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Core is more than a 6 Pack

There are certain things in the strength and conditioning/personal training field that make you cringe every time you hear them.  Core is toward the top of that list, however, sometimes living in cliche phrases is what we need to do in order to communicate better with our patients/clients.

To better define what it is, let’s describe what connects to it.

First and foremost, when we think of the core, we think of the 6 pack–known as the rectus abdominus.  The muscle is essentially a sheet that connects the front portion of your ribs to the front of you pelvis.  It gets it’s shape from a central tendon–linea alba–and tendons that run horizontally from there.

But, if that was all there was, we would be in trouble.  We have external obliques, internal obliques, and transverse abdominus that all band together to create a lattice of protection.  This is great, because without this protection we would basically rupture our internal organs housed in the area.

If we all addressed the strength and endurance of this area we would probably all be a little better off.  However, that is definitely not all that represents the core.  We have these fancy postural muscles that help hold us upright.  Commonly referred to the erector spinae group which is composed of three different pairs of muscles along the spine.  There are little tiny muscles that run between each vertebra in the spine, there is the QL, which runs from the hips to the lower ribs.  There is the iliopsoas group that runs from the lower spine to the hips.  One of the bigger players, I feel, is the lats.  They run from the upper arm and course all the way down to the hips.  They can create shoulder stability and a great extension moment in the spine.

Clearly, it is difficult to find balance.  Any imbalance, if great enough, will create movement dysfunction and surely pain.  In my experience, the majority of kids coming in can’t do a pull up or even some sort of inverted row which is essentially a lesser version.  They also present with a great amount of anterior tilt showing that their abs probably aren’t working all that well.  How do they conquer gravity then?

When taking part in a workout program, especially in the lower training ages (you haven’t worked out in a couple of months) then make sure to keep it semi balanced.  Realize that all your big lifts essentially have an extension moment on the spine, really requiring those meaty lats to hold down the fort.  I would encourage you to find some sort of flexion moment at the trunk level.

Please leave any feedback below!

 

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Two Things That Anyone Can Make Better

A common denominator for anyone and everyone walking in the door of our facility is a lack in strength or stability in particular areas of the body.  Aesthetically, people want to know if they’ll get bigger (insert body part here), but realistically, two that are tremendously important should get better.  Without further adieu, here they are:

1. Anterior Core

Almost everyone I see is tremendously weak here.  It becomes even more clear when you ask someone to perform a simple push up.  They literally just hang on the ligaments of the spine.  How have you made it this far in life without learning how to perform a proper push up???

When I say anterior core, I’m referring to the portion known anatomically as rectus abdominus.  Fancy latin.  It connects the front portion of the ribs to the pelvis and when contracting forces the hips into a posterior pelvic tilt.  Not always great to be in that position, but with proper opposition/apposition it is fairly balanced to our normal 13 degrees of anterior pelvic tilt.

When this is weak, you see a lot of extra anterior pelvic tilt.  Your body just hangs out on whatever it knows will create stability…ligaments of your hips and spine.  Is it any wonder that we have soo much low back pain!?

Strengthen the abs, it will help create stability.  It isn’t the only answer as there are a few other abdominal muscles that are needed to help create that apposition we are looking for (different topic for a different day).

2. Buttcheeks

This is something that we work on almost every day in the facility.  To create almost all athletic motion, you need the glutes.  When developed, they can also have an aesthetic side to them too.

Glutes are great players in power, stability, multi direction motion.  We all have a gluteus maximus, gluteus medius, and gluteus minimus.  The hip joint (where the femur articulates with the acetabulum of the pelvis) also has a great deal of mobility, three planes actually.  Contracting here will create an external rotation element on the femur (thigh) as well as an extension moment.  It can create stability to the pelvis in a closed chain contraction taking shear off the low back.  And it gives us great power and push off in the sagittal, frontal, and transverse planes of motion.

The right side is usually a little weaker, again, different conversation for a different day.

This is anecdotal at best on my part.  When we screen our athletes and adults though, we see this to be consistent across the board.  Maybe it is indigenous to the Merrimack Valley, but I highly doubt it.  Let me know what you think by leaving a reply below.

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2017 year review

This past year has been a roller coaster for sure.  I have accomplished many life goals, changed things that I never thought I would change, and accepted life curveballs.  Here is a quick recap of 2017.

I made a couple of small life goals in 2017 that would help give me a hobby, something that was completely lacking.  Basically, I’ve spent my college and adult life to this point filling all available hours of my day with work or class.  Now that school is done and I am working a more modest schedule, hobbies will keep me sane.  First, I wanted to get to the mountains and snowboard.  2016 didn’t allow me to do that and it happens to be something serene once you get up to the mountain and check out the horizon.  Secondly, I wanted to pick up a guitar at least once per week.  This is something that is difficult to me because I feel I don’t have a musical bone in my body. I remain humbled.  That’s my personal life in a nutshell.

On a much larger scale, I passed my NPTE, the exam of all exams essentially.  This is what licenses you to actually perform your duties as a physical therapist.  Thank goodness that chapter has come to fruition.  So instead of working a modest 40 hours per week, I have decided to get a job in a clinic in addition to running a performance center.  I know, what was I thinking???

I made it a goal to get to more of my athletes games.  In 2016 I was really handcuffed with the job I had which didn’t offer much flexibility in terms of being able to see my athletes play.  Besides coaching lacrosse in the spring and seeing literally all of my teams games, I was also able to see both of the volleyball teams I work with, the girls soccer team I work with, and the ultimate highlight was being able to see Notre Dame vs. USC at Notre Dame where one of my athletes plays football.  I’m hoping that this year extends more opportunity to see the athletes in action–as well as more deep dish pizza.

Now with the new year, I would like to keep my hobbies going as well as really refine my skills in the PT arena as well as the sports performance realm.  I would like to get to do more networking this year and travel a bit more.  Kind of a rough outline for the new year, but it works.

 

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Guest Post: Time for a Change

This is a guest post from one of my interns from the summer and current sports performance coach.  Kathy is a very intelligent and driven individual who has donated her time around a hectic schedule to Young Performance.  She aspires to bridge the gap between PT and performance and has some really good ideas.  You can find more on her blog at blendingptandsc

             I’m a PT student who, like most people, has no solid idea of what field to practice in. After going on a few clinicals, I found out that my expectations of rehab didn’t really exist in the real world – at least not yet. Having this existential crisis, I decided to go figure it out. I began throwing myself into different jobs and internships in the health and fitness field. This summer alone, I’ve been a PT aide at 3 separate clinics, a personal trainer in training , a kickboxing instructor, and a strength coach intern – which has lead to the creation of this blog. There were two glaring problems that I kept noticing: 1. the health and fitness field is muddled with misinformation and 2. everyone is constantly trying to one-up each other.

1.  People are quick to believe what they hear or read without looking for evidence.

Carbohydrates are bad. All fats are bad. No rest during a workout is a good thing. There are so many health myths, so many “fads” backed with no scientific evidence, and, with the rise of social media, so much bad information posted by a lot of unqualified people. Not only is it dangerous, but it also creates another barrier for health providers who must spend their time re-educating and getting buy-in from their clients.

2. The health field, it’s a very “cut-throat” environment.

Everyone wants to have all of the credentials, the letters after their name in order to be the “best”. People also want to believe that their way of thinking is the right and only way. Hip vs foot, barefoot running vs orthotics – these topics cause a lot of frustration and bickering. It seems likewe’ve  all forgotten why we started in this field, forgotten that we are looking down on our peerswho are using their best judgement to get to the same goal. Just because their way looks different, doesn’t make it wrong. The first thing we learn is that everyone is different and something that might work for Joe Shmoe might not work for the next person – so why are we still stuck on trying to have one golden principle? It’s all theory at the end of the day and if it works, it works!

Long story short, everyone wihin the health and fitness field needs to come together and not only educate people but to encourage peers for their different perspectives and ways of thinking. Without that, we will not progress very far.Guest

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Training Youth Athletes

A common question that I hear is, “how old do you have to be to start training at your facility?”  To me this is a pretty easy question to answer, but also a loaded answer.

When we talk about athletic development, there are a few windows of opportunity that we can expect to use to enhance performance in athletes.  Just because I have a window of opportunity to advance an athletes potential doesn’t mean I need to get all sport specific with it.  In previous articles I have eluded to spending a great deal of time developing the foundation for youth athletes, or general prep if that is easier to remember.  Just because I have an opportunity to improve athletic ability in a youth athlete doesn’t mean I need to make them proficient in 1RM cleans.  I “can” hold a firecracker in my hand and light it, but it wouldn’t be very intelligent.  Just like I “can” develop maximal cleans in a 10-year-old, but that still isn’t very intelligent.

The lost art of development, playing on the playground.  There are even schools where you aren’t allowed to run!  All because there is a fear of children getting hurt.  I could jump onto my soap box and have a complete rant, but I will stay on point here.  Kids in preschool, elementary, and middle school all are allotted time to go out and play.  They jump, run, bound, throw, play tag, etc.  If that isn’t athletic development I don’t know what is.  I spend the first 30 minutes of training sessions warming up and working on running, jumping, throwing, and agility.  These are the showcase items for my older athletes.

Specializing kids too early is a sure fire way to burn a kid out from ever wanting to play that sport again.  It’s also a great way for a kid to resent their parent.  Allowing a child to participate in a variety of events allows for better athletic development.  Experiencing movements outside of what is normal in their favorite sport will allow them to become more agile and athletic.

What can a child who hasn’t hit puberty expect to do and see?  There is no reason to take a prepubescent child and load them up under the bar.  Develop their ability to perform these exercises that you want to accomplish in the long term development plan.  Squatting, hinging, pressing, pulling are all exercises that can start off with simple body weight.  Once they become proficient in these bodyweight exercises you can consider handling a light weight.  Then slightly heavier.  And heavier.  The point is that these kids will become stronger (mostly through their nervous system adaptation), but not exactly larger.  How could they? They haven’t even hit puberty yet.

Once they hit puberty, the long term plan continues.  Start adding heavier weight and adding new challenges.  They will become more powerful, faster, stronger, insert any synonym.  They now have the hormonal profile to support what you are throwing at them.  But a word of caution: don’t throw the kitchen sink at them.  Allow for normal development.  The newest, coolest thing isn’t the best option.  Often times the new workout it either a fad or a new way of eliciting a response in an athlete who has already developed their foundation.

To sum up, kids can virtually start at any age, however, I wouldn’t really recommend them starting too early.  I have nine and 10 year olds at our facility, but realistically a mentor of mine said 11 years old is a great age to begin.  I’ll stick with that.

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Long-Slow Distance Cardio

First off, it has been a little bit since my last check-in.  I have been busy with licensure testing, changing a few details professionally, and jumping right into some continuing education.  All those things, plus I have been coaching a high school lacrosse team in the area.

I was kicking back, sipping on a nice cup of coffee the other morning, reading over some “professional development” type material, when I came across a post along the lines of “why do long slow distance aerobic work?”  That  post of course got some great professional feedback, but it got me thinking too.

Most of what I was reading in terms of feedback was along the lines of: why indeed?  Now, I like bang for the buck type exercise regimens.  I feel as though we do a really good job of accomplishing both anaerobic and aerobic work in a relatively short period of time on a daily basis at our facility.  By using simple concepts like HIIT in our lifts we are able to develop strength and power via resistance training at appropriate, demanding percentages; and, also tax the aerobic system at the same time.  We also incorporate a conditioning portion after the lift that works usually on some type of lactic or alactic interval (think Certified Conditioning Coach)  in the preseason phases.

But where can we fit in the long-slow distance type conditioning???

This is where I reflect back to my magical weekend at IFAST, listening to Joel himself hurl information grenades at all of us innocent Performance Coaches.  In a very organized manner, he managed to explain to us how to use each concept that he has written about in books like “Ultimate MMA Conditioning”.  Long story short, one cannot sustain all out lactic intervals 7 days a week for very long.  This makes sense, right?!

With all the concepts in strength and conditioning regarding the importance of the nervous system, this should be a no-brainer.  Simply put, sometimes it is just better to let your foot off the gas pedal, slow down, and let your body (and nervous system) relax.  Let’s find that parasympathetic state for once in our training year.

Now that both sides of the continuum are screaming at me, let me elaborate.  First off, no, I do not think that you should be performing long-slow distance aerobic conditioning all year round–unless your sport is running a marathon or the Tour de France in which case you still shouldn’t do it on consecutive days.  Will you see strength and therefore power decrements as a result? Maybe.  Will you be introducing a new variable into your training regimen? Absolutely!  Cooling the jets for a few weeks will not have an absurd impact on strength/power/muscle fiber type.  But, it may afford you the potential to get even better because you let the body experience a new stimulus.

Personally, I don’t like long distance cardio.  I get bored with it, unless I am chasing a ball or object.  Cycling is more doable, but still, the struggle is real.  However, when no one is watching, I will jump on the Assault Bike for about 45-60 minutes and get in a good cardio sesh.

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Cueing Through the Ground With Push-ups and Planks

When working with clients, there is a tendency on planks and push-ups to just hang out on the shoulders. This is fairly incomplete and doesn’t allow us to take full advantage of the exercise. With the management of overhead athletes as well as general population clients, we all need proper coordination through our upper extremities.

At first, the thinking is everyone knows how to plank, right? Eh, not so much as it turns out. The big-ticket items are making sure that we have a neutral spine, or have manipulated the position to target what we are after. Then we want the entire body under tension; things like the six pack, quads, butt, etc. We have made sure that the eyes are lined up with our fist to protect our shoulders in the basic plank. But, we can’t stop there! Are our shoulders under tension? How can we better the time under tension?

 

A huge muscle that goes unnoticed by most people and doesn’t get the care it necessarily needs is the serratus anterior. Big Latin words. This muscle starts on the ribs just under the armpit and kind of looks like the serrated edge of a knife. Hence the name. The muscle then courses under the shoulder blade to the inside border closest to the middle of your back. It is responsible for holding the shoulder blade down flush to your ribcage as well as giving it the proper mobility it needs to reach your arm overhead. Without this muscle firing properly, we would (and some of us have) experience shoulder impingement, rotator cuff tendonitis, rotator cuff tears, biceps tendonitis, bursitis, and any other form of itis you can think of in the shoulder region.

 

Traditionally in physical therapy, we throw a patient down on a treatment table, tell them to reach for the ceiling with one straight arm, and repeat this exercise x10 multiple times throughout the day. This is called a serratus punch and is a fairly non-functional exercise. It is designed to just get the serratus working again. What if it isn’t causing trouble yet? How can we make it functional?

Here is the simple answer! Especially in the warm up when we are performing planks and push ups to get ready for the rest of the lift we can cue everyone to push their arms through the floor. Getting that little extra reach will get that muscle working really well and with repeated bouts of this, we have taken control of most of our shoulder problems.

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Cons to All-Year Sport Specialization

It’s been a while since I last posted!  This summer has been crazy. We moved our facility to Gametime Sports and Fitness in Lowell, merged with SLS Fitness, increased the amount of space that we had available and as a result increased the amount of athletes we were able to work with.  It was a super fun transition and definitely a learning experience.

With all of these new changes, we were exposed to a number of new challenges with our athletes.  It seems like not so common sense that kids shouldn’t be playing the same sport all year round especially at the younger ranks.  Early sport specialization has been an uphill battle in the world of physical therapy and strength and conditioning, but the only thing we can do is urge kids not to do it.  Often times when I present to parents for our in-house workshops I say something along the lines of, “…I strongly encourage kids to play a different sport once baseball is done kind of like a strongly encourage you to wear a parachute when jumping out of an airplane.”  That will get a few chuckles, but the kid is in pitching the next day anyway.

What could possibly go wrong?

Good question.  Maybe we are being too conservative?  Maybe your kid is a freak athlete like the character “Spike” in the movie “Little Giants”?  Unlikely.  It isn’t just anecdotal, conservative babble either.

Lacrosse is a prime example.  In this area it has begun to take shape and kids are running around town with their “twigs” trying to be the next big star.  Awesome!  I love all that lacrosse has to offer in terms of it isn’t hockey and it gets kids outdoors.  The problem resides in how the kids will hit the ground running and play all year round.  They have their school teams in the spring, their club teams in the summer, fall ball in the fall, and indoor in the winter.  Here is a movement screen I did recently with one of my high school lacrosse players who has committed to play for a good, Division I college.

IMG_0419

See anything wrong?

While playing club over the summer, he had a tear in his Posterior Cruciate Ligament (PCL).  The first thing I thought when I heard this was, great it isn’t your ACL.  Nonetheless, the PCL is a necessary component to knee integrity and checking movement of the tibia (shin bone) on the femur (thigh bone).  His first big request like all other kids is to be able to accelerate better.

Plan of attack:  We finished the FMS and did some other non-ballistic testing to see where he was at.  Next we programmed foundational exercises so that his movement quality was up before we started giving him the big strength and power exercises.  It is truly amazing how quickly the strength and power numbers go up once you develop a good foundation!  As a side note, and I can’t express how crucial this is, I couldn’t have performed a movement screen or any other tests on this athlete without the okay from his physician.  Even as a DPT, it is paramount that I follow the wishes of the M.D. so that I stay within the scope of my practice.

To this point we have just begun working on sprint technique and form, but have remained semi-conservative with our strength-speed/power work.  Do no harm is the mantra, and in this case, don’t hurt that athlete more than what they are presenting to you with.  It may not be sexy or sleek to perform planks, KB deadlifts from a raised platform, or corrective exercises.  But, if it gets them safely to their goal without causing further damage, that is what we will do.

 

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In-Service Presentation

Recently, I had the pleasure of reciting an in-service presentation to a host of physical therapists, physical therapy assistants, and physical therapy aids as well as occupational therapists.  It was a great experience and well received which is why I’m sharing it here.  Take a couple of minutes to check it out and leave any feedback that could help in the future.

Thanks!!

PNS presentation

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Recovery Strategies

In many conversations with clients/athletes it has become clear that once they’re done with the training session, they are done thinking about training in general.  They may be motivated to eat something “healthy” to stay consistent with the day, but that really is the extent of it.  As a performance coach, it would be reckless and lazy if recovery weren’t addressed with the population I am working with.  As such, here are some of the tools that I use generally.

Breathing

For most of my adult client groups, I will use different breathing strategies towards the beginning of the workout.  This will allow them to leave the workday at work and not bring it into the gym.  For the general population you can start to program different tempos for breathing, but that may be a little overkill for someone who doesn’t know how to engage their respiratory diaphragm in the first place.  Belly breathing is quite simply done by lying down on your back, placing one hand on your chest and one hand on your belly, then trying to fill only the hand on your belly without letting the hand on your chest rise.  This is a little bit of isolation type movement, but it is pretty effective at getting people out of their overly sympathetic tone from work or life.  If someone is having trouble doing this, their is a pretty cool trick that I learned in PT school that is called the “sniff” test.  Simply ask the individual to sniff as if they were sniffing like a dog.  You will get raised eyebrows and questions, but once they get what it does it becomes rhetoric.  You can progress the belly breathing series by rolling over and doing “crocodile” breathing or play around with tempos to get different reactions.

Breathing can and should also be done at the end of a training session.  Recovery happens in a parasympathetic state.  All this means is that if you’re stressed, high-strung, ready to go postal, you will not recover very well.  If after a training session we sprinkle in some breathing techniques, it should help to facilitate that relaxed, parasympathetic tone.

Nutrition

This is such a basic tool that everyone can use, and yet, most don’t or at least don’t do it well.  There are a number of supplements on the shelf that come with a varying amount of integrity attached to each brand.  These are just as the name implies: supplements.  This means if you’re not getting enough in your diet then use it.  You can usually find out what the recommended daily intake (RDI) is for each micro/macro nutrient by simply going on the internet machine and searching.

That being said, depending on who you are you can time your nutrition appropriately with the right content to get the result you want.  For recovery purposes, usually getting in some protein after a workout is a pretty simple start. If you dive into different resources, they will tell you that you need a certain amount of grams of protein per kilogram of body mass every certain amount of hours, but let’s get real.  Just eat some protein or take some sort of protein supplement to aid the recovery process along.  You can also add in any other micronutrient source that you may require (vitamins, minerals, creatine, etc.).  It also can’t be stressed enough, eat veggies!  If you refuse to eat veggies then you refuse to reach your goals.  Kind of a blunt truth, but it is the truth.  When asked I usually recommend the more colorful types of vegetables.

Based on some of the above reading, we know that the real recovery happens when in that relaxed state.  So nutritionally, how can you influence relaxation?  Simple.  There are a number of different things that can be done to aid the recovery process.  My favorite is to have some sort of chamomile based tea at the end of the day.  This helps to relax the system and also has been shown to bring individuals to a deeper sleep which is the ultimate relaxation.  Melatonin also helps to achieve that deeper sleep in individuals, and can be purchased at virtually any health store.

Water may be one of the most paramount nutritional ideas to recovery out there.  When you’re dehydrated you run the risk of increased inflammation, decreased blood volume (carries all those important nutrients), increased cramping, decreased affect (mood), decreased nerve conduction velocity, decreased short term memory, etc.  These are all pretty important for the athlete or the professional adult.

Sleep

This is probably the number 1 recovery tool and the easiest/cheapest.  There are so many mechanisms at work when you sleep.  As mentioned previously, this is the ultimate relaxation tool, again, where we recover.  Hormonally, we see a surge in anabolic hormones (the ones that make you recover).  Interestingly too, there are some mechanisms at play that weren’t all that known previously.  The fluid that encases the spinal cord and brain, cerebrospinal fluid (CSF), normally is produced and recycled at a constant rate, however, when you’re sleeping the process actually speeds up helping to clear the system of toxic metabolites.  What does this mean?  Well the nervous system (brain and spinal cord being mega players) is what sends messages to the muscles to move.  When those metabolites build up they create a toxic environment for the system and can create a whole host of issues.  The resulting inflammation has been correlated with many chronic diseases which ironically are also usually stress related too.  The magic number of sleep hours appears to be about 8.  That means eight hours of sleep, not 8 hours lying in bed, so watching the television while in bed doesn’t count.  Also, there is some new research coming out saying that obesity is associated with greater than 10 hours of sleep per night.  I don’t even understand how you can have that amount of time to sleep and am completely envious of whomever has that kind of time.

Environment

There are also some pretty cool tricks that you can do to influence your environment to aid in the recovery process.  Different scents and oils can be used to get a better night sleep or even just relax.  Lavender oil appears to have the ability to do this and if you don’t want to invest in essential oils you can simply buy the airwick with lavender oil.

Also, as mentioned above, watching T.V. in bed doesn’t count as sleep.  How can we eliminate this potential distraction?  Remove the television from the bedroom if possible.  Seems like a simple answer, but when you confront people on this it is amazing how much resistance you run in to.  Television, tablets, computers, and especially smart phones display via blue light.  Blue light stimulates the wake cycle in the old noggin and has negative consequences for sleep quality.  If it is a must to use these things before going to bed, invest in some cool orange safety glasses at your local hardware store.  This is a neato trick that I learned at a conference a year ago from a pretty smart individual.

Take a nice warm shower roughly 10 minutes before bed.  This has also had a very positive influence on achieving deeper sleep in individuals.  If you are one of the sick and twisted individuals who enjoy cold showers, disregard this information.

Some recent research also correlates cleanliness with getting better sleep.  Having a clean environment, specifically your bedroom, you have less to think about.  Because you have less to think about, you fall asleep quicker which enables you to get a longer, deeper sleep.

Wrap up

These are just a few options that you can use or pass along, but they’re extremely cheap and efficient.  Most people just need to fulfill one or a few of these steps to see almost immediate results.  Feel free to comment anything else that is simple and works well.