Category — Strength Training

The debate about whether or not to do lumbar flexion exercises (sit ups, knee ins, bicycles, v-ups, etc) is a heated one.  To tell you the truth, it probably wont ever end as professionals will always reside on one side of the fence (lumbar flexion isn’t that bad!) or the other (stabilize, stabilize, stabilize!).

Dr. Stuart McGill has done a great job conducting research on the topic and lecturing around the world regarding appropriate training strategies for strength coaches, fitness professionals, and rehabilitation specialists.  However, one of the common debates that often comes up is, “Competitive fighting athletes go through lumbar flexion (sometimes very aggressive lumbar flexion) in their sport and thus we must train that movement to ensure that they are adequately prepared for competition.”

Sounds good, right?  After all, the role of the strength coach is to prepare the athlete for their competitive endeavors! 

The only problem I see with this argument is that as the strength coach, we need to ensure that the athletes are healthy and injury free.  If we know that the mechanism of disc injury is repeated flexion, and we know that the athletes go through this movement in their sports training and competition, is this a movement that we really need to do more of in the gym?  To me, that sounds like the same as doing a high volume plyometric program for an inseason basketball or volleyball athlete.  They are already getting a lot of contacts in practice and games, why do we need to load that up more?  In fact, we should unload that and do something with less impact that sufficiently addresses the strength needs of those athletes.  Speaking of basketball, when taking a jump shot, athletes will typically go into knee valgus.  With this same mentality, shouldn’t we train that movement it so that they are prepared for it when it happens in a dynamic environment like competition?  Obviously I don’t expect anyone to answer “yes” to that question.

The next point that is always brought up is “Athletes who fight competitively all over the world train using lumbar flexion exercises and then go and practice and compete and do more lumbar flexion and don’t seem to have problems.  Maybe it isn’t such a big deal.”

One of the things science does is helps us to remove our assumptions of what we think is going on based on our observations.  Our assumptions are brought about by several factors including the sample size of people we are working with and our own personal bias towards what we are doing.  Basically, we put it in the hands of a neutral third party who tests these assumptions and then comes back to us an either says, “Yep, you were right!  It looks like that is happening”, or “Actually, we tested your assumption and we found the opposite to be true.”  This of course leads to more research and more questions and eventually theories are developed to help give us a larger explanation of what is taking place.

While the idea that, “Training these movements is essential because they happen in sport” may sound good on paper, are the programs being created really helping these athletes compete without incident?

A 2007 study conducted by Okada et al, looked at the prevalence of nonspecific low back pain and lumbar radicular abnormalities in 82 male judo athletes in three different weight classes – light, middle, and heavyweight. 

Back pain:

• 10 out of 29 lightweight athletes had nonspecfic low back pain (34.5%)
• 10 out of 31 middleweight athletes had nonspecific low back pain (32.3%)
• 9 out of 22 heavyweight athletes had nonspecific low back pain (40.9%)

Lumbar radicular abnormalities:

• 19 out of 29 lightweight athletes exhibited lumbar radicular abnormalities (65.5%)
• 28 out 31 middleweight athletes exhibited lumbar radicular abnormalities (90.3%)
• 20 out of 22 heavyweight athletes exhibited lumbar radicular abnormalities (90.9%)

With lumbar radicular abnormalities and WITH low back pain:

• 50% in the lightweight group
• 100% in the middle weight group
• 88.9% in the heavy weight group

With lumbar radicular abnormalities and WITHOUT low back pain:

• 73.7% in the lightweight group
• 85.7% in the middleweight group
• 92.3% in the heavyweight group

The researchers concluded that the prevalence of low back pain in this group ranged from 30-40% and that the prevalence of lumbar radicular abnormalities with nonspecific low back pain (79.3%) and without nonspecific low back pain (83%) suggest a lack of association between back pain and imaging (this should come as no surprise since it has been indicated in previous research). While medical imaging didn’t give us the full picture as some athletes had pain without positive imaging and others with positive imaging did not have pain, low back pain appears to be a problem in this group of athletes and Okada et al state, “Because nonspecific low back pain is a common complaint among athletes, it is important that the athletes and their coaches work towards prevention so that athletes can continue their sports activities.”

In the wrestling community, reports of low back pain have been shown to be as high as 69%.  Wrestlers are a group who spend a lot of time on the mat getting into and (hopefully) out of a variety of positions. Iwai and colleagues (2004) evaluated trunk muscle strength and functional disability of chronic low back pain in 53 college wrestlers.  The wrestlers were evaluated for radiological abnormalities and isokinetic trunk muscle strength.  They found that 14 of the subjects with radiological abnormalities had low back pain (40%) and 8 of the subjects without radiological abnormalities had low back pain (44%).  Similar to the study by Okada et al, we see that the percentage of those with low back pain and with or without radiological findings is relatively close.  Iwai et al, concluded that low trunk extensor strength may be a potential factor in chronic nonspecific low back pain in this population of athletes.  Which would be in contrast to those supporting more lumbar flexion training for these types of athletes. 

Just looking at these two studies, we see that maybe the assumptions being made regarding lumbar flexion training and competitive fighting athletes is not a good one.  Perhaps the anecdotal information that we get from other coaches is not valid?  In other parts of the world, how much pain/injury goes undocumented or maybe the athletes don’t even bring it to the coach’s attention?  How well is the record keeping of these coaches?  Everyone seems to remember the “hits”, “This is how we’ve have always done it and we have had 10 world champions.”  However, they failed to remember the 30 other athletes that were sidelined with injury.  Are we missing people?

Conclusions

Low back pain is common in sports and the training program should be comprehensive and well thought out in a manner that helps to prevent or reduce the incidence of injury.  While some potentially injurious movements happen in sport that doesn’t necessarily mean that we need to further train those movements in the gym.  Rather, it may be more advantageous to prepare athletes to handle the loads and forces placed upon them in competition with a strength and conditioning program that teaches healthy movement and does not seek to overtrain/overuse patterns that are commonly performed in both sports preparation and competition.

Patrick
patrick@optimumsportsperformance.com

References

Okada T., Nakazato K. Iwai K., Tanabe M., Irie K., Nakajima H. Body Mass, Nonspecific Low Back Pain, and Anatomical Changes in the Lumbar Spine in Judo Athletes. JSOPT 2007;37(11):688-693.

Iwai K., Nakazato K., Irie K., Fujimoto H., Nakajima H., Trunk muscle strength and disability level of low back pain in collegiate wrestlers. Med Sci Sport Exer 2004;36(8):1296-1300.

Training and competing wear down the body.  Not everyday is going to be a day for breaking records or maintaining a high training intensity.  The recovery day is an important aspect of training as the effects of our programs are cumulative (one workout is not going to make the athlete) and we have to sometimes pause and acknowledge the entire process taking place rather than getting bent out of shape because we didn’t add 5lbs to the bar on our squat.

Athletes (and people who workout in general) have a very difficult time being objective with themselves in knowing when to back off on a training day and divert to an easier workout.  As coaches, knowing your athletes and being able to tell when things aren’t “firing on all cylinders” is essential to the overall training process.  When athletes come in looking sluggish, moving in a manner that is not typical of them, or stating that they are tired, overly sore, or fatigued, can all be warning signs that today may not be the day to try and ramp up  intensity, but rather, you may need to pull back the reigns a little bit and give their bodies a break.

Today an athlete came in pretty beat up from lots of competing, travel, and training.  So, rather than working on strength, we took a recovery day and just backed off.  Here is what we did:

- 20min. soft tissue work
- 10min. of mobility drills
- 20min of a low intensity, full body circuit:

• Kettlebell swing
• 1-arm cable row
• Lunge matrix with various arm drivers
• 1/2 kneeling DB curl and press
• Ball rollouts

The intent of the circuit is not to crush the athlete or have them work to failure.  This is where many have a hard time being objective with themselves, as back off days typically end up looking more like moderate to difficult metabolic circuits.  Rather, the load is light and the athlete is asked to move through each exercise at a self selected pace with the goal of bringing up the heart rate a little bit and getting warm/loose. 

Keep an eye on your athletes and be aware of days when they may not be at 100%.  Don’t just push them through workouts because “that is what is scheduled for the day”.  Be flexible and allow the athletes to get a break when they need it.  The entire process is more important than any one workout.

Patrick
patrick@optimumsportsperformance.com

I just wanted to let everyone know that Strength Coach Mike Robertson featured a guest blog article written by me this week regarding the Deep Fron Line and what it means to our training programs.

The deep front line is a concept taken from Thomas Myers’ Anatomy Trains text and I basically jotted down a few ideas about this line and how it pertains to what we do in the weight room.

Hope you ENJOY IT!

Patrick
patrick@optimumsportsperformance.com

This weekend I attended the Functional Movement Screen course here in Phoenix. 

Gray Cook and Lee Burton did an incredible job of teaching the course and I have 9-pages of notes/pearl’s of wisdom in my notebook, as well as several notes about the tests and the exercises that I jotted down in the FMS manual that was given to us at the course.  I wont bother putting up the notes I took in the FMS manual since they may not make sense unless you take the course.  I highly recommend taking the course if you are a professional in this field, as it is full of great info and it is presented well. 

Rather, I will document the pearls of wisdom that Gray gave us during his presentations through out the weekend.  These are just one-liners or parts of his thought process that are made to make you think.  I’ll be reading through these pearls several times over the next few weeks, as there is a lot to be learned from them.

Because of the volume of notes that I took, I’ll break it up into two parts so they are easier to digest.  Later this week, I’ll post part 2 of the pearls of wisdom.

Gray’s Pearls Part 1:

- When someone’s back hurts they don’t want to blame their lifestyle, fitness level, or daily patterns.  Instead, they want to blame their back pain on starting the lawn mover last week,  which, in reality, is probably just the straw that broke the camel’s back.  Human beings live under the philosophy of, “I have a snowball and I have to throw it at someone.”  No one wants to take responsibility.

- If the CNS and transverse abdominus don’t communicate together nothing will happen.  You can “shred someone’s abs” while they are lying on the floor, but as soon as they stand up they will revert back to the bad pattern(s) they are used to.

- Are dysfunctions anatomically specific or movement specific?  They gluteus medius may appear to do what it needs to do in a bilateral stance (IE squatting), but as soon as we get to a single leg stance or split stance, the person’s movement may deteriorate.  Is the problem really the gluteus medius?  Or is the problem the fact that they don’t move well in that pattern?

- Stop thinking about things from a kinesiological standpoint.  Movements are movements.  Movements aren’t specific to one single muscle.  You need to move better if you want to improve function.

- Eye movements alone will light up muscular activity in the direction you are looking.

- If you want people to move better stop shopping exercises and break down their movements.

- For corrective exercise, put people in a position where they are making a lot of mistakes (this position needs to be a safe position though and not dangerous) and SHUT UP!  Don’t over coach them.  Let them work it out and learn to develop the pattern…THIS is motor learning!  The baby didn’t need you to coach it on how to roll in the crib, crawl or stand.  It figured it out on its own.

- Walking and running strides have a heel strike that is between 1-4 inches apart.

- Don’t migrate to just doing one thing – IE, runners just run, kettlebell coaches just coach kettlebells, etc. – you need to have variety and be well rounded.  What would happen if I told you to eat chicken breast three times a day, everyday, for the rest of your life?  YOU’D MISS THINGS!  Don’t miss things.

- Build systems to protect yourself from your own subjectivity.

- Your soft core (diaphragm, multifidi, pelvic floor, and transverse abdominus) needs to hold everything together.  It makes up about 20% of your core activity.

- You have three things to consider when dealing with a client/athlete:

1. The first thing you always need to consider is movement.  If movement quality is not above a minimum standard, then this is the first problem you need to deal with.
2. Performance problems come next.  If you move well, go ahead and add some conditioning, strength and speed.
3. Issues with skill are the final thing to fix (IE, golf swing, throwing technique, running form, etc.)

- Even an inappropriately performed deadlift does not have as much intradisc pressure as sitting down and pushing or pulling on things (performing exercises).  Stand up and move!

- You can’t coach people to do a movement that they can’t do.  All they are doing is trying to survive the pattern!  Poor movement is a balance reaction.

• That one makes me think of the coaches who scream at their high school football players to “push their knees out” during the squat, even though the kids can’t do it.  You can scream all you want, but it will not make them push their knees out!

- Neurodevelopmentally speaking, it was always quality before quantity.  This should be true with our exercise programs as well.

- Tarzan, to me, is the epitome of fitness.  The guy is strong, agile and quick.  He can run, jump, climb and swing through trees.  If we take a person who moves well and put them on a crossfit type of training program, we turn them into tarzan.  If we take that same program and give it to the majority of people in society who move poorly, we turn them into a patient.

- If you can’t change the movement of the majority of clients you are working with then you are doing something wrong.  You need to have a standard operating procedure as a way to test and re-test their movement patterns.

- Once you can get a good toe touch and active straight leg raise, go immediately to deadlifting.  Re-pattern that range of motion by locking down the newly gained mobility with some stability.

- The brain will create a mobility problem because it is the only option you have left it.

- Foam rolling should lead you to better movement.  If it doesn’t, then you aren’t doing something right, and foam rolling may not be what you need.

- The only thing documented for depression that does not have side effects is exercise.

- Strength or mobility asymmetries of greater than 10% in an asymmetrical sport (IE, golf) are a problem!

- You can’t strengthen stabilizers and assume the timing of them will improve.  Muscles like the rotator cuff musculature and rhomboids are muscles that need to fire FAST, not necessarily strong.  Seek to improve the timing of these muscles.

- Gray on the difference between training programs and training systems:

• Programs are carried out the same way, no matter what happens.  Systems have a way of breaking things down and telling us “if this, then than” and “if that, then this”.  Use systems instead of programs to get what you want in your clients training programs.

- The FMS is species specific, not sport specific.  The FMS is made up of basic patterns that everyone should be able to perform, regardless of sport.  These patterns show themselves in everyday movements and sports movements because we are all human beings.

- Intelligence is made up of two-systems working together: Pattern recognition and memory recall.

- The FMS seeks to predict injury from a behavioral standpoint.  That behavior is measured by your ability to move through certain patterns.

…Part 2 coming up later this week!!

Patrick
patrick@optimumsportsperformance.com

Fillers are extra movements in a training program that can be added in between exercises, as active rest.  I typically will pick a mobility drill that focuses on an individual’s limitation as a filler exercise, or occasionally some sort of core exercise.

The biggest benefit of “fillers” is that you can continue to hammer out a particular limitation that the individual has and that active rest in between exercises ensures that you don’t waste time standing around during training (*Not that rest is bad!  In some phases of training, you may want/need to take full rest periods of nothing to ensure that you are fully recovered prior to the next lift or sprint).

An example of filler exercises for an individual thas has increased hip flexor tone and poor ankle mobility, would be to perform a split squat and then follow it up with psoas active isolated stretching, and wall ankle rocking, before repeating the split squat.  It would look like this:

1a) Split Squat

1b) Psoas AIS

1c) Wall ankle rocking

I have to admit, I am horrible about doing this stuff in my own training program! 

I write it into all of my clients programs, but when it comes to my own, I usually don’t do it.  I will often just take normal rest and then repeat the exercise.  The unfortunate thing is that when I don’t do it, I notice it!  I get beat up much easier in training and my durability is poor.  When I am more focused on including my filler exercises, I move much better and I have less aches and pains from hard training.  So, I have decided to get serious and add them back into my training program.

Give some “fillers” a try inbetween your normal exercises and see how they feel to you.

Patrick

patrick@optimumsportsperformance.com