CategoriesRehab/Prehab

What Your Doctor Never Told You About Arthritis

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.

It’s good. You should read it.

Enjoy.

Copyright: staras / 123RF Stock Photo

What Your Doctor Never Told You About Arthritis

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.

Random Guy: “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.

Surprisingly this is not always the case. In another article, we talk about a study that showed a significantly higher rate of arthritis in a sedentary obese population compared to a lifetime recreational runner.

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:

  1. natural aging
  2. obesity
  3. diet
  4. gender
  5. previous injury
  6. 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 no pain!

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.

The brain determines whether or not you feel pain.

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:

  1. Diet
  2. Sleep
  3. Exercise
  4. 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:

  1. You weight
  2. Diet
  3. Sleep
  4. Exercise Routine (programming and technique)
  5. Self Care Practices (mobility work and rest)
  6. 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.

  1. 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

Up To Date: Pathogenesis of Osteoarthritis.

Categoriescoaching

How The Matrix Can Make You a Better Coach

It’s no secret I love movies.

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.1The 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.2

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.

“There is no spoon.”

Copyright: fergregory / 123RF Stock Photo

 

The whole point of that interaction, at least to me, was to provide some much needed perspective to Neo.

To demonstrate to him that, sometimes, all you have to do is shift your perspective to see someone’s else’s truth. 

The Matrix is real, and you know, the spoon isn’t there.

via GIPHY

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.3

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.4. 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.

CategoriesStuff to Read While You're Pretending to Work Uncategorized

Stuff To Read While You’re Pretending To Work: 1/5/18

Why hello everybody.

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.5

We’re hunkered inside with really nothing to do so I figured I may as well cut  my blogation short.

Copyright: wamsler / 123RF Stock Photo

BUT FIRST

 

1) Mark Fisher Fitness Presents: Motivate & Movement LAB

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) Spurling Spring Seminar

JUST ANNOUNCED: I’ll also be making a cameo up in Kennebunk, Maine this Spring for the Spurling Spring Seminar.

It’s not until April, but you can save BIG now ($100 off) by purchasing an (early) early bird ticket by clicking the link above.

[Link also provides details on all the presenters and topics covered]

There aren’t many industry events that come into this neck of the woods, so hope to see you there!

STUFF TO READ WHILE YOU’RE PRETENDING TO WORK

When To Progress and When To Not Progress Your Exercises – Jarrod Dyke

It can be tricky to figure out when it’s appropriate to progress an exercise for a client/athlete and when they should probably stay put.

Jarrod offers some insights that may help make the water less murky.

How To Fix Your Knee Pain In the Squat – Brad Cox

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.

4 Ways to Include Density Sets For Hypertrophy – The Strength House

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

Instagram

CategoriesUncategorized

Best Articles of 2017: Guest Posts

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.6Thanks to everyone who pinch-wrote for me.

Here’s a few curated selections.

Copyright: pixelsaway / 123RF Stock Photo

Maybe Less Isn’t More – Kourtney Thomas

I LOVED this post from Kourtney.

Women are programmed to train to be LESS, as if adding muscle is taboo akin to bacon on a Sunday. Well, that’s a bunch of bullshit if you ask me.

How to Train Around a Groin Strain – Sam Spinelli

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.

The Planet Fitness Myth – Shane McLean

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.

No matter how delicious they are.

Healthy Living Is Hard: Accept It – Justin Kompf

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.

Fitness Celebrity vs. Fitness Pro: Part 2: Shots Have Been Fired – Erica Sutter

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.

Erica helps shed some light….

CategoriesUncategorized

Best Articles of 2017: My Picks

Yesterday I linked to the articles that resonated most with my readers and received the most traffic on the site in 2017.

You can check them out HERE.

Today, however, I’m going to highlight MY picks. Because me, me, me, me, and me.

Copyright: pixelsaway / 123RF Stock Photo

 

The Hardest Topic to Write About: Program Design

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.

Where to start? Which is best?

I attempt to answer that in this article.

My Wish For Female Fitness: Less Talk About Less

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.

I wish it would stop.

The Trap Bar Deadlift Is Not Cheating

I think the title says it all.

If you need a little more convincing please read on.7

How to Fix Scapular Winging

For the record, you’re likely not going to fix THAT (^^^^^).

That’s “true” scapular winging, a neurological issue where the long thoracic nerve is unable to innervate the Serratus Anterior.

What your client, Jake from accounting, has….is NOT scapular winging.

The Rotator Cuff and Boy Bands

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?

Yeah, that’s it……;o)

CategoriesUncategorized

Best Articles of 2017: Reader’s Picks

Well, that was fast.

2017 came and went.

It was a tumultuous year in many ways – I think many of us are a little fatigued from the events of this past year – but on a personal level quite a profound one too.

I mean, I became a dad.8

Despite the subsequent sleep deprivation – earning my parenting stripes – I still somehow managed to put up 192 blog posts in 2017.9 Today I wanted to highlight the Top 5 posts that received the most web traffic.

These are the articles that resonated the most with you, my readers.

Copyright: pixelsaway / 123RF Stock Photo

 

Sex In the Industry: Why Men Need to Lean In and Listen

This was hands down the most popular article of 2017, and was also the latest entry to make the list (I wrote this in early December).

It all started with the image above of a woman performing a cable pull-through. I used it in a presentation I was giving and unfortunately my immature reaction to it made some women who were present uncomfortable.

It was a hard article to write, but something I felt needed to be done.

Exercises You Should Be Doing: Rack Pull-Up

 

People went bananas over this pull-up progression I posted about back in April.

Click the link to see what all the hooplah was about.

A Lesson to Fitness Pros: You’re Always Being Watched

I guess this was the year of self-introspection and calling myself out. We can always improve, and in this case a slight lapse in customer service led to an embarrassing “call out” by a client of mine.

My Go To Squat Progression For Pretty Much Everyone

SPOILER ALERT: It’s not the variation pictured above…..;o)

The Unsexy, No BS Guide to Actually Getting Results

There’s a notion of late they every workout has to be a ball-buster. That if you’re not swimming in a pool of sweat or if you can’t feel the right side of your face that it was an ineffective waste of time.

THIS…IS….FALSE.

 

CategoriesStuff to Read While You're Pretending to Work

Stuff To Read While You’re Pretending To Work: 12/22/17

I’m sure I’m in the same camp as everyone else in that I’m scrambling to get some last minute Christmas shopping done.

Speaking of which, now that we have a kid and this is his first Christmas, I think I can buy an X-Box, have Lisa open it as a present, and say it’s for the family, right? RIGHT?10

Okay, time to get to shopping. Wish me luck and MERRY CHRISTMAS & HAPPY HOLIDAYS TO EVERYONE!

Copyright: gregorylee / 123RF Stock Photo

But First

1. Coaching Competency Workshop – Dallas, TX

A week from today I’ll be in Dallas, TX putting on my Coaching Competency Workshop.

I’ll break down assessment in addition to troubleshooting common strength-based exercises such as deadlifts, squats, shoulder-friendly pressing, to name a few.

This is ideal for any personal trainer, coach, or regular ol’ Joe or Jane looking to learn more on my coaching process.

Details are located on the flyer above, and you can purchase HERE.

2) Mark Fisher Fitness Presents: Motivate & Movement LAB

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.

3) Spurling Spring Seminar

JUST ANNOUNCED: I’ll also be making a cameo up in Kennebunk, Maine this Spring for the Spurling Spring Seminar.

It’s not until April, but you can save BIG now ($100 off) by purchasing an (early) early bird ticket by clicking the link above.

[Link also provides details on all the presenters and topics covered]

There aren’t many industry events that come into this neck of the woods, so hope to see you there!

Stuff To Read While You’re Pretending To Work

Do Your Bodyweight Exercises Suck Compared To Your Loaded Ones? – Marianne Kane

I thought this was an interesting article as it’s a phenomenon I see quite often: a client crushes his or her’s barbell squats or deadlifts, only to struggle with, of all things, push-ups.

One Common Myth That Will Keep You In Pain – Michael Infantino

Wow – this was/is a deep article.

Grab a cup of coffee, you’ll need it.11

Merry Christmas, Bob – Chris Shugart

I read this article for the first time waaaaaaay back in 2002 or 2003 or something like that.

Whatever the case: smart phones and social media didn’t exist.

It’s still one of my all-time favorite articles and one that Chris reposts on T-Nation each year.

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Categoriesbusiness

Business Advice For Trainers From Trainers

When I first started in this industry my business competence was pretty low. If you asked me what the term “overhead” was or what it meant to itemize business expenses I would have been like “say what again?”

I’m still not someone I’d consider to have a lot of business pedigree, but I think I’ve done pretty well for myself.

My friend Shane McLean went around and asked a bunch of coaches – including myself – some standard fitness business and gym ownership questions that I hope will resonate with people.

Enjoy.

Copyright: ruigsantos / 123RF Stock Photo

Business Advice For Trainer From Trainers

Personal trainers get into the fitness industry because they’ve got a huge passion for exercise and for changing people’s lives. However, some have no idea about the business side of coaching, particularly those who are new to the industry.

Newbie (and experienced trainers) work crazy hours to please clients which makes having any sort of social life outside of work very difficult. Trainers then start to realize there’s more to this coaching gig than meets the eye because:

  1. You’re trading a lot time for little money.
  2. It’s real hard yakka.12

Furthermore, exercise is big business nowadays. According to the website Statista, the US spent 25.8 billion dollars in 2015 on all things health and fitness. (1) That’s a fair chunk of change that has some trainers saying…….

The same hard work that goes into becoming proficient at coaching needs to be applied to the business side also.

But how do you get started?

Don’t worry this Aussie has your back.

I asked some prominent people in this industry – David Crump, Eric Bach, Johnny Tea, Chris Diamantakos, and some cat-obsessed nerd named Tony Gentilcore – a couple of hard hitting questions that will provide you with actionable takeaways on the business side of coaching.

Read on and learn things.

David Crump – Entrepreneur and Coach at DaveCrump.com 

1. At what point in your career did you realize that you needed to know more about the business side of coaching and how did you go about it?

Fortunately, I started my training career in a big box gym and moved into management relatively quickly. This gave me the opportunity to learn more about sales and the business side of fitness early on.

I did, however, realize that this gave me a leg up on many of my contemporaries as soon as I wanted to branch out on my own.

Despite my early advantage, I was still aware that if I wanted to stay ahead, that I would have to continue learning more and I found the most benefit from reading content from some of the big names in the industry as well as reading a lot of books from thought leaders in other industries.

2. What were your go to people/resources that helped you expand your business knowledge?

I can’t overemphasize the importance of having great mentors in this area. Some of the people that I have learned from directly or indirectly include Mark Fisher, Alwyn Cosgrove, Jon Goodman, Thomas Plummer and others.

It should also be mentioned that the experience of making mistakes and learning from them is paramount. Getting to make mistakes on someone else’s dime (at a big box gym) was a very valuable experience.

3. What advice would you give a coach looking to open a gym?

I would tell them to get VERY clear on what they want long-term. Many coaches and trainers think that opening a facility is the most logical next step, but that is not accurate.

Being a great gym owner means being a coach takes a back seat and increasing your level of responsibility exponentially. You have to be prepared to make your gym your number 1 priority for at least the next 5 years.

I think there are a ton of coaches that would be much happier simply renting space someone and having full freedom and control of their schedule and life.

If, on the other hand, someone knows that it is what they really want then I would tell them to start small. That means your first place shouldn’t be your 6000-square foot dream facility with every piece of equipment under the sun.

Instead, starting a modest gym and building it organically will put you in a better financial position to work the kinks out over the first couple years and eventually grow into a larger facility without being up to your eyeballs in debt.

4. The best book you’ve read about business and why?

I can’t narrow it down to 1, but I think there are 3-4 that really helped define my beliefs about business:

  • How To Win Friends And Influence People – Businesses are built on dealing with people and this book really delivers great tips on how to have better interactions and make people enjoy working with you.
  • The E-Myth Revisited – The classic business book that helps newbies learn how to move from being a “technician” to a “manager” of business owner through the use of systems in simple terms.
  • Start With Why – The most successful businesses in the world understand what they stand for and why they exist. This book helps a business owner really crystalize what makes their business unique and how to help customers understand its purpose.
  • Delivering Happiness – Written by the founder of Zappos, this is the best book on business culture, values, and customer service I have ever read.

Eric Bach, CSCS, PN1 and owner of Bach Performance.

1. At what point in your career did you realize that you needed to know more about the business side of coaching and how did you go about it?

My first training job at a big box gym gave me a first class look at the limitations of the personal training industry. Frequent policy changes, ownership transitions, and inconsistent sales goals led to a ton of stress on my business early on.

After I built a full book of business and deep relationships with clients’ ownership cut trainer-take-home pay by 30% to follow a “group training system”. At this point I was left with the decision: let my business be gutted and play the game or rewrite the rules on my own terms.

I decided to rewrite the rules, seek out mentors who had built a business I wanted to replicate and invest heavily in myself by paying for their services.

2. What were your go to people/resources that helped you expand your business knowledge?

Early on I followed the typical path: reading sporadic articles on the internet. I read everything I could on training from coaches like Dave Tate, Jason Ferruggia, John Berardi, Tony Gentilcore, John Romaniello, Jon Goodman, Nate Green, Christian Thibaudeau, and Eric Cressey.

When it came to business I dug into work by Ryan Holiday, Dale Carnegie, Chip and Dan Heath, Seth Godin, and Tim Ferriss.

Not long thereafter Jon Goodman introduced his Viralnomics coaching group to personal trainers looking to build their online business.

He was my first business mentor and pushed me to get out of my comfort zone and start treating my business like, well…a business and not a hobby.

3. What advice would you give a coach looking to open a gym?

Think long and hard whether you’re ready to run a business. Today everyone wants to be an entrepreneur and a business owner, yet no-one ever tells you not everyone is meant to run a business.

There will be long days, short nights, lots of coffee, and a constant battle to improve. While some folks are built for this challenge others simply aren’t.

Make sure you’re truly willing to make the sacrifices needed to create something great from the ground up before exploring leases, equipment deals, and opening a brick and mortar facility.

4. The best book you’ve read about business and why?

The One Thing by Gary Keller – In an age where information travels faster than ever and there’s an endless supply of “tips, tricks, and hacks” it’s far too easy to get bogged down in the minutes.

Trainers looking to build their online business fall into the same trap many of our personal training clients do: getting stuck in a cycle of information overload and inaction.

The One Thing reinforces getting clear on your number one priority for the day, week, month, and year and makes taking action on accomplishing this task the most important focus.

Johnny Tea Strength Coach, Manual Therapist

1. At what point in your career did you realize that you needed to know more about the business side of coaching and how did you go about it?

As soon as I decided to go out on my own and become self-employed in 2008, I realized I needed to learn a ton more about the business side. As new trainers, we tend to start off by thinking to ourselves, “Oh, I don’t care about the money part. I just want to train people and the money will eventually come.”

As we all know, there’s a lot more to it than just winging it and seeing where it goes in business. I’ve always loved the quote “Plan your work and work your plan”. Write down your goals (both short term and long term), and continue chipping away.

I reached out to other fellow colleagues/friends, read books, attended workshops, and picked the brains of some of my clients with a business background, and even brainstormed ideas with a trusted friend (in this case my wife).

With all this information I gathered, I applied the ideas that made sense for my business and made adjustments if needed.

2. What were your go to people/resources that helped you expand your business knowledge?

I specifically reached out to people that I respected in our industry who had a ton of success. Eric Cressey, Pete Dupuis, Chad Landers, Mark Fisher, Tony Gentilcore, John Rusin, Dean Somerset, Eric Bach, Jordan Syatt, John Goodman, John Romaniello, and David Dellanave are just a few names that come to mind, but this list is honestly endless.

Important side note: make sure you go about reaching out to people the right way. Meet with them at workshops/seminars or offer to pay them for their input and time.

Genuinely try to develop a relationship with the person before seeking advice.

No one likes creepy needy people seeking free advice.

3. What advice would you give a coach looking to open a gym?

I would say first ask yourself: why do you want to open a gym? I don’t mean that in a negative way but it’s a valid question. Here are some important questions to consider:

  • Do you want to open a gym because you just want a big fancy building with your name on it?
  • Do you have enough clients to support a gym and what’s your strategy to attract new clients?
  • Have you considered the amount of money it would cost to get started? (Oh, and don’t forget about the hidden fees too).
  • Do you have the capital to cover you for at least 6 months, just in case your business doesn’t start booming like you expected?

A lot of people want to go big and open a gigantic facility like Cressey Sports Performance (awesome facility and people by the way), but are probably better off starting small.

I would recommend possibly considering training facilities/studios that allow you to rent out space. This will give you time to build up your clientele while keeping your overhead cost low.

4. The best book you’ve read about business and why?

This is a tough one because there’s so many good books. I really enjoyed “Ignite the Fire” and “Viralnomics” by Jon Goodman because they were written specifically for people in the fitness industry, and gave actionable steps on how to become successful.

Chris Diamantakos NSCA-CPT

1. At what point in your career did you realize that you needed to know more about the business side of coaching and how did you go about it?

When I decided to leave the gym, I was looking to start my own PT business. I realized I knew nothing about business and marketing. I had a small-time frame of six weeks to learn as much as I could and actually apply it.

I picked the brains of a few gym owners and successful freelance trainers I knew and had been directed to a couple fitness business coaches who could help.

2. What were your go to people/resources that helped you expand your business knowledge?

I ended up following Jonathan Goodman and theptdc.com. If you’re wondering why, it’s because Jon personally took the time to answer my questions and he seemed to truly care about improving the fitness industry by helping trainers and gym owners with business.

3. What advice would you give a coach looking to open a gym?

Spend a shit load of time figuring out the niche you want to service and become a true expert in that field.

Realize how you can help these people the most, and continue to work hard at being great. One quote that’s stuck with me from Jon since day 1 is:

“1. Do a really good job 2. Make sure everyone knows about it.“

4. The best book you’ve read about business and why?

There are obviously tons of great business resources out there but the one that’s helped me the most directly is “Ignite the Fire.” It’s specific to personal trainers and up to date in terms of marketing techniques.

Tony Gentilcore, You’re Reading His Site Right Now*

* You’re really smart

1. At what point in your career did you realize that you needed to know more about the business side of coaching and how did you go about it?

Not soon enough to be honest.

There’s still a huge part of me that feels I’m behind the curve when it comes to business acuity and savvy.

Then I think to myself, “Huh, I’m making a profit, I’m still getting a nice stream of new clients, and my landlord hasn’t given me an eviction notice yet…I’ve got to be doing something right!?”

To answer the question, though, it wasn’t soon after meeting (and then living with) Eric Cressey that I soon learned the err of my ways. It’s hard to be around a guy like that and not absorb his work ethic and be a little more in-tune with going the extra mile to get better.

If I had to be exact, I’d say the week Eric, myself, and Pete Dupuis decided to put our balls out there and open up Cressey Sports Performance – July 2007 – was when I finally diving head first into more business-related content.13

Alwyn Cosgrove was a major influence on us when we opened up CSP, and from there all I did was following the scent of other successful trainers/coaches – Mike Boyle, Joe Dowdell, Dan John, John Berardi, to name a few – and try to emulate what they read or did.

2. What were your go to people/resources that helped you expand your business knowledge?

Giving credit where it’s due, I feel I was able to live in this unique “learning business bubble” by being in the proximity of Eric and Pete for eight years (I left Cressey Sports Performance in the Fall of 2015).

When I decided to leave I was so scared and nervous.

I thought for sure I’d fail.

Low and behold I was quite surprised to realize I didn’t suck at business as much as I thought I would.

In fact, I took solace in something I used to hear Pete always say:

“99% of operating a profitable and efficient fitness facility is application of common sense.“

That sentence alone helped mute a lot of my self-doubt and negative self-talk about business.

I mean, in a sense, business can be dwindled down to one simple act:

Don’t spend more than you collect.

Does your facility really need that expensive leg press machine or life-size early 90’s Mariah Carey statue?

3. What advice would you give a coach looking to open a gym?

The holy grail in this industry is NOT owning a gym.

There’s a connotation that you’re only successful in this industry if you own a gym.

That’s bullshit. And if anyone wants to read more of my thoughts on that I’d encourage them to check THIS out.

I could sit here and wax poetic on all the reasons why someone would and would not want to open their own gym.

I’ll just say this: I think every trainer should work in a commercial setting for 2-5 years before the words “gym ownership” are uttered. It’s times used to learn the craft, to get really good, and to understand how to develop relationships with people from all walks of life.

4. The best book you’ve read about business and why?

Profit First by Mike Michalowicz, hands down.

No one book has helped shape my approach to running my business than this book.

About the Author

 Shane “The Balance Guy” McLean, is an A.C.E Certified Personal Trainer working deep in the heart of Texas. Shane believes in balancing exercise with life while putting the fun back into both.

CategoriesExercises You Should Be Doing

Exercises You Should Be Doing: These 2 Brutal Core Exercises

Fair warning: the two exercises described below seem easy to perform and kinda give off the “huh, that’s it?” vibe.

But trust me, they suck.

They suck hard.

Like, really suck.

Okay, you get the point.

Copyright: eenevski / 123RF Stock Photo

 

I’d like to preface this by saying I’m not a fan of the term “core training.” Some coaches like to play the uppity card and say such and such exercise “trains your core,” but in my view, everything, to some capacity, trains or hits the core.

  • When you deadlift you train your core.
  • When you perform a set of push-ups you train your core.
  • When you Sparta kick someone in the kidney for talking during a movie you train your core.

Your core is namely made up of everything that’s not your appendages (arms, legs) and it’s responsible, mostly, for transferring force from your lower extremity to your upper extremity (and vice versa), and also for helping you look hella good in a bathing suit.

Another way to think about things is that your core is this interconnected “web” of muscles and connective tissue that’s designed to resist force or prevent “unwanted” motion.

There’s a bit more to it than that, but all in all…….there you go.

There are a million and one different ways to train your core. Personally, I am not someone who says “well, if you deadlift and squat that’s all the core training you need.”

I think that’s a very narrow-minded and reductionistic way of viewing things. Most people are very good compensators and I’ve seen some very strong individuals struggle mightily when asked to perform a deadbug

Conversely, I do feel we should include “core-specific” exercises into our training arsenal; but exercises that take all of the above into account.

Give these a try.

Hollow Position Landmines

 

Who Did I Steal It From: Strength coach and my ice-cream eating BFF, Ben Bruno.

What Does It Do: I LOVE hollow position holds to help people learn and appreciate what it REALLY means to get (and maintain) full-body tension.14

Adding in the landmine adds a stability and anti-rotatory component that kicks things up a notch.

Key Coaching Cues: Watch THIS video if you’re unfamiliar on how to perform a basic hollow hold.

Also, and this should go without saying, if you’re unable to perform a hollow body hold, master that before attempting this exercise.

Set up the landmine so that you’re holding the barbell just above sternum level and assume the hollow body position. From there rotate the barbell side to side trying to limit movement in your torso and hips as much as possible; a little is okay (and will likely be the case for most people).

This is a self-limiting exercise in that you should only use whatever ROM you have available and that you can control. As you become more accustomed to the exercise and the novelty wears off, you should be able to access more range of motion.

I like to perform anywhere from 5-10 repetitions/side.

Foam Roller Rollouts

 

Who Did I Steal This From: My bald brother in arms, Dr. John Rusin.

What Does It Do: Much like other rollout variations this is a superb exercise that trains the anterior core musculature, albeit, specifically, trains anti-extension.

As an added bonus, we could also make a case this is a great exercise to hit the Serratus Anterior. So, anyone who needs to work on their scapular upward rotation….you’re welcome.

Key Coaching Cues: Assume a strict plank position with forearms on top of a foam roller:

  • Abs and glutes engaged.
  • I like to start people with their hips a liiiiitle higher (so as they fatigue they end up in a “neutral” spine position).

Begin with a slight retraction in the shoulder blades and then protract/abduct away from the foam roller. From there “push” the foam roller forward/backward in a manner that allows you to maintain proper spinal position (there shouldn’t be any excessive over-arching or rounding of the back).

Be sure to MAINTAIN scapular protraction throughout the duration of the set.

You can perform this exercise for time (start at 10 seconds and work up to 30. I see no reason to go above that number) or for repetitions (10-20).

CategoriesStuff to Read While You're Pretending to Work

Stuff To Read While You’re Pretending To Work: 12/15/17

Ten days till Christmas. Like a bonehead I haven’t started any shopping yet. And by “like a bonehead” what I really mean is “like 97% of the population that has a Y chromosome.”

Apologies for the lame intro this week, but I got things to do/need to go help make Jeff Bezos richer.

On to this week’s list of stuff to read.

Copyright: wamsler / 123RF Stock Photo

But First

1. Coaching Competency Workshop – Dallas, TX

I’ll be in Dallas, TX later this month to put on my Coaching Competency Workshop.

I’ll break down assessment in addition to troubleshooting common strength-based exercises such as deadlifts, squats, shoulder-friendly pressing, to name a few.

This is ideal for any personal trainer, coach, or regular ol’ Joe or Jane looking to learn more on my coaching process.

Details are located on the flyer above, and you can purchase HERE.

2) Pedestals Make For Superior Stocking Stuffers

Speaking of ideas for gift shopping, give Pedestal Footwear a look. I’ve been a fan for years and think they’re THE most comfortable socks ever.

Plus, the added benefit is that they’re well-suited (and were actually designed) for meatheads who like to lift heavy things.

I make ZERO commission off pointing you in their direction. I just feel they’re a great company with a great product.

Go HERE.

3) Also, I’m Seeing Star Wars on Sunday.

via GIPHY

I thought I was going to be a lammo and have to revoke my Star Wars nerd card for not being able to go see it opening weekend.

However, my wife is the shit and made it so that we have a baby-sitter for six hours this Sunday.

Star Wars + Steak dinner afterwards = possibly a second baby being made.15

Stuff To Read While You’re Pretending To Work

The Olympic Lifts Are Overrated – Charles Staley

Internet’s Reaction To This Article: “Whaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaat?”

My Reaction: “Pretty much.”

6 Common Workout Myths That Are Holding You Back – Jeannine Trimboli

This was an excellent article. And given a trove of people will likely be heading to the gym at the start of 2018 to kickstart their fitness goals, I’d mark this one as a MUST read.

The Lifter’s Guide to Treating Tendinopathy – Sean Jacobs via TheBarbellPhysio.com

If you lift things up and down chances are your knee(s), elbow(s), achilles, etc, at some point or another, will get an ouchie.

Here’s your crash course on how to remedy the situation.

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