tag:blogger.com,1999:blog-3116423186275312972024-03-12T19:41:58.185-07:00Fitness PollenatorTravis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comBlogger210125tag:blogger.com,1999:blog-311642318627531297.post-89500946701320449312020-06-25T05:33:00.000-07:002020-06-25T05:33:11.406-07:00Does mobility training prevent injuries?<div><span style="font-family: verdana;">Over the last few years, mobility training has become all the rage on social media and in the fitness world. Passive flexibility is out; active range of motion is in.</span></div><div><font face="verdana"><br /></font></div><div><font face="verdana">Many supporters of this style of training tout it as the holy grail. It's believed to prevent injuries and make you a better mover. And if your mobility isn't up to snuff, well, you better "check yourself before you wreck yourself."</font></div><div><font face="verdana"><br /></font></div><div><font face="verdana">Being my inquisitive self, I was interested in what the research said about typical differences between active and passive range of motion. After taking a deep dive, I was surprised to find there was very little direct evidence for what even constitutes "typical" vs. "atypical."</font></div><div><font face="verdana"><br /></font></div><div><font face="verdana">Now, as the saying goes, absence of evidence isn't the same as evidence of absence. But for mobility training to prevent injury and improve movement, there at least has to be a plausible mechanism.</font></div><div><font face="verdana"><br /></font></div><div><font face="verdana">I teamed up with my friend <a href="http://instagram.com/jenni_rawlings/" target="_blank">Jenni Rawlings</a>, who's also been seeing these trends in the yoga world, to explore whether mobility training can possibly confer all the benefits it's been claimed to – or whether it should just be one part of a more comprehensive approach to training.</font></div><div><font face="verdana"><br /></font></div><div><font face="verdana">Here's what we came up with:</font></div><div><font face="verdana"><br /></font></div><div><font face="verdana"><a href="https://jennirawlingsblog.com/blog/end-range-training-does-closing-the-gap-between-active-and-passive-rom-prevent-injuries">https://jennirawlingsblog.com/blog/end-range-training-does-closing-the-gap-between-active-and-passive-rom-prevent-injuries</a></font></div><div><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://1.bp.blogspot.com/-JRvMmJHd8oQ/XvSZQOW5XaI/AAAAAAAATfM/joZKrCd6DF0njSVjN2bNq_EJKJ10LIR6wCK4BGAsYHg/s800/email-forum-ERT-blog-post.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="500" data-original-width="800" height="250" src="https://1.bp.blogspot.com/-JRvMmJHd8oQ/XvSZQOW5XaI/AAAAAAAATfM/joZKrCd6DF0njSVjN2bNq_EJKJ10LIR6wCK4BGAsYHg/w400-h250/email-forum-ERT-blog-post.jpg" width="400" /></a></div><div><br /></div>Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-34908497748495677502019-10-05T11:21:00.000-07:002019-10-05T11:21:04.412-07:00Why Distance Doesn’t Tell the Full Story During Hop Testing<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms"; font-size: large; text-align: left;">Over the last year or so, I’ve taken a keen interest in <b>how </b></span><b><span style="font-family: "trebuchet ms"; font-size: large; text-align: left;">rehabilitation professionals</span><span style="font-family: "trebuchet ms"; font-size: large; text-align: left;"> </span></b><span style="font-family: "trebuchet ms"; font-size: large; text-align: left;"><b>qualify athletes to resume sports participation following injuries (“return to play”</b>). It’s a natural area of research for me, as it’s essentially the bridge between rehabilitation and performance training.</span></div>
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<span style="background-color: white; font-kerning: none;"><span style="font-size: large;">One of the biggest conundrums in rehabilitation is the<b> </b>high rates of re-injury -- and <b>whether current return to play testing protocols are even helpful for reducing re-injury risk</b>.</span></span></div>
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<span style="background-color: white; font-kerning: none;"><span style="font-size: large;">One injury with alarmingly high re-injury rates is the ACL, or anterior cruciate ligament. Return to play testing protocols during ACL rehab typically consist of measures of range of motion, single-leg strength, and <b>hops for distance</b>.</span></span><br />
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<tr><td class="tr-caption" style="text-align: center;"><i><span style="font-family: Trebuchet MS, sans-serif; font-size: small;">Four different hops for distance</span></i></td></tr>
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<span style="background-color: white; font-kerning: none;"><span style="font-size: large;">Much of the debate centers on which hop tests should go into the testing battery, as there are about a million and one options: single hop, triple hop, triple crossover hop, six-meter timed hop, side hop, etc.</span></span></div>
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<span style="background-color: white; font-kerning: none;"><span style="font-size: large;">But there’s relatively little talk of <b>a simple way to derive way more information out of whichever hop tests are used</b>.</span></span></div>
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<span style="font-size: large;"><span style="font-kerning: none;">My friend Tim Rowland and</span><span style="background-color: white; font-kerning: none;"> I teamed up to shed light on this subtle addition to testing procedures that we believe can have a <b>major payoff for return to play decision-making</b>:</span></span></div>
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<span style="-webkit-font-kerning: none; background-color: white; caret-color: rgb(21, 23, 25);"><span style="color: #151719; font-family: "trebuchet ms"; font-size: large;"><a href="https://www.physio-network.com/why-distance-doesnt-tell-the-full-story-during-hop-testing/">https://www.physio-network.com/why-distance-doesnt-tell-the-full-story-during-hop-testing/</a></span></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-10808735955639408472019-07-20T06:35:00.006-07:002020-12-12T09:38:17.145-08:00Is Your Inability to Crawl REALLY Killing You?<div dir="ltr" style="text-align: left;" trbidi="on">
<a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: left; float: left; margin-bottom: 0em; margin-right: 1em;"></a><span face=""trebuchet ms" , sans-serif" style="font-size: large;">As children, we’re taught that “sticks and stones can break our bones, but words can never hurt us.” While a nice sentiment, the more I learn, the more I realize that old adage simply isn't true. Words <i>do</i> have the potential to harm. And the way some movement and rehabilitation professionals have chosen to wield them is doing just that.</span>
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<li><i><span face=""trebuchet ms" , sans-serif" style="font-size: large;">“If you can’t roll, crawl, and squat like a baby, you’re destined for pain and dysfunction. Take my course to learn how.”</span></i></li>
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<li><i><span face=""trebuchet ms" , sans-serif" style="font-size: large;">“If you do bench dips, upright rows, or behind-the-neck presses, you’ll wreck your shoulders. Buy my book to learn about optimal movement.”</span></i></li>
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<li><i><span face=""trebuchet ms" , sans-serif" style="font-size: large;">“If you don’t learn how to breathe, you’re gonna die! Come with me if you want to live.”</span></i></li>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Okay, so maybe that last one about breathing is literally true, but still.</span><span face=""trebuchet ms" , sans-serif" style="font-size: large;"> </span></div>
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<b><span face=""trebuchet ms" , sans-serif" style="font-size: large;">The Problem with One-Liners<o:p></o:p></span></b></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">The problem with one-liners like these is they lack context. Without context, we can’t possibly know for certain that a person’s difficulty performing developmental movements will cause pain and dysfunction.<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Are people at increased risk for pain/injury based on an inability to perform certain movements? Maybe. But <a href="http://www.fitnesspollenator.com/2019/06/fms-misconceptions.html" style="color: #954f72;"><span style="color: blue; text-decoration: none;">“increased risk” isn’t a guarantee</span></a>. It depends on a few things. <o:p></o:p></span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span face=""trebuchet ms" , sans-serif" style="font-size: large;">Do the person’s activities require them to perform the movements they struggle with? Also, what’s causing the difficulty with those movements? Is it just that they’re out of practice, having not attempted to roll/crawl/squat in years?<o:p></o:p></span><br />
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Moreover, pain is <i>multifactorial</i>, which means it usually isn't caused by just one thing. Things like poor sleep, physical stress, emotional stress, anxiety, depression, and inactivity can all contribute to pain, as well.</span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Note, too, that our adult proportions are different from our baby ones and they can make movements like squatting more challenging than they were for us as babies. In addition, some movement patterns we once deemed “dysfunctional” are increasingly becoming considered normal variability (e.g. <span>scapular dyskinesis</span>).<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Similarly, without knowing who that person is, we can’t say for sure those dips, upright rows, and behind-the-neck presses will damage their shoulders. While it’s true those exercises can be higher risk for many people, that doesn’t mean they can’t be performed safely <i>by anyone</i>.<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">To weigh risk versus reward, we have to answer the following questions on a case-by-case basis. What’s the person’s training and injury history? What are their range of motion and strength like? What do they look like when they perform the exercises in question? How confident are they in their ability to perform them?</span></div><div class="MsoNormal" style="margin: 0in 0in 0.0001pt;"><span face=""trebuchet ms" , sans-serif" style="font-size: large;"><br /></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;"><b>Why Make Such a Big Deal Out of a Bunch of Words?</b><o:p></o:p></span></div>
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<span style="font-size: large;"><span face=""trebuchet ms" , sans-serif">A strange thing can happen when we sweepingly promise people they’re going to hurt: some people start to hurt. </span>This process by which words can cause harm actually has a name. It’s called the <i>“nocebo effect.” </i>Admittedly, when I first heard the term, I thought it was made up. But it’s both a real word and a very real phenomenon.</span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Essentially, a nocebo is the opposite of a placebo. Of course, a placebo is a beneficial effect on health that results from positive expectations. If we’re told something will help us feel better, it often does help us feel better. When that something is physiologically inert, the beneficial effect we’re experiencing is purely <i>psychological</i>. The placebo effect speaks to the incredible interplay between our physiology and psychology.<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Conversely, a nocebo is a <i>detrimental </i>effect on health that results from <i>negative </i>expectations. When declarations like the ones above come from people in positions of authority, they can foster negative expectations and beliefs about movement — even when they’re unwarranted. (As in, even when the person should be A-okay from a physiological standpoint.)<o:p></o:p></span></div>
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<span style="font-size: large;"><span face=""trebuchet ms" , sans-serif">For instance, you might not have had any issues before, but once you learn (from someone with 'Dr.' in front of their name) that the inability to crawl is tantamount to back pain, suddenly your back begins to hurt. Likewise, dips may never have bothered you before —</span> until you found out how “damaging” they were to the shoulders. All of a sudden, dips hurt your shoulders. And so on.</span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span face=""trebuchet ms" , sans-serif" style="font-size: large;">I’m not saying people shouldn’t practice rolling, crawling, squatting, and breathing. In fact, I’m fond of all of those exercises. Nor am I saying there aren’t better choices for many people than bench dips, upright rows, and behind-the-neck presses. What I’m arguing with are the generalizations and fearmongering narratives.<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">For starters, we can encourage resilient and robust views of the body and the effects of movement on it. Stop talking about the body as if it’s made of glass, and stop imposing arbitrary standards and benchmarks. (“If you can’t do X, then Y will happen.”)<o:p></o:p></span></div>
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Also, dive into the nuance. Explore the gray area. Teach people. For whom might this exercise be good, and when? For whom might this exercise <i>not </i>be good, and when? What are the risks? Are there other exercises that can provide the same benefit with less risk?<o:p></o:p></span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=311642318627531297" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span face=""trebuchet ms" , sans-serif" style="font-size: large;"><br /></span>
<span face=""trebuchet ms" , sans-serif" style="font-size: large;">Clearly, the human psyche is a powerful thing. It’s our ethical duty to be aware of and avoid creating nocebos — not use them to our advantage to sell books and courses.</span><br />
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<span face=""trebuchet ms" , sans-serif" style="font-size: large;">It’s time some of my peers quit their marketing tactics and accept their ethical duty, too, before they do more damage. People's well-being is at stake.</span></div></div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-9040917817282493022019-06-23T20:22:00.001-07:002019-06-24T11:36:43.600-07:00WTF is “Load Management"?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif;">Since the turn of the century, the San Antonio Spurs are the winningest team in the NBA. No doubt, a lot of their success can be attributed to having had a bevy of current and future Hall of Famers on their rosters. <b>But perhaps no single person has been more influential in their success than head coach (and famous curmudgeon) Gregg Popovich.</b></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Under Popovich, the Spurs have run off a stretch of 18 straight 50-win seasons and 22 consecutive playoff appearances. Obviously, Popovich is a brilliant basketball strategist; you don’t win that many games by accident.<b> But his brilliance appears to extend off the court, too -- specifically, to the human body and its need for rest and recovery. </b>(Note: he likely also has the help of a world-class sports medicine team.)</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Case in point: in 2012 Popovich famously rested his four best players on the night of a nationally televised game. It was an unfortunate decision for fans around the country who were stuck watching the Spurs’ B-squad. Although the Spurs ended up losing the game, the move proved to be the right one for them in the long-run. They won the championship that season.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">This wasn’t the first time Pop rested healthy players, nor would it be the last. In fact, it was a decision Popovich and the Spurs would repeat again and again. <b>Popovich’s goal was simple: to avoid overworking his players during the regular season so that come playoff time, they would be in peak form (not battling nagging injuries).</b> On the nights a player did not play (DNP), “DNP - Rest” would show up beside the player's name in the box score.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">As other teams adopted this strategy en masse, the NBA league office finally put stipulations on it to prevent ratings from taking a hit. <b>Teams are now subject to healthy fines for resting healthy players, especially for primetime games.</b></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In the last year or two, teams appear to have developed a workaround --</span><span style="font-family: "trebuchet ms" , sans-serif;"> a workaround based on a fair bit of science, though it still has some pundits crying foul. The workaround shows up in the box score as “DNP - Load Management.”</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Despite sounding like a bad porno, “load management” is actually a concept that’s borne out of a good deal of sports science research over the last decade.</b> (I wrote extensively about the research in <a href="https://simplifaster.com/articles/train-more-without-injuries/">this article</a>.)</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">In a nutshell, “load” refers to players' workloads, which are the sum of all of the games and practices they’re taking part it. “Management” refers to dosing those workloads appropriately to maximize fitness and performance while minimizing fatigue and risk of injury.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">One instance of load management that garnered attention this NBA season happened right in my hometown. Down the stretch of the season, Philadelphia 76ers star center Joel Embiid missed several games due to a combination of left knee soreness (which they called tendinitis) and “load management.”</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Like the Spurs, the Sixers’ goal was to have Embiid ready to rock and roll for the playoffs. Unfortunately, to this end the Sixers weren’t able to recreate the Spurs’ success. <b>Despite the end-of-season load management, Embiid wound up missing a bunch of games in the playoffs, too.</b> When he did play, he was hobbled by knee pain, sickness, and what looked like an extra 20 pounds or so of body weight.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">So what went wrong? As an outsider, I can only speculate. </span><span style="font-family: "trebuchet ms" , sans-serif;">Despite its very real scientific underpinnings, some felt "load management" was just a coverup for</span><span style="font-family: "trebuchet ms" , sans-serif;"> something more severe going on with Embiid’s knee than the team let on. </span><b style="font-family: "trebuchet ms", sans-serif;">My hunch is that the situation may have been a misapplication of the very load management principle the team was intending to invoke.</b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">One way to manage a player’s workload is to have them do less. For example, they might sit out of a practice or perhaps the second night of back-to-back games. Oftentimes this respite is enough to aid their recovery.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: 22px;">Trouble brews, though, when that one practice or game turns into several. <b>If the player keeps doing less and less, their fitness level plummets, and so does their performance when they do get back on the court. </b></span><span style="font-family: "trebuchet ms" , sans-serif;">Add an overindulgent diet to that equation and what do you get? 2019 NBA Playoff Edition Joel Embiid.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Imagine the shock to the system when you go from a week of light activity only to suddenly playing 40 minutes of playoff basketball. That's a recipe for sore knees even if you aren't 260 pounds!</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Clearly, just doing less is an overly simplistic application of load management. The key seems to be keeping the player’s fitness level high as they rest the things that ail them.</b> No easy feat when you consider the goal of replicating the conditioning demands of an NBA game without actually subjecting the player to it.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Admittedly, I have no idea what exactly Embiid and the Sixers were doing down the stretch of the season and into the playoffs. For all I know, they did everything right and he’s just made of glass. <b>Or maybe they overexerted him throughout the season, and there was no coming back by the time the homestretch hit. </b>Again, poor load management.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>For a recent example of expert load management, we need look no further than the team that eliminated the Sixers and went on to win the championship this season, the Toronto Raptors</b>. After missing most of last season due injury, Raptors superstar Kawhi Leonard DNP'ed a total of 22 regular season games. Guess how many he missed in the playoffs. (Hint: 0.) Which isn't to say he wasn't battling injury during the playoffs. But it wasn't anything so severe that Leonard couldn't work through it on his way to winning the Finals MVP.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: 22px;">Perhaps the Sixers can look to Popovich for some load management advice. They do have an in: Coach Bret Brown was an assistant to Popovich for a decade before taking over the Sixers gig in 2013. With a poker face like this, though, I doubt Pop will be very forthcoming.</span><br />
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-13405686997681303512019-06-02T06:23:00.000-07:002019-06-02T12:24:50.103-07:00The Two Most Common Misconceptions about the FMS<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Over the past three years as part of my PhD, I’ve been researching the relationship between movement and injury. <a href="https://twitter.com/GregLehman/status/1134690725654700033" target="_blank">A recent Twitter discussion</a> reminded me that people on either side of the great FMS social media debate are still confused. I figured I’d put my research efforts to good use to clear up a couple of common misconceptions.</span><br />
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><u>Misconception #1: The FMS composite score can predict injury.</u></span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">When the FMS first became popular in the late 2000s, its creators touted it as an injury prediction tool [1,2]. The trouble was, at the time they had <b>zero scientific evidence</b> to back that claim up.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">It turns out scoring low on the FMS does increase a person’s risk of injury slightly [3,4], but it doesn’t <i>guarantee</i> it. In other words, <b>while low scores are <i>associated</i> with injury, the FMS does not <i>predict</i> injury on an individual basis</b>. Big difference [5].</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Specifically, when the FMS is conducted on a large group of people, as in a scientific study, we tend to see a lot of false negatives (people who score high but still get injured).</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The fact that the FMS can’t predict injury actually isn’t that surprising. <b>There’s no one thing that predicts injury</b> [6]. This is because injuries aren’t caused by just one factor. Instead, they’re the result of a complicated web of interrelating factors -- a web that’s different for every person based on the types of activities they do [7].</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: small;">Bittencourt NFN, et al. <i>Br J Sports Med</i> 2016;50:1309–1314.</span></td></tr>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><u>Misconception #2: Since the FMS doesn’t predict injury, it’s useless.</u></span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">As the evidence against FMS for injury prediction mounted, its creators quietly walked back their initial claims. Understandably, many evidence-based professionals take issue with <a href="http://www.fitnesspollenator.com/2018/05/5-ridiculous-claims-about-fms.html" target="_blank">the way the FMS folks handled their business</a>. No doubt, <b>they put the marketing cart before the science horse</b>. </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Nowadays, the FMS team talks about the purpose of the screen being to rate movement quality/competency [8,9]. In particular, <b>the FMS looks for movements a person can’t perform or that cause pain</b>. Most would agree this is a reasonable approach when working with someone for the first time.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Obviously, movement professionals were scrutinizing movement long before the FMS came along. What the FMS did was <b>systematize this process</b> using seven bodyweight tests and standardized scoring criteria for each.</span><br />
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<a href="http://2.bp.blogspot.com/-wj2tGwFziRI/XPNZPQoPqII/AAAAAAAAN68/Nq1fCi-XGSsskUCtk_Eoc05zFvwrLqJawCK4BGAYYCw/s1600/Screen%2BShot%2B2019-06-02%2Bat%2B1.05.50%2BAM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="215" src="https://2.bp.blogspot.com/-wj2tGwFziRI/XPNZPQoPqII/AAAAAAAAN68/Nq1fCi-XGSsskUCtk_Eoc05zFvwrLqJawCK4BGAYYCw/s400/Screen%2BShot%2B2019-06-02%2Bat%2B1.05.50%2BAM.png" width="400" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The whole thing takes about 10 minutes and provides quick and dirty information about a person’s mobility, motor control, and symmetry -- all of which can be used to <b>guide exercise selection</b> [10]. Hardly controversial when used in that way… right?</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Well, there are a couple of important limitations. First, <b>the seven tests are somewhat arbitrary</b>. They’re only a small subset of the movements humans are capable of. Moreover, testing at slow speeds with bodyweight only isn’t indicative of how a person will move at faster speeds, with added load, or under fatigue [11].</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The other issue is that <b>the FMS relies on the notion that some ways to move are better than others</b>. This is controversial, to say the least. We know for example that people differ anatomically (e.g. bone structure, limb length ratios, muscle insertion points), and these differences affect movement strategies.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Unless something’s a known mechanism of injury, it’s difficult to state with certainty that it’s “dysfunctional.” Granted, it’s a common misconception that the FMS demands “perfection.” In reality, <b>the FMS asks only for “good enough”</b> (i.e. they allow some wiggle room away from their ideal performance on each test).</span><br />
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<a href="http://4.bp.blogspot.com/-uwLuVWt1hkk/XPNXWXRVCNI/AAAAAAAAN6w/hlUBdMt0YMQWXPeTx3lVxNlhYNoDMb4SQCK4BGAYYCw/s1600/Screen%2BShot%2B2019-06-02%2Bat%2B12.57.39%2BAM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="215" src="https://4.bp.blogspot.com/-uwLuVWt1hkk/XPNXWXRVCNI/AAAAAAAAN6w/hlUBdMt0YMQWXPeTx3lVxNlhYNoDMb4SQCK4BGAYYCw/s400/Screen%2BShot%2B2019-06-02%2Bat%2B12.57.39%2BAM.png" width="400" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">So is the FMS useless? No. <b>It’s simply a lens to view movement through.</b> Do we <i>need </i>it to tell us, for instance, not to put a bar on a person’s back who can’t squat with just their bodyweight? No again. It’s just one example of a standard operating procedure.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Most movement professionals worth their salt should be able to put together their own assessment that</span></div>
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<li><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Is <b>specific to their setting</b> and the population they work with</span></span></li>
<li><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;"><b>Includes added speed, load, and fatigue</b> (when appropriate) to create a comprehensive movement profile</span></span></li>
<li><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Includes additional <b>“breakout testing”</b> depending on what the initial tests show to dig deeper into movements that appear limited</span></span></li>
<li><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Helps them <b>select exercises that are appropriate to the trainee’s level</b> and goals</span></span></li>
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<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-D-N-0e2-y4E/XPNTxSv536I/AAAAAAAAN6A/lep4se5b7IAcNj7ZHvyJAbX_G2oVsiz1gCK4BGAYYCw/s1600/Screen%2BShot%2B2019-06-02%2Bat%2B12.42.38%2BAM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="305" src="https://4.bp.blogspot.com/-D-N-0e2-y4E/XPNTxSv536I/AAAAAAAAN6A/lep4se5b7IAcNj7ZHvyJAbX_G2oVsiz1gCK4BGAYYCw/s320/Screen%2BShot%2B2019-06-02%2Bat%2B12.42.38%2BAM.png" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: small;">Sample breakout tests for a squat</span></td></tr>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Chances are good your assessment will have some sort of squat, some sort of push-up, some sort of look at hip and shoulder mobility, core stability, etc. [12]. Perhaps to the specifications of the FMS or not.</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The FMS is by no means perfect. Use it or don’t use it, but for goodness' sake, <b>do something to systematically assess movement. Don’t just guess.</b></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>References</b></span><br />
<ol style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Cook G, Burton L, Hoogenboom B. Pre-participation screening: The use of fundamental movements as an assessment of function – Part 1. North Am J Sport Phys Ther. 2006;1:62–72.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Cook G, Burton L, Hoogenboom B. Pre-participation screening: The use of fundamental movements as an assessment of function – Part 2. North Am J Sport Phys Ther. 2006;1:132–139.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Bonazza NA, Dhawan A, Smuin D, et al. Reliability, validity, and injury predictive value of the Functional Movement Screen: A systematic review and meta-analysis. Am J Sports Med. 2017;45:725–732.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Dorrel BS, Long T, Shaffer S, et al. Evaluation of the Functional Movement Screen as an injury prediction tool among active adult populations: A systematic review and meta-analysis. Sports Health. 2015;7:532–537.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">McCall A, Fanchini M, Coutts A. Prediction: The modern-day sport-science and sports-medicine “quest for the Holy Grail.” Int J Sport Physiol. 2017;12:704–706.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Bahr R. Why screening tests to predict injury do not work — and probably never will…: A critical review. Br J Sports Med. 2016;50:776–780.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Bittencourt NFN, Meeuwisse WH, Mendonça LD, et al. Complex systems approach for sports injuries: Moving from risk factor identification to injury pattern recognition—narrative review and new concept. </span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Br J Sports Med. 2016;</span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">50:1309–1314.</span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Cook G, Burton L, Hoogenboom B. Functional Movement Screening: The use of fundamental movements as an assessment of function – Part 1. Int J Sports Phys Ther. 2014;9:396–409.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Cook G, Burton L, Hoogenboom B. Functional Movement Screening : The Use of Fundamental Movements as an Assssment of Function – Part 2. Int J Sports Phys Ther. 2014;9:549–563.</span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">McCunn R. The case for movement screening - the usefulness depends on the application. Sport Exerc Sci. 2015;45:21.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Frost DM, Beach TAC, Callaghan JP, et al. The influence of load and speed on individuals’ movement behavior. J Strength Cond Res. 2015;29(9):2417–2425.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Bennett H, Davison K, Arnold J, et al. Multicomponent musculoskeletal movement assessment tools: A systematic review and critical appraisal of their development and applicability to professional practice. J Strength Cond Res. 2017;31(10):2903–2919.</span></li>
</ol>
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</div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-44438156766125483542019-05-27T11:51:00.000-07:002019-05-29T18:25:28.052-07:00What is Pain, and How Should We Manage It?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="color: purple; font-family: "georgia" , "times new roman" , serif;"><i>Today's post is written by a very special friend of mine, Dr. Fred Goldstein. Dr. Goldstein is a Professor of Clinical Pharmacology at Philadelphia College of Osteopathic Medicine. Dr. Goldstein and I go WAY back to when his daughter and I played in the same basketball league as kids.</i></span></div>
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<span style="color: purple; font-family: "georgia" , "times new roman" , serif;"><i>The topic of today's post is pain, which Dr. Goldstein is a true authority on. He's been teaching about and researching pain for even longer than I've been alive! I learned a ton from reading his article, and I think you will, too. -Travis</i></span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif;">WHAT IS PAIN, AND HOW SHOULD WE MANAGE IT?<o:p></o:p></span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Frederick J. Goldstein, PhD, FCP<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Professor of Clinical Pharmacology<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Philadelphia College of Osteopathic Medicine<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">What is pain? Toothache? Sprained wrist? Broken femur? Myocardial infarct (MI)? Obviously, all such conditions are “nociceptive,” meaning they send signals from pathological sites to brain areas for interpretation. Simultaneously activated are emotions which can certainly increase the intensity of such cellular indicators of tissue damage.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">However, it is also known that circumstances exist where pain is attenuated or, in some cases, not even felt. A person who has experienced three MIs over the years will probably feel less alarm with a fourth one than the first. Soldiers in a fierce battle may not even be aware of severe wounds until that firefight has ended.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Of course, there is also psychological pain which occurs upon losing a loved one or receiving news that the cancer which has been discovered is, unfortunately, terminal.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Thus, there is always an interplay between physical and psychological aspects of pain.<o:p></o:p></span></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">ADDICTION<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">What about drug addiction? Physical? Psychological? It is now recognized that the clinical problem classified as '<i>addiction</i>' is a mental disorder, <i>i.e.</i>,<i> </i>addiction is psychological dependence.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">A person may be addicted to anything if it meets a need, <i>e.g</i>., gambling, shopping, internet surfing, dieting (bulimia), and yes, even drugs. Several major criteria characterize addiction:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Compulsive disorder <o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Substantial amount of the addict's time (day and night) devoted to:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Thinking about doing/using it<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Doing/using it<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Obtaining the necessary money (by legal and/or illegal methods) to continue doing/using it<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">High rate of recidivism (relapse)<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">To reduce the stigma of such a term, the preferred designation health professionals are now using is “substance use disorder” (SUD).<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">There are some data indicating a genetic predisposition to addiction, but the major cause of SUD is truly psychosocial -- and this starts within the family unit. Children will be ‘drug-proofed’ if they receive care from their parents that includes <i>unconditional love, respect </i>and <i>discipline</i>. (I do not mean physical punishment; children should not receive this.)<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Also, it is NOT the drug that makes a person develop a SUD. For example, about 10% of those who drink alcohol develop an alcohol SUD. If alcohol were the cause, then <u>everyone</u> who imbibes would develop this. Clearly, we know this does not occur.<o:p></o:p></span></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">PHYSICAL DEPENDENCE<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">For many types of drugs, prolonged use will trigger development of an adaptive process. Tolerance develops. For example, coffee increases stimulation of the brain. Over time, the brain starts to resist the coffee’s effects and becomes normal even though caffeine is in the system. Then the person drinks even more cups every day to achieve stimulation of the brain. The person is now physically dependent.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Over weeks of daily use, patients can also become tolerance to drugs that depress the brain such as benzodiazepines (<i>e.g.,</i>diazepam [Valium</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">]) and opioids (</span><i style="font-family: "trebuchet ms", sans-serif;">e.g.,</i><span style="font-family: "trebuchet ms" , sans-serif;">morphine).</span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif;">The major point here is that addiction is NOT the same as physical dependence.<o:p></o:p></span></b></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">WITHDRAWAL<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">These are effects that occur when a person -- who has been using large amounts of a drug every day for months -- stops abruptly and completely. <o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The most common reactions are <u>opposite</u> to the pharmacology of the drug, <i>e.g.,</i>a CNS depressant like alcohol will cause an alcoholic to experience stimulatory effects such as hand tremors and insomnia as the alcohol is eliminated.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In the case of a stimulant drug, coffee is a good example. When a person who drinks many cups of coffee every day stops suddenly and totally, there is now no caffeine in to stimulate the system. The person will feel very tired and may also have a headache. If they continue to avoid caffeine over the next few days, the brain will return to normal. However, if the person resumes drinking many cups of coffee daily immediately, the tiredness and headache will most likely disappear quickly.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Patients who take certain drugs<i>, e.g, </i>opioids, benzodiazepines, daily for more than a few weeks could experience withdrawal reactions if they stop completely and abruptly.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Avoidance of withdrawal reactions is, in fact, the main reason that those with SUD remain connected to their drug of choice. They now are not receiving any psychological effects but continue such abuse to avoid -- or at least reduce -- their withdrawal reactions.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The longer a person takes such drugs and the higher the dose, the more serious the withdrawal reactions will be. In a severe case, a person should be hospitalized where a general approach is to decrease the person’s daily dose by about 10% per day. However, this is very variable, and the ultimate treatment decisions are absolutely based on how the person is doing while going through withdrawal.<o:p></o:p></span></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">PAIN MANAGEMENT<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Pain is a very important biological signal. In many cases, it is a message that a body part is injured, and one of the best aspects of treatment is to rest that part from which the signal is occurring, at least temporarily. When a person with such pain takes a pain-relieving drug like aspirin (and related medicines like ibuprofen) and then continues to use that part, they will not feel the pain but the injury could become worse.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">However, some types of pain are not helpful signals, for example that which occurs in cancer. Often, it can be excruciating. If unrelieved, it can lead a patient to consider -- and sometimes accomplish -- suicide. Any condition that causes this is a ‘<i>Suicidogen’</i>, a<i> </i>word that I coined in 1997 [1]. If you Google this exact word, my paper will come up, usually at the top. In my decades of treating patients to improve analgesia, I know that poor pain management is a <i>suicidogen.<o:p></o:p></i></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">There are several classes of drugs for pain management -- each with some different uses, benefits, and adverse reactions -- which I’ll describe briefly below.<o:p></o:p></span></div>
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<i><u><span style="font-family: "trebuchet ms" , sans-serif;">Nonsteroidal Anti-Inflammatory Agents (NSAIDs)<o:p></o:p></span></u></i></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Included in this group are aspirin (ASA), ibuprofen (Advil</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">; Motrin</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">) and naproxen (Aleve</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">; Naprosyn</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">). These drugs work by blocking production of prostaglandins, substances that cause pain and inflammation. They can reduce a body temperature that is elevated above normal (antipyretic action). ASA is also taken daily in a low dose (81 mg) to produce a moderate anticoagulant effect in patients where an intravascular blood clot could cause a serious condition.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">NSAID uses include musculoskeletal injuries and pain from bone cancer. Since this latter severe condition is associated with increased prostaglandin production, NSAIDs can be more beneficial than opioids. They are very effective when used properly but daily doses too high can produce adverse reactions, the most common being gastric upset, especially with ASA.<o:p></o:p></span></div>
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<i><u><span style="font-family: "trebuchet ms" , sans-serif;">Acetaminophen (APAP)<o:p></o:p></span></u></i></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">This drug shares a similar mechanism of action with NSAIDs -- reduction of prostaglandin synthesis -- and some pharmacologic actions<i>, i.e.</i>, analgesic and fever reduction. However, it has no anti-inflammatory or anti-platelet action so its effect on prostaglandin is not as powerful as that of NSAIDs. Published data suggest that pain relief provided by APAP is also due in part to activation of descending serotonergic pathways in the CNS [2]. This drug is also combined with opioids in many products designed to treat moderate to severe pain (<i>e.g.,</i>Percocet</span><span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span>, which is oxycodone + APAP).<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">APAP is a very safe drug with good features compared to ASA; e.g., it does not cause gastric upset. However, there is a <u>daily</u> limit recommended by the FDA: 3000 mg. The result of such abuse is serious: possible hepatic (liver) damage sufficiently severe as to require a liver transplant.<o:p></o:p></span></div>
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<i><u><span style="font-family: "trebuchet ms" , sans-serif;">Opioids (Narcotics)<o:p></o:p></span></u></i></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Drugs in this classification include codeine, morphine, methadone, oxycodone, hydrocodone, hydromorphone (Dilaudid</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">) and fentanyl (available in a transdermal patch, Duragesic</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">). Hydrocodone is in a combination product with APAP (<i>e.g.,</i>Vicodin</span><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span><span style="font-family: "trebuchet ms" , sans-serif;">).<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">As is known, endorphins are physiologic substances that decrease pain perception within the CNS by (a) blocking transmission of such signals upward to the brain and (b) decreasing release of pain neurotransmitters in the spinal cord. Opioids act on central endorphin receptors to produce the same effect.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">This group of drugs is the most effective for treatment of severe pain, <i>e.g., </i>post-op and in cancer patients. The current opioid overdose epidemic is fueled more by those with an Opioid Use Disorder (OUD) rather than health professionals. Some with OUD steal opioids from their very sick relatives for whom they have been properly prescribed.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The main target is to decrease use in those with chronic non-cancer pain. Patients who have cancer, are under hospice care, or are terminal are exempt from such targeting. However, the FDA has recently issued statements indicating that some prescribers are inappropriately terminating opioids in truly needy chronic non-cancer pain patients. Other meds should be tried separately or added to opioid therapy.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">When opioids are taken appropriately under the care of a healthcare professional, adverse reactions are minimal. Initially, patients may become nauseous and sedated but after several days of daily therapy, tolerance develops to them.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">However, tolerance does not develop to constipation, so some patients need to be taking stool softeners and other such meds to facilitate defecation. In addition, long-term use can result in decreased production of sex hormones.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">There are long-acting opioid products that are very useful for chronic pain management; the fewer times a patient has to remember to take a drug on a daily basis, the higher the compliance rate with using the drug as prescribed. OxyContin</span><span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">™</span> (sustained-release oxycodone) is such a product and is a very helpful for managing chronic pain; however, as is clearly known, it has become a product of extensive abuse.<o:p></o:p></span></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">ADDITIONAL DRUGS FOR PAIN<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">There are many pharmacologic options for treatment of pain that do not involve opioids; they can be alone or concurrently. Decades ago, I added an antidepressant, amitriptyline, to patients undergoing ether cholescystectomy (gallbladder removal) (3) or C-section (4). The doses I employed were lower than those used to treat depression. In both studies, those who received amitriptyline used less opioids after surgery that those who did not receive this antidepressant.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In a pilot study at Philadelphia College of Osteopathic Medicine, I am treating chronic neuropathic (nerve) pain patients with delta-9-tetrahydrocannabinol (THC); this is a product approved by the FDA for reducing chemotherapy-induced nausea and vomiting, and also to stimulate appetite in patients experiencing extreme weight and muscle loss due to severe chronic illness. Several of the patients in my study have experienced significant reduction of their long-lasting nerve pain.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In addition to NSAIDs and APAP, here are various drugs that have been shown to have analgesic actions, either alone or in combination with opioids:<o:p></o:p></span></div>
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<b><u><span style="font-family: "trebuchet ms" , sans-serif;">CONCLUSON<o:p></o:p></span></u></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Pain is an important neurophysiologic process signaling, in many cases, that a body part is abnormal and should be rested temporarily. Taking medications to reduce such pain does not remove the pathological changes; in fact, a major consequence of doing this can be prolongation of recovery. Even more significant, using that part in any athletic event when on such drugs can result in even more severe tissue damage. Using analgesic and related drugs to reduce post-op, cancer, and other medical types of pain is appropriate. It must be understood that it is not the molecular structure of these drugs that cause addiction. <o:p></o:p></span></div>
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<u><span style="font-family: "trebuchet ms" , sans-serif;"><b>ABOUT THE AUTHOR</b><o:p></o:p></span></u></div>
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<v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"><v:stroke joinstyle="miter"><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"><v:f eqn="sum @0 1 0"><v:f eqn="sum 0 0 @1"><v:f eqn="prod @2 1 2"><v:f eqn="prod @3 21600 pixelWidth"><v:f eqn="prod @3 21600 pixelHeight"><v:f eqn="sum @0 0 1"><v:f eqn="prod @6 1 2"><v:f eqn="prod @7 21600 pixelWidth"><v:f eqn="sum @8 21600 0"><v:f eqn="prod @7 21600 pixelHeight"><v:f eqn="sum @10 21600 0"></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas><v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"><o:lock aspectratio="t" v:ext="edit"></o:lock></v:path></v:stroke></v:shapetype><v:shape alt="Frederick J. Goldstein, PhD, FCP" id="Picture_x0020_1" o:spid="_x0000_s1026" style="height: 102.05pt; margin-left: 3.05pt; margin-top: 13.15pt; position: absolute; visibility: visible; width: 76.55pt; z-index: 251658240;" type="#_x0000_t75"><v:imagedata o:title="Frederick J" src="file:////Users/trpollen/Library/Group%20Containers/UBF8T346G9.Office/TemporaryItems/msohtmlclip/clip_image001.jpg"><w:wrap type="square"></w:wrap></v:imagedata></v:shape><span style="font-family: "trebuchet ms" , sans-serif;"><o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Dr. Goldstein is Professor of Clinical Pharmacology in the Department of Bio-Medical Sciences at Philadelphia College of Osteopathic Medicine (PCOM) and serves as Coordinator of Pharmacology. His research interests focus on adding non-opioid drugs to improve analgesia in patients who have chronic pain. In addition to his teaching and research at PCOM, he lectures in pharmacology at the University of Pennsylvania School of Dental Medicine. Dr. Goldstein serves on the editorial board of, and reviews submissions for, the Journal of Opioid Management. He is an active member of the National Board of Osteopathic Medical Examiners, where he writes and reviews questions for the COMLEX Level 1 test.<o:p></o:p></span></div>
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<u><span style="font-family: "trebuchet ms" , sans-serif;"><b>REFERENCES</b><o:p></o:p></span></u></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Goldstein, FJ. Editorial: "<i>Inadequate Pain Management: A Suicidogen (Dr. Jack Kevorkian: Friend or Foe?)"</i>J Clinical Pharmacology 37: 1-3, 1997.<i><o:p></o:p></i></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Graham GG1, Scott KF. <i>Mechanism of action of paracetamol</i>[acetaminophen] Am J Therapeutics 12: 46-55, 2005.<i><o:p></o:p></i></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Goldstein, FJ. "<i>Effect of chronic antidepressant administration upon opioid analgesia</i>." In: Mumenthaler M, van Zwieten PA, Farcot J-M, Treatment of Chronic Pain: Possibilities, Limitations and Long-Term Follow-up·. Philadelphia, PA: Harwood Academic Publishers; (1990): 278-291.<i><o:p></o:p></i></span></div>
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<!--[if !supportLists]--><span style="font-family: "trebuchet ms" , sans-serif; mso-bidi-font-family: "Trebuchet MS"; mso-fareast-font-family: "Trebuchet MS";">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "trebuchet ms" , sans-serif;">Witkowski, T.A., Leighton, B.L., Goldstein, F.J., Norris, M.C., Arkoosh, V.A. and Bartkowski, R.R<i>., "Effect of Amitriptyline on Spinal Morphine Analgesia" [in</i><i>elective C-section patients], J Clin Pharmacol 34(10): 1014 (1994).</i></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-78512848753793305412019-05-06T08:41:00.000-07:002019-05-07T07:51:52.373-07:00The Keys to Unlocking Explosive Power<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">It wasn’t too long ago that athletes, parents, and coaches believed strength training made you slow and inflexible. To avoid these supposed undesirable effects, athletes steered clear of weights like the plague.</span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Over the years, we’ve come to debunk these myths. We now recognize the <b>myriad benefits of strength training for sports performance</b>, from injury prevention to increased positional endurance and improved speed and power -- the subject of this post.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Most of us have a general idea of what power is. We know it when we see it. But it’s not entirely intuitive how strength affects power.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">To appreciate the relationship between strength and power, we must first understand that <b>strength is equivalent to the ability to produce force, and speed is the expression of strength quickly</b> (i.e. at high movement velocity).</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">It turns out that power is the combination of these two factors. Mathematically speaking, <b>power equals force times velocity</b>.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Strength coaches have identified four types of power, which are depicted on the “force-velocity continuum” below. </span></span><br />
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Along this continuum, maximal strength and maximal speed lie on opposite ends of the spectrum. Their hybrids -- strength-speed and speed-strength -- fall in between. Power training can be performed at every level of the curve (see examples in parentheses in the figure above).</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">In the weight room, we typically focus on the higher force end of the continuum: the maximal strength and strength-speed levels. For many athletes, though, traditional powerlifting and Olympic lifting programs aren’t optimal for eliciting explosive power adaptations.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>The keys to unlocking explosive power for most athletes lie in two scientific principles: rate of force development (ROFD) and post-activation potentiation (PAP).</b></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">ROFD is a neuromuscular property that refers to how quickly you can generate a force. <b>By increasing ROFD, you improve your ability to express your strength faster.</b> This translates to a faster first step, harder cuts, a quicker shot release, etc.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Training for increased ROFD is pretty simple. For any exercise, <b>all you have to do is intend to lift the weight as quickly and explosively as possible</b>, regardless of how heavy it is.</span></span><br />
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<span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">From a physiological standpoint, this intention to move the weight fast recruits more motor units and muscle fibers. This allows you to develop higher levels of force sooner, by calling more and bigger neuromuscular units into action.</span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For heavier loads, which will necessarily move more slowly, the actual speed of movement is less important than the intention to move it quickly. </span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b><u>Post-Activation Potentiation</u></b></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The other secret to explosive power training is PAP. PAP is a way of “priming” the nervous system to produce high levels of force. <b>To take advantage of PAP, perform a superset of two similar movement patterns. The first exercise will use a heavy load; the second will be unloaded.</b></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For example, you could pair deadlifts with broad jumps, chin-ups with medicine ball slams, or sled pushes with sprints. This method of pairing exercises is often referred to as <i>contrast training</i>.</span></span><br />
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<span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">The keys to PAP are two-fold. First, you want to select movements that are very similar. For instance, you might consider pairing a deadlift and a vertical jump since they’re both lower body movements. However, in this case the broad jump is actually the better choice for the unloaded movement because the forward lean of the torso better mimics the mechanics of the deadlift.</span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Second, it’s important to <b>keep the volume of the resisted exercise low</b> (usually under 6 reps). The goal with this first exercise is to activate the muscles in preparation for the second exercise, but not fatigue them. <b>If done correctly, performance on the unloaded exercise will actually increase </b>(i.e. a longer broad jump, a more explosive medicine ball slam) compared to if it were performed in isolation.</span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b><u>Precursors to Power</u></b></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Bear in mind that the above two techniques are for intermediate to advance trainees. <b>Before progressing to these methods, it’s crucial that athletes have mastered all of their basic movements patterns (squat, lunge, hinge, push, pull, etc). Athletes must always move well before moving more, faster, and under greater loads.</b></span></span><br />
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>Interested in learning more about power development and where it fits into the big picture training-wise?</b></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">I recently co-authored <i>Speed Training for Hockey: 12 Weeks to Game-Changing Speed</i> along with NHL Performance Coach Kevin Neeld.</span></span><br />
<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><br /></span></span></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>Speed Training for Hockey</i> is both <b>a book and series of age-specific off-season training programs</b> for hockey players. It’s specifically designed to help hockey players reach their genetic speed potential -- no matter their age or current skill level.</span></span><br />
<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><br /></span></span>
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<a href="http://2.bp.blogspot.com/-9I0_YH6gQho/XNBT7CLfVeI/AAAAAAAANKE/C9UL-Z5iJuE9Oc9A14pvnkDqJx7ReAFoQCK4BGAYYCw/s1600/Book%2Bmockup.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="271" src="https://2.bp.blogspot.com/-9I0_YH6gQho/XNBT7CLfVeI/AAAAAAAANKE/C9UL-Z5iJuE9Oc9A14pvnkDqJx7ReAFoQCK4BGAYYCw/s400/Book%2Bmockup.jpg" width="400" /></a></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>Speed Training for Hockey</i> includes</span></span></div>
<div>
<br />
<ul style="text-align: left;">
<li><span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>Comprehensive training programs</b> for U-14, U-18, and 18 & over players totaling <i>36 weeks of programming</i>, all designed with the specific purpose of increasing speed</span></li>
<li><span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">An <b>extensive exercise video database</b> demonstrating proper technique for every exercise and drill included in the program</span></li>
<li><span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">A systematic <b>20-item performance testing battery</b>, which enables you to identify individual strengths and weaknesses and track training progress over time</span></li>
<li><span style="background-color: white; font-family: "trebuchet ms" , sans-serif; font-size: large;">A <b>user-friendly text</b> that describes all of the factors that influence speed development, so you can understand exactly why the methods work</span></li>
</ul>
<div>
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><br /></span></div>
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<div>
<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Every aspect of the training programs -- from the <b>dynamic warm-up, to the speed and power drills, strength training, conditioning, and cool-down</b> -- is tailored not only to maximize on-ice performance, but also maximize durability and minimize risk of injury. The training programs even specify <b>systematic weekly progressions</b> to improve speed every single session.</span></span></div>
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<br /></div>
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<span style="background-color: white;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>Speed Training for Hockey</i> will go on sale to the general public on Monday, May 13.</span></span></div>
</div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-44423722410699045232019-04-26T11:46:00.000-07:002019-04-28T18:02:06.284-07:00Why Every Kid Should Play Multiple Sports<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">If you’ve been paying attention to youth sports over the last few decades, you’ve probably noticed a similar trend. Winter rolls around, and Little Johnny, age 11, signs up for peewee hockey. He recently hit a growth spurt and is a solid six inches taller than most of his friends.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Thanks to his size, <b>Johnny dominates in his first season</b>. The coach tells Johnny’s parents he has a bright future ahead of him on the ice. He urges them to forego the spring season of baseball (and basketball in the fall) to concentrate on skating.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Over the next few years, Johnny continues to shine. His parents thrust him onto the ice more and more until he’s playing competitively year-round. <b>At age 15, Johnny starts complaining of hip pain</b>. His doctor recommends physical therapy and time off from hockey.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">When Johnny returns to the ice a few months later, his peers all seem to have caught up to him in stature. He can no longer use his size to dominate opponents. <b>Johnny has his worst season to date and loses some of his love for the game.</b><o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">To regain his previous form, Johnny signs up for extra power skating clinics on top of his regular competitive seasons. Lo and behold, due to these added rigors<b> Johnny’s hip flares again</b>.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For the next three years, the pattern repeats over and over again until <b>Johnny is finally forced to undergo career-ending surgery</b> at the age of 18.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">What went wrong? Johnny had so much promise as a youngster. Or did he?</span><br />
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Maybe he did; maybe he didn’t. At 11 years old, there’s no way to tell. <b><u>There’s no such thing as an elite 11-year-old. There are only earlier and later bloomers.</u></b> Johnny developed physically before his friends, but they eventually caught up. When they did, it turned out he didn’t have the skills to keep up.</span><span style="font-family: "trebuchet ms" , sans-serif;"> </span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Whereas some of the other kids had played multiple sports at early ages, Johnny’s “movement vocabulary” was limited to hockey only. Moreover, the repetitive stress of year-round hockey from such a young age put a tremendous amount of wear and tear on Johnny’s body and mind. In essence, <b>Johnny’s fate was sealed from the moment his peewee coach identified him as a “superior talent.”</b><o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">It’s easy to fall into this trap. In today’s culture, more is almost always viewed as better. For Johnny to be a star, the thought was that he needed more specificity, more in-game experience, and more year-round hockey training.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">What this strategy neglects is the importance of free-play and practice time for developing hockey sense and passion. It also ignores the need for a dedicated off-season to combat the repetitive stressors of skating and to develop other movement skills -- skills best developed by playing other sports.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For example, <b>one of the best things Johnny could have done for his hockey career was to keep playing baseball, at least into high school</b>. Baseball requires multi-directional movement and rotational power, much like skating and shooting. Moreover, it trains hand-eye coordination, integrated movement of the upper and lower body, and rapid reaction. In this way, baseball is actually highly hockey-specific.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Clearly, <b>today’s athletic development approach fails to take the long view</b>. By prioritizing early talent identification, it misses out on identifying talented late bloomers. Thanks to early specialization, we’re seeing an unprecedented number of overuse injuries and shorter careers as a result. Overall, <b>we’ve created a system that produces worse athletes</b>.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Instead, we have to take a long-term approach to athletic development. <b>We need to insist on playing multiple sports, engaging in strength training, and having a distinct off-season. </b></span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For example, even if hockey is the priority, there are plenty of other sports that can provide athletes with skills that transfer to the ice (e.g. baseball, basketball, soccer, lacrosse, football, tennis, etc.).</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Above all, <b>we have to let kids be kids.</b> Encourage them to play outside. Emphasize practice and fun instead of competition and winning. Watch professional games and analyze the tactics of the best in the world.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">These are the ways to achieve greatness in the long term. Sure, it’s easy to fall victim to the idea that a young kid is the next Sidney Crosby. While he or she very well might be, we must be better about developing them gradually. Lest we risk the above consequences and the athlete never reaches his true potential.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>BIG NEWS!</b> I recently co-authored <i><span style="color: blue;">Speed Training for Hockey: 12 Weeks to Game-Changing Speed</span> </i>along with NHL Performance Coach Kevin Neeld.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i><br /></i></span>
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>Speed Training for Hockey</i> is both </span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>a book and series of age-specific off-season training programs</b> for hockey players. It’s specifically designed to help hockey players reach their genetic speed potential -- no matter their age or current skill level.</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://speedtrainingforhockey.com/wp-content/uploads/2019/02/Speed-Training-for-Hockey-Package.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img alt="" border="0" class="full-width" src="http://speedtrainingforhockey.com/wp-content/uploads/2019/02/Speed-Training-for-Hockey-Package.jpg" height="271" width="400" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>Speed Training for Hockey</i> includes</span><br />
<br />
<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>Comprehensive training programs</b> for U-14, U-18, and 18 & over players totaling 36 weeks of programming, all designed with the specific purpose of increasing speed</span></li>
</ul>
<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">An <b>extensive exercise video database</b> demonstrating proper technique for every exercise and drill included in the program</span></li>
</ul>
<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">A systematic <b>20-item performance testing battery</b>, which enables you to identify individual strengths and weaknesses and track training progress over time</span></li>
</ul>
<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">A <b>user-friendly text</b> that describes all of the factors that influence speed development, so you can understand exactly why the methods work</span></li>
</ul>
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i><br /></i></span>
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Every aspect of the training programs -- from the <b>dynamic warm-up, to the speed and power drills, strength training, conditioning, and cool-down</b> -- is tailored not only to maximize on-ice performance, but also maximize durability and minimize risk of injury. The training programs even specify <b>systematic weekly progressions</b> to improve speed every single session.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i><br /></i></span>
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>S</i></span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><i>peed Training for Hockey</i> will go </span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">on sale to the general public on Monday, May 13. <b><span style="color: red;"><i>Subscribers to my email list can get it at <u>50% off</u> the week of Monday, May 6.</i></span></b></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>If you want to be notified via email on May 6, enter your e-mail address below.</b> You'll also receive a free e-book and video e-course on exercise prescription and program design as an added bonus!</span><br />
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-85486932742180346202019-03-05T15:46:00.000-08:002019-03-05T20:42:22.642-08:00Do’s and Don’ts for Recovering from Injury<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large; white-space: pre-wrap;">Have you ever wanted to be able to do one thing so badly, yet it was the <i>only</i></span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large; white-space: pre-wrap;"> thing you couldn't do?</span><br />
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">There I was, a little over a month ago, standing underneath my pull-up bar. Like any other morning, I was planning to hammer out a few reps before starting my schoolwork. Only this day turned out </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">not</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> to be like any other morning. As I started my first rep, pain seared through my back and arm muscles. Thinking I was just sore from rock climbing the day before, I tried again. The result was the same: shooting pain.</span></span><br />
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">I had never felt this type of pain before. It took me a few moments to wrap my mind around the reality of the situation: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">I was injured.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">The strange thing is that I don't remember suffering the injury. It must have happened while rock climbing, but I couldn't recall an acute episode where the injury occurred. I just woke up that morning and had intense pain when I tried the pull-up.</span></span><br />
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<span style="font-family: "trebuchet ms", sans-serif; font-size: large; white-space: pre-wrap;">Assuming the injury was minor, I rested up for a few days and tried a pull-up again. Searing pain just like the previous go round. The severity of the injury was beginning to dawn on me. It was going to be a hot minute until I’d be back to doing any pull-ups or climbing.</span></div>
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">As a </span><a href="https://www.youtube.com/watch?v=HG5K6-7rJ08" style="font-family: "trebuchet ms", sans-serif; text-decoration: none;" target="_blank"><span style="color: #1155cc; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">calisthenics junkie</span></a><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">, I was majorly bummed. Just a few weeks before, I'd set a new personal best time for 100 pull-ups. Now I couldn't do a single one.</span></span><br />
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<a href="http://2.bp.blogspot.com/-yKw-ioidcVM/XH8NcBuwU0I/AAAAAAAALJA/9wvz-3sB_Z0FDP-L2Jjs8eItIdYzIO5MACK4BGAYYCw/s1600/IMG_20190305_170942.jpg" imageanchor="1" style="font-family: -webkit-standard; margin-left: 1em; margin-right: 1em; text-align: center; white-space: normal;"><img border="0" height="280" src="https://2.bp.blogspot.com/-yKw-ioidcVM/XH8NcBuwU0I/AAAAAAAALJA/9wvz-3sB_Z0FDP-L2Jjs8eItIdYzIO5MACK4BGAYYCw/s400/IMG_20190305_170942.jpg" width="400" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Thinking back, there were some yellow flags that an injury was brewing. In the days leading up, I was more sore than normal and had a harder time loosening up when I climbed. I didn't think anything of it at the time, and I obviously should have.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">My eternal optimism wouldn’t allow me to wallow for long, though. I decided to take my own advice. I reframed the situation as an opportunity for self-growth rather than a setback, and I set to work on rehab.</span></span><br />
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<a name='more'></a><span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">DISCLAIMER</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">: Although I’m studying for my PhD in Rehabilitation Sciences, I’m neither a medical doctor nor a physical therapist. Please do NOT take any of the information below as medical advice. If you have a nagging injury (e.g. pain that persists, worsens, affects sleep, causes numbness/tingling or shortness of breath, etc.), seek out attention from a trained medical professional immediately. Don’t take the chance that you miss something that turns out to be serious.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Practical wisdom would suggest that the first step to recovering from an injury is rest. While this can be true for some injuries, it wasn’t the case here; my pain hadn’t improved after a few days of rest. Instead of catastrophizing about any potential long-term damage I’d done, this was my signal to get back to business in the gym.</span></span><br />
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">I started by identifying the movements that caused pain and avoiding them in the short term to prevent re-injury. Of course, one of those movements was the pull-up. The other turned out to be scratching my lower back (</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">shoulder extension</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> and </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">internal rotation</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> for the anatomy nerds). Because the back scratch is an unloaded movement, I could also use that periodically to reassess for pain (as a way to measure my progress).</span></span><br />
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<a href="http://4.bp.blogspot.com/-NgjlB3-0DuE/XH8FWOYqGOI/AAAAAAAALIM/PWnEnfN2N0k-3Ox02jrf5jxGsJbYnk6JgCK4BGAYYCw/s1600/back%2Bscratch.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><img border="0" height="240" src="https://4.bp.blogspot.com/-NgjlB3-0DuE/XH8FWOYqGOI/AAAAAAAALIM/PWnEnfN2N0k-3Ox02jrf5jxGsJbYnk6JgCK4BGAYYCw/s320/back%2Bscratch.jpg" width="320" /></span></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Given that only two things caused pain, that left me with a huge menu of trainable movements. And train them I did. All my favorite lower body exercises were on the table. And for the upper body, I could still bench press, overhead press, and curl heavy without pain. I could even hang from the pull-up bar pain-free (so long as I didn’t pull up). For the next several weeks, I continued to train these exercises hard. I even established a new 10-rep max in the barbell overhead press along the way.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Meanwhile, I kept training my unaffected arm with heavy unilateral pull-downs to maintain strength. There’s a common misconception that you shouldn’t train the uninjured side because you’ll develop an asymmetry in strength and size. As a matter of fact, that asymmetry is exactly what you want.</span></span><br />
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">Injury will necessarily lead to decreased strength on the affected side. But it doesn’t mean </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">both</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> sides have to get weak. Moreover, it turns out that continuing to train the unaffected side keeps the neural drive to the affected side strong, too. So when you do get back to heavy training on the affected side, the strength returns faster. Isn’t the human body weird?!</span></span><br />
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<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">In conjunction with my heavy strength training, I also included targeted exercises for my injured arm in each session. My goal was to expose myself to pain-free stimuli only. I was okay with a little bit of discomfort, but no pain outright. Each session, I would go slightly harder and heavier. This process of gradually reacclimating to producing force without pain is called </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">graded exposure</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Here’s what my exercise progression looked like for my affected side over the span of about a month:</span></span><br />
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<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Isometric stiff-arm pull-downs at multiple angles<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Easy horizontal pulling (suspension trainer rows)<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">More challenging suspension trainer rows (at a more reclined body angle) <o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Light eccentric single-arm lat pull-downs<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Very light partial-rep* Gravitron pull-ups (e.g. 100 pounds of assistance for 135 pounds of bodyweight)<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Band-assisted and leg-assisted pull-ups<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Less and less assistance on the pull-ups until, finally, a single neutral grip bodyweight pull-up<o:p></o:p></span></li>
<li class="MsoNormal" style="vertical-align: baseline;"><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Sets of multiple bodyweight pull-ups with varied grips and <a href="http://www.fitnesspollenator.com/2014/10/how-top-fitness-pros-coach-leg-position.html" target="_blank"><span style="color: #1155cc;">bent- and straight-leg positions</span></a></span><span style="font-family: "arial" , sans-serif;"><o:p></o:p></span></span></li>
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">(*At first, my pull-ups were only partial reps. Because the very top of the movement caused some pain, I limited the range of motion during the first couple of sessions to what I could do without pain. I gradually added range of motion as tolerated.)</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">The morning after my training sessions, I carefully re-checked my back scratch motion. The pain was decreasing, which was my signal that I was on the right track.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">Once I was back to doing unassisted bodyweight pull-ups, I returned to rock climbing. To start I did a very short (20-minute) session of beginner routes without pain. The injured area was sore the next day, so I waited an entire week before climbing again. During that week, I backtracked a bit in my exercises and focused on pain-free assisted pull-ups.</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;"><br /></span></span>
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">The next climbing session was almost two hours long, completely pain-free, and included a couple of more challenging routes. To my delight, I wasn’t sore at all the following day.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">It’s been a little over a month since my injury. I’m still not 100%, but I’m getting there. My next step will be to string climbing sessions together with fewer days in between. From a strength training standpoint, over the next few weeks I’ll continue to progress my pull-ups in overall volume (lots of low-rep sets); build to more consecutive reps within each set; and lastly, add external load (e.g. weighted vest).</span></span><br />
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-size: large; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="font-size: large;"><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">If I’m being perfectly honest, this ordeal has been long and frustrating. At the same time, though, by focusing on all the things I </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">can</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> do, I haven’t actually been that limited. I’ve been able to maintain my fitness, and even improve it in some areas, despite the injury. It just so happened that the thing I’ve wanted to do most (pull-ups/rock climb) was the one thing I couldn’t, at least not for a few weeks.</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;"><br /></span></span>
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><span style="font-size: large;">While every injury is different, and the above is just what worked for me, my purpose in sharing this story is to shed light on some of the do’s and don’ts of recovery. To reiterate:</span></span><br />
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<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Focus on what you can do, not what you can’t.</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="white-space: pre-wrap;">Keep </span><span style="white-space: pre-wrap;">training the uninjured side.</span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="white-space: pre-wrap;">Keep </span><span style="white-space: pre-wrap;">training bilateral movements that are pain-free. </span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="white-space: pre-wrap;">Progress </span><span style="white-space: pre-wrap;">gradually in volume, load, and frequency.</span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="white-space: pre-wrap;">DON’T </span><span style="white-space: pre-wrap;">push through pain. </span></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><span style="white-space: pre-wrap;">DON’T </span><span style="white-space: pre-wrap;">think you’re never going to get better, even if it’s taking longer than you </span><span style="white-space: pre-wrap;">expected.</span></span></li>
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-size: large; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="color: black; vertical-align: baseline;">And remember, the above recommendations are not medical advice. </span><span style="color: black; vertical-align: baseline;">If you need help finding a good medical professional in your area, feel free to </span><a href="http://www.fitnesspollenator.com/p/contact.html" style="text-decoration: none;" target="_blank"><span style="color: #1155cc; text-decoration: underline; vertical-align: baseline;">reach out to me</span></a><span style="color: black; vertical-align: baseline;">. I know people!</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Photo credits to MingYuan Low. Thanks, Ming!</span></div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-91216773283799907552019-01-28T14:48:00.000-08:002019-01-28T20:04:49.957-08:00The Body Part You've Been Neglecting in Your Training – And What to do About It<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">Note from Travis:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">A few weeks ago, I saw </span><a href="https://www.instagram.com/p/BsYI8-3llyu/" style="text-decoration: none;"><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; font-style: italic; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">a great Instagram post</span></a><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: italic; vertical-align: baseline; white-space: pre-wrap;"> from my friend Sandesh Rangnekar on neck training. After sliding into his DMs to ask him a few follow-up questions, I knew I had to share his great information. I hope you learn as much from this Q&A as I did!</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">Travis Pollen: What types of people should train their neck? </span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Sandesh Rangnekar: </span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;">The answer is pretty simple. Have a neck? Train it!</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">TP: Why is neck training so important?</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> The entire world of rehab and strength and conditioning goes batshit crazy when asked about “core.” Ever thought of the benefits if you start considering the neck as part of the “core” and train it? If you look at it on a larger canvas, there are two school of thoughts here. One school of thought is that the core musculature consists of the lumbo-pelvic-hip complex (including the abs!), or simply put the muscles in and around the hip and low back region. The other kind of “in the trenches” school of thought is that everything is core and everything is connected. I favor the latter.</span></div>
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<span style="font-family: "trebuchet ms"; font-size: 12pt; white-space: pre-wrap;">If we divide the body into regions with regards to the spine, we get three subdivisions: cervical, thoracic, and lumbar. While the thoracic and lumbar regions generally get a lot of attention (t-spine mobility, six-pack ab training, lumbopelvic stability, this drill, that drill, those drills on Instagram), the poor cervical region is like an outcast. It just doesn’t get the attention it deserves. And therefore, we need to look at it as equally important.</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">TP: What neck muscles should we focus on during training?</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> Sternocleidomastoid (SCM) at the front of the neck. Suboccipitals help in extension and rotation of the head. Trapezius, although it’s concerned with providing stability to the scapula, originates from the lower back of the skull. Levators. Honestly, the musculature is quite complex and works in sync, so it’s very difficult to point out every specific muscle. Train it as a whole structure. I just mention a few names to sound cool and nerdy.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: If neck training is so important, why do so few people do it?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> People think of the neck as an intricate structure, which it is, but I think that scares some away from training it. Even if you try to find out more about neck training, you’re likely to come across a title like “exercises for neck pain.” As a result, the average person who isn't in pain and is just going to the gym to get in shape and be healthy might think they don’t need to train it.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; white-space: pre-wrap;">How many people do you see performing neck exercises in a commercial gym, unless their physical therapist has asked them to do so because they’re in pain? We have this idea that we need to perform these special exercises for this special structure only when it hurts. <i>The truth is, there are no special exercises. And every exercise is special.</i> If you prioritize your neck, just as you would your biceps and chest, you are likely to benefit from it (unless you do some circus shit and hurt yourself in the process!).</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;">Even some athletes have been slow to adopt neck training. Consider collision/impact sports like American football, wrestling, boxing, and </span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">kabaddi</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> (a traditional sport played in India and other surrounding countries with movements resembling a mix of wrestling and rugby. These are all looked at as sports that would require their athletes to train the neck year round. Yet if I tell most sports "experts” that cricket, soccer, and hockey players would also benefit from neck training, they would laugh it off. (Some of them have. I’ve experienced it.)</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: In your work as a strength and conditioning coach in kabaddi, how have you been able to incorporate neck training with your athletes?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR: </span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;">The first thing I did when I started was to watch the sport and understand its true nature. (Shoot, I just gave all the people a trade secret to becoming a good strength coach!) Imagine colliding with each other for more than 20 matches with full contact. Risk of concussions? You bet. So during pre-season and in-season I tried to incorporate some neck work. It wasn’t a lot, but it got me some athletes’ eyeballs. I was able to educate them about the importance of direct neck work, which may actually help minimize the risk of concussion. Notice I said "minimize the risk." The risk of concussion may still very well exist. Neck training won't totally protect you from tons of external force during collision and contact. But weak neck musculature is one factor that increases the risk of injury.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: How do you convince people neck training is important enough to prioritize it in their training?</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; white-space: pre-wrap;">Adding a lot of stuff to people’s routines will drive them insane. Just start with a few exercises (like the ones I show at the end of this Q&A). And educate people on the benefits of neck training: how it can help them build a strong upper body, how it can help them in their activities of daily living, how it may possibly reduce neck injuries. Same applies to athletes. In both populations (athletes and general population), overload them with information and they’ll ignore you. Give them just enough stuff to start with, and then guide them along the way.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: How often should people train their neck?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> I have found that three sessions per week often does the trick. Some individuals may need more. Some less. Frequency depends on the demands of the person’s activities.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: Can people who aren’t looking for huge neck muscles still train their neck?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> A few sessions of direct neck work using isometrics, resistance bands, and some neck movements against gravity would be great for anyone. And no, it won’t make your neck look like that of pro wrestler Kurt Angle or boxer Mike Tyson.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: Why do you think neck training isn’t covered more in strength and conditioning education?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> To be honest, I have no clue. I think its performance benefits should be covered more. Also, maybe we need more quality research studies with dosage/prescription to highlight its importance.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: I’ve seen special equipment for neck training. Do you recommend any of that? Or can you basically do everything with normal everyday gym equipment?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> The </span><a href="https://www.youtube.com/watch?v=loB3iIw4bLU" style="text-decoration: none;"><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">Iron Neck</span></a><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> is a pretty rad piece of equipment. Very versatile and easy to use. People have been using neck harnesses for ages now. So, if you get your hands on these, grab them and put in some work. If not, don’t worry. Bands, bodyweight, towels, and plates work just fine.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; white-space: pre-wrap;">TP: What are some of your go to neck exercises?</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">SR:</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> Before we roll this out, let me clear that none of these are my exercises. I mean, I've used my brain to put </span><span style="font-family: "trebuchet ms"; font-size: 16px; white-space: pre-wrap;">out </span><span style="font-family: "trebuchet ms"; font-size: 12pt; white-space: pre-wrap;">these variations, but I am sure they have been done already by plenty of awesome strength coaches out there. However, as always, I am happy to contribute in whatever little way I can. I would also like to acknowledge the fact that articles from awesome people like Jim Wendler, Sean Smith, Martin Rooney, Mike Gittleson, Carl Valle, and others (forgive me if I missed your names) pushed me to read and understand more about neck training. And last, but not least, thanks to Travis for giving me a nod to write this and consistently checking on my pathetic grammar so that I don’t make a laughing stock of myself.</span><br />
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<span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">Now, before you try these exercises, make sure you do not have any underlying neck-related issues. If you do, visiting a physical therapist and seeking advice is a no-brainer.</span><span style="color: black; font-family: "trebuchet ms"; font-size: 12pt; vertical-align: baseline; white-space: pre-wrap;"> Generally speaking, performing neck movements like flexion, extension, lateral flexion and rotations and moving through full ranges of motion is great to begin with. Do it every day. Maybe around 15-20 reps.</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-size: 12pt; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">After you're comfortable with those movements, add some external load. Some of the variations shown below have a slightly greater degree of difficulty. Some are easy to perform. Stick to moderate rep ranges, maybe 8-12 reps for 3 to 4 sets. Every rep must ideally be performed with crisp quality. Do it too fast and you won’t get anywhere. Too slow and you’ll get bored. Find your own comfortable tempo and work with it.</span><br />
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<span style="font-family: "trebuchet ms"; font-size: 12pt; white-space: pre-wrap;">Enjoy and good luck!</span><br />
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<b style="font-family: "trebuchet ms"; white-space: pre-wrap;"><span style="font-size: large;">Low Box Neck Bridge</span></b><br />
<i style="font-family: "trebuchet ms", sans-serif; font-size: 13.199999809265137px;"><span style="color: #666666;">Watch the Video – 0:14</span></i><br />
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<b style="font-family: "trebuchet ms"; white-space: pre-wrap;"><span style="font-size: large;">Band Blocking</span></b><br />
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<b style="font-family: "trebuchet ms"; white-space: pre-wrap;"><span style="font-size: large;">Band Anyhow</span></b><br />
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<b style="font-family: "trebuchet ms"; white-space: pre-wrap;"><span style="font-size: large;">Whole Body Tensioner</span></b><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-size: large;">About Sandesh Rangnekar</span></span></div>
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<span style="clear: left; float: left; font-family: "trebuchet ms"; font-size: 12pt; margin-bottom: 1em; margin-right: 1em; white-space: pre-wrap;"><a href="https://lh6.googleusercontent.com/eImSDNyB3CsJzpvGz7F6BG2io73lDTHpyKMr27EyMernZ522RIr1GCYCd-X46ZpSwzpD7YGD0vFdFMbjxatDevdPLRdwth8IgLv1lROL-6_INMvT0k5OiJB1D4B7qfLe6CNXo4907cON7EDEhw" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="192" src="https://lh6.googleusercontent.com/eImSDNyB3CsJzpvGz7F6BG2io73lDTHpyKMr27EyMernZ522RIr1GCYCd-X46ZpSwzpD7YGD0vFdFMbjxatDevdPLRdwth8IgLv1lROL-6_INMvT0k5OiJB1D4B7qfLe6CNXo4907cON7EDEhw" style="border: none; font-size: 12pt; transform: rotate(0rad);" width="162" /></a><span style="clear: left; float: left; font-family: "trebuchet ms"; font-size: 12pt; margin-bottom: 1em; margin-right: 1em; white-space: pre-wrap;"><br /></span>Sandesh Rangnekar has a Master of Science in Musculoskeletal Physiotherapy from the Manchester metropolitan University, U.K. and is an Accredited ASCA level 1 strength and conditioning coach.His work includes rehabilitation and fitness training of Olympic level wrestlers, Tennis players, Kabaddi players, youth swimmers and elite soccer players. He is currently the Strength and Conditioning Coach at Dabang Delhi Kabaddi Club and at Kinspire sports clinic in Mumbai. His key areas of interest are strength and conditioning, return to participation, and performance training. <span style="font-size: 12pt;">Follow Sandesh on social media: </span><span style="color: blue; font-family: "trebuchet ms"; font-size: 12pt; text-decoration: underline; text-indent: -132pt; vertical-align: baseline;"><a href="https://www.facebook.com/sandesh.rangnekar.73" style="text-decoration: none; text-indent: -132pt;">Facebook</a></span><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"> </span><span style="font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;">|</span><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"> </span><span style="font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"></span><a href="https://www.instagram.com/meathead2302/" style="font-size: 12pt; text-decoration: none; text-indent: -132pt;"><span style="color: blue; font-family: "trebuchet ms"; font-size: 12pt; text-decoration: underline; vertical-align: baseline;">Instagram</span></a><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"></span><span style="font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;">|</span><span style="color: #1155cc; font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"> </span><span style="font-family: "trebuchet ms"; font-size: 12pt; text-indent: -132pt; vertical-align: baseline;"></span><a href="https://twitter.com/sandeshrangnek1?" style="font-size: 12pt; text-decoration: none; text-indent: -132pt;"><span style="color: blue; font-family: "trebuchet ms"; font-size: 12pt; text-decoration: underline; vertical-align: baseline;">Twitter</span></a></span></div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-4971416485724845602019-01-07T17:00:00.000-08:002019-01-07T17:00:42.027-08:00What 3 Hybrid Physical Therapists and Strength Coaches Want You to Know About Pain, Exercise, & Movement [Physio Network]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: Trebuchet MS, sans-serif; font-size: large;">A couple weeks ago, I had an idea. I contacted three of my friends in the rehab/strength and conditioning world and asked them if they'd be keen to help out. </span><span style="font-family: "Trebuchet MS", sans-serif; font-size: large;">My idea? A "roundtable" on pain. Specifically, the misconceptions that abound surrounding pain, exercise, and movement.</span></div>
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<span style="font-family: "Trebuchet MS", sans-serif; font-size: large;">I wanted to put something together for trainers, coaches, clinicians, and exercise enthusiasts that would clear the air on a lot of the myths being espoused lately by a few supposed industry "experts."</span></div>
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<span style="font-family: "Trebuchet MS", sans-serif; font-size: large;">My friends graciously obliged, and this article resulted:</span></div>
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<span style="font-family: Trebuchet MS, sans-serif; font-size: large;">>><a href="https://physio-network-pn.com/what-3-hybrid-physical-therapists-and-strength-coaches-want-you-to-know-about-pain-exercise-movement/">https://physio-network-pn.com/what-3-hybrid-physical-therapists-and-strength-coaches-want-you-to-know-about-pain-exercise-movement/</a><<</span></div>
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<span style="font-family: "Trebuchet MS", sans-serif; font-size: large;">In the roundtable format, they each gave their take on the five most pressing questions/misconceptions about pain that are currently plaguing the health and wellness field. </span><span style="font-family: "Trebuchet MS", sans-serif; font-size: large;">If you're not too familiar with the research on pain, their answers may surprise you.</span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-46796018055291558162018-12-26T07:59:00.000-08:002018-12-26T07:59:17.838-08:00Master the Handstand Walk [T-Nation]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Internet commentators love to talk smack about others’ exercise choices – as if not doing certain exercises is some sign of superiority. </span><span style="font-family: "trebuchet ms", sans-serif; font-size: large;">Their commentary often centers on how the exercises in dispute are "dysfunctional," "injurious," and other inane descriptors.</span><br />
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<span style="color: #1d2129; font-family: "trebuchet ms", sans-serif;"><span style="font-size: large;">One such maligned exercise is handstand walking.</span></span><br />
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<span style="color: #1d2129; font-family: "trebuchet ms", sans-serif;"><span style="font-size: large;">Tired of seeing such baseless criticisms of handwalking, I decided to write up a tutorial. The tutorial goes over </span></span><br />
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<li><span style="color: #1d2129; font-family: "trebuchet ms", sans-serif; font-size: large;">The benefits of the handwalking</span></li>
<li><span style="color: #1d2129; font-family: "trebuchet ms", sans-serif; font-size: large;">How to assess your wrists, shoulders, and core for it</span></li>
<li><span style="color: #1d2129; font-family: "trebuchet ms", sans-serif; font-size: large;">A 7-step progression (including videos) towards mastery</span></li>
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<span style="color: #1d2129; font-family: "trebuchet ms", sans-serif;"><span style="font-size: large;">Here's the link:</span></span><br />
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<span style="font-family: "trebuchet ms", sans-serif; font-size: large;"><a href="https://www.t-nation.com/training/the-ultimate-bodyweight-challenge" style="font-family: "trebuchet ms", sans-serif;">https://www.t-nation.com/training/the-ultimate-bodyweight-challenge</a></span><br />
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-64178308726505721592018-11-12T20:47:00.000-08:002018-11-12T21:43:08.528-08:00The (Inconvenient) Truth About the FMS and Injury Rates<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">The Functional Movement Screen (FMS) is a series of seven bodyweight tests designed to rate human movement quality/competency. </span><span style="font-family: "trebuchet ms" , sans-serif;">Each test on the FMS is scored on a 0-3 scale. A perfect total or "composite score"</span><span style="font-family: "trebuchet ms" , sans-serif;"> would be 21 points.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">The FMS's relationship with injury has been studied extensively in athletes. The thinking is that scoring low on the FMS (usually 14 points or lower) puts an athlete at increased risk for injury, which the research bears out to an extent.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">When all the studies were pooled together (in 2015), <a href="https://www.ncbi.nlm.nih.gov/pubmed/26502447" target="_blank">scoring 14 or below did increase injury risk by about 50%</a>. However, for every 100 athletes that got injured, the FMS only managed to correctly identify about 25 of them as being at risk.</span><span style="font-family: "trebuchet ms" , sans-serif;"> For this reason, the FMS should <i>not</i> be used </span><span style="font-family: "trebuchet ms" , sans-serif;">to </span><i style="font-family: "Trebuchet MS", sans-serif;">predict </i><span style="font-family: "trebuchet ms" , sans-serif;">which athletes will get injured on an</span><span style="font-family: "trebuchet ms" , sans-serif;"> </span><span style="font-family: "trebuchet ms" , sans-serif;">individual basis</span><span style="font-family: "trebuchet ms" , sans-serif;">.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Despite the fairly conclusive evidence against the FMS's ability to predict injury, new studies keep coming out investigating this same tired research question. In the past two years alone there have been at least <i>nine</i> such studies on rugby, soccer, cricket, handball, volleyball, and basketball players.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Based on this continued proliferation of research, clearly not everyone has gotten the memo about the FMS's inability to predict injury. For this reason - and in an attempt to help put this issue to rest - <a href="https://www.researchgate.net/publication/328395487_Do_Normative_Composite_Scores_on_the_Functional_Movement_Screen_Differ_Across_High_School_Collegiate_and_Professional_Athletes_A_Critical_Review" target="_blank">my colleagues and I just published a critical review of the FMS</a>. I break down the results of our review below.</span></span><br />
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<b style="font-family: "Trebuchet MS", sans-serif;"><span style="font-size: large;">Objectives of Our Critical Review</span></b><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Instead of rehashing the same tired arguments and analyses over again, we approached the relationship between the FMS and injury from a slightly different angle. <b>We wanted to know whether athletes who suffer more injuries also perform worse on the FMS.</b></span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">After all, if scoring low on the FMS means that an athlete is at increased risk of injury, then being at increased risk of injury should correspondingly mean that an athlete will score low on the FMS.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">It's well known that injury rates increase as level of play increases. College athletes suffer more injuries than high school athletes, and professional athletes get injured more than college athletes. If the FMS reflected this pattern, then college athletes would score lower on the FMS than high school athletes, and pros would score lowest.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">We set out two objectives for our critical review:</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">1) To determine if FMS composite scores differ across high school, college, and professional athletic populations.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">2) To determine if lower FMS composite scores are associated with higher injury rates just within college sports.</span></span><br />
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<b style="font-family: "Trebuchet MS", sans-serif;">What We Did</b></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">In September of 2017, we searched three online databases for studies with the words "Functional Movement Screen" or just "movement screen." We included studies that reported a FMS composite score for a group of high school, college, or pro athletes.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">From each study, we noted the following:</span></span><br />
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<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The number of athletes, along with their age and sex</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The sport(s) the athletes played and their level of play</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The athletes' average composite score on the FMS</span></li>
</ul>
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<b style="font-family: "Trebuchet MS", sans-serif;"><span style="font-size: large;">What We Found</span></b><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">A total of 36 studies met the criteria for inclusion in our critical review. These studies provided composite scores for 62 different groups of athletes and over 3000 athletes in total.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><i>Objective #1</i></span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Our first objective was </span><span style="font-family: "trebuchet ms" , sans-serif;">to determine if FMS composite scores differed across high school, college, and professional athletic populations. </span><span style="font-family: "trebuchet ms" , sans-serif;">Across all three levels of play, 61% of the scores fell between 14 and 16. </span><span style="font-family: "trebuchet ms" , sans-serif;">Here was the level-by-level breakdown for average composite score:</span></span><br />
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Level of Play<o:p></o:p></span></b></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Average FMS Composite Score<o:p></o:p></span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">High school athletes<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">14.1<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">College athletes<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">14.8<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Professional athletes<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">15.7</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">As you can see, average composite scores went up <i>slightly</i> from level to level, which would oppose the notion that athletes who suffer more injuries (college and pro) perform worse on the FMS.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">It's important to note here, though, that the above differences in composite scores (1.6 points from high school to pro) probably don't exceed the FMS's measurement error. </span><span style="font-family: "trebuchet ms" , sans-serif;">Previous research has shown that you need at least a</span><span style="font-family: "trebuchet ms" , sans-serif;"> </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22585621" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">2-point difference</a><span style="font-family: "trebuchet ms" , sans-serif;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/28783618" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">if not 3</a><span style="font-family: "trebuchet ms" , sans-serif;">, to be certain you're not just looking at noise in the data. Therefore, what we conclude from this data is that there's no difference between FMS scores across levels of play.</span></span><br />
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<i style="font-family: "Trebuchet MS", sans-serif;">Objective #2</i></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Our second objective was to determine if lower FMS composite scores were associated with higher injury rates in college sports only. To our surprise, we found the exact opposite relationship.</span></span><br />
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Across 13 sports, <i>higher</i> FMS scores were actually strongly associated with </span><span style="font-family: "trebuchet ms" , sans-serif;">higher</span><span style="font-family: "trebuchet ms" , sans-serif;"> injury rates. In other words, as college athletes' FMS scores go up, so do their injury rates. This finding clearly undermines the FMS's proposed relationship with injury.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Things to Keep in Mind</b></span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">There were a couple of important limitations of our analyses. </span><span style="font-family: "trebuchet ms" , sans-serif;">First, there were several instances in which the composite scores we used for a sport were based on a small number of athletes. There's no guarantee that these data points reflect all athletes who play those sports.</span></span><br />
<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>
<span style="font-family: "trebuchet ms" , sans-serif;">Second, the injury rates we used for high school and college sports were based on national averages. Again, there's no guarantee that those national average injury rates apply to the specific athletes that the composite scores we used in this study were based on.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Despite these limitations, if athletes who suffer more injuries also perform worse on the FMS, then our results would reflect that relationship. Instead, we found no difference across levels of play (Objective #1) and the exact opposite within college sports only (Objective #2).</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Practical Implications</b></span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The astute reader probably isn't surprised that the FMS doesn't reflect injury rates within and across levels of play. After all, there are a boatload of things besides the way a person moves that can influence injury risk (e.g. age, sex, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196323/" target="_blank">previous injuries</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20840568" target="_blank">psychology</a>, <a href="https://simplifaster.com/articles/train-more-without-injuries/" target="_blank">training load</a>, playing conditions, opponent behavior). <a href="https://www.ncbi.nlm.nih.gov/pubmed/27095747" target="_blank">Attempting to predict injury based on any one factor is a fool's errand</a> (yet researchers continue to try!).</span><br />
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<a href="http://1.bp.blogspot.com/-AhHJu3Jqs9g/W-h_ASQ1pxI/AAAAAAAAKEU/vyKzJLZUYTolKKW6ea-ylkKRS0xXMmRIgCK4BGAYYCw/s1600/athletic%2Binjury%2Betiology.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-size: large;"><img border="0" height="177" src="https://1.bp.blogspot.com/-AhHJu3Jqs9g/W-h_ASQ1pxI/AAAAAAAAKEU/vyKzJLZUYTolKKW6ea-ylkKRS0xXMmRIgCK4BGAYYCw/s400/athletic%2Binjury%2Betiology.jpg" width="400" /></span></a></div>
<span style="font-size: large;"><br /></span><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Thus, the results of our critical review provide further evidence against the use of the FMS composite score for injury purposes in athletes. </span><span style="font-family: "trebuchet ms" , sans-serif;">This doesn't mean that the FMS is </span><i style="font-family: "Trebuchet MS", sans-serif;">useless</i><span style="font-family: "trebuchet ms" , sans-serif;">, though. </span><span style="font-family: "trebuchet ms" , sans-serif;">In fact, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127517/" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">the creators of the FMS themselves expressly advised against the composite score <i>four years ago</i></a><span style="font-family: "trebuchet ms" , sans-serif;">. Instead, they recommend looking for asymmetries and low scores on a test-by-test basis.</span></span><br />
<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span><span style="font-family: "trebuchet ms" , sans-serif;">Instead of trying to predict injury, the FMS may be used for several purposes: </span></span><br />
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<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">To identify folks with painful movements (and make sure they receive proper medical attention).</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">To establish a person's baseline for bodyweight movement (for comparison in the event of a future injury).</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">To identify movement patterns that can be trained with added external load.</span></li>
</ul>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Now, one could argue that the FMS isn't the <i>best</i> approach for the above purposes. There are certainly concerns regarding the FMS's validity for measuring movement quality/competency, which I discuss in the critical review. Nevertheless, at present</span><span style="font-family: "trebuchet ms" , sans-serif;"> the FMS </span><i style="font-family: "Trebuchet MS", sans-serif;">is</i><span style="font-family: "trebuchet ms" , sans-serif;"> one of the most popular screening/assessment tools available. </span></span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">I challenge the reader to come up with something better. I'm working on doing the same.</span><br />
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">If you'd like to read the full-text version of our critical review, </span><a href="https://www.researchgate.net/publication/328395487_Do_Normative_Composite_Scores_on_the_Functional_Movement_Screen_Differ_Across_High_School_Collegiate_and_Professional_Athletes_A_Critical_Review" style="font-family: "trebuchet ms", sans-serif;" target="_blank">feel free to request it on ResearchGate</a><span style="font-family: "trebuchet ms" , sans-serif;">.</span></span></div>
Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-82800688698297380232018-11-01T22:17:00.000-07:002018-11-02T09:34:28.187-07:00Are Passive Physical Therapy Treatments Worthless?<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="http://1.bp.blogspot.com/-4icPmQUSkXY/W9vbWeMaDYI/AAAAAAAAJ7I/ZXt3e2vewoAgGhMhDUbmuNYkU8sqoRdSgCK4BGAYYCw/s1600/Alliance%2Bvs%2BReliance2.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="https://1.bp.blogspot.com/-4icPmQUSkXY/W9vbWeMaDYI/AAAAAAAAJ7I/ZXt3e2vewoAgGhMhDUbmuNYkU8sqoRdSgCK4BGAYYCw/s400/Alliance%2Bvs%2BReliance2.png" width="400" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The other day, my mentor said something I thought was so profound that I asked him to elaborate on it for the entire first-year Doctor of Physical Therapy class I help out with.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">“I tend to be a hands-off PT,” he said.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">For context, we were discussing a case study in which a patient presented with several limitations. The patient couldn’t straighten or bend his knee all the way, and his kneecap wasn’t moving as much as it should.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The students were tasked with determining which restriction they’d go after first in the clinic. There were basically two camps: (1) the students who recommended bending and straightening stretches and exercises for the knee and (2) the students who recommended mobilizations for the kneecap.</span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif; font-size: small;"><i>Mobilizations for the kneecap</i></span></td></tr>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Now, both schools of thought are valid. Stretching and exercising the knee is a more “global” approach. It’ll address the flexibility of lots of structures around the knee, including the kneecap. Meanwhile, mobilizing the kneecap is a more “targeted” approach. Getting the kneecap moving more freely could also create more overall motion of the knee. Without any additional information, both approaches seem about equally likely to yield favorable outcomes.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">That’s when my mentor piped up in favor of the global approach. “I tend to be a hands-off PT,” he said. I asked him to clarify for the class what he meant by “hands-off.”</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">He explained: in this case, when two approaches appear equally valid, the decision of what to treat first comes down to <i>agency</i> (i.e. the person who’s producing the therapeutic effect). With the kneecap mobilizations, that’s largely a <b>passive</b>, therapist-administered intervention. (Granted, a patient could learn to self-mobilize their kneecap, but for the sake of argument let’s suppose that’s not an option here.) Conversely, once shown, the patient should be able to <b>actively</b> execute exercises and stretches on their own.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>This is a game-changing distinction</b> –</span><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"> and one it took my mentor many years of clinical practice to come to terms with himself.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">With the stretching and exercise, the therapist essentially gives the patient the power to actively heal themselves (under the therapist’s watchful eye, of course). In the process, the patient and therapist build a strong <b>therapeutic alliance.</b></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">On the other hand, with the kneecap mobilizations the therapist runs the risk of the patient crediting him or her with the power to “fix” them. This may not sound like a big deal, but downstream, the patient may develop a <b>reliance</b> on this passive treatment style for every little ache and pain. In some cases, the patient might even believe the therapist is the only one who can help them with their pain, leading to reduced self-efficacy and feelings of helplessness.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Now, all of this isn’t to say that passive treatments are worthless (although some therapists would certainly argue for that viewpoint). While active treatment is often preferred for the reasons stated above, sometimes passive treatments can help get someone “over the hump.” For example, a passive treatment might acutely reduce a patient’s pain enough to allow them to engage in an active treatment.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The reason I asked my mentor to elaborate on this point was that in physical therapy school, the students spend a lot of time learning hands-on treatment techniques. My mentor’s hands-off approach seems to fly in the face of much of what the students come to know as physical therapy. What a terrific exposure to this alternative school of thought in just their sixth week of school!</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Related: <a href="http://www.fitnesspollenator.com/2016/12/is-there-science-to-physical-therapy.html">Is There A Science to Physical Therapy?</a></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-49410324769242712382018-10-06T13:10:00.004-07:002018-10-07T19:16:16.704-07:00Guardian of Science [The Fitness Devil Podcast]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif;">The other day I had the great pleasure of appearing on the Fitness Devil Podcast with hosts </span><span style="color: #1d2129; font-family: "trebuchet ms" , sans-serif;">Andrew Coates and Dean Guedo</span><span style="font-family: "trebuchet ms" , sans-serif;">. </span><span style="font-family: "trebuchet ms" , sans-serif;">Over the course of an hour, we spanned topics like</span></div>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Injury prevention for gym goers and athletes</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">The utility of core training</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">My Paralympic swimming career</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">"Good" and "bad" exercises (for people over 50)</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">Misinformation in the fitness industry</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">Strategies for improving fitness professionals' communication with the masses</span></li>
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<span style="font-family: "trebuchet ms" , sans-serif;">The episode, titled "Guardian of Science," is available now at the following link (or wherever you download podcasts):</span></div>
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<a href="https://engineeredperformance.ca/dean-guedo/podcast/travis-pollen-guardian-of-science/" style="font-family: "Trebuchet MS", sans-serif;">https://engineeredperformance.ca/dean-guedo/podcast/travis-pollen-guardian-of-science/</a></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-48485175569245453922018-10-02T08:28:00.000-07:002018-10-03T03:54:34.621-07:00Is Some Injury Risk Factor Research Worthless?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif;">I recently read an interesting 2016 paper by Clifton et al. in the Journal of Athletic Training called <i><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094845/" target="_blank">Predicting Injury: Challenges in Prospective Injury Risk Factor Identification</a></i>.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The premise of the paper is that some researchers screw up when concluding they've identified risk factors for injury. In the paper, the authors describe two of the most common screwups and how to address them.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">Before I get to the screwups, a quick explanation is in order regarding the correct way to identify risk factors for injury, which is through a prospective study. It can be summed up in three steps:</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Step 1.</b> Examine a group of <i>uninjured</i> athletes at baseline (i.e. in the pre-season).</span> </blockquote>
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Step 2.</b> Track their injuries prospectively (i.e. over a period of time, usually a competitive season).</span> </blockquote>
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<span style="font-family: "trebuchet ms" , sans-serif;"><b>Step 3.</b> At the end of the study, break the sample into two groups -- the athletes who got injured and the athletes who didn’t -- and look for differences between the groups in their baseline measures.</span></blockquote>
<span style="font-family: "trebuchet ms" , sans-serif;">And now for the common screwups, as per Clifton et al.:</span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Common Screwup #1) Retrospective Study Design</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Prospective injury studies are difficult to do because they require careful and consistent follow-up regarding injury. A much easier approach is a “retrospective” one. With this type of study, you simply assess a group of athletes with and without injuries and compare the groups based on these </span><i style="font-family: "trebuchet ms", sans-serif;">previous</i><span style="font-family: "trebuchet ms" , sans-serif;"> injuries. With this design, there’s no need to follow the athletes over time.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The mistake that’s commonly made comes with the interpretation of the retrospective study. Researchers will often state that measures on which the injured athletes performed worse are risk factors for injury. The trouble is, there’s no way to know whether those factors were present prior to the injury <b>OR</b> if they are actually the <i>result</i> of the injury.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">This isn’t to say retrospective research is worthless. It’s just that follow-up studies with prospective designs are needed to determine whether the differences seen in retrospect are true risk factors for injury prospectively.</span><br />
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<b style="font-family: "Trebuchet MS", sans-serif;"><span style="font-size: large;">Common Screwup #2) Surrogate Risk Factors</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The other common screw-up is putting too much stock in surrogate risk factors, which are basically “risk factors for risk factors” for injury. (No, that's not a typo!) The way these studies work is that they look for measures that are associated with known risk factors for injury.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">For example, there’s research out there that shows certain measures of shoulder rotational range of motion (i.e. internal and external rotation) are risk factors for injury in overhead athletes (e.g. baseball players). Because range of motion takes a few minutes to measure, a researcher might try to find a different test that’s similar to measuring shoulder rotational range of motion but quicker and easier. For instance, the researcher might look at the association between rotational range of motion and whether an athlete can touch their hands behind their back.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Suppose the researcher finds a good correlation between these two measures. The mistake some researchers go on to make is saying that because being able to touch your hands behind your back is associated with rotational range of motion, being able to touch your hands behind your back is a risk factor for injury.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The trouble is, unless being able to touch your hands behind your back is <i>perfectly</i> correlated with rotational range of motion, there’s going to be some error involved. Depending on the magnitude of this error, it can greatly diminish the degree of association between the surrogate risk factor and actually injury incidence.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Once again, surrogate risk factor research isn’t worthless. But if something is found to be a surrogate risk factor, a follow-up study is essential to determine whether the newly proposed risk factor is indeed associated with injury prospectively.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In a nutshell, the above screwups are good examples of why we have to be super careful when reading research. We have to be skeptical, look carefully at the methodology and the data, and consider whether the results of the study align with the authors' conclusions. Researchers aren’t perfect, and they sometimes (knowingly or not) overstate their findings.</span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-36516648747922682642018-08-28T07:55:00.000-07:002018-09-17T15:44:01.742-07:00Do You Need Direct Core Training?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">Expert marketers have long known that two things sell better than most anything else: sex and absolutisms. Unfortunately, dear reader, this blog post isn't either of those. As polarizing and juicy as it would be to write about how you should "NEVER do crunches again" or "the one core exercise EVERYONE should be doing," none of that stuff is true.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">The only way to answer the question of whether YOU need direct core training is to identify who "you" are.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">Before we do that, though, let's get on the same page about what I mean by the core and direct core training:</span></div>
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<li><span style="font-family: "trebuchet ms" , sans-serif; white-space: pre;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">The core</span><span style="font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">: the anatomical region comprised of the torso, pelvis, and hips, including the abs, obliques, spinal erectors, glutes, hip flexors, hip adductors, transverse abdominis, multifidus, diaphragm, etc. As the link between the lower and upper extremities, <a href="https://www.ncbi.nlm.nih.gov/pubmed/16526831" target="_blank">the </a></span></span><span style="font-family: "trebuchet ms" , sans-serif;"><span style="white-space: pre-wrap;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/16526831" target="_blank">role of the core</a> is to transfer, generate, and absorb force between the upper and lower body.</span></span></li>
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<li><span style="font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"><b>Direct core training: </b>any exercise for which the primary purpose is to train the core muscles to improve their size, strength, endurance, or control. Direct core training can come in many forms, from positional breathing to static exercises to dynamic ones, either where the limbs are moving around a stable trunk or the trunk itself is moving. (I'll give a few specific examples of each shortly.)</span></li>
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<span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Now back to the who-are-you question. To aid introspection, here's a smattering of things you should ask yourself to guide your direct core training decision:</span></span></div>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Are you a competitive athlete? A weekend warrior? A couch potato?</span></li>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Do you want to lose weight? Get stronger? Reduce your risk of injury? Get on stage for a bodybuilding show?</span></li>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Do you already have a strong midsection, or is it your weak link?</span></li>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">What types of exercises are you already doing, if any?</span></li>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Do you enjoy direct core training?</span></li>
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">In relation to those questions, let's consider some conditions under which you could benefit from direct core training:</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">1. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You have a weak core -- or at least weak relative to the rest of your body.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Say you're doing a push-up, for example, and your limiting factor is your abs. By limiting factor, I mean you either (1) can’t do a clean push-up at all because you can’t achieve a solid plank position or (2) core muscle fatigue forces you to end your set (as opposed to upper body fatigue). Ergo, your weak core is preventing you from maximally stimulating your upper body. Direct core training would enable you to do more push-ups.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">2. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Your sport or occupation requires exceptional core strength -- the more the better.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> For example, mixed martial artists often find themselves needing to execute powerful sit-up-like maneuvers to counter their opponents. They’re also constantly getting kicked and punched in the ribs, so for them extra muscle around the midsection acts as “body armor.” In fact, the body armor argument applies to just about any collision and contact sport athlete (football, hockey, lacrosse, etc.). A few final examples here are dancers, gymnasts, and circus performers, whose skills all rely on incredible displays of core strength.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">3. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You want to do whatever you can to reduce your risk of injury.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Scientifically speaking, we're still not sure exactly what role the core plays in injury risk. </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29246794" style="font-family: "trebuchet ms", sans-serif; text-decoration-line: none;" target="_blank"><span style="color: #1155cc; vertical-align: baseline; white-space: pre-wrap;">A recent systematic review</span></a><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> determined that certain measures of core strength, endurance, and control -- but not all -- are related to decreased risk of lower body injury. I'm of the mind that you're better safe than sorry in this respect. More core strength, endurance, and control certainly won’t put you at </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">greater</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> risk of injury; that much we know.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">4. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You are already lean and want more core muscle definition.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> No matter how many sit-ups you do, you won’t get a visible six pack if you have lots of excess belly fat. But if you’re already fairly trim and you want your abs to pop, dynamic core exercises against progressive resistance will help to grow those muscles (just like any other muscles).</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">5. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You want to be able to do cool party tricks like front levers, human flags, dragon flags, and planches. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">These calisthenics and gymnastics movements require a ton of core strength. As such, the exercise progressions that build up to them focus heavily on the core.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">6. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You enjoy feeling the burn in your midsection.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Simple as dat.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Direct core training can look very different from one person to the next. While specific core training progressions are beyond the scope of this post, just to give you an idea, a person with a weaker core might start off with </span><a href="https://www.youtube.com/watch?v=AeqR_Dne9w0" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">positional breathing exercises</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> and progress to isometrics like </span><a href="https://www.youtube.com/watch?v=bHOteDDCrLs" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">planks</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> and </span><a href="https://www.youtube.com/watch?v=BQCdzRPE9Ao" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">hollow body holds</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> and then dynamic exercises like </span><a href="https://www.youtube.com/watch?v=rbemelnkHag" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">dead bugs</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> and </span><a href="https://www.youtube.com/watch?v=5h9E7bbrNfs" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">bear crawls</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">. Meanwhile, someone who’s ready to build exceptional core strength could be doing </span><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;"><a href="https://www.youtube.com/watch?v=sCMRxuVG400" style="text-decoration: none;" target="_blank">ab wheel rollouts</a></span><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> and </span><a href="https://www.youtube.com/watch?v=Z-xlhL-AU-w" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">hanging leg raises</span></a><span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">.</span></span><br />
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<span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><img height="224" src="https://lh4.googleusercontent.com/zosgXRl2rqxI_nQSOKg8rBeqPMZfnVYZUEDkMamAcFCDAGqvfdgHqA7dET7Qyfs1qgZe7_LqJSaT8Ex9tIkxd8YNufKC_lZqguha9LH3iNAZmK-8ciQba3ut_ITvQLt4Aa4O032P" style="border: none; transform: rotate(0rad);" width="400" /></span></span><br />
<span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span></div>
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<span style="background-color: transparent; color: black; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">One context you might have expected to see in the list above is low back pain (LBP). For many years, it was believed that core “instability” and faulty core muscle firing patterns caused LBP. Based on this premise, LBP rehab efforts have often focused on direct core “stabilization” training, especially targeting the transverse abdominis and multifidus muscles.</span></span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">These days, though, it’s looking more and more like </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25488399" style="font-family: "trebuchet ms", sans-serif; text-decoration-line: none;" target="_blank"><span style="color: #1155cc; vertical-align: baseline; white-space: pre-wrap;">general exercise is just as good as direct core training for LBP</span></a><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">. This is likely due to pain being more complicated than a biomechanical difference in muscle timing or strength alone. There are many other factors that can contribute pain, including both psychological and sociological ones, for which general exercise (full-body strengthening, stretching, walking, etc.) can be just as effective for many cases of LBP.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">To be clear, it’s not that direct core training couldn’t be beneficial for someone with low back pain. It’s just that it’s probably not fixing their spinal instability -- because in most cases there was no instability there to begin with. The point being, we want to be careful about the narratives surrounding our training decisions. The belief that the human spine is inherently unstable and fragile can itself perpetuate pain.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">As discussed above, there are plenty of good reasons why you might want to train your core directly. So under what conditions might you opt </span><span style="font-family: "trebuchet ms" , sans-serif; font-style: italic; vertical-align: baseline; white-space: pre-wrap;">not</span><span style="font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> to do so? In short, if you don’t mind not maximally stimulating your core muscles.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">Here are some specific examples:</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">1. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You already have a well-trained core.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Great! Work on something else. A subset of these people are the omnipresent cardio/ab queens and kings who do the same hour of aerobic training and ab exercises every single time they hit the gym. Your abs are good, my friend. Go learn to deadlift, please.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">2. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Your primary goal is fat loss.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> In most cases, people who want to lose weight are better off doing compound movements that will hit multiple muscle groups simultaneously and provide a more systemic effect to promote fat loss. Because there's no such thing as spot reduction, direct core training will be less effective at reducing that waistline than squats, deadlifts, push-ups, rows, etc.</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">3. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You’re short on time.</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Most people can only commit a fixed amount of time to their fitness. Is devoting some of that time to direct core training (or any isolation exercise, for that matter) better than doing something else? Maybe, maybe not. That’s for you to decide. (Of course, you could </span><a href="http://www.fitnesspollenator.com/p/coaching.html" style="font-family: "trebuchet ms", sans-serif; text-decoration-line: none;" target="_blank"><span style="color: #1155cc; vertical-align: baseline; white-space: pre-wrap;">hire me to help</span></a><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> with the decision </span><span style="background-color: white; color: #333333; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">😉</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">.)</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">4. </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">You’re already engaging in compound movements that are sufficiently* targeting your core (*based on your goals, current abilities, etc.).</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Examples of such exercises include squats, deadlifts, overhead presses, pull-ups, loaded push-ups, farmer's carries, and all their unilateral (single-arm or single-leg) counterparts. Because </span><a href="http://www.fitnesspollenator.com/2015/02/abs-as-anti-extensors-of-the-core.html" style="font-family: "trebuchet ms", sans-serif; text-decoration-line: none;" target="_blank"><span style="color: #1155cc; vertical-align: baseline; white-space: pre-wrap;">all of these movement are essentially planks with arm or leg movement</span></a><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">, the core muscles are always working hard to stabilize the torso during their execution.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Without knowing your goals, strengths and weaknesses, and current exercise routine, it's impossible for me to say whether you might benefit from direct core training.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">In the end, the decision to include direct core training often boils down to a tradeoff. If you're including it, then you're likely doing it instead of something else. Could that something else give you more bang for your training buck?</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">Only once you've laid all that out and weighed the costs and benefits can you make an informed decision. Anyone who speaks to the contrary (i.e. in absolutes) is, quite frankly, full of shit and just trying to stir the pot.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Related: </span><a href="http://www.fitnesspollenator.com/2015/02/abs-as-anti-extensors-of-the-core.html" style="text-decoration: none;" target="_blank"><span style="background-color: transparent; color: #1155cc; font-variant: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">The Abs as “Anti-extensors” of the Core</span></a></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-37275926313489954342018-07-09T04:42:00.001-07:002018-07-09T04:42:33.536-07:00How to Design a Workout Program [Free Webinar]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">A few months ago, I was asked to deliver the exercise prescription lecture for the 2nd year Doctor of Physical Therapy students at my university.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: large;">In preparation for the talk, I spent a good chunk of time reflecting on my own process for designing training programs versus what the textbooks recommend.</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: large;">I knew this would be one of the students’ only exposures to the topic. So I wanted to pass on as much essential information as I could in the hour and change I had with the students.</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The lecture was a hit, so I decided to make a recorded version of it so more people could benefit. Here it is in all its glory. Please don’t hesitate to reach out with questions.</span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-89413043064952315102018-05-21T04:32:00.000-07:002019-06-24T11:36:34.532-07:00How to Train More Without Getting Hurt [SimpliFaster]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: large;"><a href="http://1.bp.blogspot.com/-TqAFd1ekdYk/WwKs6rP2rjI/AAAAAAAAIRU/zqD5IgDAv08J3E04VmpKFwlpA2Yqp_QPACK4BGAYYCw/s1600/effects%2Bof%2Bworkloads%2Bon%2Bperformance.jpg" imageanchor="1"><img border="0" height="246" src="https://1.bp.blogspot.com/-TqAFd1ekdYk/WwKs6rP2rjI/AAAAAAAAIRU/zqD5IgDAv08J3E04VmpKFwlpA2Yqp_QPACK4BGAYYCw/s400/effects%2Bof%2Bworkloads%2Bon%2Bperformance.jpg" width="400" /></a></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: large;">Training for peak performance is tricky business. Push too hard, and you get hurt. Don’t push hard enough, and you still get hurt (from being unprepared for the rigors of competition).</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Luckily, there’s a new way to measure how hard you’re working. And amazingly, the research shows it actually protects against injury. That’s right: sports scientists have finally figured out How to Train More Without Getting Hurt.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">I break down all the latest research -- and show how to implement it -- in my brand new article for SimpliFaster:</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><a href="https://simplifaster.com/articles/train-more-without-injuries/">https://simplifaster.com/articles/train-more-without-injuries/</a></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-559182744612657652018-05-14T23:58:00.002-07:002018-05-21T04:32:53.706-07:005 Ridiculous Claims About the FMS<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: large;">Let me start by saying I’m actually a proponent of movement screening. I even recommend the Functional Movement Screen (FMS) for new personal trainers.</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">But that doesn’t mean the FMS is blameless -- far from it. When it comes to marketing their product, they put the cart before the horse. They sold certifications and made claims about the screen before they had any evidence to back them up. That’s not good science, and for this people have a right to be peeved.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">A new Facebook video by Dr. Greg Rose of Functional Movement Systems (<a href="https://www.facebook.com/functionalmovement/videos/10155098124982757/" target="_blank">watch it here</a>) is yet another great example of why people get so frustrated with the FMS. Let’s break it down point-by-point, shall we?</span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">1. Dr. Rose starts off by saying, “[I] just saw another article that says the FMS does not predict injury. If I hear that one more time, I think I’m going to explode.”</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">He has a point. We’ve known fairly definitively for a few years that the FMS doesn’t predict injury, yet researchers continue doing these same types of studies, only to come to the same conclusions all over again. Why might that be?</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">The researchers are confused! They’re confused for a couple reasons. For one, they might not have read enough of the previous research on the FMS. But for another, the FMS folks themselves have created a lot of the confusion. This video is a perfect example.</span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">2. Dr. Rose continues: “The last thing in the world you would ever do is a research paper on total score and predicting injury. That’s not what [the FMS] is for.”</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Well that’s funny. The FMS team conducted their own original research in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953296/" target="_blank">2<span id="goog_1124926960"></span><span id="goog_1124926961"></span>007</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/23324700" target="_blank">2013</a>, and <a href="https://www.ncbi.nlm.nih.gov/pubmed/24225032" target="_blank">20<span id="goog_1124926975"></span><span id="goog_1124926976"></span>14</a> on that exact topic. In fact, they actually found that professional football players and firefighters who scored 14 or less were more likely to get injured.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">And so a new wave of injury research was spawned, with dozens of follow-up studies conducted by third parties attempting to replicate this relationship in other populations.</span></div>
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<b><span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">3. Yet, Dr. Rose insists, “FMS has been saying for at least 10 years </span><span style="font-family: "trebuchet ms" , sans-serif;">--</span><span style="font-family: "trebuchet ms" , sans-serif;"> probably 20 years </span><span style="font-family: "trebuchet ms" , sans-serif;">--</span><span style="font-family: "trebuchet ms" , sans-serif;"> that it doesn’t predict injury. That’s not what it’s for,” he reiterates.</span></span></b></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Therein lies the problem, folks. FMS has <i><u>NOT</u></i> been saying that for years. Over the last dozen years, they’ve quietly changed their tune about the purpose of the screen </span><span style="font-family: "trebuchet ms" , sans-serif;">-</span><span style="font-family: "trebuchet ms" , sans-serif;">-</span><span style="font-family: "trebuchet ms" , sans-serif;"> without ever really admitting to having said something different before.</span></span></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">For example, in 2006 the creators of the FMS published <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953313/" target="_blank">the first paper on it</a>. They wrote, “functional movement deficits … may limit performance and predispose the individual to micro-traumatic injury.” </span><span style="font-family: "trebuchet ms" , sans-serif;">Their </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953296/" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">2007</a><span style="font-family: "trebuchet ms" , sans-serif;"> and </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23324700" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">2013</a><span style="font-family: "trebuchet ms" , sans-serif;"> research supported that statement.</span></span></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Yet by 2014, the creators had done a 180 based on a mounting body of third-party evidence. </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127517/" style="font-family: "Trebuchet MS", sans-serif;" target="_blank">In a new paper</a><span style="font-family: "trebuchet ms" , sans-serif;"> the creators wrote, “the use of a total FMS score for predicting injury risk should be avoided. … Looking at raw numbers is not enough. Rather, it is important to identify asymmetries and 0’s.”</span></span></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Indeed, FMS seems to pretend they’ve been saying all along not to use the composite score for injury prediction </span><span style="font-family: "trebuchet ms" , sans-serif;">--</span><span style="font-family: "trebuchet ms" , sans-serif;"> as evidenced by Dr. Rose’s next statement:</span></span></div>
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<span style="font-size: large;"><b><span style="font-family: "trebuchet ms" , sans-serif;">4. “If you get below a 14, you probably have some issues. Well if you get below a 14, guess what: you have 0’s or 1’s… If you want to do research on 0’s or 1’s, let’s do research on 0’s or 1’s that can create injury –</span></b><b><span style="font-family: "trebuchet ms" , sans-serif;">–</span></b><b><span style="font-family: "trebuchet ms" , sans-serif;"> ‘cuz they’re already injured! With 0’s they’re already injured; they have pain.”</span></b></span></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">As if to say, "we thought all along that 0's and 1's were the problem, not the composite score." </span><span style="font-family: "trebuchet ms" , sans-serif;">Of course, that last part of Dr. Rose's remark isn’t even true. Injury and pain aren’t always the same. You can continue having pain long after an injury has healed.</span></span></div>
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<b><span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">5. Dr. Rose wraps up by saying, “We can’t just take a movement screen and predict injury. That doesn’t make any sense. That’s literally saying ‘dogs can fly.’”</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Welp. Of course it doesn’t make sense. Injury is way more complicated than just the way someone moves. Yet the FMS team tried to do exactly that. When it didn’t work, they quietly backtracked on their claims.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;">Nowadays, their instructional manual treads a bit more lightly on the issue of injury: “If these compensations [from the screen] continue, sub-optimal movement patterns are reinforced, leading to poor biomechanics and <b><i>possibly contributing</i></b> to a future injury.”</span></div>
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<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif;">Considering the research that continues to be done on the composite score and injury, though, it seems that not everyone has gotten the creators' 2014 memo (much to Dr. Rose's chagrin in this video). Of course, it's no wonder this is the case, given</span><span style="font-family: "trebuchet ms" , sans-serif;"> the FMS’s general lack of transparency.</span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: large;">Unfortunately, videos like this one hardly help to set the record straight.</span></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-90997897063327853432018-02-21T07:41:00.000-08:002018-02-21T07:54:08.311-08:00Are There Good and Bad Exercises? [Lift the Bar Podcast]<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif;">Three years ago, I almost quit school for good. I’d become disillusioned with biomechanics and academia in general. Hardly anyone in my master’s program was talking about the topics I was interested in — athletes and sports science — and it seemed like all the research dollars were going towards geriatrics and disease.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">As I took some time off from school to reflect on my career trajectory, my path slowly started to take shape. I realized my true passion was bridging the gaps between training and rehabilitation as well as research and practice.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">It wasn’t long after that I met my current mentors and started my PhD program in Rehabilitation Sciences — a subject area ideally suited for my aptitudes and interests.<span class="Apple-converted-space"> </span></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In this program, I’m able to do the exact research that gets me excited </span><span style="font-family: "trebuchet ms" , sans-serif;">—</span><span style="font-family: "trebuchet ms" , sans-serif;"> research on athletes, pre-participation screening, and injury risk. As clichéd as it may sound, it hardly feels like work when you’re doing what you love.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">One of the coolest parts of this whole process has been taking what I’m learning in the research and sharing it with people in the field who can use it and apply it in their daily work. That’s what it’s all about.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">So when Stuart Aitken, host of Lift the Bar podcast, contacted me recently to appear on the podcast and talk about this stuff, I was tickled. Moreover, I was blown away by how thoughtful his questions were. It was like he had ESP in terms of asking me about all the topics I’ve been mulling over for the last couple of years.</span></div>
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<span class="s1"><span style="font-family: "trebuchet ms" , sans-serif;">Here's a taste of what we covered in the podcast:</span></span></div>
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<li><span style="font-family: "trebuchet ms" , sans-serif;">Should we label exercises as bad and good?</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">Should we do an assessment with our clients?</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">How should we make the client feel during an assessment?</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">Static postural assessments — are these useful?</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">How to help clients who are worried about posture</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;">What to do with the information we obtain from an assessment</span></li>
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<span style="font-family: "trebuchet ms" , sans-serif;">If you're interested in taking the podcast for a spin, it's available on iTunes as well as the Lift The Bar website:</span></div>
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<li><a href="https://itunes.apple.com/gb/podcast/ltb-podcast/id1194501091" style="-webkit-text-stroke-width: initial;"><span style="font-family: "trebuchet ms" , sans-serif;">https://itunes.apple.com/gb/podcast/ltb-podcast/id1194501091</span></a></li>
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<li><a href="http://liftthebarpodcast.libsyn.com/ltbp-92-travis-pollen-good-and-bad-exercises-personal-training-assessments" style="-webkit-text-stroke-width: initial;"><span style="font-family: "trebuchet ms" , sans-serif;">http://liftthebarpodcast.libsyn.com/ltbp-92-travis-pollen-good-and-bad-exercises-personal-training-assessments</span></a></li>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-85402320142976997092018-01-12T05:26:00.000-08:002018-01-12T05:37:42.672-08:00Does It Matter If You Can Deep Squat?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: Trebuchet MS, sans-serif; font-size: large;">A friend asked me an excellent question last night:</span></div>
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“How do you feel about the deep squat as a movement screen and the information you get from it?”</span></i></div>
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I’ve actually been preparing a talk on movement screening for the upcoming <a href="http://www.universe.com/iefc2018"><span class="s1">Inland Empire Fitness Conference</span></a> (April 7, 2018, in Spokane, Washington). So I’ve been thinking a lot about the deep squat (among other movements). As a result, I went a little buckwild with my answer to his question. Here’s what I told him…</span></div>
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<span style="font-family: Trebuchet MS, sans-serif; font-size: large;">You can get a lot of useful information from the deep squat. With just one movement, it can tell you whether a person has good ankle dorsiflexion range of motion, hip mobility, thoracic spine extension, and shoulder flexion.</span></div>
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But that’s only if the person does the squat well (based on whatever your predetermined standards are for how you want a squat to look). On the other hand, if the person looks like a sack of potatoes when they squat, it’s not always immediately obvious whether the issue is coming from their ankles, their hips, their t-spine, or their shoulders.</span></div>
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Basically, if someone struggles with the deep squat, it means you should probably do further testing to see what’s up.</span></div>
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That “breakout testing” often starts with having them squat with their heels elevated. It can also mean having them squat to a box, squat holding a light weight in front of them, or squat with a mini-band around their knees. You might also look independently at ankle mobility in half-kneeling, hip flexion in quadruped or supine, and active and/or passive shoulder mobility in standing or supine.</span></div>
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Sometimes, you might even look at all of those things and not find any red flags. In that case, there could be a couple of other reasons that the squat is shite. Maybe the person hasn’t practiced a deep squat lately. (That’s an easy fix.) But it could also be that their bony anatomy or lever lengths just don’t allow them to sink into a pristine ass-to-grass squat.</span></div>
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Suppose you have one of those sack-of-potato squats in front of you. Knees caving, butt winking, shoulders dislocating, the whole bit. Does that mean the person is destined for injury?</span></div>
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Not necessarily. There are plenty of people out there who couldn’t squat well if their firstborn’s life depended on it and are injury-free. Conversely, there are people who squat like babies and are walking band-aids. When it comes to injury, there are too many moving parts to try to predict it based on one isolated factor.</span></div>
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For this reason, technically speaking, what we’re doing when we’re looking at a squat like this isn't a “screen” for injury risk. A true screen would do a better job of separating the people who get injured from the ones who don’t. A more appropriate word might simply be a movement “test.”</span></div>
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One final thing to be aware of is this: If a person has a great-looking bodyweight squat (as per your predetermined movement standard), that doesn’t guarantee they’ll look the same with weight on their back. Or in a squat jump.</span></div>
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Granted, a person has a better shot at moving well with load or speed if they moved well in the slow bodyweight condition. But to know for sure, you’d need to test those other movement conditions, too.</span></div>
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<span style="font-family: "Trebuchet MS", sans-serif;"><span style="font-size: large;">In the end, I use the deep squat test to tell me whether a person is ready to train the squat with added load. If I deem them ill-prepared, I’ll have them work a version of the squat that they can do well (e.g. heels raised, to a box, and/or band around the knees) until they’re proficient enough to progress.</span></span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-47313922096148965272017-11-21T12:54:00.000-08:002017-11-21T20:00:07.630-08:00An Unlikely Hero’s Story and the Myth of Early Specialization<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: large;">On Sunday Philadelphia Eagles placekicker Jake Elliot suffered a concussion in the second quarter of a rivalry game against the Dallas Cowboys. For many NFL teams, this injury would have been tantamount to defeat.</span></div>
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<span style="font-size: large;">The kicker is not only responsible for putting points on the scoreboard via point after touchdown attempts and field goals, but he (or she!) also helps to establish field position as the opposing team's offense begins their drives.</span></div>
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<span style="font-size: large;">In carrying out these duties, kickers rarely get injured. As a result, teams don’t typically dress a backup on game day.</span></div>
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<span style="font-size: large;">When your only kicker does go down with an injury, though, a team is forced to attempt to convert on more fourth downs and go for two-point conversions after every touchdown. Perhaps worse still, they risk surrendering great field position to the opponent on offense.</span></div>
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<span style="font-size: large;">Fortunately for the Eagles, an unlikely hero stepped up.</span></div>
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<span style="font-size: large;">Backup <i>linebacker</i> Kamu Grugier-Hill saved the day on Sunday. Grugier-Hill boomed several kickoffs into the end zone, including one that resulted in a touchback. Although he didn't attempt any field goals, his on-field production wasn't too shabby for a guy who had never kicked a football in a game before at any level -- let alone in the pros.</span></div>
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<span style="font-size: large;">How does someone who has never been a placekicker perform at such a high level? Simple. He played soccer growing up. Owing to his background as a two-sport athlete, he was more than up for the challenge.</span></div>
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<span style="font-size: large;">By playing soccer in addition to football, Grugier-Hill developed a wide “movement vocabulary” during his formative years. So wide that it allowed him to switch seamlessly to a highly specialized position and excel at it many years later.</span></div>
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<span style="font-size: large;">Sadly, over the coming decade we’ll likely see a lot fewer athletes versatile enough to do what Grugier-Hill did this past weekend. This is because many of today’s young athletes are opting to specialize in one sport beginning at a very early age.</span></div>
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<span style="font-size: large;">Granted, the Grugier-Hill example is a bit contrived. Before this weekend, Grugier-Hill had never had to kick a football in a game, and with any luck he’ll never have to again. But there’s no doubt soccer has helped him succeed in countless other ways on the gridiron throughout his career.</span></div>
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<span style="font-size: large;">There are plenty of other examples of professional athletes playing two sports throughout their youth, too. </span><span style="font-size: large;">In the basketball world alone, Steve Nash grew up playing soccer. So did rising star Joel Embiid. Allen Iverson played football. So did LeBron James. These are some of the best and craftiest players ever to step foot on the court. Coincidence? I think not.</span></div>
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<span style="font-size: large;">By concentrating on one sport year-round, we’re screwing our young athletes up. We’re robbing them of the chance to develop a more diverse set of movement skills. We’re subjecting them to the same stressors over and over for 50-plus weeks out of the year, which likely contributes to injury. We’re making them worse.</span></div>
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<span style="font-size: large;">So take a page out of Grugier-Hill's playbook, and avoid specializing in one sport until the tail end of high school, or even wait till college. </span><span style="font-size: large;">It might not result in the opportunity to fill in as the placekicker for the Philadelphia Eagles, but it will certainly put you in a better position to get the chance.</span></div>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-44543290311069435212017-10-16T17:58:00.000-07:002017-10-16T22:07:11.589-07:00Is CrossFit Safe for the General Population?<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "trebuchet ms" , sans-serif; font-style: italic; white-space: pre-wrap;"><span style="font-size: large;">Q&A with Clark Hibbs</span></span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: Thanks for agreeing to this Q&A, Clark! Ever since I did my first CrossFit workout (circa 2010), I've been intrigued by it. C</span><span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">oming from more of a bodybuilding background, it gave me an opportunity to compete against myself and the clock. It was a welcome divergence from the traditional three sets of ten.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">As CrossFit has grown from a niche training style to a worldwide phenomenon over the last few years, though, so too have the myths and misconceptions surrounding it. </span><span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">As a box owner, I'd love for you to clear the air regarding what actually goes on inside a CrossFit box on a day-to-day basis.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Let's start from the beginning: how do you define CrossFit?</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Clark:</span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> CrossFit can be defined as constantly varied, functional movements, executed at a high intensity. We try to train movements that we see direct application or benefit to movements in everyday life, and we try to make it as fun as possible.</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></span>
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: I think the fun is often what hooks people. It can sometimes be missing from other styles training.</span></span><br />
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<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">What’s the difference between competitive CrossFit and CrossFit for the general population?</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">CrossFit is inherently competitive, but there is a big difference between the sport of fitness (CrossFit Games, Regionals, etc.) and your everyday class at your local CrossFit affiliate.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">The sport of fitness is about winning at all costs and truly testing an individual's maximum work capacity. It’s not uncommon to see form breakdown and dangerous levels pushed… just like any other sport or competition. We don’t always see perfect tackles made in the NFL under the pressure of competition. A linebacker will do whatever’s necessary to take down the running back. In the same vein, we might not see the greatest clean form at the CrossFit Games either. A competitor will do whatever’s necessary to get that barbell to the shoulders and stood up.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">CrossFit for the general population is focused on one thing: making people healthier. Competition inside an affiliate leads to increased levels of intensity (which people otherwise might not reach on their own), but we should never let competition inside of an affiliate get to the level of excessive technique breakdown.</span><br />
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<a name='more'></a><span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: So basically, when you’re a competitor, you do what’s necessary for the sport. When you’re a recreational CrossFitter, you can and should be more picky about the movements you choose to do and when to back off in training.</span><br />
<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span><span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">For people who are new to CrossFit, do you think they should jump right into regular classes, or should they somehow be introduced to things more gradually?</span></span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">I can’t speak for every affiliate out there because they are all different, but at our gym, beginners are subject to our intro classes. In these classes, we start with the basics like squatting, lunge steps, push ups, and proper hip hinge and continue to the other more complex lifts you see applied in CrossFit. By the end of the intro classes, beginners will have a great understanding of the 9 foundational movements and Olympic lifts.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: What are the 9 foundational movements? Does everyone in your box do them?</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">The 9 foundational movements are depicted below. We initially teach them with PVC pipes until the technique is learned, and then we progress into light weights on a barbell. There is some notion in the strength and conditioning world that some of these exercises might not be for everyone. I would agree that not everyone needs to max out on them, but they can still be valuable teaching tools to help an individual improve power output and strength. As a result of learning these exercises, we often hear things from our members like, “I’m not nervous about picking up my grandson now that I can power clean 105 lbs. He’s easy!”</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="text-align: left; white-space: pre-wrap;">Granted, if someone has a pre-existing issue when it comes to performing any of them, we simply choose a suitable alternative for them. The biggest value of the intro class is for us, the coaches, to get to know the beginners. This way we can properly determine the path they should take in each class moving forward. For example, I had a beginner this week come to us after an ankle reconstruction surgery. In his profile that is shared with all of our coaches, we can all be on the same page that impact movements, prolonged running, or movements that require large amounts of ankle mobility (e.g. single leg squats) should be scaled with an exercise that better suits his current situation (e.g. step-ups).</span></span></div>
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<span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Other individuals might have previous shoulder injuries or chronic shoulder pain and have a very hard time going overhead with weight. This could be a full blog post on its own, but we try to keep it as simple as possible. If the athlete struggles going overhead, we find a suitable pressing movements that won’t aggravate their shoulder(s). For example, say the workout calls for a barbell push press. The individual can’t do a barbell push press without pain, but they CAN do push-ups pain free. While the push-up is more of a horizontal press rather than a vertical press, it is still a pressing movement the individual can perform and make progress on. In most circumstances, we scale press movements with press movements, pull with pull, squat with squat, etc.</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><br /></span><span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">At my box, we all know very well that we are NOT chiropractors, manual therapists, or physical therapists. If we do not know how to properly progress an individual, we have a team of medical professionals that we will happily outsource the individuals to. Our members respect the fact that we can say, “I’m not sure. Go see our friend Dr. So-and-So,” rather than trying to do something we don’t have the proper training for.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: We all have so much to gain by referring out. It’s a crime that more trainers and coaches don’t have a good referral network.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">You sort of alluded to this above, but during a typical WOD (workout of the day), does everyone do the same thing, or are workouts scaled to individual needs? If so, how are those individual needs determined?</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">Everyone does the same workout prescribed for the day unless an individual needs scaling or modifications. It’s the trainer's responsibility to appropriately scale the individual's workout to be as close to the prescribed movement pattern or stimulus as possible. The number of athletes that perform the workout Rx (as prescribed) versus scaled (i.e. modified) varies from day to day, but in most cases we see about a 50/50 split.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></span>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Knowing exactly how far you can push one athlete versus another is very important. This is probably one of the hardest aspects of coaching group classes. You have to </span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">care</span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> enough to get to know each athlete and really understand how they function as an </span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">individual</span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">. The beauty of CrossFit is that every workout is scalable for the individual needs. No matter the level of fitness, people can come to classes and get a great and safe workout that is going to help them progress.</span></span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: I think scaling is the part where many coaches fall short. Take the workout Randy (75 snatches @ 75 pounds for time), for example. 75 pounds for an elite male CrossFitter is about 25% of his max. But if your max is 100, then now you're working at 75%, which is a way different energy system – and therefore a completely different workout. I understand wanting to do things Rx sometimes, but you have to realize it's a different training stimulus at that point.</span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Okay, next question. The community atmosphere is one of CrossFit’s most attractive qualities. At the same time, it can also lead people to push themselves </span><span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">too</span><span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"> hard. How do you promote safety given the go, go, go nature of the training methodology? Is it the trainee’s responsibility to stay within themselves or the coach’s?</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">We promote safety through education – both for the coach and trainee. It's our job as coaches to educate the trainees constantly so that way they know the “how and why” behind each workout. Before workouts at our affiliate, CrossFit Yellow Rose, our coaching team always explains the full workout intention.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></span>
<span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">We go over questions like</span></span><br />
<ul style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif;"><i>How heavy should this feel? How light should this feel?</i></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;"><i><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">How long should this take?</span></span></i></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;"><i><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">What’s the recovery time like?</span></span></i></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif;"><i>How do we scale movements once fatigue sets in?</i></span></li>
<li><i><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">What’s the pace we should strive for?</span></span>
</i></li>
</ul>
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<span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">If trainees are following the coach’s guidelines and suggestions, the workout will be safe and appropriate for the individual.</span></span><br />
<span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">That’s a lot of responsibility for the coach. It’s our job to stay educated not only on the technical side of coaching, but also to stay up to date with each individual in their class. Coaches need to be in communication with the individuals to make sure they are training at appropriate levels each class.</span></span>
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<span style="font-family: "trebuchet ms" , sans-serif; margin-left: 1em; margin-right: 1em;"><img height="213" src="https://lh5.googleusercontent.com/55DTIk4_BFeWJoYlhxm25BG-mGOJH589TynkXsHHgehOQYtmdo3VvAqcgiB9-IokIHZql-k3fP0pbjqFpy-QQddar23JV4cxgr0rWfJXcasiWIW_HzpW-xOYWL5uUpEftlIRs8a7" style="border: none; transform: rotate(0rad);" width="320" /></span></div>
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<span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"></span>
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: How much does the specific implementation of CrossFit differ from box to box? What about from CrossFit HQ to individual boxes?</span></span><br />
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">With each gym being an affiliate model versus a franchise of HQ, implementation can be wildly different from box to box. The affiliate model gives freedom to the owner/staff to implement CrossFit however they see fit. For example, if you wanted to do 1RM back squats every day, there’s nobody stopping you from doing that. Hopefully someone isn’t doing this, but if they are, we would expect that people would stop frequenting that gym and they would have to change up their approach (to, you know, proper implementation of CrossFit).</span><br />
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><br /></span>
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">HQ has little to no involvement past the application and approval stage of an affiliate. After you receive approval and pay your annual affiliation fees, it is a very hands-off approach. There definitely aren’t “secret shoppers” or check ups that happen like a franchise model. But that doesn’t mean HQ has no interest in the success of the affiliate. All of CrossFit HQ’s training methodologies, guidebooks, and videos are completely free to access (something I think many affiliate owners and trainers forget about). The Level 1 and 2 manuals, which are incredibly thorough, are just a few clicks away and can help answer so many questions trainers and coaches have.</span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">HQ also continuously produces quality programming that is completely free for any CrossFit Affiliate (or anyone wanting to do CrossFit) to use. Many boxes enjoy programming for their own affiliate, but more and more are starting to realize that the workouts HQ produces are quite beneficial for their members. It also frees up time spent programming to do other things like following up with members, creating member profiles, nutrition work, etc. (Fun fact: I program for my own gym, but we’re going to be doing a “Mainsite Month” where we exclusively use the workouts produced by HQ in 2018). </span><br />
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<span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><img height="253" src="https://lh4.googleusercontent.com/h0zcCwAL7wufcSDU5b2Q392WYjP2HyKwf7BL6Dz_vyjkkCJrZCyQp3Y-ZFmUFi7DZTdcziM7F9iD5aTCF8ajdjp4gVBfN1e766j6DBBM09IpVpnAed9atQN5_wYxKW7Zy7VPzjkx" style="-webkit-transform: rotate(0.00rad); border: none; transform: rotate(0.00rad);" width="340" /></span></span></div>
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<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: Programming is my absolute favorite thing, but that does make sense to use HQ’s programming (as long as it’s good!) for a stretch of time to free yourself up to do other things for your members.</span></span><br />
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Speaking of programming, here's something that I think is a common misconception. Is CrossFit programming random?</span></span><br />
<span style="color: black; font-family: "trebuchet ms"; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="color: black; font-family: "trebuchet ms"; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark:</span><span style="color: black; font-family: "trebuchet ms"; vertical-align: baseline; white-space: pre-wrap;"> Definitely not. It is constantly varied, but not random. The old CrossFit saying goes “prepare for the unknown and the unknowable.” But that doesn’t mean we don’t know how we’re going to get there every day. That would be silly.</span><br />
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<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">If you go through and look at a month of mainsite programming, you’ll see there’s really no randomness at all. It’s constantly varied, but the movements are all complementary in nature. Let’s take a week from December 2015, for example:</span><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Monday Dec. 13:</span><br />
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">“Diane” </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">21-15-9: </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Deadlifts (225 lbs for men/155 lbs for women) </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Handstand Pushups</span><br />
<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;"><br /></span>
<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Tuesday Dec. 14:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">5 Rounds For Time: </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">250-meter Row </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">25 Thrusters (45 lbs) </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">15 Toes-to-bar</span><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Wednesday Dec. 15:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">REST</span><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Thursday Dec. 16:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Behind-the-neck jerk 7 x 1</span><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Friday Dec. 17:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">As many rounds as possible in 20 minutes:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">2 Rope climbs (15 ft)</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">20 Pistol squats, alternating legs</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">40 Double unders</span><br />
<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;"><br /></span>
<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Saturday Dec. 18:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Hang squat clean 5-5-3-3-3-1-1-1-1</span><br />
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<span style="font-family: "trebuchet ms"; font-weight: 700; white-space: pre-wrap;">Sunday Dec. 19:</span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">REST</span><br />
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<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">You can see that CrossFit isn’t just picking movements out of a hat and throwing it at the wall to see what sticks. There’s some beauty in the way these movements are laid out:</span><br />
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Monday is a lower body pull and upper body push on a short workout (sub 5 minutes). </span></div>
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<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Tuesday is a simple triplet of a monostructural (cardio) movement, weightlifting push, and a gymnastics pull on a longer workout (~15 minutes). </span></div>
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Wednesday is a well deserved rest day (because rest should be an integral part of every program). </span></div>
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Thursday is a heavy day. The only focus is training the jerk and working towards a maximal effort. </span></div>
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Friday is a long 20-minute workout without any weightlifting at all. Just upper body pulling, lower body pushing, and a cardio-specific movement. </span></div>
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Saturday is another heavy day, but with more reps. This will be a different level of effort than Thursday. </span></div>
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<li dir="ltr" style="background-color: transparent; color: black; font-family: "Trebuchet MS"; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; list-style-type: disc; text-decoration: none; vertical-align: baseline;"><div dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;">
<span style="background-color: transparent; color: black; font-family: "trebuchet ms"; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Sunday is another much needed rest day.</span></div>
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</ul>
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<div>
<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">The program might look “random,” but it is actually extremely calculated. Each day plays off of each other with complementary movements, rep ranges, loads, and capacity/time demands.</span></div>
<div>
<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">
</span></div>
<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">The CrossFit affiliates that follow this style of programming (simple, elegant, and not too much volume) will rarely see injuries. After all, the most common way to get injured in any style of training is injuries from overuse. We need recovery time. By backing off volume some days, we can ensure our members stay safe and healthy.</span><br />
<span style="font-family: "trebuchet ms"; white-space: pre-wrap;"><br /></span>
<span style="font-family: "trebuchet ms"; white-space: pre-wrap;">We keep it varied to keep it fun, interesting, and challenging. After all, the fun, interesting, and challenging programs are the ones we humans will tend to stick with. </span><br />
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<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span><span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: Wow, great answer! Perhaps it looks random on the surface or if you don't know what to look for, but as you showed, there's clearly a lot of thought that goes into it.</span></span><br />
<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">This next question sometimes keeps me up at night, so I’m interested to hear your take. Are complex movements performed in the presence of fatigue and against a clock dangerous? Or only insofar as a trainee isn’t prepared for them?</span></span><br />
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">Anything you do in the presence of fatigue could have its dangers. As long as individuals have a good fitness base and the knowledge on how to bail or scale the complex movements, these shouldn’t be considered excessively dangerous.</span><br />
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;"><br /></span>
<span style="font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">That being said, we shouldn’t do complex movements in the presence of fatigue with new individuals. The knowledge might not be there yet, and the fitness base isn’t there yet. For example, instead of performing squat cleans for time with a new athlete, we could perform front squats taken from a rack.</span><br />
<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;"><br /></span>
<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Travis: My sentiments exactly! Okay, just a few more questions. What’s a typical athlete-to-coach ratio? With complex movements, can a poor ratio lead to reduced quality control and increased risk?</span><br />
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><br /></span>
<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">It’s hard to say what a “typical” athlete-to-coach ratio is, especially since each gym is different. At our affiliate, we run a 12:1 ratio. In our experience, we believe this provides great energy for the room, but also is a small enough ratio to lead to great individualized attention for every person in the class. I’ve seen some gyms do 5:1, some do 15:1, others do as much as 25:1.</span><br />
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<span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">I am always a fan of smaller athlete-to-coach ratios. A lot of gyms that I know and work with put two coaches on the floor once they get past a certain attendance marker (e.g. they’ll put two coaches in a class of 20, so that would lead to a 10:1 ratio). In theory, the smaller the ratio, the more individualized attention. The more attention, the higher quality control and lower the risk.</span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif; margin-left: 1em; margin-right: 1em;"><img height="246" src="https://lh3.googleusercontent.com/mp7LMdYdSz0czskKrDO0L0Mp9OJev47Odn6v8JmlCdXLbb6ZT-Oo4CHc8m-vwByNmPrDZO1Aa9LTiZlyHcbJ50nmX8TdM6oJ1aOccJWPAF4U5LS2YYS5CggX-b9jwm0Dmtj6sYqD" style="border: none; transform: rotate(0rad);" width="317" /></span></div>
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<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: Adding that second coach when the class size gets beyond what you’re comfortable handling is crucial, regardless of what type of training it is.</span></span><br />
<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;"><br /></span>
<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Along those lines, do you think CrossFit takes a lot of heat for things simply due to its popularity? I mean, bad training is bad training, regardless of whether it occurs inside a CrossFit box, right?</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark: </span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;">It’s easy to throw it at CrossFit because of its popularity and a lack of understanding from the people dishing the heat. That said, there is irresponsible application out there; that’s for sure. Newcomers not being properly screened and onboarded, maxing out too quickly, “beat down” workouts on a daily basis. These need to be changed. But we see it in regular gyms just as much as in CrossFit affiliates. We all need to try to raise the standard of exercise application wherever it is being administered.</span><br />
<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="color: blue; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: Amen. Beat down workouts are definitely not unique to CrossFit, although I do think it’s getting better as we continue to spread the gospel. Also, I think some people actually believe that the meme of the guy barbell back squatting on the physioball is CrossFit. Talk about misconceptions.</span></span><br />
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<span style="color: blue; font-family: "trebuchet ms" , sans-serif; font-weight: 700; white-space: pre-wrap;">Last question: What should a newbie look for in a CrossFit box as they’re scoping one out to join?</span><br />
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<span style="color: black; font-family: "trebuchet ms" , sans-serif; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Clark:</span><span style="color: black; font-family: "trebuchet ms" , sans-serif; vertical-align: baseline; white-space: pre-wrap;"> Here are my top four things to look for:</span><br />
<ol style="text-align: left;">
<li><span style="font-family: "trebuchet ms" , sans-serif;">A fun and welcoming environment. This is super important. Don’t be somewhere you aren’t going to have fun!</span></li>
<li><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">An onboarding or “on ramp” process for beginners.</span></span></li>
<li><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Individualized attention from coaches in classes. You can observe a class and see if this actually happens!</span></span></li>
<li><span style="color: black; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">A clean gym. This shows that the staff/management genuinely cares about your experience.</span></span></li>
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<span style="font-family: "trebuchet ms" , sans-serif; margin-left: 1em; margin-right: 1em;"><img height="314" src="https://lh5.googleusercontent.com/gJZLksyqvhcYKvkoLn2wRak6rBTsaxkuelRjj67oW1kRzvsZrn-1FYNcMMzqAErtHCU0OlJkGl7cnm6IKIk_qAfFaUFfnAtXDwU7G2hqaw6AurU1JybFMeP1degqfNMym7fU1-hB" style="border: none; transform: rotate(0rad);" width="250" /></span></div>
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Travis: Thanks for taking the time to share all your expertise, Clark!</span></span><br />
<span style="background-color: transparent; color: blue; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></span>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Clark:</span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> My pleasure. Thanks for the opportunity!</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br /></span></span>
<span style="font-size: large;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Related: </span><span style="background-color: transparent; color: #1155cc; font-style: normal; font-weight: 700; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;"><a href="http://www.fitnesspollenator.com/2015/09/5-essentials-of-kick-ass-crossfit-gym.html" style="text-decoration: none;">5 Essentials of a Kick-ass (CrossFit) Gym</a></span></span></span><br />
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<span style="font-size: large;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">About Clark Hibbs:</span></span>
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<a href="https://lh3.googleusercontent.com/yISrbhLg1zYthtew0qP0j2ZhjxbO_AYghYIwXr1o5CCnCckElG-MvRMMW3A4xsgnjywJYo5FayiHuUmB0wx1xOhdq5lwnkR7672DGqMzUsT9qFeR4eKy11GYrv6IWeylABLQFKNz" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img alt="15994943_10207981106395263_1821965308222151149_o.jpg" border="0" height="299" src="https://lh3.googleusercontent.com/yISrbhLg1zYthtew0qP0j2ZhjxbO_AYghYIwXr1o5CCnCckElG-MvRMMW3A4xsgnjywJYo5FayiHuUmB0wx1xOhdq5lwnkR7672DGqMzUsT9qFeR4eKy11GYrv6IWeylABLQFKNz" style="border: none; transform: rotate(0rad);" width="225" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Clark and his wife Rachel are the proud owners of </span><a href="http://www.crossfityellowrose.com/" style="text-decoration: none;"><span style="background-color: transparent; color: #1155cc; font-style: normal; font-weight: 400; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">CrossFit Yellow Rose</span></a><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> in Houston, Texas. Clark brings 9 years of fitness industry experience to the table, and his passion on the gym floor is proof of his undying love for CrossFit and people. Clark discovered CrossFit in 2011 and has been utilizing these training methodologies and principles to help positively impact thousands of everyday people ever since. Clark and Rachel’s goal is to utilize CrossFit as a way to get people to live active lifestyles outside of the gym and get the most out of life. </span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Motto: </span><span style="background-color: transparent; color: black; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><i>“Work hard. Be nice.” </i></span></span><i>
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Travis Pollenhttp://www.blogger.com/profile/06494873054202594427noreply@blogger.comtag:blogger.com,1999:blog-311642318627531297.post-53471174430775625212017-09-17T04:49:00.003-07:002017-09-21T18:45:59.347-07:00The Plank Variation That Saved All the Puppies<div dir="ltr" style="text-align: left;" trbidi="on">
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<b style="font-size: 12pt;"><span style="font-family: "trebuchet ms" , sans-serif;">If there’s one
exercise that sets the foundation for all others, it’s the front plank.</span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Think about it.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">What’s a push-up? A moving plank. What’s a pull-up? A moving
plank. What are we doing with our torsos during squats and deadlifts?
Maintaining the flat back posture characteristic of, you guessed it, a plank!<o:p></o:p></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "trebuchet ms" , sans-serif;">Yet if there’s one
exercise that’s notoriously butchered, it’s also the plank.<o:p></o:p></span></b></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">People often attempt to hold it for way too long (e.g.
several minutes on end). And when they do, it’s usually ugly. They lose proper
position (a straight line from head to heel) and, therefore, the desired
training effect. They also kill all of the puppies in the process.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Over the last few years, likely in response to the puppy-killing
plank epidemic, the RKC plank has emerged as a potential solution.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The RKC plank, also referred to as a hardstyle plank, is
exactly that: hard. The goal of the RKC plank is to dial up the intensity of the
muscular contraction to the max. It should be so intense that any more than a
20-second hold would be utterly impossible. Usually 10-15 seconds suffice.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Whereas in a traditional plank, we’re mostly focused on engaging our abs, <b style="mso-bidi-font-weight: normal;">in the RKC plank we’re
squeezing EVERYTHING:</b></span></div>
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<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Abs, by bracing as if to absorb a punch</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Glutes, by posterior pelvic tilting</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Quads, by locking the knees out</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Lats, by pulling the elbows in and down towards the feet, as
if to crunch</span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Fists, for <a href="https://www.muscleandstrength.com/articles/irradiation-makes-you-stronger" target="_blank">irradiation</a></span></li>
<li><span style="font-family: "trebuchet ms" , sans-serif; font-size: medium;">Even
the anterior tibialis (the muscle on the front of the shins) should be on full blast,
pulling the toes up towards the head.</span></li>
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<span style="font-family: "trebuchet ms" , sans-serif;">To increase the degree of difficulty even further, the
elbows can be positioned slightly closer together and a few inches farther out
in front than normal. When this position is used, you might hear it referred to
as a “long-lever posterior-tilt plank.”</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In addition to saving puppies, the RKC plank is said to
transfer well to those other movements that require a rigid trunk position. In
other words, generating all-out, global tension in a plank is a low stakes
opportunity to practice "getting tight" for heavy squats and deadlifts.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">With so many perks to the RKC plank, should we just abandon
the traditional plank altogether? Some trainers might say yes, but that would
be shortsighted.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Don’t get me wrong – <b style="mso-bidi-font-weight: normal;">the
RKC plank <i style="mso-bidi-font-style: normal;">would</i> be the greatest thing
since sliced bread, <i style="mso-bidi-font-style: normal;">were it not for just
one problem</i>. When we perform the RKC plank, we’re applying a high-threshold
strategy where a low-threshold one would suffice.</b><o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">What the hell are high- and low- threshold strategies?!<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">I’m glad you ask. This conversation was getting awfully
one-sided. Basically, it’s science-speak for the idea that we’re trying way
harder than we have to in order to execute the task.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">The body usually knows best. It reflexively (i.e.
automatically) chooses the right amount of tension for the job at hand -- unless
we screw with the natural process by consciously revving tension all the way up,
as in the RKC plank.<o:p></o:p></span></div>
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<span style="color: black; mso-themecolor: text1;"><span style="font-family: "trebuchet ms" , sans-serif;">Abdominal
bracing like this increases compressive force on the lumbar spine [1]. This compression may not be desirable for individuals with low back pain [2], who already tend to tense their core muscles more than their pain-free
counterparts [3].</span></span><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.fitnesspollenator.com/2017/09/the-plank-variation-that-saved-all-the-puppies.html#1" name="top1"><sup>1</sup></a> High-threshold
bracing is also suboptimal for performing basic activities of daily living, which
require far less activation of the core muscles [4].</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">So should we really be reinforcing such a strategy by
training people in this way?<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "trebuchet ms" , sans-serif;">Let’s not throw the baby out with the bath water. To
reiterate, <b style="mso-bidi-font-weight: normal;">the RKC plank is an effective
way to</b></span></div>
<div class="MsoNormal">
</div>
<ol style="text-align: left;">
<li><b style="font-family: "Trebuchet MS", sans-serif; font-size: 12pt; text-indent: -0.25in;">Counter people’s tendency to hang out in
ugly traditional planks for minutes at a time.</b></li>
<li><b style="font-family: "Trebuchet MS", sans-serif; font-size: 12pt; text-indent: -0.25in;">Develop the full-body tension that’s needed
to execute heavy compound lifts safely.</b></li>
</ol>
<br />
<div class="MsoNormal">
<span style="font-family: "trebuchet ms" , sans-serif;">But clearly, <b style="mso-bidi-font-weight: normal;">RKC
planks are not for everyone. Nor should all planks be of the RKC variety.
There’s still a time and place for well-executed traditional planks.</b><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "trebuchet ms" , sans-serif;">That time usually lasts for a few sets of 30-60 seconds and
serves to train the core reflexively and in more of an endurance role.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "trebuchet ms" , sans-serif;">I typically begin programing RKC planks <i style="mso-bidi-font-style: normal;">after my clients have mastered traditional planks</i>, as I consider
them a more advanced exercise. I do know other trainers who start clients immediately
with the RKC version with good success, though.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "trebuchet ms" , sans-serif;">Either way, for individuals who tolerate them well, including
both RKC planks and traditional planks in a training program provides the best
of both worlds -- not to mention saving the puppies.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "trebuchet ms" , sans-serif; margin-left: 1em; margin-right: 1em;"><a href="https://4.bp.blogspot.com/-3xY7RBbi6Gk/WbghlH6fMhI/AAAAAAAAHnw/Q_3rDnIROMAKkivRufSLhzipjw17kbpawCLcBGAs/s1600/puppies.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="303" data-original-width="564" height="171" src="https://4.bp.blogspot.com/-3xY7RBbi6Gk/WbghlH6fMhI/AAAAAAAAHnw/Q_3rDnIROMAKkivRufSLhzipjw17kbpawCLcBGAs/s320/puppies.jpg" width="320" /></a></span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
<span style="font-family: "trebuchet ms" , sans-serif; font-size: large;"><b>References</b></span></div>
<div class="separator" style="clear: both; text-align: left;">
<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div>
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText">
<span style="font-family: "trebuchet ms" , sans-serif;">1. <a href="https://www.ncbi.nlm.nih.gov/pubmed/20006294">https://www.ncbi.nlm.nih.gov/pubmed/20006294</a><o:p></o:p></span></div>
</div>
<div id="ftn2" style="mso-element: footnote;">
<div class="MsoFootnoteText">
<span style="font-family: "trebuchet ms" , sans-serif;">2. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25807161">https://www.ncbi.nlm.nih.gov/pubmed/25807161</a><o:p></o:p></span></div>
</div>
<div id="ftn3" style="mso-element: footnote;">
<div class="MsoFootnoteText">
<span style="font-family: "trebuchet ms" , sans-serif;">3. <a href="https://www.ncbi.nlm.nih.gov/pubmed/16275595">https://www.ncbi.nlm.nih.gov/pubmed/16275595</a><o:p></o:p></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;">4. </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12832165" style="font-family: "trebuchet ms", sans-serif;">https://www.ncbi.nlm.nih.gov/pubmed/12832165</a><br />
<span style="font-family: "trebuchet ms" , sans-serif;">5. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25488399">https://www.ncbi.nlm.nih.gov/pubmed/25488399</a></span></div>
</div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div>
<div style="mso-element: footnote-list;">
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<br />
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText">
<b style="font-size: small;"><a href="https://www.blogger.com/null" name="1" style="font-size: small;">1.</a> </b><span style="font-family: "trebuchet ms" , sans-serif; font-size: small;">For decades, it was believed that low back pain was caused by weakness and faulty muscle firing patterns of the core. Based on this premise, many efforts have been made </span><span style="font-family: "trebuchet ms" , sans-serif; font-size: small;">in rehabilitation</span><span style="font-family: "trebuchet ms" , sans-serif; font-size: small;"> to improve core stability in individuals with low back pain. In the end, though, it turned out that core stability training is no better than general exercise for individuals with low back pain [5]. This is likely due to pain being more complex than a biomechanical difference in muscle timing or strength alone. There are many other contributing factors to pain, including both psychological and sociological ones.</span><sup style="font-size: small;"><a href="http://www.fitnesspollenator.com/2017/09/the-plank-variation-that-saved-all-the-puppies.html#top1">↩</a></sup></div>
</div>
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