posture – All Me Fitness

Perfecting Your Normal

Many anatomical differences mean each person will need to move in a customized way that suits their body, and unless you’re ambidextrous you shouldn’t expect to move the same way with each side of your body.

Pretty much everyone who has worked out at a gym has had the experience of getting advice (frequently unsolicited) about how to do an exercise properly. frequently, this advice comes with the intent of helping you avoid injury, maximize your efficiency, or to hit on you. However, I am about to blow your mind with a revelation. People come in all shapes and sizes. Brilliant as this view of human nature may be, it is something that is forgotten far too often in the gym. People are not machines. We are not all built the same way, move uniformly, or require the same fuel. Many anatomical differences mean each person will need to move in a customized way that suits their body, and unless you’re ambidextrous you shouldn’t expect to move the same way with each side of your body. So all that advice you’re getting on how to squat normally may be a load of crap, but I am here to explain how you can do the best with what you got to perfect your body’s normal.

Red Flags

Don’t go running off to the gym and start using the equipment all willy nilly thinking that there is no wrong way to move. Because there is. It’s a large part of my job to make sure you don’t jack yourself up by doing something you saw on Instagram. When it comes to movement, I worry about the red flags, not the minutia. A red flag that can be revealed by a squat test might include knee valgus, or knock knees. We know this can lead to knee pain and ACL tears in athletes (1). There you have it, folks! If you’re an athlete and you have knock knees then you should work on that. Do you have back pain? Well if you hurt you back by falling down, doing a dead lift, or in a car accident, then those are red flags. But there is no magic stretch, strengthening program, or posture that are red flags or fixes for that matter. I’ve written about it before, but I’ll say it again “Neck pain is not greatly associated with neck posture (2). Sagittal (front to back) spinal curve does not relate to spinal health or back pain (3). It is highly likely that we all have disc degeneration, a bulging disk, and/or protruding disk in our back right now, and that’s normal (4). It’s not an unequal leg length that’s causing your back pain (5). Even the best athletes in the world have asymmetrical muscle size and movement patterns, and they don’t have issues caused by them (6,7).“

Why We Must Move Differently

I’ll keep this brief. We must all move differently because of our bone structure, muscle/tendon location, and injury history requires us to. We are all so different that it’s impossible to define perfect posture let alone perfect movement. As our bones grow and change, they don’t do so uniformly. Most people know that women have wider hips than men because of the birthing process. Well, there are similar genetic differences amongst everyone that can lead to the bones of the hip to stop you from moving in an “optimal” way (8). It’s also why the phrase “squat like a baby” is total crap. The image bellow gives a good visual on how the hip can be different from person to person. This is why no amount of foam rolling, stretching, or muscle activation will help with “tight hips” in some individuals.

Making It Work For You

So here’s where we get down to business. If you, or someone you know, have specific questions about pain, performance, or application of any of the following suggestions, be sure to set up a one on one session with me by replying to this email so we can get into specifics for you.

It’s no secret that exercising can come with aches and pains. Commonly, the shoulder, back, and knee joints. What you need to know is that pain does not always mean there is tissue damage. It may simply mean you are overstressing a particular structure. Which is why switching from back squat to front squat can alleviate knee pain even though you are still putting pressure on the joint. If your knees move towards the outside of your feet too much try taking off your shoes (9). If squatting makes your back hurt, decrease the amount of weight that you use, squat deeper, and allow your knees to go in front of your toes as seen in the picture below (10). You can also adjust the depth of the squat, foot stance, and barbell location to target specific muscles which I wrote about extensively in this post.

If you want to build a bigger chest, use less weight on your bench press because of the heavier the weight the more you use your shoulders and triceps (11). In fact, getting more reps in is the name of the game. Stretching before you exercise will decrease the strength and muscle gain you can achieve, and may not even be achieving anything worthwhile, to begin with (hip flexors in particular) (12). A little cheating isn’t always a bad thing if a bit of a swinging/momentum gets you to squeeze out an extra few reps (13). At the end of the day, perfecting your normal means you are experimenting with technique so you don’t feel pain/do feel the targeted muscles work, you are getting as many weighted reps in a possible, and you gradually increase your body’s ability to do more work. This may require a trained eye, but it will never require a universally true way to do things.

Resources

1. Quatman, C. E., Kiapour, A. M., Demetropoulos, C. K., Kiapour, A., Wordeman, S. C., Levine, J. W., … & Hewett, T. E. (2014). Preferential loading of the ACL compared with the MCL during landing: a novel in sim approach yields the multiplanar mechanism of dynamic valgus during ACL injuries. The American journal of sports medicine, 42(1), 177-186.

2. Grob, D., Frauenfelder, H., & Mannion, A. F. (2007). The association between cervical spine curvature and neck pain. European Spine Journal, 16(5), 669-678. doi:10.1007/s00586-006-0254-1

3. Christensen, S. T., & Hartvigsen, J. (2008). Spinal curves and health: A systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health. Journal of Manipulative and Physiological Therapeutics, 31(9), 690-714. doi:10.1016/j.jmpt.2008.10.004

4. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., . . . Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American Journal of Neuroradiology, 36(4), 811-816. doi:10.3174/ajnr.A4173

5. Grundy, P. F., & Roberts, C. J. (1984). Does unequal leg length cause back pain? A case-control study. Lancet (London, England), 2(8397), 256.

6. Hides, J., Fan, T., Stanton, W., Stanton, P., McMahon, K., & Wilson, S. (2010). Psoas and quadratus lumborum muscle asymmetry among elite australian football league players. British Journal of Sports Medicine, 44(8), 563-567. doi:10.1136/bjsm.2008.048751

7. Hespanhol Junior LC, De Carvalho AC, Costa LO, Lopes AD. Lower limb alignment characteristics are not associated with running injuries in runners: Prospective cohort study. Eur J Sport Sci. 2016 Jun:1–8. PubMed #27312709.

8. Pollard, T. C. B., Villar, R. N., Norton, M. R., Fern, E. D., Williams, M. R., Murray, D. W., & Carr, A. J. (2010). Genetic influences in the aetiology of femoroacetabular impingement. Bone & Joint Journal, 92(2), 209-216.

9. Southwell, D. J., Petersen, S. A., Beach, T. A., & Graham, R. B. (2016). The effects of squatting footwear on three-dimensional lower limb and spine kinetics. Journal of Electromyography and Kinesiology, 31, 111-118.

10. Hartmann, H., Wirth, K., Mickel, C., Keiner, M., Sander, A., & Yaghobi, D. (2016). Stress for Vertebral Bodies and Intervertebral Discs with Respect to Squatting Depth. Journal of Functional Morphology and Kinesiology, 1(2), 254-268.

11. Król, H., & Golas, A. (2017). Effect of Barbell Weight on the Structure of the Flat Bench Press. The Journal of Strength & Conditioning Research, 31(5), 1321-1337.

12. Junior, R. M., Berton, R., de Souza, T. M. F., Chacon-Mikahil, M. P. T., & Cavaglieri, C. R. (2017). Effect of the flexibility training performed immediately before resistance training on muscle hypertrophy, maximum strength and flexibility. European journal of applied physiology, 1-8.

13. Arandjelović, O. (2013). Does cheating pay: the role of externally supplied momentum on muscular force in resistance exercise. European journal of applied physiology, 113(1), 135-145.

Get A Sexy Back & Healthy Shoulders By Doing This

For nearly all of us, there is one muscle group that’s often ignore which can keep our backs looking good and shoulders strong.

With pool, beach, and wedding season right around the corner, most of us are thinking about the implications of showing some skin. For others, our thoughts may rest completely on the thought of keeping our body healthy and pain-free. For nearly all of us, there is one muscle group that’s often ignore which can keep our backs looking good and shoulders strong. And that muscle is….

The Serratus Anterior

The serratus anterior (SA), AKA boxer’s muscle does a lot. When it’s strong, the SA holds scapula (shoulder blade) against the thoracic wall (the rib cage) and rotation of the scapula. But when the SA is weak, it can lead to a forward head posture, winging scapula, subacromial impingement, rotator cuff tears, glenohumeral inferior instability, sternoclavicular joint pain, acromioclavicular joint pain, glenohumeral osteoarthritis, frozen shoulder syndrome, scoliosis, lateral epicondylalgia, kyphosis, thoracic outlet syndrome, headaches, neck pain, and upper crossed syndrome (1,2). Aesthetically, scapular winging can lead some to avoid open back dresses or leaving the shirt on at the pool.

The Fix

For most people, I recommend some basic thoracic spine mobility drills. If you’re in a rush, some simple thoracic spine foam rolling for about 30 seconds will do in a pinch. As for exercises, the easiest thing you can do is incorporate pushups into your workout routine! Pushups are great for building SA strength when done correctly (3). And while I could write a book on the mistakes that can be made while doing pushups, let’s focus in on how to do them correctly. Keep your hands directly under your shoulders, brace the abdomen, keep your head and neck in neutral alignment with your spine (don’t look at your toes), and emphasize the last little bit of pushing at the end of each repetition. If you are already a proficient pushup pro, there are always fun ways to spice it up a bit like using a stability ball under your feet, BOSU ball under your hands, and performing pushups on an uneven surface.

Another great exercise is the dynamic hug. In this exercise, you use a resistance band wrapped around your back to increase the resistance of moving your arms forward for a hug. When done correctly, it should look the same as when my wife hugs me after I workout and stink like an old gym sock. Of course, there are dozens of exercises that work wonders for strengthening the SA, but these two exercises are safe, easily modified, and are very effective.

Bottom Line

At the end of the day, most of us exercise for our health and/or to look good in our birthday suits. Hitting the serratus anterior on a regular basis is a great way to accomplish both at the same time. So the next time you’re in the gym if you hear a trainer say “drop down and give me 20” you know it’s for a good reason.

Resources

1. 4Fayad, F., Roby-Brami, A., Yazbeck, C., Hanneton, S., Lefevre-Colau, M., Gautheron, V.. . Revel, M. (2008). Three-dimensional scapular kinematics and scapulohumeral rhythm in patients with glenohumeral osteoarthritis or frozen shoulder. Journal of Biomechanics, 41(2), 326-332. doi:10.1016/j.jbiomech.2007.09.004

2. Nagai, K., Tateuchi, H., Takashima, S., Miyasaka, J., Hasegawa, S., Arai, R.. . Ichihashi, N. (2013). Effects of trunk rotation on scapular kinematics and muscle activity during humeral elevation. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 23(3), 679-687. doi:10.1016/j.jelekin.2013.01.012

3. Decker, M. J., Hintermeister, R. A., Faber, K. J., & Hawkins, R. J. (1999). Serratus anterior muscle activity during selected rehabilitation exercises. The American journal of sports medicine, 27(6), 784-791.

Biomechanics Aren’t As Important As You Think

With so many variables to consider, how can anyone claim to really know what’s supposed to happen when any given individual moves?

These days it seems like everyone’s a biomechanics expert. From gym teachers to physical therapists, to personal trainers, and even fringe clinicians like chiropractors and massage therapists think they have the end all be all answer to the way we should move. With so many experts around, I had to ask myself “is anyone right?” Don’t get me wrong, I’ve spent years studying movement, so I am in no way saying there isn’t something to proper movement. But, with so many variables to consider, how can anyone claim to really know what’s supposed to happen when any given individual moves? A quick breakdown of variables to consider would include 3 independent planes of motion (never used in isolation), 46 miles of nerves, 206 bones, 100-300 major muscles (out of 700), 360 joints, and seeming endless ways of combining them to move. I would need help from a statistician just to figure out how many ways there are to move, so how can anyone really know how to move perfectly?!?! Well, one thing is for sure, we can only guess and learn from the best.

Biomechanical Boogymen

All too often I have people tell me that they can’t do things because their chiropractor found something on their X-ray, their trainer said it was bad for their joints, or their massage therapist said it was giving them trigger points. When I dig a little deeper, I general find that there is nothing to substantiate the claims. Why? Because I know that some practitioners use fancy terminology to sell their services knowing that less educated folks are somewhat more likely to swallow fancy-sounding bull**** (1). And because being asymmetrical and/or abnormal is normal! Neck pain is not greatly associated with neck posture (2). Sagittal (front to back) spinal curve does not relate to spinal health or back pain (3). It is highly likely that we all have disc degeneration, a bulging disk, and/or protruding disk in our back right now, and that’s normal (4). It’s not an unequal leg length that’s causing your back pain (5). Even the best athletes in the world have asymmetrical muscle size and movement patterns, and they don’t have issues caused by them (6,7). To sum it all up, movement systems seem to have reserve capacity to allow for asymmetry and imperfections to exist without failure or symptoms (8). You’re not made out of glass and tissue paper, and pain is complicated!

The Catch

No, you do not have free reign to ignore your exercise technique and/or posture. This is because we know there are ways to avoid hurting yourself! For instance, we know that runners with weak hamstrings are more likely to be injured (9). We know that rounding your back during a deadlift is bad. But, a lot of other technique coaching tips are sort of just semantics for the deadlift. My point is, there are things that we can do to control the likelihood of injury, but seeking perfection is fruitless because it doesn’t exist. Personally, I believe that being in tune with your body is one of the best things you can to do know what’s causing you pain or discomfort. By this, I mean you should have a general sense of what your body is doing. Have proper motor planning by figuring out the actual steps involved in a movement (i.e. map out all the steps from point A to point B). Learn to have motor control by practicing perfect technique in a mirror. Gain proprioception by having a sense of knowing where your body is in space. Enhance this skill by selectively contracting individual muscles, and balancing on one leg with your eyes closed. If you don’t know whether you’re moving well, how can you tell when you’re not? Was it really that deadlift that bothered your back, or was it from sitting in hunched-over position?

What’s most important when considering all of this, is getting strong. You can’t alter biomechanics without getting strong. It takes over 1,000 lbs. of force to deform fascia by even 1% (10). So foam rolling and massage won’t change your biomechanics. Having your back cracked or hips adjusted back into place may feel good, but it’s temporary and normal for things to go back to the way they were. That is unless you get stronger overall. It’s funny how things work out when you keep the body moving. Even if you don’t have textbook technique.

References

1. Weisberg, D. S., Keil, F. C., Goodstein, J., Rawson, E., & Gray, J. R. (2008). The seductive allure of neuroscience explanations. Journal of Cognitive Neuroscience, 20(3), 470-477. doi:10.1162/jocn.2008.20040

2. Grob, D., Frauenfelder, H., & Mannion, A. F. (2007). The association between cervical spine curvature and neck pain. European Spine Journal, 16(5), 669-678. doi:10.1007/s00586-006-0254-1

5. Grundy, P. F., & Roberts, C. J. (1984). Does unequal leg length cause back pain? A case-control study. Lancet (London, England), 2(8397), 256.

8. Lederman, E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain. Journal of Bodywork & Movement Therapies, 15(2), 131-138. doi:10.1016/j.jbmt.2011.01.011

9. Devan, M. R., Pescatello, L. S., Faghri, P., & Anderson, J. (2004). A prospective study of overuse knee injuries among female athletes with muscle imbalances and structural abnormalities. Journal of Athletic Training, 39(3), 263-267.

10. Chaudhry, H., Schleip, R., Ji, Z., Bukiet, B., Maney, M., & Findley, T. (2008). Three-dimensional mathematical model for deformation of human fasciae in manual therapy. The Journal of the American Osteopathic Association, 108(8), 379.

Do This Super Super Set!!!!

The dynamic duo of fitness dominance, the walking lunge and renegade row!

Today’s topic is exercise! For those of you who don’t know what a super set is, I recommend you read my prior post discussing them in detail, as well as this blog post on the basics of training for beginners. The TL;DR version can be described as exercises targeting unrelated muscles done back to back. And today’s super set is one of my favorites… The walking lunge and renegade row! So let’s dive into the details of this dynamic duo of fitness dominance!

Deconstructing The Walking Lunge

If you have ever seen me at the gym shuffling around and looking like I’m straight out of an episode of The Walking Dead, it’s probably because I just finished doing some walking lunges. That’s because the walking lunge uses loads of muscles including the gluteus maximus, iliopsoas, quadriceps (vastus lateralis, vastus intermedius, vastus medialis, rectus femoris), hamstrings (semimembranosus, semitendinosus, biceps femoris), calf (soleus and gastrocnemius), and all the muscles of the trunk (1).

When done properly, the lunge is an excellent exercise to increase the strength of the leg and reduce the likelihood of injury for runners, field sports athletes, and those who actually do “leg day” from time to time (1,2). But, it needs to be done properly. So let’s go over how to do it right. Then, let’s go over how most people lunge.

The Correct Form

Begin By – Feet are between hip- and shoulder-width apart and pointing forward. Torso should remain erect. Keep chest out and up. Shoulders are back. Keep head and neck straight with eyes looking straight ahead. Before stepping forward, breathe in and hold it.

The Descent – Take an elongated step straight forward with one leg (lead leg). Keep your arms straight, with the dumbbells held firmly at your side and your torso in an erect position, as the lead foot goes forward and comes in contact with the floor. The rear leg (trail leg) remains constant in the starting position, but as the lead leg moves forward, balance should shift to the ball of the foot of the trail leg as the trail leg begins to flex. Place the lead foot flat on the floor with the foot pointing straight forward. Once balance is established on both feet, flex the lead knee to enable the trail leg to bend towards the floor. The trail leg should flex to a degree slightly less than the lead leg. The lowest finish position of the descent should occur when the knee of the trail leg is 1–2 in. from the floor, the lead leg is flexed to 90°, and the knee is directly above or slightly in front of the ankle. Continue to hold your breath throughout the descent.

Rise Up – While maintaining an erect torso, shift the balance forward to the lead foot and forcefully push off the floor with the lead foot. As the lead foot returns to the starting position, balance should shift to the trail foot, resulting in the trail foot regaining full contact with the floor. The lead foot should be lifted back to its original starting position, with

feet between hip- and shoulder-width apart and pointing forward. Avoid touching the lead foot to the floor until it is returned to the finish position (unless balance is lost).

LD;DR video

While these instructions are very specific and technical, they are important and correct (3). Of course, lunges won’t work for everyone. But, under proper supervision, you can modify the lunge to work for you even if you have pain in your knees or hips. Now let’s take a look at what most of us struggle with!

Common Mistakes

Leaning Back – When you lean back too far, your rib cage flares and your spine hyper-extends. This is so bad for your back that it hurts the guy watching you from across the gym! Work on that core control ASAP!

Side To Side Knee Movement – When your knee caves in or flops out, it is often the telltale sign of weak glutes. And there are lots of fun ways to fix that!

Poor Balance – This ties in with the knee movement because they both can be caused by weak feet. Weak and unstable feet will cause a chain reaction of instability and dysfunction throughout your entire body. Just another reason to have strong feet!

The Renegade Row

The jig is up. The news is out. They finally found me… on the floor doing renegade rows! If you don’t know what song I’m referencing then shame on you! Okay moving on. The Renegade Row is a tremendously effective exercise that develops upper body pulling strength (back and biceps), lumbo-pelvic (abs and hip) strength and control, as well as shoulder stability, a quality that is lacking in most people. In fact, it is one of the best exercises to do for the prevention of shoulder pathologies such as impingement and rotator cuff tears (4). This is because the renegade row has all the benefits of a plank while making you feel like a beast from lifting weights. But once again, if you’re not doing it right, you will pay the price!

Technique

Start – Get into a plank position with feet shoulder-width apart, maintain neutral spinal alignment for the duration of the exercise. Each of your hands should be gripping a dumbbell directly under your shoulders.

The Up – Keeping your hips and body completely neutral by actively tucking your rib cage towards your hips, row one dumbbell up to your ribs by initiating the pull with the muscles in your mid-back, not your arms. Be sure to end your rowing motion when your elbows are around the height of your ribs.

The Get Down – Bring the dumbell back to the start and repeat with the opposite hand without rocking from side to side.

TL;DR Video

Like the lunge, this technique should be simple but is often completely butchered. Here’s what’s going wrong, and how to fix it.

Poor Hip Control – If your butt is way up in the air, down near the ground, or twisting all over the place, you’re doing it wrong. The arms are the only part of the body where the movement should be occurring. Practice being a plank for a while and consider using less weight if you struggle with these issues.

Using Momentum – If your elbow travels well past the ribs during the rowing movement, body twists, or hips collapse and/or pike, you’re swinging for the fences too much. Use less weight, so you can control your body. That’s the name of the game, control.

Poor Shoulder Stability – Shoulder instability might be due to a past injury, an unbalanced training program, or weakness in general. Get your shoulders checked out by an exercise pro if they are causing you problems.

Super Set Super Ending

So, back to my original point. These exercises make for a great freaking super set. When done correctly, they both promote dynamic control of the hips, prevent future injury of almost the entire body, and burn some major calories. They are also fantastic for posture and getting out of the bad movement habits that sitting at a computer all day long creates.

If you want strong and sculpted legs, glutes, abs, arms, and back muscles, be sure to super set walking lunges and renegade rows. Four sets of 10 reps with a low weight for each should do it at first. So get moving!

References

1. Kritz, M., Cronin, J., & Hume, P. (2009). Using the body weight forward lunge to screen an athlete’s lunge pattern. Strength and Conditioning Journal, 31(6), 15.

2. Whatman, C., Hing, W., & Hume, P. (2011). Kinematics during lower extremity functional screening tests–Are they reliable and related to jogging? Physical Therapy in Sport, 12(1), 22-29. doi:10.1016/j.ptsp.2010.10.006

3. Graham, J. F. (2007). Dumbbell forward lunge. Strength and Conditioning Journal, 29(5), 36-37. doi:10.1519/00126548-200710000-00005

4. Arlotta, M., LoVasco, G., & McLean, L. (2011). Selective recruitment of the lower fibers of the trapezius muscle. Journal of Electromyography and Kinesiology, 21(3), 403-410. doi:10.1016/j.jelekin.2010.11.006

Core Concepts

The core is the keystone to a strong body, but there is so much more to it than that.

Today we are talking the importance of the core!!! I get a lot of questions about the core and why it’s important. In general I say that it is the keystone to a strong body, but there is so much more to it than that. Today’s article was published by the prestigious National Strength and Conditioning Association and does an excellent job in describing what the core is, why it’s important, and what we can do to make it stronger.

Here are a few highlights:

1.Core stiffness is essential for injury prevention and performance enhancement.

2. Stiffening the core between the hip and shoulder joints, produces higher limb speed and force.

3.Core training to enhance stiffness is the foundation and underpinning of one of the most fundamental laws of human motion.

A great quote from the paper describes what the core actually does “proximal stiffness enhances distal mobility and athleticism.” An example of this importance involves the pelvis when walking. If you can’t sufficiently stiffen the lumbar spine with quadratus lumborum (QL), your whole body will simply bend to the side the stance phase (foot on the ground part) of the walking cycle. This is because the QL is an essential core muscle forming the outside core. “What else can core training do” you ask? Well not much I guess. Except reduce the risk of back injury, enhance performance, reduce the risk of groin injury, sportsman’s hernia, and knee injury, particularly to the anterior cruciate ligament (ACL). Essentially, noone can afford to neglect this building block of function. So work on your core to enhance stiffness by doing things like suitcase carries, farmers walks, and planks.

All About Shoulder Strength & Stability

How to maximize your shoulders’ ability to move in a safe and injury resistance manner.

You have a choice. You can either move around in almost any direction, but be at a high risk of injury, or you can be strong, stable, and at a low risk of injury, but you can only move around a little bit. Which choice sounds better to you? Well, if you’re the joints of the hands and feet you chose the latter. But if you’re the shoulder joint, you chose the former. Being such a dynamic joint with a very low level of stability, the shoulder is naturally very prone to injury. That’s why today’s post is all about how to maximize your shoulders’ ability to move in a safe and injury resistance manner.

How It Works

There’s a lot of moving parts when we talk about getting the arm overhead. There are 12 ribs and their spinal attachments, 10 of which have attachments at the chest. You also have scapular motion through 3 dimensions (to the side, to the front, and rotations), humeral rotation and alignment within the glenoid fossa, AC and SC joint motions or limitations, spinal motion of, at minimum, the 12 thoracic spine segments, and 24 muscles that attach through the thoracic spine, scapula and humerus. In total, there’s motion from 38 joints, making for a whole lot of potential for things to get wonky. By simply raising your arms overhead, a trained eye can tell a lot about what’s going on in the upper body. Take a look at the table below, or this video, to see how important it is for the muscles and the joints of the upper body to be in sync (1).

What’s The Worst That Could Happen?

One thing that drives the issues seen above is the ever-growing tendency for us to sit! Putting other health issues aside, sitting is bad for us because it drives poor posture. Sitting drives the head forward and bends the spine in a way that makes it difficult for the shoulders to allow the arm to get overhead. It also decreases the flexibility of the big Lats and reduces the strength of the lower traps, rotator cuff, and serratus anterior (2). You may not care about those muscles, but what you probably care about is the fact that these issues can cause problems that include subacromial impingement, rotator cuff tears, glenohumeral inferior instability, sternoclavicular joint pain, acromioclavicular joint pain, glenohumeral osteoarthritis, frozen shoulder syndrome, scoliosis, lateral epicondylalgia, kyphosis, thoracic outlet syndrome, headaches, neck pain, and upper crossed syndrome (3,4). YIKES!

What’s The Best Solution?

The best solution always depends on the problem. So what’s your problem? Well, if you have to ask, you may want to seek out a professional to help you find out. In general, most people should work on a few things in particular. If you are fit and looking to do overhead or military presses to get big strong shoulders, you need to work on technique and changing up your mode of training (i.e. using resistance bands with dumbbells, bottoms up training, or changing the plane of motion). If you’re not quite ready for that level of intensity, you should be working on some basics. Essentially, you need to get some scapular (shoulder blade) positional stability and glenohumeral stability. Try to resist rotating the torso, and use a little bit of abs to hold it all together. Here are some great exercises to work on basic shoulder stability (5,6):

Prone extension – Lie face down with the shoulders resting in 90° and raise the arms up off of the ground

Forward flexion in side lying – While lying on your side with your top arm straight, raise and lower your arm off of the ground

External rotation in side lying – While lying on your side elbow flexed 90°, rotate your arm upward with a towel between the elbow and trunk to avoid compensatory movements

Prone horizontal abduction with external rotation – While lying face down hands by your hips, raise your arms off of the ground and squeeze your shoulders together

Push up plus – While in a push up position against a wall or on the ground, perform a full push up and emphasis on an extra push once the arms are fully extended (bonus points for using an unstable surface)

Plank walking – Hold a push-up position with the feet together and walk the hands sideways while keeping the feet in place making an arch

Bottom Line

To have healthy shoulders, good posture, and lower chances of upper body pain and injury, you need to work on the basics. External rotation exercises are underappreciated by almost everyone. Whether you like to lift heavy weights, or if you simply want to place a can of beans on the top shelf without pain, you need to be working on shoulder health. And while there are many ways to achieve happy shoulders, simply working on the muscles of the back is a good place to start. So, sit up in your chair, roll your shoulders back a few times, and take a deep belly breath. See how easy it is to get started?!

References

1. Howe, L., & Blagrove, R. (2015). Shoulder function during overhead lifting tasks: implications for screening athletes. Strength and Conditioning Journal, 37(5).

2. Weon, J., Oh, J., Cynn, H., Kim, Y., Kwon, O., & Yi, C. (2010). Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. Journal of Bodywork & Movement Therapies, 14(4), 367-374. doi:10.1016/j.jbmt.2009.06.006

3. Nagai, K., Tateuchi, H., Takashima, S., Miyasaka, J., Hasegawa, S., Arai, R.. . Ichihashi, N. (2013). Effects of trunk rotation on scapular kinematics and muscle activity during humeral elevation. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 23(3), 679-687. doi:10.1016/j.jelekin.2013.01.012

4. Fayad, F., Roby-Brami, A., Yazbeck, C., Hanneton, S., Lefevre-Colau, M., Gautheron, V.. . Revel, M. (2008). Three-dimensional scapular kinematics and scapulohumeral rhythm in patients with glenohumeral osteoarthritis or frozen shoulder. Journal of Biomechanics, 41(2), 326-332. doi:10.1016/j.jbiomech.2007.09.004

5. De Mey, K., Danneels, L., Cagnie, B., & Cools, A. M. (2012). Scapular muscle rehabilitation exercises in overhead athletes with impingement symptoms: Effect of a 6-week training program on muscle recruitment and functional outcome. The American Journal of Sports Medicine, 40(8), 1906-1915

6. de Araújo, R. C., de Andrade, R., Tucci, H. T., Martins, J., & de Oliveira, A. S. (2011). Shoulder muscular activity during isometric three-point kneeling exercise on stable and unstable surfaces. Journal of Applied Biomechanics, 27(3), 192.

Serape Diem: Functional Core Exercise’s You Should Be Doing

How are you going to translate the force produced from those strong legs to the arms? By utilizing the Serape effect of course!!!!

Imagine your body is made up of two big blocks of meat. You have your upper body and you have your lower body. Now imagine you want to use both of those big blocks of meat simultaneously to do something like throw/hit a ball, dig a hole or golf , push a cart full of groceries, or punch a heavy bag. How are you going to translate the force produced from those strong legs to the arms? By utilizing the Serape effect of course!!!! The Serape effect is basically the use of the core to translate force from the lower body through the arms. There are a variety of “functional” exercises that you can, and should, be doing to make sure you’re not overusing joints which can lead to injury. So now that you have a little background knowledge, let’s dive into today’s post!

“Functional”

The term “functional training” is a bit of a buzzword garbage term. My favorite quote regarding this is from James Fell that says “It’s meaningless. Any time someone says an exercise is functional it means they don’t know what they’re talking about. All exercises are functional. Your mom is functional.” Funny and true. All exercise has function, and a variety of exercise is important to maintain function. For instance, if you exclusively use exercise machines, you may lose the ability to use those strong muscles in a rotational fashion. That’s where the functional aspect of training the Serape comes in. Broadly, the core can be described as being between the joints of the shoulders and hips.The muscles that attach the pelvis, spine, and rib cage perform many functions. Hip musculature generates the majority of power, then transfers it upward through the linkage to the arms through a “stiffened” core, which creates efficient transfer of forces, and is one of the keys to injury prevention. The Serape involves these features from both ends of the core in a spiral pattern (1). It actually wraps itself around the trunk of the body, perfectly designed for rotating the hips and shoulders in an opposite direction allowing the hips to lead and the shoulder to follow in many ground-based activities such as throwing, batting, golfing, or punching (2). Take a look at the pictures below and/or this video for a good visualization of how it works.

If you’re a nerd like me and want to know what exact muscles are involved, here are some pictures detailing the exact muscles used with the Serape.

Serape Training For Beginners

Training the Serape muscles is easier than it looks. Yes, there are a lot of muscles involved. But remember, we are not isolating any single muscle in particular, we are learning how to use them all in an efficient manner. If you’re not doing so already, you will want to start doing Olympic-style lifts and traditional strength lifts such as squats, bench press, and pull-ups. These are non Serape specific exercises, but if you don’t have strength in the upper and lower body then you won’t have strength to translate through the core to begin with! You will also want to start by training the four basic trunk movement patterns with dynamic and/or static exercises. Beginners should do exercises that train in what we call single-plane basic movement patterns. Single-plane exercises are usually easy to learn and include exercises such as the crunch (trunk flexion), back extension/hyper-extension (trunk extension), Russian twist (trunk rotation), and side bend (lateral flexion) (3).

For those more advanced, you may want to consider multi-plane exercises that target areas you’re not getting with your standard training. This is because there is huge inter-personal variety in terms of which ab-exercises work best for whom (4). By simply extending your arms over your head during a crunch, you can drastically increase abdominal muscle involvement. Take a look at the chart below to get an idea of what exercises work for different parts of the core (the lower the number the better). Before we move on to the last section of this post, I think it’s important to note that any exercise performed for abs will always use all the muscle groups that compose the abdominal wall when done correctly. Proper technique is paramount to all exercise, so make sure that you consult a professional if you are a novice, are unsure of what you’re doing, or experience pain during exercise.

Hard Work Pays Off

While it’s been long proven that abdominal exercises won’t turn a beer belly into a six pack, we do know that core exercises are paramount for a healthy body and for safety during exercises that will get you strong and help you lose weight (5). Core stiffness enhances athletic performance, and guess what your doing at the gym?… performing athletically (6)! So once you have set the foundation of a strong body, you can get into the fun exercises that greatly enhance your athletic performance on and off the playing field, (aka daily life activities). Here are some of the best ways to train the Serape movement pattern:

– Rotating exercises done from a standing position and alternating punching/pressing and pulling

– Utilize various stances, 2-arm and single-arm loading

– Alternating pressing/pulling patterns, as well as different stepping movements

I’ll finish up by reminding you of why we are working on the core and Serape. Muscles of the Serape form a spiraling system that enhances the efficiency of cyclic activity such as walking, together with power and speed activities such as throwing and golf. The stiffened core enables power produced in the lower limbs to transfer to the joints of the upper end of the core (or vice versa) forming a whip. So get of those machines and start whipping yourself into shape!

Don’t forget to like me on Facebook!

References

Santana, JC., McGill, Stuart M., Brown, LE., (2015). Anterior and Posterior Serape: The Rotational Core. Journal of Strength and Conditioning Research, 37(5), 1519
Santana JC. The serape effect: A kinesiological model for core training. Strength Cond J 25: 73–74, 2003.
Willardson, Jeffrey M., editor of compilation, & ebrary, I. (2014). Developing the core. Leeds: Human Kinetics.
Boeckh-Behrens & Buskies, Fitness- Krafttraining. Die besten Übungen und Methoden für Sport und Gesundheit, 2000
Vispute, S. S., Smith, J. D., LeCheminant, J. D., & Hurley, K. S. (2011). The effect of abdominal exercise on abdominal fat. Journal of Strength and Conditioning Research, 25(9), 2559.
Lee, B. C. Y., & McGill, S. M. (2015). Effect of long-term isometric training on core/torso stiffness. Journal of Strength and Conditioning Research, 29(6), 1515.

Stretching The Truth

Today I wanted to talk about what stretching does. There are a lot of misconceptions about the actual effects of stretching are, and I am constantly asked about topic pertaining to stretching. Here are a few commonly asked questions; what should I stretch? how long/often should I stretch? what will stretching do for me? should I even stretch at all? Each one of these questions are important so I will address them one by one.

What should I stretch?

The answer to this is… it depends! There is no need to stretch a muscle that is at an already acceptable level of tonicity. Yes, a hamstring stretch feels nice but for most people the hamstring is not the problem. In many cases the hamstring feels tight because the hip flexors are putting them in a state of constant tension. This problem an even manifest as lower back pain! So, should you stretch the hamstring? No. You should stretch the hip flexors so that the hamstrings are able to get back to a normal resting length. This same situation, where one tight muscle causes another area of the body to have a problem, can happen throughout the entire body. In essence, if you want to know what you need to stretch you should probably take advantage of those free program design sessions to figure out what exactly is going on with your body.

How long/often should I stretch?

There is no definitive answer to these questions. However, a good rule of thumb to go by is stretch for around 30 seconds at least 5 days per week. The best time to stretch is after you’re done working out. “Not in the warm up?” you ask. The answer is no. Stretching the wrong area in the warm up can even be a bad thing in some cases. Like other forms of relaxation, stretching can also be the best thing for you when you feel stressed and anxious.

What will stretching do for me?

Let’s start with the things stretching DOESN’T help with. Stretching will not help with preventing delayed onset muscle soreness, injury prevention, enhancing performance, aligning muscle/tendon fibers, trigger points, or increasing muscle length. Wait… what? Stretching does’t increase muscle length? No, but I’ll explain that in a little bit. What you should know is that stretching is good for the heart, the mind, and,most importantly, it’s good for the nerves.

Should I even stretch at all?

The answer is absolutely YES. General whole body stretching is necessary to stay mobile. You need to be able to move, so stretching is a must. Moreover, a targeted stretching program can be used as a way to enhance a workout (think back to the hamstring and hip flexor story). This is why almost all of my clients receive stretching as a part of their corrective exercise strategy.

So at this point you might be asking your self “WTFruit happens when I stretch? I mean won’t it make me more flexible?!?!” Well here’s how it works. We all adapt to the stresses we put on our bodies. In turn, our bodies try to make our life more efficient to those stresses (i.e. our hip flexors become short if we sit for long periods of time every day). This action happens the nerves in the muscles sending signals to the brain on what is a “safe” length for the muscles to be at through the stretch reflex. What stretching does is increase the tolerance, or muscle length until you feel, the stretching sensation. Thus, becoming more flexible through stretching is a result of decreasing the sensation of stretching. It’s the same reason why you need two cups of coffee now even though you used to only need one. Our brain, and our nerves, just need a little more stimulus (whether its stretching or caffeine) to get the same effect as when we first started.

Bottom line. If you want to have the right range of motion, your brain, nerves, and their connection to your muscles, must be in tune. Stretching will help keep homeostasis, but other than that… well, not much else. For more info you can check out the first brief link and more extensive second link.

Foam Rollin Rollin Rollin

Foam rolling is a form of self myofascial release (SMR) used on tight muscles. But the question remains… what does foam rolling actually do?!?!

Foam rollers… you see them, you may even use them, but what are they good for? That is the question I am hoping to answer today! Foam rolling is a form of self myofascial release (SMR). I use this modality with many of my clients who have tight muscles and reduced flexibility at specific joints in an effort to get those tight areas to relax before an exercise session. I go through great efforts to identify muscle imbalances in my clients that need SMR, stretching, or conversely, strengthening. But the question remains… what does foam rolling actually do?!?! Well a fantastic review came out recently using 118 research papers. So here is a summary of what is going on with the body when we use SMR techniques, and what it is useful for.

What happens when we foam roll

I think it is prudent to first look at what fascia is, because that is the targeted tissue of SMR. Well fascia is complex, but it can be described as force transmission system made up of connective tissue that permeates the human body. Some times tender spots in discrete, taut bands of hardened muscle that produce local and referred pain develop. These are spots are called trigger points. Subsequently, these trigger points are targeted during SMR before or after exercise.

Although we (i.e. the scientific literature) are still not sure on exactly why SMR works, the best evidence points towards a neurophysiological mechanism (like stretch tolerance). This mechanism involves changes in muscle activity acutely, which differs from the way stretching is effective. Other ways SMR may work include lowering tissue pH, releasing inflammatory mediators (reduce inflammation), and re-hydrating the tissue.

What foam rolling is good for

ACUTE (IMMEDIATE) EFFECTS OF FOAM ROLLING ON FLEXIBILITY

SMR causes an increase in short-term flexibility that lasts for >10 minutes. However, it’s not exactly clear how much SMR is needed to achieve this outcome. Unlike stretching, SMR does not affect athletic performance in the short-term. Static stretching, on the other hand, often causes a temporary reduction in muscle performance. Additionally, SMR may decrease soreness and increase pressure pain threshold as a result of DOMS (delayed onset muscle soreness) during the 48 hours following exercise.

CHRONIC (LONG TERM) EFFECTS OF FOAM ROLLING ON FLEXIBILITY

SMR can increase flexibility in a long-term program of >2 weeks with effects similar to traditional stretching programs. Research has also found SMR to improve arterial stiffness, improve vascular endothelial function, reduce cortisol (stress hormone) levels post-exercise, increase parasympathetic activity(high frequency HRV), and reduce sympathetic activity (low frequency HRV). Interestingly, SMR might also improve balance in chronic stroke patients.

Key takeaways

There is a lot of information above but when it comes to YOUR exercise routine, here’s what you need to know. SMR can help with your flexibility immediately after foam rolling for a short time, and will have lasting results when done consistently. It will also help with DOMS so you don’t feel like crying the day after you do squats! Finally, it will tell your brain to release happy hormones so you leave the gym with a big ole smile 🙂

For more information, and to learn about the nerdy sciency stuff, you can access the article at the link here.

A Healthy Body Begins With Happy Feet

The foot and ankle complex provides a base of support for all of our upright movement, so why don’t more people do exercises to strengthen such an important part of their body?!?!

Today I wanted to address how your feet influence the movements of your entire body. Your feet play a critical role in many movements beyond just walking, running, and jumping. The foot and ankle complex (FAC) provides a base of support for all of our upright movement, and if the muscles within the FAC become imbalanced it can set off a chain of negative reactions. So why don’t more people do exercises to strengthen such an important part of their body?!?! Well, today I am going to lay out what what the FAC is good for, and how to best go about achieving arch strength and happy feet.

FAC Facts and FAQs

The FAC is extremely complex because there are dozens of bones and hundreds of muscles, tendons, fascial components, and ligaments at play. All of these components come together within the FAC to provide stationary support while standing and dynamic spring while moving. So I will do my best to keep it simple, but please forgive me if my inner nerd comes out and I use too much technical jargon. When it comes to movement of the FAC, one major concern is the interaction between the arch of the foot and dorsiflexion of the foot (taking your foot off the gas motion). A lack of dorsiflexion in the ankle can be the caused by several factors, but frequently involves decreased strength of the tibialis anterior muscle (1). The decrease in shin muscle strength can then lead to flat feet, increased plantar flexion (pressing the foot down on the gas) during squatting motions and gait (walking). All in all, the arch can be placed under great amount of stress during the load acceptance phase of gate, if your foot is weak and there is limited dorsi flexion. That’s because during this phase of the walking/running cycle the shin and ankle muscles assist the arch in energy absorption (2). If the ankle is unable to properly dorsiflex, a huge amount of stress will be placed on the foots spring ligament, plantar fascia, and intrinsic muscles which can lower the arch. This lowered arch in turn causes tibial (shin) rotation, hip internal rotation, slight hip flexion, and hip adduction creating a valgus (knock knee) stress (3,4). So what does this mean for you? Well to sum it all up, when we don’t pay attention to the FAC we are more likely to have stiff hips, lower back pain, tight calves, weak feet, weak ankles, altered gait, plantar fasciitis, hallux valgus (a.k.a. bunions), patellofemoral pain, increased susceptibility to medial collateral ligament (MCL) injuries, and an increased likelihood of anterior cruciate ligament (ACL) tears.

There are also some other surprising aspects of foot strength that I’m betting most of you didn’t even think about. Having proper FAC strength means you have developed some proprioception (foot eye coordination in this case). In turn, this means you know where your body is at in space. This is extremely important if you think about it because it’s the same as knowing where my fingers are as I type each letter of this post. I don’t need to look down for each letter, I just know how to move my hands. So, if you practice strengthening your FAC you will know where your lower body is during each step you take. This leads to better performance for athletes, enhancements in the standing and walking positions, and the ever crucial prevention of falls for seniors (5).

Foot Fitness

So I’m going to start this section by being a negative Nancy. To have healthy feet you SHOULD NOT use arch supports or supportive shoes. No, this does not mean you should take out those stinky old things you have put in your shoes for years and start walking around. What I mean is that the arch support is to the feet, what the weight lifting belt is to the back. Yes they are both supportive, but if you don’t let those underlying muscles develop you will end up with some limp noodles for muscles. So instead of opting for the all or nothing path, star weaning yourself off of the arch support and into regular shoes. Or if you’re ready for it, start weaning yourself onto more minimalist shoes. It’s really all about a gradual progression into a more barefoot environment… unless your feet stink like mine ;). You wouldn’t go from lifting 10 lbs dumbbells to benching 225 lbs, so don’t jump too quickly on the minimalist bandwagon especially if you have high arches to begin with (6).

Okay, I know that if you have read this far you might be a little frightened of your weak feet. But I promise you that you don’t have to do that much to whip them into shape! This is because even though you use them all day long, the interaction between your nerves and your muscles may be the real underlying issue. So to re-learn your own feet, there are a few simple steps you need to take. Use your time wisely by standing on one foot as often as you can. This can be done while you wash dishes, make phone calls, eat Ramen noodles, or other things that people who aren’t poor college students do. You can also practice flexing your toes while you’re sitting down. This can be done by simple scrunching your toes together while at your desk, or by picking up objects and putting them into a container while you’re seated (7). Additional exercises include standing on one foot, bunny hops, walk heel to toe, medial (inside) calf raises, resisted ankle inversion exercises, single-leg kettlebell swap, foam rolling the biceps femoris (outside hamstring) and plantar fascia, and walking in a straight line with one foot in front of the other. Finally, you should take care of your hips. The interaction between the hips and the ankles goes both ways. So stiff hips can mean stiff ankles and visa versa.

Resources

1. Chizewski M., & Chiu L. Contribution of calcaneal and leg segment rotations to ankle joint dorsiflexion in a weight-bearing task. Gait & Posture, 3685-89. doi:10.1016/j.gaitpost.2012.01.007

2. Spaich, E. G., Andersen, O. K., & Arendt-Nielsen, L. (2004). Tibialis Anterior and Soleus Withdrawal Reflexes Elicited by Electrical Stimulation of the Sole of the Foot during Gait. Neuromodulation, 7(2), 126-132. doi:10.1111/j.1094-7159.2004.04016.x

3. Hollman, J. H., Kolbeck, K. E., Hitchcock, J. L., Koverman, J. W., & Krause, D. A. (2006). Correlations Between Hip Strength and Static Foot and Knee Posture. Journal Of Sport Rehabilitation, 15(1), 12.

4. Simon, L., Christian, B., Peter, M., Richard, T., Roger, W., & Dylan, M. (n.d). The effect of anti-pronation foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in healthy individuals: A laboratory study. Clinical Biomechanics, doi:10.1016/j.clinbiomech.2013.11.015

5. Hashimoto T, Sakuraba K. Strength Training for the Intrinsic Flexor Muscles of the Foot: Effects on Muscle Strength, the Foot Arch, and Dynamic Parameters Before and After the Training. Journal of Physical Therapy Science. 2014;26(3):373-376. doi:10.1589/jpts.26.373.

6. McKeon, P. O., Hertel, J., Bramble, D., & Davis, I. (2014). The foot core system: a new paradigm for understanding intrinsic foot muscle function. British journal of sports medicine, bjsports-2013.

7.Siddiqi A., Kumar D., Arjunan S. Age-related motor unit remodeling in the Tibialis Anterior Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, Volumes 2015-November, 4 November 2015, Pages 6090-6093