Ice Age: Rethinking Icing Injuries and Sore Muscles

I remember when I went to the nurse in high school for a medley of ailments, and it seemed like no matter what the symptom was, a pack of ice was the associated prescription. Headache? Put ice on it. Muscle pain? Put ice on it. The building was on fire? Throw ice on it. Okay, the last one was a pretty lame joke, but somehow ice became a panacea in my nurse's eyes. It seems that in the sport and exercise world, such is also the case.

Ice Baths for Recovery

I just started watching Game of Thrones,
and I couldn't resist using this meme...

The most common use of ice that I hear people tout is its recovery healing powers. Are torturous ice baths as effective as we make them out to be?

We have evidence of the early Egyptians using early forms of cryotherapy in 2,500 BCE to treat a medley of ailments. Fast forward to 2018 and you see people immersing themselves into futuristic-looking cryotherapy chambers filled with liquid nitrogen. As you can imagine, extensive research on the subject has been done since ancient Egyptian times.

Now, one study done by Fonda and Sarabon (2013) did find that participants who utilized whole body cryotherapy reported feeling less sore than those with no intervention. While this is more qualitative rather than quantitative evidence, it does show the potential for a decrease in the perception of DOMS with cold immersion.

Hausswirth et. al. tested runners and also found a reduction in pain and subjective fatigue 24 and 48 hours after their runs in participants using cryotherapy chambers. While this is also a qualitative measurement, researchers also found an increase in strength when compared with the control group (2011).

Contrarily, Costello et. al. measured MVC (maximal voluntary contraction of a muscle) 24 hours after an eccentric exercise protocol and found no significant differences in muscle soreness in participants who were immersed in -110° C temperatures and those who weren't immersed (2012). 

Overall, the current body of research does seem to suggest that cold immersion can help reduce subjective measurements of fatigue and soreness in athletic populations, but the verdict is still mixed as far as I'm concerned. Many of the measurable, physiological markers of recovery were unchanged, but the participants simply reported feeling better. My thought process is that a lot of the attributed markers of recovery are due to a placebo effect. Effectively, if you feel like an ice bath helps you feel like you're being active in the recovery process, then keep on as you were. It may not be efficacious, but it's worth a try!

Ice Baths for Treating Injury

Going back to my high school nurse who would use ice as a cure-all, many people still assume that icing is the best protocol for soft tissue injuries. Let me start by saying that ice works as an anti-inflammatory and also a vasoconstrictor (meaning your blood vessels constrict). The downside here, is that we societally regard inflammation as a negative thing, when it is in fact your body's line of defense. Inflammation is necessary to jumpstart the healing process. The more blood flow you get to an area, the quicker the repairing process can start. Gary Reinl, author of the book "Iced" which covers this topic more in-depth, notes "the inflammatory cells remove debris and recruit cytokines and other growth factors toward the injury site." As such, swelling and inflammation are not symptoms to fear or reduce in this case. He goes on to say, "In a healthy healing process, a proliferative phase consisting of a mixture of inflammatory cells and fibroblasts naturally follows the inflammatory phase. The fibroblasts build a new extracellular matrix and persist into the final phase of repair, the maturation phase, where, if all goes well, functional tissue is laid down. The key point is that each phase of repair is necessary for the subsequent phase."

Additionally, the University of Pittsburgh Medical Center (my alma mater) noted that "…ice may not be the best treatment for aching muscles — in fact, it could even be detrimental to recovery" (2011). The British Journal of Medicine reached a similar conclusion, stating that "ice is commonly used after acute muscle strains but there are no clinical studies of its effectiveness" (2012).

Summing it All Up

Icing injuries has become a staple in workout and recovery protocols for people all across the globe for ages. As it turns out, the effectiveness as icing for both decreasing muscle soreness/damage and for aiding in the healing process of an injury seems to be unfounded. The body of research denouncing the usage of ice on both accounts seems to outweigh the papers that support its application.

I personally don't use ice in either instance, and I believe that rest, sleep and proper nutrition can be some of the most effective recovery strategies! Next time you go to jump into the ice bath or wrap an injury in a bag of ice, ask yourself why, and decide whether or not it's actually going to help you or potentially hinder you.





Works Cited:

1. Costello JT, Algar LA, Donnelly AE. Effects of whole body cryotherapy (−110°C) on proprioception and indices of muscle damage. Scand J Med Sci Sports. 2012;22:190–198.
2. Fonda B, Sarabon N. Effects of whole-body cryotherapy on recovery after hamstring damaging exercise: a crossover study. Scand J Med Sci Sports. 2013;23:e270–e278.
3. Hausswirth C, Schaal K, Le Meur Y, et al. Parasympathetic activity and blood catecholamine responses following a single partial-body cryostimulation and a whole-body cryostimulation. PLoS One. 2013;22:e72658. 
4. Reinl, Gary. Iced!: the Illusionary Treatment Option. Gary Reinl, 2014.
5. Van den Bekerom, Michel P.J et al. “What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?” Journal of Athletic Training 47.4 (2012): 435–443. Print.

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Fixing Your Achy Wrists

Do you experience pain in your wrists while doing exercises like bench presses or planks? If so, then read on!

As I've mentioned 1,000 times (and you're probably sick of me saying it already), we always have to look distally (farther away) from the area in question. Think of your entire arms as a train. If the shoulder isn't working properly, you bet that you're gonna have elbow and wrist problems too. Take a look at the photo on the right from Thomas Myers' Anatomy Trains. You can see here that the pecs of the chest will influence the structures all of the way down to the fingers.

The number one complaint I hear from clients when doing the front squat is that their wrists hurt them. While the wrist pain is the symptom, the cause typically arises with poor shoulder mobility. If your front rack position is sub-par, your wrists now have to bear the brunt of that load. The lower your elbows are, the more wrist extension you need to compensate. In this instance, you need to work on opening up the pecs and lats to ease the stress on your wrists.

Because of this horrendous shoulder mobility, his wrists suffer.

I see similar problems arise in pressing movements. In the bench press or the overhead press, clients occasionally lack the necessary strength in their forearm flexors, so they fall into a hyperextended wrist position throughout the lift. A more "neutral" wrist position can save them a lot of discomfort. In these cases, the problem might not be mobility, but grip strength. I would have these people do exercises like hangs from the pull-up bar, plate pinches, or farmer walks to combat this. Sometimes, cueing alone can also go a long way to correct this issue.

This image from Liftbigeatbig explains different wrist positions. We never
want significant extension in pressing movements.

Ultimately, if you feel pain in your wrists you have to check out how your shoulders are moving to properly assess the issue. Shoulder instability can manifest itself in a variety of different ways. Continuing to address your wrist alone will have little to no effect. I see a lot of people working to stretch their forearms to alleviate wrist pain, but rarely do they address other possible contributing factors like shoulder stability or grip strength. Global corrections will stimulate an entire chain reaction of positive effects.

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Much Ado about Hip Mobility

Since I've made a post about shoulder restrictions, I've received a few requests about how to loosen up stubborn hips.

This is my dad, unintentionally showing off his
perfect bottom position and impressive ankle
dorsiflexion.

One thing I'd like to mention, which has been noted in previous posts, is that some people are just genetically and anatomically better suited for squats. Let's take my father, for example. My dad, who does not exercise, and has no notable sports background has a picture perfect squat. He has never mobilized a day in his life, and no one taught him proper squatting mechanics. In fact, I was stunned to watch him squat down to reset our Internet modem with absolute ease. Others will take weeks or months of mobility/motor control drills to execute a partial squat. If you're interested, Dr. Stuart McGill has an excellent video discussing this concept. Unfortunately, there's nothing we can do to change one's acetabulum or femurs.

Don't be discouraged! There's hope for you yet. What we can do, instead, is put someone who may be...inept at squatting into a position that optimizes his or her anatomy. We can play around with foot position, stance, and different squat styles to see what is best suited towards their anthropometry (limb length/proportions). I always recommend that those who are struggling with their squat mechanics work with a qualified coach/movement practitioner to improve. If that is not an option for you, then you should spend some time playing around on your own trying different set-ups.  Record yourself when possible. Remember that your squat will not necessarily look the same as mine.

Once you've settled on your ideal stance and foot position, now we must consider the role of motor control (yay for unintentional rhyming) in the squat. As you can imagine, there are many possible compensatory patterns that one might display throughout the movement. From knee valgus/varus, to shooting the hips back too far, to letting the chest drop, I've seen it all; this is when attention and mindfulness become especially important. Again, it will be invaluable to have a coach review your mechanics in these cases. With just a few simple cues, most errors are immediately fixable, and then you may continue to practice these on your own and engrain the proper sequencing in your head.

One exercise that I typically use with my clients who are learning to squat is the pole squat drill: this allows the person to understand how their weight should be distributed, and helps them achieve a lower bottom position almost immediately. I would also introduce them to the quadruped rock, which mirrors the sequencing in a squat and warms up the hips. These movements are best suited in the beginning of a session.

For clients who still have difficulty squatting after those drills, the goblet squat should become your friend. It is generally easier for individuals to assume a better position in a goblet squat. Holding weight in front of the body forces you to maintain a more vertical torso and achieve better depth. I always prescribe these (typically with a pause at the bottom) before moving clients on to barbell variations.

While many people spend an endless amount of time trying to stretch the hell out of their hip flexors, I find that those efforts are often wasted. Instead, implementing movements such as the goblet squat with a tempo (slow negative and 1-2 second pause) will allow you to kill two birds with one stone. Similarly, tempo single-legged exercises will do wonders for opening the hips. Bulgarian split squats necessitate a decent amount of hip flexibility, so it may be beneficial to start with a traditional lunge, again with a slow eccentric phase.

Finally, at the end of the session, the happy baby pose is ideal. Not only does this provide a nice stretch, but it's actually quite relaxing. You can also use this time to practice your diaphragmatic breathing. Focus on pushing your belly against your thighs as you inhale through your nose. Exhale through your mouth, and repeat. 1-2 minutes should be more than enough.

In the long run, an arsenal of hip flexor stretches isn't going to address the source of the problem. Teach yourself proper squat patterns, train your lower body with an eccentric emphasis, and show your hips some love. If you're diligent in your efforts, you'll be dropping it low on and off the dance floor in no time.

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Is there Such a Thing as "Too Much" Mobility?

If you Google "mobility," you can find pages upon pages of articles about how to improve your mobility at any given joint. Thoracic mobility, shoulder mobility, ankle mobility, and the like are central themes on fitness blogs all over the internet (mine included). As a trainer, it satisfies me to see so many lifters and colleagues prioritizing the improvement in range of motion. Too much of a good thing can become detrimental, though. Having excessive mobility can be just as injurious as being tight and immobile.

These arrows above represent the stability-mobility continuum. Those who have tissue restrictions have a ton of stability, which those with a plethora of mobility lack. Some individuals, like gymnasts and dancers, fall into the class of "hypermobility." Essentially, they have ligament and tendon laxity, which means that their range of motion exceeds what is common or necessary for most people. This is more common in females than in males, but can be present in both genders.

Genetics and anatomy are going to be the two biggest indicators of where one falls on this continuum. There are, however, ways to improve this. Obviously, despite being born with tight shoulders, it's still possible to loosen up your tissues and become more supple. Conversely, those with joint laxity can do more in the way of strengthening stabilizing muscles in order to become more stable.

In some ways, stretching for someone who is hypermobile could be akin to an athlete with a stress fracture going for a 15 mile run. We want our muscles to flex and extend seamlessly, but hyperextension can be dangerous. Strength coach Eric Cressey notes, "Instead [of stretching them], these individuals need to work on building stability within the ROM they already have with quality strength training."

As an example, let's use the shoulder joint. The shoulders are already the most mobile joint, as they can move through a full 360°. With these great movement demands come tremendous risk, though. While the shoulders are very mobile, they're also one of the most frequently injured areas. A hypermobile client might have an overhead position that resembles that of the woman in the photo on the right. Not only is her lumbar spine in hyperextension, but her shoulder flexion goes well behind her center of mass. Certainly, this position is not ideal for supporting load, as it puts the shoulder girdle under tremendous stress. Now, if this client were to stretch her shoulders before a session, she's just going to further force herself into a precarious position, and she increases her risk of injury. 

We never want to enforce excess movement in a joint. Each sport and activity places different demands on the joints and tissues, so the goal is to establish enough range of motion for your given sport. No more, no less. A baseball pitcher requires more external rotation at the elbow than the average person needs. Swimmers need flexible shoulders to move freely through the water. Ultimately, you have to find the optimal amount of mobility that will allow you to achieve the necessary positions of what you do. In my case, I was blessed with natural flexibility, so I spend very little time doing accessory mobility work. 

There's no need to spend time forcing an end range that you don't need, and it may even be counterproductive. Choose your mobility work wisely, picking exercises that apply to the areas with which you need the most help. The movement requirements of an athlete of one sport aren't going to be the same for another. Some sports benefit from decreased mobility, while others require extreme bendiness: find the optimal area for you on the stability-mobility continuum!

Works Cited:

1. Hootman, Jennifer M, Randall Dick, and Julie Agel. “Epidemiology of Collegiate Injuries for 15 Sports: Summary and Recommendations for Injury Prevention Initiatives.” Journal of Athletic Training 42.2 (2007): 311–319. Print.

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Stop Stretching Your Hamstrings

If I had to pinpoint one "tight area" about which many people complain most, it's the hamstrings. I'll often find gym-goers using multiple methods to stretch those stubborn muscles: asking a partner to push them deeper into a stretch, or yanking on their legs with bands. Yet, somehow, despite their forceful, repeated efforts, the hamstrings seldom seem to sustain lasting changes in flexibility or range of motion.

Stop and think before you yank your hamstrings into oblivion.

I've mentioned in previous posts that I'm not much of an advocate for static stretching. Today I want to explain why the hamstrings, in particular, do not warrant stretching, and what you can do, instead, to create a more lasting increase in hamstring flexibility.

The hamstrings are a very important muscle group for athletic performance. They are two joint muscles, meaning they both flex the knees and extend the hips. While strong, these muscles have a tendency towards facilitation (overworking). When a muscle gets tight, that typically means it's working hard for another muscle that's inhibited, or not firing properly. In the case of the hamstrings, we're usually looking at gluteus maximus/medius dysfunction and/or core dysfunction. In short, if your hamstrings are chronically tight, you have to check the muscles upstream in the kinetic chain and see how they're firing (or not).

In this video, Dr. Kathy Dooley demonstrates how one can alleviate tension in the hamstrings just by getting the core to fire properly. This is one such exercise that you can utilize before a heavy squat or deadlift session just to encourage proper core activation. You'll notice that doing this exercise regularly will have a dramatic impact on your hamstring flexibility. It has been more immediately effective with my clients than the traditional stretching methods, as this exercise attacks the source of instability and weakness, rather than trying to treat the symptoms.

This Bushman puts Kim Kardashian to shame.

The "core," or, in this particular case, the rectus abdominis, is an antagonist of the hamstrings. What this means is that as the hamstrings lengthen/relax, the rectus abdominis flexes the lumbar (lower back). For example, in a forward bend, in which we are standing and reaching over to touch the ground, our knees are extended, lengthening the hamstrings. The trunk is in flexion, assisting the hands in reaching towards the floor. If we do not have adequate strength in the rectus abdominis, the hamstrings won't be able to relax enough to let you get lower. In short, strengthening a muscle's antagonist can work wonders in releasing it from tension.

Similarly, weakness in the gluteus medius/gluteus maximus can result in tight hamstrings. Both the glutes and the hamstrings work synergistically as hip extensors. You've probably heard of the term "glute amnesia" before, which connotes butt muscles that don't activate properly. The cause of this is too much time spent in hip flexion (read: sitting), and not enough time running, jumping, and lifting! Now, if your glutes don't show up to the (hip extension) party, then someone has to take over their job. You've guessed it: the hamstrings are now responsible for the majority of your hip extension! No wonder they're in a perpetual state of tension–they're holding onto your hips for dear life.

What are the best ways to tackle these movement dysfunctions? Here are some of my favorite exercises:

1. GHD hip extension
2. Barbell hip thrusters
3. Single leg RDLs
4. Single leg squats on box
5. Bird dogs
6. Deadbugs

So while stretching the hamstrings may give you some immediate relief, you have to analyze why they're getting tight. If you continue to repeat the same process and it just isn't working, it's time to find a new plan of attack. Work those glutes and strengthen that core, and you may just free yourself of your constant need to stretch your hammies.


Works Cited:

2. Dionne, Cassie. "Stretching Your Hamstrings Isn't Always Best." Breaking Muscle. N.p., n.d. Web. 20 July 2016.
3. Dooley, Kathy. "Dooley Noted: Core Instability Hiding as Tight Hamstrings." YouTube. YouTube, 04 May 2013. Web. 19 July 2016.
4. Nickelston, Perry. "Top 10 Muscle Imbalances and What To Do About Them #1." Stop Chasing Pain. N.p., 2 May 2016. Web. 11 July 2016.
5. Yessis, Michael. "Stretching The Hamstrings." YouTube. YouTube, 25 July 2011. Web. 12 July 2016.

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Getting Rid of the "Butt Wink"

The "butt wink" is a term that has puzzled personal trainers and other movement practitioners. Some people attribute it to tight hamstrings, others have mentioned ankle mobility, some say it's hip flexor strength, or even hip/femur anatomy. My two cents? Motor control. Everyone I've met who had a "butt wink" was able to eliminate it with some proper cuing and movement sequencing.

If you're not sure what a butt wink is, and if you have one, let me enlighten you: this is a term used to describe lumbar flexion in the bottom of a squat (pictured below).

Oof.

Now, let's first touch upon some other theories contributing to this fault...

Dr. Quinn Henoch mentions that the hamstrings cannot be responsible for the butt wink: "The hamstrings are a two joint muscle.  When you descend into a squat, the hamstrings are being lengthened at the pelvis, but shortened at the knee. So it would seem to me that the net length change is negligible." The hamstrings are not a likely culprit.

Hip anatomy makes the most sense out of all theories. Some individuals are just going to be better at squatting, out of sheer, genetic fortune. If you have the right anthropometry (limb length), you're gonna be a better squatter, plain and simple. 

Anatomical factors aside, though, it is possible to eliminate the dreaded butt wink with a little bit of practice and tweaking.

I'm not going to get too much into the hip and femur anatomy here, because I think Dr. Ryan DeBell covers that nicely. If you want to read his article on it, check out the works cited below. What I will say, though is that factors like your acetabulum (hip socket) alignment, femur length, and tibia/fibula length will all influence your squat stance. Some people have to squat wider than others, so playing around with your stance will greatly help your bottom position.

You want to work through a range of motion where you can maximize the integrity of the movement. If, initially, that means that you're squatting just to parallel, then so be it. Over time, the goal is to get progressively lower.

I usually start out my clients with a quadruped rocking drill. This will teach them how to hinge at the hips without load and minimize any lumbar flexion. If you find yourself reverting to the butt wink on this drill, move slower and focus on keeping the core engaged.

Once they grasp this concept, I would then progress them to the assisted squat drill. The goal here is the same as that of the previous drill, but now we're upright and preparing for a load-bearing squat.

Congratulations! Now you're ready to try an air squat without assistance! A couple of things to keep in mind: if my core isn't engaged, and I shift into an anterior pelvic tilt (hyperextension), then it's impossible for me to avoid lumbar flexion. If, however, I maintain a nicely braced position and descend straight down, I should be just fine. You want to imagine "pulling through your hip flexors" as you lower yourself.  If you're squatting high bar or front squatting, you will descend straight down, and if you're squatting low bar, then the hips need to come back more.

With a little bit of reverse engineering, even the most troubled squats can minimize the "butt wink." Sometimes you need to regress in order to progress. When you lay a solid foundation for quality movement, you can get a squat PR without looking like Quasimodo.

Works Cited:

1. DeBell, Ryan. "The Best Kept Secret: Why People HAVE to Squat Differently." Why People HAVE to Squat Differently. N.p., 08 Jan. 2014. Web. 16 Mar. 2016.
2. Henoch, Quinn. "The Bottom Position of Your Squat: A Defining Characteristic of Your Human Existence." Juggernaut. N.p., 05 Feb. 2014. Web. 16 Mar. 2016.
3. Somerset, Dean. "Butt Wink Is Not About the Hamstrings" DeanSomerset.com. N.p., 07 July 2014. Web. 16 Mar. 2016.

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3 Reasons Why Your Poor Mobility is Holding You Back

So many lifters are willing to complain ad nauseam about their lack of mobility, but very few of those people are willing to get up and fix it. Most individuals would prefer to deadlift heavy and get their heart rates up than spend about 10-15 minutes addressing their muscular imbalances and chronically tight areas.

What those people might not realize, is that their lack of mobility is actually sabotaging their progress. Instead, they'd rather just cut to the chase and dive face first into their workouts. They see the value in heavy lifting and pushing hard, but they neglect the accessory mobility work. It's easy to ignore, because the immediate pay-off might be minimal. They release a tight muscle once or twice, and don't make any lasting changes. Like strength training, though, consistency is the key. Doing a handful of stretches, some self-massage, and corrective exercises every few days will go a long way. Not only will you feel more loosey-goosey, but you may even PR your lifts just from adding some more range of motion to your joints!

If your overhead squat looks like that of the guy on the right, this article is about you.

Hopefully, this post will help knock some common sense into you and remind you to pay more attention to the corrective exercises. Here are three major reasons why your limited range of motion is holding you back from getting stronger:

1. You can't get into the right positions. Movements like the front squat require a considerable range of motion. If your latissimus dorsi and pectoralis minors are tight, you won't be able to achieve an ideal position in the lift. No matter how many times a coach may say "elbows up," you just can't get them any higher. Your mobility is going to hinder your progress, because if you cannot keep your torso upright, then you won't be able to support a significant amount of weight in that position. I have met plenty of people who have ample strength, but stagnate on the clean, because their chest drops every time they catch the barbell. Their legs can support the weight without a problem, but their shoulders aren't having it. If these people did some work on the areas in question (pecs and lats), they would, undoubtedly, get an immediate PR on their cleans.
2. Your potential for force production is limited. A muscle has to lengthen before a contraction. A length-tension of a relationship of a muscle explains that a muscle can produce an optimal amount of force at a certain length. For example, if you were to pick up a heavy book, you wouldn't do so with a fully extended elbow. Instead, you would probably bend your elbows a bit. Now, this continuum of ideal length is a balance. If someone is too flexible, force production will be limited, and the opposite is also true. If you are inflexible, the muscles are constantly partially contracted. Take a look at the diagram below of a muscle cross-section. The top model (a) cannot produce enough force because there is too much of an overlap, whereas option (c) can't produce optimal force because there's no overlap at all. Option (b) is just right: a little bit of overlap so that the muscles are at their ideal length for force production. So, if your hamstrings are "tight" you won't be able to produce true power on a sprint or a vertical jump, for example.
   
3. Muscles are not firing in the proper sequence. If you're tight, you're more than likely compensating in ways you don't even realize. For example, if your ankle mobility needs some help, chances are, you're using the muscles on the medial portion of your leg (hip adductors) way too much, while the lateral muscles (abductors, gluteus medius, tensor fascia latae) aren't working enough. Every time you squat, lunge, or sprint, your mechanics are altered. Because your muscles are not in symbioses, this could mean a slower 400 meter time or a weaker back squat. Once the kinetic chain works as it is supposed to, your mechanics are more efficient and you might find that previously challenging movements are a bit easier!

Bodyworker Thomas Myers notes, "organismic movement and stretching – yoga‬, pilates, training‬, manual therapy – can help cells to their proper tension environment by relieving pressure or strain, and this results in better functioning all over." It's great to work hard and get stronger, but it's also important to give your muscles some love and alleviate tension in the body.

Ultimately, if you find that your performance has plateaued, perhaps it is time to finally work on improving your tin man status of mobility and join the supple side.

Works Cited:

1. Baechle, Thomas R., and Roger W. Earle. Essentials of Strength Training and Conditioning. Champaign, IL: Human Kinetics, 2008. Print.
2. Clark, Ross A., Brendan Humphries, Erik Hohmann, and Adam L. Bryant. "The Influence of Variable Range of Motion Training on Neuromuscular Performance and Control of External Loads." Journal of Strength and Conditioning Research 25.3 (2011): 704-11. Web.
3. Myers, Thomas. "Biomechanical Auto-Regulation." Anatomy Trains. N.p., 17 Nov. 2015. Web. 01 Dec. 2015.

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Sturdy Shoulders (How to Spare Your Shoulders from Injury)

I'd say nearly every person I've trained has, during an assessment, mentioned a previous shoulder injury. Even I have suffered from the plague that is shoulder pain in the past.

The shoulder (glenohumeral) joint is the most mobile joint in the body. The ball and socket architecture allows it to move through all different planes. The downside to this excessive range of motion, however, is that, if the musculature surrounding the joint is not strong enough, injury is surely impending.

As a coach, I see two ends of the spectrum: the hypermobile (like myself), who have an abundant range of motion but lack the appropriate control overhead, and the stiff, tin men who can barely extend their elbows all of the way. Generally, men tend to fall on the latter end, while women are usually guilty of the former. Of course, there are plenty of ladies with tight shoulders, and mobile men, but this is the typical trend that I have noticed.

The ideal situation would be the middle (wo)man: someone who can achieve the positions necessary for his or her sport, but has sufficient strength as well.

Keep in mind that not all shoulder injuries are created equal. Depending where on the list of mobility you fall, your exercise prescription may need to change to cater towards your individual weaknesses. Someone who has really tight lats is not definitely going to be doing the same "prehab" as someone with weak lats.

Below, I will explain each scenario a bit more in depth, and give you some corresponding exercises to remedy those imbalances. Beware, as there are 7,000,000 clickable links coming your way for the exercise demonstrations.

Case 1: Hypermobility

The hypermobile individuals need more stability. I often find that these people  These people need to strengthen the shoulder girdle and the back (latissimus dorsi, serratus anterior, etc.)

Although these guys can seamlessly execute an overhead squat, core strength tends to be minimal in this group. Usually, this will go hand-in-hand with poor rib position during overhead movements. Therefore, we need to address the lack of midline stability first, and strengthen the rotator cuff second.

Here are some exercises that will go a long way for this population:

1. Arm bars (progress into the Turkish Get-up)
2. Barbell overhead carries (or single arm with a dumbbell)
3. Barbell roll-outs
4. Supine barbell rows
5. Scap push-ups (or banded protraction)
6. Deadbugs
7. Face pulls
8. Dumbbell serratus pull-overs (or with a barbell)
9. Upside-down kettlebell press (or use a PVC)

Case 2: Poor Mobility

If you fit into the "incredibly tight shoulders" group, then movements like an overhead squat are completely out of the question; the rack position on a clean or a front squat is nonexistent. Most likely, these people will have limited mobility in the thoracic spine (rib cage area). The pectoralis muscles and the latissimus dorsi are excessively tight, and then the lower/middle trapezius, rhomboids, infraspinatus, teres minor will be weak.

Click to enlarge.

First, you'll want to release tight muscles like the pecs and the lats. You can also try this stretch on the foam roller or this stretch on a bench to open up those overused muscles. The next step is going to be to strengthen those weak areas I listed previously. Some of the best ways to reach achieve that are the following exercises:

1. Y's, T's, and W's (or fall-outs on the rings)
2. Farmer carries
3. Cable external rotation (or with a band)
4. Kettlebell overhead press
5. Band tears
6. Cable reverse flys
7. Wall slides
8. Forearm wall-slides
9. Hangs from the bar (or single arm)

As you can see, the type of corrective exercises I would issue for each group is pretty drastically different from one another. Case 1 is working to stabilize the shoulder joint, whereas case 2 has a bit too much stability and needs to improve flexibility. While each exercise may add value to any workout routine, it's important to prioritize the most valuable movements, rather than trying to add 75 different correctives. Honestly, I could've added a gazillion more exercise ideas in here, but I figured it was best not to overwhelm you with even more links than I've already included!

As always, breathing will also influence the strength and stability of the shoulders, so make sure to reinforce proper breathing when you're doing these exercises, and even when you're just going about your day-to-day activities. Make some of these exercises a part of your regular routine, and you'll be well on your way to having solid shoulders resilient for any sport.

Works Cited:

1. Beasley, Lauren. "Getting Control of Overhead Movement: 5 Basic Drills to Prepare the Body." Breaking Muscle. N.p., n.d. Web. 18 Sept. 2015.
2. Beasley, Lauren. "The Scapula: How It Can Make or Break You." Breaking Muscle. N.p., n.d. Web. 18 Sept. 2015.
3. Cressey, Eric. "Shoulder Hurts? Start Here." Eric Cressey. N.p., 16 May 2011. Web. 18 Sept. 2015.
4. Cressey, Eric. "Shoulder Impingement." Eric Cressey | High Performance Training, Personal Training. N.p., 18 Jan. 2014. Web. 18 Sept. 2015.

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4 Quick Tips to Fix Your Ankle Mobility

"Ankle mobility" seems to be a buzzword these days. Coaches often tell their athletes that the limiting factor in their squats is the lack of range of motion in the ankles. Everyone claims to have poor ankle mobility, and they're all looking for the magical way to improve it. You'll see them stretching their ankles into oblivion, hooking resistance bands around their malleoli, and placing barbells on top of their knees, yet their efforts are futile.

Why isn't your ankle mobility improving? Well, as I've said before, stretching is like a Band-Aid. It will result in a temporary improvement, but it doesn't get to the root of the problem. You cannot, I repeat, cannot, change the length of a muscle. Therefore, no amount of yanking and distraction and stretching will not miraculously lengthen the gastrocnemius and soleus (calf) muscles. Instead, you have to address the cause of the stiffness.

A lack of ankle mobility can be the result of either improper motor patterning, poor choice in footwear (think: high heels), or it may be from minimal stability up the kinetic chain.

The ankle is, as you see in this photo, a "mobile" joint. The knee is a stable joint, and then the hip is another very mobile joint. If the ankle does not have adequate mobility, the knee and hip will suffer as well. Mike Boyle, a very well known Strength and Conditioning coach, notes:

An immobile ankle causes the stress of landing to be transferred to the joint above, the knee. In fact, there is a direct connection between the stiffness of the basketball shoe and the amount of taping and bracing that correlates with the high incidence of patella-femoral syndrome in basketball players. Our desire to protect the unstable ankle came with a high cost. We have found many of our athletes with knee pain have corresponding ankle mobility issues. Many times this follows an ankle sprain and subsequent bracing and taping.

Address the ankles, and you cure up a lot of other issues! Here are some ideas to help improve your bottom position in your squat and free up some movement in your ankles.

1. Change your footwear. Now, here's where the shoes can be a very important factor. If you're wearing shoes that act as a cast, meaning they try to provide the strength artificially, your body no longer needs to or wants to utilize this strength on its own. So many people roll their ankles because, guess what? They have weak ankles. An ankle sprain is entirely preventable, in most cases!

Other shoes like high heels force your feet to remain plantarflexed (pointed) for hours on end. As a result, the gastrocnemius and soleus muscles become reflexively shorter to adapt to the way you move. Your body remembers routines, and it likes to conserve energy wherever it can. Therefore, regularly wearing certain types of shoes will affect the musculature around the foot.

I do think training barefoot has a tremendous amount of benefits, but, at the very least, try to find a shoe that allows you to "feel" your feet and does not significantly alter your gait. You can also mobilize the plantar fascia before your workout to increase neural activity in your feet.

2. Strengthen your dorsiflexors. Individuals with tight calves have overactive plantarflexors (gastrocnemius, soleus, plantaris, tibialis posterior, flexor hallucis longus, flexor digitorum longus, fibularis longus, and fibularis brevis), which are the muscles that point the foot. A ballerina, for example, would have incredibly strong plantar flexing muscles. The dorsiflexors are the muscles that pull your toes towards your kneecap (tibialis anterior, extensor hallucis longus, extensor digitorum longus and fibularis tertius); these muscles will contract at the bottom of your squat, so if they're stronger, you'll see significant improvement.

One of my favorite exercises for this is banded dorsiflexion. This movement also strengthens the hip flexors, which will further develop your bottom position. Bear crawls will also help improve the range of motion in the calves. For an extra challenge, try them with straight legs.

3. Improve rotation of the fibular head (pronation). As you squat, the fibula, the outer bone in your lower leg, has to rotate. When you have muscular tension in this area, then you will have a limited amount of rotation. If you have this problem, you may experience pain on the lateral portion of the leg.

To improve this rotation, you can do banded eversion and inversion, or you can do this half kneeling drill. Rolling out the calves with a lacrosse ball will also help improve your range of motion.

4. Correct your squat pattern. Finally, we have to think about motor patterns. The vast majority of people I've met who appear to have insufficient ankle mobility, actually just don't understand proper sequencing. Usually, they don't grasp the concept of "hip hinging," and they initiate a squat or a deadlift in an anteriorly tilted pelvic position. I want to help my clients understand what it feels like to initiate a movement properly at the hips. I will start these people doing a squat with the help of a TRX or gymnastics rings. A wall squat will also help reinforce good movement patterns. Sometimes, people just don't really grasp how a well-executed squat or deadlift should "feel," and in those cases, these drills can elicit immediate results.

If your ankles are stiff, stop trying to stretch the hell out of them against the wall. Figure out why your calves are so tight in the first place, strengthen the weaker muscles, and build a rock solid foundation for all of your lifts. With more range of motion in the ankles, the rest of your joints will be spared of excess wear and tear, and you will improve your mechanics.


Works Cited:

1. Michael, Boyle. "THE JOINT-BY-JOINT APPROACH." Gray Cook Physical Therapist Lecturer Author. N.p., n.d. Web. 01 Sept. 2015.
2. Splichal, Emily. "Foot Function & Fascial Lines: Lateral Ankle Stability." From the Ground up. N.p., n.d. Web. 01 Sept. 2015.
3. Splichal, Emily. "Plantar Cutaneous Feedback & Ankle Instability." From the Ground up. N.p., n.d. Web. 01 Sept. 2015.

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3 Reasons Why Your Neck is Always Tight

If you had to pick one place where you regularly carry the most tension in your body, what would you choose? I'm willing to bet you chose your upper trapezius muscles.

The upper trapezius muscles seem to be (in my experience) some of the most overused and abused muscles in the human body. Many people I see are, either consciously or unconsciously, in a constant shrugged posture: their shoulders are by their earlobes and necks are pulled forward. Why is this?

There are a few factors that contribute to tight upper traps:

1. Posture. Sedentary individuals seldom remember to sit upright. Often times, you see people with significant flexion in the thoracic spine, protraction of the cervical spine (neck) who are hunched over their computers. Forward head posture will place extra stress on your vertebrae. According to chiropractor Dr. Jason Queiros, "Every inch you hold your head forward, you add 10 pounds of pressure on your spine. Let’s say you’re leaning into your monitor by just two inches, that’s 20 extra pounds that your back and spinal column have to endure." The muscles in your back and neck need to compensate for this imbalance.
2. Breathing. Stress individuals have the propensity to overuse accessory muscles for breathing like the scalenes, sternocleidomastoid, and the upper trapezius, rather than the diaphragm. The tonic muscles in the front of the body shorten, while the phasic muscles in the back lengthen. Neck breathing facilitates a constant "shrugged" position of the shoulders, which are going to put your upper trapezius muscles into overtime.
3. Shoulder stability. The overworked upper trapezii may prevent the other shoulder stabilizers and rotator cuff muscles from functioning as they should. The lower and middle trapezius, the serratus anterior, the rhomboids may all be dysfunctional or under-active as a result.

Now, the way most people look to alleviate tight traps is through stretching or massage. While these modalities can be extremely effective, they are usually short-lived in their relief.

To nip the problem in the bud, you need to address all three of these elements above simultaneously. Surprisingly, changing your breathing first may favorably impact the other two areas. When the breath is out of whack, the body cannot function optimally!

Now, conjunction with adding some breathing drills into your daily routine, some supplementary shoulder stability work could do you some good. Here are a few of my favorite exercises:

1. Scap push-ups
2. Y's and t's
3. Cable external rotation
4. Bear crawls
5. Wall slides
6. Reverse shrugs
7. Serratus pull-overs
8. Band tears

What's most important, throughout all of these movements, is to make sure you're not shrugging your shoulders, otherwise your efforts will be ineffective. I often find myself tapping my clients on their shoulders to remind them.

If you want to find provide your traps with some relief, corrective exercises and breathing drills are going to be the most effective methods to lessen tension. Once you're aware of it, you'll probably be surprised to find out just how often your body instinctively reverts to a shrugged position. The key is consistency. Let some of your other surrounding muscles do their job and give your traps a break...

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Sitting Is a Killer