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Q & A: Fixing the “Tuck Under” When Squatting – Part II

For those who missed it, last week I opened a discussion on how to go about addressing/fixing the “tuck under” when squatting.  For the record, the tuck under (or butt wink as it’s more commonly known) is not some new move that all the youngsters are raging on the dance floor nowadays – similar to the Dougie or the Stanky Leg.  Rather it’s a condition that’s infinitely less sexy and hip and basically refers to one losing proper spinal positioning when squatting to a certain depth.

See?  Not nearly as cool.

Literally, due to any number of reasons (discussed in the link above and more thoroughly below), the butt “tucks” underneath the pelvis when attempting to go into deep(er) hip flexion.  As a result, it causes a boatload of compressive load on the lumbar spine, and to a lesser degree, which I can’t prove with any science, makes my cat cry.

Because, if there are two things in this world she hates:  it’s going to the Vet and people who tuck under when they squat.

You don’t want to make my cat sad, do you?

I didn’t think so.

Before we continue on with the show, let me be clear:  I WANT people to squat to proper depth. It’s just that, given many people move about as well as a one-legged pirate, it’s not necessarily mandatory one squats to depth (or ass-to-grass if we’re speaking in Bro-science terms) on day one.

I was reading through the comments from last week and noticed that some people were saying how squatting deep is something they’re reluctant to have their clients perform.  Just so we’re all on the same page, my “end game” is to work with what I have and to (hopefully) get every single one of my athletes or clients to squat to depth.

It’s just that, sometimes, it’s not always a good idea to “force” someone to squat deep when they just don’t have the ability to do so safely. Hammering a square peg into a round hole isn’t going to accomplish anything, and it’s certainly not going to help the client. As coaches and trainers, it’s crucial that we recognize one’s limitations and try to work with what we have.  And, with a little work, maybe….just maybe, we can improve their squatting technique.

With that said, a good starting point – and something I should have touched on in part I, but only thought of after the fact – is how to go about figuring out where proper depth is in the first place for certain individuals?

While it’s something I only use occasionally, one screen I like is the kneeling rock back assessment.  Here, I’ll have someone start in the quadruped position with a neutral spine.  Slowly, I have him or her sit back towards their heels to see if or when their spine hinges.

Here’s one that doesn’t suck:

As you’ll notice, as I sit back, my spine stays relatively neutral the entire time. As such, it’s safe to assume that squatting “deep” probably won’t be an issue.

Conversely, lets look at this train wreck:

Oh boy.  Not good.  You almost immediately notice a lumbar hinge, and unfortunately, if this were some random person, I’d probably refrain from having them squat past their point of no return. I mean, if it’s this bad with no spinal loading, can you imagine how much of a walking ball of fail they’d be if I placed a barbell on their back?

Either way, the quadruped rock back assessment will undoubtedly help you better ascertain whether or not it’s safe for someone to go into deep hip flexion without their spine hating them.

Taking it a step further, though, I still like to watch someone in a more dynamic environment, and will ask that they perform a standard body weight squat. Doing so can help me distinguish whether it’s a hamstring issue or a lack of core stability issue.

While I covered the hamstrings in part I – and that’s definitely not a bad place to spend your time – it’s my experience that the larger culprit is lack of anterior core engagement and stability.

Remember what I noted previously – because the anterior core can’t counteract the pull of the hamstrings (and adductor magnus for that matter), the force couple on the pelvis is compromised and squatting may become problematic.

How can you tell if it’s an anterior core issue?  If I’m working with someone and I see a tuck under when they perform a body weight squat, I’ll simply hand them a 10 lb plate and have them hold out in front of them with their arms fully extended and perform the squat again. More often than not, the tuck goes away – like magic.

It’s like I’m Gandalf or something!

Okay, not really, but there IS a logical explanation for why this happens.

Think about what happens when you hold a plate out in front of you – what happens?  Your anterior core HAS to engage/fire so as to prevent you from tipping forward.  In short, you’re MORE STABLE, and better able to control the pelvis.

So, if someone performs a squat and I see the tuck under, and it corrects itself when I force them to engage their core, I can generally surmise that it’s probably a core stability issue. Not always, of course…..but it’s a start.

How To Fix It

While it’s easy to assume that fixing the issue is complicated, it really isn’t.  Long division is complicated. Keeping track of all the characters in Game of Thrones is complicated.  This?  Not so much.

While everyone is different and I don’t like making gross recommendations, I’ve found that the following seems to bode well for most trainees:

1. Of course foam rolling is going to be part of the mix here. I’m not going to belabor the point:  just do it!

As well, addressing any deficits in the thoracic spine is going to be kind of a big deal as well: read THIS and THIS for ideas on how to address getting and maintaining a neutral spine.

2. One of my favorite drills to help groove squat technique and help “open up” the hips is the Rocking SUMO Squat Stretch:

While I like the mobilization option (as shown), it’s also efficacious to use this as a standard stretch and just hold the bottom position for a desired time – say several holds throughout the day for 30-60 seconds.

3.  As far as grooving proper depth is concerned, again, if someone is tucking under it’s because they don’t have the stability/stiffness in the right areas to pull off a deep squat safely.  Overriding this would be the logical recommendation of squatting to a box which will prevent the tucking under in the first place.

Have them squat to a depth where they’re successful and work from there.  Below is a video a shot a few weeks ago on the difference between box squats and squatting TO a box.

Whatever ROM elicits proper spinal alignment is what I’m going to use.  If I have to resort to squatting at or above parallel, than so be it.  Focus on the ROM they DO have, and work down from there. If it doesn’t happen, it doesn’t happen.  No big deal. Sometimes we have to set our egos to the side.

4.  Finally, and more pertinent to today’s post, add in more core engagement/stability work (NOT CRUNCHES…..as a lot of direct rectus abdominus work will only pull you into MORE posterior pelvic tilt).

Like I said, almost always, if you notice someone tucking under when they squat it’s probably a relative stiffness issue, and it stands to reason that their core is weak or unable to stabilize the pelvis. To that end, I’d make a concerted effort to hammer Pallof presses, various planks, stability ball rollouts, as well as half kneeling/tall kneeling chop and lift variations.

And that’s about it, really. Like I said, addressing the issue doesn’t take anything too fancy. Assuming we’ve ruled out more elaborate root causes (FAI, for example), I’d garner a guess that everything covered in both posts will cover most everyone’s bases when addressing the butt wink…..;o)

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Q & A: Fixing the “Tuck Under” When Squatting – Part I

NOTE (from August, 2014):  I wrote this article back in March 2012. When I was an idiot. I still hope you read what I have to say below, because most of what I say still applies.

However, I’ve changed my thought process significantly since I originally posted this article. For a more up-to-date, um, update…check out the following article I wrote on T-Nation titled How Deep Should I Squat?

I.e., the hamstrings have little to do with the tuck under or “butt wink.”

Q:  Hey Tony,

Just read this old article over at T Nation – Squat Like You Mean It:  Tips for a Deeper Squat.

I’ve been trying to improve my mobility for a deeper squat and eventually got there ( I can sit in a squat position all the way down with heels still on the floor) but my problem lays in lumbar flexion at the bottom.

Obviously I’d need an assessment in front of you to pinpoint the issue but is there anything you can recommend for neutral spine. It’s driving me nuts that I cant keep a neutral spine. I’ve been retracting my shoulder blades, squeezing my lats and activating my core but still no cigar. Any common issues you see in this area?

A: Notably, it is completely bat shit crazy to say that everyone should squat to the same depth. Some people picked the right parents, have awesome levers, and are able to squat ass-to-grass with no issues at all.

PS:  I hate you.

Conversely, there are others out there who try to squat deep and, well, bad things happen.  Not everyone is the same, and it’s important – especially as a coach – to understand this.  While admirable, the end goal for every single trainee shouldn’t necessarily be to go ass to grass from the get go –  just because some meat head on a random forum who doesn’t know any better told you so.

Instead, the goal should be to teach proper squat mechanics and groove proper technique in a safe range of motion that won’t be overly deleterious to the spine.

As my good friend, Kevin Neeld, has mentioned prior:

Someone with limited hip flexion that attempts to squat deeper than their anatomy allows inevitably tucks their hips under at the bottom.  Invariably this leads to lumbar flexion under a significant load.

The question then becomes:  how can we remedy this issue?  Can we ease our way to a respectable depth without the ol’ butt tuck?

Of course we can!

Since it is a fairly common occurrence in the general training population, to start, we should discuss  what causes the tucking in the first place? While there are several things that need to be ruled out which are outside the scope of this particular post (nasty adductors – specifically with regards to sports hernia, and femoral acetabular impingement), one of the major points I want to hit on is that a vast majority of people (not everyone) are sitting in posterior tilt all day, and as a result the hamstrings tend to get stiff(er) relative to the anterior core.

It’s no secret that we spend a lot of time sitting.

In an ideal sitting posture, the pelvis is level or has a slight anterior pelvic tilt. With a posterior pelvic tilt, the PSIS are lower than the ASIS.  A posterior pelvic tilt is accompanied by an increased kyphosis. In addition, the ischials travel forward and new pressure points are created at the sacrum and the spine.

For those who are a bit glassy eyed from reading that, try to visualize how you sit in your car, or on the bus, or even at your desk…..right now…..as you read this.

Chances are, it looks very similar to the picture to the right.

Not surprisingly, and as noted above, the hamstrings become short or stiff relative to the anterior core.  Because the anterior core can’t counteract the pull of the hamstrings (and adductor magnus for that matter), the force couple on the pelvis is compromised and squatting may become problematic.

With that, I’m going to stop with the technical talk now because it’s making my brain hurt. Besides I’m sure many of you would rather swallow a live grenade than listen to me go on and on and on about PSIS and ASIS shenanigans.

Of course, the issue could be more far more reaching than just looking into the hamstrings/weak anterior core – but for simplicity sake, we’re going to focus our attention there.  And, just a heads up, in Part II, I’ll discuss training modifications that can be implemented…..so be sure to check back then.

In the meantime…..

Here’s What I’d Do If I Were You

Incorporate more multi-planar hamstring mobilizations.  I MUCH prefer these drills over just telling someone to haphazardly “go stretch.” Moreover, I find that these drills have much more of an effect since they address the hamstrings from multiple angles and not just “what’s easy.”

Note:  this last one will be a doozy for most.  The key point to consider is to make sure that you rotate through the hip and NOT the lumbar spine.

Other Stuff to Consider:

1.  Notice how I don’t flex my lumbar spine when doing these drills? You should do the same.

2.  Another thing that can’t be appreciated because of the camera angle is that the toes of my standing foot are pointing straight a head as I perform all the drills

I like to incorporate all of these as part of an (extended) dynamic warm-up, or they’re something that could easily be performed throughout the day in your office or home – all you need is a counter top or desk and you’re all set.

Bonus points if you bust them out during a business meeting!

And that’s it for today.  Tomorrow (UPDATE:  actually, it’s going to be on Monday.  Had too many things to catch up on in the meantime) I’m going to discuss how you would differentiate between whether it’s a hamstring issue or weak anterior core (Hint:  it’s usually the latter more than the former), as well as discuss some simple training modifications that can be done to help alleviate the “tuck,” and (hopefully) groove a more conducive squatting pattern.

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Stuff to Read While You’re Pretending to Work: 1/13/12

It’s been a busy week in both my professional and personal life.  We’re seemingly bursting at the seams at the facility getting everyone ready for the upcoming baseball season.  Many of the college guys who are home on their breaks will be heading back to school starting next week though, so it should slow down a bit and allow us an opportunity to come up for air.

Likewise, in a few short weeks, many of our pro-baseball guys will be making their way south (or west) for Spring Training.  It’s hard to believe that it’s only like four weeks away, but there’s still plenty of intense work and sweat to be had.

What’s more, many of our high school and general population clients are working equally as hard.  Yesterday alone we had a few people set some deadlifting PRs – Congrats to Lisa V!

On a more personal level, I have some pretty cool things in the works:

1.  In about a week or two, you should see some changes to the website.  Now, I’m not going to go all Facebook on you and add some lame scrolling ticker that everyone hates  – RELAX!! Rather, I’m just making some aesthetic changes to site while upgrading some of the social media, in addition to………..DRUM ROLL PLEASE…………….

…….implementing a newsletter!

EC, Smitty, Kevin Neeld, and pretty much everyone else I know has been busting my chops for eons for not having a newsletter in place, and I’ve finally decided to put my big-boy pants on and run with it.

2.  It seems that my resolution to do more speaking engagements has caught fire.  Currently, I have 3-4 events tentatively lined up, and more in the works.  Sweet!  I’ll keep you posted.  Or, better yet, once it’s available, you can sign up for my newsletter (hint hint).

3.  I’m going on vacation!!!!!!  Lisa and I booked a flight for Florida in March, and it can’t come soon enough – I’m about as white as a Coldplay concert right now.

There are some other things going on as well:  I started a creative non-fiction writing class earlier this week (Note to my editors: I can’t promise less grammatical errors), I pulled 500×4 last night AFTER eight hours of coaching, my cat is sitting on my lap as I type this post (such a cute kittie!!!), and I brushed my teeth like ten minutes ago.  So there you go. You’re caught up.

On that note, here’s this week’s stuff to read:

 Are You Making This Critical Corrective Exercise Mistake – Nick Tumminello

Coaches need to coach, and NOT get too caught up in this whole concept of “corrective exercise.” Too often, trainers and coaches get cute with their assessments and programming and fail to do the ONE thing that’s most important:  cue and coach their clients!

I thought this was a fantastic video blog by Nick, and is something we try to instill on our interns at Cressey Performance on a routine basis.

Assessments are mandatory, no doubt.  Corrective exercise – when indicated – IS important, obviously.  But more importantly, having the ability to demonstrate, cue, and coach a client through any given exercise is kind of a big deal, and is a characteristic that’s often overlooked.

Keep it simple people……COACH!

The Recovery Day Workout – PJ Striet

You can’t be a rock star everyday.  Sorry, it’s just the truth.  This is never more evident than in the weight room. For a vast majority of trainees out there, many are under the impression that “more is better,” and that even if they feel like they’ve gotten run over by a mack truck of fail, they should still train through it.

This is dumb.

I’ve touched on this topic before in the past, but here, my good buddy PJ elaborates a little further and provides some killer circuits to boot. Check it out!

Why Do You Train Your Clients – Lee Boyce

WOW.  Just wow.  Amazing article by Lee which asks the question:  do you educate your clients or just collect their money?

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Post Rehab Essentials

I don’t care if you’re a personal trainer who just started working at the local Gold’s Gym last week, or a seasoned veteran who’s been training people for the past 10-15 years, it’s inevitable that you’re going to be working with the walking wounded at some point in your career.

Everyone  you work with is injured to some degree. While some may walk in on day one with an already pre-existing condition – like an ACL injury or AC joint issue – others may walk in completely asymptomatic and be pain free, yet if you were to take an MRI of their spine, it could very well resemble something coming out of a meat grinder.

Nevertheless, having the ability to work around various injuries and not only help “fix” people but still elicit a training effect in a safe and timely manner, is an invaluable skill for any trainer or coach to possess.

Furthering the point above, those trainers who go out of their way to better themselves and learn to develop a bit more of a corrective exercise background, are the one’s that tend to separate themselves from the masses.

Which brings us to my good friend, Dean Somerset.  Dean just released his latest product, Post Rehab Essentials, which is designed for trainers looking to increase their knowledge of how to work with various injuries in a gym-based or studio setting. Truth be told, there’s a rather large knowledge gap between those who know a whole lot about every aspect of training and those who are looking to get a strong foothold and take a step up from average.

Dean was kind enough to send me an advance copy a few weeks ago and all I have to say is that after viewing it, I wish I could just hop onto Craigslist, do a search for “Flux Capacitor,” and then go back in time for the sole purpose of scissor kicking myself in the face for relying too heavily on what my text books told me.

Suffice it to say, it would have saved me A LOT of time if I had resources like this back then.

To that end, Dean was nice enough to sit down and answer a few questions regarding the fitness industry as well as discuss Post Rehab Essentials.

And, because I know some people won’t even bother to read the interview (tsk, tsk, tsk), here are some important things to consider:

1.  Dean breaks this down into four sections:  Introduction, Upper Extremity, Lower Extremity, and the Spine. He not only discusses some basic anatomy, but also covers assessment as well as programming variables. It’s pretty much one of the most baller products out there geared towards rookie and intermediate trainers.

2.  I think it’s an awesome product that will help a lot of trainers out there become better at what they do. This undoubtedly gets the Tony G seal of approval.

3.  Post Rehab Essentials is on sale only from now until Friday (12/9).  After that, the price increase $60, so be sure to take advantage of the savings while you can.

Okay, I’ll let Dean take over from here.

TG:  Dean, lets cut the formalities, most of the people reading this know who you are, because we’re always creepin on each other’s blogs.  For those who don’t, here’s a quick primer:

Dean’s a personal trainer and exercise physiologist who specializes in post-rehab programming, and being really smart. He likes walks on the beach, and, much like me, has an affinity for obscure Jedi references. Heck, we’re practically the same person – except he likes hockey, and I’m way better looking.

Anyways, Dean, tell us a little bit about the driving force behind Post Rehab Essentials. 

DS:  The whole program came about when I had 32 medical professionals referring me business a few years ago, and wound up at a point where I literally couldn’t take on any more business without training 4 or 5 people at once, and that was something the insurance providers and the referring professionals got pissed about.

As a result, I began to look for other trainers to off-load some clients in order to keep business flowing, but I wanted to make sure they had the right skillset to work with these people. No sit and reach testing or max rep pushups here, I wanted to have people who could look at a client and determine why their rotator cuff was getting all beat to hell.

 

As I’m sure you can attest, these kinds of trainers are few and far between, so I had to build a program that would cover the basics to up the games of those who would be working for me, coving all the major injuries you would see in a gym setting: rotator cuff tears, ACL reconstructions, disc herniations, and a few dozen others.

Once I began teaching the trainers what to do and what to look for, they also wanted to have some pre-made programs they could use with their clients (and even themselves) to help get the ball rolling. This was an idea that also piqued interest with a few doctors and insurance providers, so having the standardized plans in place helped actually build more business. Plus, it meant if a client came in with a rotator cuff issue, I could hand them to anyone and they would get a safe program that would help them out.

TG:  That’s awesome, and just goes to show how establishing a solid network of other fitness professionals can be a powerful thing.

Would you agree that the gap between the personal training side of things and physical therapy side of things is closing?  In my opinion the gap is smaller than we think, but it’s a dangerous line to walk because we now have plenty of personal trainers out there thinking they’re capable of diagnosing things because they read a book or two on the topic.  What are your thoughts?

DS: I totally agree that the gap is getting smaller, but I need to preface that a little more. The gap is getting smaller AT THE TOP of the fitness industry, and seems to be getting wider at the bottom, where the entry-level certifications are pumping out trainers with little to no experience with injuries whatsoever.

As a result, I’ve seen trainers telling clients with some obvious structural issues to “push through it” when performing overhead press and weighted crunches. Serious spin kicks needed in those situations.

At the same time, you’re absolutely right when trainers feel they can diagnose after reading Sahrmann or McGill for a weekend. The funny thing is that I’ve specialized in injury post-rehab for the better part of a decade, worked with dozens of doctors, physios and chiropractors in their clinics, observed multiple surgeries, and had my training programs picked over by some of the best minds in rehab, and I don’t even diagnose.

Sure, I can tell a lot about someone by looking at them, but there are some really specific red flags that I look for to see if going to keep training with me or go back for more treatment. I may know in the back of my mind that the person in front of me is presenting with all the right symptoms for a specific diagnosis, but I want to make sure I’m right before I decide on anything, otherwise my wrong move may wind up causing some big issues. I always want to have two sets of eyes looking at a client to make sure, and every other trainer should do the same.

TG: What do you feel are the key components for success in this industry?  More to the point, what can incoming (and current) trainers do to better set themselves up for long-term success.

The biggest advice I could get for any trainer is simple: Get better results for your clients, and get better results for more clients. Knowing how to help a client lose 5 pounds is great, but if you can help them lose 50 pounds, they’ll pay closer attention. Likewise, if you can help them lose 50 pounds, increase their strength, make their back not hurt anymore, and reduce their odds of having a total knee replacement (or helping them do all this after they’ve had a knee replacement) can make or break your ability to have someone open their wallet to get you to help them. The more problems you solve, and the better you solve them, the more in demand you will become.

 

The next piece is to make yourself a specialist in SOMETHING. I hd a client a few years ago who was a young lawyer, and he was all excited when he got his first actual business card, which read on the back “Specializing in marital law, business law, tax law, criminal defence, civil rights, andreal estate.” This means he didn’t specialize in anything at all.

He was a generalist. You shouldn’t be a generalist, because when someone needs something really bad, they want the best at what they do. They’re going to come to you, because you are the best at what you do (hopefully). Whether it’s preparing for a figure contest, getting baseball players ready to throw heat, or helping someone fix their wonky knees, make it your goal to have something account for 80% of your business.

TG: Great insight, Dean.  I couldn’t agree more.  And lastly, if you could, can you give my readers the 5 minute elevator pitch – or in this case, the 500 word pitch – as to what Post Rehab Essentials brings to the table?  Basically, how will this make trainers more awesome?

DS:  Knowledge is power, and this is never more resonant than in fitness.

The trainers who spend the most time learning from as many different sources as possible tend to make the most money, and tend to have the best reputations as fitness professionals. I’m also a big believer in quality, usable content that you don’t have to have a PhD in biomechanics to understand, so I made this product cut to the chase, show why specific injuries happen, how to assess for them, and what to do with the info you get from your assessments.

This is a quick reference guide to help you solve more of your clients problems than ever before, which makes you a better trainer at the end of the day, and as a result make more money and have a greater impact on the quality of your clients lives.

If that’s not enough, consider this: more than one third of asymptomatic people walking the streets would show a partial or full thickness rotator cuff tear on MRI, especially if they’re over 60. More than half of those asymptomatic people also had disc bulges, some at more than one level. What this means is that whether you want to work with injured clients or not, you already are, so not knowing what to do about it will be the fastest way to put yourself out of business.

If that’s not enough, I’m also going to show you a thousand different ways to make your workouts better, more effective, and way more pimp than you ever thought possible.

TG:  Awesome stuff Dean.  Thanks for your time! 

====> Post Rehab Essentials <====

 

 

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Q and A: Thinking Outside the Box

Q:  Question about push-up frequency.  I am into my fifth month of olympic lifting and while I am home for the summer from school I am working out on my own.  One thing I want to do is bring up is my chest, but I don’t want to bench much because I am still working to fix a minor bit of kyphosis in my T-spine. 

I work as a manual laborer and I’ll be doing a program either two or three days a week for the O-lifts (waiting for my coach to send it), so basically I was wondering what would be a good volume to use with pushups and their variations to bring up my chest?  I have a 45 lb vest and gymnastics rings to use as well.  Thanks!

A:  Okay, first off – I’m going to go out on a limb and assume you’re a college student (hence, the “ I’m home for summer from school” comment) – and, if that is in fact the case, what the heck are you doing spending your summer doing manual labor?

Dude, one word:  Lifeguard

I did it for seven straight summers through high school and college and all I have to say is:  Best……summer….. job……..EVER.   Well that, and being the personal pull-up spotter for whoever this girl is in the picture below (which was featured on t-nation.com last week).

Seriously, whoever took that picture deserves the Nobel Prize……..for being my idol.

Okay, with that out of the way, lets get to more pressing matters – your question!

While adding in some push-ups would be a great way to “bring up” your chest – I’d argue that if you take a grenade approach and address your kyphosis and t-spine mobility, you’d give the illusion of increasing its size.

Let me briefly explain.

Almost without fail, on a weekly basis we have some new client start up at the facility who, inevitably, goes out of his way to say he wants pecs that can crush diamonds – you know, as if having an impressive chest is somehow going to help him throw a baseball harder, or improve the chances that girls will want to hang out with him.

More often than not, it’s usually some impressionable teenage kid who reads way too many Musclerag articles (Top Ten Moves to Chisel Your Chest!11!!!1!), but we also get our fair share of weekend warriors who have spent the past 15 years sitting in front of a computer – in flexion – perusing various fitness forums into the mix, as well.

Guys want pecs – it’s inevitable.  It’s akin to women and handbags – there’s just some unforeseeable gravitational pull that can’t be avoided.

The thing is, though, when it comes to developing an impressive chest, sometimes (not always), benching – or any dedicated exercise that targets the chest – is the last thing many trainees need to be focusing on.

To be perfectly frank, if you’re walking around with a sunken chest, protruded (rounded) shoulders, and otherwise have the posture of Mr. Burns from The Simpsons, then there are other things that I feel would help.

If anything, I’d focus more on the following (a little outside of the box thinking):

1.  Lots and lots and lots and lots (i.e:  a lot) of horizontal rowing.   Really, this is something that I feel most trainees can’t get enough of.  As I noted above, many of us are stuck sitting in flexion all day, and it makes absolutely no sense to head to the gym only to perform movements that promote more of the same.

A general rule of thumb is to perform one pulling exercise (1-arm DB row, for example) for every pushing exercise (bench press).  In this instance, I’d be more inclined to use more of a 2:1 or even 3:1 (pull:push) ratio to help offset the imbalance.

By implementing more pulling exercises into your programming you’ll undoubtedly strengthen the posterior muscles in your upper back, which will then help to pull the shoulders back – and, as alluded to above, give the illusion of “bringing up your chest.”

2.  What’s more, it only makes sense that you’ll want to hammer tissue quality in the form of foam rolling – particularly in the upper back and lats.

In addition, things like quadruped extension-rotations (done right), side lying windmills, walking spiderman with hip lift and reach, as well as some dedicated manual therapy/soft tissue work on the pec minor, upper/lower traps would be in high order.

3.  Too, I’d look into any anterior pelvic tilt you may be rocking.   This is something that often falls to the wayside, but if you’re in anterior tilt (hyper extension), the spine is going to compensate by going into hyper kyphosis in the t-spine.

So, seemingly, you could help your kyphotic posture by working on your hips.  As such, some dedicated hip flexor stretches, as well as TONS of glute activation work would be kind of important.

4.  Additionally, from a programming standpoint, again, you’ll want to focus on posterior chain stuff.  The glutes in particular, help to posteriorly tilt the pelvis, so it only makes sense to focus on movements that will strengthen that area.

Movements like pull-throughs (preferably held for time at the top of each rep) and 1-legged hip thrusters are fantastic.  Also, one major mistake that many trainees make is not “finishing” their squats or deadlifts with their glutes.  As a result, when coaching someone, I like to use the cue “get your hips through,” or “finish with your glutes,” which often helps.

5.  Lastly, and arguably most important of all, you can’t forget to hit the anterior core.  People often forget that one of the roles of the rectus abdominus (RA) and obliques is to posteriorly tilt the pelvis.

Note:  see a pattern here?  Much like the glutes – which are often weak and inhibited – the RA and obliques are as well, so it’s Janda’s Lower Cross Syndrome to a “T.”

To that end, things like pallof presses, chops/lift, and roll-outs (starting with ball rollouts and working your way up to ab wheel rollouts) would be great options.

Of course, this isn’t to say that throwing in some push-ups on a daily basis is going to throw a monkey wrench into things.  As it happens, I’d much rather you perform loaded push-ups than bench presses.  But at the same time, the post above was just to get you to think outside the box a little bit.  What’s more important:  push-ups, or fixing the actual kyphosis as it relates to your chest development?  That’s the question.

CategoriesUncategorized

Leaky Roof Syndrome

To begin, yesterday, I had just finished my training session when Eric walked up to me and said, “you’re 12:30 eval is here; she’s waiting in the office.”   Oops – twenty minutes early.  I head over to the stereo to turn-off the Wu-Tang (not exactly a great first impression when M.E.T.H.O.D Man is blaring through the speakers), pound my protein shake, and change shirts really quickly before I head out to greet Paula.

Upon quickly glancing at her health history, I notice something that jumps out and grabs my attention – she noted that she had been suffering from a chronic hamstring strain for the better part of the last two years.  Hmmm, interesting.  Almost immediately a light bulb goes off in my head and I start to stroke  my evil strength coach beard (but more on that in a bit).

Anyways, whenever a new client walks into the facility, we always try to sit down for 5-10 minutes to better ascertain what it is (s)he is looking to do.  Generally speaking, this is the time where we try to dig a little deeper, discuss training background, goals, injury history, etc.  The form sitting in front of me was otherwise blank, so without even blinking an eye, I ask about the hamstring.

Paula smiled, took a deep breath and let it rip.  Without going into too many details, she explained how she had always been an athlete (she was a sprinter in college) and had always lead an active lifestyle – she even did some personal training on the side a few years ago, and really enjoyed it.  For all intents and purposes – she’s the epitome of a fitness junkie.

Giving full disclosure, however, she openly admitted that she’s her own worst enemy, and sometimes has a knack for not knowing when to hold herself back.  When she first hurt her hamstring, she waited a few weeks, and once it started feeling better, she hightailed it to the track and did some sprints – only to re-injure herself, again, and again, and again.

After what was seemingly her umpteenth hamstring strain, she finally decided to seek some professional expertise and visited a local physical therapist near her hometown.   And for many of you, I think you know where this story is going.

To say that a ham sandwich could have done a better job than this physical therapist would be the understatement of the century.  Based off of what Paula told me, this therapist did nothing other than give her ultrasound and electric stimulation for a few weeks and then sent her on her way.  Incidentally, there was no real formal assessment of her movement quality.  Basically, Paula walked in, said “my hamstring hurts,” and the therapist treated the hamstring.

I guess in the grand scheme of things, this isn’t necessarily wrong.  For instance, when one of our baseball guys shows up and says his shoulder hurts, as traditionalists, we usually end up looking at the shoulder first and work out way out crossing things off as we go:  things like, scapular positioning, thoracic mobility, contralateral hip mobility, soft tissue restrictions, to name a few.

But there’s the rub – WE DON’T JUST LOOK AT THE SHOULDER.

And this is where I feel this particular physical therapist (and the countless other health professionals whom Paula visited) missed the boat entirely.

Leaky Roof Syndrome strikes again!!

It’s akin to someone complaining about a leaky roof in their house, and hiring someone to come in and place a patch over the leak itself – when in fact, the root cause of the leak is coming from somewhere else entirely.  Placing a patch over it is just a temporary fix in the long run, and will do nothing but delay the inevitable.

So, fast forward to yesterday and Paula getting visiably emotional while telling her story.  Who could blame her?  I mean, up until this point, no one had really taken the time to listen and to actually offer any concrete resolution to her problem.  All she’s been told is that she has “tight hamstrings,” (which, as I’ve noted in the past, is a bullshit excuse more often than not), and that she just “needs to take it easy.”

All this great advice for a $25 co-pay?  Sign me up!

Bringing this to a close, here are a few points of interest from yesterday that I found:

  • By and large, whenever someone mentions the word “strain,” you can usually (not always) chalk it up to something called Synergistic Dominance. Translating for the non-nerds out there, Synergistic Dominance is defined as a condition when a muscle in a group of muscles, that share similar actions, become more dominant and in turn, another less dominant.
  • In Paula’s case, during her assessment, I found that she had little (if any) ability to activate her glutes, which is kind of a problem – especially given they’re a very powerful hip extensor.   If her glutes are unable to fire, then that means her hamstrings (also hip extensors) have to work overtime to pick up the slack.  And, when you put two and two together (poor glute function paired with hamstrings throwing you the middle finger), you get chronic strains.

  • Furthermore, after taking her through some more tests, I found that she had very little ankle dorsiflexion.  Actually, that’s just being nice.  She had NO ankle dorsiflexion.  She lives in planar flexion from wearing high heels all the time.  Is it any wonder, then, that whenever she tries to sprint, she ends up hurting herself?
  • And finally, as I alluded to above, all the therapy in the world won’t make a bit of difference if people continue to move like shit.   Renowned physical therapist, Gray Cook, has popular saying

“fix the pattern, and the muscles take care of themselves.”

  • It’s so simple, that it’s brilliant.   I took Paula through some basic movement drills, and it was readily apparent that her lunge pattern needed some work – her foot externally rotated and knee caved in on each step, and even worse, her hip would collapse; all indicative of really poor hip stability.  Sorry, but ultrasound isn’t going to fix that.

In closing, it’s things like this that make my job so awesome – cause here’s a woman that came to us as a last resort, and she left yesterday feeling hopeful that we’d be able to help.

This isn’t to say that we don’t hava a lot of work to do – we do!  On top of building some basic strength, and correcting some motor patterns, she’s going to need quite a bit of soft tissue work done.  I gotta say, though, that it definitely frustrates me when I hear stories like this, and do nothing but show how “broken” our primary care system is (at times) in this country. And,let me just say that this post wasn’t meant as a “dig” to all physical therapists, chiropractors, physicians, or orthopedic surgeons out there that may be reading.

I understand that with any profession, there are those that do their job very well, and others that, well, don’t.  And I am in no way saying that what I found is altogether right or wrong. I But this is one instance where I was pretty fired up about the lack of “giving a shit” this physical therapist had.  We can do better than that!

PS:  If you found this article useful, or just liked it’s general awesomeness, please do me a favor and “like” it, or maybe re-tweet it.  Any way to get the word out there is very much appreciated!