I was in any way an expert on it. I mean, all I have to do is sit in on EC discussing shoulder kinematics for ten minutes and I’ll instantly feel like an anatomy asshat.

Often I feel like there’s nothing going on in my head except crickets chirping when I try to have a conversation with him.

Usually I “get” what he’s saying, but sometimes I just end up looking like this:

Seriously. Dude is Robocop when it comes to  anatomy. I’m still playing with Crayola while he’s using the iPad.

Which, when you really think about it, that’s actually one way to get better:  surround yourself with people who are smarter than you!

I’ve long been an advocate of telling people to actively seek out mentors or local coaches/therapists that they can observe.  Most are more than willing to allow someone to come in and “shadow” them for a day or two (maybe even on a weekly basis), assuming you’re not some sociopathic social filter moron who’s going to inundate them with non-stop questions and inquiries at inappropriate times while they work.

Trust me:  there’s a time and place to “talk shop.” Doing so while they’re trying to coach four athletes at once or treat a patient is not that time.

You have two eyes, two ears, and one mouth.  Use them in that order.

For me, though, it’s a matter of repeated exposures to the material.  It isn’t necessarily about what book or what article you read, or who you observe, but just consistently giving yourself exposure to the material. Variety is the spice of life, right?

If given the choice, however, I’d pick various blogs and articles over text books. I definitely tend to gravitate towards those resources which are able to “dumb down” anatomy into simpler forms and contexts that I can easily digest.

Sure, we have our gold standard texts like Shirley Sahrmann’s Diagnosis of and Treatment of Movement Impairment Syndromes, Kendall’s Muscles: Testing and Function, Thomas Myers’ Anatomy Trains, and Gray Cook’s Movement which every trainer and coach should read and have in their collection.

I’ve read those books – but can only take them a few pages at a time before my brain turns into soggy cereal. There’s just soooo much information packed into those pages that it sometimes feels overwhelming more than helpful.

Instead, I prefer things such as Mike Robertson’s Functional Anatomy for Bad Asses parts ONE and TWO.

Granted Mike wrote those two articles close to six years ago – and I’m sure he’d go back and change a few things given the amount he’s learned since then – but I defy anyone to find a more well written, informative, and precise “overview” of functional anatomy than those two pieces.

Another EXCELLENT resource would be both Robertson’s and Eric Cressey’s Building the Efficient Athlete DVD series, which not only includes all the geeky anatomy stuff but also applies it to how to develop sound programming.

I’d keep going, but don’t want to spend an entire hour searching and linking back to various things.  Just do yourself a favor and bookmark the following websites:

EricCressey.com
RobertsonTrainingSystems.com
BretContreras.com
DeanSomserset.com
KevinNeeld.com

Those dudes will definitely keep you occupied as far as learning functional anatomy is concerned.

Note:  if anyone reading wants to share their “go to” resources, please feel free to share them in the comments section below.

Likewise, for further ideas on what other resources I like check out my Recommended Resources page.

Also, to add to everything – and this is something that I feel a lot of trainers neglect – I can’t stress the importance of just becoming a better COACH!

It’s funny:  whenever a new batch of interns start at the facility and we ask them what they’d like for us to cover during our weekly staff inservices, they always want to talk about anatomy and assessment.

That’s great and all, and we definitely DO cover both, but in truth, many struggle just to

teach a proper push-up!

While I do feel it’s important to know origins and insertions of muscles, and can appreciate the desire to come off as the next Rain Man when it comes to spewing out anatomy knowledge bombs, I think it’s equally as important to possess the ability to coach well.

More to the point, actually honing in on your coaching skills is a sure fire way to better learn anatomy.

Become a REALLY good coach, and I can promise you you’ll become very successful in this industry.

Of course, I’m not saying this is the case with you – I have to assume you can teach a push-up – but it’s just some food for thought.

To Review:

  • The gold standard texts are the gold standard texts for a reason. I think if you’re really serious about mastering anatomy, you’d be wise to invest in them – if for nothing else as a reference point. Or as something to put on your bookshelf to make you seem really smart and interesting.
  • Lets be real, even though those are the gold standards, they make our heads hurt. Repeated exposure from various sources is the key here.  Try to read as many different blogs and articles as you can. I provided a few above, but that certainly doesn’t mean there aren’t hundreds (if not thousands) of other great resources as well.
  • Rain Man is a film from the mid-80s starring Tom Cruise and Dustin Hoffman that won the Academy Award for Best Picture.  Just wanted to throw that one out there  for those who didn’t really get the joke earlier. You should watch it.
  • Coach your ass off!  Nothing irritates me more (and I’m NOT saying this is you) than when some internet warrior who lives in his parent’s basement spews off about how this program is wrong and how this muscle doesn’t do that, blah blah blah…….yet he’s never trained a person in his life.  Become a really good coach, actually apply what you learn to a real, live person, and you’ll do very well.
CategoriesRehab/Prehab Strength Training

Is There Such a Thing As “Knee Friendly” Squats?

Not long ago I filmed a vlog about the difference between box squats and squats TO a box.  While to the casual fitness enthusiast there may be no differentiation between the two variations (a squat’s a squat, right?), these are probably the same people who feel PCs are the same thing as Macs.

That’s just crazy talk.

Crazy I tell you!!!!!

I’m not going to beat a dead horse and go into the details here (you can just click on the link above to found out the difference between the two), but I will say that my fellow partner in all things awesome, Nia Shanks, wrote a similar blog (with video) HERE which expounds on the benefits of squats TO a box.

Anyhoo, a day or two after her post went live, she received a question from one of her readers:

“Any suggestions for squat variations for people with hip flexor issues? (Tendonitis)?”

Her response (what she actually wrote):

“Good question. I’m going to pass this on to one of my friends that could provide a better answer. I’ll post his response here.”

Her response (with what I would have added if I were her):

“Good question. I’m going to pass this on to one of my friends that could provide a better answer. I’ll post his response here.

Not that this matters, but he’s incredibly intelligent, good looking, and possibly more manly than a lumberjack.”

All kidding aside (although I’m not really kidding), Nia reached out to me and asked if I had any feedback. Below is what I wrote back to her last nightl, which I decided to make into a blog post because, well, I can.

NOTE:  I was watching the RedSox game as I was typing it, so please forgive the ADD nature of the post.

Goddamit Youkils, you have to swing at that pitch!!!!!

1. Know the difference between tendonitis and tendonosis.

The former is generally accompanied with slight joint inflammation and typically goes away after a few days of rest, ice, and NSAIDS.

The latter, though, refers to more of a chronic condition where the joint itself has seen some (or maybe significant) degeneration.  Basically, it’s something that doesn’t go away after a few days.

That being said, when someone complains of tendonitis, and it’s been an on-going issue, it’s probably really tendonosis.

…..and some of the following may help take some of the burden off the joint itself.

 

2. Take a grenade approach with soft tissue work.

Foam roll EVERY…….SINGLE…….DAY.  Not once a week, not only on the days that you train, but every day!

It stands to reason that if one’s knees are bothering them all the time, they have less than optimal tissue quality and it’s something that needs to be addressed.  Foam rolling is one of the best ways to do so.

Healthy tissue shouldn’t hurt when you palpate it, and if it does, that’s a tall tale sign that something’s up.

Hammering areas such as the hip flexors themselves (Rectus femoris, and TFL), as well as the adductors, ITB, and glutes will undoubtedly help and often alleviate much of the symptoms.

I also like to be a bit more “specific” and target both the vastus medialis and vastus lateralis with a tennis or lacrosse ball.  Both are major trigger points for knee pain, and are an often overlooked area most people ignore – along with the glute medius for that matter.

People will ignore the areas that often cause the most discomfort, but those are the areas that SHOULD be targeted.

Better yet, seek out a reputable manual therapist who will get hers or his hands on you.  Nothing bothers me more than PTs who do nothing but band exercises, electrical stim and then ultra sound.

Sure they all have a time and place, but finding a therapist who provides Graston, ART, or whatever will be a definite advantage.

 3.  Preach to yourself vertical shin angle.

“Stacked’ joints are happy joints (as Mike Robertson would say).  More often than not, it’s not squatting that bothers people’s knees, but rather, what they’re doing that bothers their knees.

I can’t take credit for the vertical shin angle cue – that goes to Charlie Weingroff – but it’s something that works wonders for people with knee pain.

Many trainees make the mistake of breaking with their knees when squatting and end up with significant forward translation of the tibia.  This induces a lot more shear loading on the joint, which as you can imagine, is going to piss it off.

Instead, I like to cue the following: Make sure to SIT BACK and PUSH THE KNEES OUT.

This does two things:  maintains a more upright torso and ensures there’s proper task distribution.

The initial decent should be with the hips sitting back.  Doing so will not only place more emphasis on the glutes and hamstrings (hips!), but also ensure more of a vertical shin angle, which is going to be MUCH more knee friendly.

I guess, in a way, this is just a long-winded way of saying that the reason most people’s knees hurt when they squat is because of technique that makes my eyes bleed.

4.  Hammer hip stability.

The knees are at the mercy of the hips (and ankles).  Most trainees have piss poor hip stability and are unable to control the femur properly, which is something that Mike Robertson touches on his is Bulletproof Knees Manual.

Taking a step back and implementing some simple drills like side lying clams, x-band walks, etc would bode well.

Yes, they’re girly and seemingly worthless, but you’d be surprised at how hard side lying clams are when done correctly. We use them quite a bit in our programming at Cressey Performance, and it’s always interesting when a dude who can squat 400+ lbs has a hard time performing clams.

Taking it a step further, I’d also make a concerted effort to include more single leg work into the mix as that will automatically force one to work on their hip stability.  When in single leg stance, we’re forced to utilize what’s known as the lateral sub-system to keep the pelvis steady.

For those unaware what the lateral sub-system entails:  it’s the glute medius and adductor complex on standing leg, along with the quadratus lumborom on the opposite leg.

One point to consider, however, is the type of single leg work you’re doing.  For those with knee issues, variations like forward lunges or walking lunges are going to be problematic due to the deceleration factor.

Ie: You have to decelerate your bodyweight in order to perform the movement.

Reverse lunges will  inherently be more “knee friendly” due to the more “accelerative” nature of the movement.

Along those same lines, don’t be a hero and be too aggressive with loading when it comes to single leg work. Most trainees use waaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaay too much weight, and as a result, end up using less than exemplary technique (which defeats the purpose in the first place).

5. Booty, Booty, Booty, Booty Rockin Everywhere

As a corollary to the above, placing a premium on more glute work isn’t a bad idea either. The glutes have a VERY strong influence with regards to control of the femur.

Think of what happens when the glutes aren’t doing their job.

– You see more of an anterior pelvic tilt.

– APT results in more internal rotation of the femur.

– IR of the femur also results in in internal rotation of the tibia (and pronation of the feet).

– Your knee hates you.

Once we got those puppies firing and doing their job, we see the opposite happen:

– We see more posterior pelvic tilt of the pelvis.

– In addition, because they control the femur, we see more external rotation of the femur

– Which, of course, leads to more external rotation of the tibia (and more supination of the feet).

– Now girls will want to hang out with you.

To that end, whether you keep it simple and perform more supine or 1-legged glute bridges, or start upping the ante and perform things like deadlifts, pull-throughs, glute ham raises, KB swings, sled pushes, or grizzly wrestling………

…..the name of the game is GLUTES!!!!!!

6. We can’t neglect the core either.

More specifically, we can’t neglect the anterior core.

Even more specifically, we can’t neglect the external obliques.

Much like the above, lack of core strength and stability (especially as it relates to the obliques) will cause someone to go into more of an anterior pelvic tilt.

Utilizing movements like various chops and lifts would be of great benefit.

As would some dedicated rectus abdominus work – GASP!!!!!!!!!

7.  And what the hell, when all else fails, just deadlift

Deadlifts = less hip and knee flexion, which are going to be far more knee friendly than squats. What’s more, if you really wanted to get some more quad work into the mix, you could always revert to trap bar deadlifts which are more of a quad dominant hip dominant variation anyways.

But at the end of the day, I feel that squats TO a box will definitely be a step in the right direction as far as helping those with knee pain.  For starters, the box will allow one to squat in a pain free ROM – whatever the height may be. But even more importantly, it will help re-groove the proper squat pattern which most people suck at anyways.

Then, at some point, one can work on getting to full depth (which can be argued are more knee friendly as well).  But lets not get too off track here, because that can be another blog post in of itself.

Now, this doesn’t mean that all the other stuff discussed above is any less important. Far from it.

But I do feel that when it comes to technique, most fail miserably.  Watch both the videos that both myself and Nia provide above, and you should be golden.

Hope that sheds some light on a pretty extensive topic.

CategoriesRehab/Prehab

Balls In Your Pants and Breathing Patterns

BOO-YAH – how’s that for an introduction!

For many the topic of breathing patterns can be about as exciting as doing your taxes, so I figured I’d push the envelop a bit and use a catchy title to entice people to click on the link.

And, it worked!  I win!!

Don’t worry. Despite the risque title, the topic below is completely PG.

So, now that you’re here and I have your attention, lets watch this video by the Miami Dolphin cheerleaders:

Okay, so, um, yeah……breathing patterns.  It’s a topic that’s gained a lot of momentum (in the mainstream fitness media anyways) in the past year or so, due in no small part to the brilliant life-long work of Dr. Pavel Kolar and the “way smarter than the rest of us” team at The Prague School.

Taken right from their homepage:

The nervous system establishes programs that control human locomotion, which is comprised of posture and movement. This ‘motor control’ is largely established during the first critical years of life. Therefore, the “Prague School” emphasizes neurodevelopmental aspects of motor control in order to assess and restore dysfunction of the locomotor system and associated syndromes.

It’s some deep and innovative stuff for sure, and it’s something that I myself have only just scratched the surface of.

Thankfully there are other fitness professionals out there like Bill Hartman, Charlie Weingroff, Jim Laird, and Dr. Jeff Cubos (to name a few), who have are doing a wonderful job of spreading the knowledge, “dumbing” it down, and exposing people to the why’s/what’s/and how’s of assessing and fixing breathing patterns.

As it happens, one of the major themes that resonated this past weekend at the Spinal Health and Core Training Seminar (of which I was a part of) was the concept of breathing patterns and how there’s a significant interplay between aberrant patterns and how they effect not only performance but everything from posture to dealing with chronic back pain, neck pain, shoulder, or lower extremity issues as well.

As it happens, one of the major themes that resonated this past weekend at the Spinal Health and Core Training Seminar (of which I was a part of) was the concept of breathing patterns and how there’s a significant interplay between aberrant patterns and how they effect not only performance, but everything from posture to dealing with chronic back pain, neck pain, shoulder, or lower extremity issues as well.

In my talk, titled Spine and Core Training: From Assessment to Badass, I dove into some of the general “drills” we’ve been implementing at Cressey Performance to help teach people more appropriate breathing patterns.

You see, most people tend to be chest breathers and completely leave their diaphragm and the other “inner” core muscles out to dry.

It’s kind of like the playground when we were kids:  one group of muscles bullies the other, says their dad can kick the other dad’s ass any day of the week, someone gets called a big, fat, poop face, punches get thrown, the moms then get involved, and everything becomes one massive ball of breathing dysfunction.

The key, then, is to get everyone to play nice, and work synergistcally.  Ideally, we’d like to see the smaller, inner core muscles – diaphragm, mulitifidi, etc – to work properly, so that the larger, more global muscles can do their job as well and not have to work overtime.

 

To do so we need to take more of a 360 degree approach to breathing.  Meaning, instead of solely focusing on the anterior core (pushing the belly out: which still isn’t a bad place to start for most people), we need to take into consideration the lateral and posterior components as well.

Before we can do that, however, we need to actually learn how to breath into our bellies.

To start, here are some simple drills you can use:

1.  3-Month Pose

This is a drill I snaked from Mike Robertson, and the idea is to lie supine and focus on breathing into the belly and NOT allowing the rib cage to flair out too much.  You’ll notice how I keep my fingers at my sides to ensure that I’m not only pushing my belly out, but also expanding the sides (and back, into the floor) as well.  Be sure to inhale through the nose and exhale through the mouth.

Of note:  a regression would be to start with the feet on the ground, and then once that’s mastered, elevate the feet in the air.

2. Prone/Alligator Breathing

Lying prone on your stomach, the objective here (again) is to breath into the belly and try to get the lower back to rise.  Make sure to inhale through the nose, push the belly into the ground, and exhale through the mouth.

For many, those two drills alone will be a fantastic starting point.

Now, for years (YEARS I tell you!) I’ve always been engrained to “push the belly out” or to “make myself fat” when getting ready to lift big weights – particularly when wearing a weight belt.  Bill Hartman had a fantastic post on this very topic not too long ago, and he noted that when people push out they do so at the expense of going into excessive anterior pelvic tilt which can be a lower back killer.

Below is a longer video where I go into a bit more detail on how we can go about re-grooving these patterns using a weight belt (correctly) and/or regular ole tennis balls (which was an ingenious idea that Jeff Cubos brought up this past weekend). Moreover, it isn’t JUST about anterior expansion. Rather we want to start grooving more of a 360 degree expansion to help increase stability.

A Few Things to Note:

1.  Yes, I’m wearing a gray t-shirt with gray sweat pants.  Whatever.  I’m bringing gray on gray back, baby.  Recognize!

2.  Clearly this is something that Rob – my demonstrator – can work on. Not to throw Rob under the bus or anything (although I kinda am…..sorry Rob), but this would be a fantastic drill for him to utilize more frequently. If for nothing else to give his body the kinesthetic feedback it needs to learn how to breath properly.  Ie:  through his belly and NOT his chest.

I purposely chose him for the video because it allowed me to demonstrate how most people look when you tell them to take a deep breath.  With a little practice, I think he’ll be able to get it down.

3.  As far as when and where to implement these drills.  I’ve been doing more of them at the start of a training session, as part of an extended warm-up.  I may lie down for a good 2-5 minutes and just focus on my breathing. Hell, maybe pop in a little Norah Jones and just chillax.

It’s a bit “voo-doo’ish,” but it works, and I’m willing to bet if you take the time to implement these drills into your repertoire, you’ll feel a marked difference in how you feel.  Try them out today, and let me know what you think!

UPDATE:  for those interested, HERE is the video done by Bill Hartman I referenced above (where he discusses belly breathing and APT).  As you’ll undoubtedly realize – if you watch it – Bill is kinda smart.

CategoriesRehab/Prehab

My Shoulder Hurts: The Finest Whine

Happy Sun’s Out/Guns Out Memorial Day everyone!

Given that it IS a holiday – and the unofficial start of summer – I actually had every intention of NOT posting a blog today, and instead, do nothing but get my lift on and then follow that by eating copious amounts of dead animal flesh and high-fiving any serviceman (or woman) that I happen to cross paths with.

While I’m still going to do those things, it just so happens that my latest article on T-Nation went live, so I actually have some content to share today afterall.  Holla!

It’s about shoulders and how to go about taking better care of them. Trust me:  if you’re someone who takes the iron game seriously, and subsequently tends to have shoulders that routinely feel like they’ve been put through a meat grinder, this article is for you.

Pretty Much the Best Article on Shoulder Health Ever Written**

** = Give or take