Today I experienced my first (and hopefully last) Hot Yoga class. My wife has recently started taking these classes and asked me if I would come along to try it out this Sunday morning. I’ve taken “Bikram” yoga before, just not with the heat so this was definitely a much different ball of wax. I’ve had countless people and clients tell me how “therapeutic” these classes are and the laundry list of physical, mental, and health ailments that can be fixed with this type of yoga is incredible. This also raises my skeptical eye a bit!
Anything that Sounds too Good Should Raise your Skeptical Eye!
The class started with 5-10 minutes of lying on our back (Sahvasana or “corpse” pose) focusing on slow breathings..this is good and something I often recommend to my own clients for both fitness/training and massage sessions to prime diaphragmatic breathing which can help balance out the autonomic nervous system (sympathetic vs. parasympathetic). It didn’t take long however for the incredible heat in the room to start becoming a bit of an issue for me. It’s not that I”m not used to heat; in fact, I train in it at least 3 days/week (even in the summer) when I do my outdoor sprinting sessions with my client and training partner Patricia. Something about being in that humid, hot, and enclosed room gets me a little claustrophobic however. After about 20 minutes, my only thoughts were on when this experience was going to be over; not good since the class was 80 minutes long. My main thoughts after about 1/2 an hour or were on escaping but I decided to stay in there to not embarrass my wife! I felt as if my body was more concerned with survival (keeping my brain and organs cool) than it was on making some cosmic connections, purging my body of toxins, or de-stressing. My heartbeat was so fast it really felt like too much of a workout for me even though I could get through all the poses (although not that gracefully!).
Some of the Traditional Bikram “Hot Yoga” Poses
Yoga and Relative Flexibilty Problems
Some of the poses were pretty cool ( like some of the warrior poses) and I remembered them from years back when I took a non-heated Bikram class at ASU for 5 weeks in a summer school session. Many of the poses however, I could tell I wasn’t even remotely in the right position so I tried to modify them as much as possible to avoid unnecessary stress on my joints, ligaments, tendons, etc.. This is the major problem I have with yoga: WAY TOO MUCH COMPENSATORY MOVEMENT!! Unless you are a fairly mobile person all over, many yoga poses will cause people to stretch what is already loose without actually stretching areas that are truly restricted (either neurologically, locally via altered connective tissue changes, or both). For those who are familiar with the “joint-by-joint” approach to mobility and stability, or have read any of Shirley Sarhmann’s (a notable Physical Therapist) work, the concept of “relative flexibility” or what Sarhmann calls a joint’s “directional susceptibility to movement” (DSM). This basically means that the body will always take the “path of least resistance,” even if this causes harm or irritation to bodily tissues..not good!
I don’t think Shirley Sarhmann would have approved of some of the positions in Hot Yoga today!
It’s not that yoga can’t be done well, it can! It’s just that many of the countless people who partake in it, are probably irritating some tissues from over-stretch and strain while other tissues are on holiday taking it easy. In private or small group yoga classes with a very keen eye of a skilled teacher, many of the poses can be modified to honor the proper alignment that is paramount to a quality yoga pose. With large “boot-camp” type of classes however, this just isn’t possible. The emphasis on profitability over actual student outcomes is probably to blame here; but people need to make a living so I can’t knock anyone for that.
This was me at the end of class….just kidding!
I personally feel better when I follow a more individualized stretching program like those emphasized in the Functional Movement Screen system of attaing a better balance of mobility, stability, and fundamental movement patterns. This way, I can ensure I am honoring the joint-by-joint approach to achieving mobilty (and stability) and ensure connective tissue (of any type) are not unduly strained by over-agressive stretching methodologies. Yoga has been around a long time and really has given us some wonderful lessons in movement and awareness. Most notably, the emphasis on proper and deep diaphragmatic breathing. However, it can also wreak havoc on our much imbalanced bodies these days that have eroded some fundamental movement patterns that were probably present back in early days of yoga’s creation. This experience has also motivated my to try and find a Tai-chi or Chi-Gong class as those types of movements calm my nervous system down much more than the “tug of war” I sometimes get into when trying out yoga classes of various type. If yoga is your thing and makes you feel better (with no increased pain) than by all means..knock yourself out!
Next time my wife asks me to go to Hot Yoga however, I think I’m going to “NAMA-STAY” home!
Review of Dan John’s Intervention: Course Corrections for the Athlete & Trainer (3 DVD set)
by: Keats Snideman
Behold Dan John’s “Intervention!”
I first met Dan John back in 2004 at one of the first Annual Charles Staley Fitness Summits that took place in Las Vegas, Nevada. I was co-presenting a talk with Josh Henkin that we called “The Myth of Functional Training.” Following our talk was Dan John and it was the first time I had ever heard him speak; suffice to say that I’ve been a fan of Dan and his teachings ever since. In addition to Charles Staley, Dan John, Josh and myself, this summit also included an incredible presentation by Pavel Tsatsouline and the always entertaining and intelligent sports nutrition expert, Lonnie Lowery. In fact, I think this was the first time Pavel and Dan met. Needless to say this was an incredible event and it is forever etched in my memory. To be presenting on stage with those guys was incredible!
What a Line-up ! From Left to Right: Pavel Tsatsouline, Dan John, Lonnie Lowery, Charles Staley, Yours Truly, and Josh Henkin!
The fundamental element that really sticks with me about Dan and all his presentations that I’ve seen is his innate ability to blend philosophical (possibly even spiritual) and technical training advice into one, cohesive system of checks and balances. You see, Dan isn’t just a strength coach, he’s really more of a life coach. No, I don’t mean he got one of those nifty Life Coach certifications at some new-age woo-woo school, but rather through years of learning, coaching, mentoring, teaching and living. Dan has really walked the walk and has “been there, done that” with so many aspects of the iron game and sport (mainly Track and Field/Discus and Olympic lifting/Highland Games) and most importantly, the school of “life.”
Have Any of These Problems with Training and Life? Coach Dan can Help!
This is where Dan John’s newest DVD project, Intervention, really shines. In classic Dan John style (with plenty of wit and humor!), we are treated to three and a half hours of a workshop where Dan shared his latest rendition of what he calls his “Intervention” tool kit. Over the 3 DVD’s we get a detailed understanding to his always evolving system of balancing training stressors with life. We also get some fantastic ideas on how to prioritize our training to improve results.
Here’s a very brief synopsis of some of the highlights of the 10 tools he gives in his Intervention Tool Kit:
1. Traffic Light- Green Light, Yellow Light, and Red Light
What’s your goal? Which traffic light are you going through in the various aspects of your life. For example, getting to the Olympics while going through a divorce might be a little difficult due to the red-light effect of that type of stress! Not that it can’t be done..just a lot harder with that kind of stress.
The Difference Between Health and Fitness: Health is the dynamic interplay between organs/viscera while fitness is simply the ability to complete a task.
Many people have goals (physique/aesthetic or competitive sports) that involve training or competitive stressors that are NOT healthy for the body.
2. The Spiral- Life must be balanced between Work & Rest, Play & Pray. If you work more, you must rest more. By balancing out these elements, your life spirals into more opportunities and possibilities. When Dan is working with someone, he wants their entire life to expand and take them to places they don’t know with the ultimate goal of enhancing their life and not just their training program. Good stuff!
3. The Glass- Absolute Strength is the glass! If you have a very small glass, it hard to take a lot of extra stress. This is where strength coaches/trainers can really help clients..give them a bigger glass!
“The Bigger we can make your glass, the more idiocy you can have!” The Bigger the glass, the easier it will probably be to attain your goals.
4. Quadrants (I-IV)- Quadrant 1 includes things like a basic PE class with a lot of basic, fundamental movement and sporting tasks learned.
Quadrant 2, includes collision sports like football.
Quadrant 3 (yin-yang quadrant) is where most of us live. It includes most events in track and field and fat loss.
Quadrant 4- 100m dash in track and field, a bench press or deadlift specialist. Dan thinks that the Olympic lifts are probably in this quadrant as well.
“Quadrant four- nobody cares about how hard you work. We only care about the answer-the finish line-the solution! How you get to clean & jerk 600 lbs? No one has ever done it before, but whoever does it has the correct answer. The rest of us are just wrong!”
5. Age- the role of hypertrophy becomes more important every year after the age of around 27 or 28. Joint mobility also become increasingly important as we age.
“Remember the show, Cocoon? You don’t have to jump into the alien water. Lift weights. Get your lean body mass jumping up a little bit and you’re going to be a royal pain for everyone trying to hold onto you. I can’t wait to move into my daughter’s place in a few years. I am going to sit in my underwear on the front porch and complain about the neighbor kids all day long. That’s my goal for retirement.” Ha ha…I can’t make this stuff up…Dan is just that funny!
6. Listen to the List- this is where Dan really gets into the nitty gritty of his current recommendations on training. He starts with what he calls the “the Five basic human movement” which are:
6) Get-ups- not formally part his list but he mentions the get-up often for its corrective potential.
He then goes to explain the benefit of patterning those movements before getting to Grinding, or slow strength movements which is then followed by asymmetrical work. The final version of each of the basic human movements is Explosive and Ballistic movements which for Dan culminates in teaching his athletes/clients things like push-presses, push-jerks, long-press, swings, the snatch, the clean & jerk, and a Litvinov workout (which is a combo of a strength or explosive strength move followed immediately by some kind of sprint).
In essence, if someone older really wants to learn the Olympic lifts, there are so many questions that need to be answered first regarding this lift of the basic human movements and their progressions. This entire section of the 2nd and 3rd DVD is just pure gold and really helps put progressions to one’s training process into great perspective.
7. Test- you’ve got to “test” for patterning, slow strength and symmetry. Dan’s patterning examples ARE the tests for qualifying clients/athletes for the appropriate level of the basic human movements.
8. Realistic Reps- the most important thing Dan can tell us about programming is “reps,” realistic reps!
The Rule of Ten: For full-body strength or explosive moves (i.e. dealifts, C & J, Snatch, push-jerks), around 10 reps seems to be the amount of reps you can handle in a key lift for a workout. Some examples of workouts are: 2 x5, 3 x 3, 5 x 2, 5, 3, 2.
1/2 Body Movements: 15-25 reps. Examples would be Bench Press, squat, front squat, etc..
Explosive Full-Body Movements: i.e. Swings, 50-100+ reps.
Key question to ask with realistic reps: “Can you come back and do that workout again and again?” “Is your workout repeatable? This is the key. Dan wants us to think of success over 6 decades, not just one competitive season or year.
“Just because you can type it (rep #), doesn’t mean you should do it!”
9. Rewards & Correctives-
Dan, being a Sr. RKC has taken the CK-FMS certification and has been influenced by this incredible system. The only difference is he doesn’t believe that most athletes/clients will come in early to their training sessions to do “correctives.” This is where Dan likes clients/athletes to sneak in their corrective mobility/stability work between sets of exercises that are already well patterned with a decent strength base. This is similar to the way I’ve been combining this type of work so its nice to see Dan incorporating this into his routines for people.
The 80/10/10 Rule: 80% of time should be devoted to an athlete’s primary sport. For a fat loss client this would be spending time on a food journal since eating compliance is the number one goal for fat loss. 10% of the time should be spent on getting stronger; getting a bigger glass so to speak. The other 10% is for correctives.
Dan likes clients/athletes to sneak in their corrective mobility/stability work between sets of exercises that are already well patterned with a decent strength base. This is similar to the way I’ve been combining this type of work so its nice to see Dan incorporating this into his routine for people. Also, if someone has never done loaded carries in their life, this is corrective. Simply following his table of the basic human movements and prioritizing the movements which are poor and being neglected, IS corrective according to Dan. Make total sense…
Dan then goes on to give some examples of how to program training for specific athletes (case studies) using his “intervention” tool kit. He breaks the seminar attendees into groups and gives them hypothetical examples for them to apply this intervention method. This is just invaluable information as being able to think about WHY someone should engage in a particular training process is probably more important than just being able to teach exercises and entertain clients.
10. Seamless Warm-ups:
the biggest problem that Dan sees when people are trying to help people (i.e. “intervene”) is that the warm-up is “X” and the workout is “Y.”
The warm-up and the workout should ideally blend in to one another..”to be seamless.”
One of Dan’s favorite way to warm-up is a combination of the following:
Goblet Squats (15-25)>Swings (75-100)>Get-ups (1-10)..or basically what we teach in the HKC. Incidentally, I am hosting an upcoming HKC with my twin brother Franz in September (the 24th) which you can read more about here.
Correctives and stretches can be placed seamlessly in between the Goblet squats, Swings and Get-ups during the warm-up as well as during the main part of the workouts between strength lifts.
This synopsis only scratches the surface of the the material that was in Dan’s lecture. I highly recommend the motivated trainer/coach or fitness enthusiast to check out this DVD set; it really helps put things into perspective (i.e. the big picture) while giving the viewer some great insight into how to put first things first and really prioritize what to do in our training.
I am constantly amazed at the editing work done by Laree Draper of On Target Pulbications; hats off to Laree for this latest DVD product; it is superbly made and the info from Dan is life changing. If you don’t have a copy of Dan’s book “Never Let Go,” and his other DVD’s, I would highly recommend these also.
As a bonus, the DVD set also includes (on DVD #1) a copy of Dan’s Intervention handouts, a full transcription of the entire talk in PDF format, an MP3 audio file of the talk, and more PDF files of great knowledge and insights from Coach Dan! Get your copy of this incredibly helpful and insightful DVD set here.
Should Sprinting and Jumping Athletes Do Plyometrics?
By Keats Snideman, CSCS, CK-FMS, LMT
What Are Plyometrics?
Probably one of the most commonly used (and abused) methods of performance-enhancement for sprinters and indeed all running and jumping athletes is “plyometrics.” Plyometrics can be defined as movements that involve fast eccentric muscle actions followed by dynamic and explosive concentric actions (aka, the stretch-shortening cycle). The best example of a plyometric drill that comes to mind is the classic “depth jump” exercise where an athlete drops off a box or step of some pre-determined height. Upon hitting the floor the athlete concentrates on explosively jumping into the air as high as possible. The purpose of this method is to “shock” the body and nervous system to produce higher levels of muscle tension and force than would normally be possible without the preceding drop. In fact, the “father” and creator of modern day plyometrics, Yuri Verkoshansky of Russia, originally named the plyometric method the “shock” method. To understand how such a system of exercises could be beneficial or detrimental to sprinting, jumping, and indeed all athletes, let’s take a closer look at basic muscle function during movement.
Reversible Muscle Action (i.e. The Stretch-Shortening-Cycle)
Through scientific observation, it has been discovered that if a muscle is stretched immediately before a shortening (concentric) muscle action, force and power output will be increased and energy expenditure will be less. To demonstrate this phenomenon, assuming you are sitting while reading this article, try to stand up. Do it now. Could you feel your body rock back to stretch the thigh muscles a little before you stood up? This is perfectly natural and is called “pre-stretch.” Many sporting actions and resistance training exercises actually involve some level of pre-stretch which enhance the subsequent performance. In the case of sprinters, have you ever noticed the different rituals they use when getting in the blocks. Often, you’ll see the sprinters stretching and kicking their legs behind the blocks before setting their feet in them. This is pre-stretch at work. Now getting back to our little sit-to-stand movement again, I want you to try standing without any pre-stretch (rocking back) whatsoever. In other words, lean forward a little from the hips and then stay still for a few seconds before trying to rise. Much harder if not impossible isn’t it? This simple test and observation is an easy example of how natural it is for human movements to utilize eccentric/lengthening muscle actions prior to concentric/shortening actions.
Even human gait (walking) utilizes this stretch-shortening-cycle to make it more efficient in terms of energy expenditure. In fact, if you walk at a comfortable walking speed (you’re preferred speed), you should be able to walk practically forever. However, if walking speed is increased or decreased from this preferred cadence, efficiency is lost and perceived effort may increase. Let’s apply this pre-stretch stuff now to running, sprinting and jumping. In sprinting in particular, there is a greater stretch of the plantar flexor muscles (gastroc-soleus, etc…) if the foot and ankle are pulled up (i.e. into “dorsi-flexion”) prior to foot strike (heel strike in walking and running). If performed correctly, this pre-stretch is followed by and explosive isometric muscle action and then the propulsive concentric action which moves the body forward and upward off the ground. This is also what happens during a vertical jump except that the arms and shoulders might be used more or less aggressively depending on the situation. This entire process is due to stored elastic energy in the muscles and tendons (think of a spring) and neurological reflexes (primarily the myotatic stretch reflex). When combined with a volitional effort to explode, improved performance (i.e. fasting sprinting times, higher vertical jumps, etc…) can be realized.
Classification of Plyometric Exercises
Plyometrics can be broken down into various types for simplicity. First off, you have “Impact” and “Non-Impact” forms of plyometrics. With impact plyos you have direct contact with a surface (i.e. the ground or playing surface) or an object (such as a medicine ball or sporting implement). In contrast, non-impact plyos involve a quick stretch (recoil) of one or several body parts and joints which then culminate in an explosive concentric muscle action. Examples of non-impact plyometric actions include various kicks and punches in martial arts and boxing. Also, you can think of a baseball pitch as a very dynamic and explosive non-impact plyometric movement. Ever seen a slow-motion or still picture of a pitcher’s arm in the cocked back position (extreme external rotation)? Now that’s some pre-stretch!
Next, plyometrics can be classified according to their intensity level. Similar to strength training exercises, you can have high-intensity plyos like depth jumps and plyometric push-ups and low-intensity variations such as skips, hops, jumping rope and jumps onto boxes for example. The intensity of plyos should really be thought of as a continuum rather than belonging to distinct categories. For instance, one athlete may find jumping rope extremely difficult and challenging whereas another athlete may find the same activity trivial, merely a warm-up. In general, it really depends on the fitness level of the athlete when it comes to choosing specific plyometric exercises. This will be discussed later in the article.
Next, you have preparatory and supplementary plyometrics which help prepare the body to hand the stress and force of fast eccentric muscle actions. This would include the lower intensity plyos discussed above such as skipping, hops, agility ladder drills, rope jumping, jumps onto boxes (but not off) and most forms of free-weight strength training. All these help to prepare the body to handle and produce more force while developing and strengthening the connective tissues.
As an interesting side note, some sport scientists such as the late Dr. Mel Siff, state that in order for an exercise to be classified as truly plyometric, the time interval between the eccentric-isometric (force absorption) phase and the subsequent concentric (force creation) phase must be short, as little as 0.15 seconds in lower extremity plyometric activities. Any longer than this and the movement is considered regular “jump” training, but not plyometrics. But this isn’t set in stone as other research has shown that some benefit still occurs in upper body muscle groups for up to four seconds after an eccentric muscle action (Wilson, et. al).
To recap, the basic premise and theory of plyometrics (and all training in general) to remember is as follows: if you can train the muscles, tendons, and nervous system to produce more force/tension in a shorter period of time during the takeoff from the ground, you can improve performance. This is primarily what the goal is with specific plyometric training. Sounds good right?
Plyometrics and Anaerobic-Dominant Sports
When you look at Track & Field (sprints, hurdles, jumps and throws) and most sports that rely heavily on anaerobic energy processes (i.e. Baseball, Volleyball, Basketball, Tennis, Football, etc…), you realize that there is already a relatively high amount of sprinting and jumping occurring anyway. It’s hard to deny that plyometric muscle action is a vitally important part of performance in these activities, but care must be taken when prescribing and performing specific plyometric movements to avoid overloading vulnerable and overworked areas such as the Achilles tendons, knees, and the lower back. If the plyometric exercises are being applied to the upper body (i.e. plyometric push-ups, medicine ball rebounds, etc…) problems can develop in the wrist, elbow, and shoulder areas. Usually, most of the injuries that occur are due to over-zealous use of and the mis-application of plyometric exercises and related drills. As with any training method, if problems arise, it’s usually the application of and not the method itself that is to blame. If plyometrics are to be used safely, a carefully planned integration must take place. Next, we will look at a rational plyometric progression process.
A Rational Progression of Plyometrics
The first step after making the decision to include specific plyometric exercises in an athlete’s program is to consider the nature of the sport and the current stress/strain being applied to the body from the sport itself. As mentioned above, sports such as Basketball. Volleyball and jumps/sprints from Track & Field already contain a high volume of plyometric muscle actions. For many of these participants, especially younger and novice-level ones, time might be better spent by focusing on getting stronger (improving maximal strength) through a progressive resistance training program and just playing the sport itself. True impact plyometrics (as discussed earlier) don’t need to be explored until the athlete is sufficiently strong and has developed a good foundation of connective tissue, joint, bone, muscle, and tendon integrity. This does not mean that preparatory and supplementary plyometrics should not be performed because they can help to prepare the body for more demanding plyometric exercises in the future.
A great place to start is to ensure adequate levels of basic strength are in order. Variations of the following strength and power lifts are a great place to start:
1. Squatting (especially front and back squats because they basically simulate the natural jumping movement pattern)
2. Deadlifts (including RDL’s, snatch-grip, clean-grip, sumo and conventional style; Kettlebell Swings would also need to be added to this category due to their “hinge’ or deadlift pattern)
4. Pressing (1 and 2-arm versions of bench press, push-up and military press variations)
5. Rows/Chins/Pull-ups (for postural support, upper back and elbow flexor development)
6. Carrying/Dragging Stuff (sled-drags, prowler pushes, farmers walks, waiters walks, etc..look to Dan John’s excellent products for more informaiton on this topic)
7. Supplementary/Assistance Strength Movements (such as single leg exercises, reverse and regular back hypers, GHR, planks, Swiss-ball exercises, medicine ball abdominal movements, chops and lifts, etc…)
The key with athletes is to keep it simple in the weight room and realize that we’re trying to create athletes, not bodybuilders. Keep the primary lifts in the strength and power building rep range (1-5 reps, maybe as high as 8 reps) and leave the higher reps for the supplementary/assistance lifts (10-15 reps is quite common for these exercises).
Depending on the specific athlete’s fitness levels and training history, some preparatory and introductory plyos can be started usually from day one. In addition to basic skipping and sprinting drills, some great beginning drills include the following:
1. Two Foot Hops/Jumps in Place- these are very mild and done in sets of 20-25 repetitions. Maximal height on these is NOT the goal here. Simply strive for a comfortable frequency that permits a fluid and rhythmic series of small jumps in place.
2. Jumping Rope- done at a faster pace, jumping rope is a fantastic preparatory drill that teaches an athlete a lot about timing, rhythm and helps to develop basic coordination. As with all plyometrics, the key is to keep the ground contact brief between jumps. Start with as little as 15-30 seconds and build up to 45-60 seconds worth of jumping. Any more than a minute of continuous jumping is not ideal since it takes the athlete further away from the anaerobic energy systems they are trying to improve (ATP-CP & Anaerobic Glycolysis). If you want to make it harder, simply make the jumps more complicated by adding in side-to-side, front-to-back, high knees (running man), Ali-shuffles, double jumps (2 revolutions per jump) and rope crossing. The variations are almost endless! For more information on jumping rope check out the informational products from Buddy Lee and great speed experts such as Lee Taft.
3. Agility Ladder Drills- similar to jump roping, the variations are endless. Simply focus on short ground-contact times and fluidity of movement. Keeping the eyes up and not on the ground adds to the difficulty.
After a period of adaptation to the above mentioned drills, higher intensity drills can start to be introduced:
4. Jumps onto Boxes- just as the name says, perform individual jumps onto boxes while sticking the landing with ideal body mechanics. This means a nice “athletic” position with knees lined up in the direction of the toes (no excessive inward or outward bowing of the knees)! As the athlete improves, jump height increases. Sets of 5 reps or so should be performed for only a few sets. Ensure the athlete steps off (not jumps off) the box in preparation for each successive rep.
5. Depth (Altitude or Drop) Jumps- in this variation, the athlete simply steps off the box and then “sticks” the landing in the ideal athletic position as mentioned above. It’s important to strive for a quiet landing as this ensures that the force is being dissipated properly upon foot contact with the floor. As famous Strength Coach Michael Boyle likes to say, “if it doesn’t look right, it isn’t.” Always start with a low box and only progress when form is near perfect.
6. Depth Jumps- not all athletes need to progress to this level of training but if they are to be done, they must be done right. The set-up is very similar to the Depth Drops as discussed earlier; the only difference here is that the athlete will explosively rebound off the floor upon hitting it, as if the surface was red hot. Since depth jumps are very ballistic movements, there must be some planning in advance (in the athlete’s mind), a process known in motor control as a “feed-forward” type of control. All ballistic actions utilize this feed-forward type of planning because there is not enough time to use “feedback” as with slower more predictable type of movements and activities. This is what differentiates true plyometric movements from the more commonly performed “pseudo-plyometric” movements. The reps and sets on depth jumps are similar to depth drops but include greater rest periods (3 to 5 minutes for maximum height depth jumps). Remember, these movements are HIGHLY stimulating to the nervous system! And since the nervous system take longer to recover than the cellular/metabolic system, you must take this into account if you are to maximize the potential benefits, and minimize the risks.
There is so much more that could be said regarding plyometrics and athletes, but hopefully I’ve hit the major points that need to be taken into account when designing athletic enhancement programs. I truly believe that many sprinting and jumping athletes can get phenomenal results without EVER doing any super high-intensity plyos. Getting stronger and more explosive in the gym can go a long way to improving game speed as long as some speed work is continued at least most of the year. If true plyos are to be used, than at least do a little homework to ensure a safe and proper progression for your athletes so performance can be maximized with less risk of injury.
What is Posture? Is there a Perfect/Ideal Posture?
To begin, I suppose it would be a good idea to define what we mean when we’re talking about “posture?” According to Taber’s Cyclopedic Medical Dictionary, “Posture is the attitude or position of the body.” Ideal or “Standard” posture is the skeletal alignment accepted as normal? The problem is that there is no truly universally accepted “scientific” standard of what ideal or “normal” posture is supposed to be. The closest we can get is the typical sketletal body chart (like the one that hangs in my massage room) which depicts both lateral and saggital views of the human skeletal system, stacked up nicely with the gravity line bisecting the major central axes of the joints.
Thou Shall Not Deviate from This Posture!
Another term that I learned from the works of Moshe Feldenkrias is “acture,” which combines the words “posture” and “action” to signify the dynamic movements that are still taking place even in seemingly static type of postures. Unless an area of the body is paralzyed, it is actually near impossible to be totally still since the body will always need the slightest of movements for interoception (i.e. propriocepetion) to occur. These subtle movements give information to the brain about the state of the body (i.e. Homeostatis) so that appropriate ouput or motor response can occur. It should become obvious then that even in so-called static states movement is the rule which can be summed up nicely in the following statement: Movement is Life, Life is Movement!
Other clinicians today, such as Pavel Kolar and even Gray Cook to a certain extent, use what is known as a “neuro-developmental” model of rehabilitation which basically acknowledges the developmental sequences or “milestones” that infants have to go through to achieve the upright or mature posture. They give special interest to the process of breathing and how that influences all the other bodily systems in normal growth and devlopment. Although Kolar’s courses are limited to medical clinicians, the interested reader, trainer, or coach can get a great insight to this system in a chapter written in Craig Liebensons’ Rehabilitation of The Spine: A Practitioners Manual. Gray Cook and his team at Functional Movement Systems also focus on respiration in the correction of faulty movement patterns and while not directly assessing posture per se, acknowledges the need to properly line up the joints during functional movements (called “joint centration” by Kolar). Gray poses the following question that should make us all think: “does the poor posture cause the faulty movement pattern or does the faulty movement pattern cause the poor posture?”
In contrast to the what I like to call the “Posture Police Approach” (more of a “Kendall-ish” approach to posture), there are other voices these days that question the biomechancal model of pain and posture. Most notably, Eyal Leaderman, wrote a paper called “The Fall of The Postural-Structural-Biomechanical Model in Manual and Physical Therapies: Exmplified by Lower Back Pain.” It is a good read and will give many coaches, personal trainers, and clinical types of therapists a nice dose of cognitive dissonance since posture and biomechanical models have been taught as the gospel for decades! While I do not agree with Leaderman’s critique completely (his use of and critique of scientific literature is lacking IMO), he does bring up some good points that should make us all think. Posture and mechanical factors (especially static posture) alone, cannot explain the vast variations in human posture we see and the differences in pain and/or dysfunction any given individual will have.
Posture and Pain? Which Came First?
In line with Leaderman’s critique of the postural-structural-biomechanical model, there are many critics of relying on static tests like posture assessments and x-rays and various medical diagnostic imaging studies. Many people have blemishes, disc bulges, arthritic/degenerative changes and other imperfections on x-rays, MRI’s, etc., yet have little to no pain. In contrast, countless people have terrible pain while showing almost no signs of “structural” damage on imaging studies. Clearly, there is more going on here than structural/mechanical explanations can explain. Enter modern neuroscience!
With advances in neural sciences, we now know and understand much more about the human brain and the central nervous system. The recent revision of our understanding of pain has shed light on how the brain can learn pain as a recurring “tune” in the brain (think chronic pain syndromes). Even after an injury has healed, a person can still feel terrible pain altough there is no medical reason to explain. Through a newer pain theory called “The Neuromatrix of Pain,” we now realize how many inputs are contributing to the pain experience at all times, including mechanical, physiological, and bio-psyo-social (emotions) stressors. Pain is a multifactorial phenomenon! For a great read on the current science and neurobiology of pain, I recommend “Explain Pain,” by David Butler and Lorimer Mosely. I reviwed the book in a blog here.
Understanding all the bodily systems involved in maintanence of upright posture is very important and one must also not ignore psychology and the mental/emotional factors that go along with posture; something that is well illustrated in the following classic Peanuts comic:
Charlie Brown Knows How to Be Depressed!
Conclusion and some Videos on Postural Assessment!
As you can see, the concept of posture and postural correction is not a black and white subject; much controversy exists with the truth (i.e. “reality”) probably existing somewhere in the middle between a purely biomechanical/structural approach, and a neurological/bio-psycho-social approach. While I still look at posture in my own training and massage clients, I always combine this information with more dynamic testing which could be anything from Paul Chek’s Primal Pattern Tests,The Functional Movement Screen (or its medical counterpart the SFMA), or perhaps Janda’s Six Functional Movement Patterns. If my client is healthy and athletic (a hard combo too find!), then more specific fitness or sports testing would also need to occur to ensure adequate capacities in the required Biomotor abilities.
To end, I will leave you with some videos on posture and postural assessment that I filmed back in February of this year (2011) with my friends and colleagues Bret Contrereas (right before he left for New Zealand to pursue his PhD!) and my facility partner Patrick Ward! Thanks for the help guys and its only taken my 1/2 a year to get this darn blogpost up!
Instructing this course will be my twin brother and Senior RKC, Franz Snideman, and of course I will be assisting! The first two courses I hosted were taught by the always amazing Master RKC Mark Reifkind (assisted by myself and the Queen of Swing, Tracy Reifkind) and were incredible experiences for all who attended! For a recap of the first HKC held in AZ read here.
However, this will represent the first time I’ve been able to teach with my brother since he was appointed a Senior RKC and we are both very excited for this opportunity. When the twins get together watch out…it’s like being bombarded by Hans and Franz (HKC Style)!
Get Ready to be Pumped Up..HKC Style!
The course will be limited to 20 people so make sure to sign up early if you are really interested! To sign up and read more about the requirements of the course, go here!
Last week (5/12-5/15/11) in St. Paul, MN, I was fortunate to partake in the CK-FMS (Certified Kettebell-Functional Movement Specialist) Workshop. Although I have taken the regular 2-day FMS workshop as given through Perform Better, this is a 4 day monster course for certified Russian Kettlebell Challenge (RKC) instructors that really went a lot deeper in terms of the assessments and advanced corrective strategies. Lead by Brett Jones, Master RKC, and Physical Therapist and Functional Movement Screen creator Gray Cook, it was intensive workshop for all of those attending.
Like the regular 2 day FMS course, the CK-FMS starts with basically the same layout by going over the background/history of how the screen was created and the foundational principles and concepts of why baseline screening for fundamental movement patterns is so important. An explanation of each of the 7 tests was given as well the scoring criterion. Day 1 was basically learning the principles behind the screen (the “why”) as well as becoming competent in administering the screen (the “how”). Like most newbies to the FMS, many will nit-pick about scores and try to figure out what the person’s “problem” could be which makes the screen take too long. A good screen should be performed in under 15 minutes and Brett Jones was adamant about that! Once you get the scores, then you try to figure out what needs to take priority based on the numbers and any additional breakout tests could then be performed as assessments to gather more information.
Some noteworthy statements that I jotted down this first day include:
“Hey look, its a skinny version of Franz! (David Whitley)
“FMS is a filter, its going to catch the shit..and not allow us to add fitness on top of dysfunction!”
“Compensation is a survival mechanism!”
“Specialization will compromise durability..it ruins adaptability and symmetry, which are more important for long-term health.”
“Seeds vs Soil- Seeds (exercise, movement, programming, etc..) won’t grow in infertile (dysfunctional) soil!”
“Movement Competency (not the same as perfection) vs Physical Capacity (Metabolics, strength, power, etc..)”
“Workouts should be educational, not just metabolic packages…”
“What is stiffness? It is the body’s way of trying to survive problems with mobility and stability; it is the default strategy when you have poor motor control..”
“Remove a negative (exercise, lifestyle habit, occupational habit, etc..) before adding a positive. Example, adding flax seeds to breakfast cereal when you already smoke and excessively drink alcohol! The flax seeds probably aren’t going to do that much!”
“The FMS is not designed to screen people in pan..STOP and go to the SFMA (Selective Functional Movement Assessment) or refer to competent clinician.”
Days 2 and 3
The next two days involved the basic and advanced concepts of how to correct the dysfunctional scores in all of the 7 screens. Another really cool thing was the constant integration of the screen to the fundamental KB lifts with special emphasis placed on the TGU (Kalos Thenos Turkish Get-up) and its potential to correct a lot of movement problems in and of itself. On day 2, Doc Cheng actually took us through a good 60+ minutes of Kalos Thenos Get-ups, first unloaded (naked get-up) and then with a light to moderate KB. What a tough movement this becomes when you really slow it down to avoid skipping over your “movement potholes or speed bumps!” Want something really challenging? How about a 2 minute get-up..can you say Super, SUPER SLOW TRAINING! Try it and get back to me…
Dr. Mark Cheng knows the TGU!
A great presentation was also given by Master RKC Jeff O’Connor on how the RKC is still a “School of Strength,” and that although Kalos Sthenos Get-ups are great, the goal is to eventually perform a get-up with a respectably heavy KB (for each individual of course). Jeff also lead a great review of the six RKC I moves (minus the get-up) on the 3rd day that really exposed how many of us (including myself for sure!) had slacked off on the precision and quality of some of our fundamental lifts, most notably the KB Swing! Since the “swing is the center of the RKC Universe,” as Mark Reifkind is known to say, than it makes sense that we should all be trying to ensure that this move gets better or at least does not stagnate!
The KB Swing is Still the Center of the RKC Universe!
Mark and Nikki Snow gave a great presentation on how they incorporate the FMS into their KB Boot-camp classes and showed how individualisation of the corrective strategies for each class member was still possible in a large class setting. In their own little pilot study they demonstrated the fat loss was greater when movement screens improved. They also took the entire class though a sample workout where we mixed in our corrective mobility and stability drills into a KB workout during the rest periods. This is something I’ve been doing in my own small group classes and really is a nice way to incorporate the correctives needed for each person. Great job by Mark and Nikki!
Mark & Nikki Snow of SG Human Performance in Omaha, NA
The final day we finished going over the advanced corrective strategies for what are known as the Big three,” which are the In-line lunge (ILL), the Hurdle Step (HS) and the Deep Squat (DS). These were saved for last because you really can’t correct problems here without cleaning up the bottom 4, more “primitive” patterns of Shoulder Mobility (SM), Active Straight-leg Raise (ASLR), Trunk Stability Push-up (TSPU) and the Rotary Stability test (RS). In the afternoon, Gray gave a lecture about the clinical/medical version of the FMS called the SFMA (Selective Functional Movement Assessment) which is counterpart of the FMS for those people in pain. Unfortunately I had to leave early that day to catch a plane back to Arizona with my boys so I didn’t get say good-bye to the many people I met and the awesome instructors and assistants who made it such a great experience for all.
All in all it was a great (and somewhat exhausting) experience! I highly recommend every RKC instructor to take this course; our clients, friends or family that we work with deserve the best and the FMS really serves as a compass, or guide to ensure safety and durability first, followed by kick-ass performance of course which the RKC is so good at delivering!
I would also suggest that if any trainers or coaches (or even recreational KB enthusiasts) who are not RKC’s out there, to at least take the FMS workshop as given through Perform Better; it is a paradigm shift who’s time has come. Better yet, become an RKC first and then take the CK-FMS!
I just wanted to quickly announce to any Phoenix area Kettlebell and Strength Training Enthusiasts that on Saturday, April 9, 2011, my facility partner Patrick Ward and I will be hosting our second Tactical Strength Challenge (TSC) which consists of the following three events: (For more info and all the rules check out the Tactical Strength Challenge Website)
A three-attempt powerlifting deadlift
Pullups for max reps
Kettlebell snatches for max reps in a 5:00 time period
Franco Columbo Would Probably Win the TSC With This Lift!
This Cat Would Definately Win The Pull-up Portion!
My Twin Brother Franz is Pretty Good at Snatches!
Where: Reality-Based Fitness/Optimum Sports Peformance Training Facility: 2009 E. 5th St, #12, Tempe, AZ 85281
(my cell #602-738-0562)
When: Saturday, April 9, 2011. Weigh-in @ 9 AM sharp with lifting immediately after that.
I recently recieved a question from a woman who read my article from last year (2010) on problems of the big toe (hallux). Her comments and questions were as follows:
“I just read your article “One ‘Hallacious’ Problem! (http://www.coachkeats.com/?p=395) Thanks so much for discussing this problem so thoroughly! I’ve been suffering with Hallux limitus/rigidus since high school (I know it’s genetic in my case) I’ve never been able to wear high heels or anything with a semi-tight toebox since then. I went to a PT when I was in college and he basically gave me a somber prognosis – orthotics with a firm section under my toe, motion control shoes with a wide toe box. The problem is those never helped really. Anything with a normal toe box that confines my toes in any way, puts pressure across the top of my foot or has a thick sole ends up hurting my toe to the point of not being able to keep them on anymore. My personal solution, that I stumbled across, was Chaco sandals, they are the only thing that keeps my big toes pain free. When I have to dress up I wear Earth shoes with the Kalso reverse heel which are okay for a while but end up still hurting. That being said I still wear regular running shoes with my orthotics when I run/train… and my feet still hurt during and afterwards. I need new running shoes, so I have been doing some research and came across the Vibram Five Fingers… and your article. My quesiton for you is – if I do go to a more minimalist shoe, is that going to speed up the deterioration of the joint? And it looks like you wrote this article almost a year ago, do you still feel the same way about the minimalist footwear? What do you wear on a daily basis? I want to be able to be more active, but with running shoes that hurt my feet, it makes it harder to get up the motivation to do it (although I used to enjoy it and loved playing soccer.) Thanks for your reply if you have the time!
And here was my response with added pictures for fun and clarificaiton!
Thanks for the reply to my article. I wrote that in response to my own on-going problem with my big-toe joints as you read in the article. Hallux mobility problems are quite common yet are seldom addressed in the mainstream media literature.
In response to your questions about minimialist footwear, I am a fan of the concept in general but feel that certain foot (and/or toe) problems might require some sort of orthoses to prevent further damage to irreversible dysfunction thay may have occured to a certain part of the foot or toes. I do own a pair of Vibrams 5 fingers and wear them several times per week. I also perform much of my strength training in them and do feel I have a better “connection” to the ground in terms of tactile sensation and pushing through the ground during exercises like squats, deadlifts, kettlebell swings, standing presses, etc..
I still recommend and wear the Vibram 5-Fingers! But they might not be for everyone!
I really struggle with lunge type of movements though (due to hyper-extension required at hallux joint) so will opt for a minimilaist type of shoe with at least a little stiffness in the upper or forefoot part of the shoe. My left toe especially really struggles with barefoot (or Vibram) lunges. I will perform them slowly with bodyweight a few times per week though to try to keep whatever mobility I have left in those joints.
Lunging requires adequate Hallux mobility!
I have been playing around with various form of proprioceptive taping around my feet and toes lately to see if I can position my big toes in such a way that they “glide” a little better during extension movements. I’m not quite sure I’ve found the right taping technique yet but will continue to mess around with the concept.
There are many uses for Proprioceptive Taping!
Whether or not going barefoot or wearing vibrams will accelerate the degeneration is a good question and probably depends on how much they are worn and what they are used for. For just basic walking around and standing I don’t have a problem with minimalist type of shoes. My main sport is track and field (sprints) and I usually wear a minimalist running shoe for warm-ups and slower sprints on the grass with spikes being worn on the track during my faster runs. However, I really like the idea of keeping the rest of my foot relatively healthy though so some use of Vibrams/minimalist footwear should be worn during the week.
Additionally, it is important (for me at least) to try to get some frequent massage/soft-tissue work on my feet and legs as well some joint mobilizations by some skilled colleagues of mine (one a massage therapist, the other a chiropractor). This, combined with self-massage and joint mobilization/stretching can possibly delay the process of degenerative changes that are bound to eventually get worse over time.
These two guys have the daunting task of tring to keep me orthopedically healthy!
Getting proper function up the kinetic chain in the pelvis/core area also has a profound affect on the lower extremeties and feet/toes so proper treatment includes balancing out the pelvis and possibly even the neck/head area! Chronic forward posture can cause all kinds of bodywide changes that can negatively affect the feet (amongst other areas).
The Kinetic Chain must be addressed in all Foot/Toe Problems!
In conclusion, I think everyone has to experiment with different types of footwear (or lack thereof), therapy, stretching and exercise to see what works best in the various type of activities one likes to engage in. I am also not opposed to certain type of orthotic devices being worn at times for people with real, irreversible foot/toe problems. Maybe some type of customizable shoe will eventually be invented that is “minimallist” in design in all the relatively “healthy” portions of the foot with just enough “support” for the areas that need it (like our poor big toes!); the best of both!
What Will Science Come With Next?
Thanks for reading my blog! For a little humour, here’s a funny cartoon video on Vibram 5 Fingers that is bound to give some of you a chuckle!
I recently found an article I wrote a few years back that I don’t think was ever published. It a nice primer on trigger points, pain, stress and adaptation. Enjoy!
Self-Help Strategies For Neuro-Muscular Pain
By: Keats Snideman CSCS, LMT, NMT
Pain is such a universal human experience that it suffices to say that pain is a normal part of life. We all know that pain can be such a debilitating experience and is probably the number one reason why any of us visits a doctor, a chiropractor, a massage therapist orany other kind of practitioner that deals with the body. But this still doesn’t answer the question: why do we have pain?
Before we can answer this question, it is important to look at the big picture. The body’s main goal is to survive by maintaining homeostasis, or the “steady state of the body.” It is through this goal of equilibrium that our body deals with the day to day stresses and insults imposed upon it. How the body copes with these stressors dictates in many cases whether pain will be experienced. When faced with stress of any type, the body can essentially do one of three things:
1. It can adapt
2. It can compensate
3. Or, it can decompensate.
These responses to stress occur in all types of tissue including skin, bone, muscles, connective tissues, viscera (organs), glands, and even the brain and central (and peripheral) nervous system.
INITIAL STRESSOR→ ADAPT→ COMPENSATE→ DECOMPENSATE
INJURY, PAIN, DYSFUNCTION
If the stresses we are exposed to are excessive, compensation will occur but only for so long. When no more compensations can be made, decompensation occurs, which leads to eventual injury, dysfunction, and eventual disease. When no more decompensation can occur, death of the various tissue and/or organism usually takes place. This is the basic process of life as we know from a biological standpoint.
Once we understand the big picture better, we can basically break down every type of stress we encounter into one of three types:
1. Biomechanical Stress: overuse, misuse, trauma, disuse, congenital, etc.
3. Psychosocial Stress: unresolved emotional states, somatization, anxiety, depressions, other mental illness, etc.
All of the above categories do not act alone; they are constantly interacting to produce what we call LIFE! Addressing one or more of these categories can go a long way towards improving one’s pain status and thus the quality of life. The remainder of this article will focus on my particular specialty, biomechanical stress (with a hint of biochemical stress due to the complex interaction between the two). Specifically, I want to address the very common muscle aches and pains we all suffer on a day to day basis.
Why Do I Hurt?
Probably the most frustrating type of pain is the daily chronic type of pain that many people experience. Tight, stiff and sore necks, shoulders, lower-backs and hips are very common experiences among people these days. To the people experiencing the pain, much of it seems unwarranted since in many cases, no precipitating specific event (like a whiplash or a fall) occurred. Nevertheless, tissues have been irritated and there is pain; often of a chronic nature which nags people daily.
However, I see most of this type of pain as “lifestyle-induced,” as many people have very poor habits of use with their bodies and are unaware of the things they are (or aren’t) doing that keeps their body in a chronic state of pain. These poor habits of use include poor body mechanics while sitting, standing and lifting as well as improper set-up of ergonomic factors (including seat/chair height, table height, computer keyboard and monitor arrangements, etc.) Additionally, stressors like carrying a heavy purse on one’s shoulder(attention ladies!), lugging around a heavy briefcase, talking with a phone between the ear and the shoulder, repetitive typing and mouse clicking can all contribute to chronic pain syndromes.
All these factors and many more can set the body up for ensuing pain and discomfort. Next, I’d like to explain the six key factors that need to be addressed when dealing with pain. These factors are also some of the key tenets of Neuromuscular Massage Therapy, which I began studying in the late 90’s. They still hold true today:
1. Ischemia- a state in which a tissue becomes deprived of an adequate supply of oxygen (also called “hypoxia”) for its current physiological needs. This can be the result of pathological processes (narrowed arteries or thrombus), anatomical blockages (tendon or muscle obstruction of blood flow), biochemical changes (vasoconstriction by the body to reduce the blood flow to a specific area of the body), or by functional adaptations (trigger point activity, muscle spasm or guarding). The end result of ischemia is less blood getting to a tissue (let’s use muscle as an example). With less blood, less nutrients (including O2) get through to the muscle and less waste products are removed. The result is a stagnant tissue with a lowered Ph. Eventually the increased ischemia will lead to the formation of trigger points and even increased scar tissue (collagen) to be laid down.
2. Trigger Points (TrPs)-
When muscles and other soft-tissues such as tendons and ligaments are placed under increased stress due to overuse, postural strain, etc., they have a tendency to develop localized areas which become hyper-sensitive, irritated and painful. Many of these localized areas are known as trigger points (TP’s). Trigger points have been shown by researchers to be the cause of much of the pain people feel on a day to day basis. The characteristics of a trigger point include:
* Local Sensitivity/pain on pressure
* Ability to refer pain (often radiating) to a remote, often distant area from where the TP lies. Sensations such as burning, throbbing, tingling, aching and even itching are not uncommon symptoms to experience from TP activity.
* Ability to increase tone or “tonus” in the tissues in which the TP lies, as well as in the target or referred zone/area.
* A weakening effect on the strength and endurance of the muscle(s) in which it lies, including the muscles in the target area.
3. Nerve Entrapment/Compression- Entrapment by myofascial tissues or compression by osseous (bony) tissues can interfere with neural communication and lead to pain, numbness, weakness, tingling, burning and host of other distressing signals into the brain and spinal cord. If left untreated, these types of dysfunctions cause significant changes and losses of normal function.
4. Body Misuse And Biomechanical Dysfunction- repeated movements of any nature done excessively and often with improper technique can and will lead to biomechanical dysfunction. Repetitive stress disorders like Carpal Tunnel Syndrome, Golfers Elbow, Patella Tendonitis and a host of others, are all associated with faulty body mechanics during the movement. With continued performance of the faulty repetitive techniques, tissues will eventually become tense, fatigued, and fibrotic. This is when tissue feels very hard and “ropy” during palpation. Although massage therapy techniques will bring pain relief, the real key is to try to remove and/or alter the conditions and situation in which the pain and dysfunction are being developed.
5. Nutritional Factors- imbalances and/or deficiencies in key nutrients, or hormones can and do cause issues with pain syndromes. The nutritional component of pain is vast and worthy of a separate article in the future!
6. Emotional/Psychological Factors- the amount of mental and emotional stress that each individual is under will play a major role in his/her current state of discomfort or pain. If left untreated (for example without needed medication given from a Psychiatrist) disastrous things can occur.
A Quick Recap: Plus More On TrPs!
One thing that’s important to realize is that any type of stress (biomechanical, biochemical, or psychosocial) affecting you as a whole, will cause TP’s to be more active and thus sensitive/painful. A climactic change, a stressful emotional event, a physical effort, a chill on the neck or almost anything else which places an adaptive demand on
your body will affect trigger point activity and pain in general. TP’s are therefore barometers of your overall stress level, acting as reminders of what we should be paying more attention to in our physical, chemical, and emotional lives.
Trigger points can therefore be seen as alarm signals sent to our conscious brain to make us aware that something is not right in our body. Just as it would crazy to smash a fire alarm with a sledgehammer without seeing why it went off in the first place, it is also unwise to try and eliminate or shut off a trigger point without examining why it exists. This doesn’t mean that the trigger point should be left alone, but that an investigation must occur to see what could be causing its activity to begin with. The moral of the story here is that if you don’t alter or remove the cause of the trigger point, it’s just a temporary fix (like a band-aid) and is bound to come back with a vengeance.
When pain occurs?
First off, it’s important to rule out any visceral involvement as many organs use the muscular system to warn us of current health problems. A common example of this phenomenon (called a visceral-somatic reflex) is a heart attack. In this condition, the left arm, neck, and jaw can become very painful despite nothing being wrong in those areas directly. Additionally, problems with the liver or gall bladder can refer pain into the right shoulder. How about the lower back with a kidney infection? Lots of referrals into the muscular system occur from problems with organs so it’s important that we rule out more sinister problems first.
Additionally, during cases of unstable joints or recent injury to a joint complex (including ligaments, cartilage and joint capsule), trigger points may form to help splint or “stabilize” an area. In this situation, it would be unwise to remove any related trigger points because they may be actively involved in protecting the area. Again, looking at the big picture as to why we may have pain or spasmed muscles is very important!
Self-Treatment of Trigger Points
There are several methods that can be used for treatment of trigger points including:
1. Trigger Point Pressure Release (aka “ischemic compression)
2. Chilling techniques (cryospray, ice, spray and stretch)
7. Self-help strategies (Epsom salt baths, hydrotherapies, breathing techniques, stretching, exercise and toning exercises)
What’s The Best Method?
For self-treatment, the trigger point pressure release is probably most effective and can be administered via many mediums including:
1. Your own thumbs and fingers
2. Foam Rollers
3. Tennis Balls/golf balls/lacrosse balls
5. Stretching (PNF, Static, or Muscle Energy Techniques)
6. Hydrotherapies (i.e. hot bath or contrast bath/showers)
7. Cryotherapy (i.e. Instant Ice Product by Gebauers)
Length of Pressure
A great way to self-treat trigger points is as follows:
1. Press the tender area until symptoms (and possible referred sensations are elicited) and hold this pressure for 5 seconds.
2. Ease off the pressure by about 50% for 2-3 seconds.
3. Continue this ratio of 5 seconds on/2-3 seconds off for up to 60 seconds or until the tenderness and/or the referral pattern is noticeably reduced.
4. At this point, the pressure should stop and a gentle stretch of the muscle should take place. This helps to keep the trigger point from returning again. Moist heat can follow this treatment followed by application of ice is there was exquisite tenderness or if any swelling was suspected at the attachment sites (where the tendons merge into the bone).
Rules Of Self-Treatment
1. Treat TP’s only to ease pain. Pain and other symptoms may be the result of more serious problems or pathology. Professional medical consultation may be needed.
2. Do not treat TP’s that lie on or near a swollen area, lump, or inflamed tissue.
3. Do not treat TP’s that lie on a mole, a wart, a recent scar or varicose vein.
4. Do not treat painful areas that lie on a woman’s breast. Seek medical evaluation if a tender nodule is found.
5. Although several trigger point lie on acupuncture points (up to 70%), do not self-treat with needles and try and be your own acupuncturist!
6. Do not overtreat an area. Always stop after a minute of on/off pressure as mentioned earlier.
7. Always try to figure out the actual causes of TP’s, such as poor posture or ergonomic set-up, the wrong use of the body, as well as any nutritional or hormonal inadequacies. Even exposure to toxic chemicals/substances can cause increase pain and trigger point activity.
8. When in doubt, always seek competent medical care.
Pain is mostly a useful sensation to alarm us that there may be a “threat” or problem occurring in or to the body that needs our immediate attention. When pain becomes chronic however (greater than 6 weeks), the pain might persist without any real tissue damage being present. In these cases, the pain itself can become the disease and need a multidisciplinary approach to treat it.
Since much of the pain we experience is of a less sinister nature, it helpful to adhere to proper lifestyle habits with regards to biomechanical, biochemical, and psycho-social stressors which we are all bombarded with on a daily basis. Hopefully you, the reader, learned some helpful self-help suggestions on how to manage and reduce any aches and pains you may experience on a daily basis.