Stuff You Should Read: 4/25/11

Written on April 25, 2011 at 5:19 am, by Eric Cressey

To kick off the week, here’s a quick rundown of things you might like to read (or watch):

The 5 Most Common Deadlift Mistakes – I published this blog at Men’s Health last week, and thought I’d give you a heads-up on it.  It’s a good tag-along to the FREE video I provide HERE on how to deadlift (you can also subscribe in the opt-in box at the bottom of this blog to get access).

Does Hip Range of Motion Correlate to Low Back Pain?  Maybe Not in Everyone – This is a good post from Mike Reinold that talks about how research on the topic can be tough, and that rotational sport athletes and sedentary folks need to be considered differently.

Anti-Rotation Sled Dragging – Here’s an innovative core exercise from Jim “Smitty” Smith utilizing the sled for your strength and conditioning program.

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Dean Somerset Interviews Me – Part 1

Written on March 14, 2011 at 6:34 am, by Eric Cressey

I recently was interviewed by Dean Somerset, and thought that interview might be of interest to all of you.  He asked some great questions that deviated from the hackneyed “tell us about yourself” and “what’s your philosophy?”  Check it out below.

DS: You have a very busy facility that trains pretty much every baseball player in the eastern seaboard, you write a daily blog, and write for T-Nation, Men’s Health, etc, etc, etc. On top of that, you train like a demon and have a wife and puppy that need the occasional quality time. Have you found some rip in the space-time continuum or managed to clone yourself in order to get all this done?? What’s your secret for time management and productivity?

EC: I inherited my late grandfather’s love of coffee and managed to find a wife who is quite understanding (although she thinks I am a crazy workaholic as well).

Kidding aside, while I have picked up on some good time management strategies over the years, the truth is that I am still very much a work in progress.  The main problem is that when things are going well, it’s tough to cut back – so instead, you keep pushing the bar higher.

When I’m tired and overworked, I usually just remind myself that this is how it’s supposed to be when you start a business.  While I’ve been writing articles since I was 20, the truth is that Cressey Performance is just 3.5 years old.  Read any entrepreneurship textbook and it’ll tell you that the first five years are the most challenging and include the longest hours.  Things have definitely gotten better since 2006-2007, which was undoubtedly the most hours I’ve ever worked, but I’m not ready to rest on my laurels and pat myself on the back.

As for strategies on how to get things done, loving what you do is the most important thing.  If you don’t enjoy it, the hours go by very slowly.

I actually outlined a few strategies in this blog post as well: How Do You Find Time for Everything?

Lastly, I’m very lucky to have an excellent staff that does an awesome job.  When you have good people working all around you, time management is a lot easier – as you don’t have to waste time second-guessing everything they do.

DS: I bumped into you waiting for a sandwich at the NSCA conference in Las Vegas last year and joked about how you were easy to pick out as you and your whole crew were wearing Cressey Performance T-shirts and other paraphernalia. For trainers looking to create an image or brand and increase their exposure, what should they do besides printing off kick-ass T-shirts and setting up Facebook pages to increase their drawing power?

EC: Treat people right, overdeliver on all your promises, and focus on results.  I’ve had quite a few people tell me that I’m a good marketer over the years – but they are remarkably surprised when I tell them that we haven’t spent a penny on advertising since we opened Cressey Performance.  The truth is that we have grown 100% by word of mouth; our clients are our marketers.

If we make a t-shirt, it’s to give our athletes a sense of ownership in Cressey Performance and help them feel at home.  If we create a Facebook page, it’s to build camaraderie among our clients, disseminate information to make their lives easier, educate them, and help connect them.  If we write blogs about our athletes, it’s because we’re proud of them and want to recognize their achievements.  If we write blogs about our area of focus, it’s because we feel like we have valuable information to share that can really help people.

In other words, the client experience – both in terms of enjoyment and results – is at the center of everything we do.  You don’t get exposure and build a brand unless you get results and make people happy.

DS: The sacroiliac (SI) joint is a tricky bugger, it’s not the low back and it’s not technically the mobile part of the hip. What do you do with any suspected sacroiliac dysfunction issues to get them moving and reduce pain?

EC: Well, I think that the first step is determining whether whatever is going on is clinically within my scope of practice, and if not, who the right referral is for them.  Two minds are always going to be better than one in solving a problem, and there are specific interventions (e.g., manual therapy) that I can’t offer that would expedite their recovery.  So, the first step is appreciating that I’d likely be working hand-in-hand with someone else to make sure that we’re covering all the important things.  It’s not feasible from a time or skill-set standpoint for me to handle everything, nor would it guarantee the best outcomes (even if that individual did wind up symptom free).

That said, I think that one problem we run into nowadays with respect to this particular issue is that everyone just wants to call one-sided back pain “sacroiliac dysfunction.”  It’s almost become a “shin splint” or “impingement” garbage diagnosis that really doesn’t tell us a whole lot about how someone moves.  Many of the folks we’ve seen come through our doors over the years with “sacroiliac dysfunction” have actually been those with previous soft tissue injuries in the area, or even folks with femoroacetabular impingement (FAI) that has just led to chronic spasming in the area because they couldn’t flex or internally rotate the hip sufficiently (particularly in closed chain).  They don’t necessarily have sacroiliac dysfunction; they just have pain on one side that happens to be somewhat near the SI joint.

The truth is that in 85% of cases, lower back pain has no definitive diagnosis.  Even still, over 80% of people have disc bulges or herniations that they don’t even know are there; they’re completely asymptomatic. So, even if we could diagnosis what was structurally wrong in all the cases, we’d never know that it’s exactly what’s causing the pain.  So, we have to look to movement – and here’s what I’ve most commonly seen:

1. Left AIC/Right BC patterning – If you look at the Postural Restoration Institute philosophy, they talk extensively about how many people (especially right handed individuals) are “stuck” in right stance: right hip adduction, internal rotation, and posterior rotation.  Not surprisingly, you see more hip surgeries (labral repairs, sport hernia surgeries, and FAI cases) on the right side – but you also see a lot more sacral injections on that side.  Get people out of right stance – even if you just yell at them every time you see them sinking back into the right hip in standing – can make a big difference.  The PRI folks also have a myriad of corrective drills – from breathing patterning to muscle re-education – to bring people back to center (even if true symmetry isn’t a reality).

2. Poor Motor Control and Strength of the Glutes – We spend a lot of time on our butts – so much, in fact, that they shut down.  The gluteus maximus is active in the sagittal, frontal, and transverse planes, so it’s a big player in hip stability and femoral control. If you don’t use your glutes in the sagittal plane, you’ll hyperextend at the lumbar spine as a compensation (and increase your risk of excessive anterior glide of the femoral head secondary to hamstrings dominance in hip extension).  If you don’t control the femur in the transverse and frontal planes, you’ll end up in excessive adduction and internal rotation – which is “no bueno,” as I described in the previous example.

3. Poor Hip Rotation (and mobility in general) – This works hand-in-hand with the previous two factors, but warrants mention on its own. Vad et al. found that lead hip internal rotation correlated with a history of back pain in golfers, but the problem extends further than just rotational sport athletes.  You need a fair amount of hip internal rotation to squat, so if you’re lacking it – yet including squatting or athletic activity that requires it – it’s not unreasonable to assume that the lumbar spine (or sacroiliac joint) will get a big angry at you eventually.  Likewise, if you have a structural hip issue (like the aforementioned FAI), the lower back is often the first place where people become symptomatic.

4. Poor Thoracic Spine Mobility – Charlie Weingroff made a great point that the thoracic spine is an even bigger player in the joint-by-joint approach than just about any other segment, as it interacts directly with the scapulae, rib cage (respiratory system), lumbar spine, and cervical spine.  Just about everyone is stiff in the T-spine, aside from some of the pitchers I see with freaky mobility.  Asymmetrical t-spine mobility is a centerpiece of the PRI philosophy in light of their heavy focus on respiratory function.  The area I see this being a big player the most is in rotational sport athletes, as the thoracic spine allows for continued creation of elastic energy when hip range-of-motion is maxed out – and it’s also essential for creating a longer deceleration arc – whether we’re talking about throwing or swinging/shooting.

5. Poor Core Stability – Here’s my turn to use a garbage term, but let’s be honest: most of the 25% of Americans in low back pain at any given point are the ones who don’t do anything that even closely resembles exercise.  Then they go out to shovel snow, play catch with their kids, or just put on their socks – and their backs go.  They don’t need to be absolute physical specimens to get through life pain free; they just need enough stability to buttress against shear stress and create enough multi-directional stability to handle compression.

6. Soft Tissue Quality – This one is a bit of an X factor and not the answer for everyone, but I won’t lie: I have seen people with years of back pain who get immediate and lasting relief from symptoms following more aggressive soft tissue treatments like Graston and Active Release.  If you use (or overuse) muscles, they can get fibrotic over time.  This tends to work more commonly in a trained population than an untrained population because they’ve accumulated more wear and tear over the years.  The point is simply that you can’t overlook tissue health, especially if there is a previous history of strain.

Check back soon for the second half of this interview.

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Strength Training Programs and Squat Technique: To Arch or Not to Arch?

Written on January 14, 2011 at 7:17 am, by Eric Cressey

Q: I’m confused about when I should arch.  I was re-reading some of your older articles, and noticed that in the Neanderthal No More series, you and Mike Robertson advocate posteriorly tilting the pelvis while performing some core exercises, yet when it comes to performing squat and deadlift technique, you encourage people to maintain the arch.

My back tightens up a lot when I arch strongly, but if I just bend over to touch my toes in flexion, it doesn’t bother me at all.

1.  Could it be possible that I am arching too much during everyday movements and strength exercises?

2.  What really constitutes a neutral spine?  Is it different for each person?

3.  When is it (if ever) appropriate to have a flat spine?

A: The main thing to consider – at least in my experience – is whether there is compressive loading on the spine. In compression, you want an arch – or at the very least, the natural curve of your lumbar spine.  The discs simply don’t handle compression well when the spine is in flexion (or flat).  We do more of the posterior pelvic tilt stuff when you are on your back (glute brides, as the glutes posteriorly tilt the pelvis) or on your stomach (if you arch, you’re slipping into hyperextension, which defeats the purpose of trying to resist gravity as it pushes you down to the floor).

Bending over is a LOT different than squatting and deadlifting (and comparable strength exercises).  When you add load, the game changes.  Cappozzo et al. found that squatting to parallel with 1.6 times body weight (what might be “average” for the typical weekend warrior) led to compressive loads of ten times body weight at L3-L4. That’s 7000N for a guy who weighs about about 150.  Meanwhile, in a study of 57 Olympic lifters, Cholewicki et al. found that L4-L5 compressive loads were greater than 17,000N. It’s no wonder that retired weightlifters have reduced intervertebral disc heights under MRI! They get strong, but at a “structural price.”

According to Dr. Stuart McGill in his outstanding book, Ultimate Back Fitness and Performance, the spine doesn’t buckle until 12,000-15,000N of pressure is applied in compression (or 1,800-2,800N in shear) – so it goes without saying that we’re always playing with fire, to a degree – regardless of the strength training exercise in question, as there’s always going to be compressive loads on the spine.  That’s a laboratory model, though; otherwise, the Olympic lifters above wouldn’t be able to handle much more than 12,000N without buckling.  In the real world, we have active restraints – muscles and tendons – to protect our spine.

If those active restraints are going to do their job, we need to put them at a mechanical advantage – and flexion is not that advantage.  The aforementioned Cappozzo et al. study demonstrated that as lumbar flexion increased under load, compressive load also increased. In other words, if you aren’t mobile enough to squat deep without hitting lumbar flexion (because the hips or ankles are stiffer than the spine), you either need need to squat a little higher or not squat at all. That said, I don’t think that you have to force a dramatic arch when you squat (or any strength exercise, for that matter); I think you need to brace your core tightly and create stability within the range of motion that you already have – and, indeed, “neutral spine” is different for everyone.  For instance, females have an average of 5-7 degrees of anterior pelvic tilt, whereas males are more like 3-5 degrees – meaning that females will naturally be a bit more lordotic.

Having sufficient lumbar flexion to touch your toes with “uniform” movement through your lumbar spine is certainly important, and for most, it’ll be completely pain free (regardless of range of motion), but that doesn’t mean that a flat or flexed lumbar spine is a good position in which to exercise with compressive load.

So, to recap:

1.  Neutral spine is different for everyone.  What’s the same for everyone is the need to have stability within the range of motion that you’ve got.

2. Flexion is fine (and a normal functional task) when it isn’t accompanied by compressive loading.  And, there is a different between subtle lumbar flexion and end-range lumbar flexion.

3. Arching (lumbar extension) doesn’t need to be excessive in order to be effective in improving tolerance to compressive loads.  In most cases, that “arch” cue simply keeps a person in neutral spine as they go into hip flexion in the bottom of a squat or deadlift (or comparable strength exercise).  “Arch” doesn’t mean “hyperextend;” it means to maintain the normal lordotic curve of your lumbar spine.

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Lower Back Pain, Diesel Little Leaguers, and Resistance Training Solutions

Written on November 8, 2010 at 3:22 am, by Eric Cressey

Here are a few blasts from the past that you definitely ought to check out:

Lower Back Pain and the Fitness Professional – It’s amazing how many fitness professionals know NOTHING about lower back pain even though it will occur at one point or another in every single one of their clients.

Can Little Leaguers Strength Train? – It’s a question I get all the time – and this was my first response to the inquiry a few years ago.  I updated this and got a bit more detailed and geeky in a follow-up, The Truth about Strength Training for Kids.

Solutions to Lifting Problems – This T-Muscle article is a must-read for anyone who wants to be able to stay the course even when setbacks occur along the resistance training journey.

Lastly, for those who are looking to shed some pounds over the holidays while everyone else is packing ‘em on, check out these two free Holiday Fat Loss special reports from Joel Marion.  Joel’s got some quick and easy to apply tips you can put to use right away.

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CP Intern Blog by Conor Nordengren: Up the “Ab Ante”

Written on October 5, 2010 at 7:44 am, by Eric Cressey

Today’s guest blog comes from current Cressey Performance intern, Conor Nordgren.

We’ve all heard those stories about the training regimens of celebrities and how they do 500 crunches first thing in the morning and 500 more right before bed to get that perfect six-pack of abs.  Many of you have probably also seen that infamous video of T.O. performing crunches while conducting an interview with reporters.

While exercises like crunches and sit-ups can bring out those abs and sculpt a nice six-pack, is this the safest method to train the core? Top strength and conditioning coaches like Eric Cressey, Tony Gentilcore, Mike Robertson, Mike Boyle, and Jason Nunn have recently written and talked on the subject and say that it is not.

As an intern at Cressey Performance, I’ve been exposed to a ton of programs and not a single one of them has included a crunch or a sit-up. Here’s why:

If you’re familiar with Mike Boyle’s joint by joint approach to training, you know that the lumbar spine requires stability as opposed to mobility. Think about the execution of a conventional sit-up: what is your lumbar spine doing? That’s right, it’s flexing. The lumbar spine is not designed for a great deal of movement (whether it is flexion or extension), let alone repetitive movement. Our spine as a whole is not meant for a ton of flexion or extension, either. While you may “feel the burn” in your abs when performing a set of crunches, you are essentially training spinal flexion. World-renowned low-back researcher Dr. Stuart McGill says that we have a finite number of flexion/extension cycles in our back until injury is caused. That number is different for every person, but the bottom line is that by performing exercises like crunches and sit-ups, you’re increasing your risk for injury with every rep! Dr. McGill has actually done experiments where he’s put pig spines in a crunch machine and after a certain number of crunches, or flexes, spinal disks explode.

Crunches and sit-ups also promote a kyphotic, or rounded back, posture. Visualize someone in the top position of a crunch or a sit-up. Now, keep that visual of their upper-back, but picture them standing up. Hello Quasimodo!

Would you consider this good posture? Of course you wouldn’t (well, hopefully not). So why would we want to reinforce it?

James Porterfield and Carl DeRosa have written that the core musculature is primarily designed to transmit force, not to produce it. While crunches and sit-ups are promoting flexion of the spine, our core should instead be trained in preventing movement. If we train our core to be rigid and prevent movement, the stronger it will be; this translates to more overall force production throughout the whole body which will allow for bigger lifts. Sounds pretty good, huh?

Thanks in large part to Mike Robertson, we’ve been introduced to four acceptable movement patterns that should be utilized when training the core. They are anti-rotation, anti-extension, anti-lateral flexion, and hip flexion with a neutral spine. While there are several variations of the following exercises, here are some of my favorites:

Anti-rotation: Tall Kneeling Pallof Press – the kneeling version really forces you to use your glutes and your core, since your quads are taken out of the picture (this exercise can also be done on a cable machine).

Anti-extension: Ab Wheel Rollouts – progress to band-resisted or off of a box for added difficulty.

Anti-lateral flexion: Waiter Carries – can also be done with a kettlebell.

Hip Flexion with a Neutral Spine: Prone Jackknifes with a stability ball – you may find this to be one of the more challenging movements, so really focus on keeping that core tight!

Some of you may have a hard time imagining your workout without any crunches or sit-ups. You might be skeptical that the above exercises may not get you the results that you desire. Well, Tony “The Situation” Gentilcore performs these movements on a regular basis, and when he voluntarily and superfluously flashes his abs at us interns every day, let me tell you, I could wash my clothes on those things! But seriously, change is hard and not an easy thing to accept. However, the good thing about change is that it can be for the better. I’m not demanding that you immediately stop performing crunches and/or sit-ups; that choice is yours. It’s my hope that you think about how you’re currently training your core and ask yourself if this is the most optimal, functional, and above all else, SAFEST way to do so. This may help to keep you injury-free down the road so you can continue hitting the iron hard.

Conor Nordengren can be reached at cnordengren@gmail.com.

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Preventing Lower Back Pain: Assuming is Okay

Written on June 21, 2010 at 7:43 am, by Eric Cressey

It’s widely known that approximately 80% of the population will suffer from lower back pain at some point during their lives.  What isn’t widely known, however, is that even those who are asymptomatic are usually walking around with a host of nasty stuff going on with their spines.  Don’t believe me?

A 1994 study in the New England Journal of Medicine found that in a study of MRIs of 98 asymptomatic individuals, 82% of those MRIs came back as positive for a disc bulge, protrusion, or extrusion at one level.  And, 38% actually had these issues at more than one level.  You can read the free full text HERE.

As the others discovered, it doesn’t stop with disc issues, either – and that’s where a great study from Soler and Calderon comes in.  They looked at the incidence of spondylolysis (vertebral fractures) in elite Spanish athletes, and found that 8% of those they examined had them.  Only about half of those diagnosed via imaging actually had back pain, though.  The incidence was highest in track and field throwers, rowers, gymnasts, and weightlifters – and I’d expect that this figure is actually higher in the U.S., where we have more sports (hockey, baseball, lacrosse) involving violent extension and rotation, more contact sports, and more participation in weight training.

What does this mean for us?  Well, as Chou et al. reported in The Lancet, “Lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition.”  That’s not the point of my article today, though; I’ll leave that stuff to the physicians to decide and rehabilitation specialists to interpret and treat.

As fitness professionals, strength coaches, and even just fitness enthusiasts and athletes, we need to assume that there is are probably a lot of structural abnormalities going on in the spines we encounter – including our own.  The programs we write and follow need to be sound and take these issues into account, considering differences in age, gender, sport participation, and injury history.  The technique we use needs to position us so that we can avoid causing them to reach threshold.  And, we need to appreciate that there is a risk-reward balance to be “struck” with everything we do in training because nobody will ever be “perfectly prepared” for the demands to be placed on their bodies.

Rather than lay all my thoughts out here, I’m going to direct you to some previous writing of mine:

To Squat or Not to Squat?
Lower Back Savers: Part 1
Lower Back Savers: Part 2
Lower Back Savers: Part 3

I’d also highly recommend Ultimate Back Fitness and Performance by Dr. Stuart McGill.

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The Best of 2009: Stuff that was Fun to Write

Written on January 8, 2010 at 12:11 pm, by Eric Cressey

Thus far this week, we’ve covered the top articles, product reviews, videos, and guest submissions of the year.  Today, I just wanted to cover the stuff that was fun for me to write (or film) – and it isn’t just exclusive to EricCressey.com.

Birthday Blogging: 28 Years, 28 Favorites – I just remember that this thing rolled off my fingertips as I wrote it on my 28th birthday.

What Folks are Saying about the Cressey Performance Majestic Fleece – I just remember that we had to film this about 47 times because none of us could stop laughing.

The Opportunity Cost of Your Time – I don’t know why this one was fun to write, but it was.  I suppose it might have something to do with the fact that I started out at business school, and then moved over to the exercise science world to complete my undergraduate degree.

The Truth About Unstable Surface Training – This was actually introduced at the end of 2008 (and written in sections between 2005 and 2008), but deserves mention in light of its first full year of availability.  I’m most proud of this work because it took a ton of time to compile both the literature and our original research, which was the first of its kind.  Nobody had looked at how a long-term training lower-body unstable surface training intervention would affect healthy, trained athletes’ performance.  This book presents not only those results, but a series of practical application recommendations that are of value to any strength coach, personal trainer, or other fitness professional.

Lower Back Savers Part 1, Part 2, and Part 3 – Featured at T-Muscle, these were really fun to write because I had a chance to be dorky and practical at the same time, blending research with what we’ve anecdotally seen in those with lower back issues.  Honestly, I still have enough content to write a part 4, and that may come around in the next few months.

Strength Exercise of the Week: Pallof Press

Written on November 24, 2009 at 10:19 am, by Eric Cressey

(even though our camera/editing guy spelled it incorrectly)

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Two Anterior Core Progressions

Written on November 9, 2009 at 1:42 pm, by Eric Cressey

Here’s a quick continuation of last week’s newsletter, which featured some introductory anterior core training exercises and the rationale for them.  You’ll need a TRX set-up to do these; it’s an awesome investment, if you haven’t picked one up already.  They make it very easy to take your training anywhere you go.

For more information on my overall approach to core training and where these exercises fit in, I encourage you to check out Part 3 of my Lower Back Savers series.

Assess and Correct Now Available!

Written on October 26, 2009 at 5:10 am, by Eric Cressey

Today’s a really exciting day for Mike Robertson, Bill Hartman, and I – and hopefully for you, too!

You see, after months of planning, filming, and editing, our new product, Assess and Correct, is now available at www.AssessAndCorrect.com.  And, for the first week ONLY, we’re making the product available for $30 off what will be the normal retail price.

Assess and Correct is the first resource that empowers you with not only a series of self-assessments to identify your own flexibility and stability limitations, but also exercise progressions to correct those inefficiencies.  In the process, you’ll take your athletic performance to all new levels and prevent injuries from creeping up on you – whether you’re a high-level athlete or someone who sits at a desk too much.

With 27 self-assessments and 78 corresponding exercises, you’ll cover virtually everything you need to feel and perform well. And, you’ll have plenty of variety to use for many years to come!  And, while the DVDs alone are really comprehensive, the bonuses we’ve added to this really sweeten the deal.  Included in this package are:

• DVD #1: Your Comprehensive Guide to Self-Assessment
• DVD #2: Your Individualized Corrective Exercise Progressions
• Bonus #1: The Assess and Correct Assessment E-Manual, which is a guide to which you can refer to in conjunction with DVD #1.
• Bonus #2: The Assess and Correct E-Manual, which includes written cues and photos for each recommended drill in DVD #2 so that you’ll have a resource you can take to the gym with you.
• Bonus #3: “The Great Eight Static Stretches” E-Manual, which shows you eight additional flexibility drills that we use on a regular basis in addition to the drills featured in the DVDs.
• Bonus #4: The “Optimal Self Myofascial Release” E-Manual, which shows you the soft tissue methods and techniques we use with our clients and athletes.
• Bonus #5: “Warm-ups for Every Body” E-Manual, which is a collection of two sample warm-up templates for 19 different sports/scenarios.

Again, this introductory offer will end next Sunday, November 1 at midnight EST.  For now, though, I’d encourage you to head over to www.AssessAndCorrect.com to check out some of the sample videos from the DVDs – including the introduction in which we discuss our rationale for creating the product.