TRAIN OUT PAIN

Monday Motivation: Why Do We Fall

2013-05-20T09:29:00.001-04:00

Nothing new in terms of speech or movies. But this was very well done.

Notes on Anterior Core Training

2013-05-14T08:48:00.000-04:00

I recently watched Eric Cressey's presentation on the Anterior Core. I found it very good. One of those, wow, Internet is amazing kind of moments. Fork over 15 bucks and get to sit and learn for 45 min from a respected leader in the field.

He opens with one comment I've come to truly appreciate. If I can learn one thing to take back to my clinic for my patients and athletes and start implementing, it was worth it. Give me one thing to take away that can have real value in my world. Not conceptual. Applicable. I learned a few.

First, I found a nice tie in with the Postural Restoration information I had went through a few weeks ago. Eric is very familiar with it, having taken their seminars and was actually one of the ways I first heard about PRI. So I found a lot of practical information on how to implement the PRI principles much easier.

Get good proximally before distally. If the core/spine aren't right, the extremities won't be either. Get to neutral and stay neutral. Use warm ups to work on getting flexed people into extension and those locked into extension into flexion, thus getting both to neutral. The workout then becomes what cements the neutral spine.

Many of the modern injuries we see can all be related back to the anterior core. Sports hernias, femoral impingement and hip labral tears can all be related back to having anterior rotated pelvis. Excessive tension through muscles like adductor longus and rectus abdominis. Thoracic outlet can also have roots from a dysfunctional anterior core.

A great test is have the patient supine. Flex the hip and internally rotate the hip. This may cause a pinching pain in many people. Now, have them brace the abs and slightly posterior tilt the pelvis. Retest flexion and internal rotation. Often the pain will be gone. It's not a hip problem, it's an anterior core problem.

He talks about another simple test to decide if your patient/athlete should even be doing overhead work. Can you raise your arms overhead without letting the ribcage tip up in the front? Important for all the Crossfit athletes that live overhead.

Everyone is unique. There are many great exercises, but you may have to coach and cue one person much different then another. Again, one may be locked in flexion, one may be locked in extension. Don't coach the exercise the same.

Anytime you lift something overhead, you are working the anterior core. Gain length in the Lats and strength in the obliques and rectus abdominis and you will gain a much more functional anterior core.

Eric goes on to discuss exercise progressions for many different lifts and exercises. These progressions, how to implement them and why you would, make up the heart of the presentation. I would highly encourage anyone that works with athletes to give it a watch. I'm sure you will walk away with one applicable nugget of information you can start to use right away.

Review of Postural Restoration Institute Respiration Course

2013-05-09T08:32:00.000-04:00

A few weekends ago I had the opportunity to take a Postural Restoration Institute (PRI) respiration course. It was myself and about 7 physical therapists at the University of Michigan Pain clinic. James Anderson was the PRI teacher. He knew his stuff inside and out and was a great teacher, engaging and open to questions. I had several, more on that later.

First, if your thinking on taking one, I would highly recommend it. I study anatomy a lot and found myself learning and thinking about concepts in a new way. As this was a respiration course the primary focus was on the diaphragm, rib mechanics and how they influence the rest of the body. I feel I gained great insight and better understanding to both of these anatomical concepts. Surprisingly, none of the information about rib biomechanics are taught very well in chiropractic school.

PRI is built with the premise that the body is actually asymmetrical and that it's the sum of these asymmetrical parts working together in harmony that make us move and function well. It's because of some of these asymmetries that we create known dysfunctional patterns that are labeled and treated in PRI. I'm not going to get into their patterns and treatment methods, as that would take quite a lot of time, but basically the left front leg gets tight and is called an Anterior Interior Chain (AIC) which includes the diaphragm, psoas, rec femoris, TFL, vastus lateralis and biceps femoris. Also, the right upper arm gets tight, labeled Brachial Chain (BC) including the intercostals, deltoid, pec, Sibsons fascia, SCM, scalene and diaphragm. Right rib hump on the back and left rib flare on the front is generally seen (also 90% of scoliosis has this pattern)

The respiratory system is not symmetrical. Right diaphragm is larger, thicker, has a larger central tendon, has thicker crural attachments to the lumbar spine and because of this creates a right rotated lumbar spine. It's 1 to 1.5 vertebral levels deeper on the right and has a more dome shape on the right because it drapes over the liver. Because of this it has better abdominal integration for opposition. It can push better against the abs essentially.

The unique anatomy allows us to breath easier on the left and harder on the right. So the right ribs become more locked down and the left ribs become blown out on the front. We are a culture that is carrying dead air, we don't fully exhale. All of this leads to dysfunctional patterns.

Some interesting anatomy. Subclavius is the only scapular retractor on the front of the body. When it gets tight, it can inhibit the lower trap and serratus anterior, two muscles that get inhibited a lot. Thus, subclavius is an important muscle for respiration and shoulder function.

The diaphragm when dysfunctional actually becomes a paraspinal extensor. If you don't use it and breath well, you will have a tight back. Because of the described anatomy the right ribs become rotated under the scapulae. This makes the scapula dysfunctional and will create shoulder impingement at times on the right shoulder.

One of the concepts that I have an issue with that was touched on in the seminar was the use of flexed positions in the lumbar spine to create a neutral spine. They believe most people are locked in extension and to actually create a neutral spine, squats ect, must be done flexed. Please reread that. This concept attacks my paradigm. I can understand the concept that we are both after a neutral spine. Obviously no one is saying squat with hyper lordosis but to go the opposite and squat with a flexed spine to get to neutral, I'm not buying it yet. I brought up McGills research and didn't really get much of a response on that, but we agreed we are after neutral. I actually did a bunch of flexed exercises and to be honest, I had some radicular pain down my right glute and I haven't had any radicular pain in about a year and a half. N=1 was a failure for me. But, I don't believe I'm locked in extension. So flexed spine for me was a flexed spine in my opinion.

The other concept that was touched on briefly was the use of an orthotic. He pretty much came out and said if your not in a PRI orthotic all the work you are doing to solve dysfunction won't last. Really? I don't buy that one at all. I'm a big believer that feet play a major role in how we move, but not that big....for everyone. Need by need basis. He was very down on the minimalist shoe for everyone. I talked with a buddy doing PRI with himself and a few athletes and was told he has been doing great without the orthotic and is stronger then he has ever been.

Overall, I really enjoyed the PRI seminar. I truly believe I'm a better clinician having attended. I'm working with diaphragms and having success with improving shoulder mechanics via the diaphragm. They give a ton of exercises that can be used for your patients as homework. I plan on attending more of their seminars in the future, so you can say I like their stuff.

Building a Circadian Rhythm Template Through Food, Light and Sleep

2013-05-08T09:04:00.001-04:00

One of the most interesting chapters in the book "Perfect Health Diet" by Paul Jiminet was the chapter on Circadian Rhythm. Circadian Rhythm (CR) is the bodies natural tendencies and hormonal fluctuations. Every cell in your body has an internal clock. The more we learn about health and fitness the more importance the roll of maintaing a healthy CR becomes.

The body is an incredible adapter. It can adapt to anything, almost. You can get it to run faster, jump higher and lift small cars if need be. You can train it to run across deserts and climb mountains without oxygen. It can thrive (not just survive) on vary diverse diets, from Inuit protein and fat to some almost pure plant based diets. One thing we can't adapt to and probably never will, is lack of sleep and sleeping in the day time.

Sorry 3rd shifters, but that is not normal and you are messing up your CR big time. There are a lot of health risks involved with this. Maintaining a healthy sleep schedule, getting sunlight in the right time and eating at the correct period are probably the biggest steps in keeping your CR healthy.

Here are some highlights from the PHD chapter to be used as guidelines for setting up your proper Circadian Rhythm.

Get sunlight on your eyes early in the morning. Sunlight not only kick starts the CR but also we absorb Vit D more in the morning. Sunlight has tremendous amount of blue spectrum light. Great in the morning and day. (not at night) Cataracts block blue light and this is one reason elderly have messed up CR.

Avoid blue light in the evening. Just as blue light in the morning is helpful, blue light in the evening is harmful. It will block the hormone Melatonin from being produced as much. (almost 50% less) Melatonin is highly important for health. There are now filters that can be put on computer screens and ipads ect to block the blue light.

Sleep as much as you can. There are so many studies about sleep and they all say the same thing, go long enough with limited sleep and you are going to have some health issues. Some pretty serious. This is something we as humans have not been able to adapt to. Sure there are people out there that thrive on "4 hours of sleep" day in and day out, but chance are you are not them. There are amazing outliers in everything.

This brings us to food. Food can have a powerful influence on the CR. Generally speaking, eat during the daylight. Create an eight hour window to eat. Stop about 2 hours before you go to bed. Carbs have a powerful effect as they promote night rhythm and sleep. Carbs influence the hormone leptin, fat does not.

The hormone leptin follows a circadian rhythm. Low in the morning and rise as the day goes on, peaking at night. Eating carbs increases leptin levels 4-9 hours post consumption. So to time carbs influence on leptin and your natural leptin levels, most carbs should be eaten around sunset. So dinner. This goes against most of the dietary advice out there. (so it's probably right....this also has strong agreement with the Warrior Diet by Ori Hofmekler)

A few supplements that may help are Vit D in the morning, Magnesium at night and Melatonin at night. All will have strong influence on creating optimal CR. Light physical activity with your initial sun exposure in the morning can also be highly beneficial.

A healthy circadian rhythm is a template to allow you to do the things that are important to you. If you are looking for a faster 5k, lose 15 pounds of fat, total elite in powerlifting or just have the energy to enjoy your grand kids, setting your Circadian Rhythm is the foundation to the person you are building.

Monday Motivation: People are Awesome 2013

2013-05-06T08:49:00.001-04:00

Charlie Weingroff Notes from Southwest Michigan Strength Clinic

2013-04-23T08:41:00.001-04:00

A Systemic Approach to Athletic Evaluation

"The Greatest Improvements is made by the man who works most intelligently." Bill Bowerman.

As therapist/coaches, we have to do stuff. Compete at something, want to get better at something. Don't forget what it's like to want to improve and excel.

General physical prep is where most of our efforts will be. As human we have minimum level competencies. Athletes have Wide level. Have a way to measure. Baseline can be some thing like FMS but must be bodyweight, minimally cued and modifiable.

Evaluation principles. 1. Movement 2. Preparation 3.Sensory Systems.

Movement.

Locomotion testing. Crawl-roll-step-lunge-walk-shuffle-skip-run.

look at simple to complex, slow to fast, closed loop to open loop. Can measure it by time or quality of movement.

Power is single expression. Capacity is multiple expression. Various jump tests can give us indicators for both power and capacity. Energy systems (all three are doing work).

Capacity is important as clinicians. If you're out of shape that can contribute to fibrous tissue. Don't have the ability to use oxygen as all. Aerobic fitness can normalize the nervous system. Things don't hurt as much when you have good aerobic fitness. (this doesn't mean you have to run)

Preparation:

Measure what we can measure. Get some biomarkers. (objectively measured as an indicator of normal biological processes)

Examples are omega wave, heart rate in the AM, grip strength tools like hand dynometer or bottoms up kettle bell press, vertical jump.

Are you ready to train or do you need to do some low CNS activity. Don't dump on your patient/athlete more if their already down.

Sensory:

5 senses (sight, touch, taste, hear, smell) All are CNS driven and all cause a reaction.

Vision is underrated. 20/20 vision is no longer the best. Elite guys are showing up as 20/10 and 20/8. Have your athletes tested.

2nd Talk

Understanding Joint Centration (applying DNS to rehab and training)

Control in the presence of change is stability. Motor control and timing of tonic and phasic muscles.

Joint centration allows maximum amount of load bearing. Balance of mobilizers and stabilizers working on a joint. Balance of agonist/antagoinst.

Babies and the strongest,fastest people in the world do it the same. Joint positions. No one teaches babies. That is why DNS (Dynamic Neuromuscular Stabilization) is powerful stuff.

4x4 Matrix is 4 postures and 4 variances with them.

Postures are 1.unloaded (prone, supine, on side) 2. quadruped 3. Kneeling 4. Vertical. What can change is the following.

1. position 2. static vs dynamic 3. load vs no load 4. assistance vs no assistance.

Examples. May have poor hip centration in vertical squat, but be good in quadruped. May give assistance to the vertical squat with a band around the knees and restore hip centration this way.

Getting the diaphragm working is a major goal. Any of the 4x4 matrix can be used. Powerful stuff. Diaphragm when fully engaged will get the pelvic floor engaging as well. Breath over the brace while lifting as McGill would say.

There is a time for bracing and a time for not. Air squat should not have the same effort as an all out barbell squat. Biomechanicly exactly the same, but nervous system should not be. That's why biomechanics don't always give you all the truth.

Exercises that require all out bracing like hard style kettlebells, but perhaps should follow that up with something like Indian clubs where there is flow and big movement.

If you train tonic muscles to be phasic muscle you are lost (I've been guilty of this) Example Glute med is a tonic muscle, yet most exercises to challenge them are making them into phasic muscles. Clam shells/band walks.

Loss of centration when phasic muscles are forced to stabilize.

Some interesting points that didn't really fit into the flow of my recap but I found interesting.

Biceps can be used as a thoracic extensor with crawling.

Taylor sits with young girls may be one of the reasons girls are predisposed to ACL injuries. (note to self, don't let my daughter sit this way)

Babies from 3-14 months development go through all phases of the Turkish Get Up.

Deep toe flexors get active, has a very negative effect on the entire body. Try yoga toes to walk around in.

T4-8 is an important area for mobility as it is highly proprioceptive.

Never seen serratus anterior winging without pain resolve with push ups plus. Put a heavy bell in their hand overhead. Watch the winging scapula disappear.

Brain loves extremities crossing midline, it's like candy, and their is more to PNF then just contract relax.

Skipping in multiple planes of motion barefoot is a great for the nervous system. Foot is loaded in multiple planes, lots of mechanoreceptors active, crossing the body is involved with things like skipping carioca. I used to always think skipping with arm movements was a waste of time in my warm ups in college. Now I can see the merit.

Exercises that are crawling based don't need as much time to recover from. Think pulling heavy ass weight as you crawl.

Everything is brain driven.

These were most of the notes I was able to jot down. The room we were in lost lights during the presentation so I was writing in the dark. If you see my hand writing you would think I have an upper motor lesion, now compound that with scribbling in the dark. Charlie is one smart dude, if you get a chance to hear him speak, definitely jump at it.

Could You Eat It?

2013-04-17T11:35:00.000-04:00

The first things people do as they try to get healthy or ensure health is to look at food. What are you eating? Whole foods, no chemicals, no preservatives, get rid of crummy oils, no sugar, most everyone will agree on that.

I'm as guilty as anyone when it comes to the next part, absorption. Your skin is the largest organ in the body. What you put on it can matter. In fact, because it doesn't go through the digestion process, the body doesn't break it down. It enters pretty much unchanged. What you put on it can be good or bad.

Don't think it can have that big of impact? Men with low testosterone are often given a cream to rub on them to boost this hormone. Think of all the baseball players busted in the past decade, most of these performance enhancement drugs were lotion or cream based.

Enter a chemical called Parabens. In lotion the ingredient will be "-paraben." Used as a preservative, for the most part it doesn't even need to be there. It has been shown to be a xenoestrogen, chemicals that can mimic some estrogenic properties. They have shown that you can have paraben build up in the bodies tissue. No one is saying that it increases cancer risk outright, but the question becomes why risk it.

Most people use lotion at least once a day. Over 5-10 years, that's a lot of chemicals that your bodies tissue is absorbing and holding on to. There are lots of options out there now that are paraben free, in fact, many are able to be ingested if for some reason you had to. (Not saying do this) but there should be that level of safety when it comes to the thought process. Could I Eat This?

We care about what we eat, lets care about what we absorb on our skin routinely.

Monday Motivation: People are Awesome 2012

2013-04-15T08:54:00.001-04:00

Piriformis Pain in Runners

2013-04-10T09:30:00.000-04:00

Piriformis syndrome is a pretty common dysfunction pattern that usually presents more in women then in men. Described literally as a pain in the butt. It can present not only with local pain, but also a sciatic type pain as the sciatic nerve can become compressed over time when the Piriformis is tight.

Soft tissue methods directly on the Piriformis can lead to short term improvement. The question becomes why is the Piriformis irritated or feels the need to tighten. This is how long term improvement is achieved.

One possible answer lies in the surrounding anatomy. Looking at where the piriformis has attachments, the lateral portion of the sacrotuberous ligament has fibrous reinforcement from it. The sacrotuberous ligament is made up of three separate bands, medial, superior and lateral.

The sacrotuberous ligaments role is to limit nutation of the sacrum. Further down the line, the biceps femoris muscle (lateral hamstring) has direct attachments to the sacrotuberous ligament. The biceps femoris now is understood to contract before heel strike. Without a strong biceps femoris, gait mechanics will be changed and Sacrum/Iliac (SI) joint dysfunction can occur. This may lead the piriformis to tighten up to try to help stabilize the SI joint.

While one can never achieve great results with just following a cookie cutter recipe in manual therapy, recognizing patterns is always helpful. Test for weakness in the biceps femoris next time piriformis pain presents in your patient/athlete. For the athlete dealing with this roll out the hip rotator complex and perform some hip/hamstring Swiss ball leg curls with the feet slightly turned in to try to target the biceps a little more. Try this everyday for two weeks and see if the pain in the butt leaves.

Monday Motivation: People are Awesome

2013-04-08T08:39:00.001-04:00

Creating Hypertrophy in Lumbar Multifidi

2013-04-02T08:36:00.000-04:00

Eight out of ten of us will have back pain in our lives. Chances of having low back pain are significantly higher if you have had low back pain before. Take away, it comes around again if you don't do anything about it.

One of the main reasons in the research and therapy world is that after the first bout of acute low back pain (LBP) the lumbar multifidi start to atrophy. Not only atrophy, but they start to get fatty infiltration. It can be one sided atrophy on the side of the pain as well. So not only will we have asymmetrical function from the back, but asymmetrical form as well.

The role of the multifidi was long thought to be that of a rotator/extensor. It is probably too short to be much of a power producer but it has a high amount of muscle spindles. This means it sends a lot of information to the brain about position and movement. So with atrophy we get loss of form and function and lack communication with our most important organ, the brain. It most likely alters its relationship with another important communication system as well, connective tissue. There has been some understanding that the multifidi also play a roll in maintaining a proper lordosis or curve to the back.

The big question then is after back pain, how do we restore hypertrophy to the multifidi? It's been shown through EMG that although lumbar extension and things like bird dog exercises make the multifidi active, they did not produce any changes in cross sectional area.

Finally, a study showed that holding a contraction, an isometric hold of 5 seconds, was successful in increasing cross sectional area. In between the concentric and eccentric phase of a movement, hold the contracted position for 5 seconds. Do not go to failure. Also, having an upper body extremity do an isometric hold increased activity of the lumbar multifidi up to 51%. This may be a great starting point for someone coming off acute LBP or back pain surgery.

Adjustments of the area have shown to increase the lumbar multifidi to contract and activate better. Not only post adjustment, but one week later as well. Before an exercise program is begun, creating better mechanics through HVLA adjustment may be the kickstart the body needs.

Notes on Gait Function with Thomas Michaud

2013-03-22T08:03:00.000-04:00

These are some of the highlights or things I found of importance in a recent webinar I took given by Thomas Michaud.

Walking, your center of mass (COM) is highest at midstance. Running the COM is lowest at mid stance.

Inefficiency of the Gastroc is the point where speed goes from walking to running.

Some studies done with forefoot running as a means to prevent injury were flawed as they were done with college runners that had already become midfoot strikers.

Runners that are not elite that transfer to a forefoot or minimalist type shoe show arch inner calf problems if they have a flatter arch, higher arched individuals show with more metatarsal strain/stress fracture.

Most runners are more efficient with heel strike when energy expenditure is looked at. Around the 6 minute clip is when forefoot running becomes more efficient.

Shape of the heel is perfectly suited to absorb impact. 100lb female has a larger heel bone then a 350lb Gorilla.

Heel expands and contracts like a rubber ball. Thin outer layer of bone and and extensive blood supply to help repair.

The heel is protected by a well designed 3/4 inch fat pad. The fat pad is spiral chamber of sealed fat. Fat pad is several chambers. Outer layer is a protective cup. The inner layer is a major shock absorber. It quickly deforms and reforms. Retains all its shock absorption even in cold environments. It is made of polyunsaturated fat.

Barefoot running shows 60% deformation of heel pad. Shoes it is 35%. Walking is 40%. Thinning of the heel pad is a major predictor of foot pain.

With a heel strike the Tibialis Anterior is used to handle the absorption of impact which it is well designed to do. Midfoot strike the Tibialis Posterior is responsible for slowly lowering the heel. Forefoot strike the Gastroc is used. It is not well designed for this as it crosses 2 joints. 2 joint muscles are easier hurt.

Flexor Digitorum muscles are important for dampening the oscillation from bony vibrations.

Lateral Gastroc and Biceps Femoris were important for pre muscle contraction right before impact. This is why running surface matters very little.

While glute med/min are important for hip stability, the faster you run, the more important the Glute Max becomes.

One myth is that disc act as shock absorbers. McGill has proved that the endplates of the vertebral bodies are what absorb impact.

IT Band is an energy storer. Hips are force producers, lower legs act like rubber bands storing and returning energy. Prosthetic makers have started to take advantage of this key understanding.

Seems counterintuitive, but the calf muscles don't go through big lengthening, more of an isometric with the tendons going through large changes in length. As we age, tendons get more brittle, hence we have a harder time moving fast.

Flexor Digitorum Brevis is an important muscle for maintaining arch height. Weakness may be a important cause of plantar fasciitis.

Slow running possibly less stress on the joints then walking.

Flexor Hallucis Longus pulls the fibula head down. This deepens the ankle mortise and helps to prevent ankle sprains. So if dealing with an ankle sprain, mobilize fibula and strengthen FHL.

Achilles is unique as it rotates 90 degrees before attachment. Gastroc/Soleus (GS) primary role is not one of concentric (shortening) but more isometric impulse as and anchor for the Achilles tendon and allow the Achilles to go through large ROM.

Plantaris is located between the GS. To thin to be used for force production, now known to be loaded with mechanoreceptors. It provides detailed information to CNS to allow the GS complex to create precise isometric impulse for proper Achilles function.

When Achilles is storing and returning energy efficiently, it reduces the load on the hip flexors.

Looking forward to reading through Thomas Michaud's latest book. "Human Locomotion."

A Few Product Reviews

2013-03-19T15:38:00.000-04:00

Here are a few of the products I've been using that I think are worth mentioning.

First up, the Squatty Potty. It's kind of a funny concept growing up in the United States, but many cultures still go to the bathroom using the "Third World Squat." I first read an article about the proper way to eliminate and started looking further into it. This is a pretty well made video.

Now I'm starting to see these recommend in a few places. I like it and think there pretty cool. I'm keeping mine.

Next up is the Slingshot from Marc Bell. It essentially unloads some of your weight and supports your elbows as you bench or do push ups. While it did do what it said it would do, allow you to complete more push ups. I didn't really see much benefit from doing them that way. It was strange in that I didn't get a pump in my triceps or chest from doing more push ups and after playing around with it a few days, haven't really used it to much since.

I've been doing some reading about how computer screens late at night can trick your body into not falling asleep. Since I read a ton on my iPad at night, I looked into some options. I forget who recommend the blue light filter from LowBlueLights, but it seems to work. The blue rays are what causes suppression of the sleep hormone Melatonin. My first night using it, I fell asleep while reading. I had never done that before, but did all the time while reading hardcover books. It's easy to remove in the daytime as well.

I had heard of the Perfect Health Diet for awhile now and finally bought the book and read through most of it. I agree with most of it and think it's a solid way of eating.

So those are a few things I've been playing around with. Enjoy!

Best Athlete Motivation and Inspiration

2013-03-18T09:44:00.001-04:00

Cool TED Talk: Become a Gangsta Gardner

2013-03-15T10:03:00.000-04:00

Worth your ten minutes. Cool to see people "changing the culture."

Beauty and Health in Symmetry

2013-03-13T21:00:00.001-04:00

If you look around the world, you will be instinctively drawn to symmetry. We are hard wired for it it seems. Babies will stare longer at symmetrical faces then non. We unconsciously are drawn to more symmetrical people of the opposite sex. Symmetry to us is beautiful. It's embed in nature. There may be even some deeper underlying health issues with symmetry as men and women with asymmetrical faces are more prone to depression and stomach issues.

In general we know that asymmetry in the body also predispose one to injury. Not necessarily cause injury, but perhaps is a contributing factor, more so then general "inflexibility" or strength.

For instance, if one is on their back and raise one leg up, then the other, compare. The standard is 90 degrees to the floor. If both are about equal, even if they are much less then the standard, the new way of thinking is that it is probably less of a deal then if one leg is more limited. The limited leg may be a problem. I stress MAY be.

There are a few instances where asymmetry may be appropriate such as a baseball pitchers elbow. The lay back position has increased as thousands of repetitions have brought about appropriate bone and soft tissue changes to allow that 90 mile per hour fastball.

Most of us are not in the asymmetry will help category though. Everyone now realizes that mobility is important, but many don't really know where to begin. Movement screens have become very popular as of late for that simple reason. It's easy to understand this is different then this. Asymmetry is not just range of motion though, it can also be a firing pattern. Sure your thoracic rotation was equal, but you were strong on the right and weak on the left. This too is asymmetry.

Instead of blindly doing a half ass warm up at the gym or before a run, do a few symmetry checks, improve them and then go about the workout. Not only will the workout most likely go better, but you may have increased your chances of staying injury free.

Everyone has a trademarked (number with cool sounding name) so I'm calling these the T.O.P. 6. (get it?)

1. On the floor, legs straight. Press one heel into the floor, keep the other leg straight and raise it up. Check the angle and feel. Test the other leg. Posterior Chain

2. Same position. Raise the leg up and slowly abduct the leg away from the body. Keep your pelvis on the floor. Return and test other leg. Medial Chain

3. Same position. Bend one leg, heel on the floor. Other leg is straight. Keep you ankle in dorsiflexion on the straight leg. Rotate the leg internally and externally. Compare to the other leg. Hip Rotation.

4. Same position, bend one leg and keep the other leg straight. Press through the heel of the bent leg and raise hips off the floor. Keep your pelvis level, don't let the pelvis rotate. Feel the glute or did you feel the hamstring? Did your pelvis rotate? Compare to the other side. You want to be able to feel the glute and control the pelvis. Glute Activity and Oblique Strength.

5. Both legs bent. Heels on the floor. Keep your ribcage down, or parallel to the floor. Keep the arm straight and raise it above you to try to get it the hand to the floor. Again keep the ribs down, you will try to hyper extend the low back to cheat. Keep it flat. Test other side. Thoracic Extension

6. Same position. Arms abducted ninety degrees to the body. Bend 90 degrees at the elbow. Rotate the shoulders internally, back to vertical and then externally rotate. Shoulder Rotation

Run through these as part of your warm up. It's feel as much as function. Gain some symmetry. Work for symmetry.

Monday Motivation: Power of One

2013-03-11T09:12:00.001-04:00

Regaining Intrinsic Foot Function

2013-03-05T20:43:00.000-05:00

I would have said a few weeks ago that I value the intrinsic foot muscles as an important part of the global integration of health and performance. But, I've never truly given "foot exercises." So how important did I really value it?

It's not belief it's practice. Without practice do you really truly believe it's that important. Apparently I was fooling myself or hadn't quite realized how to implement. I check on most of the muscles that contribute to big toe function and have patients roll with a golf ball to improve the tissue quality, but just kinda assumed just walking would be enough to strengthen. The foot intrinsic muscles and especially the big toe, triggers reflex's not only in the quads, but also in the hip. They are important.

Things like plantar fasciitis have now been shown to be more of a degeneration then inflammation. Degeneration is things mechanically not working well so they are abused. If we have tendon degeneration we would work on tissue quality and perhaps go into some eccentric strengthening.

So I'm still an advocate for golf balling the muscles of the foot. Part of the process helps reintegrate the proprioception in your foot. Proprioception is just information from your body to the brain. It also helps to free up perhaps one layer of the foot from a deeper layer. Improving the glide function. This part is somewhat controversial, but still improves movement.

After rolling, start with learning to control the big toe in dorsiflexion. The video below is me working on just that for a few days. I was pretty astounded when I first worked this drill and couldn't move the big toe at all. I had zero brain connection to my hallucis muscles. Humbling. The drill is press your toes into the floor and without letting them lose contact with the floor, lift the big toe up. Trust me, you should be able on conscious control to move any part of your anatomy. It took several, several sessions of rolling and just trying to get that toe to move. Now it seems easy. Does this translate into anything amazing? I don't know, but I do know I have more control. We'll see what this produces down the line. Get to work.

Monday Motivation: Training Compilation (HD)

2013-03-04T08:40:00.001-05:00

Monday Motivation: GET RESULTS

2013-02-25T13:33:00.001-05:00

Beet Juice for The Brain

2013-02-21T08:48:00.000-05:00

I'm on a brain kick lately. What kind of nutrition can we take to help our brains? I came across this article about Beet juice in Science Daily. Essentially, giving an older adult 16oz of beet juice allowed more oxygen to get to the white matter of the frontal lobe. This area is associated with degeneration leading to dementia.

The mechanism is thought that beets contain a high quantity of nitrates. Bacteria in your mouth converts the nitrate to nitrite. Nitrites help open up the blood vessels and allow oxygen to get into areas of the body that normally don't get as much oxygen.

This is why it had been studied and shown some performance benefit for endurance athletes. Why products such as Nitric Oxide pop up. Why Viagra is sometimes taken by athletes, but not for that type of performance enhancement.

It was a small study done on cyclists, but the results were promising. I can't get a hold of the original study, but the participants showed some improvement with beet juice, via the same concept of increasing NO.

Ben Greenfield from Ben Greenfield fitness, states that probably the best way to use it for performance is to take 5oz for several days up to your big bike race. He also stated that a study done on elite XC skiers showed no improvement from beet juice.

Beet Juice probably won't be the "secret sauce" people are always searching for, but it shows a lot of promise for generally just increasing your health.

Do You Train Thoracic Mobility?

2013-02-19T08:44:00.000-05:00

I'm a big believer in the concept of improving thoracic mobility to improve all your other movements. If your t-spine is moving, your lumber will be more stable. It will promote shoulder stability/mobility. It will improve cervical function and will also influence breathing patterns.

Yet, how many of us really strive to drive thoracic mobility? If one sits for a living (desk jockey) bikes a lot, is in the car for any amount of time, or tries to do some computer work, chances are you do these activities for some significant time.

Now, lets add in some specific strength training. We all like to deadlift, squat, farmers walk and do single leg work. All of these are tremendous exercises and all are done with stiff thoracic spine. (and rightfully so).

So we have frequency from life, volume and intensity from our lifting, all trying to inhibit are ability to move well in the thoracic spine. Thanks Evan Osar for getting me to think about how I lift in relation to actually hindering my thoracic mobility.

Enter crawling exercises. Having a one year old that is crawling all over the house has let me see first hand how crawling forces thoracic mobility. Crawling for time or distance can have an immediate impact on the t-spine. It's a closed chain activity which the brain loves. I really like some of Mike Fitch's "Animal Flow" exercises. Paul Chek has some crawling variations on YouTube that are worth pursuing.

So, if your want to do one thing to add into your programs or daily activities to have a good bang for you buck, crawl around.

Monday Motivation: It's the Process

2013-02-18T11:22:00.001-05:00

Monday Motivation: OUTLAST THE PAIN - RONNIEL "VENEE" VARGAS

2013-02-11T09:24:00.001-05:00

Define Your Goals: Health or Performance

2013-02-07T15:28:00.001-05:00

The vision for what you want has to be very clear for you and for whoever is helping you. I often get patients that want performance even though when you probe deeper, they truly only want health. You can have health without performance, but can't have performance without health.

If your goal is to run a 5k without your knee hurting, that to me is health. If your goal is to shave 5 min off your 5k, that's performance. Go to the gym and do some pull ups without your elbows hurting, health, compete at the Crossfit open without your elbows hurting, performance.

Often times health is simply removing some of the ~~stupidity~~, misinformation that is out there. How many times have I simply stopped someone with a flexion intolerant back from doing hundreds of sit ups each day. "I was told my core is weak, sit ups strengthen the core."

Misinformation

"I want to lose weight, so I started running." Do you enjoy running? "No, but it's the only thing that will keep my weight off."

Misinformation

Weight is 90% of what we eat. There is so much misinformation about food and eating though, I can understand the confusion. Find the common ground and go from there. Don't get paralysis by analysis, throw up your arms in frustration and hit McDonald's. Cut out the sugar, don't eat anything in a package. Do it for a month. Go for a brisk walk each day. See what happens.

Health can sometimes be achieved with simple (not easy) tweaks in a daily routine. A few minutes of tissue work with something like a foam roller, a few activation drills, something to get you stronger and some body awareness. It may only take 5-10 minutes in your entire day. Sit at a desk all day? Buy and egg timer, every 15 minutes it goes off, stand up and try to touch the ceiling. Go back to work. See if that nagging back pain starts to go away.

Performance on the other hand is a commitment. It is carving out the time in your day, every day. Performance becomes a lifestyle. Asking your body to do something it has never done before, whether it's distance, speed or volume, requires you doing something you have never done before. This can be time consuming. Performance has a much higher cost.

Be clear on your goals, it will dictate the course of action that is required.