Today let’s talk about back dysfunction.

To talk on that topic, here is John Izzo.

Here at EFI, we have chatted about John before. I did a review of his Lunging to Improve Performance a few months back.

A few weeks back we were chatting about back dysfunction.  It was based on what I learned from watching his Shatterproof Spine program.

I asked if he could expand on things and share what he had said with EFI readers.

Take it away, John.

In this day and age of technology, sedentary lifestyles, and poor posture—all trainers have their hands full trying to enforce optimal exercise execution. And I don’t simply mean “not swinging the arms” during biceps curls or “not going low enough on barbell squats”. I am referring to very small deviations in optimal performance.

Common Rookie Trainer Mistakes

Starting with advanced exercises is the most popular and most unknowing mistake made by exercisers in gyms today. This mistake is committed because users choose complex exercises or heavy loads without working with progressions first. An even bigger mistake committed by personal trainers is not assessing clients at all before beginning an exercise program. How do people in the gym commit this mistake? They lack proper instruction, coaching, and body awareness. Most novice exercisers don’t know how to “feel” a muscle during certain movements or drills. Their bodies are loaded with muscle imbalances and compensations that further exacerbate dysfunction without them even knowing. Trainers miss these subtle hints because most trainers do not perform movement assessments or they simply don’t have the keen eye to spot everything during a movement. That keen eye is polished with a competency in basic anatomy and exercise biomechanics.

Body Movement versus Machine Movement

Most trainers and exercisers assess capability with the “first set” of a loaded exercise. I’m sure you’ve seen it or experienced the “Express-Line” at your local commercial fitness facility. Most new exercisers are placed on strength machines consisting anywhere from 6-12 exercises. Trainers are instructed to orient new exercisers on these machines without a movement screening or basic assessment. Once a client is placed on a machine, a load is placed and there you have it: the trainer “no longer” pays attention to the mechanics of the body. They only focus on the proper “usage of the machine”.

Importance of the Keen Trainer Eye

Other trainers that do not place their clients on machines but try to incorporate “core” or free weight exercises usually miss important points. Clients will perform a squat with a shoulder press using dumbbells –because the trainer has informed them that it is “a great multi-joint exercise that utilizes a lot of muscles and therefore, burns a lot of calories”. However, without a proper assessment or keen eye for cueing, once a load is introduced such as body weight or dumbbells, and the movement has not been properly coached or assessed, the dysfunction is engraved in the nervous system. Check out this poorly executed glute extension. This is a perfect example of building on top of dysfunction:

The video shows a constant pelvic rotation without any proper alignment of the spine. Sure, her buttocks area is getting a great workout, but at the expense of the constant rotation at the lumbar spine. Recent research from Dr. Stuart McGill shows that rotating at the lumbar spine is contradictory in low back health.

5 Stage Approach to Exercise Program Design

Witnessing many of these unfortunate instances in the gym, and listening to tales of poor training programs used by my clients in the past, I began studying much of Dr. Stuart McGill’s work. Dr. McGill is a world renowned low back researcher based in Canada and has done a tremendous job of covering the back in his book, “Low Back Disorders”. Upon reading this research and implementing many of the protocols, I began to implement a 5 stage approach to exercise program design.

This 5 stage progression looks like this:

• Stage 1: Corrective Exercise
• Stage 2: Stability
• Stage 3: Endurance (training core with fatigue)
• Stage 4: Strength
• Stage 5: Power & Speed

These 5 stages are sometimes blended, modified, or executed in different order depending on the client’s fitness level and qualitative data I get from the movement screening and the initial assessment.

Furthermore,  the time it takes the client to progress from stage to stage depends a lot on frequency, exercise adherence, and present fitness level. My job is not to keep them in a “corrective state” if their goal is to lose body fat. More than likely, when excess body fat loss has occurred, most corrective measures tend to clean up themselves–helping me to concentrate on the next stage or combining modalities. Sounds meticulous? It’s really not. The end goal is to optimize movement AS BEST AS POSSIBLE. It may never be textbook, but it is important to improve the movement in the capacity for which it is contained. Here is an example of the quadruped glute bridge featured earlier in this post with better coaching and body awareness.

Some “fussy-ness” or “exact-ness’ is important when observing a client exercise.

Does it mean that you should try to correct every little thing?

Absolutely not. If you employ that idea, you will never progress. Culmination is the name of the game and once a client or exerciser sees results, you have achieved a majority of your mission.

The work of Stuart McGill is explained in simplistic terms and practiced in this new workshop video, Shatterproof Spine. The help of assessments will aid trainers and exercisers alike to better understand how an exercise is affecting the movement pattern and muscles involved. With this type of feedback, dysfunction can be minimized and function should be optimized.

John Izzo is a prolific fitness blogger, amazing trainer and cool guy.

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Thanks, John.

Great to have you here at EFI.  Thank you for sharing your knowledge, expertise and passion with us.

Rick Kaselj, MS

The disc herniation and corrective exercise article sparked some discussion, which is great to see.

I wanted to respond back right away but I took so long to reply because I did not want to start an argument or come across as being defensive.

After reading things and letting everything sit for a few days, here are a few things that came to mind.

Before I get to the stuff, just a reminder that this month’s Injury of the Month is ready to go.  It is Piriformis Syndrome.  You can check it out here.

Now back to disc herniations.

Most People Have Disc Herniations

Let’s face it, a lot of people have disc hernations.  The chances are good you have one.

Here is some research that highlights this:

Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. (1994). Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994 Jul 14;331(2):69-73.

• Thirty-six percent of the 98 asymptomatic subjects had normal disks at all levels.
• With the results of the two readings averaged, 52 percent of the subjects had a bulge at at least one level, 27 percent had a protrusion, and 1 percent had an extrusion.
• Thirty-eight percent had an abnormality of more than one intervertebral disk.
• The prevalence of bulges, but not of protrusions, increased with age. The most common nonintervertebral disk abnormalities were Schmorl’s nodes (herniation of the disk into the vertebral-body end plate), found in 19 percent of the subjects; annular defects (disruption of the outer fibrous ring of the disk), in 14 percent; and facet arthropathy (degenerative disease of the posterior articular processes of the vertebrae), in 8 percent.
• The findings were similar in men and women.

A little more research.

Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. (1990). Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Mar;72(3):403-8.

• One-third of the subjects were found to have a substantial abnormality.
• Of those who were less than sixty years old, 20 per cent had a herniated nucleus pulposus and one had spinal stenosis.
• In the group that was sixty years old or older, the findings were abnormal on about 57 per cent of the scans: 36 per cent of the subjects had a herniated nucleus pulposus and 21 per cent had spinal stenosis.
• There was degeneration or bulging of a disc at least one lumbar level in 35 per cent of the subjects between twenty and thirty-nine years old and in all but one of the sixty to eighty-year-old subjects.

I know you are thinking, “Man, my back must be messed up”.

Let’s talk about your neck now.

Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. (1990). Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Sep;72(8):1178-84.

• Abnormality in 19 per cent of the asymptomatic subjects
• Of the 19 per cent, 14 per cent of those who were less than forty years old and 28 per cent of those who were older than forty
• Of the subjects who were less than forty, 10 per cent had a herniated nucleus pulposus and 4 per cent had foraminal stenosis.
• Of the subjects who were older than forty, 5 per cent had a herniated nucleus pulposus; 3 per cent, bulging of the disc; and 20 per cent, foraminal stenosis.
• Narrowing of a disc space, degeneration of a disc, spurs, or compression of the cord were also recorded.
• The disc was degenerated or narrowed at one level or more in 25 per cent of the subjects who were less than forty years old and in almost 60 per cent of those who were older than forty.
• VERY IMPORTANT, AND THIS APPLIES AS WELL TO EXERCISE PRESCRIPTION – The prevalence of abnormal magnetic-resonance images of the cervical spine as related to age in asymptomatic individuals emphasizes the dangers of predicting operative decisions on diagnostic tests without precisely matching those findings with clinical signs and symptoms.

If 52% of People Have a Disc Herniation, What Are We Doing to Keep Them Out of Lumbar Flexion?

My life in lumbar flexion:

• When I go to my family doctor, I sit on my bicycle and bike there. Sitting on my bike puts me into lumbar flexion.
• When I go to the Chiropractor, I drive there. My truck seat puts me into lumbar flexion.
• When I go to the physical therapist, I sit on the edge of the treatment bed and this puts me into lumbar flexion.
• When I go to the massage therapist, I sit in the waiting room on a firm hard chair, which puts me into lumbar flexion.
• If you do what Dr. Stu McGill calls the “Midnight Mambo”, this put you into lumbar flexion.

It is nearly impossible to avoid lumbar flexion and a lot of what we do on a day-to-day basis puts us into it.

It is probably more important to look at duration, frequency and load compared to the act of lumbar flexion.

Plus, it is tough to think all of the above is okay, but doing 30 seconds to 60 seconds of exercise is going to be the thing that slips your disc or causes a disc herniation.

What Kind of Client do You See?

The setting I work in will affect the type of disc herniation client that I would see.

When I worked in a Medical Rehabilitation Program (MRP), I would see the worst of the worst.  The ones that tried Physical Therapy, Chiropractics, Massage Therapy, etc but did not get better.  The disc herniation clients that I would see had all kinds of symptoms and limitations.

How the MRP worked was, each client would be seen by the sports medicine doctor, he would let me know what the medical findings were and then provided direction for the exercise program.  Then I would design, implement, supervise and progress the exercise program.

Looking at all the settings I have worked in, the type of disc herniation client varied.  The client differed depending if they were in a Work Hardening Program, Occupational Rehabilitation Program, Chronic Pain Program, Physical Therapy Clinic, Community Based Rehab, Personal Training Studio, Gym or Recreation Centre.

I think we see or hear something and think of the typical client that we see or that we come across in our work environment.

Now I see clients that have finished their medical care and have been cleared to start an exercise program.  They have an injury, limitations and an area that I need to focus in on.  Based on their injury, function and goals, I need to know which exercises will help or make things worse.

We Like to Focus on What Not to Do

When I go to the doctor, my list of what I should not be doing is a lot longer than my list of what I should be doing.

Many times I leave with the fear that if I do anything, I am going to make it worse.

I feel I should lie on the floor and not move.

I wonder if I breathe too hard it that will make things worse.

I very much felt this way after my car accident or after I saw my physical therapist when I flared up my back and had all kinds of neurological signs.

Now my guidelines are simple.

• Movement is good for you.
• Focus in on the movements you can do.
• Work around the movements you can’t do.
• Do what you can with the movement you have.
• Work on constantly improving your movements.

Have We Drunk To Much of the McGill Cool-Aide?

I remember when Paul Hodges came out with his research on transverse abdominis activation and how this was now going to save the world from back pain.

I remember when Paul Chek came out with his concept of core training and how this was going to save the world from back pain.

I remember when Juan Carlos Santana did all kids of core exercises with the stability ball and now this was going to save the world from back pain.

Now everyone is quoting Dr. Stu McGill on bits and pieces of his research and how this is going to save the world from back pain.

I wonder what will be next.

Hodges, Chek and Santana were in very 1990′s.  McGill was very 2000, let’s see what comes up in the rest of this decade.

Stu McGill’s Research Says…

I have two of Stu’s books.

I have organized a conference and brought him to Vancouver.  I have attended his course.

I have heard him talk at another conference.  I have read a few of his research articles of his 147 that are on PubMed.

I use his information as a piece of my core exercise continuum.

I can’t say that I have read and know all of his research.

He has probably forgotten more about the back and his research than I know about the back.

Corrective Exercise is Not For Acute Clients

Corrective exercise has a lot of misconceptions around it.

One of them is what an acute client should be doing it.

When I worked with acute clients, I never did any corrective exercise stuff.

I use corrective exercise for healthy individuals who need to have specific movements restored.

Random Stuff

• Stage of Recovery – This will play a role in deciding the exercise.  Whether they are acute, sub-acute or chronic will play a role when it comes to the exercises they need to do.
• Guest Blog Posts - I like to let guests speak their minds.  I don’t like censoring them.  I like to hear their perspective because their education, learning and experience is different than mine.  Many times this leads to discussion, which is great.
• McKenzie Protocol - I do like this system and have hosted them in Vancouver before.  I find it very effective for SI Joint pain.

I am getting  a little long with this post.

I will cut it off here and pass it onto you.

One last thing.  I had a reader email me and say now they are confused on what to do about exercise and a disc herniation.  I will be back next week with some clear guidelines on what to do.

Let me know what you think.

Rick Kaselj, MS

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I always get great feedback on back pain articles and today I have one on herniated discs.

Enjoy and make sure to Facebook like this and leave us a comment or question.

A herniated disc, also referred to as a bulging or slipped disc, is an injury that can set back even the most highly trained individual. It can result from the effects of aging (as in degenerative disc disease), cumulative and repetitive disc trauma over time, or a specific, traumatic event.

The information presented in this article will focus on the lumbar region. If a herniated disc presses on a nerve, it can cause back pain or sciatica. If you are experiencing low back pain and/or pain down one or both legs, it is advised that you seek the help of a licensed health-care provider.

The goal of herniated disc treatment is to decrease stress on the spine. This is typically done utilizing exercises that improve core stability and posture, as well as those which correct muscle imbalances. Manual therapy and other modalities are often used in combination with an exercise plan.

Corrective Exercises for Disc Herniations

#1 – Hip Flexor Stretch
Kneel on a soft surface and bring one leg in front, placing the foot flat on the ground so the knee, positioned over the ankle, is bent at about a 90-degree angle. The back knee should remain on the cushioned surface and should be bent at a 90-degree angle as well. Slide the front foot forward a few inches. Brace the abs and squeeze the glute of the side that is being stretched. Shift the hips forward. The angle of the back knee should now be slightly greater than 90 degrees. Hold for 10 seconds and perform 5-10 repetitions, then switch sides.

For a version of the stretch that’s easier on the knees, try starting from a standing position. Take a big step backwards with one leg. Bend the front knee until it’s over the front foot while simultaneously shifting the hips forward. Keep the back leg straight throughout. Hold for 10 seconds and perform 5-10 repetitions, then switch sides.

#2 – Ham Stretch
Stand next to a bench or table. Lift your leg up onto the table so it is fully extended and straight. Rest your hands on the top of your upper leg for stability. Slowly lean forward, keeping your leg and back straight until you feel a stretch in your hamstring area. Hold the stretch for 10 seconds, then stand back up and rest. Perform 5-10 repetitions and switch sides.

#3 – Bilateral Knee to Chest
Lie on the floor, arms out to the side and knees bent. Slowly bring one knee toward the chest, then the other, aided by placing both hands on the back of thighs. Hold for 10 seconds and perform 5-10 repetitions.

#4 – Single Knee to Chest
From the initial position for the Bilateral Knee to Chest, slowly bring one knee close to the chest, aided by pulling with both hands. Hold for 10 seconds and perform 5-10 repetitions. Switch sides.

#5 – Pelvic Tilts
Lay on your back with your arms by your sides, your knees bent and feet flat. There should be a space between the floor and your low back. Inhale first, and then initiate the pelvic tilt movement as you exhale. When you let your breath out, your belly button should come toward your spine as you tilt the bottom of your pelvis up. This will result in your low back gently stretching and reaching in the direction of the floor. Inhale to come back to starting position. Perform 10 repetitions.

#6 – Bridges
Lay on your back with your arms by your sides, your knees bent and feet flat. Make sure your feet are hip-width apart. Push through your heels to raise your hips up, creating a straight line from your knees to shoulders. Squeeze your glutes and brace your core. If your hips sag or drop, lower yourself back on the floor. The goal is to maintain a straight line from your shoulders to your knees and hold for 20-30 seconds. You may need to begin by holding the bridge position for five-second repetitions as you build your strength.

(Above is a more advanced bridging version with the foam roller)

#7 – Iso Hip Flexion
Start in the same position as the Knee to Chest stretch. Draw both knees toward your chest until your thighs and torso form a 90-degree angle. Place your hands on your knees and try to move them closer to your chest, but resist with your hands so no actual movement occurs. Hold for 10 seconds and then relax, and perform 10 repetitions.

#8 – Safe Crunch
Lie on your back with your left leg extended. Your right knee should be bent and your right foot flat. Place your hands palms down on the floor underneath the natural arch in your lower back. Slowly raise your head and shoulders off the floor without bending your lower back or spine, and hold this position for 5 seconds as you exhale. Perform 5-10 repetitions and then switch legs.

#9 – Bilateral Knee Raise
Sit on the edge of a chair or bench with your knees and feet together. Lean slightly backward, keeping shoulders pulled back and chest up. Bring your knees towards your chest then extend them back out towards the ground. Perform 10 repetitions.

(If you want to know what exercises that I start my clients with that have a disc herniation, check out Core Stability of the Back.)

#10 – Air Bike (more advanced progression)
Sit on the edge of a chair or bench with your knees and feet together. Lean slightly backward, keeping shoulders pulled back and chest up. Bring your knees towards your chest then perform a pedaling motion. Make sure that you aren’t simply pushing the feet in and out, but forming a circular motion with them. Perform 10 repetitions pedaling away from you, and 10 repetitions pedaling toward you.

#11 – Accordions (most advanced progression)
Sit on the ground with your knees bent and feet flat. Your hands should be extended out to the sides and parallel to the ground. Raise your feet off the ground and bring your knees toward your chest. At the same time, bring your hands toward one another and exhale, pretending you are squeezing an accordion. Then extend legs out straight and parallel to the ground and extend arms out to the sides.

Rick Kaselj, MS

Here are some other exercises that may be of benefit to you:

If you are looking for more on what to do with a client with lower back pain, I did a course that takes you through it all, call Core Stability for the Rehab Client :

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Let’s hit the mail bag for this week.

Anything On SI Joint Problems

Hi Rick,

I was looking for the info on the SI Joint on your website.

I bought “muscle imbalances revealed” upper body and really enjoyed it.

I have a client with SI joint issues and wondered if you had any articles / videos for the SI joint available ?

Thanks
AR

The question is very timely as this month’s Injury of the Month is Sacroiliac Joint injuries.

It has everything you need for a client who has an SI joint issue.

What the Sacroiliac Pain Solution Program has:

1. A recording of a presentation that I did on SI joint and exercise which will give you all the anatomy, exercise considerations and exercise programs when it relates to SI joint injuries.
2. A 3-stage exercise guide for someone who has an SI joint injury.
3. Then it has videos of each of the exercises.

I am proud of it.  It was a lot of work but I am getting closer to how I envisioned a perfect exercise and injury program.  If you want to check out the program, click here.

Can the SI Joint Program Help Non-Professionals?

Hi Rick,

I am a client, not a trainer. Does your Sacroiliac Pain Solution Program deal with hypermobile or hypomobile SI joint dysfunction?

Thanks!

Wendy D

Yes, it does.

It deals with it from an exercise point of view.  If I had a client who was given the diagnosis of “hypermobile or hypomobile SI joint dysfunction”, I would give them the program that is in Sacroiliac Pain Solution.

I know the program can help the non-professional.

The presentation will educate you on you SI joint, the exercise guide will give you photos and descriptions of the exercises and the videos will show you how to do the exercises.

It is very comprehensive.

Worst case scenario is you bring the program to your health and fitness professional.  They will take you through the program.  I am sure when they look at it, they will have never seen anything like it.

Few More Kinds Words about MIRU

“Being a wannabe personal trainer, I often find myself not being able to do all the things right.

Things like programming considerations for every client, giving them the correct protocol for their needs, and sounding smart enough can sometimes intimidate young trainers.

With Muscle Imbalances Revealed: Upper Body this is no longer the case.

Dean, Tony, Jeff and Rick did a really great job on covering every topic imaginable on how to train the upper body of every athlete.

Even though the title has “imbalances” in it, the product is even more complete than that.

You can see how a strength coach uses various exercises to strengthen the upper body, while using assessments to see what is wrong with the athlete.

You learn about the fascia and how to use it in while also seeing different stages of core training, whether you are injured or an advanced athlete.

You now understand why breathing mechanics are essential for your well being and how to use different soft tissue tools for your goals.

And finally you see how important is the neck in your movements and delve into the shoulders anatomy and movement.

But the most important thing that you learn from MIR is that your body moves as one unit. Every speaker references the presentations of other speakers, making you understand that although you might talk about your low back, you must not forget your thoracic spine and interesting pieces of information like this.

All in all I think that MIR:Upper Body is a great product that can be used in your arsenal of tools while also giving you the luxury to ask the experts any questions you might have!”

Fotis Chatzinicolaou

Exercise enthusiast

Greece

Thank you so much, Fotis.  Glad it could help you out.

If you have not checked out MIRU, here is a clip from one of the presentations:

Great Answers on EFI Facebook Fan Page

Thank you for everyone that visited the EFI FB Fan Page and answered the question that was up there.

There were 44 responses and a lot of great exercise ideas.  I picked up a few new ones, thank you.

This morning I am going to head to the gym and take a few more photos and videos of the exercises that you suggested. Plus work on the next Injury of the Month which is Piriformis Pain Syndrome.  It is similar to SI Joint Pain but still some very key exercise prescription differences.

Manu Peeni won the DVDs for that week.

Make sure to visit over the next 10 weeks. Each week I will ask a question and you get put into a draw to win a set of DVDs.

Today, I will be make a draw for a 3-DVD set of Muscle Imbalances Revealed – Lower Body Edition -.  All you have to do is head over to the Facebook Fan Page and answer this question:

“What is the Most Common Muscle Imbalance That You Come Across?”

Discussion on Postpartum Exercises

On a post that I had done a little while back on postpartum exercises, there has been some discussion behind the scenes.

The ideas that were brought up in the article are a little different then we are used to in the area that I live in.

I am always open to new ideas and I find ideas from different parts of the world and disciplines are great new ways of adding or looking at things differently.

Thank you all for reading the blog and adding your insight.

I am off to bed.

Have a great day.

Rick Kaselj, MS
 

Ending the Most Common Back Injury In Women – Exercises for Sacroiliac Joint

The most common and most ignored injury in females is the sacroiliac joint.  Most times the exercise program that is given is what one would give for someone with a lumbar spine lower back injury, which is not correct.  SI joint exercise program design is very different than that of a regular lower back injury.  In this practical and hands outs session you will learn the 5 step exercise process to overcome your client’s or your sacroiliac joint (SI joint) injury.
3 Benefits of the Presentation -

- The “don’t’s” when it comes to your exercise program design after your client has received medical approval to start an exercise program

- The things to avoid outside of the gym if you have SI joint injury

- Go-to exercise program for your client or your sacroiliac joint client

Got some amazing information for you today.  It is from a strength coach that I brought into Vancouver to share his information on how to Bulletproof Your Knees and Back.

The seminar was amazing!

I got some clips of the seminar below.

The great thing is, Mike recorded the full 16 hour seminar.  If you missed the amazing seminar, you can check it out here:

Now let’s get into the great info, take it away Mike…..

We’ve all heard the stats – 80% of Americans will suffer from lower back pain at some point in time in their lives. As trainers, coaches, and therapists, our goal is to not only to get them healthy, but to keep them healthy as well.

The question then becomes – is your coaching and training really making your clients better?

Or, in a worst case scenario, possibly making them worse?

Below are the three biggest coaching mistakes I see trainers and coaches making when it comes to back pain.

While they may seem simple at first blush, these are the tools that make our team at IFAST incredibly successful at working with everyone from the injured and beat-up “corrective exercise” client up to high-level performance athletes.

Back Training Mistake #1 – Not Training Neutral Spine

Neutral spine is a concept that Panjabi first started discussing as far back as 1992. The hypothesis was simple: There’s a “neutral zone” where your spine is happy and healthy.

The further and further you move from that “neutral zone,” the more likely you are to get injured!

Coaching neutral spine is incredibly easy. All you need is a 4’ piece of PVC pipe that you can carry around with you during training sessions. While many have seen this tool used on core training exercises such as front planks, side planks and birddogs, its use really is unparalleled.

Instead of just coaching and cuing neutral spine on core exercises, start using it on virtually all of your big bang lower body exercises. Most clients will be shocked at how quickly they deviate from neutral when they’re asked to squat, deadlift or lunge with a neutral spine.

And if you think this is just too simple or just won’t work, here’s some food for thought.

I attended a seminar several years ago where strength coach Joe Kenn was discussing the power clean. He mentioned that one of the first things he does is put the PVC pipe on his athletes’ backs to teach them neutral spine!

Coach Kenn has worked at major universities like Boise State, Utah, Arizona State, and Louisville. And by the way, he’s now the head strength coach for the Carolina Panthers of the NFL.

If it’s good enough for Coach Kenn, it’s good enough for me!

Back Training Mistake #2 – Not Understanding the Role of Neutral Pelvis

Intuitively, neutral spine makes a lot of sense to people. Unfortunately, the pelvis tends to get lost in the shuffle.

Why is this a problem, you might wonder?

Simple – all the joints of the body are intimately connected to and influence the other joints. When you change the position of your foot, this can drive changes all the way up your kinetic chain!

The pelvis has a very direct connection to the lumbar spine. If your clients are walking around with a massive anterior tilt of the pelvis, this is going to increase the lordosis of their lumbar spine.  As such, it doesn’t make sense to hammer your clients with neutral spine without also working to achieve neutral pelvis!

My two favorite exercise branches for mastering neutral pelvis are half-kneeling and tall-kneeling exercises. I recently gave a presentation at the NSCA conference outlining these two tools, and afterwards, I had an attendee come back and ask me what else I did to reinforce a neutral alignment.

I hated to break it to him, but this was it!

The key, however, is putting your client in these positions numerous times during their workout. For example if someone is coming to me and they need to really hammer neutral pelvis we could easily perform 2-3 tall- or half-kneeling exercises in each workout to make sure we really drive home the concept!

Dan John always says that if something is important, do it everyday. My clients may not be in the gym every day, but when they are there, we are going to spend the bulk of the time on addressing their weaknesses.

Back Training Mistake #3 – Not Focusing on the Details

This shouldn’t come as a surprise, but when it comes to training people in back pain, the devil really is in the details.

A few years ago we had a client with debilitating back pain that came into our gym for several weeks. On his 2nd or 3rd workout he came in complaining of pain, and told me he couldn’t work out.

Never one to accept defeat, I told him let’s just go through your warm-up and see how you feel.

We got him loosened up a bit, and he started feeling better. Next, I asked him to just try going through the exercises as best he could, and if he had any pain, we could immediately stop.

We actually got him through his entire workout that day without one single tweak or flare-up. He was pretty shocked, but I wasn’t.

The details are critical; when someone comes in with back pain, here are some suggestions to get them through their workout pain-free:

• Ask them to just go through the warm-up. Often some gentle stretching, foam rolling, and movement will get them feeling better immediately.
• You must coach every set of every rep. Decrease the load, decrease the range of motion, whatever is necessary, but you must be 100% dialed in to your client and their workout. Any deviation from good alignment or lack of attention on your part could get them injured!

Summary on the Back Training Mistakes

Back pain is an epidemic. Americans spent $90 BILLION in 2006 alone treating their low back pain.

If you adhere to the simple guidelines I’ve provided above, you’ll be well on your way to becoming the go-to back expert in your area. And let’s be honest – if you’re the go to expert, you’re never going to have a shortage of patients and clients walking in your door!

Read the rest of this entry »

I received a Facebook message and thought I would share with you my reply.

Here you go:

Hi, my name is TB and I was doing some research on the internet with regard to exercise after surgery.

My husband had a L5 fusion 4 yrs ago and has been on pain management since. We are desperately seeking ways to give him relief.

He is only 37 and we have 4 children, yet he is unable to live his daily life due to his back pain.

The information I found in regards to your work was geared toward Medical Professionals.

Do you have information that we can access and hopefully put to good work?

Thank you so much for any time that you may spend on this, we are pretty desperate.

Sincerely,
TB

Heartache

My heart aches when I hear stories like this.

I understand how it is to be in pain and to wonder if you will ever be able to do the things you love or even be able to play with your kids.

All I can say is - you never should give up.  Keep searching for an answer and keep moving.

It is my passion to help educate fitness professionals and clients to use exercise to help overcome their injuries.

One of those injuries is lumbar fusion.

Let me get to TB’s specific questions:

Will the Lumbar Fusion Exercise Program Help Those Recovering from Lumbar Fusion?

Yes, it will.

I initially created The Lumbar Fusion Exercise Program to help fitness professionals, but I have received feedback from those recovering from lumbar fusion that they have used the program to help themselves recover from their lumbar fusion.

#1 – Video Presentation

In the lumbar fusion exercise video program, I go explain what lumbar fusion is, a few of the causes, things you need to do to recover from a lumbar fusion, and outline an exercise program that you can do at your local gym or fitness centre to help you recover.

#2 – Copy of the Exercises

I also give you a copy of the presentation, with pictures of the exercises that you should be doing..

I recommend bringing the list of exercises to the gym or community centre and ask one of the staff to help you out ,even though I explain everything in detail in the presentation.

Feel free to bring the program to you surgeon, doctor, or physical therapist in order to get their feedback.

#3 – I am Here to Help

Plus, you can alway send me an email and I certainly try to help you out.

#4 – Here is Your Money Back

Lastly, if it is not what you want or does not help you, I will give you your money back.

I am here to help people and have been doing so since 1994.

Before I wrap up.  I just want to say that this program is not a quick fix.  You need to be able to dedicate time to exercise 3 times a week for 12 weeks.  That is 36 sessions.  The exercise program helps and it works, but not unless you do it as outlined.

Rick Kaselj, MS

P.S. – Here are a few more blog posts on spinal fusion exercises:

• Spinal Fusion Question
• How Common is Spinal Fusion Surgery?
• What is a Spinal Fusion?
• Lower Back Spinal Fusion and Exercise

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Last week, I headed to the gym to workout with Lou Schuler and Alwyn Cosgrove.

Well kind of.

I took their new book, The New Rules of Lifting for ABS to the gym with me.

I did a workout based on the exercises in their book, and I wanted to go through some of the exercises that I liked.

#1 – Dumbbell Two-Point Row

Start Position

End Position

I am a big fan of unilateral work.  I focus on this a lot in my Lumbar Fusion Exercise Program.

Technique:

Select a dumbbell weight that you can do 8 to 12 repetitions with.  Beginning in a hip width to shoulder with stance.  Activating the core and bending the upper body at the hips while still keeping the upper body in alignment.  Have the dumbbell straight down while still activating your scapular muscles.  Lift the dumbbell up while focusing on pulling through with the elbow and having the muscle around the shoulder blade do the work.  The core is activated preventing movement in the sagittal (forward and back) and transverse (rotation) planes.

#2 – Dumbbell Offset Squat

Read the rest of this entry »

How Can Hip Injuries Be the New Injury of Choice?

Hip Fractures are on the Rise

Hip Pain and the Lower Back

Read the rest of this entry »

I was digging in my YouTube channel and came across this video.

I don’t think you have seen it.

I know you will find it interesting information and get you thinking about lower back pain & the leg press machine.

Does the Leg Press Machine Cause Lower Back Pain?

Read the rest of this entry »

Since my back flare up, I have been doing a lot of thinking about lower back pain.

I got thinking about what was the most important thing that helped me overcome my back pain in three days.

I also thought back to the clients that I have helped over the last 15 years and what they had that helped them over their lower back pain.

After doing so, I did this video.

The Most Important Lower Back Pain Exercise

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I had a lower back pain flare up about two weeks back.

I am still recovering from it.

Well, kind of.

The pain is gone but I am trying to write down and take some videos on what I did in order to help recover from the lower back pain flare up in three days.

Here is a little video explaining the three things I addressed in order to have a speedy recovery.

3 Things You Need to Do When You Have a Lower Back Pain Flare Up

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I just got a question about the Lumbar Fusion Exercise Program.

I though the answer would interest you.

Hi Rick,

I have just started the program today!

I got a surgery (fusion of D12 with D11 and L1, after a fracture) on August, 25 and I have been doing, for the last 3 weeks, a first rehab program (walking on the treadmill, aquatic walking and some basic strengthening exercises). I found your program very helpful for me, specially for the next stages. After one month of the surgery I was wondering what type of exercises would be appropriated for my case.

Regarding your proposal for Stage 2 and 3, can I assume that each one will last one month, with 3 sessions per week?

Best Regards,

PH

Read the rest of this entry »

What I do When a Back Flare Up Hits

Yesterday I has my first back flare up in about two years.

I was a work and I was in an awkward posture lifting something.  As soon as I lifted, I felt that little click.  I hoped it was nothing but I could feel the pain increase in my back and all the muscle in my lower back tighten up.

I was right in the middle of work and could go now where.  I had to keep working.  There was no lieing down.  I had to take care of it right now.  I was able to get through the day by managed my back pain and doing 3 things to decreased my lower back pain.

Let me share with you a three things that I did right away as soon as I felt my lower back flare up in order to decrease the pain.

Read the rest of this entry »

Exercise Rehabilitation of the Lower Back

DESCRIPTION:

OBJECTIVES:

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.

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What Makes Up the Lower Back?

It is difficult to fully understand a lumbar spinal fusion without briefly discussing the normal anatomy of the spine. The vertebral or spinal column consists of 33 bones called vertebrae. Each are that stacked on top each other to for them spine. The spine, which extends from the base of skull to the pelvis, has four regions: the cervical spine, thoracic spine, lumbar spine and the sacrum. Between each vertebra are the flat and circular plates of cartilage called the interverbral discs. Intervetebral discs maintain the integrity and continuity of the spine by holding one vertebra to the next. It acts as an effective cushion that absorbs shock and pressure placed by the everyday movements of the back. This disc also makes bending and head rotations possible.

The lumbar spine makes up the lower back, extending from the lumbar curve down to the sacrum. Among the four regions of the spine, the lumbar region endures the greatest stress. Carrying the entire body weight, this region is supported by the five thickest and sturdiest of all vertebrae of the spinal column. It has also been determined that the intervertebral discs between two adjacent lumbar vertebrae are the thickest. Attaching to the lumbar vertebra are some of the largest stabilizing muscles of the lower back, which include the lumbar erector spinae, psoas and quadratus lumborum. Because the greatest amount of work and stress are placed against this region of the spine, the lumbar spine is most susceptible to injuries and structural alterations.

How Common is Spinal Fusion Surgery?

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What is a Spinal Fusion?

Background on Spinal Fusion Surgery

When I was in Indianapolis earlier this year at the NCAA Final Four, I stopped by to

visit Mike Robertson and we did a quick video for you.

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Mike and I did a quick interview for you so you have a better idea of what to expect from the courses/seminar.

Lets get to the interview.

What You will Learn in the Seminars with Mike Robertson

In Part 1 of the interview, Mike Robertson will share with you:

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Bulletproofing Your Client’s Knees and Lower Back Seminar with Mike Robertson [ 12:37 ] Play Now | Play in Popup | Download

Lower Back Spinal Fusion and Exercise

Webinar Description: