If your golf swing is weak and feels upper body-driven, poor lower extremity mobility may be stealing your power and leaving you as the guy no one wants to play with on a scramble. Or does your athlete look rigid on his lead leg while pitching (or rear leg while swinging)? Check this out:
When analyzing an athlete's movement, it's important to realize that human movement is a system of systems. While that may sound complicated, what we find is that oftentimes clearing up a dysfunctional pattern can resolve poor position and position = power.
Check out the the video above. In the video of super-stud Jared Krout (speed coach extraordinaire - he'll be featured on this site in future posts), you can see that as he rotates he's essentially running out of room in his hip and any further rotation comes from his spine. This is a sweet example of Regional Interdependence, in which dysfunction in one region causes dysfunction in another. It doesn't take much to figure that his rotation has to come from somewhere and once runs out of internal rotation and jams his femur into his pelvis, the rest of the motion will come from the lumbar spine, potentially causing some back pain down the road.
Obviously I have oversimplified the analysis of this (motor control is always an issue with athletes in addition to mobility - more on this in later posts), but look at how much his rotation improves! In my practice, we will typically go after this with several correlate movements (conjugate training/mobility) in addition to the one Jared is doing, followed by actually practicing the affected movement (golf swing in this case) to motor program the movement and maintain his new range of motion.
Poor hip rotation is a huge problem in rotational athletes including throwers. We see an increase in upper extremity injuries in those with poor hip internal rotation as they essentially make up for the loss of hip rotation through the shoulder and elbow (also potentially through the lumbar spine). Lacking hip internal rotation may also be correlated to hip impingement (FAI - femoroacetabular impingement) and possibly cause poor positioning of the knee and ankle (knee valgus). Mobility and control of the body over a fixed leg is huge folks and we're going to come after this like an angry caddie in future posts.
In this video, you can see how poor hip mobility can negatively your swing (and this dude could use some more hip mobility himself).
Check out these articles on the correlation of hip range and injuries (Nerd Alert):
Associations Among Hip and Shoulder Range of Motion and Shoulder Injury in Professional Baseball Players
Hip rotation in golfers may determine pathology
Basically, by putting the athlete into positions of restriction and improving that position we can optimize their movement at these limited end-ranges of movement. Why should you care? Because your performance will improve and your back won't feel like a wet rag after 18 holes. And your church league softball swing may have a little more oomph in it. After all, performance improvements are what we really care about. Try the method above - one of many ways to improve hip internal rotation - and let me know what you think.
We must always treat, train, and move with purpose. So why should the way we manage musculoskeletal injuries be any different?
True or false: you use and trust the mnemonic RICE (rest, ice, compression, elevation) when dealing with injuries?
True or false: after a hamstring strain or ankle sprain, ibuprofen or aspirin (common NSAIDs - non-steroidal anti-inflammatory drugs) are popped like Skittles?
The truth of the matter is, despite what we all have learned, RICE may not be such a good idea if the goal is promoting adaptation and tissue recovery following injury and/or intense muscle soreness.
In a healthy person with a normal functioning system, the Inflammatory stage is paramount to healing. In fact, the inflammatory process must be initiated for the body to progress to the Repair stage (collagen is laid down and scar tissue begins to form) and finally the Remodeling stage (collagen is realigned and strengthened).
Now, the inflammatory stage does create swelling which causes fluid pressure to build. The pressure from swelling blows out free nerve endings causing pain and inhibiting muscle contraction. So swelling, NOT inflammation, is the real problem here. By icing or taking NSAIDs we are retarding, and potentially eliminating, the natural inflammatory response and not letting the body go through the necessary steps for tissue repair. The body does a great job of healing itself if we quit being bozos and get out of the way! Our GOAL is to promote tissue repair and create the perfect healing environment, not just numb the area with ice and ibuprofen - which does nothing to reduce the swelling, by the way. Don't get me wrong, we take injuries seriously and continuing to irritate a hot and inflamed joint will stall the healing process but we have to look beyond ice and ibuprofen to promote repair.
I know this is tough to deal with considering everything you've been told about the benefits of ice and NSAIDs so below is some hardcore evidence (the peer-reviewed kind - NERD ALERT):
“Is Ice Right? Does Cryotherapy Improve Outcome for Acute Soft Tissue Injury?”
Abstract: Aims: The use of ice or cryotherapy in the management of acute soft tissue injuries is widely accepted and widely practiced. This review was conducted to examine the medical literature to investigate if there is evidence to support an improvement in clinical outcome following the use of ice or cryotherapy. Conclusion: There is insufficient evidence to suggest that cryotherapy improves clinical outcome in the management of soft tissue injuries.
Journal of Emergency Medicine, Feb. 2008; 65-68
"Does Cryotherapy Improve Outcomes With Soft Tissue Injury?"
Results: The authors reported ice to be no more effective than rehabilitation only with regard to pain, swelling, and range of motion. Ice and compression seemed to be significantly more effective than ice alone in terms of decreasing pain.
J Athl Train. 2004 Jul-Sep; 39(3): 278–279
"The Use of Ice in the Treatment of Acute Soft-Tissue Injury A Systematic Review of Randomized Controlled Trials"
Results: There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment.
Am J Sports Med January 2004 vol. 32 no. 1 251-261.
"A Randomized Controlled Trial of Piroxicam in the Management of Acute Ankle Sprain in Australian Regular Army Recruits"
Results: 'Interestingly, subjects treated with piroxicam showed some evidence of local abnormalities such as instability and reduced range of movement.'
Am J Sports Med July 1997 vol. 25 no. 4 544-553
Check out this New York Times article on NSAIDs. Not to mention the side effects - read your ibuprofen warning label if you want to get freaked out.
There's even more out there on this but here's the point:
We have to improve circulation and promote healing and tissue recovery through improving venous and lymphatic drainage (passive circulatory system that returns proteins too large for the veins - stuff like swelling/waste). The BEST way to do this is through compression such as active muscle contraction, compression gear/clothing, etc. to squeeze the passive tubes and get the swelling out of the system to restore homeostasis - not just stop it in its tracks. Now, don't be ridiculous and flex a broken bone or start contracting your newly-repaired rotator cuff but even gentle muscle contractions in uninjured, regional muscles will do the trick. This benefit is amplified when combined with compression. Elevate as much as possible.
*Check with your physician if this freaks you out or if you have an out-of-control immune/inflammatory system (like RA) - NSAIDs may be warranted in some, typically non-musculoskeletal conditions. Seriously though, look at this evidence with an Eagle eye.
Rest: not really an option, we need to move safely when we can. And don't even get me started on the horrors of immobilization
Ice: not nice, kick it to the curb - no thanks I'd like to heal
Compression: absolutely, check this out for more ideas
Movement: yes, safely
People, we have to kick our habit of ice and ibuprofen post-injury/post-surgery. Do NOT let the drag of orthodoxy rear its swollen, ugly head! Just because have always done it doesn't mean we always should.
Pain or stiffness at the bottom of a squat? Unable to get low (NOT Li'l Jon low) for a dig? Bunion throb after running? Do your feet look like Frodo's?
Above is the foot of a collegiate volleyball player and high school national champion. Even big-time athletes have to fix their mechanics. This is a typical athlete that also lacks a significant amount of ankle range into dorsiflexion (bringing the foot back towards the leg). In order to compensate for this during movements requiring a ton of dorsiflexion - like digging, squatting, running, etc. - athletes will turn the foot out and totally collapse the arch in order to still advance the leg over the foot. That's the source of many bunions as well as knee injuries and even hip impingement because of that unstable and collapsed position.
Basically, your body puts up with your crappy range and tries to adjust (even successfully for awhile) but will eventually hand you the bill. So, if you have flat feet, tight ankles, Achilles problems, a history of MCL/ACL injuries - check yourself before you wreck yourself.
Try this - here's betting you'll be in a more powerful , stable foot position to load the lower extremity on-axis during squats, digs, even walking instead of crumpling through that arch and having feet like Frodo.
* Remember rotate your leg to the outside over your foot (squeezing your butt) to cue a stable foot - go for as long as it takes for you to improve, probably a few minutes.
-Seth (feet like Gandalf) Oberst
Today's episode is a brief look at ways to improve core activation through Olympic style lifts. ALL Olympic lifts require a huge amount of core stability, however we will often see athletes do a poor job of organizing their trunk and instead relying on structural rather than active support (like your vertebrae - does your low back ache after push-press or deadlift?)
Even when an athlete has mastered the Two-Hand Rule (as described in video), they often lack lateral stability during landing, running, throwing, etc. which displaces their trunk outside of their base of support causing a large external force in an unstable position - dangerous for the knee. Seriously think about the volleyball players you know who land like this after a serve or guys landing like this during box jumps in Fight Gone Bad, they are the same ones who complain of hip and knee pain!
So to improve lateral trunk control, have the task drive the result you want to see rather than isolate muscles and hope it carries over to skilled activities. The exercises described are a great launching point to improve lateral stability prior to or in addition to moving into landing activities. Get creative, try varying the stimulus from weight/resistance in one arm to having resistance in both arms but while standing on one leg (you get the idea).
Don't be a knucklehead - if you are the person who rocks a manbelly during deadlifts, you need to be organizing your spine like right now prior to doing these exercises.
I have had several athletes (and coaches) ask me about wide grip bench press (i.e. hands more than an inch outside shoulder width) and whether or not it's appropriate to use in the weight room, especially for young lifters.
In order to effectively and safely generate lots of force, we have to cultivate a stable and organized environment rather than rely on our passive structures (joint capsules, ligaments, etc.). The inability to generate sufficient stability in the wide grip bench press is not a good recipe for those attempting to throw up some serious weight.
** I should mention that I am all for changing grip width to vary the stimulus but not at the expense of decreased stability and ultimately decreased performance and skill transfer which is what really pisses us off (not to mention your shoulder and elbows.). My athletes have to demonstrate active stability and excellent shoulder internal rotation range prior to varying grip width.
The other HUGE advantage to setting the shoulders (creating shoulder external rotation against the bar) is that it optimizes the length-tension relationship of the pec major muscle allowing it to have sufficient capacity to contract forcefully throughout the whole range. Google the pec major and you'll see that it's fibers actually spiral onto its insertion on the arm, so by creating an actively stable shoulder we can open up that anterior compartment and take advantage of the pec's considerable cross-sectional area (which increases force). With the wide grip, we lose that tension and you'll see this with an athlete when he's unable to finish at the top of the press.
Seth - power farmer - Oberst
Fellow Power People,
Two items in this inaugural post:
1. The goal here is to be a resource for anyone interested in improving performance and optimizing movement. Look for a combo of video and written posts. Remember if we aren't always pushing the envelope of what we know and how we treat and train, we are stagnant, weak, and slow - don't be that guy! Now, onto the meat of this...
2. As we dive deeper into the performance pool, here is a primer on a few things we need to consider in regards to how we are looking at and training athletic movements. We shall revisit.