IOL Strength and Conditioning

Having a trainer move you through a joint mobilization program or a masseuse go to work on your soft tissue is fabulous. But it’s not enough. This stuff is of the “daily importance” variety, and none of us are rich enough or have enough time to trot across town to get that kind of hands-on help. We need a program to follow at home, something that requires cheap or free tools and that can be done quickly, pre- or post-workout as needed.

In the forum and around the internet we’re picking up more and more pieces of the puzzle, and for a lot of people practice makes perfect… the picture’s getting clear. Others, though, need guidance: What’s a foam roller?; what’s it do and how do I use it? and what’s joint mobility? isn’t that the stretching I did in high school? are common questions we hear, and maybe these are questions you’re wondering right now.

Nick Tumminello, a trainer and educator at PerformanceU, set out to document two main pre-workout programs he uses with his clients (and what he suggests they do at home on off-training days) to make this material available to those of us without hands-on guidance. His two Secrets dvds, Secrets of Self Myofascial Release and Secrets of Self Joint Mobilization, answer the questions you have, and add a few twists to the mix for the somewhat educated.

This is done in a live setting; an athlete goes through the pre-workout rolling as Nick instructs so we can see how the movement is done correctly while we listen to his coaching.

Covered, from the bottom up: plantar fascia, gastroc/soleus, illiotibial (IT) band, piriformis, low back, adductor, quadriceps, tensor fascia latte, groin, lats, posterior shoulder, and chest and shoulder.

Because I already knew most of the rolling techniques of the Myofascial Release dvd, the Joint Mobilization held my attention better. Still, I got a few valuable tips, ideas I hadn’t seen before as he introduces foam rolling and other self-massage implements, tips and warnings and when to use which tool. This is the best foam rolling demo I’ve seen, including other dvds and a couple live sessions at conferences.

Secrets of Self Myofascial Release, 25 minutes, $29

I’m very [read: extremely very] into joint mobility, and have been reading, watching and practicing variations of joint mobility exercises about a year, long enough that I’m pleased to see unusual stuff a bit off the beaten trail. You should see my hen-scratching as I scribbled bits and pieces—and stickmen—while Nick explained his joint mobilization moves. If you’re not already doing joint mobility, this dvd offers all the basics, plus a few real golden keepers.

Covered, after a short pre-mobilization trick: ankle mobility (3 techniques), T-spine mobility (4 variations), shoulder mobilization (3 exercises), hip mobilization, (2 options), closing with two shoulder and hip coordinated movements that I’ll be adding to my daily mobility program. These… these were outstanding! Here’s a look at one of them.

Lest you think I’m completely in the tank for Nick, I do have one criticism and that’s price. To be fair, it’s a trend that’s growing industry-wide in which a 30-minute dvd selling for $49 fits right in, but I just don’t agree with it. Still, the material is original, and that’s a lot more than I can say for a number of other pricey dvds.

These are quality educational pieces, especially for readers amped and ready to start but having no instructions. If you regularly do the exercises and foam rolling shown on these dvds, you’ll be all set and ready to train well… for a long time into the future. Good job, Nick.

When I saw Anthony Carey was presenting at the IDEA convention, I knew in advance it would be a real highlight for me. His book, The Pain-Free Program, is an outstanding contribution to corrective exercise self-help, and really had an impact on my early steps in getting to pain-free movement. I was eager to hear him in person and to watch him interact with the crowd.

Snipped off the top of his session handout, we find,

“Limitations and dysfunctions of the hip joint result in a transfer of responsibility to the lumbar spine. The lumbar spine is not designed to work the way the hips do, so the outcome is often lower back pain. Recognizing the contribution of the hips is key to long-term function and back pain prevention.”

I think most of us are starting to get the hint, but let’s get a little deeper into the material. Here are the bullet points from my notes, in no particular order.

• Functional anatomy is more complicated than cadaver anatomy, ie Gray’s. The way the body actually works is different than it appears. For example, the hamstring curls the leg up, but functionally its purpose is much more useful.

• The maximum rotation in the lumbar spine is 8-10%.

• Hip flexion equals lumbar flexion; lifting the leg (hip flexion) causes posterior tilt. Hip extension equals lumbar extension.

• Hip ABduction equals ipsilateral lumbar flexion. Hip ADduction equals contralateral lumbar flexion. Hip AB-ADduction is excessive frontal plane movement—frontal plane hip tilt.

• A normal pelvis rests in 5-10% anterior rotation (toward the front). Sagittal plane deviations are excessive anterior rotation (more than 10%), posterior rotation (to the back) and asymmetrical rotation, meaning one side rotates forward, one side rotates back. Asymmetrical rotation doesn’t dissipate force on impact.

• Frontal plane deviations include hip adduction (elevated) and leg length discrepancy.

• Hip internal rotation equals lumbar rotation toward the involved hip. Hip external rotation equals the opposite (away from the involved hip). This is rotation on the transverse/horizontal plane.

• Corrective exercises for sagittal, frontal or transverse plane deviations should work the planes that need attention, establishing normal range of motion in all three planes. Additionally, train stability of the hip musculature at all ranges of motion and stabilize the lumbar spine when the hip is moving. Include in the program foam rolling, static stretches and dynamic stretches.

• 85% of disc bulges are posterior lateral, meaning they bulge to the back of the spine, not the front, and to the outside.

• When you have a sciatic nerve problem, don’t stretch the hamstring. That makes it worse.

• The sciatic nerve passes under, over or thru the piriformis muscle under the glute maximus.

• Tight hip flexors decrease hip extension and pulls on the lumbar spine during walking, contributing to pain for even the sedentary person who walks 2,000-3,000 steps per day on average.

• If a person has an elevated hip, look for a low shoulder. You’ll also find a short waist on the high-hip side.

• When a hip is in internal rotation, the knee is internally rotated and the foot is pronated; in external hip rotation the knee would point out, with the foot supinated.

• Hips need mobility and stability equally. Don’t just think mobility.

• Average hip rotational range of motion on a clinical testing table is 90 degrees of external rotation and 70 degrees of internal rotation. This is completely different than useful range of motion, which depends not only on mobility, but also on stability.

• When working on joint mobility, look for quality of movement and don’t over-fatigue. Stop before you’re exhausted with the movement.

• Bonus: If the arms are pulled forward in the overhead squat, look for tight lats.

• Bonus # 2: In cases of fibromyalgia, work on posture. That will help with the pain.

Again let me recommend Anthony’s The Pain-Free Program to anyone with recurring back pain or who has determined he or she has problems in the hips. It’s exceptional in helping the reader discover where to start and how to progress. The exercises are well explained, with photos to pull the whole thing together. Exceptional book, grab a copy… read it… then DO THE EXERCISES. That’s the only way it works, eh?

You ever notice when you add an overhead arm reach to a kneeling stretch, the stretch deepens? Why is that do you think? Adding a left arm extension to a right glute stretch puts the left lat into play, sending stretching fire into the glute. What might have happened here?

Those of us newer to the corrective exercise side of training are beginning to understand a left hip problem might show up as right shoulder pain. How can that be?

Behold our beginner’s introduction to the muscle and fascia pathways known by some as myofascial slings, by others as myofascial meridians or flexibility highways.

Fascia is the connective tissue that holds us together. The slings are stretches of fascia connecting muscles in a length of which a tug on one end reflects up the length of the line to the other end. If there’s any obstacle in the length, be it a tight muscle, a triggerpoint, tight fascia or a faulty neural connection, the entire sling will lose its ability to function optimally. If the originating problem is serious, the muscles along the sling are pulled out of whack, and this is how a faulty muscle on one side might display itself as pain on the other.

A couple of the lines run as we might expect: the superficial back line running from underfoot, up the legs and spine, behind the neck and over the skull; the superficial front line at the top of the foot to the front of the legs, up the rectus abdominis, along the sternum and to the sides of the neck.

Still pretty logical is the lateral line, which runs up the sides of the body from the outside of the ankle, up the sides of the lower legs to the iliotibial (IT) bands, through the tensor fasciae latae (TFL) and glutes to the sides of the obliques, the intercostals and the strong muscles of the neck.

After that, things get a little screwy. The spiral line, parts of which are also called the oblique slings, runs along the outside of the leg, then crosses over the body at the hip, where it moves over to the opposite shoulder. Along this line, it also moves from the back of the body to the front. Problems arise throughout the myofasical sling network, but crossing from side to side and posterior to anterior is where the most baffling problems crop up.

Let’s say we have a length of fascia wrapping the TFL at the outside of the right glute of our favorite bench presser. Its lower connection passes through the IT band to connect to the outside of the calf, where in this particular guy there’s a nasty triggerpoint that’s been in place for, oh, maybe a year. (That’s not at all uncommon, lest you think otherwise.) Things are getting worse, and the outside of the calf hurts. The IT band is going to be tight, but unless our guy rolls the outside of his leg over a foam roller, he might not even know it. Moving up the chain, this tightness is pulling on the TFL, which in turn is pulling on the remainder of the sling above, only in this case, it’s a cross-body line, so our guy’s got himself an aching left shoulder. Who’s going to connect the right calf with the left shoulder? Not this powerlifter; he’s going to whine to whomever will listen (and some who won’t), quit his bench pressing, start icing the shoulder and chewing on Aleve.

The experienced corrective exercise specialist isn’t going to discount the possibility of a shoulder injury in a bench presser, of course, but in the process of sorting out the potential causes, cross-body stretching and strengthening running from head to toe is going to be one of the clear options of treatment.

It’s complicated, but in a funny way, it’s kind of simple. We’re sure to be talking about this in the forum and reading about it more and more on the ‘net in the next few years until eventually we all know it as well as we know our hamstrings from our quads.

The most accessible work in this field today is Thomas Myers’ book, Anatomy Trains, however the concept of myofascial slings dates back to the 1920s. Unfortunately, medical science at the time didn’t pick up on it, setting us back in our understanding of how the muscles work in concert. Had this research progressed forward since its original discovery, many of us – and certainly all athletes – would have passed over decades of bodypart training in favor of training how the body actually moves.

A lot of dull pain could have been alleviated along the way, no kidding about that. We’re late to the party, but getting up to speed is relatively easy. Let’s talk some slings, shall we?