It was kind of hard to do just a 3 part list, as I have learned a ton this past year through my formal physical therapy educations as well as reading on my own to stay caught up in the strength, conditioning, and nutrition fields. However, the following 3 things really stood out this past year.
1. In the case of persons with lateral patellar subluxation and patellofemoral pain kinetic MRI reveals significantly more lateral displacement with non-weight bearing verses weight bearing exercise. In addition during closed chain weight bearing movements MRI revealed that the patella doesn’t actually move, rather that the femur internally rotates on the patella.The first thing I took out of this research is the importance of using weight-bearing or partial weight-bearing positions in positions to treat patients with PTFP and lateral subluxation to minimized patellar displacement and associated symptoms. Perhaps more importantly this research demonstrates the need to address the role of hip external rotators to maintain proper patellar alignment in closed chain activities. (Powers, 2003 JOSPT)
2. Breathing facilitates movement in the following ways:
Inhalation: thoracic extension/shoulder flexion/scapular elevation and glenohumeral internal rotation
Thus, when performing the preceding movements breathing should be used in conjunction to improve both quality and quantity of movement.
3. Don’t take the advice of our government when it comes down to nutrition and food intake recomendations .The obesity epidemic has dramatically rose since the year of 1980, which represented a major change in the dietary compositions of Americans. Americans began eating less fat, less red meat and dairy and ate more chicken, shortening, and soy oil. Coincidentally this was a year after the first “Dietary Guidelines for Americans” were produced.. Thanks food pyramid. For more charts and other interesting info about this trend check this out: file://localhost/. http/::www.ericcressey.com:healthy-food-options-why-you-should-never-take-nutrition-advice-from-your-government. Therefore in 2012 I’ll continue to have my daily dose of red meat, WHOLE eggs, real butter and full fat dairy products along with lots of fresh veggies and fruit of course.
“Neck-Packing” is a combination of strong cervical retrusion and capital flexion. In more simple terms, it is more or less making an unattractive double chin. Try this two-part process. Stand with your back against a wall and your head touching the wall. Wiggle your head up the wall to make yourself as tall as possible. Next, allow your chin to drop back toward your throat. You have now executed a packed neck. I have known for a while that training with your neck in a hyperlordodic position, like the guy in the picture below, is probably a safety issues and is going to lead to problems down the road.
However, not until recently watching Charlie Weingroff’s “Training = Rehab” did I begin to realize the performance implications as well. In movements used in training, such as swings and deadlifts, the spine functions as one long chain rather than as distinct sections of cervical, thoracic, and lumbar. The human spine has unique curves that allow it to act in a spring-like fashion to balance out compressive forces and accommodate shearing forces. Thus, when one area of the chain moves, the human body will respond by doing what it does best and compensate in other areas.
For now, lets consider the consequences of letting the neck drift into extension with a movement like the deadlift. When this occurs it causes what Mike Reinold has termed a “kinetic chain ripple effect“ (you can read more about this topic here: http://www.mikereinold.com/2011/11/the-problem-with-the-kinetic-chain-concept.html). When the head falls out of optimal alignment, strap muscles from the anterior neck that attach to the scapula pull it into slight protraction and elevation. The thoracic spine then accommodates by flexing slightly as well.
In addition, when cervical spine extends, the deep neck flexors become inhibited. As the deep neck flexors are intimately connected to the rest of the inner core (including the diaphragm, transversus abdominus, multifidus, and pelvic floor), inhibition leads to suboptimal or delayed contraction in these other important muscles of intrinsic stabilization.Further down, the lumbar spine will continue the previous compensatory patterns by falling into lordosis. This results in the lumbar spine relying posteriorly on bony approximation for stability and therefore telling the core stabilizers that they can take a break.
(This looks so much better!)
These may not seem like major changes and might not even be visibly noticeable all of the time. Nevertheless, these compensations bring the joints out of positions of centration where optimal stabilization and force transmission can occur. From a performance standpoint, this creates energy leaks where force is sub optimally transferred up or down the chain.
I believe that in all controllable training environments, packing the neck is a key feed-forward mechanism you can use that will lead to improved performance and safety. At first when attempting this with your training, you might have to lower the weights and really focus on keeping the neck in the right position.I have found, though, after practicing it for several months, it has become more reflexive and something I have started to find myself doing out of habit. Check out Bret Contreras in the video below for a good demo of what this looks likes.
The push-up should be a staple in any exercise program, whether the goals be related to strength, hypertrophy, athleticism, or aesthetics. However, there is a little more to this exercise than most people realize. This lack of knowledge often leads to incorrect technique, which in turn leads to not getting the most benefit out of doing this great exercise. I am going to point out 3 of the more common mistakes I've seen with push-ups as well as give some ways to fix them and make this exercise even more effective. There is an attached video below for reference to each of the mistakes I will describe.
First off, many people will often do push-ups with their elbows flared out at about 90 degrees from their sides. The main reason this happens is because it simply makes the exercise easier, albeit less effective and more likely to lead to shoulder and elbow issues down the road. With the elbows flared like this, the pectoral fibers are in a position better suited to produce force. In addition to this, EMG research has shown that with the elbow in this position as opposed to keeping them at more of a 45 degree angle, the exercise results in less muscle activation in the pecs and triceps. Since a number of people (especially bench press loving males) have a deficit in shoulder horizontal abduction, flaring the elbows up lets them use the muscular tightness to help push them out of the bottom portion of each rep.
The second common mistake is letting the hips sag, especially on the concentric (upward) portion of each repetition. This is also referred to as “caterpillaring,” as you can observe in the attached video. What happens is that on the way up, the shoulders rise faster than the hips, causing extension through the lumbar spine and possibly associated anterior pelvic tilt. This can happen for several reasons. The first would be simply due to the fact that it makes the exercise easier and creates the illusion that you are performing full range reps. You only pushing part of your lower body up as the hips sag behind, instead of pushing your whole body up as a single unit in a correctly performed pushup. This is often fixed by some simple verbal or tactile cues. The second reason is due to the lack of interior “anti-extension” core strength.Compensation for this weakness occurs by hanging on ligamentous supports such as the hip flexors anteriorly as they fall into anterior pelvic tilt, and through approximation of vertebrae in the lumbar spine posteriorly.These individuals probably have tight hip flexors and lumbar extensors along with weak glutes and rectus abdominus.
The third common mistake seen is limiting the range of motion by jutting the chin forward on each rep. This can also occur for several reasons. The first is that the individual’s deep neck flexors may be weak and working against the extra force of gravity in the prone position is just to much for them. If a person has a slight forward head posture in standing, it is often magnified when assuming a prone position. The other reason for doing this involves lessening the range of motion so that the clear bottom position is avoided. The bottom position requires one to hold up the highest percentage of body weight as the body should be close to parallel with the floor. This could also be an ego issue. It’s pretty easy to rep out on push-ups doing it this way versus using correct form and banging out fewer than 10 reps.
There are several things that can be done to avoid these mistakes as well as to increase the effectiveness of this exercise. The first correction deals with problems related to flaring out the elbows. A way to help with this would be to slightly turn your hands outward. This makes keeping those elbows in less than a 45 degree angle much easier, and it also prevents them from flaring out. This position also shortens the lever arm, allowing higher activation of the pecs and triceps, and it brings the lats on board to help with core stabilization via the tightening of the thoracolumbar fascia. As far as grip width, the best advice would be to try to find a position that puts your elbows straight over your hands in the bottom position, as well as puts your elbows just behind your shoulders. This position allows for the optimal sharing of forces over the wrist, shoulder, and elbow joints.
As far as correcting the hip sag problem, there are several different things that may help out. The first would be to begin by tightening up your body in the top position. Think that someone is going to bump into you from the side at any minute. Next squeeze your armpits down to engage your lats and “pull” yourself into the bottom position. Don’t just relax and fall into it the bottom. If you tend to go into anterior pelvic tilt, then think about setting yourself into a neutral position by squeezing the glutes hard. If you are still unable to adequately stabilize your torso, choose a regression exercise variation that decreases the stability demands.
In addition, think about pulling your chin back into your neck and holding it there for the duration of the exercise. Your chin/nose should never touch the floor before your chest does. If you are unable to do a correct full range of motion, find a variation that allows you to do so, and build your strength levels from there.One you have mastered a given variation, move on to more advanced exercises. Never sacrifice movement quality for quantity.
I recently finished the book Supertraining by Mel C. Siff. It was a beast of a read, but had tons of great information and I would highly recommend it to anyone seriously interested strength training and rehabilitation. I took a lot away from the book, so I would like to share some key bits that really stood out. One point Mel touched on was concerning how different tissues adapt at different rates throughout the body. The discussion on this point made me rethink some of the things I have done in the past as well as make sure I have some checks to keep me honest and provide the best and safest training experiences for the clientele I will work with in the future.
To quote some research from the book... “Muscle tissue adapts to increasing loading within several days whereas the connective tissue (tendons, ligaments, and joint capsules) or systems which contain a high proportion of connective tissue (bone and cartilage) only display significant adaptation and hypertrophy after several weeks or months of progressive loading (McDonagh & Davies, 1984)”.
This got me to thinking about some of the athletes and clients that I have worked with in the past, especially those who were fairly new to strength training or those having a low training age. With this population, strength gains tend to initially occur in leaps and bounds as almost anything you have them do makes them stronger. Thus, it can become easy to just keep upping the poundage fairly drastically week in and week out. However, as Mel points out, one must take into account how different tissues adapt at different rates when prescribing loading. Even though these people’s muscle tissues have adapted to the increased loading they are encountering, it is more than likely some of the connective tissue adaptation is lagging behind. These factors leave these individuals at an increased risk for injury especially during heavy loaded strength exercises, since at slower loading rates the body insertion of a ligament or tendon is the weakest component of bone-soft tissue complex.
With that being said, our first rule should always be to no harm. Thus, there are some practical things we can do to keep progressing our clients and athletes without putting them at an increased risk for injury. First and foremost, technical proficiency must be demonstrated in a specific lift with bodyweight or light loads before additional loading is considered. After that, keep a close eye on the person and terminate the set as soon as there is any break in form. With specific increases in loading, use good judgment. A ten point jump in a lift after a week would be drastically different when working with a junior linebacker versus a freshman volleyball player. Slowly and gradually build up the lifts and make communication with clients and athletes a priority. Muscle soreness from DOMs is to be expected and is a normal part of the training process; just make sure it never lasts for more than a few days. In addition, if the person is sore, make sure it is limited to the muscles and not felt in tendons or joints. Following the preceding steps can go a long way toward helping your clients and athletes stay healthy and on the path to achieving their goals without encountering any major setbacks in the training process.
