2.26.2013

if you could bottle this and sell it

...I tried to name it, but alas, I could not find a worthy label, much less bottle this thing people want.   

Exhibit A: 20-rep squats

Did you know that it's awesome to barbell squat 315 lbs? That's a 45-lb barbell with three 45-lb plates loaded on each side. Merely the sight of it is something to behold.

Do you know what it feels like to squat 315-lbs? With good form? No knees buckling inward. No plia half reps or rounding of the spine or exaggerated forward trunk lean? I think that feeling is something like miseraspectacular.

Do you know what you can do in life if you can squat 315 with good form? Your posture is good. Your trunk and legs are strong and stable. Unless you're a huge meat head, you probably have a deep well from which to draw when jumping and sprinting and practicing various feats of athleticism to your hearts content.

Now imagine what it's like to squat 315-pounds for 20 repetitions in a row. With each effortful rep comes an additional heaping of misery and mental fortitude and awesomeness broad and wide. You don't need repeated death circuits or 45 minutes of running (though you probably could if you had to) because you just squatted 315-lbs for 20 freakin reps.

Why 20-reps? Well, because. If you care, read THIS IS 20-REP SQUATS.

Exhibit B: Kyle Kohler

Last week Kyle squatted 315 for 20*. He's fast. He can tuck jump close to 5 feet. From what I hear he's a force on the (hockey) ice.

My 1-year old daughter runs to him with open arms, which may be a larger accomplishment than all the rest.

I don't want to hear excuses. When I first met Kyle he had severe right hip pain that was possibly a torn hip labrum. He was weak in the hips and core. His ankle and hip mobility were terrible in all directions. He literally could not squat 20 reps with a broom stick over his head.

When many athletes and gym rats his age were fooling around with fads and high tech-looking gadgets, Kyle put his nose to the grindstone at square one. He worked on controlled mobility (flexibility and stability). I recall performing some manual hip "adjustments" but he probably did close to 1000 total reps in appropriate wimpy rehab type moves. He revised his training. He could run and ice skate and lift weights without hip pain.

He showed up to train in a little basement with a crappy ipod player and less than $1200 worth of gear. He didn't change his set and rep and exercise scheme every other week. When squatting 225 for twenty was brutal he took on 230 the next week. When the weights increased but his form dwindled he cut back. When butterflies and vertigo struck BEFORE going under the bar for 275, 280, ...300 X 20, he went there and got 'er done.

He listened. Well, he 80% listened, which is about 40% better than I could achieve at his age.

How do you get a person to define exactly what they want and actually listen and work hard at pursuing it for longer than 8 or 12 weeks? I'm not suggesting that these goals are the best goals for everyone or that my way of training is the only good way. But our ADD technology driven population sure could benefit from trying some consistent, basic, hard work done well.

These qualities seem too familiar and simple, but they cannot be bundled into a neat package. Hopefully there's value in the understanding gained from reading about it!


*Squats were technically 1/2 to 3/4 depth squats. Not butt-to-heels as required for an official powerlifting meet or whatever. Depth is sufficient to be miseraspectacular and safe given Kyles stature and slight impairments in hip and ankle ROM that he's still working through. I rarely advise heavy full squats due to patellofemoral damage that they usually do impose over time.

Kyle dead lifting 350X5:

video
                                                               "Nobody Elllssseeee???"
                                   

2.17.2013

elbow pain from throwing


"ice. rest. wimpy wrist curl."
If you have sought the attention of a medical doctor, physical therapist, athletic trainer, or personal trainer for the treatment of throwing related elbow pain, you MUST demand more out of them than the old stand-by treatments that even a cave man can advise.

-Take two weeks off. 
-Apply ice.
-Apply electric stimulation and/or ultrasound.
-Do these 12 variations of wimpy wrist curls. 

There is a time and a place for these modalities. They often help control pain and inflammation and promote healing in the first few weeks after an injury. But what do you think is likely to happen when the athlete attempts to return to awesome beast-like throwing?

Medical professionals should at least attempt to track down the source of the elbow injury. There's almost always a clear reason why the tissue is being over loaded. Really, it doesn't require a huge amount of effort or knowledge base to show the world that you're more than a cave man. Your PT, trainer, etc should consider these as a minimal demonstration of non cave man competency:

-Shoulder strength and range of motion.
-Thoracic mobility and scapular stability. 
-Hip strength and range of motion.
-At least ask if the athlete or parent has a video of them throwing, and at some point, take a video if possible. 

Any decent non-cave sports medicine man or women knows that medial elbow pain (near the "funny bone") is generally due to overload of the ligaments and stabilizing muscles during the acceleration phase of throwing, and that lateral elbow pain (thumb side) is due to overload when the arm is decelerating after ball release. They know when and how core and hip strength applies to throwing. They know that throwing with a higher arm slot tends to protect the elbow and strain the shoulder, while a lower arm slot (often referred to as "three quarters") tends to protect the shoulder and strain the elbow.

Over the years of evaluating and treating shoulder and elbow injuries, this grunt has learned to be suspicious of the hips. Lack of hip and/or shoulder external rotation (ER) or internal rotation (IR) often results in more torque at the elbow. The shoulder IR/ER values that are acceptable for an overhead athlete are not what the textbook says.

Years of hard headed trial and error experience as an athlete and working as a small private practice medical professional tends to help my patients/clients survive the modern era.

2.12.2013

My doctor said I can't do squats


Your doctor says you can't do squats? You sought the help of a trained medical professional for specific guidance only to receive a simple can't?

"It hurts when I do this doc."
"Well, don't do that."

The only problem with "Don't do squats" is that they're good for so many things and squatting is a part of everyday function. But mostly, I'm too hard headed to accept simple cant's.

Does your doctor allow for partial range squats? Will he change is mind if you "do time" working on the strength and mobility of your trunk and hips and ankles and feet? Does he allow you to squat down to lift a bag of groceries, or would he prefer that you do the old spine mangling bend and twist? What if you have to poop in the woods? Or get down to give a cold cup of milk to your baby kitten?

So many questions. Do they not realize that for some people, giving up on squats is giving up, and forfeiting a huge portion of their Awesome Card.

Straight up Cant's are usually not necessary. They often reveal ignorance of the topic matter. Cant's are often dolled out as blanket statements that enable the doctor to move on quickly to the next patient.

Now don't get me wrong. No one is exempt from time. You and I are no exception. At some point we simply can't run, jump, vault, or pull 360-cork twists off a ski jump.  At some point you will move on to more appropriate and noble deeds than being physically awesome.

A squat is not a squat is not a squat.

Yes, if you had ACL surgery you should never try doing heavy loaded, butt-to-heels squats. Deep squats are generally not good for the ACL or the cartilage on the back of the knee cap, whether or not you had surgery. If a person tore their knee meniscus from crappy form while squatting and they still have crappy form, then by all means, that person should not squat. At least not until they make some major adjustments.

Proper squats and variations are actually GREAT for establishing the strength and stability that protects the ACL, patella, as well as your ability to be awesome! Are leg extension or recumbent bikes going to make your legs resilient when it comes time to accelerate or cut hard or catch yourself from a stumble?

Have you tried Goblet squats? Single leg variations? Lunge variations? Bowler squats? Strength and mobility corrective exercise are often extremely helpful for people of all ages and interests getting back to doing what they want. It doesn't take a genius to know that you should not be piling on the plates in the traditional barbell squat if you have
  • huge thoracic kyphosis
  • minimal lumbar lordosis
  • core (mid back, lower back, abdominal) weakness
  • hip inflexibility (and aformentioned weakness) that causes your lower back to round
  • hip weakness (especially gluteus medius - the side butt muscles)
  • ankle inflexiblity
If squats hurt and you really want to squat, I'm nearly certain that I can get you there. You may not set a new world record. You may have to finangle ways around a touchy meniscus or patellar chondromalicia (worn out knee caps). But you will get stronger in ways that protect your joints and deepen your awesome bucket.

- - - - -

[And then there is surgery. A good rule of thumb is that if you elected for a doctor to open up your body for carpentry, then you should heed the can't. Don't botch up their handiwork. But other than surgery-as-a-final-resort, you should not go down without a battle. ]

 - - - - -

I'm going to be very stubborn with this. I've seen and helped too many people who have smashed through their can't.

...At least for the time being.

2.09.2013

The best training split


There was a time when I devoted FAR too much of my limited life on this planet to planning my training. I majored in the what, where, and when of training and other minutia. Would every system, muscle, and movement be covered? What about sports? How would the almighty training split fit with my class or work schedule?

Oh, the agony of this #FirstWorldProblem.

Then I found somewhat of a clue about life and cut back from the ridiculous over-the-top scheme meant for steroided middle-aged bodybuilders. The idea was to cut back to three training days per week. It was a decent split that went something like:

Pummeling Split:

Chest, shoulders, and triceps on day 1
Back, biceps, and abs on day 2
Legs on day 3
There would be one to two days off between each work out. 

That worked for a while and then quickly turned to over-kill. For example, day one had me doing variations of lateral (shoulder) raises and cable tricep pressdowns after going hard at multiple sets of two or three big "push" moves like bench press, incline dumbbell press, and overhead presses.

The Pummeling Split left muscle groups terribly sore for 3 days, then kind of static. Progress halted but the 3 days of soreness never stopped. I hated training legs only once per week.

So from there I moved to a 4 day per week plan that looked something like:

I Have No Life Except for Weight Training Split: 

Lower body (squats and leg press focused) day 1
Upper body (chest and back focused) day 2
Lower body (dead lift, single leg work, leg machine focused) day 3
Upper body (Shoulder and arms focused) day 4

This worked for a while. I was one of those people who you see every time you set foot in the gym, there when you arrive and still there when you leave. I'm not proud to admit that I did this for a long while during college. But there were only 7 days per week to include everything I read in the glossy training mags and what I was being taught in class.

Some college kids go off and go crazy with the drugs and beer. I got caught up in weights and frivolous supplements.

For some reason when I was playing serious flag football and basketball in college I stepped the training down a notch. Finding an ounce of a life and later being involved with physical therapy (grad) school actually worked to my training benefit. I finally had to respect recovery. Isolating the rear head of the deltoids, the medial pecs, and the long head of the who-gives-damn wasn't necessary if I stayed balanced from working hard on the big lifts with nearly perfect form.

That's when my 3 day per week split looked something like:

The Graduate:

Lower Body Day 1
Upper Body Day 2
Total body Day 3

I'm happy to admit that I stuck this out for a long while, making plenty of mistakes and refining it along the way. A notable wave of progress in this split came when I quit the big gym. The limited options in my home gym were actually a benefit to cutting the fluff and focusing on what matters.

This split brought plenty of progress and would surely have allowed for more if I would have better refined my goals and kept the workouts even more simple. I let them get too long to fit everything in. I tried to accomplish too much at once (like squatting and dead lifting for low reps and heavy weight within only a few days of each other). But I still like this split.

Then at some point I kept having a job and more kids. I truly quit caring much about training my upper body and I found a love for sprint/plyometric type conditioning. So these days, my total weekly training split looks like:

The Minimalist

Total body day 1 (focused on dead lifts, single leg squats, and bench press variation, in that order)
Total body day 2 (focused on weighted Chin-ups, overhead press variation, and 20-rep squats)
Plyo Friday day 3

I do throw in some hard and heavy auxillary work like "lawn mower" rows, barbell curls, and push-up variations, but that's about it.

This is the split that I used to reach a 375 lb bench press, 600 lb dead lift, tuck jump over 5'4", and chin up plus 135 extra pounds around my waist.

These days I'm still learning plenty. For example, I've found that after squatting upwards of 400 pounds X 20 on Saturday, my legs aren't fully recovered for heavy dead lifting on Tuesday. Since it's not easy to postpone or shuffle training days due to work and family schedule, the only alternative is to let one of the major movements drift in order to progress the other.

What training splits have you found effective or otherwise favorable?

Fitness fanatic type people: I dare you to try cutting back just a bit and see what kind of new resolve and effort you pour into your training days. Find what else you can accomplish with that extra time and energy during the "off" days.

**Athletes in endurance-based sports** it is highly likely that you would greatly benefit from the minimalist or the graduate resistance training split - at least for a significant portion of your off season. And ain't nobody not got time fo that ; )

Nonfitnessy type people: serious results can be had by training only 2 or 3 days per week if you're willing to be consistent and pour it on.



2.05.2013

Shoe inserts for plantar fasciitis


I. Hate. Sounding like a salesman.

But that is exactly what happens when, at a clients request, I explain the rationale for custom inserts in the management of plantar fascia pain. The most common question goes something like, "How are custom inserts going to be any different than the inserts I bought at the shoe store?"

All the discussion is for good reason. Custom inserts are often used and abused as a treatment option, and many clients pay cash if their health insurance does not cover them. Thankfully, the rationale is far more science than marketing hype. When used with attention to detail, they are often effective in dealing with this common, stubborn problem.

Without getting too geeky about ankle/foot biomechanics and the function of the plantar fascia (PF), we'll just say that there are many causes of plantar fascitis. The function of the achilles tendon and great toe are intimately connected to the plantar fascia, and inflexibility or weakness at either point can place undue strain across it. People with high arches typically have PF for different reasons than those with low arches.

The most important thing that you need to understand about plantar fascitis is that the problem is not due to ground pressure into the foot, but from abnormal strain ACROSS the length of the foot. The chronic pain, inflammation, and degenerative changes are coming from the PF being pulled apart and/or twisted, not from being pressed into. 


This is why squishy shoes, gel heel cups, and soft cushioning inserts rarely provide long-term relief. In fact, fluffy footwear like Crocs may make the problem worse since most provide inadequate rigidity to counter the forces that are pulling the plantar fascia apart.

Some quality shoe stores and Walmart offer off-the-shelf inserts that are "prescribed" based on pressure measures taken when standing on a computer-interfaced mat. That information is somewhat limited:

1. The computer does not identify what takes place when you walk or run. 

2. Even the best off-the-shelf inserts are shooting for the average foot. To accommodate a large subset of the population, they must necessarily be fairly pliable and thus provide insufficient rigidity and control. Off-the-shelf rigid orthotics are rarely well tolerated because appropriate contour is nearly impossible to achieve with one or three orthotics for every foot type.

3. Footwear makes a difference. The computer doesn't know what shoes you typically need for work, what you prefer, or what is good to "marry" to the right insert. 

4. Lastly, some feet are simply structural outliers and will not fit into even a soft orthotic that is tailored toward the average.

Now don't get me wrong. When the plantar fascia is acutely inflamed and swollen it will feel better to have just about anything soft between your foot and the ground. And if you bought a $12 Doctor Scholls or other over-the-counter insert and it relieved the pain, then that's great. Really, why not try it?

When those fail, here is what custom inserts have to offer:

1. Based off a static and dynamic (you move!) ankle and foot evaluation, they can specifically facilitate the "help" of the achilles tendon and great toe, thus taking some of the strain off the plantar fascia. 

2. They can provide some rigidity to help resist the strain and twisting forces. We have found that in reality, a custom insert made with a semi-rigid shell is better tolerated and just as effective as a rock hard, crush-your-foot-to-smithereens rigid shell.

3. They can promote more even distribution of pressure throughout the length of the foot (including ON the plantar fascia) sparing the typical high pressure areas on the heel bone and the ball of the foot that twists and pulls the plantar fascia apart. Based off a plaster cast of the foot, custom inserts truly stand out as the only option for pressure redistribution.


2.03.2013

my first workout was a huge FAIL


I once was a training outsider, completely disinterested in resistance or any other training. I remember the feelings of intimidation, uncertainty, and insecurity like it was yesterday. You thought I was born with a silver barbell (weighing well over 500 pounds ; ) ) in my mouth hands?


I first stepped into the Mount Pleasant High School field house, during the end of 10th grade. I was clueless about training beyond hope, but held vast knowledge in terms of where everyone begins that journey. [Bet you can guess!]

Of course it was the bench press! I surveyed the scene and decided to start with something a little less daunting than the two big plates that perched with great heft on the barbell. It turns out that each of those weighed 45-pounds, plus 45 for the bar, but what did I know?

I proceeded to tug one of the plates. It quickly slid horizontally down the bar, coming to the end before I had the chance to adequately grip it. Forty five pounds of metal free fell from waist height directly onto my right big toe.

That toe would throb for weeks and at least four years would pass before it quit cracking when I walked barefoot.

And with that my first work out was complete. There would be no sets or reps or awesomeness. I could not even lift the dropped 45 pound plate off the ground, sliding it across the floor as I struggled to get my fingertips beneath the square edges. It taunted me as I limped outside, pretending my toe wasn't screaming. I plopped down in the grass with my back leaning against the brick wall of the field house, and waited there for my my mom to come pick me up.

 - - - - -

These days, I try to make a mental note of something I learned from each and every work out. I never keep a journal, but sometimes write about it here. The only thing I learned from my first lift ever was that the coefficient of friction between metal barbell and metal plate is minimal. But there's another lesson from this trip down memory lane.

I recently stated how I'm particularly impressed with the young athletes that dive into training. I blathered on about them learning the value of hard work. Until the age of about seventeen I was most definitely not one of them.

It's good for me to remember what it was like to be a child and adolescent whose world revolved around fun and sports. I remember ignoring my dad, uncles, and coaches who knew what I needed. I wanted nothing to do with discomfort and discipline and effort. Not even athletic failure could immediately tear down the massive blockheadedness. It simply wasn't going to happen until I was ready.

So mom, dad, and coach, don't be too discouraged if your charge(s) has yet to value effort. Encourage. Inspire. Lead by example. Do not indulge your own feelings, muting the lessons of pain, failure, and consequence. Life is a process. Be a solid powerhouse of patience and grace.

- - - - -

2.01.2013

Effort trumps victory, and...



Kyle Wagner recently gave an outstanding facebook shout out. It was directed to a group of young men he recently worked with at GoWags and it particularly applies to the nature of baseball. But could not everyone in any walk of life use this reminder?

I want you to know how proud I am of your effort lately. You are truly starting to appreciate the value of hard work. Your performance will always have its ups and downs. That's life. But effort...effort never goes in a slump.

You have to understand that Kyle is a coach of coaches. He will not call a turd a golden nugget, so when he speaks it means something. So, wow. 

And you thought all this was just about baseball and training?

Many young men and women love sports. Few of them will obtain a scholarship or collect a paycheck for baseball. But sports have the potential to be a vehicle, a priceless over-sized tractor trailer packed with life application, for the majority of them.

Mom, dad, kids...don't just watch the game. Pay attention to the what and who and how of their surroundings.

You have to remember that even setting foot onto a playing field or gym is a huge step for anyone. So when I see adolescents and young men actually digging the hard work and not merely the victory, I'm completely impressed. 

Yes, effort definitely trumps victory. But there's more. The cool thing, the outstanding thing is that effort tends to lead to victory.