This week's post is a primer on an excellent, quick way to view an athlete's ability to maintain motor control during a movement needed for virtually everyone (athlete or not). The ability to simultaneously stabilize on one leg while dynamically moving and controlling the other gives insight into whether an athlete is a coordinated gazelle or a broken mess. Check out the video and ideas below. Observing this simple movement (let's call it Standing Knee to Chest) can go a long way in screening and helping to diagnose movement faults:
Why is this movement important? Effective single leg stability and mobility is essential for those in nearly any sport. Sprinting, jumping, throwing, even going up the stairs all require movement of one leg with simultaneous stability in the other leg. If you don't create active stability and control in the system, your body will compensate to find it potentially resulting in overextension of the spine, pelvic drop, decreased range of motion, potentially leading to injury. Don't believe it? Read this new systematic review. These compensations create an inefficient motor pattern and waste energy which will decrease performance. While this motion is accounted for/in other excellent screening and assessment systems (FMS, SFMA), they don't require maximum knee to chest motion which is necessary in sport and also further elucidates movement and mobility faults.
As stated in the video we are really looking for 3 things during the Standing Knee to Chest (try it, can be an eye-opener):
1) Midline Control: First observe how the athlete controls the pelvis/lumbar spine. These regions are coupled meaning that pelvic position dictates lumbar position. An athlete that overextends at the lumbar spine (due to anterior pelvic tilting) is demonstrating inadequate abdominal motor control. This indicates that the athlete does not understand how to effectively brace the spine, allowing the hip flexors to powerfully tilt the pelvis forward and pull the lumbar spine into extension. The result is a decrease in hip flexion range as the femur prematurely runs into the hip. Try it yourself: first try the Standing Knee to Chest with appropriate midline control, then try it once with your back arched. You will notice less hip flexion and maybe even some pinching indicating that you're essentially self-impinging which is not great if you enjoy having a hip labrum. I'm not suggesting that the spine is mechanically unstable (the vertebrae probably won't buckle and collapse) but rather the lack of appropriate midline control is a detriment to optimal movement patterns.
The fix: Organize your spine! Squeeze the glutes and brace the abdominals prior to lifting. Clear up a disorganized midline and range of motion and stance leg stability will often fall into place. Some of Gray Cook & company's anti-rotation exercises are great here to stabilize in the diagonal planes - don't forget about spinal rotation.
2) Active Range of Motion: Active range is what we care about in athletics. The ability to control this range is even more important. Don't forget to look at the quality of the motion. Is the hip flexion smooth and coordinated? Does the leg externally rotate excessively (indicating a possible mobility impairment in an effort to get the hip up)? If you're able to passively take the leg further than the athlete can actively take it, that indicates a motor control problem.
The fix: Dig deeper. Start with organizing the spine - what may appear weak or stiff may just be a lack of proximal stability. Then figure out if the athlete's control is ugly or if they need some hip internal rotation/flexion mobility.
3) Stance Leg Stability: An inability to effectively stabilize on the stance leg is unbelievably common even in high level athletes. It's amazing how much poor stability people get away with before it catches up. Look at the pelvis: do they compensate for poor pelvic/glute control by excessively leaning the trunk? does it drop towards the stance leg (which loads the medial knee compartment and changes the pull of the quadriceps on the knee)? What about the foot? Clawing or splayed toes is something I see all the time in runners lacking stability, excellently described by Chris Johnson, PT. A wobbly foot and ankle is a shaky foundation and if the patient can't stabilize here, there is little hope for stability up the chain.
The fix: Start with an organized midline first. Then take a top-down or bottom-up approach to figure out the limiting factor. You may need to break down the movement into less-demanding components (decrease the hip flexion, for example) to find when and how the athlete is losing stability. Remember, it's often a coordination issue instead of just plain weakness.
Bottomline: the ability to dynamically stabilize and control movement is essential in both everyday life and athletics. If you're an athlete (or coach them) and cannot get your knee to your chest without falling over, it's time to dig deeper into what's driving this faulty movement pattern and the Standing Knee to Chest is a great starting point to make the invisible become visible.
Last week we discussed 3 common mistakes athletes and coaches make that destroy training sessions and decrease performance. We have gotten you to stop sitting, encouraged (mandated) goal implementation for every training session, and improved your warm-up. But what about during and after the training session? The goal for this week's post is to fix some common errors during and after the workout that are killing efficiency and productivity.
1) Missing the details. When it comes to training for performance, not paying attention to how you or your athletes are moving is a common and crippling mistake. Proper exercise prescription and progression is an art and science that takes experience and knowledge (as well as some trial and error) and can be difficult even for experienced physios, coaches, trainers, and athletes. Often if someone is struggling with a particular exercise, the response is "that guy/girl must be weak, let's load up the weight". That's borderline moronic. Increasing load or reps will only serve to exacerbate the athlete's poor movement. In the rush to "strengthen" in an attempt to fix the ugly movement, we miss what is staring us right in the face - how the athlete is moving!
The fix: Watch the athlete move! The manner in which someone moves is the best way to deduce why they are struggling. The problem is almost always staring us right in the face if we just take the time to figure out why. It may be a mobility problem (unable to achieve appropriate position due to joint and/or soft-tissue restrictions) or a motor control deficit (unable to simultaneously stabilize and control a movement). If someone has poor motor control increasing the difficulty of the task will only serve to make them more unstable. Poor mobility and increasing load will just put them in an untenable position that is destined to fail. Both of these deficits can and do lead to injury. So take a step back and look at how the athlete moves. Knees come in when landing from a jump? They may lack hip internal rotation or they may have poor control of their glutes and posterior chain. Unable to tell in real-time? Slow it down, man, and film it. Coach's Eye is a great app that allows video analysis in slow-motion and is very effective at making the invisible become visible. Not sure what's going on? Find a good physiotherapist (contact me for some help) to get on the right track. Proper exercise progression should be based not just on load, speed, and other quantities but on quality! The goal here is to pay attention to the details, unload the movement, and do some problem-solving. Perfection is in the details and will propel you or your athlete to higher performance.
2) Improper recovery habits. Taking a training session seriously is just not enough to significantly improve performance. Multiple variables are either forgotten, ignored, or misused in recovering from workouts. These include improper nutrition and hydration, ignoring or mistreating post-workout soreness (DOMS - delayed onset muscle soreness), and improper sleep habits. Screw these up and they neuter your best efforts in training (and in rehabilitation - often these variables are forgotten by physios and patients when they are needed most).
The fix: Nutrition - poor caloric and protein intake is critical to recover from training. If you are involved in strenuous exercise and are not eating adequate amounts of protein, it's counterproductive. Muscle damage needs repaired and protein (specifically amino acids which make up protein) is the constituent that needs replenished. Current NSCA recommendations are for 1.5-2.0 g of protein per kg of bodyweight. Protein supplementation is likely necessary though a majority of it should come from high quality, animal protein. Get a portion of this protein immediately after exercise and at least every 4-5 hours thereafter. Eat clean, eliminate inflammatory foods (gluten, sugars), and perform better.
Hydration: drink half of your body weight in ounces per day and throughout the day (not all at once - a large bolus of fluid will flood the kidneys and prevent appropriate uptake). Hydration is so important for not only muscle suppleness, but also joint surfaces (via glycosaminoglycans) which draw water into the synovium and maintain joint hydration, reducing friction. Get hydrated and take it seriously.
Handling post-workout soreness: How are you dealing with soreness now? Waiting for it to go away while you limp up the stairs? Don't be that guy. Soft-tissue work is a must in this situation: foam roll or lacrosse balls applied (sometimes aggressively) to the offended tissues provides tissue mobility and better intra-muscular sliding which prevents them from becoming matted down, ugly messes. Don't ride your muscles hard and put them away wet. A 5-10 minute cool-down will also aid in post-workout recovery. You can try tart cherry juice for some relief, check out this study in runners. Thinking about ice and ibuprofen for your soreness? DON'T! Friends don't let friends take ibuprofen. Read this and watch:
Sleep: Multiple studies are coming out regarding the increased risk of injury in those who are sleep-deprived, including factory workers and athletes. In fact, adolescent athletes who slept more than 8 hours per night were 68% less likely to get injured. The exact mechanism is unknown (decreased reaction time, poor healing?) but the benefits for injury prevention are real. Appropriate sleep also improves retention (crucial when learning a new skill) and is necessary for growth hormone to be secreted - a potent anabolic hormone. Bottomline: get your 7-8 hours. I suspect one of the causes of high injury rates in college and professional sports is due to sleep deprivation - take your sleep seriously!
Bottomline: when determining exercise progression, determine if it's appropriate based on the quality of the movement not just on the numbers - pay attention to the details! Trust your eyes and don't be afraid to unload the movement and get to the "why" of the problem. And take recovery seriously. As you can see from last week's post and this week's, performance is 20% training and 80% what you do outside of the actual physical part of training.
Keeping in line with this website's dedication to improving human movement and performance, this week's post is a list of everyday errors made by desk warriors and elite athletes alike. Errors that are made often, sometimes unknowingly, and hinder optimal movement. Movement and performance, by the way, are one and the same; poor movement patterns will crush and entomb hopes of elite performance and at the very least will shorten the ability to sustain high levels without injury. Anyways, here's the list:
1) Sitting. If you could change only one thing to improve not only athletic performance but also everyday performance, rid yourself of sitting. The average American spends at least 6 hours per day sitting. Kelly Starrett calls sitting the new smoking and that could not be more accurate. The real issues with sitting are two-fold:
1. General health problems: Sitting causes fat deposits around the heart, increases blood pressure, decreases bone density, and literally may kill you. The scary part of that article: even exercise and physical activity may not be able to undo the nearly 40% increased risk of death.
The fix: Stand the heck up. Walk instead of sit while on the phone, take frequent breaks while driving, and just plain stand at your workstation. This is often easily done but neglected due to appearances, if your coworkers look at you funny just know that you'll be cashing in on your pension while they're taking a dirt nap. Check this out to make a walking workstation on the cheap.
2. Performance detriments: Besides the above scare tactics, sitting can really mess up your movement mechanics. When you sit, your hip flexors (particularly your iliopsoas) control the position of your spine and pelvis and are continuously in a shortened position. This causes them to get crazy stiff and hypertonic (imagine keeping your elbow bent for 6 hours then trying to straighten it - gonna be stiff man). Additionally, sitting can drive the hip forward and jam it into the acetabulum (socket) and I suspect this is a major factor in the development of hip impingement. So now when the sitting warrior takes his talents to the training room he's unable to achieve full hip extension, totally overextends at the lumbar spine, and wonders why his back is killing him when he tries to power clean.
The fix: Prioritize anterior hip and quadriceps mobility with a goal of undoing every hour of sitting with 5 min of this stuff. Own up to your sitting sins!
2) Lack of goals: This is a common and major error among both beginning athletes and elite ones. Do you have a plan in mind for each training session? Not a vague, "I want to get a pump" goal but a thought-out goal and plan to achieve it. If the goal is to get stronger that's too general, we can do better.
The reasons we make goals and checklists are to hold ourselves accountable and enhance the effectiveness and efficiency of the time spent training. If each exercise, mobilization/stretch, etc. doesn't exactly match the goal of what you are setting out to achieve, why the heck would you do it? This is in-line with the research on deliberate practice by Ericsson et al; training is about mastering a skill/sport and without a set goal in mind you're wasting time. Expertise and elite status is not gained by simply putting in a high quantity of training, it is gained by putting high quality training. This is most easily realized by a firm set of goals with a plan. Coaches this applies to you too, having a training goal for your athletes is an absolute with practice, workouts, walk-throughs, everything!
The fix: I always prioritize having a daily goal with my clients, they cannot walk out without having addressed that goal. They are expected to have one for the session, too, and we discuss the plan for each session prior to crushing that impairment. Develop a short checklist (3-5 items max) that can be addressed THAT training session (for instance: 1) gain full hip extension after sitting all day, 2) emphasize glute drive during deadlift pull, 3) improve jump landing positioning for better repeatability). Each daily checklist should work towards reaching an overarching goal - reaching Olympic status, eliminating pain when using the stairs, squat 500 lbs, etc. Checklists reduce waste and improve consistency.
P.S. Read the Checklist Manifesto by Atul Gawande
3) Inadequate movement preparation: This goes along with prolonged sitting but too many times athletes roll in, do some half-hearted "stretches" and are ready to test their limits. I would argue that a proper warm-up of progressive intensity is just as important as the workout itself. Without a proper plan to prep for the movements, you or your athletes will never know how hard you can push the training session because it will be halfway over by the time true gains are to be had. The goal is to progress each warm-up from general to specific.
The fix: 1) Restrictions: Prioritize improving movement restrictions for movements to be performed that day. For instance, if you're deadlifting or sprinting and lack hip extension then you need to address this first, otherwise that movement will be wrecked by the restrictions. I know there are detractors that say static stretching decreases acute performance and I agree it may but if you are so restricted in a certain movement (like elephant-in-the-room-restriction) that is not going to fix itself you have to prioritize or jeopardize health and performance. Get a minimum of 2 minutes and mobilize at the point of restriction! Here's an idea for restricted ankle mobility. * You may need to check out a physio to screen and evaluate your specific movement needs.
2) Elevate: Increase your body temperature. 5-10 min of whole body movement to improve tissue temperature and improve elasticity. Jumping jacks, jump rope, treadmill to elevate the heart rate and prep tissues for loading.
3) Specificity: Here is where you prep for the day's movement by progressively loading and priming the tissues. For explosive training bouts (and competition-level) you need to prime the neuromuscular system for loading. This may involve some low-level plyometrics, progressively loading for weightlifting, increasing running intensity gradually. The goal is to progressively prime and load the systems for the day's specific movements. Here are 2 ideas for squat prep:
And one for sprinting from KroutPerformance.com:
Bottomline: Fix these 3 everyday errors and you're on way to improving movement and performance - which is why you're here in the first place. Drop some other ideas in the comments.
Next week: 2 MORE errors
Part 1 of Improving the Overhead Squat - Cueing and Maintaining an Upright Torso - can (must?) be read here.
As we discussed last week, the overhead squat is nearly unmatched in its demands on stability, motor control, and power. One of the main faults in performance of the movement, dumping the torso forward, was effectively crushed last week. However, as with all squat variations (back, front, and overhead), another common fault is the knees tracking forward and inward with the athlete unable to achieve full depth without falling forward or backward. Is this you? Right the ship.
Here's the problem: Improper cueing and loading of the glutes and hamstrings (posterior chain) causes quad dominance in which the knees track forward during the squat. This causes tons of compressive forces thru the patella but also prevents adequate depth and control during the squat. This is what the coach or physio will see with athletes attempting the overhead squat (or any squat for that matter):
1) They will avoid loading their hamstrings and glutes (won't sit back in the squat) and the knees are erroneously loaded first
2) The torso or shoulders may start to come forward
3) The knees cave in and the arch of the foot collapses
3) Near the bottom of the squat, they will stop short and are unable to go further down because something (self-preservation?) tells them if they go any further down, they'll fall over (not good)
4) They are unable to efficiently complete the up phase of the squat, will say "gee, I must not be very strong" and you will cringe.
So, here's the real question: is the athlete (or you) weak?
Anytime the athlete feels as though they will fall backwards during squats, motor control is always at the forefront of diagnosing the movement. *Mobility and tissue extensibility are also possible differential causes - though not the focus of this post*
Here's the solution: Oftentimes, the athlete is not necessarily weak (though it is certainly a possibility) it's just that they do not know how to fire muscles appropriately in the context of that particular movement. For instance, if I manually resist an athlete's glutes or hamstrings they may be quite strong yet they are unwilling or unable to activate that same posterior chain musculature during a squat, deadlift, jump landing, etc. Comparing isolated strength to dynamic, functional movements is like revving the engine on a parked Ferrari versus taking it out on the Pacific Coast Highway - what tells you more about how that car runs? Same muscles, very different motor program - it's a system of systems.
Nerd Alert - In order to improve motor control of complex movements, research on patients (including those with neurologic injury as well as running injuries) indicates that task-oriented training (or practicing and training the movement of interest in its entirety) is the best method to improve movement skill. This makes sense, right? If the movement is the problem, training the movement at its point of restriction is the most viable option. Gray Cook and his Functional Movement crew refer to this as pattern assist because you are performing the faulty pattern with assistance to appropriately fire the correct muscles and strengthen within that movement.
So, short answer: put the athlete in the squat position but reduce the demands so they learn to fire the appropriate muscles without fear of falling over. Check it out:
1) Again, load ordering the squat appropriately is key. Read this.
2) Place the Jump Stretch (or elastic tubing, bike tire inner-tube, whatever works) just below the buttocks and have the athlete perform the picture-perfect squat with assistance from the band. Important, do not hang on the band! It should be only enough tension to assist the motion, not allowing the athlete to rely on it. You can and should reduce the amount of assistance as the movement skill improves.
3) Dosage: enough to make change - this may take a few minutes or a few sessions depending on the individual. How do you know if it's working? Test and re-test the squat - if it's a cueing problem they may improve in a few minutes. Which is so much better than doing quad sets or straight-leg raises for 3 weeks hoping it improves the squat, right? This is why I also like to use this as a warm-up prior to activities requiring lots of posterior chain work - squats, deadlifts, jump landing. You SHOULD see improved depth and stability at the bottom of the squat following this exercise - if not, your dosage may be too low or mobility impairments may be contributing.
4) Variations - try putting a board under the heels or the exercises from last week to also help cue the athlete to fire the appropriate motor program.
Bottomline: As discussed last week, in order to improve complex movements such as the overhead squat, we have to improve the athlete's understanding of stability and control over the entire range of movement. Providing neuromuscular cueing and assistance to the movement teaches the athlete to load their hamstrings and glutes thru performing the movement we aim to improve! Want to improve a movement? Practice that exact movement, while reducing external demands! Sometimes, it is as simple as that.
The overhead squat is nearly peerless in developing proximal stabilization and control over a huge range of motion. It drives an athlete's balance and proprioception (sense of the body's position in space) and demands/develops functional flexibility. It is a staple of the Functional Movement Screen (FMS) and the challenges of an external load with the arms fully-elevated allow physios, coaches, etc. to diagnose/observe athletes' faulty movements otherwise unseen in the back and front squats. Poor overhead squat technique prevents an athlete from transferring power from the large engines (hips and shoulders) to the smaller joints (knees, ankles, elbows) - a MUST for athletic performance. But, man, if it's not done properly it is just plain ugly and dangerous.
Here's the problem: Many beginning athletes are poorly (like REALLY poorly) instructed on appropriate overhead squat technique. Couple that with many athletes being progressed to this movement without having mastered the back squat and front squat (excellent form on the back squat followed by the front squat is a prerequisite for training the overhead squat in my practice) and it's a recipe for some nasty pain and gross form. There are many issues that arise when evaluating one's overhead squat - including mobility, position, and motor control. The focus of this post is to improve motor control of the forward trunk lean - the bane of the overhead squat.
From a motor control standpoint - the ability to maintain an upright torso is absolutely essential to perform this movement otherwise you're dumping the weight and/or subjecting the shoulders and low back to dangerous forces. Additionally, it prevents the athlete from getting to full depth as the pelvis runs into the femur causing a pelvic fault and lots of anterior translation and shear forces to the knees and shoulders. This leaves the athlete unable to generate adequate force in the primary engines (hips and shoulders) and robs athletic performance. Many times the athlete (particularly the beginner) has a difficult time understanding how to organize the movement and pitches the trunk forward to unload the glutes and shoulders. An inability to set the shoulders and create torque early in the movement also unlocks the shoulders allowing the chest to drift forward
Here's the solution: Often, athletes just need some simple neuromuscular cueing to clean up the motor control problems.
1) Clean up any load ordering faults in the movement
2) Using elastic tubing (can be Theraband, thin Jump Stretch band, etc) have the athlete perform an overhead squat while maintaining a posterior pull on the band. This engages the back musculature (including the lats and erector spinae which invest into and tighten the thoracolumbar fascia - shared by the glutes, weird right?) allowing the athlete to generate torque and stabilize the movement. The key here is that the resistance from the band is high enough to provide assistance and cueing to the athlete but NOT high enough that they can passively lean on it. This exercise allows the athlete to perform the full movement with proper activation but without the danger of trying to teach this exercise under load. You can attach the band to a wall, pull-up bar, friend's arm, whatever. Check it out:
3) The next exercise is a progression from #2, in which now the athlete has stabilized the torso but is still struggling with locking and stabilizing the shoulders. Using elastic tubing, have the athlete pull the band apart while external rotating at the shoulder and prioritizing an upright torso. This allows the athlete to optimally stabilize the shoulder and thoracic spine allowing for a legit-looking upright torso, not to mention an improved ability to handle an external load overhead once the skill is learned.
4) Load the hamstrings and posterior chain to set the hips and lumbar spine: stay tuned next week for more on this one!
The above exercises are great for a pre-workout neuromuscular primer in order to teach or prep the athlete for the overhead squat. They are also definitely appropriate for overhead athletes to teach midline and proximal stability, balance, and control.
Bottomline: In order to improve complex movements such as the overhead squat, we have to improve the athlete's understanding of stability and control over the entire range of movement. Providing neuromuscular cueing prior to loading up the movement is a must for those learning or struggling with improving their technique - EVEN for those already adept. There is always more potential to be had!