CategoriesCorrective Exercise Program Design Rehab/Prehab

What Would I Say to Someone Starting Out?

Being human means being enamored by a litany of things in the health/wellness/physical preparation realm. Some people are easily swooned by fancy watches and elaborate looking exercises

Others by cryochambers and Paleo recipes that taste like sawdust.

I am not here to play judgement police. For the most part, everything has a time and place[footnote]Except for kipping pull-ups. Stop. Just stop it. No, seriously, stop.[/footnote] and everyone responds differently to different things.

What works for me may not work for you (and vice versa). It’s all good.

Back in 2009-2010, while at Cressey Sports Performance, I was introduced to PRI (Postural Restoration Institute). As a collective, we adopted some of their principles & protocols (specifically positional breathing) and applied them to our athletes’ and clients’ programming, I’d say with a high degree of success.

In the years since, PRI has grown in popularity and is still something I “subscribe” to. However, the key term I want to highlight here is “some.”

I’ve adopted some of their principles.

The thing about PRI (for better or worse) is that it has an uncanny ability to suck people in and plop them into a never-ending rabbit hole of mystery and multi-verses.

Today’s guest post is via Boston-based physical therapist, Mike DeMille, and offers a needed perspective on this phenomenon.

(PS: I’d encourage anyone interested with PRI to check out Mike’s course/mentorship below).

Copyright: yanik88

What Would I Say to Someone Starting Out?

In a world of biomechanics, neurology, complex chronic pain, and a desire to create resilience, it can be difficult to decide as a Physical Therapist or movement specialist what continuing education courses to take and why.

Personally, I have been a PRC (Postural Restoration Certified) Physical Therapist for five years, and anyone familiar with the Postural Restoration Institute (PRI) knows how easy it can be to go down the “rabbit hole”

Note From TG: I wrote a bit about this “rabbit hole” a number of years ago when PRI was first gaining steam in the S&C side of the spectrum. You can check it out HERE.[footnote]FYI: I’m still miffed about never beating Mike Tyson. I think about it everyday and it’s still one of those things that haunt me about my childhood. That, and other things like, “Why did He-Man think a bowl cut was cool?,” and “Baywatch. Damn good show.”[/footnote]

After taking different courses, it can be very difficult to sift through the information and add principles to your practice (or programming), while leaving behind minutiae that ultimately won’t contribute to the further results of your clients.

via GIPHY

What is that minutia you ask?

What are those techniques, exercises, prehab/rehab protocol, cues, sick hip-hop rhymes that probably do not need to come along for the ride as you build out your systems as a coach?

That is exactly why we are here today.

After working in a cash-based Physical Therapy and Personal Training setting over the last four years and starting my own clinic (just outside Boston,. MA) I’ve developed rules (or tenets) of information to hold on to and which ones to leave behind.

Let’s dive in.

Think Practitioner/Coach, Speak Client

Your clients do not care what things are called, and neither should you.

Exhale, eccentrically orient, compress, early-mid-late stance, inhaling from an exhaled skeleton expansion, these terms can get complicated, if not bordering on someone speaking Elvish.

via MEME

A general rule of thumb would be if you cannot explain a concept in very simple terms to your client, then you likely shouldn’t spend a ton of time thinking about it yourself.

I like to think of this as writing a letter with a big bold sharpie instead of a small fine pencil that is difficult to see and read.

For example, if you have a client who you feel like is in a position of lumbar extension and they need to learn how to exhale to help get them out of pain, then you can leave the messaging at just that.

 

You will create the buy-in from spinning a simple story and allowing your client to feel the difference when undergoing your program. You do not need to explain all of the varying “compensatory strategies” to them in an effort to create belief in your program.

This will more likely than not lead to confusion, in addition to increasing the urge they’ll want to punch you in the face.

Nothing Is New; It Just Has a Fancier Name

Remember that these principles existed long before the most recent course that you took. One of the biggest problems that I see mentees and fresh PTs and movement professionals face is shiny object syndrome.

Understandably, when you go to a course and watch someone’s shoulder flexion increase from 140 degrees to 8000 after a fancy breathing exercise, you want to give everyone that fancy breathing exercise.

via GIPHY

Remember, there is a difference between a new technique that creates transient changes, and principles that create long lasting repeatable results.

Examples of a few principles that could make sense in a movement practice geared towards clients with pain:

  • Sound communication (avoiding nocebo).
  • Axial skeleton position that creates pressure underneath load bearing joints.
  • Progressive overload.

Does it feel less exciting to not be blowing all of your clients minds?

Sure it does.

But will these principles give you a sustainable business where you can more accurately sell results to potential clients?

Definitely.

Closing Thoughts

There is nothing wrong with taking new courses, finding helpful information, and creating buy-in with prospective clients, as well as appreciating the nuances of Physical Therapy and Strength and Conditioning.

But let’s not forget: the name of the game is being able to tie your name to something that can produce consistent results, and that is why we decided to take on this profession in the first place.

PRI Pique Your Interest?

Does this message resonate with you? Are you a Physical Therapist or movement professional looking to sift through the information and take the relevant principles into your practice?

Tyler Tanaka and I have created a community where we take individuals that are looking to finally apply the information that they have learned and effectively communicate with their ideal clients to build the business that they have always wanted.

This is your chance to learn the system of two PRC PTs and ask any and every question that you have ever had. In the 10 week Solidify Program you will undergo a detailed curriculum as well as take part in one on one Refinement calls to get your questions answered about those difficult patients that are the ”non-responders” as well as big picture questions about your practice and business.

Click HERE for more information.

Solidify begins June 6th and the spots are limited.

CategoriesCorrective Exercise mobility Strength Training

Strength Starts Here: Breath, Control, Express Badassery

I always enjoy when I have the opportunity to introduce my readers to someone new; coach’s who are “in the trenches,” doing great things, and are well articulate in conveying their message.

Ladies and gentlemen I give you Chris Abbott. He’s a coach and gym owner based in Chicago. As it happened, he sent me a t-shirt out of the blue as a “thank you” for what I do on this blog. It was a class move and nice gesture to say the least.

Not long after Chris expressed some interest in writing a guest post, and well, it took me all of three seconds to say yes.  I hope you enjoy it as much as I did.

Strength Starts Here

Life is better when you’re strong, and that’s a fact.

Over the years as a trainer I’ve worked with average Joes, stay at home moms, significant weight loss clients, professional athletes, and a wide variety of broken and damaged people ranging from hip replacements and torn labrums to herniated/broken discs and torn knee ligaments – to name a few. Every one of these clients had one thing in common; they all reached their goals by becoming stronger.

Perhaps I’m stating the obvious, but based off of the people I see and work with daily I feel people may know they need to get stronger, may know they need to get in better shape, but they really have no idea how to actually get stronger, hence strength starts here.

Commonalities in Strength

There are certain aspects of strength that are required for success – this goes for sport, individual hobbies, and most importantly quality human movement.

My approach to those aspects can be viewed in the following way; you have attachment sites – your arms at your armpits and your legs at your hips. All movement will come from these attachment sites.

In addition you have your thoracic spine (T-spine).

Your neck, shoulders, and t-spine are all tied together; therefore healthy movement of the neck, head, and shoulders (really the entire upper body) requires healthy t-spine functioning. One could go on to describe how the upper body and more importantly a lack of alternating, reciprocating movement affects your lower body (hips and knees), but that goes beyond this post.

Furthermore, my approach can be summarized by this relationship:

  • Positional breathing leads to increased control
  • Increased control leads to increased strength development
  • Being stronger allows you to do whatever you’d like in life

Let’s break this down a bit further and see how you can own all to generate massive strength gains – and really enjoy life more!

Position and PRI

Are your shoulders really tight or are your scapula maybe just in a poor position which is limiting your range of motion?

This is usually the first time someone looks at me with a sideways head tilt expression of “huh?”

When searching for strength your key to performance will reside within your ability to take a breath properly.

All my sessions start with a common goal; restore proper breathing mechanics and allow your diaphragm to work as a primary breathing muscle rather than a postural stabilizing muscle. This does a few things:

  • Triggers parasympathetic activity in the body which results in the body “letting go” or relaxing more
  • “Letting go” will lead to increased range of motion at the attachment sites and T-spine
  • You’ll feel “lighter” – which never hurts anyone
  • You’ll be more focused – which is awesome just about any time
  • And most importantly, you’ll be in a better position to get stronger

The approach and exercises I use to correct someone’s breathing mechanics (and ultimately help restore control) stem from an organization called the Postural Restoration Institute, PRI for short. The Institute’s director, Ron Hrsuka, has devoted his life to PRI. It’s a powerful concept and one that immediately grabbed my attention after I first took one of their home study course a few years ago.

In a nutshell, PRI’s take on the relationship of posture, movement, and performance begins with asymmetries and the fact that everyone, whether you’re “righty” or “lefty”, has the same features internally – one heart, one liver, etc.

These asymmetries predispose us to shift our center of gravity and throw off our position; which in turn affects our posture, limits our movement abilities, and decreases performance. As a result, areas such as your shoulders, t-spine, and hips (sound familiar?) are placed under distress – compensation patterns develop and your ability to get strong has been diminished.

Positional breathing can be viewed as achieving the following:

  • Re-training your diaphragm from being used as a stabilizing muscle to a primary breathing muscle – this allows your body to “let go”
  • “Untwist” your body, positioning it in more of neutral state thus giving you more joint centration and ultimately greater potential for building strength

Positional breathing will open doors that lead to increased control. Remember, increased control leads to greater strength development so taking 5-7 minutes on positional breathing can and will make a difference during your set of heavy deadlifts. Here are a couple of my favorite positional breathing exercises:

90/90 Hip Lift

 

All Four Belly Breathing

 

Control is King

Flexibility seems to be the rabbit everyone wants to chase when something goes wrong.

However, as we just discovered, a lot of your flexibility concerns might in fact stem from your inability to breathe properly and your poor position. It’s not uncommon to see a significant increase in range of motion in your attachment sites after performing some positional breathing exercises.

Now that you’re in a better position, you can more easily gain control!

I view flexibility as your ability to passively pass through a specific range of motion – no ownership here, just swinging by to say hi to grandma.

Mobility on the other hand is your ability to control a specific range of motion – you’re laying the foundation and moving in!

Mobility = Control. Control = Strength.

Therefore Strength = Mobility.

In order to be strong you need to have control – you need to have the mobility needed to perform your sport, hobby, or live as a healthy functioning human being. Perhaps another head tilt “huh?”

Your sport/activity will determine how much control is needed at said attachment site(s) in order for you to perform at a high level.

A gymnast for example needs far more control than a basketball player.

You can name plenty of other comparisons that support this notion. However here’s my argument; wouldn’t you rather be able to control a much larger range than you need so as to not only become freakishly strong, but also increase your longevity by decreasing your risk of injury?

I’m not suggesting a football player be able to move like Neo in the matrix – it’s not needed, in fact for some athletes having too much range of motion is detrimental to performance.

But in the game of life – that’s a much different story and can in fact tell you from personal experience and client experience, yes you do want the increased control!

I’m falling more and more in love with Dr. Andreo Spina’s FRC system and its ability to give you loads of control. More importantly it’s blending very nicely with the positional breathing exercises I have my clients perform.

Dr. Andreo Spina is a world-renowned musculoskeletal expert. His system stands for Functional Range Conditioning. Its focus is on three main goals; mobility development, joint strength, and body control (fits pretty nicely with what we’re talking about).

The end result is people doing some crazy sh** that would likely land most people in the hospital.

A photo posted by Hunter Cook (@hunterfitness) on

I’ve been fortunate enough to learn from colleagues who are FRC certified. I myself cannot wait to join them!

Through various series of controlled articular rotations (think searching through your end range in various joint motions) one can find where he/she is limited. Once limitation is found, applying progressive and regressive isometric loading (PAILs and RAILs as he calls them) can be used to increase your usable range of motion – more control = more room for strength.

From there you can play with lift offs and other fun movements but the overall takeaway is clear; you will gain loads of control which can lead to loads of strength!

One of my favorite non-FRC exercises for control is the Arm Bar as it allows the athlete to simultaneously gain shoulder and t-spine control

Life is better when you’re STRONG

This is the fun part. In my mind the end of my little equation is whatever you want.

If you’re an athlete maybe it’s run faster, jump higher, or get stronger.

Or, maybe it’s longevity – for athletes this can mean millions and millions more in income. For people who are injured or de-conditioned it could mean a fresh start or at least a new perspective on life.

The key I’ve realized is this; no matter what sport you play or what hobby you enjoy, everyone needs to be strong and there IS a relatively easy way to get there. It all starts with a breath followed by owning your body – gaining control.

Once you have control you are in fact in control – do what you want!

Until then, keep practicing.

I myself am a simple man. I’ve become attached to swings and getups everyday for my workout. My workout is short, effective, and to the point. My newest warm-up routine has 1 rule – I can’t use anything other than my bodyweight. This has not only placed me in a great position to start my swings, but also led to some fun movement sessions prior to my “workout”.

To summarize; strength starts with a breath, is enhanced with control, and transforms into greater strength – which leads to all around awesomeness in life.

Be STRONG!

About the Author

Chris Abbott has been a personal trainer for the past 7 years. He and his wife recently moved to Chicago where Chris Abbott Piche started Evolution Strength and Performance – a company dedicated to getting people strong through postural restoration, body weight training, and kettlebell training. He develops programs used for weight loss, total body strength, and overall health and wellness. Additionally, he works with clients who have suffered from back, knee, hip, and shoulder pain.

Along with neighborhood clients, he has worked with a variety of professional athletes including NFL, NHL, MLB, MMA, Pro Lacrosse, and European Basketball.

“I want people to realize there is more to life than the gym, and that life is better when you’re strong. It unlocks opportunities to enjoy life more, become a faster, more powerful athlete, or return to hobbies you’ve been unable to do for years.”

You can learn more from Chris by joining his newsletter or visiting his website. Additionally he’s on instagram and facebook.

 

CategoriesAssessment Exercise Technique

What We’re Really Saying When We Discuss Breathing

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

Photo Credit: Shawn Rossi

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

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

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

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

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

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

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

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

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

Having Said That…..

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

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

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

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

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

Thanks for the insight, dick.

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

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

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

That’s it.

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

Which begs the question: What effects DOES it have?

From my perspective here are a few bullet points.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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