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Consistency is the key

The importance of repeatability cannot be overstated. When you appraise someones ability to perform a particular exercise or movement it is absolutely imperative that your set up positions for testing are the same each time.

If you watch someones overhead squat and the first time you check their technique you cue them to have their toes straight forward; they struggle down, get halfway through and  their hands come forward and knees collapse inward, then when you re-test them after some intervention and their feet are turned out 5-10degrees and they dramatically improve, you cannot compare the two squats.

These three are all examples of unloaded overhead squats, but they are all very different mechanically, and place very different movement requirements on the body.

Overhead Squat? yes, but narrow stance and straight feet

Overhead Squat? yes, wide stance, wide grip (not good form)

Overhead Squat? yes again, but feet turned out this time. 

The difference between feet straight and feet 10degrees turned out, changes the entire assessment. Slightly externally rotating the feet, changes the position of hip to enable easier internal rotation, it brings the adductors into a position where they can act as a hip extensor (as opposed to adductor), it changes the strategy required at the ankle to allowing the arch to collapse slightly and fascial tension to change. All of these as result of slightly turning out the feet!

Thomas Myers (anatomy trains)
is definitely onto something.

The body needs to be thought of as an interconnected web of tissue, whereby an action in the toes can impact on the stability or mobility of the low back, a slight change of knee position could be implicated in the stability of the shoulder or neck. If your focus is too narrow when looking at the way you or your client moves you will get stuck trying to address limitations that might be caused by something in a different region all together. Conversely if you go too broad and don't approach your movement appraisal in a systematic way to ensure that each time you appraise something you do it exactly the same way, you will never actually know if what you are doing is working.

It is understandable that as clinician, trainer or coach we want to show our clients that what we are doing is helping them improve. However, if you are re-testing your client or even yourself and you are allowing modified positions from test to test, you will never know if the corrective exercises or training strategies you are using are working or not. You are only cheating yourself and your client, and eventually you or your client will pay a price either through injury or limitations in performance.

So, make sure you use objective measures and use a systematic approach to technique/movement appraisal. Whether you use Gray Cooks' Functional Movement Screen or another movement assessment standard it doesn't really matter just make sure your test re-test approach is clear and repeatable.

Getting it overhead - with a twist

Our shoulders get an absolute beating over our lifetime, in fact studies have found that 28% of people under the age of 60 with asymptomatic shoulders (without pain) had evidence of rotator cuff damage and 54% for those over 60years (1), and these are the lucky ones…without pain.

I think most people have an appreciation for the functional need to be strong overhead across the lifespan, crossfitters and olympic lifters in particular, place an enormous emphasis on the capacity to take weight from the ground and put it overhead, and rightly so. However, the last thing we want happening in our quest for increase performance, health and independence is injuries.

YES.

The loading of overhead lifts such as strict presses, clean and jerk, snatch, push press, crossfit style kettlebell swings etc. is fantastic full body strengthening if you are able to achieve the optimal body position to allow the shoulder to be stable and packed, doing the least amount of work as possible. Unfortunately not all of us using these lifts are getting there.

To get into this optimal position the shoulder needs some help from the thoracic spine (T-spine), or the upper back. The best way to take some load off your shoulders is to ensure you have good thoracic spine (T-Spine) mobility primarily the ability to extend and rotate. If you are in a rounded position with your  T-Spine, you place the shoulder joint in a forward position blocking it from using its full range. Other than looking crap from the side there are a couple of important issues with this position:

1. It can result in subacromial jamming, causing you to mash the tissues between your humeral head (top of the upper arm) and the acromion (boney structure at the point of your shoulder) = tears/ inflammation/ pain.

2. It requires you to arch you low back (lumbar spine) to make up for the lack of range at the shoulder/T-Spine = potential for low back aggravation/pain.

3. Your head position will move forward causing a pokey chin posture = increased susceptibility to neck problems/pain.  

Don't be that guy

Because of the oblique angle of the facet joints in your T-spine you can add a great deal of extension range by improving your rotation. So try this t-spine rotation exercise to improve your overhead position and save those shoulders:

Start.

Middle: Pause at end of each exhalation, inhale and rotate some more

Finish: After three breaths/rotations reach the arm. Pause and return to the start

 Key Points:

1. Make sure you support the top leg with a pillow or foam roller
2. Take a deep breath in, exhale and rotate stop when you run out of air, pause, take another deep breath and repeat.
3. Drive the rotation by turning your head
4.Try to relax your lower body completely
5. The upper leg must be at or above 90degree at the hip


The aim is to have both shoulder relaxed and flat on the floor.
Repeat 3-4times each side.


References:
1. Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77:10-15

Shoot from the Hip

One piece of the movement puzzle I see missing all the time, is good hip extension. A lot of emphasis is placed on  strengthening the posterior chain these days and for good reason. However the value of a strong posterior chain or powerful hip drive is lost if you dont have the range of motion to deliver this strength through a full range. Your gluteus maximus is the main contributor to powerful hip extension and its strongest contraction strength is seen in full (terminal) hip extension. So it goes without saying that if you are unable to full extend your hip then you are going to miss out on some glute assistance which means less power.

No hip extension issues here!

The most common compensation for lack of hip extension is to extend (arch) the lumbar spine. You will get away with this for quite a while but eventually this extra demand on the low back to make up for the hip will result in some low back pain.
A lot of astute gym goers, crossfitters and trainers recognise this and aggressively try and increase their hip extension by stretching their hip flexors (illiopsoas). While the hip flexors are a great place to start another significant and often poorly stretched muscle is rectus femoris (RF). The RF is crosses both the knee and the hip joints, for this reason it is very often overworked and is quite susceptible tightness. Because the RF crosses two joints it is also a prime candidate to have an negative impact on the lower back position. By pulling on the AIIS (front of pelvis) it can tilt the pelvis forward slightly causing the low back to arch to accomodate the change of position.

The trouble with common RF/Quadricep stretches is they dont limit lumbar spine movement, so what ends up happening is we continue to compensate for our tight RF with excessive low back extension.

Compensating for a tight hip by extending the lumbar spine, not cool.

The easiest way to limit your lumbar movement in a quad/RF stretch is to flex the opposite knee to 90degrees. This will act to block the lumbar spine from moving into extension. So here's how you check if you are missing some hip extension.

Make sure you keep the lower leg at or above 90degrees of hip flexion. Take hold of the ankle of the upper leg and pin it to your backside. Keep the ankle pinned to your backside while you drive your knee back as far as you can, opening the hip into full extension.  

         

Start Position

Take note of your finish position, have a friend hold a broomestick above you aligned through your shoulder and and hip. If your knee is still in front of the stick you need to spend some time here. When you are in full extension squeeze your glute and try to drive you hip forward. Hold each glute squeeze for 10seconds, relax and repeat. Accumulate 2 mins of stretch time on each side.

Finish  Position

The Language of Movement

My intention for this blog is to try and provide as much of the information I am exposed to in my work and study as possible. But given the depth and breadth of information available to discuss relating to human performance the hardest thing is knowing where to start. So I guess when in doubt start with the basics.

I recently attended the CrossFit level 1 certification which is open to anyone able to pay the attendance fee with an interest in CrossFit. As you would expect there were a significant number of personal trainers eager to add the CrossFit methodology to their training repertoire. There were also a number of CrossFit enthusiasts that just wanted to train from CrossFit HQ mainsite and understand the method better for their own training. There were even a few people there who had never even done a CrossFit workout before. The seminar instructors were very good, well prepared, charismatic and enthusiastic. The bulk of the material – as you would expect – was simplified into practical terminology and examples to make it as user friendly as possible for the broad range participants. Even with the simplified material a large number of the participants had trouble getting their head around the descriptions of movement. What is hip flexion, adduction, abduction etc. So I figure if a group of exercise enthusiasts and personal trainers struggled to get their head around the terminology, it couldnt hurt to revisit this topic as the first addition to the blog.


The language of movement is essential in our ability to understand and communicate human movement to each other. It is very difficult to describe human movement without a common language to help paint the picture. The beauty of understanding the language is it allows you to break down and accurately describe the component parts of different exercises and activities and can help you better identify any missing pieces when trying to improve your technique or performance. It provides a common language that all exercise, health and medical professionals can speak. And you can impress your physio or doctor with your perfect descriptions at your next visit.

Planes of Movement

There are 3 primary planes of movement, Frontal (coronal), Sagittal, and Transverse. These are kind of like the human movement compass, they don’t tell you what’s happening they only describe where you are going. Here are some examples of exercise in these different planes of movement:

Frontal – Strict Press, Jumping Jacks (star jumps)

Sagittal  - Squat, Running, Kettlebell Swing, Front Raise, Push Ups

Coronal – Russian Twist, Carioca Drill, Cable Rotations

Obviously, when you think about each of the aforementioned exercises you start to realize that they don’t fit perfectly into each category, that each exercise is comprised of a mixture of different movement planes. So now we know where we are going we just need to describe how it is we are getting there. This is where it can get a little confusing, but bear with me you will hear these terms come up time and time again in the health and fitness world and the more you are exposed to them the easier it gets.

Describing Movement

Start to think about some of the exercises that you do at the gym, in sport or at the CrossFit box and what are the primary movements of these exercises. For example, the squat is comprised of an intial flexion at the hip and knee and dorsiflexion of the ankle as you lower, then reversed by extending at the hip and knee and plantarflexing at the ankle.

The better you understand these movement descriptions the easier it will be to communicate to your clients, trainer or health professional what it is you/they are struggling with and what needs to be addressed.