IOL Strength and Conditioning

The way I figure it, the movement pattern and corrective exercise experts began their study of human motor patterns through the work of Moshe Feldenkrais. He’s the guy who started this trend back in the ’40s, although he didn’t live to see it hit the athletic world, or for it to trickle down to those of us on the fitness side. Of course the new generation of teachers expanded on his efforts to include strengthening weak areas and stretching tight ones, but the underlying idea of how the brain makes the body move began with Feldenkrais a long time ago.

Today’s rehab leaders probably don’t talk about the Feldenkrais influence much because most of their readers would think it sounds like some kind of voodoo magic; yesterday was my second class, where the six of us rolled around on the floor as the instructor pondered out how we first taught ourselves to crawl.

Pretty out there, but no less true, and the movement pattern guys who re-teach us to squat will often remind us of how a baby learns to squat, and how the body originally built stability on top of great mobility. Somewhere along the line, we lost it, lost the mobility and eventually forgot the movement pattern.

Here’s an example of both. Over the course of about 35 years, increasingly bad posture that began in my teens had my thoracic spine not moving, about as close as you can get to immobile while still moving around town. Daily effort on a tennis ball peanut, plus plenty of careful and consistent exercises brought my T-spine mobility from really poor to pretty darn good, so much progress that I was confident on that score. Yet the back pain remains solidly in place, and I’m still tinkering around with new ideas such as movement awareness.

During my first Feldenkrais class two weeks ago, as we were doing a sort of spinal wave movement, the instructor crouched in front of me and held my neck in her hands, immobilizing it. Suddenly I could no longer do the spinal wave… everything stopped. She told me later her effort was to trigger me to begin using the spine, that my upper back was moving as a block, rather than in smaller vertebral segments.

What had happened was over the course of my corrective exercise work, I’d gained exercise mobility, but not much natural movement. Mobility does not necessarily mean motion!

From the Feldenkrais point of view, and I’m certain most of the corrective guys agree with this, once mobility was compromised, the brain skipped over that area and found another way to bend and move the back. The other way is very likely one of the causes — probably the main cause — of the chronic back pain that triggered this whole rehab progression for me in the first place.

Not only do you have to regain mobility, flexibility and stability, you may have to relearn how to use it. This was quite a revelation to me as it occurred, made small today when put into words. The few readers who have made progress in the corrective arena, yet are still in pain may find it useful to ponder this the next time you’re lying quietly on a foam roller.

Introduction to Feldenkrais Movement Awareness Class:

We’ve got a dozen lengthy articles here in the blog, and another fifty or so threads in the rehab/corrective exercise section of the forum dedicated to sorting out our various physical dysfunctions. Let’s do a quick recap to bring it all together into a sort of introduction to fixing pain caused by a poorly functioning body.

Often we’re in pain here or there; other times we just don’t move as well as we used to. Everyone we know says, “Ah, getting older,” as if we’re not supposed to be able to move our joints after we hit our forties. The field of physical therapy has begun to develop new ways to teach people who to move again, and their work is expanding into the training rooms of pro and collegiate level sports and trickling down to us. Those methods give new life to beaten-up athletes and middle-aged desk jockeys alike, and somewhere in that group slides the likes of you and me.

Once on the structure and movement rehabilitation path, each time we find another problem we discover it’s connected to something else, another weak or tight or immobile or inactive bodypart that’s not working as it should. Sometimes it’s so confusing or overwhelming we want to give up, but usually before we get to that place we’ve had an amazing success… enough to keep us eagerly and greedily searching for more.

Because every body is malfunctioning to a different degree, and there are so many joints and muscles that might be involved, it’s pretty much impossible to tell you how to get started. Still, let’s take an overview, possibly enough to get you started on your own path to rehabilitation. Each bolded point below is a link to more information on that topic; when you get to one that intrigues you or sounds like something you’re having a problem with, click over and start your journey there.

• Joint mobility and stability—joint movement, encompassing both the ability of the joint to move through its widest safe range of motion, the ability of the nearby muscles to cause that motion, and stability, such as at the knee, low back, neck and elbow that have a short range of motion and the need to be stable
• Muscle flexibility—muscle lengthening, whether it can move to its full structural range, or if it’s instead shortened to a less than optimum length
• Hip mobility—tightness of some muscles and weakness in opposing muscles keeping your hip from its natural ability to move
• Pelvic tilt—anterior (tilts to the front) or posterior (tilts to the back); you may even have both
• Hip rotation—internal or external rotation; we need both, but in balance
• Strengthen weakness—discover and strengthen lesser muscles that are overpowered by larger surrounding muscles
• Fix the feet—if foot problems aren’t fixed, the structure will never be fully sound
• Activate muscles—waking up a muscle group that’s not firing well
• Thoracic spine mobility—optimal freedom of upper spine movement
• Pectoral flexibility—releasing tight muscles in the front caused by our forward-positioned lifestyles, creating poor upper spine position and mobility
• Core stability—the enduring power of the deep abdominal muscles that control posture and stabilize the spine
• Foam roller—a dense foam cylinder used in self-massage of the legs and torso, and even for the front delts, triceps and forearms
• Triggerpoints—adhesions in muscles or between muscles and tendons that cause surrounding muscles not to function well

Now let’s move over to the forum and get you some help sorting out your next step. Click here to review the topic list of our prehab/rehab and corrective exercise section; you’re welcome to join the conversations in progress, or to start a new topic with your personal concerns. Note: You do have to register and be logged in to post in the forum.

Want to skip all the reading and just get started? Here’s a three-week workout plan for those who don’t care much for the theories, and just want to get started on corrective exercise rehab work.

Long-term trainees with aching shoulders usually start with rotator cuff work using thin rubber tubing. We started doing that in the mid-‘90s and the trend continues, both for rehab and for daily warm-up.

A few years ago many added shoulder YTLWs to the mix, on a stability ball if they were bold enough to do that in public.

A couple years ago wall slides and joint mobility came to the forefront, and the forward-thinkers jumped on board. And the desperate.

These shoulder rehab efforts work, unless the damage done is serious enough to require medical intervention… er, surgery. For most of us, pretty good is good enough.

But is it really? What if there’s one more thing you could do that would make your shoulders feel young again? Would you try it?

A couple months ago in Florida, I had Bill Peel run me through the Gray Cook Athletic Body in Balance version of the functional movement screen. I passed the overhead squat progression, but it was nothing to brag about, and there was room for more range of motion in the backward shoulder movement. The worst of the lot that day was the thoracic mobility screen; I claimed a pass, but barely.

A month of focused attention to shoulder range of motion and remedial thoracic spine mobility work didn’t change much, so what was missing? I thought about some of the practices of the past months and remembered my problems with posture; specifically that in the end it wasn’t back strength to hold my shoulders in position that was missing, it was that tightened muscles in the front were pulling the shoulders forward. No amount of strength would be enough to keep my shoulders back until the muscles in the front were stretched regularly to give them the length to rest in good postural position.

Huh. What if that’s the problem with the rear range of motion in the shoulders? Huh! What do you know? It’s magic!

If your shoulder range of motion to the rear is lacking, one side more than the other or both sides equally, give this a try:

Lie on your back on the floor, knees bent, feet flat as if standing. Raise your arms overhead to rest on the floor; if both arms are flat on the floor, move along… there’s nothing for you here.

If only the backs of your wrists or not much more of the arms are touching the floor, or if one side if touching more than the other, rest in position, breathing regularly and deeply into the abdomen. Occasionally, breathe deep, expand the ribcage and keep it expanded by letting out a tiny bit of air and refilling the space. The point of this is to use your full air to hold the ribcage open and as far as possible from its connections at the spine. Stay there, arms overhead, knees bent until you begin to feel the backs of your arms flatten onto the floor.

This is probably going to take awhile, five minutes, ten, maybe more. You’ll probably be okay with that, though, because as it happens it feels a bit miraculous. The muscles and tendons of the upper torso and the thoracic spine and rib cage are relaxing, lengthening, and you can feel it happening.

In a few days, what was stressful and took fifteen minutes will be easy, relaxing and will only take five.

Couple of tips:

If you simply can’t get your hands overhead, start with a lesser angle, such as hands outstretched in a T position. If (or when) the backs of your arms rest heavily on the floor, move your hands up a bit, heading towards a Y angle. This way you’ll ease your way into the overhead position over time; it may take what feels like too much time, but in the end, it will work.

If there’s a twinge in your upper back, different than the stretching that you feel throughout the upper torso, you may need to roll around on a tennis ball or medicine ball to address a triggerpoint or a tight lat before doing the stretch. The trigger point work can be outrageously painful, but the upside is releasing that triggerpoint may be a key — and immediate — factor in relieving your shoulder pain.

Final points:

Don’t do this early in the morning; afternoon or after a workout is best. A light and easy doorway stretch — not forced — is good in the morning to reverse overnight sleeping posture, but your thoracic spine and rib cage aren’t ready for this radical stretch before warming up to the day.

After resting with the arms overhead for awhile, has one side settled onto the floor with the other side still lifted? Try shifting the hip of the lifted side. Did the shoulder just flatten? Triple bingo going on here: Go back and read up on the troubles of hip rotation.

It’s remarkable, really. And it may be the answer to the last of your shoulder distress.

*****

Late edit: I’ve had a few private notes about this from people who were amazed at how this worked for them. However, one person pushed too hard and tweaked his shoulder, so let me bring up two more points.

Relax into this; don’t push it. The point is to wait long enough to allow your body to relax. You can’t make that happen… you have to be patient enough to lay there until it happens.

Which brings up point two: This may take days, weeks even. Dave’s doing this, and his hands overhead are nearly a foot off the floor behind him. Seriously… no, I’m not exaggerating. No amount of forcing is going to loosen up his upper torso. He’s going to have to wait it out, and so might you.

I was talking with my friend, Val, recently, and discovered I’d never told her about foam rolling. She’s a hairdresser, works hard with her hands outstretched at shoulder height hour after hour, day after day. If anyone’s a candidate for foam rolling, a hairdresser would surely be in the first balloting.

First you want to know what the heck is a foam roller. Simple: it’s a dense foam cylinder used (for this discussion; there are other uses) in self-massage of the legs and torso, and even for the front delts, triceps and forearms for the adventurous.

Think of it as a way to get a short massage daily, without driving anywhere or paying anything, where you get to zero in on exactly the spot the responds the most. Perfect! You’ll roll your way from calves to shoulders, staying on each muscle area for about ten short strokes, avoiding the joints and bony spots.

The key to enjoying the process and getting the most benefit is to settle in, relax and enjoy the process. Trying to hurry your way through this is a bit of a waste of time, unlikely to do much, even though it doesn’t take very long to run the body.

With regular foam rolling of the thoracic spine, my back stays loose and unbound, free and mobile with rare need of a chiropractor. Compared with pre-foam rolling, that alone is remarkable.

Those knots of spasming muscle you have, or those nasty, pain-referring adhesions in the fascia that connects the muscles into tendons and bones, those can all be released and relieved with your cheap home foam roller.

Calves, hamstrings, quads, IT band along the outside of the legs, glutes, spine, lats, back of the shoulder, front delts, triceps, top and bottom of the forearm, one tool, no waiting for a mate to feel like giving you a massage. I love this thing, and when you get one, if you have patience and try it daily for a week, you’ll love it, too.
I use a quick run over the foam roller as a pre-workout wake-up call that takes two minutes at most and prepares the mind and body for the warm-up moves to follow. Post-workout, five minutes becomes ten as the worked muscles welcome the gentle massage. A glance at the clock is required to remind me there’s still work to be done, time’s a’wasting.

It’s a wonderful feeling that will help athletes, week-end warriors, aging fitness enthusiasts, desk jockeys, hairdressers and construction workers alike. As those decades-old aches begin to diminish, you’re gonna write back and thank me for this one. In turn, I’ll refer you on to my pal, Dan Martin, who’ll tell you to thank Eric Cressey and Mike Robertson. I pretty much lose the trail there, and cannot tell you who first began rolling or who invented the foam gizmo.

Here’s our forum conversation on foam rolling if you’d like to read more or join in the conversation. Quick pointer: Spend a few extra bucks for the black or blue EVA rollers; the white foam seems to crush too easily for all but the smallest of adults.

The astute will have noticed a certain level of weirdness gaining steam in my training the past couple of months. It’s been all over the map as I jump to a problem area, make some progress and move along to another. The upside of training weaknesses is that progress comes fast; the downside is there sure are a lot of them to work on once you get to noticing, and hey, add to that the training sometimes looks ridiculous.

It’s a mess of small and large issues to write about, but since it’s a sure thing most who read this have one or two pain problems that are a result of weakness in another area, I wrote a long forum post describing all the exercises I’ve used over the past couple of months. Some are still in the rotation; others provided the needed results and have been dropped for the time being, if not forever.

My purpose was to try out a variety of movements to find out which felt most effective for me, what I personally needed the most. Those that were easy got dumped after the first try; the hard ones are the exercises that made it into the rotation. Remember, we’re looking for problems and fixes, not easy exercises.

That was my thought in making the long list for others to try. If it feels too random for you, pick the exercises you think you need and create your own workout/s.

I do think most people who’ve been training for a long time will be surprised at how feeble they feel on some of these easy-peasy exercises. Most of us have weak spots that need attention, and that’s why I hope you’ll continue on and give the post the time needed to simmer into your brain.

You’ll be surprised to discover the workouts each took only about 20 minutes to do a single set in the order listed. The first couple of times through will probably take about twice that until you get the hang of the exercises.

I’d do one set of each exercise the first week, two the second and up to three the third if you can spare the time. By that point, you’ll know which are hard, which are easy. The easy ones get set aside in favor of those that are difficult for you… those are the ones you need.

Off you go then: Bodyweight Rehab Introductory Workouts.

Physical therapists and coaches for professional athletes have not always been ahead of bodybuilders when it comes to building a muscular body. In fact, in terms of nutrition and weight training, the guys of Dave’s competitive years led the charge for today’s athletes. Yet I must say that leadership role has been reversed over the past decade, and these days it’s the strength and conditioning coaches and the athletic PT folks who are making remarkable strides in revamping how we think about our training programs.

What a great time this is to be a young athlete, and what I mean by that is that over the next few years the new generation will get corrective exercise, movement screening and instructions such as daily foam rolling as part of their athletic training. Soon this stuff will be done by coaches down to the high school level, and, as the athletes age, they’ll take this knowledge with them into adulthood. Those athletes have an excellent chance at less pain in their golden years, something the Golden Era bodybuilders unfortunately were not able to demonstrate.

Corrective exercise and movement screening is how this is filtering down to the average weight training athlete.

I’ll give you a brief introduction so when your kid comes home spouting his or her coach’s instructions, you’ll be up on the lingo. Better yet, you’ll start taking note when the terms come up in forum conversations and exercise newsletters, because there are gems in this new work that can truly reverse some of your nagging aches and pains. I kid you not.

The term corrective exercise broadly refers to specific exercise or stretches designed to target a defect in a person’s physical movement. What happens is in our lives, either through our day-to-day work, unbalanced exercise selection in the weight room, lopsided sports activity like golf, tennis or softball, or just plain sitting around too much, muscle groups work at diminished capacity, letting others take over the tasks.

Often the wrong muscles doing the work, or one side of the body working better than the other, will cause a cascade of physical problems, such as back and knee pain. Sometimes the problems have gone on long enough they can’t be fixed without surgery, or can’t be fixed at all, but more often than not, a month of attention to corrective exercise rehab will reverse a future of pain, and with surprisingly little effort.

The guys leading us into this bright future come from two basic schools of thought: movement screening and structural assessment.

Gray Cook, the author of Athletic Body in Balance, and his business partner, Lee Burton, have designed what they call the Functional Movement Screen, a set of physical tests used by physical therapists, strength and conditioning coaches and, increasingly, forward-thinking personal trainers. Their philosophy in creating the screen is to test the movement and use the exercises they’ve come up with to correct the faulty movement pattern. The point with the FMS is to fix the problem, not dissect it down to the various causes; to their thinking it doesn’t matter what caused it, just fix it.

On the other side we find guys like Gary Gray, Justin Price and Anthony Carey, who prefer to assess the athlete or client’s structure, discover the discrepancies and prescribe exercises to fix the various issues.

Many of the suggestions will be the same, regardless of the method of discovery. The real problem for most of us in today’s environment is that, while increasing rapidly, the professionals able to do the assessments are still few and far between. Chances of a skilled pro in your town are relatively rare, which leaves us looking at the movement screening for our at-home fixes.

As an aside, I will say if I lived in San Diego, I’d be at Justin’s or Anthony’s clinic in a heartbeat, or if near Danville, Virginia, I’d be over at Gray and Lee’s place as soon as I could get an appointment. Ditto Gary Gray’s in Michigan. Another guy who can help you out in Connecticut is John Izzo of StandApartFitness.com. The beauty of this stuff is it can be as little as a one-time visit – get tested, get your assignment and get to work, so even if you have to make a drive to get assessed or re-assessed, it’s not like it’s a weekly appointment. It’ll be worth it, I promise.

Assuming you don’t live in those areas, here’s whatcha do next: Gray Cook took the Functional Movement Screen that he and Lee designed for the pros to use, and dumbed it down for the rest of us. In Athletic Body in Balance, you’ll find five simple tests (don’t read that to be easy tests) you can do at home to determine your weakest link. From there, the book goes on to tell you exactly how to fix it, which exercises or stretches and in what order you should best tackle them.

On Tom Incledon’s recommendation, I tested myself when the book first came out in 2003. I failed so miserably I bagged the project, thinking a book for “athletes” wasn’t for me. Failure in movement means pay attention… Get a clue!Unfortunately, I didn’t pick that book back up until a month ago.

This time, however, I knew enough about the corrective exercise movement to know the failures were signposts pointing me in the right direction. I followed the instructions and re-tested a month later, last weekend in fact, and the success of February’s exercise effort was remarkable. Instead of ramming the pvc marker into the doorway, falling over (yes, I’m talking about to the floor) or missing the position entirely, all five tests received a passing grade. I’m not done; nothing was perfect, yet the progress in four weeks was truly outstanding.

Lest this not sound like it’s simply about passing a test, let me tell you a bit about how things feel: My back feels better, my shoulders move better and without pain, my posture’s straighter, and my stride is longer and more athletic. I want more of that and have targeted the exercises suggested for last weekend’s lower-scoring tests.

I want this for you, too, so just go ahead and spring for Gray’s book, Athletic Body in Balance. Yes, I know you don’t feel like an athlete. Just do it anyway.

Late edit to cross-link posts: Finding a local corrective exercise specialist.

Body alignment starts at the ground and works its way up the body via the fascia beginning at the toes and moving through each joint. Over time and for a variety of reasons, we develop weakness and tightness in various muscles around the joints, which will need to be addressed for good body function. However, if foot problems aren’t fixed, the structure will never be fully sound.

Most shoe-wearing adults pronate at the heel (tilt toward the inside) on either one side or both, and some people pronate on one side and supinate (tilt toward the outside) on the other.

This sets off a pattern causing problems of the foot such as bunions (a bony protrusion grown to help balance the tilt) and plantar fasciitis (irritation of the fascia sheathing under the foot).

Moving upward, foot positioning other than neutral pulls on the calf muscle, twisting it, which in turn torques the knee, causing knee pain, faulty wear and eventually arthritis or worse.

Crossing behind the knee and moving up the other side, the IT band along the outside of the leg gets tight, yanking at both the knee and the hip at the other end.

Now we’re at the hip and discover, because of the calf twisting and knee torquing, a pronating foot on one side leads to a functional leg length discrepancy on the other. The bones of the legs don’t actually measure different; the abnormal function of the other side causes a tilt in the hip.

We can then cross over the body and expect to see a lower shoulder on the other side, one that if nothing else, loses mobility and aches as the years go by.

Ligaments in this body lengthen over time (and these do not regain the normal length even after the problem is fixed, which is to say, fix this as early as you can); muscles and tendons lengthen or tighten; muscles weaken or stop firing entirely.

Additionally, this body is a mess of triggerpoints and sensitivity as over time it reacts to disfunction that begins in one or both feet.

For about 85% of adults, this can be fixed by foot and ankle exercises and a flat shoe with a $40 orthotic such as the green Superfeet insole. Begin wearing the insole about a half hour a day, because you need to retrain your body to handle the neutral position.

You’ve been training for 20 years, maybe 30. You’re strong, in much better shape that your co-workers. But where’s the payoff? Your back hurts as bad as the next guy’s, heck, maybe worse. You know it’s been worth all the effort, you just know it. I mean… right?

We’ve been talking about steps needed to take to bring things back to the upside. One of the ideas that’s floating to the top is that after decades under the bar, without doing anything to strengthen the smaller muscles, the big movers are strong and they sort of take over and do all the work. The smaller stability muscles weaken and sometimes stop firing entirely. We need to fix that.

Then, in a lot of cases with us doing the same exercises over and over, we’re building a case for decreasing joint mobility.

Even more likely these days, it’s a case of plain old sitting too much. Hey, what are you going to do? You have a job that requires sitting at a desk, right?

Here’s what you’re going to do; you’re going to find the problem areas and fix ‘em. You don’t have to get a new job—hopefully. You just need to strengthen what’s weak and loosen what’s tight, get the joints back in full range of motion and when you do, it’s pretty likely that nagging ache will fade into a memory.

We’ll be talking about this stuff a lot more in the coming months and years. In the process, we’ll introduce and link you up with some of the guys doing remarkable work in this fascinating new field, guys who do hands-on work, who’ve written books, articles and dvds, and who give seminars on this emerging field of structural assessment. During the course of the past few years, and projecting ahead another year or two as the dust settles, we’re getting to the place where the common person can sort this out without memorizing anatomy. It’ll tax you a little, but won’t push you over the edge.

Meanwhile, John Izzo has started a great thread in the forum with his article “5 Exercises Everyone Should Perform.” In it he describes the foundation you can use to fix a broken body that works well in the gym, but flounders through the rest of your daily life.

The thread then goes on to develop the thoughts of how and when to train spinal rotation, and provides an introduction to faulty movement patterns. That’s going to be the base of a whole lot more conversations that will set your brain afire. Until then, join us in the forum to develop the discussion, and feel free to ask your questions there.

Bumping against a genetic ceiling (again and as usual) after 25 years under the weights can make a person lazy in the gym. Once a person gets fairly close to the top of the strength curve, the return on workout investment is tiny. And many of us back off because maintaining 80% is simple, and seems like enough… in fact, is enough for most.

But guess what. Last week in the gym turned up a couple of PR sets. Nothing spectacular — I haven’t gone to low reps, heavy work on anything — but notable after not seeing any gains for years, and while not working toward them.

Why do I think this is happening? A few contributions:

The stabilization work is strengthening weaker muscles, so there are more overall muscles firing. The cardio fitness gets me past the reps where perhaps the muscles would have been strong enough before, but gasping for breath stopped the set early. Core strength adds an extra percentage of oomph that can’t be measured, or even noticed to the uneducated. Ballistic kettlebell work is contributing to fast-twitch muscle fibers not used in bodybuilding or powerlifting.

It’s a big picture effort that will take attention. Speaking as one a few months down the road, it’s worth it, folks. What I’m saying here is this stuff is for everybody. You young folks, dedicate a few minutes a day toward this now and you’ll never have to drop back to basement-level rehab. Youth will compensate for weakness for a while, but eventually the weaknesses will get your attention. Oh, man, will they get your attention.

If you’ve been nursing an ache forever, address it now. Unless you remember a specific injury, it’s likely there’s a weakness showing itself, or you’re doing something wrong — either at work or in the gym — or, very likely, it’s posture-related.

Overcompensating with the stronger muscles works for awhile, and the stronger you are, the longer this may work, but when the weakness shows through, you’ll be at the least slammed to the ground, and at worst, doing rehab not only on the underlying weakness, but also on your newly injured compensating muscles. The longer you ignore it, the more complicated it becomes to sort out the mess.

But. There’s a huge upside: Rehab works astoundingly fast. A month, two months… the progress can happen so quickly it’s hard to remember what the bad times felt like. Some of the things I tried didn’t work, or other solutions were perhaps unnecessary for me; others are still on the template for next efforts.

Perhaps there was a little waste of energy and money, but not much, and compared to what might have eventually been spent on doctors, chiropractors, massage therapists, physical therapists — mental therapists! — well, hey, not bad. Not bad at all.

What worked, in order of presentation, but not necessarily importance:

Back extension exercises to strengthen posture muscles

Foam roller and myofascial release ball to release spasming muscles and break down trigger point knots

Attention to upright posture, five minutes at a time, hour after hour and day after day

Heart rate monitor, indoor cycle with good bike pedals, mp3 player to propel aggressive interval cardio work

Back stabilization and fundamental core work

A few minutes daily of joint mobility and muscle stretching

Kettlebells, three types of workouts in support of the above (cardio conditioning, core strength and back strengthening)

To catch up with us, this is where the back rehab story begins.

You’ll have to put yourself and your physical wellbeing at the top of the priority list for a few months to pull this off. Once finished (knowing, of course, that we won’t be completely finished until that final day), you’ll be in a much greater position to affect your family and friends, your work and your projects because you’ll feel good — excellent even — and you’ll be strong and hearty. Things that were difficult or impossible will seem effortless. Go for it!

This is a reprint from a forum post of 2006. The conversation continues with more ideas to further your journey, here.

I’ve been sorting out a long list of structural problems over the past few years, one spot after another resulting in various levels of pain or annoyance from neck to feet. Some of the trouble spots are now completely fixed, and remain moving easily with a few simple exercises, stretches and some easy soft tissue work.

Once in a while the relief happened so quickly it felt like magic. Other problems are taking more time, especially after guessing wrong a few times and compensating or over-compensating with incorrect movements.

Many of you suffer some of the same problems, or will when the length of time your body is moving wrong catches up with its ability to mask them. It seems we can do things really badly for a whole long time before things start breaking down, but once the structure starts faltering, look out.

A remarkable aspect of weight training is it strengthens our musculature enough to keep us going through pain that would knock down our non-training neighbors; the bad part is we’re strong enough to compensate for weakness. This is done automatically, without awareness, so the problem gets deeper ingrained than it would have been otherwise… which is to say, hard to find and even harder to fix.

Now, after several years, books, dvds, paid site subscriptions and a variety of goofy-looking rehab tools, what things boil down to for me is a few minutes a day of pre-hab and a couple minutes of pre-workout activation. This is an amazingly complicated process, this structure and movement rehabilitation, made simple by a few easy exercises and stretches done consistently and forever.

Many of the mobility and functional movement experts, their books, dvds and workshops, are truly outstanding, and I highly recommend them. The thing is, most of us get a little lost in the volume of material, much of it using language we don’t understand. The writer or presenter expects us to know where the ever-spasming piriformis is, and before he gets to the vital part of how to fix it, we’ve tuned out.

In this thread on mobility, rehab and functional movement prep, we’ll discuss some of the products of the best thinkers, and where to spend your attention and money when you’re ready to focus in on your troublespots. Before you branch out, though, I suggest you spend a month on the following remedial tips.

Everyone who lives upright should do the following most days of the week.

Soft tissue work:
Tennis ball rolling under the foot
Foam rolling of the glutes and legs (front, back and sides)
Tennis ball rolling of the piriformis (deep in the glute, rolling leg bent at the knee to access)
Tennis ball rolling of the psoas (front of the torso, inside and above the hip)
Foam rolling the upper back

Deep core work:
Plank
Side plank
Hip bridge
Birddog

Mobility:
Ankle bending (forward and to the inside and outside)
Hip circles (leg to the front, back and sides, circling in both directions)
Cross-over lunge (one leg lunges back, crossing behind, hips rotating)
Step-overs (lift leg high enough to step over a hurdle from the side and front)
Thoracic spine (upper/mid-back backwards, then chest up, scapula back)

Stretching:
Pectoral stretch (arm from elbow to wrist against wall, lean into the stretch)
Hip flexor stretch (lunge one leg forward, body upright, spine long, arms overhead)
Hamstrings (body flat on floor, one leg up, against doorway, other leg flat)

Before we move on, perhaps a bit of clarification would be useful. We see a lot of “mobility this” and “stability that,” but what’s it all mean?

In this context mobility means joint movement, encompassing both the ability of the joint to move through its widest safe range of motion and the ability of the nearby muscles to cause that motion.

Flexibility is referring to the muscle lengthening, whether it can move to its full expected range, or if it’s instead shortened to a less than optimum length.

Stability can be both joint stability, such as the knee, low back, neck and elbow that have a short range of motion and need to be stable, and muscular stability, as when talking about the deep abdominal muscles that stabilize the spine.

When we talk about activation, we’re talking about waking up a muscle group that’s not firing well, such as the glutes after a day sitting at the desk. Glute activation movements are a perfect example of a two-minute pre-workout program that will provide an enormous payoff.

Most of us have a problem in one or more of these areas, and those problems trigger other compensation problems that eventually knock us off the gym floor until we figure out how to fix them. That, or we get our own Costco membership card so we don’t have to sneak in with a friend for wholesale, mondo-size bottles of Aleve.

There’s a lot more to it that this, and once we get the flexibility started, the core strengthening and the activation going, there are other exercises we can use individually to fine-tune our hip mobility and to make outstanding progress.

The coolest part? After a few weeks of this introductory stuff, we can keep things humming along nicely with a few minutes a day on the pre-hab stuff and a couple minutes of pre-workout activation.

Hey, you could potentially stay pain-free for the duration, however long that happens to be.

Joints begin to ache as we get a little older, or not so older in the case of aggressive athletes, who often hurt as much as someone three or four times their age. Nagging pain day after day coupled with decreasing range of motion equals just plain old bad juju that’ll ruin your life.

It may amaze you to discover those daily pains can be fixed, and pretty darn quick, too. Since your choices are getting a new job once you can no longer do the old, go on pain pills, like, forever, or even submit to surgery that may or may not work, you owe it to yourself to dedicate a few weeks to joint mobility to see if you can fix the aches that ail you.

Sick of regular, low-grade pain, the mobility program I picked is Scott Sonnon’s Ageless Mobility, a one-on-one workshop DVD that takes 75 minutes. The dvd arrived three weeks ago, has been through our player a grand total of six times, and already the difference is remarkable. I’m hooked, as well as committed, because I can tell this effort will pay off for the forever years.

Scott writes, “The best way to oil the rusty “tin man” joints is with the body’s natural lubrication. Our connective tissue doesn’t get any nutrition from blood flow after puberty except through movement (the exception is the jaw – which we tend to flap the most anyway.)

Add to that the compressive nature of weight lifting and you see the ‘squeezing out’ of this natural lubrication and nutrition.

Ten to fifteen minutes of dynamic joint mobility exercise will transport the nutrients of the food you’re ingesting to the places where it’s needed — your joints. It will also wash the joint capsule with lubrication, smooth off the bony profiles of any build-up of joint salts and calcification to abate arthritis and offset osteoporosis, as well as release adhesions and restrictions to movement.

It will also decrease your recovery time between your workouts to give you pain-free mobility, lessen and prevent delayed onset of muscle soreness, so that you can more enjoy the fruits of your muscular labor.”

Watch a few minutes of his presentation at the Active Aging Festival for a taste of what’s in store for your joints. (The full dvd class takes 75 minutes and moves from the neck down to the ankles.) Even this small segment of the live demonstration — just the neck work — has proven beneficial in three short weeks: I can see over my shoulder better when driving.

To keep you busy while you’re waiting for your new dvd to arrive, here’s more from Scott on back pain relief, and his commentary on the difference between joint mobility and overall flexibility, often confused but are not the same.

Let me add a tiny caveat: If you’re not committed to regular sessions in front of the tv, this isn’t the program for you. While this is educational, the point is the effort a few times a week. Watching it once and never again is like paying $24.95 for a trip to the theater, without the expensive popcorn.

Achilles tendon pain, plantar fasciitis and dropped metatarsal bones, common lower leg and foot problems that drag on forever and a day, can often be treated by triggerpoint therapy. While the pain of the treatment can be intense, a real tear-jerker, the near-immediate relief of a ache that’s been lingering for weeks feels almost miraculous.

There are three parts to this process, assuming you have all three ailments, which often go hand-in-hand, and are intertwined. If you fix one part, it’s likely to be re-ignited by another if you don’t get after them all at once. For that reason, work on one side at a time. Fix the worst foot first, then work on the other.

Part one: Triggerpoint therapy deep in the calf for Achilles Tendinitus
Deep in the calf is a triggerpoint that reflects pain in the achilles. For me, once I found that and put myself through the agony of pressing it out with my thumb, one side eased after the first treatment; the other side is still triggering and needs regular painful triggerpoint therapy.

Massage your calf, paying attention to the tender spots. Then push the calf muscle aside a bit so you can press around deeper. Move your fingers around, pushing harder and harder with your thumb until you find a lump. Press hard on that spot; if it’s a triggerpoint, it should hurt… a lot.

Hold… hold… hold… then as it pain lessens, press harder. Really make it hurt.

After a few minutes, two, maybe four, the triggerpoint will release and the pain will be gone. If you’ve found the right spot and if, as is likely, this is what was extending the achilles tightness, when you get up the next morning, that familiar ache that eases as you move around will instead be gone when your foot first hits the ground.

Part two: Fascia work on the foot
I do this with the footballer from tptherapy… looks like this:

Most people just use a tennis ball, which works basically the same, although the footballer rolls better, and once you make some therapeutic progress, you can step down on it harder. Because it’s more narrow than a tennis ball, you can actually get some popping as the bones shift back into place, just like going to a chiropractor, only you do it on yourself, for free, and daily, without an appointment. I do this on both feet for a minute or two after my morning bike ride.

My friend, Jeff, wrote a more thorough commentary in the forum toolbox that you’ll want to read also: Preventing and Treating Plantar Fasciitis.

Part three: Triggerpoint therapy at the tip of the metatarsal
This was the last piece of the key that I found accidentally. It didn’t make sense to me that this bone kept dropping out of place, even after the achilles and fascia were loosened and healthy. Then it dawned on me: A triggerpoint could be keeping the metatarsal out of place, so I went looking for it.

For me, and hopefully this will be the same for you, I found it at the top of the metatarsal, at the base of the toe. This is going to be hard to explain, so bear with me, and then feel around until you find it. This requires a great deal of pressure with your finger, parallel with your toe, pressing into the bone the base of the toe. If it hurts like the dickens, you’ve found it.

Keep pressing, grin and bare it until the pain begins to subside, indicating a release in the triggerpoint. You may have to repeat the process over the course of a few days, or it may be a single treatment will fix it. That depends on what caused the trigger in the first place (tight achilles or fascia, perhaps), and if the underlying problem has been fixed.

By the way, if you’ve had a dropped metatarsal very long, you probably have a toughened callous right where the bone hits. I’d cut off that callous now, as you’re getting started, because it’ll be hard to know if things are working as long as the callous is there since the metatarsal and the callous feel pretty much the same when you’re walking.

If these don’t work for you, or you otherwise need relief in the meantime, I found the metatarsal pad shoe inserts just made the problem worse, but a heel pad insert actually helped quite a bit.

We’ll be talking more about home-done rehab therapy in the coming months. Learning about triggerpoints and muscle spasms will help determine the severity of what we used to consider injuries, and with this self-therapy we’re discovering many aren’t injuries at all.

Tendons take forever to heal, and after waiting patiently with intolerance all summer for an Achilles tendon to normalize (shoe inserts, regular icing, attention to Joint Connection and fish oil supplements), by accident I stumbled upon what feels like a miracle.

Pulling out Clair Davies’ Triggerpoint Therapy Workbook to look up referred pain sites for thumb soreness for a friend, I stumbled over a triggerpoint for Achilles tendinitis located deep in the middle of the calf. Gouging away at it — hurt like the dickens! — the pain lessened over a period of a few minutes as the triggerpoint eased.

The next day, my long-suffering Achilles tendon was healed.

Now I know that sounds ridiculous and that only the triggerpoint faithful will believe it.

And to the scoffers, let me dig a bit: You *have* triggerpoints. This isn’t some hocus pocus voodoo. They may not be causing you any trouble… or maybe they are. That tendinitis you’ve been anxiously waiting out could possibly be cured today. I’m really not kidding.

Quoting Clair Davies, author of the Trigger Point Therapy Workbook, “The defining symptom of a trigger point is referred pain; that is, trigger points usually send their pain to some other site. This is an extremely misleading phenomenon and is the reason conventional treatments for pain so often fail. It’s a mistake to assume that the problem is at the place that hurts!”

And from the painful conditions list on the triggerpointbook.com website, it’s no joke; from tendinitis, ankle sprains and back pain, to carpal tunnel, tennis elbow, rotator cuff, runner’s knee and sciatica, the list of potential favorable treatments by triggerpoint therapy is long.

Aside from how quick and miraculous this is, the second-best thing? You can perform this on yourself. There’s no need to find a therapist, wait for an appointment and hope the attendant knows his or her stuff, then line up to pay the big bucks. Using your ingenuity and a tool or two, you can hit every part of your body. I’m not saying a visit to a practitioner for an initial treatment wouldn’t be a good idea, quite the opposite. But in many areas, you simply won’t find a knowledgeable therapist, and heck, for the cost of a couple visits, you can stock up on all those choice therapy tools.

In fact, I broke down and sprung for the full triggerpoint therapy kit, and am using it faithfully, daily. This is one outstanding toolkit, highly recommended, and at least until they run out, you can get a set from Elite Fitness for $119. Or you can pick up individual parts of the set at the manufacturer’s site, TPTherapy.com.

Surprise! Rolling my foot over the smaller unit fixed the dropped metatarsal problem I was griping about all summer. Bodyparts aren’t working fully optimally yet, but things are a whole lot better. If you’re aching all over, check this stuff out. And if you aren’t — you lucky dog — check it out anyway and save yourself some future trauma.

I don’t play hockey, but when I noticed Joseph Horrigan was one of the authors of the book Strength, Conditioning, and Injury Prevention for Hockey, I decided to flip through it. I read Horrigan’s Sportsmedicine column in Ironman magazine and it had a big influence on my training and health. The book is excellent overall, but one part in particular grabbed me.

Horrigan quotes Tudor Bompa’s prescription for flexibility, and I am paraphrasing here, but this is close:

If you want to improve your flexibility, stretch twice a day, hold the stretch for one minute three times, at a point you’d rate about a four on severity.

That little blurb would be very easy to motor past, but read it again. That is a very dense sentence. Following these instructions to the letter is quite a bit different from the prescriptions I had previously learned for stretching.

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