I just got a copy of Functional Stability Training with Eric Cressey and Mike Reinold.

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:

• motor control
• proprioception
• dynamic stabilization
• neuromuscular control

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

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.

>>> CLICK HERE to Check Out Functional Stability Training <<<

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.

Okay, that’s it, have a great day.

Rick Kaselj, MS

I was not really filtering out my spam box. These are a few things that were in my inbox and on Facebook. Let’s get to it.

Cure My Elbow Pain

This was a question that came up for the Muscle Imbalances Revealed – Upper Body (MIRU) coaching call.  I thought the answer would be of interest to you.

Can you tell me how to cure elbow pain? Basically it hurts if I do chin ups, lying dumbell skull crushers (I think that’s where I hurt it and a little on bench press). Also, can you tell me the other types of elbow pain there is (if any other) and if the treatment for curing would be different for each one?

Of the MIRU crew, Dr. Jeff Cubos took on the question.  Just a reminder that the MIRU crew will be holding a seminar this June on Spinal Health & Core Training.  We hope to see you there.

“Unfortunately, it is quite difficult to answer clinical conditions online.

There are many components to the elbow proper and far more components to pain itself.

I will say this, unless there was an acute trauma or structural deformity, the tissues surrounding the elbow may likely be overloaded. Aside from training that progresses too quickly or with too much load, I’d look to the thoracic and shoulder girdle regions.

Often the scapulothiracic joint complex lacks requisite dynamic or static control causing the muscles that cross the elbow to do more work. I’ll often start by addressing mobility issues, then go after control.

I really like quadruped both on elbows and hands for scapulothoracic control ensuring that the scapula is properly positioned or centrated throughout the movement. The hand should also have good contact with the floor in a slightly external rotated position with load being put at the 1st and 5th mcp and base of the palm. The fingers should be spread out.

It may also be worthwhile to seek the help of a clinician who does soft tissue therapy to address the quality of the local tissues and mobility of the distal tissues.

I hope that helps. Sorry I couldn’t be specific but you are more than welcome to email me.”

- Dr. Jeff Cubos

It is back to Rick.  I would say, get it looked at and get an accurate diagnosis and approval to start an exercise program.  If what you have is lateral epicondylitis or tennis elbow, I will suggest this program:

What to do about Osteochondritis?

Tom, I would check out the interview with I did with Zach Moore on Exercise and Osteochondritis. I know this will help you out.

Funny Stuff

Since I do this injury stuff, I have been getting all kinds of nicknames, here is another one to add to the list:

I am Very Weak in the Push-up?

A question from Quebec:

Harold, I know you have both the Upper Body and Lower Body of Muscle Imbalances Revealed.

I would take the time to work on the scapular stabilizers.  You can do this in a plank position – Dr. Jeff Cubos talks about above or you can do this in an open chain fashion with exercises targeting the middle fibers of trapezius, lower fibers of trapezius and serratus anterior as I go through in the Scapular Stabilization Exercise Program.

I would also check out Tony Gentilcore’s Component #1 – Corrective Exercise Strategies for Athletes (and Meatheads, too) with Tony Gentilcore that is in MIRU.  He goes through some great exercises that you can do to help with upper body strength exercises.

My Shoulder Cracked?

A question from Brazil:

Sergio, I want to help you out but there is not enough to go on. My advice would be to get it looked at.  Get an accurate diagnosis, clearance to start an exercise program and written guidelines on what you can and can’t do.  Then we can go from there. My big advice: take the time to rehab your shoulder or you will get injured again.

Nice Stuff on Facebook

I am so glad to help fitness professionals and people with injuries.  Very motivating to get comments like this:

Kind Words

More amazing words for the Scapular Stabilization Exercise Program:

“I would describe the Scapular Stabilization Exercise program as very comprehensive, foundational and exceptionally accessible for clients, with a wonderful explanation for the “why” behind all exercises / approaches.

Exceptionally well laid out, with a great background review of the scapular, shoulder movement, and involved muscles to provide a holistic approach.

The exercises are very well described, LOVE the “errors” section to assist with improving accuracy of each exercise. Love the handouts and the E-book. Overall, the best thing is the ease of lay out/presentation of material, so all is easy to understand and implement immediately.”

Catherine Holden

Baltimore, MD

Occupational Therapist, Registered, Licensed

Nice that People Like EFI

 Ahhh, thanks:

Shoulder Injury Guide

Little feedback on the free shoulder injury guide that I give away at EFI:

“I think the gifts are wonderful.

I’m looking to take my knowledge in this direction (corrective exercise).

Where I am in Atlanta, (Roswell GA) there are a lot of tennis moms with the issues, back issues, plantar fasciitis and shoulder pain.

I want to be the go-to guy in this region”.

Thank you in advance,

Andre Coman

Roswell, GA

Personal Trainer

Effective Rotator Cuff Exercises

Feedback on the program:

“I currently work with clients who have past or present shoulder injuries due to overuse or athletically related. Because of Effective Rotator Cuff Exercises, I have a more in depth knowledge of the functions of the rotator cuff and it’s vulnerability to injury.”

Brian Bobo

That is it.

Have a great weekend.

Rick Kaselj, MS

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Another post for you on corrective exercise for performance.

It is post that I lost but I am glad that Nick reminded me about it.

Now, Nick has been on EFI before.

You can take a look at his other posts:

• Corrective Exercise to Improve Your Deadlift – Part 1
• Using Corrective Exercise to Overcome an Injury – Part 2

Here we go with part 3 of Nick’s articles.

8 Things I Learned About Corrective Exercise for Performance

I could probably write a book talking about everything I’ve done with this experience but I think this gives you a pretty good idea of what went down. Here are some main points that you should take home from my experience that can hopefully help you whether you are a lifter or any kind of athlete.

#1 – Don’t be Afraid to Take it Easy Once in Awhile

I knew the importance of this and did deload from time to time, just not as much as I probably should have. Plan deload weeks and take it easy if you are feeling off. It’s OK.

However, you do need to be training hard enough to earn this. Many people don’t train anywhere near hard enough to warrant this.

#2 Find Someone Who Can Analyze You and Find Your Muscle Imbalances that Need to be Taken Care of

Everybody has something and anybody who trains hard is going to have bumps in the road and aches and pains here and there.

If you don’t, then you aren’t training hard, plain and simple.

But find out what could use some work and do something about it. You will thank yourself later and will avoid injury setbacks and probably hit some surprising PR’s.

#3 – Don’t Underestimate the Importance of Soft Tissue Work

Massage therapy, ART, chiropractic, self massage tools and the list can go on. Tissue work can speed healing, address muscle imbalances (when combined with the appropriate exercises and movement) and help keep your body healthier and functioning better like you wouldn’t believe.

It is so important that I actually went to massage therapy school so that I can better help clients.

A couple of things on this, though: make sure you know why you are working something and make sure you know how it affects you muscularly and neurologically.

“Rolling” blindly can do more harm than good. (I should have some work coming out about this in more detail soon)

Also, if you get work done by a professional, make sure that they know their stuff and at least have a decent understanding of what it is that you do.

With an injury to a muscle, other muscles around the area are going to need treatment as well since they will develop trigger points and adhesions as a compensation effect. If it doesn’t seem that you are getting back to 100%, perhaps synergists or antagonists need some release, whether it’s adhesions, trigger points or neurological related stiffness. In my case, my deep rotators, TFL, psoas transversospinalis, erectors, lats and teres major all needed work to truly get things better.

On top of this, the fascia in the area will most likely need to be released in order to restore normal movement. It needs to glide nicely in all directions. If it doesn’t, movement and muscles will not be optimal and healing will not be fully sufficient.

Keep in mind that once you break up scar tissue, it needs to be realigned through proper movement or you’ll be right back to square one. I also want to add that if you don’t have an S tool such as a thera cane or the kind I have, the body back buddy, you should get one. With my S tool, I can hook right into any specific spot along my back that I need to. I was able to get deep into QL and the surrounding musculature to break up lodged adhesions and trigger points. It’s amazing. Lacrosse balls also work wonders when it comes to getting deep into the hip. Without self massage tools, I can’t imagine how hard it would have been to fully heal the injured tissue.

#4 – Address Your Weak Points and Find Someone Who Can Help You Figure Them Out if You Aren’t Sure

I have been a huge fan of Louie Simmons’ work for quite some time and one main point that he always makes is that bringing up weak points is probably the most important thing one can do to raise their big lifts.

You can squat all day but if you have a weak muscle holding you back and you don’t take care of it, you will not progress like you want. I think that for a decent amount of time, I did not focus on what were truly my weak points. External obliques, glute max, glute med and lower traps all were holding me back. Since I was forced to deviate from my usual style of training, I’ve been able to make these all strong points through different methods and exercises. The results: my squat and pull have never felt better and I feel more stable than ever with my presses because of the lower trap and scap work.

#5 – Don’t Try to do Everything on Your Own

There was a period of time after finishing my time at Ifast and leaving La Crosse that I didn’t have anybody knowledgeable around me to keep an eye on my movement.

Once I found some knowledgeable people in Milwaukee (where I’m at now), things suddenly got a lot better. Surprise!

Even the very best lifters on the planet need training partners and coaches to help them get better. Don’t try to be a hero all on your own. It’s impossible to fully analyze yourself. Get some help from somebody knowledgeable and you will go much farther. If you do have an injury, find a new way to train hard and get better.

For me, I set goals on the major single leg lifts with the sled, with my special exercises, with conditioning and even with technique. With most injuries, there will usually be a way to still train hard without aggravating the problem at hand. Set some new and exciting goals and work on your weak areas so that when you are ready to go again, you will be even better.

#6 Do Everything You Can to Educate Yourself on Movement and Anatomy

McGill, Sahrmann, Kendall, Myers, Chaitow, Robertson, Hartman, Cressey, Kaselj and the list goes on; I’m always constantly trying to learn more. I always do so that I can better help clients; with my situation, I wanted to learn everything I could to make myself better and prevent future occurrences. There are a lot of very smart professionals out there putting out priceless information and you can always find something that can help you with your issues. I think a lot of people with injuries and pain tend to rely too much on doctors, specialists, etc. and passive treatments/temporary pain reducers.

Ultimately, you need to take initiative for yourself in order to truly fix issues and get better. If you are a professional in a related field, books and DVDs, etc. from people like those listed above can be great. If you are not, find a professional who can turn you in the right direction.

#7 – Have patience

This is probably one of the biggest issues for me. Injuries take time to heal, imbalances take time to fix and strength takes time to build. Let things heal and take an ample amount of time to make problem areas better and you will ultimately come back stronger than ever. At first, I wanted to go hard again overnight. I had to learn to step back and realize that it was going to be a longer process to get the healing and the training that I needed to come back healthy and stronger with. Be patient, work at things that will help you get stronger and promote healing and you will come back better. You have to invest both mentally and physically in the process.

#8 – Injuries Don’t Always Need to be a Total Setback

They really can be a blessing in disguise and just might help you get over a hump. Hopefully, my experience can give you some kind of information or some kind of push to help you with your own experience and get you on the path to new PR’s and better performances!!

Remember, train hard but also train smart!!

About the Author

Nick Rosencutter is a Certified Strength and Conditioning Specialist and Certified Personal Trainer through the National Strength and Conditioning Association and is also a Nationally Certified and Licensed Massage Therapist. He received his Bachelor’s degree in Exercise and Sports Science with a Fitness emphasis and Strength and Conditioning Concentration from the University of Wisconsin La Crosse, and received his diploma in Massage Therapy from Lakeside School of Massage Therapy in Milwaukee. He has worked with all varieties of clients ranging from fat loss to various levels of athletes and is also a competitive powerlifter. He currently trains clients at Southridge Athletic Club in Milwaukee and offers corrective exercise and movement training at Miller Sports and Wellness Chiropractic in West Allis. You can learn more at his website www.rosencutterultrafitness.com

Rick Kaselj, MS

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As you know, last month’s Injury of the Month was tennis elbow.

It has been a few weeks and I am starting to get feedback on the program.  One person has been having issues with their tennis elbow pain and the program has made it worse.  She has asked me if I could help.  We have been emailing back and forth.  Here are some clips from our email conversation.

“I think my pain has increased a bit so I’m cutting back in intensity but I’m hoping that if I keep at it, it will eventually go away. Bursitis in my shoulder really flared up after starting the program. Not sure if it is related but that is the only thing different that I was doing.”

This brings up a number of points to remember about injuries.  They apply to tennis elbow but to all injuries when you are using exercise to help them recover.

4 Key Things to Remember when Exercising for an Injury

• Intensity – How aggressively you do the exercises has an effect on your injury recovery.  I always suggest to be conservative when staring an exercise program for an injury.  Go easy and light.  See how things feel after the exercises, a few hours after the exercises and the next day.  You should feel like you have done something but your symptoms should not increase.
• Resistance – Once again, the resistance you use will determine the stress put on the injured area.  We want to stress the injury but not irritate it.  It is a fine balance.  Once again, start off light and see how it feels.
• Cumulative Stress – If you are doing exercises for an injured area, you are adding more stress to that area.  If you do not decrease or eliminate other things you are doing that add stress to the injury, this will lead to more irritation and pain.  Make sure to look at things that are putting stress on your injured area and decrease or eliminate them.
• Pain Techniques – Do the pain techniques in the evening.  Doing the ice, stretching and self massage are most effective before you go to bed or a few hours before you go to bed.  It relaxes the tissues and then the tissues get a chance to heal while you are sleeping.
• Nutrition – Staying hydrated, properly fueled and focusing on inflammation lowering food is important as well.  This will help you in your injury recovery.

Now let’s get to the shoulder bursitis.

I am not sure what the cause is of the shoulder bursitis (inflammation of the bursa in the shoulder).  I would focus on shoulder position, rotator cuff exercises and scapular stabilization exercises.

When it come to tennis elbow pain exercises leading to shoulder pain, I cover this in the video presentation of Tennis Elbow Pain Solution but also Stasinopoulos 2011 says it well:

“If the affected arm is not supported, our experience has
shown that patients complain of pain in other anatomical
areas distant from elbow joint, such as the shoulder, neck,
and scapula.”

I would suggest you do the tennis elbow pain exercises with your arms supported.  You can look at the exercise descriptions and videos for Exercises 9b and 10b in the program.

“Regarding my bursitis – I took a break this past weekend from exercise and the tennis elbow program and it seemed to be less painful.

I am doing mostly stage 2 exercises but am sticking with a modification of scapular exercises #6.”

It has only been a week or two since you have got the program. You might not be ready for stage 2 exercises.

If you are getting elbow pain from the exercises, look in the exercise descriptions and I give you ideas of what you can do if you get pain from the exercises.  Here are a few things to remember:

• Conditioning – If you are getting elbow pain from doing the exercises, do exercise #3 for two to three weeks.  This will help work on the conditioning of your elbow muscles.  By being in stage 2 so early, you are getting pain because of the points that I covered at the top of this article.
• Posture – Look at your posture when you are doing the exercise. Make sure it is ideal which is ear-shoulder-hip in a straight line.  Being out of alignment puts greater stress on the shoulder.
• Technique – If an exercise is irritating, go back and make sure you are doing the exercise correctly.  Look at the exercise description and watch the video of the exercise.

“My left elbow and left shoulder are super tight. When I do the tennis elbow program my arm feels worse. Should I work on my shoulder first? Should I stop? Would be happy to have your feedback!”

Follow what I wrote above.

What caused what:  What I have seen in many people is a shoulder injury leads to your tennis elbow pain.

I know you have the Shoulder Pain Solved program of mine.  Make sure to the pain techniques that I talk about in that program for your shoulder but remember the key points that I talked about above.  They are very applicable to all injuries.

“Does my tennis elbow cause my shoulder pain or does my shoulder pain cause my tennis elbow? Is it possible to work on both at the same time or should I focus on one first and then the other? If so, which should I focus on first? Which program would be most helpful – tennis elbow, shoulder, scapula?”

From my experience, one injury often times leads to others.

I feel you can do both but follow what I said above in the article.

If what I said above does not help, go get your diagnosis confirmed by a qualified health professional and have them rule out that there is something else going on.  Then take the programs to someone that can help you with the program.  You can go to a fitness professional that focuses on injuries or another health professional.  The key thing is that they will spend the time with you to go through the exercises.

Remember the points that I said above.

These would be your priorities:

• Work on your scapular stabilizing exercises as this will provide stability for your shoulder and decrease the stress on your elbow.
• Work on improving your posture as this will decrease the stress on your shoulder and elbow.
• Work on the pain techniques in order to relax the muscles around the shoulder and elbows.
• Work on strengthening the shoulder and elbow as per the Shoulder Pain Solved and Tennis Elbow Pain Solution program.

Thank you for your question Chris, all the best.

Rick Kaselj, MS

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I know when I talk about core stability, some people will roll their eyes.

There is always a discussion in the fitness world on what the core is and if we should be focusing in on it.

Well when it comes to injuries, I focus on the core.

It is looking like core stability is playing more of a role when it comes to injuries.

I know in previous Injuries of the Month (patellofemoral pain syndrome, sacroiliac joint pain and piriformis syndrome), core stability has been a component of the exercise program that I have recommended.

I wanted to highlight some research that talked about injuries and core stability.

What They Looked At

They looked at 80 female and 60 male intercollegiate basketball and track athletes.

This was very interesting. They measured core stability by testing:

• Isometric hip abduction strength
• Isometric hip external rotation strength
• Back extensor endurance (modified Beiring-Sorensen test)
• Quadratus lumborum endurance (side bridge test)

Interesting Points in the Introduction

• Decrease in lumbo-pelvic (or core) stability has shown an increase in lower extremity injuries, especially in females
• The injuries that females are at greater risk for are: anterior cruciate ligament (ACL) ruptures, patellofemoral pain syndrome, iliotibial band friction syndrome, and stress fratures (femoral, pubic, tibial, and metatarsal).

What They Found

These were the main results from the study:

• 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

Rick’s Comments

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

Rick’s Comment

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.

Rick Kaselj, MS

Another year has passed, wow.

They just keep truck’n on by.

It is always nice to stop and take a look at the year that is just about to pass.  Before I look at the year, I wanted to see how far this little blog has come.

Looking Back at ExercisesForInjuries.com

I started this Exercises For Injuries thing on February 26, 2009.  My first post was Keeping Up with the Bones .  It was a bad post.  I had no idea of what I was doing, but I just started writing.  Nearly 3 years later, I am well past my 400th post.  Things have improved drastically but there is still a lot more that I can do.

Rick and YouTube

One other way that I have been helping getting the word out when it comes to injuries and exercise has been my YouTube channel.  I started it on December 25, 2008.  Looking at the channel, I am getting very close to 250 videos.  Not sure what I was doing starting a YouTube channel on Christmas Day but I am happy how it has progressed over the last 3 years.

Facebook and Rick

I might as well finish off with the last place that I spend my time when it comes to getting the word out on exercises and injuries.  It is Facebook.  I started my fan page this year and I am still figuring it out.  Just like my blog and YouTube, I will:

1. Keep delivering the best content that I can
2. Help people in any way that I can
3. Stay consistent with what I do
4. Try to improve with every day

If you plan on doing this blog/YouTube/Facebook  thing, remember those four things as I think they are very important and have helped me out a lot.

Okay, lets get to the list.

Top 7 Posts for 2011

Read the rest of this entry »

A great article for you today.

It is a guest blog post from Nick Rosencutter.

Enjoy.

Take it away, Nick.

Injuries are no fun.

They are a pain, literally.

They can stop you from doing something you love.

They can cause nagging aches and pains.

They can affect you mentally.

They can ruin your day.

They are something that most people try to avoid.

On the other hand, they can also be a blessing in disguise. This is something that I have realized first hand.

The Rush of Training

I absolutely love training, especially powerlifting. I love the thrill and rush of stepping on the platform to compete. I love pushing my body past limits and growing stronger both physically and mentally when I push past barriers with my training. I love being in great shape and moving weights that most people can only wish to move. I’ve loved training (notice I said training and not “working out”) for over 12 years without a break (which really isn’t that much and I still have a long way to go).

When I’m not training, I’m helping others train, reading about training or dreaming about training. The deadlift happens to be my ace and pretty much my favorite thing to do in the world. In my opinion, there is absolutely no better feeling than locking out a heavy deadlift as you feel every muscle in your body tighten up to make it happen.

The hip drive, grip strain, the glutes coming through, the back locking out, the traps stabilizing, the intrinsic foot muscles gripping the floor, the blood rushing through the veins and the rush that flows through the body and mind; just an amazing feeling that only certain people will understand. Not being able to do this for a period of time was devastating.

Great little video from Nick on Gluteus Medius Exercises:

Training Stupidity

Flash back to November of 2008. I had just done my fifth meet in about seven months, which was probably a little too frequently. I was on pace to pull my first 600lb deadlift at a bodyweight around 178-180. Training had gone well as I had pulled 610 with band tension, tripled 540 and had made good progress on most of my assistance work. Well, I ended up missing 570ish at the meet when I had nearly locked out 585 a few months earlier. Part of the problem was just training stupidity. I had gone too intense for too many weeks before the meet and had competed too many times. But I knew that couldn’t be the only issue at hand because when I made that attempt, the weight was coming up smoothly; I thought for sure that I had it locked. Then as I approached lockout, I just couldn’t finish it. I was upset to say the least.

The Injury was in the Details

So at this time, I was in my last semester in the exercise science and strength & conditioning program at UW-La Crosse. Luckily, I was surrounded by some very knowledgeable people who knew their stuff. I spoke with one of my mentors, an amazing strength coach who knows a thing or two about the iron game. I showed him a video from my missed deadlift. He immediately pointed something out that I hadn’t noticed or really even thought of. My left leg began to shake as I approached lockout. He looked at another video of a 560 pull I had made easily a few months earlier. I had some rotation occurring through my hips and trunk as I pulled the deadlift. It was subtle, but you could sure see it.

So what the heck was going on?

He evaluated me and found out that:

1. my left glute was not firing as well as my right with hip extension
2. my right shoulder had some issues as well
3. my subscapularis was very fibrotic and was stopping my scapula from moving as efficiently as it could

If you have ever read any of Thomas Myers’ stuff on fascia and exercise, this should make you think of the spiral line: opposite hip and shoulder.

I’m assuming that many who read this page know about the book, Anatomy Trains, so I won’t get into tons of detail, but the spiral line is a line of fascia that wraps around the body and at a certain portion of its path, connects opposite hip and shoulder together; basically meaning that an issue with one can affect the other with various movements.

This had implications with the rotation that was occurring with my movement. So he did some ART on my hip and shoulder (left TFL and right subscap among other things) and gave me a few corrective exercises to fix this imbalance that I had. This was probably my first real personal experience/encounter with the world of muscle imbalances and corrective exercise.

I had been decently well versed in every strength and conditioning modality imaginable but had apparently slacked on this whole other department. I was determined to fix my imbalance and get better. I decided to take some time off of competing and hammer these things out for a little while. The January following this encounter, I would embark on my full time internship in order to finish up my degree, which would turn out to be one of the best experiences of my entire life.

Muscle Imbalances that Affected My Lifting

Enter Indianapolis Fitness and Sports Training with a couple of guys named Mike Robertson and Bill Hartman. I learned a tremendous amount about training during my amazing time there and was totally immersed into the world of analyzing and addressing postural faults and muscular imbalances. I had no choice but to get better.

They discovered some of the same that my mentor at La Crosse had plus more:

• left glute medius was weak
• left glute max had gotten a little better but still wasn’t great
• external obliques weren’t where they needed to be, which meant that I didn’t have optimal control over my pelvis and trunk and was leaving pounds on my lifts
• lower traps were weak, especially the left side, which meant that my scapulae were not as stable as they could have been (implications for all of the big lifts)
• I had a slight shift and rotation with squats and pulls, which was definitely part of the issues listed above.

Those were some of the main problems for me. So I hammered out lots of special exercises to help balance things out and get my lifts up. I did however, make one mistake. I still trained too intensely, too often. I picked a meet that I wanted to do that May and trained for it.

Little clip from Bill Hartman’s Presentation in Muscle Imbalances Revealed – Lower Body Edition:

Now, these issues that I had were things that were probably going on for a long time. In my early days of training back in high school, I really had no true idea what I was doing (though I sure thought I did) as I pretty much just taught myself and learned from random gym rats and magazines back then.

The shifts and rotation that I had with my squat and pull were subtle enough that an average eye would never notice them, so who knows how long that had been going on. While I had gotten along fine and had built up to a respectable strength level and build, fixing some of these things earlier could have saved me lots of trouble and probably helped me to hit bigger weights easier. I mean, locking out a max deadlift with one glute firing versus two glutes firing is kind of a big deal. So anyhow, I was training hard and lifts were going up, etc. until…..

===========================

That is the end of part 1.  I got part 2 coming up very soon.  Big thanks to Nick.  We all have an in jury story.

About the Author

Nick Rosencutter, CSCS, NSCA-CPT, LMT – Nick is a Certified Strength and Conditioning Specialist and Certified Personal Trainer through the National Strength and Conditioning Association and is also a Nationally Certified and Licensed Massage Therapist. He received his Bachelor’s degree in Exercise and Sports Science with a Fitness emphasis and Strength and Conditioning Concentration from the University of Wisconsin La Crosse, and received his diploma in Massage Therapy from Lakeside School of Massage Therapy in Milwaukee. He has worked with all varieties of clients ranging from fat loss to various levels of athletes and is also a competitive powerlifter. He currently trains clients at Southridge Athletic Club in Milwaukee and offers corrective exercise and movement training at Miller Sports and Wellness Chiropractic in West Allis. You can learn more at his website www.rosencutterultrafitness.com

Rick Kaselj, MS

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Great article for you today on the joint by joint approach.

Thank you, Sam, for sending it over.

Take it away, Sam…

Coaching the Joint-by-Joint vs. Talking About It

Preface: I am purposely keeping the text in this article short to allow for lots of applied content via the illustrations involved. The redundancy is on purpose. Enjoy!

In modern training jargon the “joint-by-joint” has made its way into colloquialism. By now most who speak it understand the implications. Michael Boyle introduced it to the training world after discussions with Gray Cook  and thus was born the Joint-by-Joint Principles (1).

A little while after, Dr.Charlie Weingroff elaborated and optimized the model to satisfy the nay sayers and thus was born the Advanced Joint-by-Joint (2) and Advanced Principles (3).

If you’re reading this and aren’t quite familiar with such things, please review those articles before continuing reading here. You can get the links to those articles at the end of this article in the reference area.

For those who are familiar and want a deeper understanding, I recommend products (4) put out by Charlie Weingroff, Shirley Sahraman, Gray Cook, and a few select others you can find on my resources page (4).

So let’s get into it. Throughout this profession you’ll find coaches claiming the manner in which they cue exercises is optimal and satisfies the joint-by-joint principles, ensuring utmost safety and transfer of training stimulus to the desired structures/tissues. However, many times what is said and what is shown in their articles, blogs, social media, etc. are two different things, revealing their thought process drops off at the distal body segments.

Most understand, for example, the “shoulder blades back and down” coaching cue because the scapula-thoracic joint is a “stable” joint. It’s just as obvious via the anatomy that the lumbar spine is a “stable” joint and should not be cued into large flexion/extension/rotation moments during an exercise. What’s not so obvious for some, still, is things like the foot, hallux (big toe), cervical spine, etc. How should you coach these joints during exercises? Below is a “quick hitter” display of optimal coaching examples that I feel often go unnoticed even by well intentioned coaches.

The Hallux

The hallux is built for mobility and a lack thereof causes compensations further up the chain like a mobilized mid-foot (which should be stable), stabilized ankle (which should be mobile), and continues even up to the hip and beyond causing a lack of hip extension (via the mechanisms discussed in reference 3 ) and consequently increase lumbar extension. We could elaborate further but I think you get the idea. All of these processes are not good and in the long run (sometimes short run) wears passive structures down to the point of breaking pain threshold. Notice I didn’t say “injured”, as they may already be damaged but simply haven’t reach pain threshold yet. (This thought process extends to all areas of the body discussed throughout this article, not just the hallux)

Half-Kneeling: Non-Optimal Coaching

Half-Kneeling: Optimal Coaching

Tall-Kneeling: Non-Optimal Coaching

Tall-Kneeling: Optimal Coaching

Quadruped: Non-Optimal Coaching

Quadruped: Optimal Coaching

Hopefully the pictures served their purpose in elucidating the point. The correct hallux position applies for any exercise you would perform in the half/tall-kneeling, quadruped, front/side plank, etc. positions.

The Cervical Spine

The upper cervical spine is built for mobility and the lower cervical spine for stability. How do you coach this? By getting your client to pack-the-neck/make-a-double-chin/make-a-surprised-look/neutral/whatever-you-want-to-call-it. The reasons why and what happens if you don’t have already been elaborated in reference #5. Below are some uncommon and common mistakes I see most often made throughout coaching strength exercises and mobility exercises. Note that it’s incredibly effective/important to stabilize the neck during a thoracic-spine mobility drill because it shifts the mobilization right to where we want it – the thoracic spine! If you left the neck “loose” some of your mobilizations would get shifted upwards toward the cervical spine. This is not what we want, obviously.

Front/Side Plank: Non-Optimal Coaching

Front/Side Plank: Optimal Coaching

Chop/Lift: Non-Optimal Coaching

Chop/Lift: Optimal Coaching

Front Squat: Non-Optimal Coaching

Front Squat: Optimal Coaching

Deadlift: Non-Optimal Coaching

Deadlift: Optimal Coaching

Bent Over T-Spine Rotation: Non-Optimal Coaching

Bent Over T-Spine Rotation: Optimal Coaching

Doorway Wall Slides: Non-Optimal Coaching

Doorway Wall Slides: Optimal Coaching

Chin/Pullup: Non-Optimal Coaching

Chin/Pullup: Optimal Coaching

Pushup: Non-Optimal Coaching

Pushup: Optimal Coaching

Quadruped Extension-Rotation w/Internal Rotation: Non-Optimal Coaching

Quadruped Extension-Rotation w/Internal Rotation: Optimal Coaching

Bench T-Spine Dips: Non-Optimal Coaching

Bench T-Spine Dips: Optimal Coaching

T-Spine Extension on Foam Roll: Non-Optimal Coaching

T-Spine Extension on Foam Roll: Optimal Coaching

Just like the principle regarding the hallux, the principle of neutral cervical spine can extend to many other lower/upper body exercises as well core training exercises.

After reading this article the “glass half empty folks” might think to themselves – “how much does this seemingly minutia stuff matter in the grand scheme of things?” The obvious answer is– why NOT do it – seriously, why not? What are you getting out of NOT implementing these strategies? Should we be ok with just not caring if we have a good amount of reasons to support these benefits of these coaching cues? If you’re going to do something, anything, why not optimize it? Sometimes the combinations of doing things just a little bit better makes the difference in the long run. I hope you found value in these illustrations and a novel appreciation for some of the smaller aspects of coaching. If so, please pass it along to your colleagues so we can all get better at what we do.

All the best,

Sam Leahey is a Certified Strength and Conditioning Specialist from the National Strength and Conditioning Association and a Certified Personal Trainer through the National Council on Strength and Fitness.

He is an assistant strength and conditioning coach at Springfield College. Prior to that he was an assistant strength and conditioning coach at American International College.

Currently pursuing a masters degree in Strength&Conditioning as well as manual therapy licensure, Sam also holds a BS in Exercise Science from Becker College in Massachusetts and a BSE in Physical Education with a minor in Sport Coaching from Arkansas State University.

While being a serious collegiate athlete himself at both the division 1 and division 3 level, he maintained the highest academic honors and graduated Summa Cum Laude.

It is back to Rick.

Great info, Coach Sam.

This is one of the best posts on Exercises For Injuries.

Thank you so much, Sam.

Before I go, if you like the info above, watch for Muscle Imbalances Revealed – Upper Body Edition where Tony Gentilcore, Dean Somerset and Dr. Jeff Cubos will be sharing their tips, tricks and exercises when it comes to upper body training.  Mark down the date, it will be coming out Tuesday, August 9, 2011.

References

1. A Joint-by-Joint Approach to Training by Michael Boyle
2. Expanded Joint by Joint by Charlie Weingroff
3. Foot-Related Interview
4. Recommended Resources by Sam Leahey
5. Packing in the Neck by Charlie Weingroff

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I think it is Friday . . . well, maybe it is. Maybe not.

Here are some random things from the past week:

Muscle Imbalances Revealed 2.0

I received some surprise feedback from a hockey coach - very cool!

What a Hockey Coach Says About MIR:

“I found the ideas presented in Muscle Imbalances Revealed as a comprehensive way to reach trainers who are just starting out, right up to those of us who have been at it for years. I see this as a great tool for trainers and strength coaches. If this is an area where you are lacking, I suggest you check this out.”

Maria Mountain, MSc
Owner/Strength & Conditioning Coach
HockeyTrainingPro.com
London, Ontario

You can see the article HERE, where she talks about how MIR2 can help ice hockey goalies.

here are some more kind words about MIR2:

“Being a personal trainer, it’s difficult to set yourself apart from the “Norm”.   The Muscle Imbalances DVDs I received through the mail are fantastic, and I find ExercisesForInjuries.com invaluable. I constantly refer to the information you post and send in your newsletter daily.”
LuAnne Platt

Hey, People Read My Stuff

Some days you wonder if anyone is reading your stuff and if it is helping anyone.

It is great when you get surprise Facebook messages like this.

Thank you, Nicole and please keep them coming.

“I always love your posts and hearing what you are up to with writing. Very inspiring and informational to fellow fitness pros, like myself.”
Nicole Ciarlelli Almeida
Personal Trainer

I work I do what I can to help fitness professionals work with injuries and exercises.  I am so glad that I am helping out.  It looks like it is helping Dannielle as well:

“I find your products really useful & recommend you to my trainers, instructors, & clients. (Although I haven’t posted feedback for you yet – I’ve been spreading the word.)  Thanks Rick.”
Danielle Briggs
Personal Trainer & Fitness Director

What People Think of the Scoliosis Manual

I just shipped out manuals to Taiwan and Hawaii, so I am happy to report that the program is helping people around the world.  Here is what one fitness professional said:

“After completing Effective Exercises for Scoliosis,  I will use the information from the course to help my clients with scoliosis incorporate proper exercises for their situation.  I will be better educated now about how to address clients with a scoliosis issue”
Kathleen D Thomsen

What is New on Facebook

I took a break from Facebook for a bit, but now I am back.

It is great to see things like this on my wall:

I think that’s it for today.

Have a great one.

Rick Kaselj, MS

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I have a guest video blog post for you today.

It’s from Justin Price.

Justin answers the most common question he is asked during his courses and at the conferences he presents:

What Causes Over-Pronation?

In the video, Justin shares with you:
- What over-pronation is
- What causes over-pronation
- How the shoes you are wearing can be making your pronation worse
- The influence of gluteus maximus on pronation
- How the illiotibial band and tibia affect pronation

Here is the “What Causes Foot Over-Pronation?” video from Justin Price.

Justin Price will be coming to Vancouver to present his course for the first and only time in March of 2011.

In this course, Justin will focus on Day One on the assessment side of things, and on Day Two he will focus on what exercises to give based on the assessment.

I selected Justin as one of the international experts to bring to Vancouver because I have learned a lot from him when it comes to lower body assessment, and his assessments of the foot have been very helpful.  Plus, I find his corrective exercises very unique and quite different from others I have seen.

That’s it for today.

On Wednesday, I will have a very exciting announcement for you – I can’t wait to tell you about it!

Rick Kaselj, MS

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I just want to give you a heads up on a course that I am hosting next year.

I will have full details soon, but here is a sneak peak into what will be covered.

Structural Assessment and Corrective Exercise Program Design with Justin Price

Course Description:

Main Objectives of the Course:

I got an interview with Mike Robertson for you.

3 Keys to Remember when Assessing Your Client with Mike Robertson

Enjoy the interview.

Mike Robertson goes through:

- Why assessments are so critical to the fitness professional
- What kinds of assessments that Mike goes through
- The boundry a fitness professional has when assessing a client
- Tips for your assessment
- The number one trap that fitness proffesionals fall into when assessing a client.

Read the rest of this entry »

One of the presenters of Muscle Imbalances Revealed, Eric Beard, just finished up this great video:

Read the rest of this entry »

I just got the latest issue of BCAK Kinnected magazine.

There were a lot of great articles in it and they also were kind enough to publish one of mine on abdominal hallowing and hamstring injuries.

I don’t know why I keep typing hallowing, it should be hollowing.

Since it has been printed in the magazine, I am now able to share it with you.

It is one of those research summaries that I have done a number of times and fitness professionals have liked them.

Lower Abdominal Hollowing During Prone Hip Extension May Prevent Hamstring Injuries

What is the Big Deal?

Details of the Study

Foundations of Upper Body Conditioning

DESCRIPTION:

OBJECTIVES:

Here is another edition of Rick’s Rambles.

This has been fun to do.

You can see one of my past ones, here.

Have a look at this one, it is my 3rd ramble but 151st blog post.

Fun on Facebook

I am big into Facbook.

A lot of times when I am bored, I will go on Facbook to see what others are doing.

I am also adding a lot more stuff on injuries and exercises over there.

I try to put up a quote of the day and an article that I have read that day.  A lot of people are getting a lot of benefit from all the stuff I am putting up.

If you are looking for some more stuff on exercises and injuries, make sure to visit my Facebook page – http://www.facebook.com/Rick.Kaselj

Read the rest of this entry »

On Tuesday, the Muscle Imbalances Revealed will officially go on sale at 9 am EST at the one-time grand opening sale, but…

Today’s your one and only chance to win a copies of “Muscle Imbalances Revealed”.

“Why Muscle Imbalances Revealed would be the perfect resource to finally help you with your clients with injuries, fitness plateaus and prevent injuries?”

It has been a bit of a crazy week.

I have been in Orange County at a Fitness Conference.  It was a little more than a fitness conference, it was a fitness mastermind group.

After the fitness mastermind in Los Angles, I was off to Seattle for a fitness business conference.  The people presenting were Tom Plummer and Bill Parisi.

Just Marked Her Rotator Cuff exam

The great thing about the scoliosis and rotator cuff manuals that I have written, I have been able to help people with these injuries and fitness professionals better understand these injuries.  These manuals have helped people around the world.  I just sent off a scoliosis manual to Seol, Korea.  How cool is that.

Here are a few kind words from a fitness professional in Calgary, Alberta, Canada had to say about the Effective Rotator Cuff Exercises.

“Thanks Rick!  Always great to read your manuals though – I find them very thorough and I really like the progression that you write them in – anatomy, purpose of exercising, etc.”

Fiona Yeoman
Wellness trainer, Kinesiologist
Talisman Centre, Calgary

Read the rest of this entry »

Before I get to the exercise, I got a few videos for you.

What is the Best Patellofemoral Pain Syndrome Exercise?

What is Patellofemoral Femoral Pain Syndrome?

If you are Looking for an Exercise Program to Help you with Patellofemoral Pain Syndrome, check this one out:

What Exercise is Ideal for Clients with Patellofemoral Pain Syndrome due to Muscle Imbalances

Approximately 60% of athletes have patellofemoral pain syndrome (PFPS) sometime in their life, and a long line of research has shown that PFPS is primarily caused by muscle imbalances in the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles.

Highlights of the Study

Other Amazing Stats about Patellofemoral Pain Syndrome

These random thoughts things have been fun.

I don’t think anyone reads them but I enjoy sharing and writing.

Hip Replacement

I got an email from a Kinesiologist in Regina, Saskatchewan who specializes in training clients with hip and knee replacement.

She had taken the Core Stability of the Hip webinar and is using the concepts and exercises with her hip and knee replacement clients.

If you are looking at increasing your understanding, confidence and getting some exercises for clients with hip and knee replacements, I would recommend Jody Kennett.

Jody Kennett, is a fitness professional that has a specialization working with clients with hip and knee replacements.

She will be presenting her The Joint Replacement Client: Pre & Post-op Exercise Guidelines on November 6 in New Westminster, BC.

I have taken the course twice and I highly recommend the it.

Read the rest of this entry »