For this week's post I wanted to feature an article written by my friend Dr. Dan Pope of FitnessPainFree.com. This guy has some great ideas on functional assessments and correctives and this piece on the deadlift pattern is one of them. Dan has some of the best information out there on improving performance, optimizing programming, and increasing training longevity. Not to mention he's a beast of a CrossFit athlete himself.

We all know how important it is to keep a neutral spine while deadlifting. For most, just cueing to keep your back flat is enough to square things away and get the spine in a neutral position.  For others it’s not so easy.  If you’ve coached people in Olympic lifts or deadlifting for long enough you’ve probably encountered this.

For some athletes as they reach the bottom of the deadlift, their lumbar spine starts to round.  It’s even worse with a snatch grip or deficit deadlift.  Your first intuition is to tell the athlete to keep their back flat.  Then their snatch or deadlift ends up looking like this:

These exercises can be performed as often as you’d like (I tell my patients to perform them twice per day for best results with the exception of the eccentrics).  Make sure you test your snatch grip deadlift before and after to ensure you’re making a change with the exercises.


Seth's thoughts: I love the systematic assessment and correctives laid out here by Dan. As he says, it is crucial to maintain a neutral spine throughout in order to optimize position and ensure efficient mechanics. Those who are able to maintain neutral spine under load are those who can lift more weight and maintain longevity, period. Loss of neutrality is a dead giveaway for performance loss and injury risk.

For more from Dr. Dan Pope check out his most excellent website at FitnessPainFree.com

- Seth

P.S. My last post on grip training and hacking the nervous system was extremely popular - thanks for the readership fellow performance junkies! Expect more on how to hack the nervous system and optimize adaptation in future posts.

Movement baselines, or the minimum movements necessary for human function and performance, are essential to efficiency and resiliency. The inability to perform basic movements set us up for failure down the road as I believe it lowers the ceiling on performance and movement efficiency.  You can buffer large loads and high reps with poor movement for a while, sometimes even a long while, right up until you can't. Taking some time to work on these basic movements can improve system adaptability and ultimately improve performance. 

The hip hinge is one of these baseline movements. The ability to load the posterior chain without compromising the spine and lower extremity sets up the system for optimal loading patterns. I continue to be amazed at how many athletes (from the strong to the injured) seem to be unable to adequately perform a hip hinge. Certainly, I see it often in those with spine, hip, and knee dysfunction. Those who are unable to dissociate the spine from the hips and the hips from the knees are leaving a ton of potential on the table and are probably gonna get hurt, bro. Those who ARE able to perform this well typically have great pulling mechanics and are able to effectively load order the squat, something I've discussed in detail previously. 

The hip hinge is a prerequisite movement for so many patterns: squat, deadlift, jumping, going from sit to stand, running (think single-leg hip hinge). So rather than always skipping ahead to those movements our best bet is to master the movement baselines so that each rep of the more advanced patterns makes you better, not worse! 

This is primarily a motor control exercise of spine and pelvis, which should always be prioritized. After even brief work with the hip hinge, we can see marked improvements in squatting and pulling patterns. The hip hinge is a great movement to teach because of its scalability (all patterns should be scalable). You can add bands around the knee for a knees-out cue, and we can add speed, range, and load to challenge the movement.  
Using an external focus will help with skill retention and transfer. Progressing to a single-leg hip hinge is an excellent lateralization for training pistols. In the rehab setting, hip hinging is extremely effective as a preliminary closed-chain rehab intervention for those with spine or knee dysfunction because restoring movement patterns tends to re-map and resolve pain. It seems like I am teaching this to almost every person with problems at the spine or below with excellent results. 

**It is crucial to pay attention to the details here. Mastering this movement gives a schema to understand how to load the hips while bracing and stabilizing the spine. Any change in the curvature of the spine during the motion or premature knee flexion is a fault and must be corrected with a proper breathing and bracing strategy.**

Here's more on the why:

A good starting stance is individual depending on each person's motor control and anatomical alignment. 

Bottomline: Take 5 minutes to work on this movement pre-workout (just add it into your warm-up). Many will be surprised at how much of a struggle it is to maintain a neutral spine while flexing at the hips and maintaining vertical shins. Try it prior to a pulling or squat pattern and see if movement quality improves and pain resolves. 

-Seth

In case you missed it, here is the piece I wrote for my buddy Dr. Dan Pope's site FitnessPainFree.com:

Proper squatting forms the basis of any performance system and is essential to meaningful function as an athlete and human - which includes the elderly (might need to scale though, bro). As an athlete and as a practitioner who treats fellow CrossFitters frequently, one of the things I love is the emphasis on the squat pattern. But with high squatting volume in any performance system we need to ensure it’s reproducible. 


I understand and share the pride that comes with the ability to squat deep while lifting some serious weight. However, many athletes are unable to squat deep with load due to hip or low back pain. Femoral-acetabular impingement is often the culprit here, where the neck of the femur is literally jamming into the acetabulum of the pelvis. Dan goes into much greater detail in one of his prior posts on FAI. These same biomechanics also cause butt winking where there is a reversal of the lumbar spine causing a loss of segmental control. This spinal shear under load is dangerous and never okay - a butt wink is an immediate fault and nobody gets a pass. Altering squat width is a strong start to fixing these train wrecks. 


So how do we determine best squat width for depth and performance (and to help prevent hip pain and butt winking)? “Shoulder width” is often used however that differs for each individual. Many times we just start with a random width and that becomes the default. However, factors such as motor control of the entire system (particularly the over-extended spine), hip and ankle mobility, and individual structural differences in acetabulum and femur alignment all influence squat width and depth. 


The sooner the femur runs into the pelvis, the less depth you’ll achieve and squat numbers will plateau. But you don’t need an x-ray to determine how you should squat. Rather, we need to find the best squat width that allows the most depth while maintaining movement integrity (such as a neutral spine). The best position yields the best performance and the fewest injuries. The test below helps find where these limitations are least restrictive and determines the best starting squat width. 


I like this test (originally from Dr. Stu McGill, spine biomechanist) as a screen for new lifters, those who are having hip or low back pain, and athletes whose squat numbers are plateauing. 

Things to consider with this test:
1)    Performing this test on your hands and knees allows you to assess the hip and core without bringing other structures into the equation.  You’re also performing this in an unloaded position (i.e. not standing) which helps eliminate movement inefficiencies you might find while standing.
 
2)   Demonstrates lumbopelvic motor control. If a strong contraction of the anterior core allows greater depth prior to butt winking or decreases pinching in the front of the hip, motor control deficits are present. This is not an anatomical variation, you need to improve trunk stiffness as the lumbar spine is over-extended causing the pelvis and femur to meet prematurely. In so many cases, we can prevent butt winking and un-impinge the hip with appropriate movement patterns and control rather than rushing to surgery to correct bony deformities. Improve motor control first and foremost regardless of structure.

3)    Once you’ve found the width that allows the most depth without impinging or butt winking, this is where you should start when squatting. Can use this screen for those new to squatting as a way to determine the most effective width to start while you work on motor control and mobility to allow for a variable squat program.


4)    Those who show poor motor control in this test and have hip or low back pain will most likely need to correct this for successful rehabilitation and return to squatting.

So ultimately, what is the best squat width? The one that allows the best depth while preserving a neutral spine. Regardless of starting squat width or structural variation, this does NOT change the essential movement principles of the squat. Feet should be straight, knees tracking over the foot, shins vertical as possible for as long as possible, hips externally-rotated. You MUST prioritize and control the lumbar spine and pelvis, above all else. In my opinion, the ability to control the spine and pelvis is a prime determinant in the performance ceiling of athletics and human function so don’t lower that ceiling with improper movement patterns. Squat depth and width do not matter if these principles are not upheld. 

Acknowledge what we can’t change (structural alignment), optimize the many variables we can change including squat width, and then vary it for an effective motor program.

- Seth

In Part 1 of this series, I discussed how mouth breathing can alter head-neck control. In Part 2, we talked breathing during max effort. And as we discussed, holding your breath (with appropriate mechanics) is a natural, physiologic method for maximizing spinal stiffness and force output under very heavy loads. However, holding your breath during repetitive movements is not only metabolically costly, it is also mechanically inefficient - and most of our daily movements involve the need to breathe under sub-maximal load and for more than one repetition. So for Part 3, we need to establish how to breathe during high-repetition, serial movements without loss of mechanics.

Ever see someone take a huge breath of air to pick their shoe up off the ground? Or to rep out pull-ups - only to gasp for air midway thru and totally over-extend their spine? We see it all the time but, assuming the weight of the shoe isn't their one-rep max, this is not normal. As I mentioned last week, those with low back pain have been found to hold more air in their lungs during sub-maximal lifting. Why? It's likely they are unable to dissociate diaphragmatic breathing (belly breathing in which the diaphragm descends into the abdominal cavity) with movement thus making every movement a max effort one as they lack a proper global bracing strategy. 

The diaphragm has a dual role during movement as it not only drives respiration, but also assists in spinal control. In movements that require breathing while still under load, the diaphragm is often underused as a stabilizer due to it's mechanical attachments to the thoracolumbar spine and by increasing intra-abdominal pressure. This may work for max efforts but as soon as we have to take a breath, neutral spine position is lost and mechanics break down. Athletes will attempt to combat this when they need to breathe by inconsistently using their diaphragm as a stabilizer and instead gulp air into their chest and neck. This is highly inefficient as demonstrated in those with asthma - heavy chest/neck breathers - who have markedly higher levels of work associated with breathing. 

Some hallmarks of faulty bracing: the athlete inhales with an apical breath → traps the air in the upper chest → performs a few repetitions then gasps for air → loss of neutral spine then occurs while still under load commonly into overextension  → unable to reconstitute spinal stiffness while still under load (pathologic neutral)

To move more efficiently we need to have a global bracing strategy during high-rep movements (which, face it, submax repetitive movements are what make up daily life and most athletic movements) in which spinal control is never lost and efficiency is high.  

Here's a simple and effective breathing/bracing strategy

• Take a diaphragmatic breath (belly breath) - this takes practice (see Part 1) as many athletes, especially those with history of asthma, LBP, etc. really struggle with this. *Diaphragm is accessed
• Near the end of inspiration, increase abdominal muscle tension. As you exhale, think about squeezing the air out and crushing the toothpick (see Part 2) or wringing out the air with your abs (this is when abdominal and glute tension is the highest). *Canister on max tension - this is when the majority of the movement is performed
• Take one or two small breaths into the diaphragm by slightly reducing abdominal tension, allowing the diaphragm to descend while still in a compressed system. This will increase intra-abdominal pressure and allow the diaphragm to assist in stabilization while the abdominals are at slightly reduced tension. *Spinal stiffness maintained during the next breath

Think about breathing into a steel canister - this will allow breathing to occur where it's most effective (the diaphragm) without having to reconstitute spinal stiffness after each breath. The goal is to never lose position nor stiffness, while still being able to breathe under load. Chest breathing will accompany this when demand requires it - and that's okay to supplement the diaphragmatic breathing - but a proper bracing strategy will always apply. This will take some time and mental energy to master during training but will pay dividends in terms of injury prevention and performance (which are synonymous in my opinion).

There a ton of advanced breathing assessments and techniques out there but we can lop off a lot of dysfunction if we follow this basic principle of an appropriate and reproducible breathing/bracing strategy. 

- Seth

In Part 1, I discussed why mouth breathing destabilizes the entire upper body via the loss of packed neck position. In Part 2 of this series on breathing and performance, we need to discuss breathing under max load. There is a growing interest in breathing mechanics and how it relates to human performance. The ultimate goal is to maintain stiffness and spinal control under load and breathing has a huge influence on these variables.

Here's the deal: The abdomen is essentially a canister with the diaphragm as the lid, the pelvic floor as the bottom, and the spine running thru it (think banana with a toothpick stuck thru it). There are 85(!) joints within this canister - all of which need to be appropriately controlled because as soon as we see a shearing or translational movement across these joints, force production is altered - a big problem when going for maximum effort.

So how do we stabilize under maximum load? We hold our breath.

Ever see someone take a huge breath of air and hold it when trying to push a wagon full of hay (okay that's a reference to me growing up on a farm) or lifting a couch. Of course you have, this is a normal physiologic response to a max effort - I dare you to push a car without this strategy.  With normal descent of the diaphragm, air fills the lungs and intra-abdominal pressure increases outward in all directions. By tightening down the abdominals, we simultaneously counter these forces with a global abdominal contraction directed inwards. Squeezing the glutes pulls up the floor of the canister - do not forget that the glutes need to be engaged prior to and during max efforts (glute insufficiency is a major culprit in stress incontinence). This dynamic stabilization allows equalized pressure across the spine to actively control and mitigate shear forces across the spine. This system also upregulates the nervous system for increased force output and increases heart rate and blood pressure, keeping tissues perfused and preventing you from passing out - great for that max performance.

This is important: you must counter the increased pressure from the held-in air with a STRONG abdominal contraction, otherwise you are only partially stabilized. This is probably why those with low back pain hold more air in their lungs during lifts - they lack a proper global bracing strategy with the abdominals and glutes and attempt to rely more on intra-abdominal pressure created from the greater volume of air. As a cue for global bracing, think about crushing the toothpick from all directions or tightening down on your spine. When do we see failed lifts or less than optimal max jumps? Often, it's when the athlete has exhaled too quickly prior to finishing the movement, throwing a destabilizing wrench into the system. Ask any accomplished powerlifter and they will tell you it takes considerable practice to brace under load. Doing heavy abdominal work, like tons of crunches, will NOT improve your ability to sustain and maintain intra-abdominal pressure - it's a completely different motor pattern.

Is holding your breath under max loads a good idea for those with a heart or vascular condition? Not so much (and I question whether they should be performing max lifts in the first-place) which is probably why you've heard of the cue to exhale during the concentric phase of a movement. In normal, healthy populations the breath-holding technique actually likely decreases the likelihood of blowing out a blood vessel by reducing the pressure gradient.  Thus, holding your breath under max load (Valsalva maneuver) is the best and safest way for healthy athletes to generate maximum stability for competition-level max efforts (vertical jump, Olympic lifts, taking a punch) without the need to take another breath.

But what about when we do need to take another breath?: While breath-holding is a physiologic response to max effort, what about submaximal efforts - like high-rep or serial movements - the ones we typically use in training and activities of daily living? We can't just hold our breath for these movements, otherwise you'd creep people out with a blue face while standing up from your desk chair - not to mention lose spinal control with each breath.

These serial, submaximal efforts are where mechanics break down and an effective diaphragmatic breathing and bracing pattern is crucial - we will address this in Part 3!

-Seth

In the past few weeks I have seen numerous athletes with jaw pain or TMJd (temporomandibular joint dysfunction- Google it for more general knowledge). In all cases, they had chronic forward head positioning particularly exacerbated with heavy exertion. We see this often with athletes, the head juts forward (aka chicken neck) when concentration is diverted towards completing the movement (particularly with overhead movements and lifts such as the overhead squat, snatch, pull-ups, throwing). This forward head protrusion is also clearly a postural fault seen in daily life, particularly those deskbound at work. There is some research to support head-neck posturing and jaw dysfunction. And most importantly, forward head/ugly posture decreases your attractiveness (but you probably already knew that, Quasimodo).

Anatomically,  a forward head changes the line of pull of several muscles (the infrahyoids) running from the mandible (lower jaw bone) to the sternum and even the scapula. This new alignment causes an altered pull on the jaw jamming up the delicate, sensitive disk within the TMJ. So if we're adding poor control of the head (forward head posture is an open, unstable position) to an altered and weak jaw alignment, the result is an ugly - literally - and painful TMJ.  The real problem is that coaches and athletes are NOT paying nearly enough attention to head position and it's impact on the jaw. Especially when athletes are biting down hard, adding huge compressive loads to a poor jaw position in an effort to close the circuit and gain stability.

Here's the fix:

• Prioritize and pay attention to head-neck positioning! You should have a packed neck position (meaning chin back and down, vertebrae stacked on top of each other) at all times - honestly I cannot think of reason where a forward head, chicken neck necessary. This is especially important during lifts as chicken necking to finish out a pull-up is not helping you, amigo.
  
• The jaw's natural resting position is slightly open (lips closed) with the tongue gently on the roof of the mouth behind the teeth (say "nine" and you've found it).
  
• Ask yourself or your athlete while practicing a movement or skill...How are the head and jaw positioned? We need to be more positionally aware people!

As with prior posts on prioritizing spinal position, proper head and jaw position is crucial to avoid injury and stabilize movements.

Thoughts? What are some cues you use to fix the dreaded chicken neck position?

- Seth

This week's post is a short explanation on why we need to prioritize motor control, particularly of the spine, in our tight and restricted athletes. The tendency is often to look right at the joint or muscles that appear tight. Can't bend over? Must be the hamstrings. Can't follow through with the golf club or baseball bat? Must be tight hips. Well maybe, but it's also likely that underlying poor motor control of the spine is  negatively affecting mobility and ultimately performance of the extremities and spine.

There is some compelling research by Moreside and McGill (click here for the article) in which they improved hip range of motion by stretching (the hip itself as well as the myofascial components). Makes sense, right? But here's the interesting part: another group performed only core endurance and control exercises and didn't stretch the hip at all - and hip rotation improved. A third group stretched and stabilized - no surprise they improved hip range the most. Why does this matter, besides being pretty cool? Well those with low back pain have been found to have MORE lumbar and pelvis motion during hip rotation which increases dangerous shearing forces across the spine (by the way, the spine was built to handle lots of compression but not so much with the shearing stuff). Hip-spine dissociation then becomes critical in which the stiffened spine allows improved realization of hip motion and power - improving performance.

While this hasn't been explicitly studied in other body regions, I believe there is a significant neuromotor, self-protective event occurring - the nervous system limits joint motion in response to poor dynamic control of the spine. The result is what appears to be tight hips, tight hamstrings, tight shoulders but really may be a vicious cycle in which poor spine control causes poor extremity control and a reactive tightening or fixating of the tissues downstream ultimately causing altered movement of the spine - won't be long before your back hurts. Not to mention excellent hip mobility is necessary for nearly all athletic movements.

What does this all mean? Put simply, organize your spine and prioritize control AND set-up. Getting into a flexed, bent-over spine position prior to swinging a golf club is difficult to overcome once you then load that system. Providing a stable platform to work from (again, proximal stability yields distal mobility) by getting the athlete into a good and repeatable position, along with some selective motor control exercises aimed at separating spinal movement from hip movement, will go a long ways to improve performance. Decreasing load and prioritizing quality is essential especially when learning or tweaking your skill or movement. We've discussed prioritizing spinal control with shoulder performance previously.

Bottomline: Improving spinal control (no, not sit-ups/crunches but functional positions with progressive core demands) and being hyper-aware of spinal positioning before and during movement can help improve extremity control and performance and will certainly augment your ongoing mobility work. Here's a prior piece we did on improving hip rotation mobility in swinging athletes.

-Seth

Shoulder pain is the 3rd most common orthopedic complaint (behind the low back and knee) and it's no wonder considering how so many of the sports, exercises, and skills we perform are 'shoulder expensive'. Olympic lifts, volleyball, throwing sports, swimming all require a tremendous combination of mobility and stability at the shoulder joint itself as well as the scapulothoracic articulation (though it's not a true joint, people, just the interaction between scapula and thorax). Classic interventions/corrective exercises target the rotator cuff  and potentially the periscapular muscles - though it is surprising (disappointing) how many physios will neglect even this. However, the purpose of this post is to draw attention to how screwed up your lumbar spine position is with overhead tasks and it's impact on shoulder mechanics. Check it:

Here's the deal: Before we can even attempt to fix your messed up shoulder we first have to look at the ability to globally control the midline. Last week's post is a good start in looking at motor control and stability though it doesn't account for the extreme demands on the torso seen in overhead positioning. Without accounting for the ribcage flying open due poor control of the spine, our best efforts to fix the shoulder are thwarted by the undue loads placed upon it due to lack of spine control. We can get the scapula under control, mobilize the thoracic spine, and optimize the rotator cuff, but once we go back to throwing, pressing, or spiking all is lost if midline control is compromised. Not to mention loading an overextended spine is dangerous for the facets (hello spondy) and nerve roots being crushed by the vertebrae above.

But most importantly, this robs force generation and power production. Minimal active tension prevents control at the end-ranges where we need it most. Want a stronger spike, faster pitch, better push-press? Proximal stability will buffer poor mechanics much better than a soft spinal position. Otherwise we're just blowing through our much smaller engines at the shoulder and elbow and asking them to do what they aren't built for.

Try it yourself: take your arm up overhead. If you can't get your arm to your ear (with your elbow straight!) without flying open and exposing your rib cage, then there's a problem. Why is it a problem? Well if your a thrower, opening up too soon alters the load to the shoulder and elbow - there's a ton in the pitching mechanics world about the detriments of opening too soon and over-extending. It also changes the positional relationship between the arm and torso and can cause excess anterior translation of the humeral head (not good for your labrum and biceps tendon) making it more difficult to actively stabilize the shoulder - particularly in Olympic lifters and overhead pressers.

Key Point: The question then becomes, is the athlete flying open because their thoracic spine is stiff? Maybe but if they're over-extended then they're.... over-extended. Fix this first then we can address the t-spine. Otherwise the learned pathomechanical motor pattern remains, such that even if we do loosen up the thoracic spine the athlete will not likely utilize this new range during the task. As evidenced in the hip by Dr. Stuart McGill, a must read. We need to organize before and while we mobilize! The athlete can loosen up the thoracic spine as much as they want (and I do think that thoracic spine mobility is hugely important) but without the training to overcome the hundreds or thousands of reps they performed overextended, the carry-over will be minimal.

You will be shocked at how organizing your spine (squeezing your butt and bracing the abs) generates much more stability and power with overhead tasks. Try an active brace while holding something overhead, you literally feel the difference. One point I should make - this often feels weird for athletes who are used to being so over-extended. They feel as if they are pitched forward (another indication their sense of midline control is lost). Hollow rocking is a great way to initiate anterior core function while making the connection to overhead position prior to reloading the athlete overhead. Nothing in sport happens statically, so we need to progress to dynamic isolation quickly where possible.

Bottomline: organize your lumbar spine and pelvis first (noticing a theme here from previous posts?) then we can address the thoracic spine, scapula, and rotator cuff when dealing with overhead positioning. More to come....

-Seth

Here's a quick vid on hollow rocks:

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.

-Seth

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!

-Seth