I’ve had the honor of presenting at two previous iterations of the Motivate & Movement LAB (the brainchild of MFF’s Harold Gibbons) and it’s unequivocally one of the most unique events in the fitness industry.
Think: TED Talk, but with deadlifts and lots of f-bombs.
Anyways, the next LAB is this coming February, and will feature myself, Dan John, Pete Dupuis, my wife (Dr. Lisa Lewis), and several of the MFF coaching staff including Brian Patrick Murphy and Amanda Wheeler.
2) Appearance on the All About Fitness Podcast
Host Pete McCall does a superb job with this podcast and keeps things light and entertaining.
In this episode I discuss my journey towards my 600 lb deadlift.
You can go HERE (Episode 85) or HERE (Episode 85) via iTunes.
I’ll go a head and say it: I feel this is one of the single most important courses I have ever taken.
If you train women it behooves you to understand the intricacies surrounding this topic: pelvic floor dysfunction, prolapse, incontinence, etc.
Dr. Sarah Duvall covers everything from assessment/screening to corrective exercise (tons of attention to proper breathing mechanics) to training considerations immediately postpartum (1-4 weeks) onward to a year plus.
What’s more, what I truly dig about Sarah’s approach is that she advocates women to eventually “lift shit to fix shit” (my words, not hers). Sooooo, there’s that.
FYI: Use the coupon code TONYG at checkout for an additional $50 off your purchase.2
Per the usual Mike takes a rather complicated topic and dumbs it down for us peons. I REALLY liked his breakdown on the differences in adaptations between aerobic training and anaerobic, and how it’s the former (aerobic) that will likely help with better progress in the weight-room.
The deep squat screen can tell you a lot about a person. It can tell you his or her’s ability to achieve adequate ankle dorsiflexion, as well as much hip mobility, thoracic extension, and shoulder flexion they have.
About the only thing is doesn’t tell you is their favorite installment in the Fast & Furious franchise.
But what does the deep squat really tell us? Travis sheds some light.
Very comprehensive article that covers a litany of popular recovery strategies:
– Those that work well
– Those about which science is uncertain
– Those that don’t seem to work as planned or much at all.
Social Media Shenanigans
Twitter
Be sure to “finish” your push-ups. Scaps shouldn’t be retracted, touching, or making out at the top. Think about pushing away so they move around rib cage (protract) on each rep.
A lot of articles and information directed towards postpartum women cover the initial weeks and months after giving birth. That’s awesome. But what about one year after? Five years?
PCES is an outstanding course, and one I’m currently going through now. It’s only being offered for another week, with a special offer for TG.com readers below.
Are there any special considerations for training a woman that is over a year postpartum?
For this question we need to ask ourselves, “does the postpartum period end at an arbitrary time?”
In some cases, yes.
Time does have a positive impact and in other cases, no. So, let’s take a look at when time matters and when it doesn’t.
In the early stages postpartum women are still dealing with excessive ligament laxity that was needed to help get the baby out. Most women notice a decrease in the laxity by 4-6 months postpartum but for those that continue to breastfeed, the laxity can continue well over a year.
This matters because laxity creates instability and increases vulnerability to injury, especially in the pelvic floor.
So, being further along postpartum is a real win for not having to worry about the extra ligament laxity.
Most of the stories I hear from patients about post-delivery prolapse development happen in this one-year window. There is still a chance of women getting prolapse outside this time frame, but thankfully, the chances go down with the recovery time.
Why does this matter?
Women should take it slow getting back into impact exercise that could place an unnecessary strain on the pelvic floor while it’s still healing. (This goes for C-Section ladies as well!)
Incontinence or leaking during exercise is another one of those pesky issues that a significant number of women complain about and we often associate with having a baby. A survey taken among women that experience leaking showed that women with no leaking three months after delivery had a 30% chance of experiencing leaking twelve years later.
This is a significant number!
Now we’re talking about a woman who decides to get in shape and head to the gym and all of a sudden she is experiencing this pelvic floor issue she never had before.
Why does this happen?
I think it’s a breakdown of the system. An accumulative effect, if you will.
When proper steps aren’t taken postpartum to ensure complete pelvic floor recovery, our system can form compensations. Sometimes these compensations can take years to show up. Much like many preventable chronic injuries throughout the body.
The same thing can happen with the core. If 100% of women that go into delivery have a diastasis, then checking for it should be a routine part of any initial visit. Pregnancy pushes women into poor movement patterns.
The large amount of weight in the front causes a posterior weight shift and lengthened abdominals.
Because of this weight shift, women will often end up with tight paraspinals and a hinge point at the T12-L1 junction. This can cause back pain and tightness as well as perpetuating a poor breathing system that prevents complete core recovery.
Along with this weight shift, the baby itself pushes up on the diaphragm continuing to shut down deep breathing. Proper breathing is the foundation for core and pelvic floor recovery.
These postural compensations can stay with women for the rest of their lives unless someone gives them the right corrective exercises to break these patterns. Checking for a diastasis and asking key questions about pelvic floor health should be high on the priority list for a woman at any stage postpartum.
Check out this video for a couple key posture tips that help promote diastasis healing.
Bottom line, once a woman is postpartum she is always postpartum.
Being pregnant increases her risk of pelvic floor issues, diastasis and postural changes.
These risks are not limited to the first year or even the first five years postpartum. These are issues that affect many women for the rest of their lives. The good thing is that with a little knowledge we can do something about it. These women can have hope for healing at any stage in life.
I’m not going to beat around the bush, if you’re a fitness professional you should considering taking this course.
It will undoubtedly make you a better coach and better prepare you for the delicate nature of working with women postpartum (which, as Sarah noted, never really ends).
I’ve trained several women through their pregnancies and have obviously trained hundreds after the fact. I thought I knew what I was doing, and I’ve done okay.
I guess.
This course has helped me immensely and has really shed a spotlight on some coaching/information gaps on my end. I can’t recommend it enough.
Sarah only offers it a handful of times per year and she’s been kind enough to extend it for another week so my readers can take advantage. What’s more, if you use the coupon code TONYG at checkout you’ll get an additional $50 off your order.3
A wife, mom and adventure sports athlete, Sarah is a women’s fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting-edge exercises to bring you results-driven programs for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting athttp://www.CoreExerciseSolutions.comand figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life.
References
Viktrup L, Rortveit G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol. 2006 Aug;108(2):248-54.
I’ll be the first to admit my brain is a little lackluster. It doesn’t work in the same fashion as other coaches like, say, Ben Bruno, BJ Gaddour, or Meghan Callaway.
I’m often dumbfounded by all the practical (and inventive) ways they’re able to put their own spin on certain exercises and/or methodologies. I’ll watch a video or read an article and immediately think to myself “Well, I guess I’m an idiot for never thinking of that.”
Now, granted, giving credit where it’s due, when it comes to movie quotes or 90’s hip-hop trivia I’d be able to hang with the best of them:
What was director Paul Thomas Anderson’s second feature film and is generally considered Mark Wahlburg’s breakthrough role?4
What two albums were released on November 9, 1993 and are both considered hip-hop classics? ADDENDUM: These same albums were also the one’s I listened to most as a teenager in my bedroom, alone, not hanging out with chicks, ever. 5
But since we’re currently not hanging out in a bar playing Stump Trivia or on the set of what would arguably be the greatest game show of all-time, lets just chalk things up to me being an exercise comer-upper buffoon.
In today’s iteration of Exercises You Should Be Doing I want to share a row variation I’ve been using a lot with my clients of late and one I think you’ll enjoy as well.
In reality I think what ended up happening was Jessica was like “hey, I’ve been using these lately and really like them. What do you think?”
So, here’s what I think:
1. They’re a superb upper back/lat exercise. I’ve always liked “deadstart” or “deadstop” variations because:
They help to “standardize” the exercise: Everyone has to start and stop at a given point.
I like the subtle “reach” involved with the bottom portion of the lift. This helps aide better scapular mechanics/movement (shoulder blades moving around the rib cage and not stuck in place glued together the entire time).
The fact one KB stays “anchored” on the floor at all times helps to keep people a little more honest and prevent too much body-english from coming into play.
2. The set-up very much mimics the deadlift. To that end I think this is a great accessory movement for anyone A) has a weak upper back and B) has trouble with too much rounding of the upper back during their deadlift.
Key Coaching Cues: I like to tell people to “find their hamstrings” upon the initial setup. As they bend over to grab the kettlebells on the floor, they should be situated in way where they feel a lot of tension in their hamstrings.
From there they’ll “row” the kettlebell up making sure their elbow doesn’t go past the midline of their body (avoid excessive glenohumeral extension) in addition to trying to maintain a 45(ish) degree torso angle throughout the duration of the set.
In short: try to limit torso rotation or creeping up as the set progresses.
I’ve had the honor of presenting at two previous iterations of the Motivate & Movement LAB (the brainchild of MFF’s Harold Gibbons) and it’s unequivocally one of the most unique events in the fitness industry.
Think: TED Talk, but with deadlifts and lots of f-bombs.
Anyways, the next LAB is this coming February, and will feature myself, Dan John, Pete Dupuis, my wife (Dr. Lisa Lewis), and several of the MFF coaching staff including Brian Patrick Murphy and Amanda Wheeler.
Things like hypermobility (which tends to be more prevalent in females) and high-heels come into play when discussing the mobility needs of women.
Some awesome stuff in here from Trish.
Today’s Edge: Strengthen Your Adductors Part I and II – Tim DiFrancesco
I appreciate Tim’s insights and contributions to the strength & conditioning community. My brain does not work like his. He’s always thinking outside the box and coming up with stellar content.
If you’re not already, you should be checking out his website and social media accounts. He’s routinely providing short, bite-sized gems.
HERE’s Part I of Strengthen Your Adductors; and HERE’s Part II
Social Media Shenanigans
Twitter
I’ve got an influx of clients extolling the virtues of detoxes and cleanses. Alas, it’s that time of year. I just tell them their money is better spent tossing it into a live volcano.
I’m a member of a local neighborhood bank here in Boston. I joined a year ago when I finally grew tired of all the shady hidden fees my previous bank was hammering me with – maintenance fees, minimal balance fees, checking fees, etc.
It’s been a lovely experience and I appreciate the more personalized approach my current bank provides. In particular I appreciate Nelson, the gentleman responsible for helping to set up all my business accounts.
Every time I walk in he greets me by name, asks how business is going, and it’s not uncommon for us to detour into some movie small talk.6
Also, since he’s the one who manages my business accounts, Nelson also knows what I do for a living and he’ll often ask me for some fitness advice…like he did today when he asked my opinion on what’s better for weight loss: cardio or lifting weights?
Now, normally when I’m out in public and stranger or even casual acquaintance asks me that question one of two things happens:
I immediately fall to the ground and feign an epileptic seizure.
The theme music from Jaws reverberates in my inner dialogue.
It’s such a murky and convoluted question with so many variables to consider that there’s no one definitive way to answer. What’s more, if I were to be honest, my answer is usually not what most people want to hear and all I get in return are a bunch of “mmm’hmms” and “uh-huhs” peppered with a few “so, that’s great and all , but what I read on the internet was…….”
I’d rather swallow live bees.
However, in Nelson’s case it’s the least I can do. He’s helped me out a ton in the last year, and, I’m not a dick.
So, of course I’m going to answer to the best of my ability and hopefully point him (and you, dear reader) in the right direction.
Losing Weight 101
At the most basic level, losing weight comes down to one umbrella theme: eliciting a caloric deficit via taking in less calories than you burn7. I often tell clients of mine that this can be as simple as not inhaling that bowl of Fruity Pebbles on a nightly basis…….
……one’s nutrition and being dialed-in with calories in vs. calories out always has been and always will be the main obstacle to consider/tackle with regards to weight loss.
But too, eliciting a caloric deficit can also be achieved via consistent exercise whether it’s by taking a spin class or by lifting heavy things.
Which is more effective or optimal, however?
Well, that depends.
BOTH work and I often reiterate to people that the answer is not to perform one in lieu of the other. In fact, I encourage everyone to implement both strategies if they have the time and means to do so.
I understand why the bulk of people tend to gravitate towards the cardio end of the spectrum.
Hopping on a spin bike or lacing up a pair of sneakers for a jog tends to be more “user friendly.”8
Cardiovascular’centric endeavors tend not to require a gym membership.
They can also be performed anywhere.
What’s more, one main reason why I feel a lot of people shun lifting weights – outside of not knowing really where to start – is that they see a picture like this…..
Or this…..
And proceed to destroy the back of their pants.
They see pictures of advanced, highly-trained individuals performing seemingly unfathomable feats of strength and think to themselves “that’s a whole lotta nope right there.”
[I’m not going to get into the “will lifting weights make me bulky” argument right now. For starters, “no, it won’t.” But mostly doing so will just make me want to throw my face into a brick wall repeatedly.
The other, more germane reason (I think) why many shun weight-training is, hate to break it to you, sheer ignorance.
I’m Biased – But Here’s Why I Think Weight Training Works Well And Should Often Take Priority
I try to limit the number of blank stares I receive when trying to explain why weight training is important for weight (fat) loss.
Here’s my go-to elevator pitch:
NOTE: Yes, I understand there are many nuances to consider when breaking down the topic. This is a blog post, not a dissertation.
“Comparing minute-to-minute…accounting for intensity, cardio will almost always burn more calories compared to lifting weights – I’d say somewhere in the range of 2-3x more. However, it’s what your body is doing afterwards, when you’re sitting at home binging Stranger Things on Netflix or playing Magic the Gathering (<— can we hang out?), that’s the difference maker. When you hop off the elliptical machine you’re pretty much done burning calories. However, when you lift weights, in the hours after9, you’re not done. It goes by several names – Thermal Effect of Exercise, Afterburn Effect, being a brick fucking shit-house – but when you lift weights, you’re burning calories looooong after you’re done.”
You can also think of it this way:
Again accounting for intensity, lifting weights, for all intents and purposes, breaks down muscle to a (much) larger degree compared to cardio. It takes energy to build that muscle back up. This requires more energy from the body. This is what’s often used to best explain the AfterBurn Effect mentioned above.
Muscle is more metabolically “active” tissue compared to fat. The more muscle you have, the more calories you burn at rest.
Cardio doesn’t build (that much) muscle. You lose weight, but then you just end up looking like a smaller, weaker version of your original self. Sad face.
At the end of the day, though, it does come down to personal preference and what people are actually going to do.
If someone really hates lifting weights or just really likes doing cardio…I’m going to encourage them to stick with whatever modality allows them to remain the most consistent.
But Here’s My Final Say
#1. Don’t eat like an asshole
After that….do both (cardio & lifting weights).
I’ll tell people they should prioritize 2-4x per week of weight training and use their cardio to either compliment those days or serve as ancillary “bonus” days to get some exercise in.
I just feel the benefits of adding strength and muscle to the mix far out-weighs any misconceptions that may exist (and will only help to expedite the process).
As far as how to lift weights or where to start? A great option would be to read The New Rules of Lifting by Lou Schuler and Alwyn Cosgrove (HERE’s the version for men, and HERE’s the version for women) or maybe check out my CORE Online service.
Today’s guest post comes courtesy of physical therapist Dr. Michael Infantino, and covers a topic every human in the history of ever has had to deal with.
Physician: “Welcome. Thanks for coming in for your appointment this morning. It says here that you are having shoulder pain. Is that correct?”
You: “Yes it is. I didn’t think anyone actually read that intake form. I am glad that I took the 30 minutes to fill it out in the waiting room. Also, thank you for taking me back only 45 minutes later than my scheduled appointment time. That’s way better than my previous appointments.” [In a sarcastic tone.]
Physician: “Well there could be a host of reasons that you are having shoulder pain. Did you fall recently? And how old are you? Did you know that most 40 year olds have arthritis?”
You: Inner dialogue, “No, I didn’t fall. Fall? What am I 90 years old?” “I exercise regularly Doc. It hurts sometimes when I am bench pressing or doing shoulder press. Can’t think of any specific incident when it first started hurting.”
Physician: “Did you ever consider not lifting weights? It may be rewarding to have those big muscles, but it could increase your risk of injury. Look at me. I do 20 minutes of stationary biking each day, no pain… try that.”
You: [Scratching your head] Again, inner dialogue, “He is kidding, right? I would rather beat my head into a wall than stationary bike for 20 minutes.”
Physician: “Ok, lets do some testing on you. (Three minutes later) Well, luckily I didn’t find anything that resembled a rotator cuff tear or instability. You also don’t seem to be missing much motion so we can throw a frozen shoulder diagnosis out the window. Why don’t we have an X-ray done?”
You: “Ok Doc. You are the boss… this should tell me what the problem is, right?”
Physician: “For the most part, yes. We can see if you have any bone spurs or arthritis. Remember what I said about old people right? They get arthritis.”
You: “Old? I am 40 bro!”
THE FINDINGS:
Physician: “It seems here that you have some arthritis in your shoulder. This explains your pain. You could try taking some anti-inflammatories. Exercise might help to. Here is a list of rotator strengthening exercises that we use. Have at it! If this doesn’t work come back in a few weeks and I can inject it with cortisone.”
You: You think to yourself, “Shoulder exercises? I work out my shoulders all the time. Is the Doc saying I am weak? Am I going to be popping anti-inflammatories my whole life?”
As doom sets in you start to think about all the moments you have taken for granted.
The joy you get from bench pressing and the euphoria that bicep curls provide. The ease in which you were once able to perform the perfect landmine press, never having to worry about your shoulder.
You start questioning past decisions. If I only would have strengthened my rotator cuff muscles earlier or just road the stationary bike like the DOC.
As you are drowning in self-pity the pause button is pressed, and some random guy pops out to provide what might seem like a cheesy infomercial.
RandomGuy: “Hello! I am aware that your physician just made arthritis seem like the death sentence. Before you leave today demoralized, let me give you some facts about arthritis to ensure that you don’t sentence yourself to a lifetime of stationary biking. He tried that line on me once too.”
What is Arthritis and What Does This Mean For Me?
Osteoarthritis is the most commonly diagnosed form of arthritis. Referred to as the “wear and tear” arthritis.
This label holds some truth, but it does not tell the whole story. Living a life enriched by the joys of picking big things up and putting them down may lead to more arthritis than stationary biking.
Osteoarthritis is actually the result of increased inflammation surrounding the joint.
Remember that inflammation is your body’s attempt at healing tissue.
Unfortunately, your joints and cartilage do not always allow for optimal blood flow. Instead of providing healing it just leads to some degeneration. What you need to understand is that many other factors can contribute to arthritis.
This includes:
natural aging
obesity
diet
gender
previous injury
your god given anatomy
Arthritis. “The Get Out of Jail Free Card.”
Arthritis seems to be that “get out of jail free card” for most clinicians.
You show up complaining of pain without any recent trauma. You don’t recall dropping a barbell on your chest or hearing a pop after throwing a no-hitter… for your co-ed softball league.
It seems like your rotator cuff and labrum are safe and sound.
We strive to avoid wrinkles like we strive to avoid arthritis.
So what usually happens next?
Your medical doc whips out the “big guns” of course.
In this case that would be an X-ray, MRI or ultrasound.
Come to find out you have a little bit of arthritis at the shoulder.
Lets stop for one second.
For some reason we imagine this life where we defeat the natural aging process. We strive to avoid wrinkles like we strive to avoid arthritis. Wrinkles may be a source of pain just as much as arthritis is.
More importantly, having arthritis does not necessarily mean you are going to have pain.
It wasn’t until some brilliant people started putting people without pain under X-ray that we realized something extraordinary.
They have arthritis too, but nopain!
One study found that arthritis and degeneration of the spine progressively increased with age. However, that is generally NOT true with pain. People also complain of back pain more frequently in their 40’s to early 50’s (Louw, 2017). From there it steadily declines despite the fact that arthritis steadily increases.
More than 90% of 60 year olds (without complaints of pain) will present with some form of degeneration around the spine (Brinjikji W. et al).
As much as we hate to hear it, we need to remember that inflammation does not create pain. It just warns the brain that we may have a problem.
People who have had limb amputations because of rheumatoid arthritis (another form of arthritis triggered by an autoimmune disease) continued to feel stiffness in a limb that was no longer there (Haigh et al).
Basically, phantom limb pain.
This reinforces the idea that part of your discomfort is also because of a sensitized central nervous system. Your brain and nerves get all hyped up the longer your pain lasts. This is why pain management and physical therapy are focusing on finding ways to desensitize your central nervous system. This includes things like graded motor imagery and helping people understand how pain really works.
It is Time To Do Your Best Sherlock Holmes Impersonation.
With what you know now, how terrible would it be if arthritis were blamed for your pain without considering other causes?
We may go through the rest of life thinking that nothing that can be done.
On top of that we think, “if I have arthritis now how bad will in be in ten years from now?”
You may even consider canceling your gym membership and living in a bubble. Before it gets to this point try to enhance your self-awareness. Consider what activities may be contributing to your pain. Poor programming, bad technique and lack of focus on mobility.
These are all low hanging fruit.
Other considerations for reducing inflammation:
Diet
Sleep
Exercise
Physical and Emotional Stress
Failing at any of the categories listed above can elevate local joint inflammation. Potentially leading to pain. People neglect the importance of a diet that minimizes inflammation. We have a general idea of the foods that cause more trouble (breads, pastas, dairy, sugar, red meats, and so on).
Losing weight, minimizing alcohol intake, not smoking, exercising and cleaning up your diet is usually sufficient for getting on the right path.
Many recommendations for herbal supplements and vitamins exist. But don’t think that taking some turmeric and fish oil will override the bowl of ice cream you take down every night.
Or the occasional soda with lunch.
We also know that being deficient in certain vitamins can result in increased levels of inflammation. In a study that looked at the relationship between knee pain and arthritis, “people with knee osteoarthritis who were obese but had healthy vitamin D levels were less disabled than people who were obese individuals but had insufficient vitamin D levels.”
Make sure you consult with your doctor before implementing any vitamin supplementation.
More is not always better.
Consuming too much of one vitamin could cause toxicity or alter the effectiveness of other vitamins (Glover et al).
If You Are Already Making All the Right Lifestyle Choices and Still Having Pain What Can We Do?
Muscle can often be the source of a lot of the aches and pains we experience. Inflammation at a joint or trigger points in a muscle both increase those danger signals back to the brain.
Our goal is to decrease those danger signals in as many ways as possible.
That could be treating the muscle, reducing stress, getting more sleep, improving our diet and so on.
To start moving in the right direction we can benefit heavily from seeing a professional.
Who exactly?
It really depends on your preference.
A lot of overlap exists between massage, physical therapy, chiropractic, acupuncture and so on these days. Many of these disciplines are using similar services when it comes to hands on treatment.
For example, cupping, joint mobilization, manipulation, soft tissue manipulation, instrumented assisted treatment, active release techniques and more. Other disciplines besides physical therapy are also using exercise. Doing your research, and finding out which provider specializes in your injury is more important than ever.
Been There, Done That and Still No Success?
This is when I would look to a medical doctor, preferably someone that specializes in orthopedics or sports medicine. Knowing that you have been through conservative care already they will most likely recommend an X-ray, ultrasound and/or MRI.
Caution: Ignorance is sometimes bliss. This is when you are going to see what your joint really looks like. It is not always pretty, and “degeneration,” “tears,” “bone spurs” are not always synonymous with pain. Do not let these findings immediately make you think that surgery is necessary.
2/3 people over the age of 70 have pain-free rotator cuff tears (Milgrom, Schaffler et al., 1995)
50% of people with knee arthritis have no reported pain (Bedson and Croft, 2008)
35% of collegiate basketball players without reported knee pain have notable abnormalities on MRI (Major and Helms, 2002)
The doc offered a cortisone injection… should I do it?
Cortisone tends to be used more commonly with knee and shoulder pathology. It has been shown to be effective at reducing pain. The goal is to reduce inflammation local to the joint.
“Yea, but isn’t inflammation a good thing?”
Great question.
Yes, it can be, but excessive inflammation can cause increased stress on a tissue, enhancing those danger signals. Ultimately resulting in more pain.
Could cortisone cause more damage?
It is possible that excessive use of cortisone can weaken tissues leading to possible tissue injury. What is “excessive use” defined as? That part varies depending on who you ask. Learn a little more about cortisone injections from the Cleveland Clinic.
Should I take Aspirin (anti-inflammatories)?
Anti-inflammatories may be effective as reducing local inflammation.
Some studies have shown that cortisone may be more effective, but not in all cases. Anti-inflammatories like aspirin are not meant for long-term use secondary to its harmful effects on the gastrointestinal system.
“Possible risks of all NSAIDs include: stomach problems (such as bleeding, ulcer, and stomach upset), kidney problems, high blood pressure or heart problems, fluid retention (causing swelling, such as around the lower legs, feet, ankles, and hands), rashes, or other allergic reactions.” (Rheumatology.org).
As always, consult with your physician.
The doctor gave me a home exercise plan for my shoulder. Will this work?
It depends.
As we mentioned earlier, exercise that does not increase pain can be beneficial.
To keep it simple, “motion is lotion.”
Movement also increases local blood flow, which can help reduce inflammation.
Cardiovascular exercise can reduce pain through endorphin release (self made pain killers). Keep in mind that working through pain on your generic rotator cuff strengthening program will get you no where. Not to say that working through a little pain is a bad thing. The assumption that a weak rotator cuff is the culprit is often misguided.
Interested in a FREE Shoulder Mobility Program to help reduce pain? Click here.
Overview
Arthritis is not a death sentence.
It also does not mean that you need to resort to stationary biking and aquatic therapy.
Arthritis is as normal as developing wrinkles when it comes to aging. Before you blame your pain on arthritis consider the low hanging fruit that you are not addressing. If you need a little boost get a second pair of eyes on you at the gym. Also consider seeing a medical provider that can do some soft tissue and joint mobilization.
Low Hanging Fruit:
You weight
Diet
Sleep
Exercise Routine (programming and technique)
Self Care Practices (mobility work and rest)
Stress (physical and emotional)
About the Author
Dr. Michael Infantino is a physical therapist. He works with active military members in the DMV region. You can find more articles by Michael at RehabRenegade.com.
References
Arroll, B., & Goodyear-Smith, F. (2005). Corticosteroid injections for painful shoulder: a meta-analysis. The British Journal of General Practice, 55(512), 224–228.
Bedson, J., & Croft, P. R. (2008). The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders, 9, 116. http://doi.org/10.1186/1471-2474-9-116
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology. 2015;36(4):811-816. doi:10.3174/ajnr.A4173.
Glover T, Goodin B, King C, Sibille K, Herbert M, Sotolongo A, Cruz-Almeida Y, Bartley E, Bulls H, Horgas A, Redden D, Riley J, Staud R, Fessler B, Bradley L, and Fillingim R. (2015). A cross-sectional examination of vitamin D, obesity, and measures of pain and function in middle-aged and older adults with knee osteoarthritis. Clin J Pain; 31 (12); 1060-67.
Haigh RC1, McCabe CS, Halligan PW, Blake DR. Joint stiffness in a phantom limb: evidence of central nervous system involvement in rheumatoid arthritis. Royal National Hospital for Rheumatic Diseases, and Department of Medical Sciences, University of Bath, UK.
Liu-Bryan R, Terkeltaub R. Emerging regulators of the inflammatory process in osteoarthritis. Nat Rev Rheumatol 2015; 11:35.
Louw, A., Zimney, K., Johnson, E.A. et al. Aging Clin Exp Res (2017) 29: 1261. https://doi.org/10.1007/s40520-017-0731-x
Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum 2012; 64:1697.
Major and Clyde A. Helms. MR Imaging of the Knee: Findings in Asymptomatic Collegiate Basketball Players. American Journal of Roentgenology 2002 179:3, 641-644
Milgrom, Charles & MB, Schaffler & Gilbert, S & van Holsbeeck, Marnix. (1995). Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. The Journal of bone and joint surgery. British volume. 77. 296-8.
Serdar Kesikburun, MD, Arif Kenan Tan, MD, Bilge Yilmaz MD, Evren Yasar, MD, Kamil Yazicioglu, MD. Platelet-Rich Plasma Injections in the Treatment of Chronic Rotator Cuff Tendinopathy: A Randomized Controlled Trial With 1-Year Follow-up
I always joke that if I weren’t a strength coach I’d try to finagle a way to watch movies for a living. I don’t know know how I’d make a living doing that, all I know is that it’s pretty much my life’s dream (outside of owning my own real-life Airwolf).
I can’t think of an instance in my life where I haven’t been transfixed or excited to head to the theater to catch a flick.10The ones that really stick out in my mind, that made my jaw drop and were almost biblical in how they affected me are…Return of the Jedi (of course), Back to the Future, Forrest Gump, Avatar, and The Matrix.11
Who can forget that opening sequence with Trinity? Remember how it started off with her taking out that whole SWAT team single-handedly, with that slow motion 360 degree camera shot, then building to a chase scene crescendo out-running an “agent?”
Nerd boner city.
You knew, after watching that, that the next two hours were going to be something special.
And, arguably, maybe one of the more iconic lines/scenes of the movie was when Neo first visited The Oracle and he had the “bending spoon” conversation with the little girl.
In the health and fitness industry, and in particular as a health and fitness professional, understanding someone else’s perspective is a crucial and germane talent to posses.
I + XI = X
Take for instance the equation you see above.
Is that a “true” or “false” statement?
I snaked this little gem from author Dan Brown’s latest novel, Origin.12
You’re looking at the equation and thinking to yourself:
“One plus eleven is ten? That’s false Gentilcore. Idiot.”
Alas, when the main character in Brown’s novel, Robert Langdon, wrote out the same equation in sand during a pivotal moment in the story, and presented it to another character (named Ambra)…he received the same perplexed reaction.
When told that the equation is “absolutely false,” Langdon responded with “And can you see any way this could be true?”
“No, the statement is definitely false,” replied Ambra.
Langdon then reached out and gently guided Ambra’s around to where he was standing.
It was only then that she saw the equation from his vantage point.
The equation was upside down:
X = IX + I
“Ten equals nine plus one.”
I was sitting in bed when I read that tidbit and chuckled to myself. “That’s good,” I thought to myself. I then reached over and wrote the equation on the little notepad I keep at my bedside figuring I’d use it at some point to make a blog post out of it.
SPOILER ALERT: This is that blog post…..
Many of us are steadfast in our beliefs in this industry.
I remember when Mike Boyle caught a metric shit-ton of flak years ago when he told the strength & conditioning world that he had omitted back squatting from all his programs.
I think he could have live streamed himself clubbing a baby seal and that would have been more universally accepted.
From his perspective, however, he saw a correlation between back squats and the vast number of athletes experiencing back discomfort and in worse case scenarios…missing playing time due to injury.
He switched gears and opted to emphasize building single-leg strength instead. For the record, he’s still producing world renowned athletes (and he’s seen a reduction in injury rates).
This is not to insinuate I agree with all of what Mike has to say about back squats – if it’s any consolation, I still use them with my athletes – but rather it’s to note that he’s not wrong.
He just has/had a different perspective.
He’s still getting results.
And the world is still spinning.
Likewise, I recently saw a thread on Facebook with a personal training attacking Jenny Craig.
She went off on how she’s frustrated with one of her client’s who decided to enroll in the program.
I’m paraphrasing but she said something along the lines of:
“It’s just a foo-foo fad diet, and she (her client) is just wasting her money.”
Don’t get me wrong, I too have a hard time not rolling my eyes at Jenny Craig. It is a touch “faddy,” and I believe most are better off not adopting an often unhealthy relationship with food by following a point system.
Hamburger w/ wheat bun: 719 points
Celery sprinkled with sawdust: 1 point, Mmmmmmm.
That being said, it does work for a lot of people and it does serve as a way for many to learn to appreciate portion/calorie control.
That’s not a bad thing.
Are there better, maybe more long-lasting and sustainable avenues to take?
Yeah, maybe.
But from a client’s perspective, Jenny Craig may be the most un-intimidating starting point to take.
And that’s a huge win. Assuming they follow the rules to a “T” and stay consistent, it stands to reason some cool things will happen.
What they don’t need is their trainer/coach discouraging them.
Perspective goes a long ways.
It helps to explain why some coaches don’t use back squats, or don’t incorporate a lot of overhead pressing, or maybe omit the olympic lifts from their programs. You may not agree with them, but that doesn’t mean they’re wrong.
In addition it’ll help to better understand where your clients are physically and emotionally, and what will likely be the best course of action to take to set them up for long-term success.
I’m not even sure what my overarching rationale was for writing this post. Maybe it was to note that Keanu Reeves is capable of making good movies.13. Or better yet, to encourage you not to be an uppity dick.
No one is saying to turn your back away from your experience and expertise. I implore all fitness professionals to use both to educate their clients/athletes.
But too, try to make a habit of walking around to the other side, to see the vantage point from their perspective. You’re only going to be a better coach in the end.
I took a brief blogcation this past week because I was down in Dallas, TX visiting family (and eating copious amounts of carrot cake). It was cold as balls down there – in the 20’s, what the hell? – only to return to Boston two days ago to be met with even colder than balls weather…something called a “Bomb” Cyclone.
Parts of downtown Boston flooded and now there’s about two feet of ice in the streets. Thankfully none of that affected us. What’s more, with the wind-chills today, it’s reported we’ll see balmy temperatures of -30 degrees.14
We’re hunkered inside with really nothing to do so I figured I may as well cut my blogation short.
I’ve had the honor of presenting at two previous iterations of the Motivate & Movement LAB (the brainchild of MFF’s Harold Gibbons) and it’s unequivocally one of the most unique events in the fitness industry.
Think: TED Talk, but with deadlifts and lots of f-bombs.
Anyways, the next LAB is this coming February, and will feature myself, Dan John, Pete Dupuis, my wife (Dr. Lisa Lewis), and several of the MFF coaching staff including Brian Patrick Murphy and Amanda Wheeler.
I always appreciate the content Brad puts together and the cool things that can be done with some of the ACUMobility protocols.
In this article/video Brad breaks down squat assessment and in particular hones in on both one’s ability to rotate their tibia and adductor length and how they can affect squat performance.
REALLY enjoyed this article from the guys over at The Strength House (Greg and Tony). If you’re looking for some quick-n-dirty ways to add muscle….density sets are a fantastic way to do so.
Social Media Shenanigans
Twitter
Heading into 2018 it stands to reason many are making their fitness goals a priority. Sweat less the details (optimal program, diet, etc) and sweat more on being CONSISTENT with something.
The blogcation continues. Today I’m going to highlight some of the best guest posts from this past year.
Guest posts played a crucial role on the site in 2017. Having a kid, while one of the most rewarding things in my life, was also one of the most time-suckiest things too.
For obvious reasons I just didn’t have as much free-time to write as much as I would have liked.15Thanks to everyone who pinch-wrote for me.
It’s one of THE most annoying injuries that can happen to an athlete or lifter. In this post physical therapist and strong AF strength coach, Sam Spinelli, sheds some light on how to conquer it.
There will always be gyms who compete only on price and price alone. However, most people’s health and fitness is worth way more than $10 per month and free tootsie rolls.
It ain’t easy to be “healthy.” It takes effort, dedication, and consistency. However, there are simple tricks you can use to make it easier and more palatable to fit your lifestyle.
There’s a stark difference between a fitness celebrity who has an IG account with lots of selfies and someone who’s actually a fitness professional and knows what the heck they’re talking about.
Whether you’re a fan of undulated periodization, block periodization, or plain ol’ vanilla linear periodization….writing effective training programs is a must if you want to be known as a legitimate coach or personal trainer.
Look at the magazine cover above. What do you see?
Airbrushing, yes.
But look at the words and titles…..lose, lose, slim, guilt-free, sexy…all are words used to insinuate women need to be less or that they’re not good enough now.
Sometimes you write something you feel is going to resonate so hard and be such a hit with your readers you’ll make a draft of your Pulitzer acceptance speech before you click “publish.”
And then there’s articles like this one…..LOLs.
I thought it was going to be hit and I thought I was being clever. Come on….how many people have tried to tie in boy bands when discussing the rotator cuff?
But, well, sometimes you miss.
Maybe this is a perfect example of people not recognizing greatness until after the fact. Maybe I’m a literary version of Van Gogh?
A wife, mom and adventure sports athlete, Sarah is a women’s fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting-edge exercises to bring you results-driven programs for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at
Dr. Michael Infantino is a physical therapist. He works with active military members in the DMV region. You can find more articles by Michael at 
