Tag Archives: sports performance training

Increasing Intensity Without Increasing Load

This is an article I originally posted on SportsRehabExpert.com, and thought it would be a great piece for the blog audience as well so I apologize ahead of time if some of the terminology is a bit too ‘medical’.

 

I’m constantly on the lookout for ways to challenge my patients and athletes, but without overloading their joints and tissues.  Many of them want to really push themselves, but sometimes they are at that point in their lives or careers where it’s just not appropriate for longevity sake.  In this article I’ll discuss some of the strategies I use to get the most out of strength training without overloading the weakest link.

There are 4 basic ‘solutions’ to this problem that I will use.  I think the best way to cover these would be to describe a couple cases for the lower body and upper body:

Case 1:  Active military gentleman with 2 episodes of disc hernation and radicular symptoms within a two year period.  Both episodes were brought about with heavy lifting, but he also spends quite a bit of time sitting in the back of a helicopter in a seat that’s about 6″ off the ground (his knees are practically in his face).

I worked with him after the first incident, cleared his movement and had no symptoms.  He resumed weightlifting and all other previous activities. After 6 months in the clear he went back to heavy squats and deadlifts, and after 2-3 months of that began noticing the radiating pain into his left leg again.

This guy is an absolute beast when it comes to his fitness level and his form has always been very good.  But because of his past and his work demands, this is a guy that I want to limit the load he is using, as well as the positions he puts himself in.

Solution #1 – Move from bilateral stance to split or single leg stance

This one is pretty obvious in that there is no way he is going to load single leg activities the way he can load a traditional squat or deadlift.  Single leg deadlifts and squats are great options here because of the extra stabilization needed just to balance and control the trunk.  There is only so much weight you’re going to pull with these single leg movements.

Solution #2 – Asymmetrical loading

An example of this would be a single leg deadlift in which the weight is held in the opposite hand (of the stance leg) so the trunk must work in an anti-rotation manner as well as anti-flexion (see video above).  Another great example would be a front squat with a kettlebell in one hand (see picture below) using either the traditional grip or bottoms up.  The demands on the core can be quite high loading in this manner so the athlete gets a great workout with less overall load.

Single Arm Kettlebell Squat

Solution #3 – Postural Assist

Split squats or rear foot elevated split squats (REESS) are ideal for this type of athlete because the positioning makes it easy to maintain an upright spine and therefore decrease the shearing type loads you would see with a traditional squat where the trunk is angled forward.  Mike Boyle (one of the top strength coaches in the world) has talked extensively about this and thus his programs have moved from back squats to front squats to RFESS over time.  This type of squat can easily be asymmetrically loaded as well (different weighted dumbbells in each hand).

Rear Foot Elevated Split Squat

Solution #4 – Bottoms Up

There are many reasons I like kettlebells, and the ability to go bottoms up is another one of those reasons.  I can instantly make any kettlebell exercise much more challenging to the athlete’s grip and stability.  The video above showing the KB front squat is a great example, plus I will frequently use this with Turkish Get-Ups, various carries, and presses.

Double Bottoms Up Kettlebell Squat

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Case 2:  This is more of a general example here as I work with a number of adult athletes post rotator cuff repair looking to return to their sport and the gym.  Unless they are competing in powerlifting or weightlifting events, I really don’t need them putting a whole bunch of weight on the bar to bench or shoulder press any longer.

My #1 job is to protect the repair while they are seeing me in PT, but also when they are beyond my care.  Job #2 is to give them tools to enhance performance and get them back to the sports they enjoy.  Again I believe this can be done using the ‘Solutions’ mentioned above.  Here are some examples for the upper body (although in the clinical or performance setting I would never really divide them up this way).

Solution #1 – Move from bilateral to single arm exercises.

The same idea applies to upper body as lower.  The amount of stabilization and balance needed to perform single arm presses (horizontal and vertical) is going to make it quite difficult to really load up with weight.

The single arm bench press is one of my favorites.  I have the athlete scoot their hip and shoulder off the bench so they really have to fight the weight pulling them off the bench.  I usually have to start athletes at about 50% of what they could dumbbell bench using the traditional two arm method.  Athletes are not always happy about going down in weight but they feel right away this is going to make them work.

Solution #2 – Asymmetrical loading

In the case of upper body pushing and pulling, the ‘solution’ of asymmetrical loading is usually just a version of ‘Solution #1’.  Another way to inject greater asymmetrical loading into singe arm lifts would be to have the athlete lift from a single leg stance position.  This isn’t something I use real often but there have been times I’ve had to be cautious with someone’s shoulder and wanted to increase intensity without increasing load.  Single leg/single arm kettlebell presses fall into this category, as well as single leg rows (hamstring killer!).

Can’t believe I couldn’t find a better picture than this!

Solution #3 – Postural Assist

In this instance, requiring the athlete to stand to overhead press (or go tall or half kneeling) brings a lot of postural and stability requirements to the table.  It makes it more difficult again to really load up the lift when they don’t have a bench to press into.

Solution #4 – Bottoms Up

Same thing again using the kettlebell bottoms up to work the grip harder and force great stability from the upper quarter.

Single Arm Press – Now that’s a picture! That KB is 55 KG by the way

Now don’t get me wrong, I still love to see big lifts.  There are just times when the person in front of you needs less loading so be creative and use these techniques to help create an optimal environment to make gains without risking injury.

Elite PT and Sports Performance Exercise of the Week – The Whip Snatch

I wrote this article for my SportsRehabExpert.com site a few weeks back, and figured it would be good to share here as well just to give you an idea of some of the more advanced strength and power methods we use here at Elite Physical Therapy and Sports Performance.

 

I picked up this exercise from strength coach Paul Longo at Central Michigan University about 8 years ago (and now at Notre Dame). This was one of his favorites since it was so simple to teach and really hard to do incorrectly. I’ve used this exercise over the years with my more advanced athletes, and they’ve really like it so thought I would share.

Couple prerequisites here:

1) Deadlift is first and foremost. As you’ll see in the video, a great hip hinge is a requirement so the athlete must be technically sound in the deadlift.

2) Swings are a favorite of mine and I really just see them as deadlifts for speed and power. The athlete must demonstrate a perfect hip hinge, good power as they drive the hips into extension, and also must be able to stop the kettlebell on a dime and throw it back down. The last point here just shows me that the athlete has the ability to coordinate and stabilize through the entire body in an instant. This is important to me now that they will be going overhead with a bar.

3) Hard Style Overhead Presses are also important, not just for upper body strength, but also for that ability to learn how to stabilize the entire body while driving a weight overhead. It’s one thing to press a weight, and an entirely different thing to catch a weight overhead. I want to know my athletes are rock sold with their arms overhead.

Now on to the Whip Snatch:

Teaching Tips:

1) I don’t get real technical with measuring for grip on the bar for this lift. Have the athlete get their hands at just the right width that the bar sits at the level of their hip crease.

2) Push the hips back with the bar as far as possible. I will have them just do reps of this hip hinge initially.

3) Jump and shrug!

4) Catch overhead.

I find that if we have the start position correct and we’ve worked through the progressions, the rest of the lift usually falls in place. The only other cue I find I need at times is ‘elbows to the ceiling’ after the jump shrug to keep the bar close to the body.

The whip snatch is a great power move and one that falls in line with many of the other lifts we talk about here on the site. Definitely one to give a try!

Ankle Rehab Update

So last week I posted this message on Facebook:  “Limited ankle mobility is a very common reason for nagging foot, knee, hip, and back pain in runners. Unfortunately not too many PTs or doctors are looking there. Maybe it’s time to call us and rid yourself of that pain for good!”

In the past week I have been asked 3 separate times about what is the best way to check your own ankle mobility and then how to improve it.  So to bring you up to speed on why it is so important to have great ankle mobility I refer you to a previous blog post title “Movement Proficiency and the Ankle” which you can find here:  http://www.elitepttc.com/blog/?p=20

Now for the measuring and correcting!

The first video below shows how I measure ankle mobility in the clinic with the foot on the floor and controlling the ankle to prevent pronation (arch flattening out):

To measure your own ankle mobility, simply assume the kneeling position shown in the video.  Rock your knee over the foot to touch the wall measuring how far your big toe is from the wall with a simple tape measure.  The heel must stay down and arch not allowed to collapse.  The goal is 4 inches!

The next video demonstrates how you can quickly address the soft tissue component of the limitation.  Be sure to measure again as we did in the video as this is the only way you are going to know if it is effective or not.  Always follow the rolling with stretching.

If this does not result in an immediate improvement in ankle mobility, you may have a joint restriction that will not be resolved with rolling or stretching.  Another sure sign of joint restriction is pain or pinching in the front or side of the ankle during the testing.  This can often be resolved quickly with ankle joint manipulation and/or mobilization and certain taping techniques that I employ here at Elite Physical Therapy (in other words it’s time to call the professional).

If you have any further questions feel free to contact me:  joe@elitepttc.com

 

 

 

Does Gaining Range of Motion Really Have to Hurt???

Not all physical therapists are created equal, nor does gaining range of motion have to be extremely painful!  I know there is this idea amongst the public that PT has to hurt to effective, but in most cases nothing could be further than the truth.  Sadly enough there are plenty of PT’s out there who also believe ‘No Pain, No Gain’ to be true.

Here is why it does not have to hurt:

–  When the brain starts feeling ‘stress’ it goes into protection mode.  Pain signals coming in to the brain result in signals back to muscles, fascia, and joint capsule to literally tighten down to protect the painful structure.  So the entire time your PT is cranking on your new Total Knee Replacement, or you are cranking on it at home per their instructions, your brain is busy fighting back.  The result is lots of pain and minimal progress.

– Pain fires up your sympathetic nervous system, the part of the system that handles ‘fight or flight’ situations.   My good friend and physical therapist/strength coach Charlie Weingroff has been consulting with Nike and their athletes on this very topic.  What they have found is that athletes who are in this sympathetic state even at rest exhibit increased stress hormone levels that result in poor sleep patterns and poor recovery from workouts and games.  This elevated level of stress over the long term can have some serious effects not only on athletes, but on the rest of us as well.

Balance is good!

The moral of the story here is that increased pain and stress levels can delay healing and recovery.  Some pain is going to be present when you’re dealing with an injury or surgery, but your therapy should not be making you consistently feel worse  Not what you want when trying to recover from an injury or surgery, and certainly not an ideal situation for someone trying to gain range of motion, strength, and returning to work or athletics.

At Elite Physical Therapy and Sports Performance, we recognize that there are a number of soft tissue and joint mobilization/manipulation techniques that can improve range of motion and quality movement without creating excessive pain.  Some techniques may be a bit uncomfortable at the time of application, but what little pain there is should go away quickly with an obvious increase in joint motion and overall movement quality.

Graston Technique can be used to break up scar tissue and improve range of motion of the knee.

 

Graston Technique is also very effective for treatment of tendinopathies – in this case treating the posterior rotator cuff.

In most cases, there are better ways to gain range of motion and strength than trying to push through restrictions and pain.  If you’ve got any questions concerning our soft tissue and joint manual techniques, feel free to contact us.

C1-2 Thrust Manipulation – this one is money for headaches!

Trigger Point Dry Needling – Coming Soon!

 

The Best Mobility Drill Ever?

I’m into exercises that give you more bang for your buck since I know most athletes are pressed for time, and there are plenty of other training skills they would rather be working on.  The ‘Spiderman’ exercise happens to be one of those exercises that can address everything from hip mobility to thoracic spine mobility to shoulder stability. It is absolutely one of the best warm-up drills you can perform and it’s a staple in our programs.

Check out the video below for a short tutorial on how to perform the exercise, what you should be feeling, and what to watch out for as far as ‘cheating’ through the movement.

Previously posted on SportsRehabExpert.com (the video was originally shot for physical therapists and sports performance professionals so I apologize for all the medical lingo)

Elite Sports Performance

Sports performance training is one of the favorite parts of my job.  We definitely do some unique things here, and I happen to think we get some pretty good results too.

I put together a compilation video that you can check out below.  I doubt you’re going to see anything else like this in Northern Michigan!

 

Michael Phelps talks Graston Technique and Training

This article was sent to me yesterday, and I found it not only very interesting, but also validating what I do at the same time.

http://on.details.com/PLYA8S

Michael discusses the benefits of Graston Technique (GT) on relieving pain and freeing up his shoulders and back for swimming.  This is only his subjective report but who is more in tune with how they are performing and functioning than an elite Olympic athlete?  There is plenty of research being done on GT with great evidence based outcomes so I’m very confident that the benefits are real.

One more thing I do want to mention concerning the use of GT in the article, and Phelps’ comments on the pain and bruising that go along with treatment:  the research indicates that GT is just as effective without the pain and bruising.  Of course there will be some pain as you are trying to break up scar tissue, but there is no need to be ultra-aggressive and bruise.  The majority of my patients will tell you they have some mild to moderate discomfort during the treatment, but are rarely all that sore afterward.  The pain relief and improved motion following the treatment is well worth it.

On the subject of training, Michael talks about how his focus this time around has been on developing more power.  He specifically mentions performing the Olympic lifts and pulling/pushing sleds, both of which are mainstays in our sports performance programs.

At first glance you may wonder why in the world a swimmer would need to do power cleans and run with a sled?  Especially when he’s not even on his feet more than a split second to push off the platform.  Many of the benefits of this type of training are for the nervous system and the speed at which muscles can contract.  Training for power means moving a certain weight as quickly as possible.  The faster you can move it, the more powerful you are.  Strength is different in that time doesn’t matter, only how much weight can you move.  Strength is very important, but in swimming and pretty much every other sport out there, its the speed at which you can generate that force that is most important!

Here is a great example of a power clean (one of the Olympic Lifts – this from my buddy Cal Dietz at the University of Minnesota)

Aaron Studt Cleans 400lbs

Anyway, I hope you enjoy the article.  I can’t wait to see how he does this summer.

Plank Exercise Progressions

If you’ve mastered the front and side plank basics that I’ve discussed on here previously, now you’re ready for some challenging progressions that I feel really carry over to athletics and can get you closer to your training goals.

Each of the following plank progressions add hip motion to the equation so you will be supported on one limb for a period of time.  It’s the support leg that is most important for stability and will be working the hardest.  With all of these exercises, you must maintain a stable core.  So in other words, when you lift a leg your trunk should remain motionless.  If you have to lift your butt up or it sags down then either it is too much for you or you are getting fatigued and need a break.  Perfect reps, nothing less.

The other great thing about these exercises is that they give you a chance to look at symmetry.  By this I mean how does your right leg compare to your left leg when doing a front plank, or how about right and left sides when performing a side plank?  It should be just as easy or difficult on both sides.  Right-Left asymmetries are a huge predictor of injury so work to limit these.  Typically I will have patients or athletes perform an extra set on the weaker side to bring that side up to par.

Alright, done with the lecture.  Check out the plank progressions below.

Prone Plank with Hip Extension -alternate lifting legs about 4-6 inches off the floor.  Nothing moves but the hips.  Shoot for 10 solid reps each leg without losing form.  And if you’ve been paying attention in previous posts, hold the leg up long enough to cycle a breath, then set it back down.  That will be the true test of your inner and outer core working together.

Plank with Hip Extension

Side Plank with Hip Abduction – I really like the side planks as they test your entire lateral kinetic chain for stability.  Post up through the forearm by pressing it ‘through the floor’.  Now lift the top leg keeping the hips high.  Shoot for 10 quality reps with proper diaphragmatic (belly) breathing throughout.  When you can achieve that, now hold the leg at the top and cycle a breath before bringing it back down. 

Side Plank with Hip Abduction

Side Plank with Hip Adduction –this is another great variation that I think gets overlooked.  The bottom leg will be off the ground in this case so the adductors (inner thigh muscles) of the top leg will be carrying more of the load.  Breathing is crucial again so get it right.  Start with 10 second intervals if necessary shooting for 30 second holds ultimately.  If you’ve achieved that, then progress the exercise by moving that bottom leg back and forth.  It should look like a running stride – flex the hip up and then extend it back.  Adding the front to back movement will make your core have to work that much harder to remain stable.  I’ll shoot for 10 reps here again as well.

Side Plank – Hip Adduction

Three great ways to challenge yourself!  Remember to play close attention to those side-to-side differences.  Cleaning those up will bring the greatest benefits.

 

Exercise of the Week – Front Plank

I’ve discussed the front plank here previously as a way to demonstrate the mistakes many people will make when performing ‘core’ exercises.  The most basic mistake is allowing too much lumbar extension (excessive inward curve of the spine).   In this position, the spinal joints are compressed and providing the stability.  This is a great way to hurt your back over time!

In that post I wrote about achieving a more neutral spine position by trying to pull the belly button to your nose.  This activates the abdominals and rotates the pelvis backward slightly bringing the spinal curve to a more neutral position.  Check out the examples below.

Too much extension

Neutral spine posture

You can see in the second picture that a straight line could be drawn from her hips through her spine to her shoulders.  That straight line should also extend through the neck to the ear, but I’ll talk more about that in a moment.  The neutral spine position is the first correction that must be made, but once you’ve mastered that here are a few other  techniques to get the most possible benefit from the front plank exercise:

1.   ‘Breathing behind the shield’ – this is a cue used by the RKC (Russian Kettlebell Challenge) to improve spinal stability and strength in the plank and other kettlebell exercises.  When breathing appropriately, you should feel the abdomen expand circumferentially (see the picture below).  The chest will expand slightly but definitely do not want to feel the shoulders rise toward the ears.

Using the diaphragm appropriately during any activity triggers the deep muscles of the core that are responsible for segmental spinal stability.  This is the most basic level of stability in the spine and what keeps our vertebrae in proper alignment.  This is a must for injury prevention and optimum performance.  We all breathed this way when we were younger but most of us lose this ability especially when challenged.  Check your breathing right now.  Do you feel your abdomen expand when you inhale?  Or do you feel the expansion in your chest?  Worst of all are your shoulders rising when you inhale?  Pathological breathing pattern can contribute to all sorts of orthopedic ailments and reduces your ability to exercise efficiently.

The ‘shield’ refers to the braced muscles of the abdomen.  If you’ve taken the steps I’ve described above then you should feel the abdominals contacting hard.  The breath should feel like it is pressing out into the abdominals.  Many trainers and clinicians advocate drawing the belly button in toward the spine, but this only destroys the breathing pattern and weakens the deep stabilizing unit.

2.  ‘Pack the Neck’ by pulling the chin back to your spine.   The common mistakes here are to bring the chin down toward the chest or to look up.  You should be looking straight down and feel like your head moves up away from the floor.  This small movement activates the deep flexor muscles in the front of the neck which are known to be a ‘trigger’ for recruitment of the inner core muscles I spoke of in #1.  Again, anything that makes you stronger in this exercise will only help bring you closer to your fitness goals, prevent back pain, and improve carry over to everyday activities and sports.

Packing the Neck – I was unable to find a good example in the plank position – which should tell you how few people do it correctly!

3.  Increase abdominal muscle activation by pulling your elbows to your toes.  The elbows aren’t going to move, but you want to feel yourself pulling into the floor in that direction.  You will feel the abdominal contract much harder as well as the large latissimus muscles on each side of the upper back.  Once you can hold your plank using this technique, now try to pull your toes toward your elbows.  Once again you will feel everything tighten down and bring more muscles into the exercise including the abdominals.  This uses the principle known as irradiation which basically means the more muscles you can recruit the stronger you will be.

When you try these techniques you realize how hard the plank exercise should really be.  I’m not impressed by people that tell me they can hold the position for 5 minutes because they are doing it wrong.  This should be an extremely difficult exercise.  Start with 10 second holds with 10 second rest breaks.  The goal should be to hold 20 seconds per rep, rest 10 seconds in between, and then work up to 10 reps.

Feel free to leave your comments and let me know what you think.  Thanks!

“Don’t Put Fitness on Dysfunction”

This is one of my favorite sayings from Gray Cook (physical therapist,). What he’s getting at, is we need a solid movement base – meaning joint mobility and stability, muscle flexibility, and balance – prior to training for strength, power, speed, and so on. Or before just going out and participating in a given sport or taking up something like jogging. Here is the Functional Performance Pyramid he came up with.

What this basically says is we need to move well before we should begin any training program or athletic endeavor. The purpose of this is not only to get better results from our training, but also to prevent the injuries that seem to go hand in hand with training and athletics.

The research is now clearly showing that the movement skills we once possessed as children, are vital to our health and performance as teenagers and adults. Research done in professional and collegiate sports, as well as in the military, is demonstrating that a base level of movement competency is necessary to prevent injuries. Not only that, but training and performance are enhanced in athletics. In the military it has been shown to correlate to drop out rates in basic training.

Do you still move like this?

Here are two factors from the research that relate how well you move to injury risk:

1) Previous injuries
2) Right-Left asymmetries

These are the two biggest predictors of injury in athletics and in those that train, run, bike, ski, etc. Previous injuries we have experienced often create compensatory strategies to allow us to continue to perform our desired activities. Something as simple as an ankle sprain provides a great example. To continue to run, just in this example, the calf muscles tighten down to protect the ankle and you lose ankle joint motion. This requires compensatory motions from the knee, hip, and up the chain into the spine. This is meant to be a short term adaptation but often becomes chronic – a new way of doing things. Over time the accumulating microtrauma can lead to overuse type injuries such as plantarfascitis, achilles tendinopathy, knee pain, or back pain. Occasionally it can lead to bigger, more devastating injuries.

Right to left differences in movement (asymmetries) can create a similar scenario. Often our work, school, and athletic activities create these side to side differences that will have much of the same affect. We move well one direction, but not the other. Repetitively moving in our more mobile direction creates excessive wear and tear on our joints and muscles. When forced to move in our not-so-mobile direction repetitively or with great force (a.k.a sports), serious injury can result.

45 deg on the L and maybe 20 deg. on the R = not good!45 degrees of hip rotation on the Left and 20 degrees on the Right = Not Good!

This is just the tip of the iceberg when it comes to movement quality and injury prevention, but I wanted to give you a little flavor of what’s to come. At Elite Physical Therapy and Sports Performance, we put a premium on enhancing your movement capabilities while rehabbing or training with us. The research is showing that we’re playing with fire by just jumping into training programs or athletics without first assessing how one moves, determining base levels of strength, conditioning, etc. I prefer using the Functional Movement Screen and Y Balance Test with all athletes and those who want to train hard, but it can be any system that takes a good hard look at how you move prior to putting you under the bar or out on the field or court.

I think this quote by world renown physical therapist Diane Lee (who has worked with the Canadian Olympic team) puts in all in perspective: “Don’t run to get in shape, you must get in shape to run”. If you move well, you can train hard. If you have a ‘weak link’ then we must address that to help you meet your goals.