This was Tony’s first presentation at a major seminar. He did amazing. He brought the performance perspective when it comes to spinal health and core training.
In the clip above, he talks about assessment. He spends most of his time in this clip talking about overhead assessment, plus he highlights what hip width to get someone to take when they are doing an overhead assessment and you are teaching them to squat.
Just prior to this clip, Tony went through the table assessments that he uses with his athletes.
Oh ya, at the end of the clips he highlights how you know if it is stability or a mobility issue when someone squats. Great tips and cueing.
Exercises for Core and Spinal Fitness with Dean Somerset
As usual, it was amazing stuff. Here is a clip from the DVDs:
Rick and His History of Core Stuff
Before I get into the review, let me chat about core stuff.
I was introduced into core stuff in 1997. I was working at a physical therapy clinic and the physical therapists at the clinic asked me to do some research and put an in-service together for them on core stability exercises.
The class was a hit with the physical therapists and it led to me teaching the class at Simon Fraser University.
Over the next 4 years, this led to the building of a 16 hour course related to core stability for the rehab client, on advanced core stability, core stability of the shoulder, and core stability of the lower back.
I am always excited to see what new research is out there when it relates to the core, or what leaders in the field like Reinold and Eric Cressey have to say about it. I know I am always open to new idea and I am always learning. In the end it benefits my clients, those that attend my courses, and myself.
Let me go through the program and highlight a few things I learned.
Module #1 – Introduction to Functional Stability (Length – 52:26)
This is where they explain their concept of core training. They explain it is based on numerous disciplines.
Mike started explaining what FST is and how it is based on four components:
Mike also spent a good chunk of time talking about what creates dynamic stability and going through his perspective of the 4 things that play a role in it. He discussed how dynamic ligament tension, joint compression, force couples, and neuromuscular control impact dynamic stability. It was great to hear his perspective and get insight into how he interprets things.
Few highlights from this module:
reverse posturing is a big thing we need to focus in on with our clients
isolation training has an important role in the process of rehab and performance
how the hips might be the place to start with a lot of things we do as trainers, coaches and therapists
muscle imbalances affect the core in a negative way and need to be addressed
Here is a clip with Mike chatting:
Module #3 – Maintaining a Training Effect In Spite of Common Spine and Lower Extremity Injuries (Length – 1:00:48)
It was great they took the time to look at some stuff when it related to exercise and injuries:
This is great to stuff to see. This module really focused on stuff that I love, which is injury and exercise stuff. It is great to get the perspective of a strength coach and how he keeps getting training results, even if clients are injured.
Eric shared his experience working with 40 people that had spondylolysis. He classified it as the new ACL epidemic in the sports performance world.
Eric went off on a tangent and commented on how many of the injuries that professional athletes have could be the result of what they did between 10 to 15 years of age. The focus on competition and less on training, plus the early specialization of sports, has changed how people have developed.
Eric also talked in detail about disc herniations, hockey hips, sports hernias, and exercise considerations. He also touched on anterior femoroacetabular impingement, anterior hip pain, femoral anterior glide syndrome, anterior knee pain, and ankle issues.
A few things that stood out:
look at the mechanism of injury and consider that when it comes to the exercise program
Module #6 – Performance Progression Lab & Advanced Stability Lab: Training Outside of Sagittal Plane (Time 56:20)
It was great having Mike go through bridges, bird dogs, side planks, and kneeling rotation exercises. Hearing his cuing and seeing his progressions are things that I will use with my clients.
Mike focused on lower body and then Eric came in and started talking about upper body exercises. Eric started with serratus anterior and lower trapezius work. Then Eric went into his med ball stuff. This was great. A lot of stuff that I have never seen before, but what was more important than just the exercises was his program design. I typed out 14 pages of notes full of little photos like this:
Enough of my little stills. Here is a clip from Eric, talking about med training he does with his athletes:
Other Things that I Like about FST:
I never get tired of listening to the Boston accent. When I read Eric and Mike’s blogs, I make sure I read it in my mind with a Boston accent. It make it more interesting and easier to remember the material.
I get a chuckle when coaches bring out their khakis for the camera. Mike and Eric, did the same. Nice.
It is always great to get new cuing for exercises and exercise progressions.
The little story that Eric shared about rubber and why there were so many faulty med-balls last year was very cool.
It was interesting to hear why Cressey does not spend much time on Olympic lifts with his athletes and spends more time doing medicine ball work.
Okay, let me be honest. I have only gone through 3 of the 6 modules but I am very very happy so far. I have learned a number of exercises, got some great cuing tips, a bunch of progressions, was reminded of a bunch of stuff, and learned a stack of new stuff.
I will watch the rest next weekend as I have a long flight to Detroit and then off to Windsor to present. Take care.
Here are some answers on knee pain when you lunge, plus checking in with a few answers from EFI readers.
Over the week, I received a bunch of questions from readers and I want to take some time to answer them. I can’t answer them all but I will do my best to get back to everyone. If you don’t hear back from me after a few days, just send me a reminder email.
Knee Pain When You Lunge
I purchased your muscle imbalances revealed package on the weekend and I
just wanted to say I love it so far!! Extremely informative.
Just one question. I have a client right now whose left knee is really
bothering her. It makes cracking noises every time she flexes her knee. She
is alright for hip flexion exercises like squats but for lunges she cannot
perform anymore because of her knee.
I just watched the Maximizing Strength and Stability of the Knee and I am
curious if those exercises will work for her condition.
The doctor gave her exercises like the Bulgarian lunge on the bench but
that is putting too much pressure on her knee. I do not agree with that
exercise choice and I was wondering if you could help me.
My client is overweight so I’m thinking there is too much pressure on her
knee joints but how do I get around this? I have her do squats on the Bosu
ball and leg extensions on the TRX, to really focus on her knees to make
them stronger but are there other exercises that I could be doing?
Thank you for your time!
I am so glad that Muscle Imbalances Revealed has been such a benefit to you. It is a bit of a labour of love. Glad it is helping you out.
Yes, a lot of the exercises in the knee component will help out. Many of the exercises are in my Knee Injury Solution program. There are all kinds of levels of exericses plus videos and descriptions of the exercise in Knee Injury Solution.
Here are some videos that I have done that may help you. You can see more on the YouTube channel.
The Bulgarian Squat is a good exercise but I would call it an advanced exercise that the average person cannot do. It puts a lot of load on one leg. Often times the weakest point in the leg will give way and with most clients it will be their knees. With the client being overweight, this makes the situation even worse.
I am a big fan of regressions. The more you can modifiy an exercise, the happier the client will be. The more regression exercises you have the more you can change things up to challenge them, keep them guessing, doing new things and keeping them pain free.
One quick thing you can do for knee pain when lunging is decrease the distance between the feet with the lunge and also move the trunk in a forward position. This decreases the range of motion of the lunge which make the knees happy plus the forward trunk activates the gluteus maximus more which decreases the stress on the knee extensors.
When it comes to other exercises, try the modified lunge that I talked about above. You can also try bilateral ball squats against the wall or unilateral ball squats. This decreases the stress on the knees. You can also try lunging onto a risor or a back lunge.
Let me know how this goes.
If you have something else to add, just leave a comment in the comment box below.
Here are details on my Knee Injury Solution program:
When the spring comes, I always get asked about tips for new grads. I will be doing an interview in the future about this. I just got in touch with an old colleague of mine and he has agreed to do an interview on tips for those going through a human movement or exercise science degree. Watch for it.
Exercises After Hysterectomy
Do you have anything for clients returning to exercise after abdominal
I do not have anything for that specific condition.
I often times start people off with the exercises in Core Stability of the Back ebook. You can check it out here.
Make sure the person has medical clearance to start an exercise program and the medical team supervising has provided you with exercise guidelines.
Heads Up – Live Courses and Internship
I am working on a bunch of live presentations and an internship. I will have more details on them soon.
Males produced greater hip abduction, hip external rotation and quadratus lumborum measures
Athletes who did not sustain an injury were significantly stronger in hip abduction and external rotation
Hip external rotation strength was the only useful predictor of injury status
Often times when we focus on working on the core we think of crunches or bridge variations. It is interesting how this research expands on things further and looks at core function in different planes of movement and different movements. I like the fact that it highlights the importance of looking at hip abduction and hip external rotation strength. Many times this is not mentioned or covered in an exercise program.
Here is an exercise that I give to work on hip movement and strength:
A few comments on the exercise. The exercise can be used for:
Educating the movement of hip movement from the rest of the body.
A dynamic stretching of the hip rotators.
A body weight active hip rotator exercise.
The directions given and the cueing can change the function of the exercise.
Where to get more information – Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34.
If you are looking for exercises to strengthen the external rotators of the hip, these are what I use:
Easy and Effective Exercises for Tennis Elbow
I am working on this month’s Injury of the Month. It is Tennis Elbow.
I was doing my research on the injury and came across this article, which was interesting. It talks about isometrics for an injury and really highlights the new trend in exercise rehabilitation.
What They Looked At
They wanted to see if isometric exercises were as effective as medication for pain relief in those with lateral epicondylitis (tennis elbow).
They had two groups:
Group 1 – Were shown the exercise and then they did it at home
Group 2 – Began the exercise after 4 weeks of medication
Interesting Points in the Introduction
An increase in symptoms from exercise will decrease the compliance rate to the exercise program
Performing the exercises too aggressively can increase the risk of irritation or injury
The above two points are obvious but nice to see them highlighted in an article
Tennis Elbow Exercise Performed
The researchers only gave one exercise. Here are the details of the exercise:
The subjects did the exercise in a sitting or standing position with the arms flexed to just below shoulder height. Then the wrists were moved in a slow controlled manner into extension with the fingers relaxed. The focus was on moving the middle finger towards the elbow in order to target extensor carpi radialis brevis.
The exercise was performed without pain and in a controlled manner.
Four sets of 50 repetitions with each repetition being held for 10 seconds, done daily.
What they Found
After one month, group 1 had a greater decrease in their pain levels compared to group 2
At 3, 6 and 12 month follow up there was no difference between the groups
Those that did not feel any benefit from the exercise program after one month were referred on to shock wave therapy
Interesting to see the benefits of isometric strengthening on an injury, specifically with lateral epicondylitis. Isometric exercises are not exciting but effective when it is comes to an injury and the safest of the three types of contractions.
A lot of the research out there focuses on eccentric exercises for tennis elbow. This article highlighted the benefits of an isometric exercise which is less stressful on an injured area.
The number of repetitions was a surprise to me. Over a day performing 200 repetitions or about 33 minutes of exercise sounds like a lot. This is a trend that is occurring in exercise rehabilitation. The standard used to be 1 set of 10 repetition but this is fading away and does not correlate well with what many people do during the day (number of movement cycles performed in a day). Performing low load (isometrics) more frequently transfers more over to what one does on a daily basis and assists in recovery.
Just so you know, the tennis elbow exercise program will be coming out at the end of the month.
Where to get more details – Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. (2011). Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3.
That is it for another edition of the research review. I hope this helps you out when it comes to core stability and injuries, plus a great little tennis elbow exercise.
Let’s get to this week’s questions. Starting off with a question on scoliosis exercises.
Lessons from Albert Einstein about Scoliosis
I have scoliosis which I’ve been diagnosed since I was 14 years old but haven’t taken the time to take care of it.
iIm 20 now and am currently attending a Schroth method practitioner (I own the book, but it’s too complicated and detailed for me), a method where you stretch your tight and short muscles and strengthen the weak. Breathing exercises are also a big part of it but we haven’t gotten any deep with this yet.
Anyway the practitioner I go to said that I should first work on my posture until we get into stretching the imbalanced muscles, so basically she makes me sit on a swiss ball with my back straight, take a wooden rod and mobilize my upper back by doing behind neck presses etc. and then proceed to do exercises like clam shells on a yoga mat. Makes me doubt if I’m heading in the right direction.
I understand your frustration, I get complaints that I am not technical enough.
I do what I can to keep it simple because if you can’t explain it in a simple manner, then you probably don’t fully understand the information.
I think some guy name Albert said something to that effect:
“If you can’t explain it simply, you don’t understand it well enough.” – Albert Einstein
Muscle Imbalances Revealed can be advanced for someone with no fitness or health background, plus Effective Exercises for Scoliosis relates to the challenge you are having.
The manual is written for fitness professionals but I know what will be most beneficial will be the 12 week exercise program. I tell you what to do and have photos and descriptions of each of the exercises, plus I am always easy to reach if you have a question.
Congratulations on taking control of your health and seeking out solutions.
All the best.
Your Spelling and Grammar SUCKS!
Thanks for all of the great info in your blog posts. You seem very passionate and committed
to your work and seem genuinely interested in hearing feedback on your posts. I’m a registered massage therapist of 14 years and read many different health related blogs and articles, and I just wanted to give you some constructive feedback.
Something that you might consider doing is having a copy editor or at least someone with editing skills scan your posts and articles before you put them up on the web. Spelling and grammatical errors end up being distracting for readers and tend to dilute the professional aspect of the posts. For example: writing “I got a great post for you” rather than “I have a great post for you” is grammatically incorrect and immediately distracts the reader from the following content. If it occurs frequently, it actually undermines your expertise. I understand that you may be going for a more casual way of delivering info to people to make it more accessible, but readers still appreciate good writing. Spell checking posts would also be very helpful. If you are delivering information to the public as a skilled professional and someone with a special skill set, the written form of your information should be equally skillfully constructed. You can still maintain your personality, humour, and individual style in your posts, but cleaning up the spelling and grammar will do wonders for the presentation and quality of your work. It can make the difference between ground beef and tenderloin on a handle!
I hope that you receive this in the spirit with which it was intended. You clearly put a lot of effort and time into what you do! Good luck with your blog!”
Spelling and grammar have been an issue for me forever.
I once had a sociology instructor tell me in third year university, “It is a disgrace to the university that you made it this far with such poor spelling and grammar.”
That was not much fun.
I Could Use These Excuses:
I can focus on the fact that I grew up in a Croatian family and we mainly spoke Croatian but I keep writing and blogging.
I could focus on the fact that I am a little bit of a slow learner. It may be because I am almost blind but I keep writing and blogging.
I could use the fact that my mind races and I have a very difficult time sitting. I am sure I could go out and get a diagnosis for this, but I keep writing and blogging.
I had someone edit my stuff, but it would slow down the process of getting things done.
I do have a friend that helps me and she goes back and cleans up my past blog posts. She keeps saying I have improved so much since Junior high school. I am proud of that.
I have accepted the fact that I will only get better with my spelling and grammar if I write and blog more. Kind of like an elite athlete, you get better with practice or doing.
I know my spelling and grammar will frustrate some but those that look past it and see my passion will take what I share and run with it.
That is It
When you read my blog or get emails, expect me to do the best I can at the moment with my spelling and grammar. I promise you the emails or blog posts have been read twice, spoken out loud twice and spell checked.
If you can not look past one of my weaknesses and see the passion that I have for injuries and exercises as I work to my mission of helping 1,000,000 people become injury and pain free by 2020, then I guess I am not for you. Good bye.
Core Stability of the Back
Some kind thoughts from a happy reader:
“I initially bought Core Stability of the back to prepare myself to teach a knee and back pain class.
It was very helpful because Rick was really detailed in the instructions of the exercises which helped me to be effective in teaching them.
I also use them with my other low back clients and have been told that the exercises really helped them. I myself like the mini anatomy lesson in the beginning of the book. The lesson helped me to better understand how the abdominal and low back muscles work together, mainly due to the easy to understand language.
It’s hard to compare this product to other products because there isn’t a lot of post-rehab and corrective exercise products on the market. And what little there is on the market, your products are the only ones I can really afford right now.
I appreciate your products very much because as trainers I feel that we need post-rehab and exercise therapy education because we are increasingly running into clients with these injuries, and many products are dedicated to physical therapists, athletic trainers, and chiropractors, things we can’t really use.
But thanks for what you do, it’s much appreciated.”
The importance of core stability when it comes to the function, stability and strength of the back has been well researched and publicized. In the shoulder exists a group of muscles that have similar importance when it comes to function, stability and strength. These muscles need to be activated and strengthened when the shoulder is recovering from injury, and should be addressed in every exercise program.
– The specific muscles involved in core stability of the shoulder.
– How to assess the core stability muscles of the shoulder.
– An extensive list of exercises will be discussed, demonstrated and practiced using a variety of equipment in order to activate and strengthen the core stability muscles of the shoulder.
I don’t know why I like doing these research reviews so much.
I always end up learning something or it confirms what I am doing.
I try to break them down for you so they are easier to understand and you can get the take home message from them.
For those that want a lot more detail, I have included the reference so you can read the original article.
Lets get to the research.
Do Elite Athletes Have Muscle Imbalances?
What They Looked At:
They looked to see if elite athletes performing team or individual sports had muscle imbalances. They looked to see if they did with MIR investigation.
What Did They Find?
They found a variety of muscle imbalances in the trunk and pelvic region. They feel muscle imbalances may be related to injuries athletes get. They suggested that each sport needs to be looked at to determine what muscle imbalances are common and what specific muscle rehabilitation can and needs to be done.
It shows that athletes do have muscle imbalances. It is tough to say if these imbalances are needed in order to excel in their sport or are leading to injury or decreased performance.
It is cool that the concept of muscle imbalances is being discussed more and more. Even in research papers.
I wish I had more to say but I was not able to get the full journal article as it was still being processed. I look forward to getting it soon enough.
It was interesting that they identified muscle imbalances using MRI, I have never heard of this before.
Where to get more information: Franettovich M, Hides J, Mendis MD, Littleworth H. Muscle imbalance among elite athletes. Br J Sports Med. 2011 Apr;45(4):348-9.
Is a Single Leg Squat a Good Indicator of How Your Hip Functions?
What They Looked At:
The researchers wanted to see if a single-leg squat was a good tool to determine poor hip muscle function because lately the focus of addressing knee pain has been by focusing on the hip. They felt that people that performed better on a single leg squat would have earlier onset of gluteus medius activity, greater lateral trunk strength, greater hip abduction strength and greater external rotation strength.
They had 5 people evaluate 34 participants when performing a single leg squat. They measured the muscle activity of the participants when it came to their hip strength based on electromyographic activity.
What Did They Find?
They determined that a single-leg squat is a good tool to determine if someone has poor hip muscle function.
I have been using the single-leg squat for an assessment for a long time and use it in the Core Stability of the Hip program.
It just highlights that getting your client to do a single-leg squat is important and will give you a good idea of what you need to focus on in your exercise program. If you or your client perform poorly on a single-leg squat, you will need to work on gluteus medius, lateral trunk, hip abduction and external rotation strength.
Where to get more information: Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med. 2011 Apr;39(4):866-73. Epub 2011 Feb 18.
What is a Good Test for the Core?
What They Looked At:
They looked at a dynamic core test of a chop and lift test and compared it to a static endurance posture tests of the Biering-Sorensen and side-plank.
Cool Points that Were Brought Up:
– “Trunk musculature absorbs, produces and transports multidirectional forces to and from the upper and lower extremities by maintaining a balance of stability and mobility.”
– “Researchers have hypothesized that defects in muscular capability (power, strength, endurance) and motor control (amplitude, timing) lead to poor trunk stabilization and can alter performance or increase injury susceptibility.”
What Did They Find?
The chop and lift is a good power test to test dynamic trunk control.
I have seen the chop and lift around for a while. I have not used it very much but I will now. I will use the two endurance tests to measure directional endurance for the core but will add the chop and lift in order to look at more dynamic core function.
Always great to take the time to read these research articles.
Where to get more information: Palmer TG, Uhl TL. (2011). Interday reliability of peak muscular power outputs on an isotonic dynamometer and assessment of active trunk control using the chop and lift tests. J Athl Train. 2011 Mar-Apr;46(2):150-9.
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