My life as a mom is anything but consistent. What is consistent is my life is always changing. Always trying to find and maintain balance. I have found myself divorced at 34, after 14 years of marriage. Never thought that this is where I would be and with three children later. Training for me, even being a personal trainer, has become a challenge. Finding the time around our always changing schedule has been demanding to say the least. I have a wonderful team of lifters at my home gym, NBS Fitness, that I train with who always encourage and push me in the right direction. Lately though, with trying to find what is the new normal for our family, I find I have to train alone earlier in the mornings, late at night or on the weekends. I find that I am inconsistent with my training schedule and I find that mentally hard to swallow. What I am coming to realize though is I have to keep chipping away. By that I mean staying focused and doing the best I can. Not every week or day will go as I want it to right now. This year hasn’t gone as I had wanted or envisioned it to but I will keep chipping away. I will keep showing up, I will keep training and I will keep chipping away. One day I will look back on this and see the lessons I learned. The mental and physical strength I built just by continuing to show up no matter what and never giving up. Do I wish I was sailing easy right now just being able to focus on work and training for another competition? Yes. But for right now I will just keep showing up, grinding and blogging about my journey and experiences with you all, soaking up the lessons. Not everything thing in our life will go perfectly but we can continue to make positive steps forwards instead of backwards and in the end that constant chipping away pays off.
Your support team, the people you surround yourself with, are everything that will help define who you are. I once heard a quote by Tim Tebow saying, “I never surround myself with yes people.” By that he means, he never surrounds himself with people that always tell him yes to every question or issue when he is trying to make a good decision. That has always stood out to me. Do you always want to be around people that will never tell you anything different than what you think? Or who will never tell you when you are going down a path that might not be right for you. We are all on this journey of life together but the people you surround yourself with will help determine the direction you are going. Look at them and see what direction they are going and ask yourself is that the same path for you? Your team will ultimately impact you on the way you think, act and feel in your day to day. You are the product of your environment so if you want to make big changes make sure your support team is top notch and then work hard at cultivating the best version of you. Don’t surround yourself with toxic and negative team members who will add no value in your life. Instead surround yourself with people that challenge the way you think and what you know but also want the best for you. Start there and build yourself an amazing support team. Watch how much of a difference it makes in your ability to thrive and accomplish big goals. I am constantly aware and observant of my support system. Lucky for me, I have grown more in this life than I thought possible. I know that it wasn’t me alone it was from the team in my corner from the beginning.
My Love For The Iron
My fondness for the iron is something I have found to be one of the most beloved things in my life besides my family. So odd how it came to be about. I was taking weekly yoga classes, at a local gym, and up to date on the most recent juices and body detoxes. I was all about being centered and finding my peaceful place. One day a friend and myself decided to venture over to the side of the fitness facility that had all of these amazing machines and free weights. No telling what exercises we actually did but we knew we were having fun and wanted to learn more. A mutual friend invited us to try powerlifting in their garage. So there we went with all kinds of expectations but the one thing I remember more than anything was the sight of that 45lb barbell. We began training and the second my hand wrapped around that bar for the first time, I was forever in love. The constant push it gave me, always challenging me to do more, better, consistently. I found that the iron challenged me mentally in a way I had been longing but didn’t know I needed. It pushed me to expect more from myself every time and when I slacked it definitely let me know it. No lies, no sugar coating. Did you put in enough? Did you follow your training program, nutrition and stress management like you needed to? Accomplish what you so desperately wanted?…. A better, stronger version of me than I thought possible.
I want that gym membership
How can you afford that gym membership?
I found that when I first started on my fitness journey the prices of gym memberships were a little intimidating. Family budgets can be tight and especially for me with three boys. I found myself determined to find a way to make this happen as I knew postponing it would never set me on a pace to reach my goal. My goal was to get in better shape and healthier from the inside out. I have suffered for years from endometriosis which affects 1 in 10 women. That is approximately 176 million women in the world according to endometriosis.org, a global forum for news and information.
Some of the expenses that I personally went over were the amount of money certain medicines cost to maintain my “health” at the time, the amount of money I was spending at Starbucks and my lunch dates with friend
s throughout the week. Did I enjoy my hot cup of Starbucks coffee after my third drop off in the mornings at my children’s schools? YES!! Did I enjoy meeting my favorite people weekly to catch up and delight in the all amazing sushi conveyer belt? YES! I enjoyed these luxuries but I was not enjoying my health and saw I could actually swap those expenses for that gym membership I had been craving. So I decided to shop around, do my research and find the best place to start. I exchanged those expenses that I thought were little but sure added up, and applied that money into hiring the best personal trainer and gym around the Memphis area. I eventually was healthy enough that I no longer needed all of those doctor appointments and medicines. I was also able to hire a nutrition coach. That took my game to a whole new level!
Find out what are you are spending all of your extra money on and apply that into something that will not fade but last hopefully a long and prosperous lifetime.
So many places to start here so let us just pick a few and jump right in! “I am a mom; I don’t have time to exercise anymore. I can’t fit in everything I have to do all day let alone find the time to go to the gym and train.” Bull. That is my answer and it is time as women and mothers we leave that mentality behind. We should accept that it is perfectly okay to take care of ourselves mentally and physically. Taking care of ourselves is a priority, reaching our own physical goals and mentally having the outlet of physical exercise provides are all things we should be doing even as “moms”.
As mothers, we have the role of being caregivers for everyone else and at the same time trying to balance all that comes with life. The constant rushing that starts the second our feet hit the floor till the second we rest our heads at night only to think of the list that starts all over again the next morning. Making sure our children’s emotional needs and physical needs are constantly being met daily as well a spouse and or partner, friends, family and even co-workers can be exhausting enough. So where is the time for us? The answer is you have to make time. Just as you block off times for those important school functions or physical activities that your children participate in. This time, even just an hour, is imperative and should be made a priority. Running ourselves down physically and not making the time for exercise is only setting us up for a poor future in the long run. Research shows exercise reduces the risk of dementia by improving cognitive function, boosting mind function and energy. Exercise decreases our risk of osteoporosis, preventing muscle loss, which is huge for women. The cardiovascular benefits as well should be a key motivating factor to make the necessary time to exercise, with 1 in 4 women dying from heart disease alone. Our children don’t need us just in the short term but the long term and our lifestyle choices are what affects the outcome of that. The “mom” guilt can feel overwhelming as society has made us to feel this way but there is nothing wrong with looking at your future and blocking time to take care of yourself. There is nothing selfish about wanting to see your children grow and maybe even one day your grandchildren grow up healthy and happy. Remember your habits your children are watching and taking notes on.
Watching and helping our children reach their goals is an awesome feeling as a parent but just because we are “moms” doesn’t mean we can’t have goals of our own. Childbirth can change our bodies and mentally that that can take a toll. I hear moms all the time say, “I wish I could look like that.” Or even, “I remember how my body looked before I had my child/children.” While it is true that our bodies may never go back to the way they once were we can get pretty close. What it takes is less complaining and self-pity and more action. That action of working just as hard as you do at everything else and investing back into yourself. It is your life as well and why not be as comfortable as you can be in your own skin? Why not feel and be strong physically? Let go of all the excuses that you are giving yourself and understand it takes action and commitment on your part but you can reach those physical goals you envision in your mind. Make a plan, join a gym, hire a trainer and get started. No more excuses. It is just that simple to start and don’t stop to you reach your goals.
Exercise provides a huge mental outlet that is essential to having that release we seem to never have time for. The constant stress we are under can at times become overwhelming. Physical activity is shown to reduce stress, depression and anxiety. According to the Mayo Clinic, “working out can definitely help you relax and make you feel better, keeping anxiety and depression from coming back.” When you exercise, neurotransmitters and endorphins that ease depression are released. We as moms need this, making us better at being able to enjoy those moments no matter how crazy or hectic life can feel at times. It provides us that release to be better mothers, friends and partners. With the busy lives we all seem to lead now days, who wouldn’t want the mental benefits that come from that break we so desperately need?
So as you see, letting go of all the excuses and making time to exercise even as a “mom” actually can benefit us tremendously. Prioritizing exercise is something that you must do and gaining the physical and mental rewards that come with it are all enough reasons to throw the excuses out of the window. Block it off on your calendar just as you would any other appointment. This is an appointment with yourself you can’t afford to miss. So what are you waiting for? Get motivated, get serious and GET STARTED! NO EXCUSES!
Everywhere you look these days, there’s another scheme at work.
“Get rich quick!”
“Lose 30 lbs in 30 days!!”
“New trick for six pack abs fast!”
Thing is, they’re all bullshit. Now, I know that’s a grand statement. Some things may have some efficacy here and there, but most don’t. You see it in the supplement industry, you see it in pharma, and you see it in rehab.
Whoa. Rehab? Yeah, I said it. Maybe not so much from the specialists, but this culture affects how people expect us to practice.
One of the most frequent questions I get is this: “I hurt X, how long will it take for me to be back lifting heavy?” The single act of hearing that question prompts quite possibly the least thought out response I can muster : “12-16 weeks”. Oftentimes, this may hurt the individual’s feelings. He or she knows I’m a physical therapist, and has heard people say how good I am at what I do. They come to me with stuff so destroyed I can barely wrap my head around it, have been told surgery is the only fix, and ask what I can do to get them back lifting. Here’s the rub: if you have a symptomatic serious injury, and a top notch surgeon says they need to go in there and fix it, I’d typically recommend you listen.
Otherwise, you’ll try all kinds of exercises, working around you injury, thinking it feels better a few weeks later until you try the movement that injured it in the first place, and BOOM, reinjury happens. Then you try something else. All that time could have been spent productively rehabilitating a post-operative repair and have you back in the game far sooner than expected. At this point, I’m sure some of you are thinking I’m a little angry and riled up tonight. Perhaps I am slightly, but I have a perfectly good reason.
At NBS, we have the luxury of amazing trainers and programming minds working hard to make sure the lifters and clients alike are receiving the best possible programming to achieve their goals. You will consistently hear people say “I have never done this, but I’m willing to give it a try.” They BELIEVE in the program and TRUST those at the helm that the process will work. They trust that all those reps, jumps, sore days and the like will add up to improved performance and better living through strength and fitness. It’s almost a no-brainer, and you see that same term bandied about by all those well known coaches across the internet. It’s a growing phenomenon. TRUST THE PROCESS.
Now, I really wish that we could make the same strides in regards to rehab. Nothing comes quickly when it comes to fixing you body. I can make some adjustments, stretch what’s tight, etc and provide rapid relief, but you have to continue to manage that tissue long term or it will go right back to what it was. It’s even more tedious after an operation, unfortunately. For 99.9% of the population which is not genetically elite, it will take time to heal, and then time to strengthen, and then time still before you’re back at it with the iron. Most post-operative reinjuries of repaired tissues happen 6-8 weeks after surgery. Why? Because that’s when things start feeling “normal” again, and people typically ignore their therapists and doctors and try to go back to daily activities at their previous rate. It just doesn’t work that way. You heal at a fairly fixed rate, and other than some exogenous hormones, there’s no way to speed it up. Listen to the timelines and stick to it. The PT will always progress you when they feel the time is right.
My main point with writing this is simple: TRUST THE PROCESS. Most physical therapists coming out of school today have a doctorate. It requires an intensive level of schooling to achieve, and I think that should garner a certain level of respect when we make recommendations to the progress of your rehabilitation. Now, some of us think differently than others, and may introduce certain exercises or activities earlier than others, but the bulk of the process remains the same: the tissue must heal before it can be strengthened. Once it can be strengthened, then one must take particular care to ease back into previous strength based activities or risk reinjuring tissue. Listen to your therapists. TRUST THE PROCESS. We are in the trenches with you trying to get you back up to speed. We want you to be able to compete again. Listen. Learn. Pass on. And once again:
TRUST THE PROCESS.
Stay strong my friends.
Taylor Weglicki, PT, DPT
Owner/Director of Strongman PT, PLLC
“We don’t get stronger in training, we get stronger in recovery.”
-Josh Thigpen, 3x WSM Competitor and author of Cube for Strongman
Everyone knows rest is important. In the midst of this three day holiday weekend, founded on the idea that the workforce needs to rest sometimes, this topic seems particularly poignant. Tips for recovery in the strength game are as wide and varied as home remedies for rashes: there is tons of stuff that is outright false and made up. RICE is no longer the optimal acronym for recovery, ice is barely supported by the research now, and just resting isn’t enough anymore. My hope is to shed a little light on the topic, use a little bit of science, and hopefully give you as the reader/lifter what you need to maximize recovery and accelerate gains.
Passive vs Active
First, I’d like to go ahead and make a distinction between different recovery methods. By my own definition, passive recovery methods are things like simple rest/decreased activity, ice baths, contrast showers, etc; active recovery involves a bit more movement and activity to accomplish similar results. Some define active recovery more along the lines of a workout of lower intensity compared to typical workouts. From my viewpoint, I prefer active recovery in the sense of more functionally active leisure activity. This could mean, sled drags, walking, swimming, or any number of activities that do not involved your particular sport of choice. We’ll go into the how and why here in a second, but first, think about what you’re doing on the days you aren’t in the gym. Seriously. Are you sitting around on the couch watching movies, or is walking the most strenuous activity you’ll experience that day? This will be important for a number of reasons, which I’ll explain.
Work Hard, Play Hard
The powerlifters here at NBS just started a new phase of training, many of the strong(wo)man competitors are gearing up for fall shows, and everyone is getting a little beat up. It happens. We train hard, make gains, and train harder to (in theory) make more gains. Eventually that train stops though, and we begin to out train our capacity to recover. In essence, you have a sink to symbolize the amount of training your body could handle. The size of the drain is your work capacity, and the water inside is all the training you’re doing. If the drain doesn’t adjust in size, there’s only so much you can do before the sink overflows. Recovery methods can serve as an overflow valve, preventing over training and allowing you to keep making progress if done alongside properly programmed training and nutrition.
As all these little aches and pains start to add up, we start looking for reasons to fix it. Not enough calories, mobility sucks, etc, when in reality the problem may simply be we aren’t recovering appropriately. Life gets in the way sometimes, sleep cycles aren’t always perfect, and we have to find a way to supplement our recovery in other avenues. That’s where the idea of active recovery comes into play. There are three primary reasons why I like to prescribe active recovery and limit bracing alternatives for smaller injuries/aches:
Active recovery may help you recover quicker and reduce soreness from the previous workout.
Depending on your goals and how you go about it, active recovery could also let you burn some calories and work on training technique.
And finally active recovery may serve some important psychological benefits not the least of which is that many people simply feel better when they exercise daily; movement is known to be able to elevate mood among other things.
Game Plan for Getting Right
The following are the techniques I personally use and recommend for anyone looking to speed recovery along. I’ve used these successfully on a variety of athletes, including on myself when my primary sport was distance running and now currently for strongman. The methods have been refined somewhat but they work, especially in conjunction with appropriate nutrition, periworkout intake, and training.
1) Contrast Showers – immediately postworkout. 2 to 1 ratio of hot to cold. As many rounds as it takes until you run out of time or start feeling invigorated again. It usually takes me 4-5 rounds of 1 minute as hot as I can tolerate, followed by 30 seconds of as cold as I can tolerate. Always end on a cold round.
2) Foam Rolling – morning after. I know, I wrote the article on avoiding foam rolling. But here’s where it is useful. Hit your muscle groups most trashed from the previous workout about 10-20 passes before you head off to work. Get some fresh blood and nutrition into the tissues.
3) Take A Walk – evening after. Here’s where I let people pick their poison a bit. Spend 20-30 minutes walking at a brisk pace outside. Work up a bit of a sweat. Alternatively, try some lighter sled drags, or if you have to be in the gym, go through some lighter accessory work to bring blood into the area. Make sure and eat beforehand. Some studies are showing it positively affects nutrient partitioning if you do.
And that’s it. It seems simple, because it is. But I promise you’ll be surprised at what all this can do for recovery. If you’re taking the time to supply your body with good sources of fat, carbohydrate, and protein, should you not also do everything you can to make sure all that wonderful fuel makes it to the tissue that needs it?
That’s what I thought. Until next time, stay strong, train hard.
John Taylor Weglicki, PT, DPT
I deal with muscle imbalances all day with my training and massage clients. When people feel an ache or pain they immediately assume the point of discomfort is the problem. What I have learned from my years of practice is that it is not usually the only problem. When someone comes to me for massage on a specific issue I always try to look just above and just below the problem area to determine if there is a bigger issue. While everyone knows the big “sexy” muscles like Lats, Traps, Biceps, etc. they don’t think about the little muscles that help with all the work. Additionally people don’t think about the fascial system that runs throughout the body. “The fascial system surrounds, infuses with, and has the potential to influence profoundly every muscle, bone, nerve, blood vessel, organ, and cell of the body. Fascia also separates, supports, connects, and protects everything.”
When working with massage clients it is always important for me to consider the surrounding tissue to attempt to determine the cause of a client’s complaint. If I only work the specific “problem” area I may be able to elicit a short term period of relief, but the problem will keep returning until the root issue is found. If a client presents with a complaint of pain in their mid traps, I will also check the stability and mobility of their scapula. The trap may be locked in place as a protective mechanism. I also check the client’s pectoral region. Tightened pecs can create an anterior rotation of the shoulder region causing strain on the traps because they are being forced to work harder due to the anterior tilt. This is similar to when you have to smile a lot more than usual. While you may not be using more muscles to smile (this has been studied extensively, but never proven) you will notice that your face will get sore quickly from using muscles that are not used to being active for prolonged periods of time.
I have been working with a client for weeks to help alleviate his hip tightness. A couple of weeks ago he commented that his feet were really hurting as well. I gave him some specific stretches and exercises he should do to help his feet issues. When I saw him next I asked how things were going, and if he had been doing the work I suggested. He had been doing the hip work, but not the work for his feet. He said he doesn’t need to worry about them to squat. This is a perfect example of not looking at the bigger picture. What many people don’t think about is that discomfort in one body part can lead to problems elsewhere in the body. For example, if your foot is hurting you will likely change your gait putting more weight on the opposite leg. This will likely cause a decrease in the mobility of your ankle or for you to walk with your knees more bent than usual. From there your hips will be thrown out of alignment causing low back pain, and hip tightness. Therefore, all of the hard work he and I are doing to open his hips is limited by his foot pain and the problems arising from said pain. While addressing the foot pain will not immediately cure his hip immobility, it will take one more component out of the mix keeping his hips from the mobility he needs.
In short, don’t lose sight of the big picture. Your body works as a unit, and when one thing is not working correctly it can be felt throughout your body. Also, don’t dismiss small aches because the faster you get them fixed the easier it will be, and the less work it will likely require.
1. Myofascial Release – the search for excellence John F. Barnes, P.T.
2. Snopes “Does it really take more muscles to smile?”
Core Training: Revised and Revisited
By John Taylor Weglicki, PT, DPT
Every gym rat and personal trainer has a different outlook on how to train the core musculature. There are countless gadgets and gimmicks on how to get six pack abs. 6 Minute Abs, Ab Rollers, those freaky looking ab chairs, all of them have selling points, and virtually all of them are useless for the strength athlete. Luckily, this article is not going to focus on those. As strength athletes, form follows function, and a six pack is useless if it can’t support heavy weight in such sports. This article spawned out of a need to seek the truth, so to speak: to find the diamond in the rough. There are articles everywhere on what works and what doesn’t, but very little of it has any scientific support.
Recently, I was lucky enough to speak with Benjamin Lee, a gentleman who works with Dr. Stuart McGill, whom many of you will recognize as the “spine guy.” McGill practically wrote the book on the biomechanics of the spine, and his work is very highly regarded in the field of physical therapy and rehabilitation in general. Lee has done some groundbreaking work of his own with comparisons of results of core strengthening protocols in training and non-training subjects, and the results have proven useful not only in my own training, but in that of many of my training partners and clients as well. But before we get into the good stuff, I feel like it’s a good idea to review the anatomy first.
Anatomy and Potential
With regards to the trunk musculature commonly referred to as “abs” and ignoring those muscles of the low back for now (that’s a whole different article), we see 4 primary muscle groups: Rectus Abdominus, External Oblique, Internal Oblique, Transverse Abdominus. The rectus is those muscles you typically see in the fabled “six pack”. Their function primarily is trunk flexion. The external obliques perform lateral flexion. The internal obliques and transverse abdominus primarily perform rotation and lateral flexion. All four groups are paramount in bracing the trunk when performing heavy movements under load. As such, training these groups as “anti- movers” is a significantly better use of training time for the strength athlete.
To address all those who may be wondering, I have nothing against training the abdominal region with various crunches and movements. However, training those muscles strictly for hypertrophy does not necessarily equal stronger muscles. For instance, if you train the abs exclusively with crunch movements, how then will you respond under a heavy squat when you attempt to maximally engage those muscles? If all you’ve trained them for is flexion, I imagine you’ll likely be folded up under that squat. Not exactly the success for which we are looking. So what’s a lifter to do you may ask? That’s where Lee’s work comes in to play.
Gains, Gains, Gains
Lee saw great potential in the use of isometric movements to brace the core musculature, and subsequently strengthen the area to respond better to the pressures of protecting the spine under load. Per his research:
- “Traditionally, dynamic movements such as flexion, lateral bending and twisting core exercise maneuvers are used in training programs; an approach consistent with training the distal limbs where muscular effort is mostly devoted to creating motion. However, knowledge of the functional anatomy of core musculature and spine injury mechanisms questions the use of these types of exercises. Alternative core exercises make use of isometric postures and static bracing to create muscular activation while minimizing spine loads and injury mechanisms linked with movement.” (Lee, 2014)
And as such, Lee posed the following questions in regards to “typical” core training:
- Isometric core exercises are reported to help some people who have low back pain. Is there a short lasting ‘enhanced stiffness’ after performing these exercises?
- Core training regimens use Isometric and Dynamic core exercises to enhance core bracing properties. Is one method superior to the other in terms of enhancing core stiffness?
- If adaptations to core stiffness can be achieved with core exercise, do these adaptations differ between beginners and trained individuals? (Lee, 2014)
What Does It All Mean?
While investigating these questions, Lee discovered some surprising information regarding the use of isometrics in training core musculature, particularly through exercises such as planks, side bridges, and bird dogs.
“Enhancements in core stiffness are thought to subsequently enhance traits such as load bearing ability, pain management and athletic function. The results of short term training give insight into how a short training session performed prior to a load bearing task can make the task safer and easier to perform. The results of long term training show that Isometric training performed over a long duration may induce more permanent enhancements to stiffness and core function.” (Lee, 2014)
Despite some variance secondary to smaller sample sizes and individual response to the training, I think the results speak for themselves: short duration isometrics can be useful prior to sessions (as part of a lifter’s warm up) to establish stiffness in preparation for heavy loads. You can also perform the isometrics as part of a more long term core strengthening program to facilitate more permanent carryover to trunk stiffness and stability, and thus, a healthier spine.
Lay It All Out There
So, this entire discovery is great; now let’s turn it into results:
*Note: all exercises performed in similar fashion, flexing abs and active glute(s) as HARD AS POSSIBLE for entire duration of each rep*
2-3 Rounds, choose Bird Dog, or Plank: 10 seconds on/5 seconds off
Long Term Plan (choose ONE per training day)
- 10s on/5s off Planks, perform 2-3 rounds of 10 reps. Rest 1-2 minutes between rounds.
- 10s on/ 5s off Bird Dogs, 2-3 rounds of 10 reps. Rest 1-2 minutes between rounds.
- 10s on/5s off Side Bridges. Start from knees if too difficult with legs extended. 2 rounds of 10 on each side.
- Russian Death Protocol (if you hate yourself) 10s/5s for the following: 10 reps, 9 reps, 8 reps… all the way to 1 rep. 1-2 mins rest between number rounds. I recommend only using this one in the offseason, and even then, sparingly. It will hurt.
Now go forth, lift heavy, and destroy PR’s.
Taylor Weglicki, PT, DPT
The Battle Of Wounded Elbow: A Case Study of Sorts
Taylor Weglicki, PT, DPT
I decided to take a bit of a different direction with this month’s article. I’ve had an interesting time lately working with some folks on elbow rehab, and beyond the typical “tendonitis” kind of stuff you hear about most frequently. One lifter in particular at NBS has had a hell of a time trying to get everything healed up, and it’s his path to healing that I’ve decided to make the focus of this article. Our outcome is not yet complete, as he’s not completely back to normal yet, but we’re heading that direction. Rehab is often an x+y=z path, but not everyone’s path is. As such, I think it is important to illustrate that when faced with a particularly difficult rehab, the most important thing is to keep trying to move forward. I want to provide a bit of history on the lifter (I have his permission, don’t worry), just to show how every case is not the same, and how important it is to start simple before you get to complex diagnoses (and attempt to major in the minors).
A History of Where He’s Been
The lifter in question competes in powerlifting. He’s competed in a few weight classes at this point, and in multiple meets to boot. He first approached me a few months ago with complaints of elbow pain when squatting. He wasn’t noticing it terribly when pressing, but squats were definitely a trigger for him. Luckily, he is body aware enough that he was able to determine that he was holding the bar more on his wrists than across his back, and subsequently increasing stress on his elbows. Doing a quick assessment, I noticed his external rotation was borderline nonexistent. In a range where you’d expect 90 degrees as “normal” he had maybe 30 degrees without substituting with thoracic extension to gain range. So, we started him on a generalized shoulder mobility program to address this. Should fix the problem right? Wrong.
A Look at Where He’s Heading
So this is when things got interesting. We made huge gains in shoulder mobility, achieving closer to 60 degrees of external rotation cold, as well as improving overhead mobility. All things pointed to his pain should be improving. However, he continued to report pain with pressing. That seemed odd to me, so I began looking for soft tissue entrapment. Yvonna, our resident massage therapist, took up the challenge and began mashing all around shoulder and elbow to hit our typical compression points at the thoracic outlet of the brachial plexus, and also along the radial nerve through the tricep and proximal to the elbow. Upon palpation, our lifter had a band of tissue that seemed to be compressing the radial nerve along the proximal radial tunnel at the olecranon process. He continued with his shoulder mobility programming, and began reporting decreased pain when squatting, but it still remained when pressing. Interesting, right?
Thus, we began getting a little more aggressive. Our Lifter began getting dry needling done along parts of the tricep in an effort to release any of the tissues likely to be causing any source of compression. He began reporting relief of 2-3 days at this point, but then the symptoms and pain would come back. Not exactly the kind of result we were hoping for at this juncture. We tried a few more sessions but the result was the same. It was at this point that I began to sit down at the drawing board, so to speak, and take a look at the big picture at what really could be going on. What I concluded is less than exciting, but, once addressed, will hopefully give us a better look at what the depth of the injury actually is.
An Insight Into What Is To Come
From a neurologic standpoint, our Lifter has not experienced any loss of motor or sensory function in either arm. This would rule out any axonotmesis or neurotmesis type injuries. At this point, my thought is that when he squatted without the shoulder mobility he now has, that maintaining upwards of 500 lbs with regular frequency on both elbows, he experienced some traction injury to the radial nerve. This would make sense, as the flexed position you maintain when squatting is more of an open packed position for that joint (compared with lockout on the bench, for example). I’d classify the type of injury as likely a neuropraxia, which is the most mild form of nerve injury that luckily allows for full healing. It can take up to 6-9 week for full function to return from initial onset of injury, but therein lies our problem: our Lifter may have injured the radial nerve on both elbows MULTIPLE times before we discovered the issue. Thus, we currently can’t determine the exact healing time on the injury because of the lack of a definite initial onset.
As such, I’ve realized we might be beyond conservative measures that I as a PT can provide (along with my fellow therapists from different fields). Currently, I’m hoping to get this Lifter in to get a nerve conduction study to determine what the depth of the injury actually is. Thus, we could determine our time until we reach healing, and possibly get him back to functional levels faster than if we just continue on our current path. The key to success as a physical therapist is being able to understand differential diagnoses of a particular problem or injury, and know when to refer out for treatment. Hopefully we can get this Lifter to see a neurologist with a good understanding of sport related nerve injuries, and get him on the path to wellness.
That said, he will continue to maintain his mobility to prevent any further loss of function. That’s a given.
If you have questions, concerns, comments, or cries of outrage, let me know in the comments.
Taylor Weglicki, PT, DPT
There are a multitude of forms of massage available to choose from: Swedish, Thai, Hot Stones, etc. While most people know the most common massage style (Swedish), sometimes referred to as relaxation massage, the style I find most beneficial to my clients (both athletes and non-athletes) is therapeutic massage. During a therapeutic massage session the Licensed Massage Therapist (LMT) works to alleviate their client’s major area of concern, within the time allotted. They can use various massage techniques depending on how the client’s muscles respond. In addition the therapist may choose to incorporate lotions like Bio Freeze or Cryoderm, or massage tools like hot/cold stones, hot packs, and special therapy balls to relieve tension as well as increase blood flow to the area worked. Therapeutic massage can be performed in 20 minute, 60 minute, or longer sessions depending on the client’s need and the areas to be addressed.
During a 20 minute session focus is generally limited to one or two smaller areas, i.e. neck and shoulder girdle, low back and glutes, forearms, post workout stretching, etc. Therapeutic massage is generally started with a medium pressure to palpate the condition of the muscle tissue to be worked. From there the therapist can use deeper more directed pressure to break up knots found and loosen tight muscles, perform various stretches, or simply continue with moderate pressure if it is obtaining the desired result.
60 minute massage sessions can be full body or concentrated on specific areas of concern which are significant problem areas requiring more detailed work. The areas to be worked are always discussed before the massage begins in order to make sure the needs of the client are addressed. There is never a set “pattern” followed because one area may need more or less work than the same area on the other side of the client’s body.
Longer sessions are very useful with clients who train heavy or have significantly more muscle mass than the general population, i.e. power lifters, body builders, distance athletes, etc. The longer session allows more time to do full body massage, and generally allows for extra concentrated work in one specific area.
Communication is the most important thing remember when getting a massage of any type. Discuss your goals with your therapist. We can tell when muscles are tight, but you may not be as bothered by one area as you are with another. Be open about massage pressure during the massage whether you would like more pressure, or less pressure. A good therapist looks for signs that the pressure is adequate, but that does not mean it is what the client wants.
Therapeutic massage is optimal for non-athletes and athletes alike because it can be tailored to the specific needs and time requirements of each client. Whether it is a specific area that is keeping you from performing your daily routine, decreased range of motion preventing you from hitting a major lift, or just overall recovery from the stresses you put on your body. Therapeutic massage is just another “tool” in the arsenal available to get you living optimally.
A Treatise Against Foam Rolling
Taylor Weglicki, PT, DPT
For some time now, mobility has been taking the fitness industry by storm. Everyone is too tight, we sit like crap, we move like crap, and only the foam roller and mobility workouts of the day can fix it. Now before everyone jumps down my throat about this, remember: it’s only a tool for the tool box. The way you hear some people bandy about on the internet, foam rolling/mwod could cure cancer.
I’m not saying that neither of these options is useful. Quite the opposite really: they can be amazingly useful, but only if done right. Mobilizing every day is useful for the absurdly tight with terrible movement patterns, and I often use this with my own patients – but only in 1-2 week intervals. Mobilize everything, everyday, and soon you’ll be dumping torque and tightness left and right. Literally.
My goal for this article is to discuss foam rolling in particular: why it’s good, why it’s bad, and why you should honestly think about why the hell you’re using it. This process in my own training resulted in a complete revolution in my warmup, and subsequently considerably less pain before, during, and after training. I’m hoping this article can help do the same for you. Now let’s get down to it.
Look at him. So supple. I bet he foam rolls every day.
Get Your Learn On
First thing’s first. The Science. Yeah, we fancy, huh? So, the scientific term for foam rolling is SMR, or self myofascial release. It’s a nifty style of soft tissue work often used by chiropractors, massage therapists, and physical therapists for a particular purpose: INHIBITION. You read correctly folks, inhibition. So what about all those minutes of foam rolling you’re doing before your workout? That work is essentially turning off the muscle groups through a concept known as autogenic inhibition(1). Many people have experienced this in a different way. Everyone knows the feeling of going for a max effort attempt, and then suddenly it seems like your body simply shuts off. That right there, folks, is the activation of the autogenic inhibition reflex from the Golgi tendon organ to prevent muscle tearing, thus inhibiting the muscle and “saving” it.
The development of high tension is the key. Therapist will often use focal point tension on trigger points to elicit the same effect. Trigger point work feels like hell (as can foam rolling, but it’s highly effective when used properly. It can be therapeutic, but can also be detrimental to your performance. You do something similar when you foam roll at length. That’s why those nasty spots that feel so bad when you’re rolling suddenly seem to relax and feel better. You’ve inhibited the tissue and caused it to ease up on its focal point contraction.
Knowing Is Half the Battle
How many of you go attempt a max deadlift after a massage session? Or get under the bar for a record setting squat after being adjusted by the chiropractor? Hopefully at this point the NBS team has taught you better than that. You shouldn’t do it. If you go attempt to straight in to heavy work after inhibiting primary structures, something is going to fail. Could be muscular, could be ligamentous, but something will fail. On a similar note, then, why do you foam roll before a heavy workout? Why?
My major point here is this: THINK about why you’re warming up. Are you doing a particular thing for a purpose? Or because you read it was useful somewhere on the internet? Inhibition can serve to help us in certain circumstances, but gone (should be) are the days of foam rolling from head to toe for 20 minutes prior to training. It doesn’t make sense. So stop it, and attack your warm-up from a different angle. David and I both have options that should work pretty well. Feel free to come talk to us and ask. Or read any of David’s articles really.
But I Love It, and Can’t “Let It Go”
She can let it go. But does she even lift?
I’m not saying you have to give up your precious foam rolling completely. Not at all. I’m just saying use that noggin’ of yours and make sure you’re doing it with a purpose. On training days? Use it only to inhibit that which needs inhibiting. In most lifters, you’re looking at IT Bands, maybe adductors, and maybe calves. That’s it. Don’t stretch your back over the roller, don’t pop your midback on the roller before a workout. Just don’t. Mobilize intelligently and with a purpose. Best times to go all in on the foam roller are after meets, during deloads, or on off days. Feel free to roll the snot out of everything after you can after a rough ME day. Just be smart about what you’re doing on the days that you train. Your body will feel better, and you’ll perform better as a result.
Now get in there and lift heavy.
Questions? Comments? Concerns? Cries of Outrage? Leave them in the comments section below!
I’ve been getting a ton of questions in the gym lately in regards to shoulder issues. The powerlifters are gearing back up for another meet and things are getting heavy again, the strongmen are working the press hard again, and so all the nasty issues, aches, and pains start to rear their ugly heads once more.
“My elbows kill me when I squat, and then get worse when I bench”
“How come my shoulder hurts when I deadlift?”
“Do you know anything I can do to keep my shoulder from feeling like crap when I bench?”
And the list goes on.
SO WHAT’S THIS ALL ABOUT?
Thing is, in the large majority of cases at NBS, the answer is simply this: lack of mobility. So far I’ve talked to one lifter who had a torn labrum, which is an entirely different issue. Damaged structures may need surgical management. There are ways around surgery, sure, but those in general are for the mortals who don’t lift stupidly heavy things for fun. For those who train heavy, hard, and often, if it’s torn bad enough, you might as well get the surgery and rehab out of the way and get back to training. Hence your own “bloody mess” to deal with.
But mobility? You can fix that. You just have to be dedicated enough to do it. And no, I’m not talking about a 30 minute warm-up that requires a protein shake to make it through before you begin your actual training session. That’s just silly, and is the source of a major pet peeve of mine (for another article though). 15 minutes should be more than enough to get you ready to train. That said, you should probably be spending another 10-15 minutes throughout the day working on your weakest/tightest structures to ensure progress. I try to make it a point to address hip flexors and my shoulder ER almost every day, and I’d hazard to guess that the vast majority of lifters at NBS and elsewhere could benefit from doing the same.
ANATOMY OF A BEAST
So the shoulder is a particularly difficult structure to wrap your head around if you haven’t been in any healthcare classes before. I could post pictures and talk about individual muscle groups, but in my opinion, that’s a little much. I don’t need to prove to you that I know science-y stuff. To keep it simple, we’ll talk about basic movements: 1) Supination and pronation at wrist/elbow; 2) Internal and external rotation at the shoulder; 3) Flexion overhead at the shoulder without thoracic substitution.
Remember this: in order to have the mobility to reach every which way, you end up sacrificing stability to some degree. Or, conversely in the case of many lifters, to gain stability, your muscles and connective tissues tighten down so much you lose mobility.
I’ll put it another way: can you reach your arm behind your back and scratch just below your shoulder blades? No? Benching will probably end up being pretty nasty for you then. Can’t fully supinate your wrist or externally rotate your shoulder? Deadlifting with an alternate grip is going to be a ticking time bomb for you.
Now don’t take this the wrong way, I’m not saying you need to be Gumby to bench or deadlift well. Far from it! However, if you can’t move well through the pattern of a press, how well do you really expect it to go when you load it up heavy and try the same thing? Same with the deadlift: if you can’t get your hand all the way into position for an alternate grip without weight, then what is a max attempt doing to the tissues in your shoulder? So, my solution is this: try this mobility routine I’m going to outline for you. Do this each and every time before you press. You may even want to do the overhead band mobilization before you squat or deadlift too.
THE PROGRAM YOU’LL HATE (LOVE?) ME FOR
1) LAX Ball Pec & Under Clavicle Areas
a. 1-2 minutes to each area listed
b. Find a spot that feels awful, then hold for ~10 seconds or until it becomes painful
c. Remember “hurts so good” does not equal “pain”!
2) Overhead Band Mobilization
a. Toss a grey band over a squat rack
b. Stick your hand in, rotate thumb to ceiling and sit back like a squat.
c. Do your best to keep your rib cage down. You want a straight line between arm shoulder and torso.
d. Don’t force it, but this one will be uncomfortable. 2 minutes each arm to start.
3) Internal Rotation Walk Aways
a. Find a column, rack, or piece of sturdy equipment to grab onto.
b. Facing away from structure, reach hand behind back and grab structure.
c. Squeeze Shoulder Blades together.
i. Most should feel a significant stretch here. If so, 2 mins each arm.
d. If no major stretch, Keep shoulder blades squeeze and gently step away from structure until you feel a stretch.
i. Hold here for 2 mins each arm.
THUS, ERGO, CONCORDANTLY
Boom. Done. Finito. That’s it. 10 minutes of your time to mobilize most major shoulder structures and get things ready to move. Now if you stick to this honestly and are still having problems, let me know and we can work out a more specific mobility program suited to your needs. Or I’ll be able to tell you if the problem is beyond conservative management. Either way, at least you’ll be on your way to better shoulder health, and hopefully bigger numbers as well.
Stay Hungry, My Friends.
Taylor Weglicki, PT