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Are Breathing Modifications Practical in the Group Setting?

A huge area of emphasis in Strength and Conditioning for the past year or so has been addressing breathing patterns to optimize function. The biochemical, neurological, stability function, and recovery benefits of optimized breathing patterns have been covered at great lengths both directly and indirectly (breathing into stomach before attempting a big lift) for quite some time now. However, something I don’t see mentioned often is the practicality of such methods in the group setting. That in mind I wanted to relay some experience and perspective on that front, and here we are with the point of this post.

To start I’ll go ahead and say that no one has a perfect evidence based understanding of what a perfect inspiration/expiration cycle should mechanically look like. We have a lot of quality data on the area, but the standard for a perfect breath is not well established. That said, I’m willing to take the leap and say that the ideal breath involves 12th rib posterior and lateral dominant migration initially as opposed to apical, superior 12th rib migration dominant breathing pattern. So how do we get people into the former pattern?

  • Coach sternum to ground and TL junction contact with ground
  • Coach packed neck
  • Coach neutral pelvic alignment
  • Coach ‘wave’ of breath from pelvis to neck
  • **** This usually calls for a separate technique (maybe alligator breathing) to get people into the correct pattern

My hair betrayed me.

I like to coach the prior methods with early progressions of deadbugs for all athletes. Generally I think it’s better to start with a challenging, higher-level progression that most people can still perform well when teaching a new exercise, but with a group of athletes that I know are not in the optimal range of breathing patterns I would start with the lowest level sagittal plane core exercise possible.

To sum it all up, it just takes a little bit more coaching to address breathing in the group setting. When I first learned of these considerations in a seminar put on by Neil Rampe at Cressey Performance, he used the analogy that we wouldn’t have our athletes squat with poor technique for 100 reps. So why would we let them breath with poor technique 20,000 times a day?

We don’t need to get all fuzzy and esoteric like some folks that emphasize breathing do to coach this stuff. Just try a deadbug with the prior mentioned modifications and then try the classic, relaxed head position, spine completely flat deadbug. These modifications makes the exercise more difficult. More difficult and more beneficial. I’m sold on this- even in the group setting.

A Pun-Free Update On What I’ve Been Up To

I’m going to try and write this post without cracking a groan inducing pun, but no promises.

I haven’t had time to write blogs for a while now because I’ve shifted gears and started focusing on the next step. I have decided to make the leap into medical school. This is something I’ve had interest in doing for as long as I can remember. Jumping into medicine flies in the face of the thousands of hours of coaching experience and studies I have dedicated to Strength and Conditioning. Actually, that’s not really the case. I lied.

We’re on the brink of a revolution of sorts when it comes to the integration of human performance and health metrics into the grander scheme of health, athletics, and a somewhat idealized society of lesser health cost upkeep and greater general quality of life. With a medical credential I can be a stronger influence on the people I work with than I currently am, and with said credential I will have an even broader scope than exercise programming, social influence and behavior modification. I’m going to toot my own horn for a second… To date I have helped people by teaching them the tools necessary to take them from a situation of pain to a level of pain free performance, but more and more I see situations where I do not have the tools to help take people from point A to B as expeditiously as possible (or at all). Manual therapy, pharmaceuticals and so on and so forth are all treatments I do not have in my skillset (or scope of practice) that I am dedicated to acquiring through my future education.

My goal is to take the paradigm of prevention and optimization and drive forward with a different approach to medical practice.

There are holes in the my idealized method of practice. I am still young and naive (and an idealist to boot). I don’t have all of the answers. Bottom line is that I am not satisfied with the status quo. I will never be. Things need to change within Sports Medicine and general care for the population, and I know that a medical credential will allow me to be part of the impetus for change.

Here’s a basic chart I wrote describing a few of the many Dimensions of Performance that the best in athletic development address…

Although it is true that some in medicine are concerned with this great variety of concerns, it has been my experience that some professionals look at one piece of the pie to the exclusion of some or even all others when working with their clients. Part of this is due to the fact that in order to address all of these dimensions of performance, we must include professionals from a variety of backgrounds. No one individual can fully address every concern within the overarching program. This is precisely why we must work as a team, and this is a huge motivator in my drive toward a medical credential. Now here’s my big leap that is the thesis of my career. With all of our technologies and depth of understanding, why can we not address these concerns from the context of health and longevity for more individuals? The entire general population doesn’t need to do a single leg unsupported squat, but being able to do a split squat well will help anyone (fall risk reduction, glute activation to mitigate extension based back pain risk, etc…).

This is what my life’s work will be dedicated to and I’m excited to see which or if there are any at all medical education programs will pick me up.

And I didn’t even crack so much as a slice of a pun. Uhh, woops.

All the best,

Sean Lacey

Examining an Exercise. . .

In this exposition of the many elusive benefits of commonly used exercises, I will attempt to introduce perspective on methods frequently used but infrequently appreciated in their entirety. In strength and conditioning we can look to other practices and see common methods to our own quite readily… On the surface this can make it seem like many people are abiding by the same principles and therefore no one practice is unique outside of intangibles. Truly, I do not think this is the case. Just because a lot of people use front planks does not mean:

1) We’re all coaching them the same way

2) We’re all using them in the same context

3) We’re all using them with a perfectly identical outcome in mind

4) We’re all progressing them the same way

5) We’re all using the same modifications to approach unique cases

This blog series will focus on the prior mentioned points in the context of a particular exercise or method. My view is that the methods we use are not simply exercises. My view is that every action we take to influence our clients is part of the stimulus toward the desired outcome.

First in the lineup of our examination of exalted example exercises is the sled push. My view is that low position sled pushes promote talocrural mobility. I believe this will primarily occur through the active system, as the horizontal body position and increased horizontal forces necessary to overcome frictional and other forces will promote length in the gastrosoleus complex.

Forces present in this type of exercise may offer benefits above and beyond those experienced from traditional methods of influencing gastrosoleus length. Many trainees note an increase in lower leg hypertrophy after heavy sled pushes, likely due to the eccentric muscle action that occurs during the initial stance phase of this exercise, but I believe a parallel physiological event to this muscle damage is the primarily neural adaptation of increased active range of motion.

We can take this one step further and look at lateral sled drags… My view is that these may influence subtalar joint mobility.

The amplitude and time spent at end-range during rapid sled-drag variations makes it unlikely that a lengthening adaptation will occur, leading me to the conclusion that the heavier variations of these exercises with longer ground contact time will encourage active system lengthening adaptations more than the rapid, speed-strength directed variants.

There are other more obvious benefits that should be the primary reasons to include these exercises in a program, but we should note all benefits present in an exercise in order to accomplish addition by subtraction.

Now it’s your turn! What benefits of sled variations do you see beyond those typically noted? Think about the shoulder…

Thanks for reading,

Sean Lacey

Get Outside Your Sandbox

When it comes to training there is a lot to be said for sticking to basic exercises and simply altering sets, reps, tempo, etc. to get from progression A to progression D, but it may not be best to do the same basic exercises over and over again. Depending on the athlete’s personality and training age, lack of exercise variation is not necessarily a bad thing. However, there is a lot to be said for using variety in training. . . More than altering the physiological stimulus, psychology tells us that novel tasks (new exercises) increase compliance to programs, so we do our athletes a service when we vary the exercises on a semi-regular basis. The typical 4-6 week mesocycle is plenty of time to track progress on a given exercise without changing the stimulus before finding some indicator of outcomes. These considerations beg the question: how do we approach getting more exercise variations?

I use this approach:

  • learn from as many places as possible
  • grow my exercise database as much as possible
  • be humble enough to attribute newly acquired methods or progressions to those that taught them to me (I’ve seen interns leave a facility and post entire progressions they learned as their own…)
  • listen and learn from people, even if I do not agree with them in certain areas
  • ‘screen’ each exercise through my current beliefs, but don’t be afraid to get outside my comfort zone and try something that isn’t a first impression ‘winner’

Now where do we get our exercise variations from?

I have been greatly fortunate to be surrounded with phenomenal professionals at Athletes’ Performance, Cressey Performance, Andrews Institute Rehabilitation, Turtle Rattle Learning, and The University of West Florida. Also, I have traveled to seminars (drove down to see EC speak in Ft. Lauderdale when I turned 19), conferences, and other colleges and training facilities to listen, learn, and present on my own practices and perspectives. After these experiences I have done my best to attribute what I have learned to the source, but I am also not afraid to provide my interpretation or my own unique methods.

We hear about conferences, internships and seminars as good places to learn, but there is one source that doesn’t get enough press as a source of exercise variations. . .

The internet.

The internet gives us a unique portal into other people’s practices, and this provides a great chance for us to get outside of our exercise-selection comfort zone. If you understand physics and physiology and try the exercise variation yourself, you and your athletes can benefit greatly from internet videos. Ben Bruno’s blog has frequent “For Your Viewing Pleasure” posts including great variations (and Ben is a great person to ask about variations himself…). Of course, Cressey Performance, Performance University, 1441 Training… and the list goes on… also have great variations on their youtube pages.

On that note, I wanted to mention a particularly innovative Coach’s youtube page… Coach Raphael Ruiz. Coach Ruiz runs the training facility 1441 Training. I saw Coach Ruiz in seminar a few years back when UWF Head Strength Coach Kent Morgan organized a seminar at UWF. Coach Ruiz has a ton of great stuff. I wouldn’t necessarily use all of the variations shown in the following video with myself or my athletes, but this is not the point. Watch some 1441 videos with this in mind: listen and learn from people, even if you do not agree with them in certain areas. I’m willing to bet you’ll pick up a few great variations if you watch the videos.

Check out Coach Ruiz’s stuff and get outside your sandbox:

Thanks for reading,

Sean Lacey

A Random (Hooke’s Law) Break Post

This week I’m on Spring Break away from classes, so I’ve had a good opportunity to recharge and do whatever. I thought I’d write a blog on some of the things I’ve been doing. I’ve had less opportunities to coach than usual simply because most of our teams were allowed to go home, but I decided to fill that void with some reading, lectures, and writing.

Since it’s Spring Break, the first thing I thought to do was look over Hooke’s Law: http://en.wikipedia.org/wiki/Hooke’s_law

This Hooke’s Law Break I enjoyed the time away from classwork to spend more time on my education…

I reviewed:

  • Science and Practice of Strength Training by Zatsiorsky
  • Motor Learning & Control for Practitioners by Coker
  • Supertraining by Siff

and read:

  • Adaptation in Sports Training by Viru
  • Why Zebras Don’t Get Ulcers by Robert Sapolsky

Viru’s book was fantastic. My favorite part of it was the flow charts he used. I love flow charts, probably because I used them a great deal in the past when I was doing more Project Management / Information Technology work. Process flow charts for the win. Also, the last due date on Viru’s book was April 2003…. No one has read this book for just about 8 years at UWF. Not cool, UWF. Not cool.

Sapolsky’s book was also a fun read. It was a great review of Physiology concepts and included many examples from the research that tied into the major points of each chapter. Sapolsky is brilliant. Here’s proof: http://video.google.com/videoplay?docid=1877467554618436978# This guy is phenomenal.

Aside from reading I trained some folks, did some of my own training, and ate some good food. For the first time in a while, I’m actually ahead on writing programs, so I basically have the next 2 days before classes and teams get rolling again to look over this and that.

By the way, check out Carson Boddicker’s blog for his latest series on ‘Top Athletic Development Books’ from the perspective of a handful of industry leaders. I was referred to Viru’s book through these posts. Suffice to say my wishlist has expanded.  http://boddickerperformance.com/

And for now I’m going to break off into a tangent… I think we need to start looking more at scapular dyskinesis and poor scapular mobility/stability as a contributing factor to pec strains. Typically subcapularis activation/tissue quality are assessed for in individuals with chronic pec strains, but, in my mind, it would follow that a weak/underactive serratus anterior could be just as great a risk factor for pec strains as subscapularis dysfunction. A SICK scapula may lead to a strained pec (on top of RC tears, etc…). If we look at scapular protraction, it isn’t just about the muscles attached to the scapula. The shoulder complex will move by sufficient activation of any muscle connected to the axial skeleton with the proper line of pull…

Yes, I’m saying that in function pectoralis major contributes to the pattern of movements including scapular protraction. From here, we can revisit Sahrmann’s synergistic dominance to see just how SA dysfunction could contribute to pec strains. This is just sPECulation, and I’m under no illusion that people assessing for subscapularis dysfunction are not also looking at SH rhythm and addressing such concerns in the training program. My intent is simply to point out another possible contributing factor. What do you think?

Oh, and

I never let my schooling get in the way of my education.

- Mark Twain

And before I close this post, I invite you to take a momentum to reflect on Hooke’s Law while watching:

All the best and thanks for reading,

Sean Lacey

A Gait Thing to Understand

Recently, I put blogging to the wayside because I had concerns to address in the real world with my athletes and coursework. Now, I’ve systemized the previously time intensive concerns and they no longer take a considerable amount of time to accomplish. So thank you very much for dropping by my blog again! I appreciate it.

Anyway, let’s go ahead and get to it!

If everything is an assessment, then what do we have to assess the very moment we are introduced to a client?

  • ‘Static’ posture
  • Stance dominance
  • Breathing patterns
  • Broadcasted emotional state
  • External indicators of internal function not ‘as’ related to the nervous system
    • Eyes
    • Skin tone based on physiological factors
    • Etc…
  • Walking gait
  • etc…

Of all of these factors the least discussed is walking gait. Some professionals discount walking gait as being too detailed to assess accurately, but I see it is a funnel we can later dissect with table assessments and/or more specific movements. How much you trust your eye is up to you, but be wary that there is research to show our visual estimation of joint angles to be generally inaccurate.

One study by Abu-Rajab, R.B., et. al. analyzed the ability of observers (Doctors or Physiotherapists) to estimate elbow joint angle compared to a goniometric measurement when looking at a digital image of an overweight or lean arm. Consider that these individuals were estimating against a consistent background and looking at the humeroulnar joint, a hinge joint with one plane of motion. The study’s result showed “…the inaccuracy of visual estimation of joint angles at the elbow, with only 70.8% of estimates overall being within +/-5°.” Now, consider walking gait and the multitude of joint actions in myriad planes. This makes our eyes seem at least subject, but I don’t feel we will be doing any harm by using gait as an assessment tool. Also, I realize we aren’t taking goniometric measurements during walking gait. However, we should consider that, according to Jacquelin Perry, the contralateral pelvis is allowed 4-6° of frontal plane tilt after heel strike. That’s a pretty specific value in my mind, one that if greatly exceeded tells us a great deal about frontal plane hip stability (the extreme here is Trendelenburg gait)… How well we estimate joint angle can determine our ability to decipher an element of someone’s gait as noteworthy vs. normal. Regardless, our more specific, objective assessments come with enough inherent validity to verify or discredit our observations of gait.

But I digress. The goal of this post is to provide a sparknotes style breakdown of the walking gait cycle. Chances are this will be a review for many readers! That’s fine, as I do not intend for it to be all inclusive, but rather a tool for familiarity and portal to additional analysis and research. Check out the J. Perry’s Gait Analysis: Normal and Pathological Function for more specifics.

Gait Cycle picture from: http://www.orthoteers.com/

GAIT PHASES

  1. Initial Contact: Ankle @ 90 degrees to initiate heel rocker
    1. Heel strike and/or calcaneus contact to floor
    2. 3-5 degrees of eccentric (pretibial muscle action) plantarflexion to absorb forces
    3. Pelvis is posteriorly tilted relative to contralateral hemi-pelvis, femur is externally rotated
  2. Loading Response: First arc of ankle plantar flexion
    1. Heel rocker to move body mass forward
    2. @ 2% of entire gait cycle: 60% of BW loaded to stance limb
    3. 10 degrees eccentric plantarflexion to absorb forces
    4. Forefoot contact is a quiet event due to eccentric muscle action of tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius
  3. Mid Stance: First arc of ankle dorsiflexion
    1. Ankle Rocker
    2. Body vector continues advancing forward
    3. Dorsiflexion torque rolls tibia forward from an initial 8 degrees plantarflexion to 5 degrees dorsiflexion
    4. Hip internal rotation, distribution of load from metatarsal heads to the great toe, pronatory torque
  4. Terminal Stance: Heel rise with continued ankle dorsiflexion
    1. Maximum dorsiflexion torque at ankle
    2. Active gastrosoleus action results in minimal dorsiflexion, only 5 degrees additionally (roughly 10 degrees maximum)
    3. Ankle remains in dorsiflexion until other foot contacts the ground (terminal double support)
    4. Roll off, not push off
    5. Hip external rotation, supinatory torque
  5. Pre-Swing: Second arc of ankle plantarflexion
    1. 20 degrees plantar flexion
    2. Rapid knee flexion
    3. Tibialis anterior and toe extensor muscle activity at end of pre-swing decelerates rate of foot fall
  6. Initial Swing: Initiation of the second arc of dorsiflexion
    1. At moment of toe off, ankle is in 20 degrees of plantarflexion
    2. Subsequent swing requires dorsiflexion for toe clearance of floor
    3. Dorsiflexion into 5 degrees plantarflexion, near neutral
    4. Toe dorsiflexion also element
  7. Mid Swing: Continued ankle dorsiflexion
    1. Foot inversion due to greater mass of lateral aspect of foot and failure of extensor digitorum longus, peroneus tertius to support dorsiflexion
    2. This phase continues to vertical shin
  8. Terminal Swing: Support of the ankle at neutral
    1. 3-5 degree drop into plantar flexion
  9. REPEAT FROM #1

Think about gait as a collection of sinusoidal curves.

In walking gait the reciprocal nature of upper and lower extremity motion is negligible in regard to its ability to counter forces in the transverse plane. During higher velocity motion, this situation changes, of course.

And to follow are a few videos for my fellow auditory and visual learners. . .

I’d be sure to assess talocrural dorsiflexion in closed and open kinetic chain on this guy. What do you see?

Edit: here is another video with color coded muscle activity in different phases of gait:

Does looking at such considerations mean we are not improving other physical qualities (speed strength, rate of force development, power endurance, etc. . .)? Maybe for those that can’t appreciate without fixating. Analyzing gait is another tool in the toolbox. I’m not going to spend 10 training cycles solely fixated on correcting a small alteration in gait. But such considerations may have an influence on volume, frequency, or presence of certain training/corrective techniques. Learn gait but don’t throw the baby out with the bathwater, as they say.

Now think about these concepts the next time you people watch. Just don’t make it too obvious, or trouble may be afoot. If you are assessing someone’s frontal plane hip stability during gait, they will probably just think you are eccentric and checking them out. When in all actuality you are looking at eccentric function of the ipsilateral to stance leg gluteus medius, TFL, adductor magnus, gluteus minimus, and contralateral quadratus lumborum etc…

After you’re comfortable with walking gait, stride on into running gait.

Thanks for reading,

Sean Lacey

Sources:

Abu-Rajab, R.B., Marsh, A., Young, D., & Rymaszewski, L.A. (1970). Visual estimation of joint angles at the elbow. (http://strathprints.strath.ac.uk/18704/1/strathprints018704.pdf.) Springer Verlag.

Perry, Jacquelin, and Judith M. Burnfield. Gait Analysis: Normal and Pathological Function. Thorofare, NJ: SLACK, 2010. Print.

Hulme, Janet A.. Solving the mystery of the pelvic rotator cuff in human function and movement: back pain, balance, bladder and bowel health. Missoula, Mont.: Phoenix Publishing Co., 2005. Print.

They See You Rollin’…

… they patterning your fundamental neuromechanical movement patterns.

I saw this video on facebook posted by the prolific Dr. Craig Liebenson:

Which got me thinking even more about why we use rolling exercises in training. . .

My neck position wasn’t ideal in a few poses, but you get what I mean.

At any rate, my interpretation of this is that our programs should include strategies like:

  • Crawling variations
  • Rolling variations
  • Low level progressions that encourage proper activation of intrinsic core muscles
  • –Core exercises with diaphragmatic breathing
  • And I can’t put it better than M. J. Comerford: “Strategies to manage mechanical stabililty dysfunction require specific mobilization of articular and connective tissue restrictions, regaining myofascial extensibility, retraining global stability muscle control of myofascial compensations and local stability muscle recruitment to control segmental motion.” (this is from the article
    Functional stability re-training: principles and strategies for managing mechanical dysfunction“)

While coaching we should not assume that just because a movement looks right on the surface that everything under the surface is going well. Our programs should address basic patterns, perhaps best used in the warm – up and progressed into loaded variations during the more intensive aspect of the training session.

Thank you for reading,

Sean Lacey

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