Wednesday, June 30, 2010

Pressing Matters: a wee chat with Dan John

Greetings b2d readers and especially, if i may, to fellow Canucks, as tomorrow be Canada Day. To Roll in the New Great Summer month of July, something special: an interview with Dan John - mainly about pressing.

For some folks in strength training, Dan John needs no introduction. He is both an active coach in sport, and strength and conditioning as well as being an just-won't-quit competitive athlete in both his favorite sport, the discuss, as well as in the Highland Games. In very recent times, he has become a fan of the humble russian kettlebell, and a proponent of its value as part of one's trainstreing program.

I had the pleasure of connecting with Coach John at the past RKC II in San Jose, where we got talking about the Press in particular, and since then has ranged to a host of related topics from what makes a press beautiful, where it sits next to the deadlift, instinctual training, coaches and training women.

Dan will also be co-delivering a new workshop this fall with Pavel Tsatsouline for RKCs called SCIENTIFIC STRENGTH SECRETS for EXTREME PERFORMANCE (with a book to follow). The workshop i am told is also a once-only, not-to-be-repeated event.

And so without further ado, a conversation with Dan John.

Dan's Book. You have a book out called "Never Let Go" the title of which struck me as  a wee bit ironic for a guy who has a reputation for throwing objects at speed away from himself. I know you explain this in the book, but could you review the rationale?
The Sword in the Stone
Never Let Go: A Philosophy of Lifting, Living and LearningWell, of course, I discuss this in the book, but it comes from T. H. White’s “The Sword in the Stone.” It was the book, along with Jerry Kramer’s “Instant Replay,” that turned me into a reader. In the book, young King Arthur (Wart) is taught by Merlyn by being turned in animals. The first law of the foot, animals who live and die by their foot or talons, is “Never Let Go.” I base my life on the principles of that book…odd as it might sound.
No, thank you, that makes sense.  That's really kind of cool. So with that grounded base for discussion, let us move to something it usually makes good sense to keep in hand when practicing. Kettlebells.

Kettlebells in general - You've progressively moved into working with KB's. How come? what's the attraction to this tool? Where, if i may, does it fit in with the rest of your personal practice and work you do with the athletes you coach?
The attraction of the tool is simply that: it is an awesome tool! On my limited porch, I recently moved, I can train hard, really hard, with the space that used to be about the size of my storage in my training area. I love Double Kbell Cleans and Front Squats for working hard and I love windmills and Get Ups for stretching and assessments. The Kbell is harder than it should be no matter what you are doing. Too light? Do them bottoms up! And, there is nothing better than Kbells for swings.
It's really intriguing to me how many senior kb practitioners are celebrating  the Swing and the bottoms up press. Potent training can be pretty simple.

The Press And speaking of the press,  you seem to be a guy who likes the Press as a move, why? where does that fit into the Dan John picture of strength practice?
The overhead press would be along with the deadlift as the two most important lifts that most people should do. Yes, you should do a squatting movement every day, for the same reasons toss in a hinge, a walk, and joint mobility work, but for loading, you want the press (maybe even first and foremost in my thinking now) and the deadlift. I have worked with women in fat loss programs that simply get everything they need from pressing. Now, they also were on zero carbs, stacking ephedrine and caffeine and aspirin, drinking huge amounts of water and walking every day, but the simple overhead press seemed to pop them to another level. 
If can overhead press it, you can bench it. The more you press overhead, the more stable you become overall. Also, for whatever reason, call it what you want, but pressing overhead seems to apply to sport and general badassary.
Do these thoughts vary when thinking about the KB press rather than bar/dumbbell? or when you think of the press now, do you think pretty much press=kb press?
Well, for me, with my new situation, I can’t just pop into the garage and pick one of four O lifting bars, or dumbbells. I have kettlebells, so there you go!
When you think about the press, or the kb press in particular, then,  what would you say is the art of the press, and of developing a beautiful press?
Well, two things: first, the alignment of wrist, elbow and shoulder. I used to be dumb enough to teach this, now I just have the person do a Bottoms Up Press and then, after lots of failing, flailing and fumbling around, the person gets it right and I say “Yes, just like that.” The response is “Oh, I didn’t know that.”
The second is stability. Pick up a foot (either works, but not both at the same time) while pressing and just note how the body locks down in support. That is the key. Certainly, there are details, but I like to let the body teach you what to do. If there is a “secret” to coaching, it is to provide a simple drill to address an issue.
Around women and pressing.
When we were talking about improving the press, you suggested that in your experience women have to press more than guys to press heavier.
“Press more” in terms of volume, of course…women should press probably every day, doing something in a pressing movement. I didn’t say heavy, I didn’t say 100 reps. In the same vein, woman should stop stretching all the time. They are predisposed to flexibility, yet lack in pressing strength. No, for total candor, I like the female design and I am not being critical. My point is that everyone likes to play to their strengths and ignore their weaknesses. Women need to press. Women tend to have a narrow shoulder base vis-à-vis the waist and it is difficult to press with that issue. I would argue that a guy can get away with just one press in his program, but a woman should master every variation they can find. I have had some great insights, by the way, from training women, as working with this “problem” has given me some insights to improve my own lifting. So, I decided to add more variation into my training and it has made it more fun and more productive.

In terms of load, well, adding weight to a woman’s press is stubborn work! Percents are worthless and it is really hard, like with Dragondoor Kbells, for a woman to jump up the four kilos from like the 12 to the 16. So, we get back to drills and stability work. This is fine. One little thing: if you screw up a press, you can get hurt like “Bang!” So, drilling, training and thinking is also a way NOT to hurt yourself.
In that conversation, you've also plugged in doing windmills with presses to complement the press. How have you seen these go together?
The more I teach and work with Windmills, the more insights I am gaining about the upper body. This one guy in Ohio dismissed the Windmill with “I just feel it in my ribs.” I thought to myself, well, you know, the ribs are a amazing series connective tissues, hard matter and key organs below and the beauty and design of the things are poetry (certainly, it’s a rare epic that doesn’t mention them somewhere) and if you feel them moving and stretching, that’s good. Also, with all the hip work I have been doing, the Windmill is a MUST after every hip stretching workout. It is the best way to stretch the outer hips I know.
Are there other moves related to supporting the press you'd suggest?
The Get Up for a moving shoulder analysis, the various presses like SeeSaws and the like, and, this won’t surprise too many people, the Double Kettlebell Front Squat. If you worked with me, you would know this one. It is a great way to teach the rack and the need to squeeze.
RKC II Strength Requirements for Women's press
Dan, in the RKC II as you know, one of the skills/strength tests for certification is a kb press. For men, it's half their body weight. For women, it's 1/4. Some gals have been saying a quarter is too light, why not a third, or even half for women too? For a 60KG woman, going by the men's chart, this would mean, closest bell is the 28. Personally, while the 20 is fine, i'm still working to get the 24 as a 58-60kg gal.

I guess what i've been wondering is given that if we accept that women need more volume to press heavier, more volume can also mean higher exposure to possible overuse injury. Is it worth it to put up the strength requirements for women? and if they were to go up, what would you see as a sane progression?
For me, this is one of those questions for someone with more experience. I wouldn’t mind a quick study of this as something to discuss it with the hard numbers, but I think a lot of women can just grab the 16 and press it with no training. The 106 KB is NOT something most guys can just pick up who weight over 100 Kilos. So, I have mixed feelings about this. I like standards, but I also like people to feel they can do accomplish the task. Real mixed feelings…
Interesting...So if we think about upping weight, though, what are the cues you'd give your athletes - perhaps the gals in particular - to help head off overuse injuries before they occur?
Overuse injuries are rarely caused by me! The volleyball crazies and the basketball loons with all their year round clubs and travel teams and all the BS lying about full ride scholarships. We have girls with multiple ACL surgeries and then someone comes into the weightroom and tells me that I am overdoing something? I guess it “can” happen, but just remember Pavel’s basic programming point: any idiot can “work you out.” And, there seems to be plenty of idiots on the internet. Hire someone who will teach you, train you. That will prevent most problems: proper training. Pay attention: if you are about to fail, stop. Rest, start again.
high volume; lighter loads for strength
Something all yours, kenneth jays and pavel's volume emphasis along with Asha Wagner's training results. Asha pistoled a 24 without ever training it - just trained a lot of pistoling the 12. a lot - is that doing a lot of lighter reps (50-60%) is a potentially great way to train for The Big Lift. This may seem like stating the obvious, but i'm not sure if i have lost the plot? how might you suggest that be tuned?
The one great lesson that lifters can learn from throwers: you should thrive in submaximal ranges. Not every throw is the World Record…they can’t all be gems!

* women's strength in general
Training colleague Kira Clarke recently suggested that a coaching colleague has seen a correlation between strength and persistent well being. This is worth repeating so let me post it here, from Kira:
"My coach friend (Will Heffernan) has a simple test (and benchmarks) he uses regularly on his athletes (he adjusts them for different types of athletes, but these are his general guidelines)
Squat or deadlift: 2 x bodyweight
Inverted rows in 1 minute: 30+
Pushups in 1 minute: 50+
Pullups in 1 set: 10+
Bench press: 1.5 x bodyweight

In his experience, once his athletes hit these numbers (and ratios) their injuries drop significantly. And as they surpass them, he still likes to see lower/upper body strength numbers increase together, and the bodyweight numbers increase maintaining the ratio of approximately 5:3:1."
He recommends the following for female athletes ...
deadlift: 2 x bodyweight...
pullups: 8+
pushups: 50+
inverted rows: 30+
bench press: 1-1.25 x bodyweight
(It's basically the same benchmarks he uses for 100kg+ male athletes)

He also shared the following snarky remark ...

"The biggest problem that female athletes suffer from is the low expectations of male coaches"
Does the above resonate with you at all as injury proofing? Anything you'd highlight or modify?
I have two very strong daughters (State Champion in the shot for Lindsay) and a very strong wife. One of things I would agree with entirely is that male coaches often coddle their females (sadly, literally true) but I have pushed my family to some big numbers in the weightroom simply by expecting it. There is no question that the human female is not that weak in comparison to the male, I just read about this in a book (I’m usually reading about two or three at a time, so I don’t remember which one) and for primates we are pretty even between males and females. So, we shouldn’t be afraid to push females in the weightroom. I do.
What are your approaches to help keep your athletes injury free, and do you modify that council at all between gals and guys?
This is going to shock you, but I change nothing working for males or females. I have to admit, I have more feminine products in my gym bags than most guys.
* everyone needs a coach?

On the theme of gym bags and coaching then, a lot of folks who practice their sport or their skill do so without getting together with a coach. They run or they lift or do whatever independent of any formal checks. They may say i don't know anyone, i'm only doing this for myself, not competing, why do i need to spend money on a coach i know what i'm doing. THoughts? Suggestions?
Well, I need a pair of eyes to watch me! No one coaches me and it really hurts my quality of training. I would strongly suggest that everyone get some level of coaching. It doesn’t have to be much, but it really helps. I am cutting my own income, but some coaching can help. Now, don’t let the coach become a God with all knowledge and all knowing and all this and that. It’s just a coach. One’s deity should be a bit more complete.
* attitude of the Converted?
Related to dieties, and conversion, are there any attitudes that you see in folks coming to a new training practice - like oly lifting or kb's - where they've drunk the kool aid, and focus seems to narrow perhaps rather than enlarge, or everything is seen through the lens of the One True Movement?  Any suggestions for folks either going through this, or observing it?
How about: Get over it?
How about: Shut up?
Number Two is my issue with the guys on the net, especially. One 40 kilo snatch and they start giving advice like the Olympic champ. Show some discipline and continue to learn. I snatched 142.5 and felt like I still knew nothing. Hell, I still don’t!
That's pretty clear. Still on coaching,  this topic of instincutal vs planned routine training seems to come up more frequently. Your thoughts  on "instinctual training" vs "training plan? 
I really think you need a lot of experience to train without guidance. I like what Alwyn Cosgrove says about doing a program: now, you can critique it. So, do about ten different programs, then try something on your own. I was a fairly accomplished athlete when I did ETK from Pavel, AfterBurn II from Alwyn and the Velocity Diet from Chris Shuggart. That’s the key: follow plans until you trust your instincts to follow plans.
* Athletic Achievement/reality-checking
You coach folks who are frequently identified as athletes, who compete formally in sport, and then there's the rest of us who mayn't compete or think about competition. I'm not quite sure how to frame this question, but do you think there's something important about either formal competition or some kind of external check in performance that any athlete - formal or not - should consider? Do you think it's important (that's not the right word) for people to compete or be evaluated in some way (i think about the challenge of being evaluated at the RKC certs for instance)? and if yes why? or why not?
Well, sports gives you the right world for a goal. It is on this day, at that place, with these “things.” So, no BS. You do what you say you will do. It is hard for a person to follow their goals without the built in support systems that a sport naturally has going for it.
Personal moments of athletic happiness?

Well on that note, could you offer a few moments in your own athletic practice that have been particularly meaningful to you, and why?
  • My daughter’s last throw, personal best, winning toss to win the State Championship in the shot put.
  • Having both daughters in the finals at the state meet in the discus…at once!
  • The many times I have won things on the last throw or last effort.
I always love overcoming all the barriers in the way of being a champion. There are so many…
* Dan Faves?
- fave dan lift?
Double Kettlebell Press
- fave dan throw?
- fave dan move he wishes he could do but currently does not see himself doing in this lifetime?
The Bent Press
- fave dan move he wishes he could do and can see that happening this lifetime?
A correct Windmill
Final Dan Thoughts
What's a practice perspective that you'd say has been of most pracitcal (and/or spiritual) benefit for you in your athletic career?
If you'd reference “To Grad from Dad” on my website here? It is all of this…and more!
You bet sir. Thank you for your time. Much obliged. That was fun.

Coming up Later This Week:
Hope y'all enjoyed that.  With Dan's permission granted, coming up later this week i'll post the routine Dan gave me for increasing the press (part II of the interview).

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Monday, June 21, 2010

The amazing shoulder - part 2: glenohumeral joint & muscles (yes rotator cuff too)

In part one of this quick tour of the amazing shoulder we looked particularly at the shoulder girdle and the muscles that act pretty much directly on the scapula. The main take away was that significant muscles like the traps, rhomboids, pec minor, serratus anterior and levator scapula all work pretty much *just* to move the scapula and so reposition the shoulder joint socket to extend range of motion for the arm moving in the shoulder.

In this piece, we'll overview those pixie rotator cuff muscles and look at why they can be such a pain - in the shoulder - and how understanding the movements these muscles support may help reduce injury risk.

We'll also take a quick look at the big muscles like the lats that opperate on the main shoulder joint, the glenohumral joint. From here we'll speculate about shoulder injuries and habits to avoid them.

The shoulder tour part II: The Glenohumeral Action

Rotator Cuff What is it with the rotator cuff? we hear about so many injuries to the shoulder, and we likewise hear so much about the need to "prehab" these muscles to defeat injury. And i'm not a bystander here: i've likewise run my shoulder into the wall and shook my head to say "what is this pain? what is this thing? what needs to change? what the heck is wrong here?" I've had folks say "ah, that's the supraspinatus most like" -Um, could you unpack that a bit? No? ok.  So here's a go at trying to get a little better understanding of a bit of what's happening with the rotator cuff.

First, the GlenoHumeral Joint. In moving to the rotator cuff, we're moving away from a focus on the shoulder girdle and the movement of the scapula to the main reason for the scapula: the gleno-humeral connection - or connecting the extremity that is the arm to the trunk of the body - the upper body in particular.

Where that connection takes place is with the humeral head of the humerous being knit into the glenoid cavity (or fossa) of the scapula. Note again the side view of the scapula - the glenoid fossa is rather shallow, but there's a liner/washer called the glenoid labrum that gets inset into that cavity before the humeral head makes contact.  And then there's a capsule that goes around that unit, and ligaments around that. Those ligaments are kind of like a snugly-but-loosely laced sneakers - there's some give because of all the range of motion in the shoulder. This looseness - it's a bug; it's a feature.

Rotator Cuff Job 1 - holding ball in socket.
Just for context, there are four rotator cuff muscles: 1 on top, the SUPRAspinatus, 1 covering the front that goes against the underside of the scapula that is against the ribs the SUBscapularis, and two on the back of the scapula, the infraspinatus and and the teres minor 

The top muscle, the supraspinatus (supra=above the spiney bit), attaches from the top of the scapula at the big scapula spine, runs along the top of that ridge, goes under the acromium process of the scapular spine, over the bursa on the top of the glenohumeral capsule and then attaches onto a big bump at the top of the humerus, the greater tubercle. That is a very popular attachment point - like the superior spine of the scapula but much smaller a peak.  So when this muscle contracts, it's going to help pull the arm up to 90 degrees from one's side - called abduction. Note i say "help" - we'll come back to this assistance role. Mainly it's stabilizing the ball of the humerus in the glenoid socket.

The subscapularis which attaches along the entire scapula underside (the scapula fossa) the attaches around the front of the humerus at the lesser tubercle. If you imagine these fibers contracting, they're going to contribute to turning the humerus in (internal rotation), pulling the humerus across the body, pulling the arm back (into extension) and, of course 'stabilizing the humeral head in the glenoid fosa' - as the manual of structural kinesiology puts it.

The infraspinatus is the complement to the subscapularis: subscapularis = under(side) of the scapula; infraspinatus means below the spiney bit. Names are nicely descriptive. Where the subscapularis covers the underside of the scapula, the infraspinatus covers the whole backside of the scapula below that big scapular spine. Where the supraspinatus attaches to the top of the greater tubercle, the infraspinatus attaches to the back of the greater tubercle. So again, if we imagine pulling / contracting that attachment, the kinds of things that can happen to the arm are - its turned out (externally rotated), it's also going to pull the arm back into extension. It also helps with what's known as horizontal abduction. Big role - stabilize the arm in the socket - we might add especially when it's being moved about.

The teres minor is like a support for the infraspinatus. Teres just means round and smooth (cylyndrical). and that's sort of what this muscle is. It hangs onto the lateral border of the scapula (the edge closer to the arm), and then plugs in under the greater tubercle of the humerus. So what's it going to do? Exactly the same as the infraspinatus: *stabilization,*external rotation, extension and horizontal abduction.

Note: horizontal abduction is different from abduction: abduction, the arm is being raised up at the side; horizontal abduction assumes that the arm is already up at ninety degrees and infront of the body, and so the arm is being pulled back (abduction - ab is latin for from, as in away from rather that ad, to, towards).

Summary of RCM Action That's it: 4 muscles with pretty functionally descriptive names.
They all have four things in common: 
  • they all attach to the scapula 
  • they each attach near the humeral head 
  • they all primarily stabilize the the arm in its socket.
  • they all rotate the arm in the socket either up, in or out (hence the name, rotator)
Collectively, the way they attach around the humeral head forms a cuff. Hence the other part of the name for this muscle group: cuff. In plumbing, the goal of a cuff is to cover a joint while acting as a joint attachment - sameish thing here.

They're so WEAK, what's the point of being muscles?
In reading kinesiology texts, a word repeated all the time about the rotator cuff muscles is "weak" - they provide weak adduction, weak abduction, weak rotation - weak weak weak.  no leverage. like a person trying to open a door when the handle is in the middle of the door.

If they're so weak what are they doing there? One of the best reframings of the roll of the RCMs is in the Anatomy of Movement.  There Calais-Germain uses the term "active ligaments" to describe the function of these muscles. Considering that it's the tendon part of the muscles that usually comes to grief when we talk about overuse injuries or RC problems, gosh that makes sense.  Ligaments are pretty fixed things - little stretch - that are used to support attachments around joints and often over joint capsules. In many ways, the RCM's mirror this role. 

Indeed, every movement that a muscle in the rotator cuff supports "weakly" there is a complementary big muscle to do, literally, the heavy lifting. So let's look at these big lifters next.

Extrinsic muscles of the glenohumeral joint: the heavy lifters. The big movers of the arm are the deltoids, mapping mainly to the action of the supraspinatus, the lats, mapping mainly to the infraspinatus and teres minor, and the pecs with the subscapularis. Mainly. There's also the corachoid brachialis, a small but potent flexor.

The deltoid is usually considered the main "shoulder" muscle. It's a goodly three part triangular mass that connects on both the first third of the scapula, around the front of the acromion process and into the under edge of the scap spine.  And the next big deal is that it attaches to the humerous at its very own "deltoid tuberosity" of the humerus.

So what's it do? This will sound familiar: the front bits will elevate the arm (abduct) and going past that, flexion the arm, as well as turn the arm in. The mid part will also abduct or lift the arm up to the side - as in a "side lateral raise" move. And the back part will do that horizontal abduction thing while rotating the arm out. So front rotates in; back rotates out. Cool that one muscle has these opposing motions within it.

The pec major - the big chest muscle -  likewise has mutlipte parts: upper or clavicular and lower or sternal.

The muscle attaches around the clavicle at the top and then along the sternum (middle of the rib cage). It plugs into the frontish of the humerous at yet another tubercle, the "intertubercular groove."

The pec's upper fibers turns the arm in as well as pulling the arm across in horizontal adduction. We see horizontal adduction when we bear hug someone. The lower fibers also support horizontal adduction and internal rotation, but they also complement the lats' action of  extension from flexion down to neutral (arm at side).

The lats - i've written about the action of the latisimus dorsi in relation to the pull up and the swing elsewhere. Suffice it to say here that it's a great big muscle that runs along the bottom half of the thoracic spine and into/onto the hip and attaches to the inside (medial lip) of the humerus.

The action here is to pull the arm back (horizontal abduction) also to extend the arm back down (extention) past where the pecs can get to, rotate the arm in, and bring it down/across the body.

 Aside - you've likely noted that with the body, if there's a greater somewhere there's a lesser; if there's a minor there's a major. 

The Little Lats: the Teres Major Tucked away on the back of teh scapula is one more muscle - the teres major. It is not a rotator cuff muscle; it attaches on the humerous not up at the head but just behind where the lats attahes at the medial lip of the intertubercular groove.  It's main action difference from the lats is that, when the arm is out at the side (abducted) it helps pull the arm back down to the side.

It complements the lats, the pecs and works with the rhomboids.

RCM vs Extrinsic Muscles - Local vs Global or Hinges vs Handles.
So what's with the duplication of effort between the rotator cuff muscles (intrinsic g/h muscles) and these big muscles? If we use the model of active ligaments for the rotator cuff, i think we're away: the RCM's have the local job of just focusing on the socket: keeping the humeral head in that fosa and supporting that contact while the joint is moving. Snug snug snug. Hang on tight.

The big muscles are all about levers - all about really lifting the whole upper arm up, out, over, down, across and back with load. And to do big lifts we need both big fat rope and length.

Consider openning a door. The hinges hold the door in place and hold it up - they're close to the edge of the plank that moves around the door attached to the lintel. Great. They're not huge, but they're strong and do the hinge job nicely of keeping the door in place and letting it move when it's moved.

But what does this big moving action? The big handle on the door enables force to be used to open the door more easily. We know with heavy doors, some handles are also really big bars and can be grabbed with both hands. Why so far from the hinge and so big?  If the handle were right close to the hinge, or even in the middle of the door - short lever - a heavy door is hard to open - maybe immovable. Indeed, putting a lot of force on a small handle close to a hinge may simply wreck the handle and still not open the door.

When the handle is close to the end opposite the hinge, then the width of the door becomes the length of the lever and a longer lever (in this case acting like a wheel barrow type lever) can make a big door easy or easier to move. Having a big handle means more force can be applied more easily, to the lever as well. Consider the teres major on the scapula complementing the pull on the humerus of the lat - kinda like a two handed pull.

Likewise, we can look at position: the pecs pull from the arm to the furthest possible point away - the middle of the front of the body. The lats also go to the arm from the middle of the back of the body. With the delts, which are well supported by the pecs and the lats - likewise these muscles run almost to the middle of the top of the scap and the clavicle and then into near the middle of the humerus, like a tetter totter.

So why all these injuries? A modest proposal.
SO if the rotator cuffs are just support muscles, and there are these big levers to move the arm when loaded, why are they getting hurt so much of the time? That's a good question. Let's assume we're not talking about accidents where someone flies into one's shoulder, rips it off, or one falls on the shoulder and dislocates it, ripping tendons. Or let's also assume there's not some genetic defect that causes tendons to rub against a deformation in bone. From here, it seems a biggie issue in athletes is "overuse" injuries of various kinds, resutling in various kinds of tendinopathies (discussed with respect to the shoulder, over here).

When do these kinds of injuries usually happen? For instance why do i get issues with my left shoulder not my right? After months of double pressing was i listening to my left shoulder or my right during sets? was i relecutant to stop when my left may have been flagging a little more than my right? did that cause me to hyperextend my shoulder a bit, and cause the supraspinatus to rub against the acromium and inflame and pull and get messed up?

In other words, can a lot of overuse injuries be put down to form failure of one kind or another? Shoulder overuse issues are really common in swimming apparently - is one side of teh stroke less perfect than the other causing the support muscles to do more work than the big muscles?

Practice to avoid Failure?
There are lots of folks who have lots of programs for strengthening the rotator cuff, rehabbing it and all that. Maybe that's great and appropriate. Me, i'm wondering however if focusing on the site is missing the source of an issue. How often is an overuse injury for instance the fault of the little muscle that pays the price rather than limitations in the effectiveness of the big muscles?

How might one know? My bias is a movement assessment.

Consider if the problem in the shoulder is from lack of good mobility in the thoracic spine. Or if the issue has to do with poor firing of the lat to support the shoulder. Will rotator cuff-focused rehab hit these issues? In other words, my bias is to consider at least first what the larger movement issues may be and work from there.

How might one address the issue? Suppose one has done their movement assessment and has a bunch of specific movement oriented work. Then  joint mobility work as part of normal practice, and exercises that support one's practice (like the turkish get up and the windmill for the shoulder) are going to assist in good holistic movement.

Likewise, everyone needs a coach. It really pays to have an experienced coach look at our form and critique it and tune it. Some of us have never had an expert look at our movement. Hopefully the complexity of the above muscular interaction will provide good reason to make sure the movements we are performing are optimally supporting the way we move best to perform an exercise - and to be ready to quit when that form fails.


Scapula Moves for Greater ROM. In the first part of this series, we saw that the scapula moves up and down, back and forth and rotates up and down too for depression, elevation protraction retraction upward and downward rotation - all to extend the possible range of motion of the shoulder

RCMs In this part of the series we've seen how the arm that the scapula is moving about to extend its reach is both held to the body at the joint via the rotator cuff muscles - and more particularly how the big movers like the lats and the pecs especially and the delts in concert with these actually LIFT the arm up down around and back from these various scapular positions.

Glenohumeral Joint We've considered the role of the rotator cuff as local stabilizers or "active ligaments" to keep the arm in the socket for when the global levers of muscles are moving the humerus through its range of motion especially with load. That the rotator cuff muscles are like door hinges to hold the door in place so it can move, and that the big muscles are like the action on the well positioned lever to open the door.

Based on this model, we've considered that when injuries to the little support muscles occur it may be not always be becuase of particular weakness on their part but because of more systemic failure on the part of the grosser movement. As such, tuning our movement is a good idea, and we can do this by working on the range of motion of our joints, our movement quality with practice of rich multiplanar movements like the turkish get up and windmill, and that we can get a pair of pracitced eyes on our form at least from time to time to ensure we're moveing as well as we think we are. 

This two part series is by no means exhaustive in terms of the shoulder girdle or joint - i haven't even touched on the role of the clavicle or the role of elbow flexors and extensors that connect into the shoulder. Nor have we talked about the nerves running through the shoulder and how neck mobility can consequently help with shoulder movement.

Really this two parter has just been meant to share some appreciation of the three core components of shoulder movement: that the scapula moves to support range of motion; that the rotator cuff holds the arm moving with that scapula and that the big arm movers lift/pull that arm as its stabilized in that joint. That story is told in the amazingly odd shape of the scapula.

I hope these pieces may inspire folks to explore a little deeper or at least help make a bit more sense of what's happening in the shoulder and from here help make a bit more sense of our own movement practice.

Any mistakes in here - including soggy analogies - are mine.



Sunday, June 20, 2010

the amazing engineering that is the shoulder, part 1: scapula and shoulder girdle

How does the shoulder really work? What is it, anyway? When we think of working the shoulder, most of us likely think of the delts, maybe the traps (shoulder shrugs and all). When we think about shoulder injuries, the term "rotator cuff" enters the vocabulary and we worry about how to prehab/rehap these little stabilizer muscles. But really, the shoulder, or more particularly the shoulder joint and shoulder girdle is an amazing feat of evolutionary engineering, so much so that most of what we tend to think of as uppert body work is really shoulder work.

Consider that we usually think of the lats, traps, rhomboids all as back muscles, and the pecs and seratus anterior as chest muscles. Yes, ok, that's more about where those muscles are located, but they're all, really really, shoulder muscles. Even the triceps and biceps are involved as shoulder muscles - and require the shoulder as their anchoring points.

Understanding a little bit more about how the shoulder works in terms of where the muscles attach to what and how they act on the shoulder may help enhance our lifting, prevent injury, and help us understand what we're doing - or not - when we think about working out.

So the goal of this set of posts on the shoulder is to offer a wee tour through the shoulder, and provide further resources if you get fired up to look further.

Part 1: the Scapula and Shoulder Girdle

In structural kinesiology - the study of movement in terms of nerves, bones and muscles and joints - there are two main ways to look at the shoulder: the shoulder girdle and the shoulder joint. Both of these views considers one of the weirdest and coolest bones in the body, the shoulder blade or scapula.

In this first of two parts looking at the shoulder, we'll first take a quick look at the multifacetted structure of the scapula and also look at the muscles associated with the shoulder girdle - or the muscles primarily involved with moving the scapula itself.

In part two, we'll look at the muscles acting on the main shoulder joint, the glenohumeral joint (gh), from the rotator cuff muscles to the lats and pec major.

The Scapula: It's a wild wild bone.

This figure above shows three views of the scapula: the front side that faces the back of the ribs, the back side that we can feel or palpate, especially along that honking big spine, and where the magic focuses, the side on view that features the glenoid cavity - the aras where the arm - in particular the humerous fits into the shoulder.

Take a look at the ridges and bumps: every bit of an indentation or edge has a purpose in the muscular rigging that is the shoulder joint and shoulder girdle.

Overview: Let's take a quick look at the shoulder girdle muscles to get a sense of the specialness of the shoulder girdle design and what i mean by this rigging - and possibly why this approach in our design (is so cool).

The scapula first and foremost is situated behind and at the top of the rib cage. It has muscles attached to both sides of it: there are muscles along it's back; and muscles along its front. The ones we're looking at here are the ones that primarily move the scapula, and help keep it in position along the back of the rib cage.
As said, each bump, dip and pointy part of the scapula has a mechanical design purpose.  By way of example, the image to the left shows the back view of the scapula. In red, the levator scapula is attached to the superior border of the scapula. This shoulder muscle, while attached up at the top four vertebrae in the neck is not a neck muscle per se, but exists to help pull the scapula up (and a bit towards the spine, elevation and adduction)

If we look back at the image of the scapula bone, we see the medial border on the back/posterior side of the scap. Follow along to the medial border (left side of spine in the image with the levator scap shown) and the minor and major rhomboids are attached there and plug into the bottom of the cervical spine, and top half of the thoracic spine. If we just follow the line of the muscles, which go up diagonally, we can see that when they contract they'll pull the scapula towards the spine and up in elevation, but actually in doing so, can also rotate the shoulder socket down. We'll come back to why this rotation is important.

On the other side of the spine we see another rich and amazing attachment, the trapezius which is considered in three parts. The upper fibers attach along the far end of the clavicle or collar bone and the scapula's acromial process, and also along the start of the big spine on the back of the scapula. Again shoulder elevation helped here as well as adduction. Then the middle fibers which attach a little along the scapula spine, but also this time, rotate the socket up. The lower fibers of this massive muscle which connect on the scapula spine under side-ish area. These also contribute to pulling the shoulder socket up, but also bringing the shoulder down blade down.

To take a quick look at the front-ish part of the scapula, there's the pec minor and the seratus anterior.

The pec minor attaches to the scapula at the coricoid process (the biceps at one point do, too, among others) and then into the ribs. Again, if we follow the line of the muscles, we can see that when contracted, these muscles will pull the scapula, well, rather over the shoulder, rotating the socket downwards. The scapula also gets pulled away from the spine (abducted), and likewise dowward (depression).

The serratus anterior is an amazing set of muscles that connects all along the medial border on the inside/front of the scapula, on the opposite side from the rhomboids.

Where the rhomboids pulls the scap up and towards the spine, the seratus anterior pulls the scapula away from the spine and the scapula up at the same time via the attachment upwards along the sides of the ribs. The joint tension of the rhomboids and the serratus anterior both help keep the scapula down against the ribs in movements like the push up.

Why all this Scapular Movement? RANGE EXTENSION. I dunno about you, but while i've heard about shoulder depression and elevation and rotation, it hasn't meant a whole lot to me until i got to see what the bones actually do relative to what's getting rotated: the arm in the shoulder joint.

An image may help. Take a look at the relative positions of the scapulae in the picture to the right here (in red the supraspinatus is highlighted, but that ain't important right now). If we look at the left arm, we'll note that the glenoid fossa - where the humerous fits into the shoulder) is in neutral. With the right arm elevated, like in an overhead press, we see that the whole scapula is titled away from the spine and that the glenoid fossa - where the arm connects - is pointed more UP.

Bottom wonderful line is that, by rigging up the scapula so that it's got all these guy wired muscles holding the scapulae as a kind of floating anchor point, we get far greater range of motion with our arms than if we had a more or less fixed ball and socket joint.

That is, if the scapula, which is largely designed to act as an attachment for the upper limbs, were fixed to the spine as a bone such that the socket for the humerus was fixed ( unable to rotate up, down, back and forward), the arm would have far more restricted motion. We'd be unable to press up, cross our arms, do push ups, waltz. Awful to contemplate.

So let's not. Let's sum up where we're at today.

Summing up part 1
In this first article on the shoulder girdle & scapula, we've had a quick look at the muscles that support the movement of the scapula and concurrently the resulting rotation of the glenohumeral joint that allows for the all important rich range of motion of the arm at the shoulder.

Next, we'll look at the muscles acting on the glenohumeral joint, like the giant lats, pec major, teres major, and including those pixie trouble makers, the rotator cuff muscles. Guarenteed once we go over how they work and where they are in the scapula, remembering the names of the four will be simple.

But heck, isn't that scapula an amazing bone or what, eh? 

Some great books to help get into structural kinesiology are

Manual of Structural KinesiologyManual of Structural Kinesiology
Anatomy of Movement (Revised Edition)really really good source for getting at the complete details on joints, muscles, actions, planes of motion, nerves. THere are great exercises and quizes with the book as well for self-testing

Anatomy of Movement (Revised Edition)
A very personable look at anatomy in the context of not only athletic but every day movements.

Trail Guide to the Body BookAnd for getting into the actual feel of where these muscles are and how they operate live, there is the very popular Trail Guide to the Body Book

And heck if you've ever tried to figure out whether that groin pull is an adductor magus or gracialis, this is the one for you.

More books that include seeing the real tissue (making the case for illustrations) next time.

Related posts:

Tuesday, June 8, 2010

Vacance - short break at b2d

just fyi, there'll be a wee hiatus at begin2dig till after June 18.
Time for a wee break from all things plugged in - a Health Act, as it were.

Hope to see y'all again in a couple weeks, and that your practice continues great in the intervening period.

best to you,

Friday, June 4, 2010

One less Rep - It's ok NOT to finish a set. Really. Less is hard but can be more

Workouts are about work, about sufficient challenge for adapatation, about getting more perfect in each step of our practice. So why so many overuse injuries? Why so many of us getting jacked up? I wonder if it's at least in part from the reluctance to quit when we need to quit? So let me all fellow workout heads ask this quesiton:

when you workout, if you have 10 reps of a set to do, or 5 sets to do, you WILL DO those reps; you will DO those sets. Even if you don't feel perfectly happy with yourself, entirely, especially if there's only three more reps, you're gonna do those reps. Or one more set, you're gonna do that set. Well are you, punk? your inner voice inquires?

Fave example: you're doing viking warrior conditioning - you have your 8 reps per 15 secs to do - ok wait, that's me, let's just own it: i'm doing VWC, these are my reps and sets, the timer is ticking, i have 3 more sets to do, the blister is forming on my hand - i can feel it - but will i quit? NO, because i HAVE TO FINISH MY SETS.

What's the Value of Having to get That Last Rep? Um, question to self: Why? Is this a competition? does someone have a gun to my head? What do i get out of a big fat crap-technique-showing blister except nearly a week off snatch practice? All i get is wow, i finished my sets. great. So what? i'm now looking at a several day hit to my training?

You know, saying this i'm thinking, this is just so obvious, isn't it? Hand starting to blister: stop.  Duh. But the Duh has not been there, at least for me in the set, while the set is happening.

At the RKC II cert in Feb, Pavel Tsatsouline, frech off the research for his Power to the People Professional,  gave a related lecture on old time strong man training. A big part of that was strong men staying away from 1RM work; staying fresh.  This theme is nothing new to Tsatousline's training approach. Stay fresh, gas in the tank, perfect form.

And yet...

Even when i believe i'm focusing on Pavel Tsatsouline's guidance to "stay fresh" - always end the set feeling fresh rather than ever going to failure, see i'm thinking i'm not - or haven't been. Why? Because i have been recovering from what has been called an "overuse injury" - tendinopathy in the shoulder. Painful arc syndrome. What ever.

There are lots of reasons for overuse injuries: lots of reps being one of them, but usually that's lots of use that is beyond the capacity of that tendon. And what wears into overuse? Form issues? And what happens to form on the weaker side when going with the stronger side? Fatigue? And with fatigue comes injury. We know this. This is basic.

Pain is the Last Warning for Change, not the First. The ugly side of overuse injuries is that they don't show up as pain until there's been some damage. Imagine pain being like an oil gage that only tells you when there's a teaspoon of oil left in the engine: there's no funky needle showing you the oil steadily leaking out of the system. And by the time that needle is in the red, well ya know something has likely been hurt in the engine, too.

Another analogy - this time with the human body, but same "if you feel it, it's gone too far" effect is like thirst. Waiting to hydrate till we're thirsty - especially on a hot day out in the sun - is too late.  By the time we're thirsty symptoms of sun stroke/dehydration have hit our systems.

Pain is really our LAST warning. And as i've written about before, from the pain literature, pain is a warning (or signal) to change. Figuring out what to change can sometimes be an issue, but in working out with weight

And in working out, it seems we need to get better at developing our early warning system. What is that early warning system? Learning to trust ourselves. How might we do that? Let me offer an example.

Test It.  The other day i had a write up to do 10 sets of X for my particular routine that day. By set five i was feeling a bit fatigued. So i thought wow this is too early to quit, surely, but let me test it. So i did a fatigue test (described here) - waited my normal recovery time - and retested. Nope. Not ready. Wait, retest. Good to go. Did the next three sets, and when going to do set 9, i had to own i felt not quite fresh. Like i'd be pushing it. So i didn't push.

What's the difference between 9 sets or 10? Let's see. That's 90% of the workout instead of 100%. 10% less volume. Let's put this in context: 10 fewer reps out of 100. Once in a week. What's the performance difference? My recovering shoulder was not saying the next day "don't do that again," so i was able to go ahead with my next day's plan. Great.

For folks not doing rehab/recovery for an injury, you may be wondering what does this have to do with me? I'm going to push hard. Bien sur. No one is saying don't work hard. We have to work hard for an adaptation. Work smart and hard.

After all, has my body lost anything by those 10 fewer reps in one workout session all week? In terms of absolute total volume, sure, but in terms of adaptation, i *don't* know. My guess is, not likely. Indeed, maybe for me i just optimised my load, doing the best for me at that moment by doing a few less today than what was an arbitrary number on a piece of paper. Ranges are better than absolutes, perhaps; intensional rather than extensional.

Pain is the Last Signal, not the ONLY signal. Every workout since then i've been trying to *listen* to my body to hear the signals that are there before pain happens.  Rather than ignoring them as "nothing" i've been asking "what if?" - what if this tiny tiny bit of lost form, or this teeny weeny bit of fatigue may actual be more than i want to give it credit as being?

The cool thing is (and it took me a long time to put together this simple 2+2 is 4) i have a suite of self-assessments i can use to self-test whether or not this is an "ok, just pause the set here - not even quit; just pause, do some recovery and then continue" kind of issue or a "bag it" one.

Now personally i do not test every set, every exercise, and perhaps i'll learn that that is less than optimal. Right now, what i'm testing is simply that set of question marks i would simply have ignored before and carried on to GET MY NUMBERS complete my workout.

Practicing Less(ness) - towards overuse prevention. What's interesting for me at least is that part of this practice is practicing a different perspective: letting go of the last rep. I have been consciously trying even if i feel fine going for X planned reps, just once in a while - usually at the end of the workout - to do X-1. Or one set in the block (if this is a volume day) to do a set that's half or two-thirds the no. of reps for that set.

Why? because i'm thinking it's kinda stupid to be so obsessed with getting in numbers - i'm pretty sure my "overuse shoulder injury" is not practicing a true focus on perfect quality rather than arbitrary numbers.

I may have thought oh ya i'm still fresh my form is still dandy, but my shoulder has told me something else, like "you blew it." I don't want that to happen anywhere else. So gonna listen - and lessen.

Less is Hard. Right now, i have to say, doing a set of 5 rather than 10 (in ten sets), finishing a set of 100's instead as 99's still causes a twinge in my brain. I still kinda clench my teeth, like somehow that means what? my whole workout is toast? i'm not as great as if i'd done the full count? That somehow without that weary adherence to numbers i'm a loser? can't cut it? oh dear. What would i say to someone i was coaching who was expressing such concern?

I guess i just decided i don't want to be that person anymore - who "has to do it" when there's no good reason why to do so and a potential raft of better reasons not to do so, or at least be flexible.

I'm not there yet - i'm not at a place where that less than planned sits well, but i'm working on it.

Take Aways Pain from overuse injuries shows up after the injury has happened. It may help therefore to learn to listen for other signs in the body to help suggest when actions that may  contribute to overuse are happening.

There are ways to help hone this awareness - self-tests that we can leanr and practice when wanting to reality check how we're doing - lots of them in the essentials of elite performance dvd. BUT in order to hear something at all to trigger a test, speaking at least for myself, comes a willingness to do LESS than was scheduled for a day. And like any other performance skill, less needs to be practiced.

On the plus side, i'm finding that actually practicing less, learning less, has let me do more and in this recovery phase where doing anything has been a bonus, my better self is pleased with that progress.

How you doing with less is hard, but less can be more?

Related Resources

Thursday, June 3, 2010

660 seconds (11 mins) of minimal resistance training = a HUGE difference for fat burning

ResearchBlogging.orgWe know pretty unequivocally that the biggest part of a fat loss program is nutrition. That's first. BUT we also know that exercise can really help with keeping that program going. If we look at work on obesity and the role of exercise, we're looking at 5 hours of exercise a week (along with diet and expert support).

5 hours may be a good and healthy norm, but do you know any geeks who will say ya you bet i can get that 270-300 mins a week in. You bet. Not.

So a question might be, what's the minimal amount someone - especially someone at risk of being obese - can do in terms of working out to achieve a metabolic difference - where that metabilic change is to a boost start burning more calories in a day, and in particular burning more fat calories. 

Researchers in 2009 took a look at just this question. The answer is - we're not entirely sure, but here's something that looks really promising:
Long-term resistance training (RT) may result in a chronic increase in 24-h energy expenditure (EE) and fat oxidation to a level sufficient to assist in maintaining energy balance and preventing weight gain. However, the impact of a minimal RT program on these parameters in an overweight college-aged population, a group at high risk for developing obesity, is unknown. PURPOSE: We aimed to evaluate the effect of 6 months of supervised minimal RT in previously sedentary, overweight (mean +/- SEM, BMI = 27.7 +/- 0.5 kg x m(-2)) young adults (21.0 +/- 0.5 yr) on 24-h EE, resting metabolic rate (RMR), sleep metabolic rate (SMR), and substrate oxidation using whole-room indirect calorimetry 72 h after the last RT session. METHODS: Participants were randomized to RT (one set, 3 d x wk(-1), three to six repetition maximums, nine exercises; N = 22) or control (C, N = 17) groups and completed all assessments at baseline and at 6 months. RESULTS: There was a significant (P < 0.05) increase in 24-h EE in the RT (527 +/- 220 kJ x d(-1)) and C (270 +/- 168 kJ x d(-1)) groups; however, the difference between groups was not significant (P = 0.30). Twenty-four hours of fat oxidation (g x d(-1)) was not altered after RT; however, reductions in RT assessed during both rest (P < 0.05) and sleep (P < 0.05) suggested increased fat oxidation in RT compared with C during these periods. SMR (8.4 +/- 8.6%) and RMR (7.4 +/- 8.7%) increased significantly in RT (P < 0.001) but not in C, resulting in significant (P < 0.001) between-group differences for SMR with a trend for significant (P = 0.07) between-group differences for RMR. CONCLUSION: A minimal RT program that required little time to complete (11min per session) resulted in a chronic increase in energy expenditure. This adaptation in energy expenditure may have a favorable impact on energy balance and fat oxidation sufficient to assist with the prevention of obesity in sedentary, overweight young adults, a group at high risk for developing obesity.
 Just to be clear about what the program included:
Participants performed 1 set of 9 exercises designed to train all major muscle groups (chest press, back extension, lat pull down, triceps extension, shoulder press, leg press, calf raise, leg curl, and abdominal crunch) using a resistance of 3–6 1RM, approximately equal to 85–90% of 1RM.
So not what anyone would call a super arduous program or one that folks without mobility/pain issues could perform as these moves are all done on machines. Some of us might have chosen different moves - like only compound moves without machines - but let's leave that aside. These have the advantage of also being seated, which for an inactive overweight population may be a good thing.

Main Pluses. The main thing is that after 6 months, the folks doing this very simple, every-other-day program had significantly greater fat free mass (FFM) - or lean mass (eg, muscle) than the Control group. That's nice. But what is associated with this in terms of potential fat loss support? An upped metabolism, as measured by various metabolic resting rate measures. Faster metabolism is a known associated outcome with exercise; that means more fuel will get used more quickly. For example, 24hr energy expenditure went up from 13091 kJ's a day to 13618. That's a big deal.

And one more finding - the RQ measure - checking expiration gasses - showed that the (resistiance training) RT group seemed to have an upped "fat oxidation" level - that is, burning more fat for fuel, as opposed to carbs. That's what we want from exercise: more fat burning.

Reality Check. Working out alone doesn't cut it for fat loss. In the results, both groups over six months had their weight go up and their BMI go up. That's not good. BUT the fat mass increase in the RT was "non-significant" at 3.3% but definitely significant in the C group  at 8.8%.  Note, there was no specified dietary intervention in the study; the only mandated change was the exercise program:
Differences in reported dietary intake (total energy, carbohydrate, fat, protein) were not significant between the baseline and intervention periods for either RT or C, or between the 2 groups during the intervention. The mean intakes for total energy, and percent of dietary carbohydrate, fat and protein were 9538 kJ/day, 50%, 34%, and 16%, respectively. There was no difference for either group at baseline and 6 months between energy and macronutrient intake during the three days of standardized food prior to or during the calorimeter stay.
In other words, eating habits didn't change BUT over six months, these folks gained lean mass, had there metabolic rates go up, and instead of losing fat free mass as in control, had their fat free mass go up.

Take Aways. So what are the possible take aways from this study? One the authors suggest is that 11 mins. of resitance trainging might pose an interesting alternative to cardio/aerobics. As the authors state "the positive influence of even a small amount of RT on fat oxidation suggests an important role of RT on body mass management."

So imagine the benefit of combining a minimum 11mins of resistance training with some simple non-calorie-counting nutrition habits (like those found in precision nutrition) and who knows how the world might change?

Simple Program for fat loss? workout: 11mins of resistance, 3 days a week + nurtition: Change one thing a month with say the PN habits (download), and suddenly persistence of simplicity carries the day.

If you try this approach or know someone who will, pleaes let me know how it goes.

KIRK, E., DONNELLY, J., SMITH, B., HONAS, J., LeCHEMINANT, J., BAILEY, B., JACOBSEN, D., & WASHBURN, R. (2009). Minimal Resistance Training Improves Daily Energy Expenditure and Fat Oxidation Medicine & Science in Sports & Exercise, 41 (5), 1122-1129 DOI: 10.1249/MSS.0b013e318193c64e

Miller, W., Koceja, D., & Hamilton, E. (1997). A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention International Journal of Obesity, 21 (10), 941-947 DOI: 10.1038/sj.ijo.0800499


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