Shoulders

In bodybuilding, shoulders mean deltoids, but that’s not the case in sports nor when thinking of  healthy joint stabilization. The shoulder is an extremely complex joint. It is by design the most mobile and least stable joint in the body. Very small changes can change the mechanical function and can cause problems.

The muscles that stabilize and support the joint are primarily the rotator cuff muscles and the scapular stabilizers, the rhomboids, traps and serratus. Let’s talk a little about these elements of what’s commonly called the shoulder girdle, but what’s more like a yoke that includes the clavicles that attach at the sternum, the glenohumeral joint, which is the ball-and-socket shoulder joint, and the scapulae, otherwise known as the shoulder blades.

The Rotator Cuff

The introduction most gym trainees get about shoulder health are instructions to do internal and external tubing exercises for the rotator cuff. Strengthening the rotator cuff muscles is often a good idea, but by no means is it a guarantee of optimal shoulder mechanics. You’ll never have proper shoulder mechanics with a weak rotator cuff—rotator cuff work is necessary, but it’s not sufficient.

Often you’ll see the rotator cuff referred to as tendons, but don’t rule out a rotator cuff muscle as the root cause of a problem. In fact, most of the damage that gets done by the bones fraying the tendon is originally because of a muscle problem.

Regarding the rotator cuff, the current thinking in physical therapy involves several steps to get back to good function. The first steps involve healing the individual muscles, restoring strength and range of motion, and getting them to neurologically fire well. The little isolation exercises do this, and physical therapy is where we learned those tubing exercises.

The next step is to relearn the motor patterns that cause these muscles work in concert with the whole body. Compound exercises are good, and exercises that make extra demands on stabilization may help a lot.

How Rotator Cuff Structures Get Injured

The rotator cuff muscles get beat up for two reasons. First, they’re little muscles with a big job, and second, they’re in a position where the joint will literally grind them up if the shoulder isn’t functioning properly. This grinding is called impingement. If you hear a click or pop every time you hit a certain point in a movement, it might be impingement and you’re wise to address it because over time that little abrasion can cause big trouble.

Strong rotator cuff muscles will be better able to do their jobs without getting injured from the strain, and will help keep the shoulder moving properly. But strong external rotators alone do not insure healthy shoulder movement.

If you’re not flexible in the pectorals, you’re going to have trouble. And the muscles that control the scapulae have to be sufficiently strong—meaning the rhomboids, mid and lower traps and serratus. And finally, even if everything is strong and sufficiently loose, if your coordinating motor patterns aren’t sequencing well, you still might have trouble.

First, consider this: If your rotator cuff is injured, you may need to wait before you strengthen it. See a doctor;  make sure there’s nothing torn that needs repair. You may get sent to a physical therapist if passive movement is in order.

How We Strengthen the Rotator Cuff

Ultimately, most people will have to do direct work to maintain adequate strength in the stabilizers. For one thing, if you aren’t doing elbows-out rows, you might not be hitting the rotator cuff much. Even if you are, there’s an excellent chance the big prime movers will get ahead of the stabilizers and wind up doing more than their share of the work, leaving the rotator cuff muscles lacking. The odds that all four of the rotator cuff muscles will be strengthened enough to adequately support the shoulder just by doing row are  small.

There are two ways to go. One is to periodically test the rotator cuff for strength, making sure adequate strength and range of motion is there in all the various positions. Then do exercises to bring up the weak points as necessary. The other is to just do some rotator cuff work. Since we’re talking about 10 minutes a week, just doing a bit of it is easy enough.

Rotator cuff strength is normally tested by seeing how much weight can be handled in direct rotator cuff exercises. Ideally, rather than look at that number in a vacuum, it would be compared to strength in compound upper-body exercises, which we’ll cover in another segment.

The rotator cuff external rotation exercises are just a small part of keeping a healthy shoulder, and are not the be-all answer you might expect as you see your gym mates grabbing the tubing to warm up before every training session.

Next: Basic Shoulder Health

Now at age 56, I spent many of those years seated at a desk, an IBM Selectric in front of me long before my first PC, the one that arrived after IBM’s first commercial manufacturing run in 1981, dual floppy drives, no hard drive, almost no software. Yah, that’ll give you a neck ache, and a headache, too — I had my share of chronic pain. This long stream of pain came to a climax in 2007, and I nearly quit working. I simply couldn’t sit at a desk for more than about 10 minutes at a time. Production… stopped.

Training continued as normal, powering through as I’d been taught by the powerlifters of Dynamo Barbell Club in the early ’80s, reinforced by Dave’s example when we met a few years later. Powering through isn’t the right answer but, like a lot of things, I didn’t know it at the time.

Eventually desperate, as the new year rolled over into 2008 I turned in my training program for a corrective exercise regime. As you can guess, progress came quick and within a few weeks things settled down. I learned and practiced and learned some more, but within a few months I realized I’d gone as far as I was going to go on my own and went looking for help.

There’s a guy in town, Larry Goldfarb, who teaches Feldenkrais training to professionals. I knew Larry from the gym; we used to talk at the gym  in the mellow Santa Cruz afternoons in the early ’90s. He told me about Feldenkrais, no doubt seeing what was in my future, because my shoulders had been rounded and my head forward, heck, probably since I was 20. Whatever his best intentions, he was talking was Greek to me. I had no idea what he was saying, and anyway, weight training obviously cures everything, which I certainly knew at the time. How could he not know that? I didn’t listen.

Project yourself forward a decade, double the aches and pains, discover you can no longer make progress… and remember your old friend Larry. What the heck was he talking about, anyway? I worked the heck out of google for a week, but reading about Feldenkrais doesn’t do much. I didn’t make any progress; I still had no clue what it meant. I bought a set of mp3 lessons, including the famous pelvic clock lesson that opened my eyes but wide. Wow! So much I hadn’t been able to feel, and so much progress in just that first half-hour.

I was hooked.

Hands-on lessons and group lessons and lessons on the floor at home, at least twice a week I spent a half hour or an hour re-learning how to coordinate those stuck vertebrae and jammed up joints. The more I learned, the more I noticed in myself, and the more I wanted to fix things. Even though the process took a couple of years — it’s a life-long thing, really — within a month I was relatively pain free and back to work.

Now if you think back for a sec, you’ll realize this was happening back before Dan John’s book, Never Let Go. That’s right. I almost quit work before working with Dan. That means before Michael Boyle’s Advances in Functional Training. Before Gray Cook’s Movement. Before the Reifkind/Whitley kettlebell workshop DVD, Dan’s Utah DVD set or Gray’s Applying the FMS Model DVD. Before Dan’s Intervention and Mass Made Simple. Think that through. None of those would exist, at least not in the form you know them, without Feldenkrais.

There’d be no audio lectures on movementlectures.com.

I’m not sure what I’d be doing, but there’s no way I could have done the production necessary to make those media products. Could not have been done.

Now, what’s this all about?

It’s a challenge. I want you to learn what I’m raving about. Whether you’re in chronic pain or work with people who are, you owe it to yourself to discover how Feldenkrais strategies work. There’s been a lot written lately about how the brain learns, and doing the small, slow movements taught in Feldenkrais will show you exactly how that works. It’s remarkable, life-saving really.

So, I challenge you to learn something new: Larry’s teaching Moving Beyond Physical Fitness at the end of this month. Make the effort to be there.

Well, here, actually. It’s in Santa Cruz. And the weather on the coast is amazing. Outside the US, he’s also doing the same workshop in Madrid, Melbourne and Sydney.

Here’s Larry doing a hands-on lecture for Feldenkrais teachers, not for the rest of us. The upcoming Moving Beyond workshop will be partly general learning lecture, but mostly active floor lessons. In the lecturing section, he’ll discuss what went on during the lesson, what he normally sees and, when it’s possible to know, why he thinks changes are happening.

[youtube:http://www.youtube.com/watch?v=8xNW6Qu_Ib4]

Boris Bachmann, the guy who recorded the squat techniques lecture (he’s also the Squat Rx guy from YouTube), asked me the other day, “Are there some sleeper lectures you think are absolutely fantastic that might have gotten overlooked so far? Let me know and I will do some impulse buying.”

Boy that’s a real hard one because for me, I’m more into the talking than the learning, if you know what I mean. So while trainers might really go for one and coaches might really go for another and therapists yet another, I get a kick out of just listening to the talking… Dan John’s (goal setting), Dick Tyler’s (storytelling), Chip Conrad’s Sweet Chant and Lou Shuler’s Hero’s Journey. People like me who like bio stories will enjoy listening to Ric Drasin tell his tale.

Mike Mahler’s discussion of hormone optimization was fabulous (hold on to your wallet — I ended up buying four new supplements to try!), as was Jerry Brainum’s on supplements and Robert Yang’s on gluten. Brooks Kubik’s talk is on training for senior lifters, learning how to plan recovery, real good for some of this crowd. Tom Furman’s was excellent, especially as we get a little older and lose mobility.

Charlie Weingroff’s is a real big learning circle, very nice, and Evan Osar kicks in there on the human movement side as well. I really enjoyed Robb Rogers’ and also Tim Anderson’s; those were both a little different and off the mainstream.. stuff you probably haven’t heard before.

Oh, jeez, I can’t believe Boris got me doing this.

Anybody with trigger point curiosity, Perry Nickelston’s is super; there are a couple lectures on back pain (Eric Beard and Sam Visnic, and Eric also has one on shoulders), and one by Tom Patrick about his journey through back pain and back to golf.

Locked up t-spine? Sue Falsone is her usual wonderful self. Foot pain? Ron Jones has you covered. Wondering if all this fascia science is real, or important? Paul Ingraham dives into that one.

Want to learn something unexpected? Stacy Barrows and Martha Peterson. Need a Gray Cook fix? Self-limiting exercise, plus a discussion with Craig Liebenson and one with Joe Heiler. Lee Burton’s work with the core is unmatched, as is Brett Jones on corrective exercise and strength… short but complete overviews there, then you’d just get to work, right?

Brian Bott works with football players, Brijesh Patel with college athletes. Dave Whitley teaches breathing drills, Jim Schmitz has been coaching O lifting since the ’60s. Chiropractic literally saved Keith Wassung’s life — Keith Norris, Skyler Tanner and Mark Alexander are physical culture slash paleo crusaders; Mark Snow works group and bootcamp trainees using the FMS, and Pat Rigsby knows the business side of bootcamps like nobody else.

Michael Boyle’s talk on fat loss — well, Mike’s just great at everything, really — and Mike Roussell talks fat loss like a lean guy, too.

The Nicks — Winkelman and Tumminello– are superb coaches and know how to teach (the Winkelman talk is pretty cutting-edge, coaches should check that out), ditto Vince McConnell, who talks about privately coaching athletes in season in their sports. Zach EvenEsh is an extremely successful high school athlete coach, and in his lecture he tells how he trains them.

Galina Denzel is a specialist in training pregnant women, and tell us not only how the body changes during pregnancy, but how to train a woman to get her ready for delivery and baby rearing. If you train women, or if you’re pregnant, this one’s a must.

Oh! And there’s this Boris Bachmann guy who really knows squat.

Here’s your link to the Movementlectures.com Full Lecture Listing.

The movementlectures.com site launch last week went super smooth and we didn’t crash the server, not even once! Nearly a year in the making, we now have 45 lectures available for immediate download, ranging from exercise technique to physical rehab, from physical culture to goal setting — there’s something for everyone, and inexpensively, with instant access. There are another 17 lectures nearly ready for publication, and a dozen recorders jetting around the country collecting new material. Which of these is your new favorite lecture?

Boris Bachmann: Squat Talk | Brett Jones: Corrective Exercise Essentials | Brett Jones: Key Concepts in Corrective Exercise | Brett Jones: Strength for Success | Brian Bott: Building a Bulletproof Program | Brian Bott: Training the Trenches, Football | Brijesh Patel: It’s Not All About the Sets and Reps | Brooks Kubik: Strength Training for Older Adults | Charlie Weingroff: Trainable Human System | Chip Conrad: Why On Earth? Excerpts from Our Sweet Chant of Frantic Power | Craig Liebensen and Gray Cook: Dialogue on Function | Dan John: Intervention

Dan John: Goal Setting, Second Millennium, Plus a Decade | Eric Beard: Anatomy of Shoulder Impingement and Beyond | Eric Beard: Understanding Lower Back Pain: Functional Anatomy Interventions and Prevention | Evan Osar: Strategies and Techniques to Improve Human Movement | Gray Cook: Applying the Functional Movement Screen Model | Gray Cook: Self-Limiting Exercise | Jerry Brainum: Supplements: Those that Work vs Those that Don’t | Jim Schmitz: Olympic Style Weightlifting for Strength, Health, Physique, Fitness and Sport

Joe Heiler and Gray Cook: Meaningful Impairments | Keith Norris, Skyler Tanner and Mark Alexander: Paleo Discussion | Keith Wassung: Introduction to Chiropractic | Lee Burton: Core Testing and Assessment | Lou Schuler: Hero’s Journey into Fitness | Mark Snow: Using the FMS in a Group or Bootcamp Setting | Martha Peterson: Relieving Chronic Muscle Pain With Somatic Education | Michael Boyle: Fat Loss Secrets | Mike Mahler: Importance of Optimizing Hormones Naturally | Mike Roussell: 21 Ways to Lose More Weight

Nick Tumminello: Practical Program Design | Nick Winkelman: Coaching Science: Theory into Practice | Pat Rigsby: Boot Camp Financials | Paul Ingraham: Fascia Science: Does it Even Matter? | Perry Nickelston: Triggerpoints for Pain | Ric Drasin: The Golden Years | Robb Rogers: Functional Training vs Performance Training | Robert Yang: Nothing Wholesome in Eating Whole Grains | Ron Jones: Health from the Ground Up: A Practical Guide to Understanding Feet, Ankles and Shoes

Stacy Barrows: Foam Roller Methods for Optimal Posture and Movement Organization | Sue Falsone: Thoracic Spine: The Missing Link to Core Stability | Tim Anderson: Miracle of Crawling | Tom Furman: Ability to Move | Vince McConnell: Role of a Personal Strength Conditioning Coach | Zach EvenEsh: Training and Development of the High School Athlete

President Obama’s in the White House, perhaps sitting in the Oval Office looking around in wonder at this very moment. Smoking is banned there. Will this help him in his efforts to break the dreaded cigarette habit?

We can all agree it takes a tremendous amount of discipline to train most days of the week; it does regardless of the challenges of the job — we’re all busy. The current President trains six days a week (ditto the previous, as a matter of fact, and it’s a remarkable attribute to both men — I mean, seriously, can you imagine?!), and this includes a daily workout while on the campaign trail for much of the past two years.

So, here we have a guy, our new President, who’s devoted to his health and fitness, yet he smokes. He’s careful not to smoke in public where a photographer could grab a shot; even though he’s been upfront about the addiction, he obviously knows a picture of him smoking gives image to a weakness, a detriment to his strength and perhaps even his popularity. And still, with that awareness and with all his extraordinary discipline, he’s apparently been unable to quit smoking.

Now this certainly puts smokers in good company, doesn’t it?

Don’t feel alone, but don’t give up to weakness, either.

We have a couple of folks in the IronOnline forum who’ve had both drug and cigarette habits and have said it was easier to stop heroin and crack than it was to break the stranglehold of cigarettes. It’s both a chemical addiction as well as a habit, something you often do without thought, or that you do along with reading the newspaper or as you finish a meal. The physical and mental addictions combined make it a particularly difficult problem; still, it’s one millions of people have solved and you can, too.

In 1984, U.S. Surgeon General C. Everett Koop launched his campaign for a smoke-free America by the year 2000. While he missed that goal by a long shot, according to the American Lung Association, cigarette smoking dropped from 30 percent of Americans to around 20 percent during the period 1985 to 2007. In the 20 years prior to his campaign, an earlier 12 percent quit the habit, so while it took over 40 years, it’s still a drop from 42 percent to 20. Getting there.

We’ve all seen the long list of health hits you’re taking with each inhalation of smoke, but did you know it’s messing with your muscle building? Big time! The list of people in the forum and at your gym who can confirm this is long.

If there are readers of the blog, newsletter or forum prepared to step forward with a Smoke-Free Challenge, we can put together a Facebook group and support you in your efforts if you’d like. Meanwhile, here are a few links to previous conversations we’ve had as others in our group have successfully kicked the cigarette habit.

Dave wrote on breaking the smoke habit twice, here and here.

And a number of IronOnline forum readers provide their success methods in this archive, where they discuss the patch or gum use, and show how quickly the benefits of quitting begin to occur.

Heck, at, what? $4.00 a pack, in this economy isn’t that enough to give you the final kick? When I was a kid and cigarettes were thirty cents a pack, my folks told us they’d stop when they hit a half-dollar. Sure enough, that’s what happened and that’s what they did. Four dollars a pack! Let’s get going on this one, folks.

Do you think I could talk you into starting the year off with a near-daily joint mobility program if I made it really simple? Just one or two easy movements per major joint will take you about five minutes; do it in the mornings and your joints will be oiled up and ready to take on the day. What a great way to start off the New Year, a resolution that’s really easy to keep and comes with a major big payoff.

As we age, our joints lose their ranges of motion, limiting our ability to move well in addition to causing other problems or pain in nearby muscles and the joints above or below. Working the joints—not the muscles, the joints—reminds the brain how to access the full range of motion while at the same time circulating the synovial fluid, removing waste products and breaking down calcium deposits. The result: confident, smooth movement in the joints, a reduction of pain and an increase in injury prevention. It’s golden, and worth the five precious minutes.

The main thing to remember is we’re working the joints. Pay attention to joint motion, keeping other areas of the body as still as possible so the joint alone can move forward and back, side to side or rotational. Whenever possible, close your eyes and get an image of the actual joint in action. Slow the action down and make the movement smaller rather than as pushing far as you can go; you’re looking for smooth, easy action, not big jerky movements.

Here we go, real simple, no frills, just do it. Five reps per move, per side — as you get comfortable with the routine, you may feel like doing a little more in areas where you feel less confident. Some people do dozens of reps with great results, but this is a beginner’s set-up where time and interest will run out fast; you’ll see a difference with only  a few reps if you perform them regularly.

Toes:
Standing tall, move one foot behind, heel raised with the pads of the toes flat on the floor. Move your heel toward the floor, and back up, keeping the toes pressed into the floor. Do this five times; now, with the heel high, put more weight on the pad of the big toe, then move the weight outward toe by toe until the weight is more heavily on the little toe. Reverse and take the weight back to the big toe. Change feet and repeat.

Ankles:
Still standing, most of your weight on one foot, roll the un-weighted foot to the inside and outside, paying attention to side-to-side movement in the ankle joint, repeating on both feet. Then, standing near a wall or countertop, put your weight evenly on both feet, feet flat on the floor, and bend toward the nearby surface, making sure the movement takes place in the ankles. You’ll be moving your ankles forward and back; your knees are slightly bent, holding that position (not increasing the bend), and there’s no movement in the hips. Your entire body moves forward and back, with the action taking place in the ankles.

Hips:
Warm up the hips from a standing position, weight equally on both feet, moving forward and back in a small hip thrust, back and forth with the movement taking place almost entirely at the hips where the top of the quads attach. Then, rest your weight on one foot, pull the other foot off the ground to the front, then cross over the front of the stance leg so your foot is turned, inside facing behind you. Begin to circle your foot, again with the circling taking place at the hip joint; your ankle is not circling or bending, nor is your knee. Circle five times and reverse directions for five more circles. Move your foot to the front of your body and repeat; move it to the outside to repeat in both directions; move it to the rear and circle it, again in both directions. You may feel pretty sloppy at this one at first—stick with it, it comes fast and is a real doozy for good hip mobility.

Thoracic spine:
Still standing, weight evenly balanced, extend your arms to the front, palms down. With your hips stable and unmoving, extend and contract your arms by moving at the mid-back. Your chest will be caving in and moving out in opposition to your thoracic spine activity. Now move your hands to your sides to perform a slight side bend. This isn’t the side bend you remember from gym class; instead you’ll be moving at the upper back, your lumbar spine and hips are immobile, with the only movement taking place between the neck and bottom of the rib cage above the low back.

Shoulder joints:
Keep standing for a few more minutes while we finish this up. Skipping over the scapulae, we’re going to target the ball-and-socket part of the shoulder joint, starting with forward to overhead raises. Next up, small circles beginning with the hands to the sides and low, moving forward and at shoulder height, then in an extended Y position, palms facing out. Do five circles in each position, reverse direction and repeat. Remember to picture the joint in action, and make the circles as small as necessary to keep the action smooth.

Wrists:
As long as you’re standing there and your arms are handy, hold them outstretched at shoulder height, palms facing down. Move your fingers toward the floor, then back up toward the ceiling with the action entirely at the wrist. Then circle the hands in both directions, again with no action at the elbows or shoulders.

Neck:
Finally, still standing, move your head back and forth with your body stable and the movement happening in the neck. Circle your head from side to side (the universal “no”), with no activity from the shoulders down. Now move your head up and down, as if indicating “yes.” As you practice this over a few days, the range of motion will increase and the crackling sounds will decrease as the small bits of calcium deposits are broken loose and dispersed.

That’s it. Print this out. Run through it a few times this week and after you get the hang of it, it should take you about five minutes, maybe seven if it starts feeling good and you get carried away. And it’ll only take a couple times for you to realize all this typing was simply to describe ways to move your joints forward and back, side to side and in circles… nothing to it, no special exercise names, just rediscovering the ranges of motion of your mobile joints.

Once you have a taste of how powerful this stuff is, you can expand on the areas that have previously given you the most trouble. There are a variety of incredibly powerful joint exercises that will literally reverse the chronic pain of a middle-age life. I’m serious, you truly can feel like a kid again, and it doesn’t take a whole lot of time, either. Persistence, maybe, but other than that, it’s not hard at all.

At our IOL Bash event last weekend in Scranton, PA, folks who knew I’d spent the first part of the year with hip mobility being one of the top goals wanted to know more about the process. Once I discovered there was a problem, what did I do to fix it?

It was a priority, thus we’re talking about a lot of effort, meaning doing hip mobility work at least a couple times a day. Patience is key, because with immobile hips, there’s not much movement, and the exercises feel, er… stupid. I went from locked down hips — about as immobile as one can be and still be walking — to fairly mobile, and in the process rid myself of chronic back pain and at the same time regained joy of movement. It was more than worth the effort, a great payoff and highly recommended.

One thing before we get started: The mental aspect is a big component often forgotten. Many of us hold our lower abdominal region tight — suck in your gut, right? — and that certainly contributes to our pelvic immobility. You’ll have to purposefully relax your pelvic region in order to get your hips mobile when you’re walking down the street.

Another key to help you get started: Learn where you hips are. If when told to put your hands on your hips you find your hands on the sides of your waist, you’ve got it wrong. The hip joints we’re working on with our mobility programs are at the top of the leg, where the long femur bone rests in the hip socket. This is not to say we don’t need pelvic mobility; we do. The thing is, you’re going to get pelvic mobility out of hip mobility work, but if a beginner at mobility targets the top of the pelvis, what’s probably going to happen is lumbar rotation, not pelvic or hip mobility. So focus on the actual hip joint and save yourself a backache as you’re starting down the mobility path.

To make sure you keep this up long enough to see some progress, and to grab a little pre-workout activation in the process, do some of your hip mobility exercises before your workout. And absolutely do some hip mobility along with some foam rolling on your non-workout days to keep things progressing. Those readers with desk jobs will get double benefit by doing hip and thoracic spine mobility work after sitting all day, and if it’s possible to do a little at other times during the day, so much the better. Sitting is the absolute worst possible thing for optimal hip mobility.

If you combine strengthening the small muscles with stretching the tight ones, for example using the arms-overhead lunge stretch, your hips will begin to loosen up within a couple weeks. You really will feel the difference.

My full list of hip mobility exercises used to free up locked-down hips follows. Why don’t you pick four different exercises and do them daily this week; pick another four for daily use next week and continue changing weekly until you’ve tried them all. By then, two things will have happened. First, your hips will be more mobile and there’s a reasonable change your nagging backache will be gone. Second, you’ll know which exercises were hard for you; those are the ones you’ll want to keep after until the movement is fluid and easy.

One of my favorites is one-leg hip circles. Stand tall; stick one leg across the body to the opposite side and make small circles with the foot outstretched to the side, then reverse direction. Move the foot to the front and repeat; shift the foot to the outside and repeat; continue to the back and repeat the circles on both directions. Change legs and do it all again.

As you begin, the circles will be small and the hip will fatigue quickly. Happily, these small muscles strengthen fast. Hip circles were originally suggested by Dr. Eric Cobb over at Z-Health, and are also taught by other joint mobility proponents.

Your other selections follow:

Hurdle stepovers from the front, facing the bar
Hurdle stepovers from the side, side to the bar

Side-lying leg swings, forward and back
Hockey groin stretch

Lunges, lunge backs, side lunges
Dynamic kneeling hip mobility

Step-ups, step-downs
Single-leg deadlifts, hands supported

Standing leg swings, front to back
Standing leg swings, side to side
These are done standing near a counter top where the hands are placed for balance; the swing is small — not energetic; if the low back moves, the swing is too long.

Hip rockers
Hip bends
Hip circles
Hip thrusts

Holds at the bottom of the squat, done at the corner of the kitchen counter, one hand supported on each side

Stability ball side to side hip extensions
Medicine ball Heismans
Quadraped hydrants

Internal and external hip rotation: side-lying clams, hip abduction/adduction (feet against wall, body on floor), a femur rotation move with the legs upright against the wall, and a pilates move: body on floor, legs raised with a small ball between the feet, opening and closing at the knees

Pelvic clock, a Feldenkrais movement pattern

Another great full hip motion for which I have no name: From a side-lying position with the left side on the floor, put your right foot upright, a “standing” position on the inside of the left leg. Lift the leg straight up a bit, the knee moving toward the ceiling. Then begin to turn the leg over toward the left — it feels a bit like unhinging at the hip socket. Continue lifting and turning in a coordinated effort until you touch the top of your right knee to the floor next to your left leg. Then reverse sides and try with the left leg over toward the right side. Note if both, either or neither knee touches the floor, and if the movement is smooth or jerky.

Some of the hip range of motion exercises – leg circles being a great example, or the pelvic clock – may have a part of the circle “missing” – your circle isn’t round. It’ll feel stupid and you’ll want to discontinue the exercise, but if you stick with it, the smaller muscles will strengthen, you’ll gain more control of the movement and the circle will round out. Bravo! It’s small things like this what will contribute to that miraculous day when your back pain goes away for good.

The most unusual and perhaps most effective thing I’ve learned in all this is to slow down and to make the movement smaller. That’s how we can really feel what’s going on, where the action starts and ends, where there’s a hesitation or a “dead spot,” and then we can start sorting out the origin of the problem.

That’s the thing with hip mobility — there are so many things going on that allow, stop or create movement. We think of it as a ball moving around a socket and forget all the muscles, tendons and ligaments that contribute to making the motion happen.

The hardest part is figuring it out. Fixing it is easy, sometimes ridiculously easy.

If you’re a visual learner and want to see some of this in action, I got a good introduction to hip mobility from John Izzo’s Free the Hips dvd. Here’s a preview:

Be sure to read Mike Boyle’s Understanding Hip Flexion, too.

Bonus material:
* Listen to Caroline Blackburn explain some of what we’re working on fixing here.

[youtube:http://youtube.com/watch?v=3MIZ6Fl2BTY]
* Run yourself through Boris Bachmann’s hip and hamstring mobility drills

[youtube:http://youtube.com/watch?v=WKnpmQNhc3w]
* Rope or band stretches: Hamstring, groin, IT Band (cross body), quad (facedown, pull back), ankle, calf and knee

*Note: This blog post was written in 2008. While still factual, since that time we’ve learned so much more about this, including the most important point: Every person’s condition is different. Get medical attention and you’ll save yourself months of experimentation. Or more!*

Dave’s newsletter last week spurred a lot of questions about hip mobility in general and an elevated hip in particular, with readers asking how to recognize the problems in themselves, and what to do to fend off the back surgery Dave eventually needed.

When I first met Dave in 1984 he had the elevated hip; I noticed his stiff, one-sided walk a long time ago. He says he’s had it a lot longer, but doesn’t remember when it started. I had an elevated hip — one hip higher than the other — for at least a couple of decades, that I know for sure.

Here’s the thing: It wasn’t until this year we learned it wasn’t a structural deficiency and that it could be fixed. I’d never heard of such a thing, and I suspect that’s true of most of the readers, and is the reason I’ve been nagging at this joint mobility and corrective exercise stuff all year.

In some cases there’s an actual leg-length discrepancy; usually it’s a functional issue, not a structural issue. Only about one in six people with a higher hip have a physically longer leg; the rest have an elevated hip that can be fixed in fairly short order. Muscles on one side are pulling the hip up, while muscles on the other side are weak and unable to offset the stronger side. We do weight training around here to make things stronger; this should be easy enough to fix, right?

If you look in the mirror at the top of your pelvis (that spot where we erroneously put our hands when we put our hands on our “hips”) and think one side looks higher than the other, you may have an elevated hip. If you’re unsure, take a couple of photographs — straight on, not at an angle, front and back shots. Print them and use a ruler to draw a straight line if you can’t tell for sure by looking. Better yet, take the photos in front of something straight, a window frame for example, to help you see level. In a clinical setting, the modern rehab folks will take photos with a grid background, full length with the patient wearing nothing but shorts or shorts and a bra top so they can really see what’s going on.

Once you’ve determined one hip is higher than the other, have someone measure your legs with a tape measure from the top of the anterior superior iliac spine (ASIS), the front of what we wrongly call the hip, to the inside of the ankle bone. If there’s a discrepancy of more than a quarter-inch, go to a medical doctor or chiropractic physician for an x-ray — that’s the only way to know for certain if the actual bone lengths are different.

Structural issues should definitely be addressed, usually meaning an elevated shoe on one side, to limit the problem so it doesn’t contribute to a cascade of whole-body pain.

Most commonly you’ll find no difference in leg length and can go to work on fixing the elevated hip on your own.

Why it’s worth the trouble fixing it is the list of other problems that tag along with an elevated hip. We can trot along fine with this in our 20s, 30s and maybe even 40s, but in my experience and in Dave’s, trouble is just around the bend after that.

Picture a skeleton hanging from a rod. Now visualize pulling on one hip to lift it higher than the other. Is it obvious in your imagining that other parts of the skeleton have to shift to allow that to happen?

That’s exactly what happens in real life, too. When the hip comes on up one side that leg gets a little shorter on the way to the floor, and upwards, the spine bends a little toward the opposite side, making the waist a little shorter on the elevated side and putting the person in functional scoliosis. It’s not structural scoliosis, where the spine is permanently bent, it’s functional and can be fixed.

It also means it will stay that way if not fixed, indicating a future of back, hip and leg pain for the person who’s either uninformed or unwilling to step back from their training long enough to fix what could eventually be a serious physical issue. If the sufferer ignores the pain long enough, maybe he or she will need back surgery such as Dave’s, getting another chance to go back and fix the functional problems after recovery from a major surgery.

With an elevated hip where one side is higher than the other there’s fascial or muscular tightness pulling the spine, and weakness on the other side allowing it to be pulled. We get regular massages or work on self-myofascial release with a foam roller and a tennis ball, add a little stretching and over time the soft tissue normalizes, the pulling stops and the spine goes back into its normal alignment. This is quite common… just most of us haven’t known that before.

We then work to balance the endurance strength of the two sides so that normal posture becomes easy to maintain.

This would also be the time to sort out any pelvic tilt and rotational issues to bring the pelvis back to its optimum position of a *slight* anterior tilt, which puts the spine in a mild lumbar lordosis, exactly where we want it.

At the same time, we would be working on joint mobility, especially in the hips and upper spine. In fact, this is exactly what Dave began working on this past week as part of his back surgery rehab. The more mobile and freely moving those areas are, the easier it is for the postural muscles to hold us in good static positions.

Here’s a review of joint mobility and foam roller rehab programs. I hope you’ll take some time with this and treat it seriously even if you don’t have an obvious hip elevation, because free moving hips is the key to easy movement now and into the later decades. If you do find an elevated hip, here’s how to get started fixing it.

Which supplements should I buy? That’s one of the most common questions simmering in the IOL discussion forum. The confusion caused by over-the-top advertising combined with a petrol-powered shrinking wallet size will mess with a new trainee’s head, so let’s boil it down to something simple.

Start with this: Rarely is taking a supplement short term valuable. Occasionally we’ll have an issue such as a bladder problem that can be addressed with a short course of D-Mannose for example, but generally speaking, if you can’t afford to continue a supplement over the long-term, a single bottle of a $50 product “just to test it” is not worth your money, and even less worth the concern.

We want to select supplements that will help us over the lifetime, not the newest fancy-label ingredient popular this month with the gym floor gossip crowd.

But first, before anyone starts with the specifics, set a budget. That’s right… a budget. That credit card you’re using for your internet buys is not a magic money maker; you need to decide in advance exactly how much you can afford to spend on supplements each and every month. How much is it? $75? Less? More?

We’ll use the seventy-five number and see where that takes us. Not too far, I think you can guess, so get serious from the outset: Those testosterone boosters are flat out on this budget. If you get all eager-beaver and press the Buy button without thinking it through, you’re either going to forego your multi-vitamin and protein powder, or you’re going to eat into your evaporating retirement fund.

Before you can begin to choose the supplements that are right for you, you’ll next have to take stock of your circumstances. Look here:

Regular food consumption: Do you eat a variety of whole foods daily, or do you flake off on the vegetables or run yourself through the local drive-through at lunch?

Protein intake: Do you get protein several times a day, or just at dinner?

Fish as food: Do you eat fish regularly, particularly oily fish such as salmon?

Fiber intake: Is there plenty of fibrous vegetables, fruits or bran in your menu?

Training goals: Are you striving hard but not making the gains you hope for?

Access to the sun: Do you get outside daily, and does the sun hit your skin?

Vitamin C intake: Do you eat red bell peppers or citrus fruits?

Dairy intake: Do you get enough calcium?

Age: Are your joints beginning to ache; are you beginning to have trouble with digestion; do you sleep well?

Genetics: Does osteoporosis run in your family? Heart disease?

Given your personal answers to the above considerations, you can begin to hone down your list of priority supplements. Starting with our budget of $75, you’ll discover we don’t get very far down the list. Heck, we barely get a protein powder with our multi-vitamins!

Hint: Dave’s big idea… move the protein powder out of the supplement category and over to the food budget. That works pretty good, but it might be cheating some. On the other hand, a protein shake is probably replacing a meal, so I guess it’s fair; let’s do it.

1.    Quality vitamin/mineral
2.    Fish oil
3.    Protein powder
4.    Metamucil
5.    Creatine
6.    Vitamin D
7.    Vitamin C
8.    Vitamin E
9.    Vitamin B-complex
10.   Calcium, magnesium and zinc
11.   Glucosamine/Chondroitin/MSM

A sharp shopper who moves the protein powder and Metamucil over to her food budget, and if she tosses the creatine off the list (which I can do because I’ve switched our shopper over to the female gender, and women for the most part don’t like the water weight gain of creatine), can probably get that list done on budget. Nice work!

Past the basics most everyone should use, we begin to get to the specifics an individual might need, stuff like L-Glutamine for gut health and muscle repair, ZMA and melatonin for sleep issues, iodine to boost a sluggish metabolism, enzymes for an aging digestive system, or 5-HTP for a serotonin lift.

Those with an eye toward the most current nutrient science are already taking a second look at Vitamin K, a vitamin the rest haven’t yet heard about in the nightly news.

A hard-striving athlete will probably try to widen the wallet for some branched-chain amino acids (BCAAs) or a handful of liver tablets, and would find no quarrel here. He also might spring for a bottle of NO2 for a test run; most of the reports around the forum have been less than stellar, as was Dave’s experience (a dud is what he called it), but there are definitely some who keep rolling with it, so it’s worth a try if it fits in the budget.
The same athlete getting a little long in the tooth and stuffing a bigger bank account will be extremely pleased with Ageless Growth, no stretching the truth there. But again, none of those are on the month here-month there plan; if you don’t have the budget for them, don’t try a bottle to check ‘em out. No gains from BCAAs or Ageless Growth will hold after the initial supply runs out.

Digging a little deeper brings us to the serious issues of hormonal imbalance and heart health. Supplementation can absolutely help in some cases, but first we need to dedicate some time and finances to a doctor’s visit and a list of blood tests.

Buying all the latest forum rage of testosterone boosters and heart strengthening supplements is both expensive and stupid. If you need these, you need a baseline test and a real specific supplement plan, not a fancy ad-itorial or a synopsis of the newest research that may or may not suggest hope for some off-beat herbal preparation.

And you need to move those ingredients — worthy stuff like CoQ10, policosanol, an estrogen blocker like DIM or 6-OXO (quick tip: try daily broccoli first) — out of your supplement budget and over to your medical one. There’s no room left in your supplement category, particularly for some of these expensive items.

A long conversation spanning the past four years takes place here in the forum. Feel free to join in the discussion with your current thinking.

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.

We’ve been talking about corrective exercises a lot, and many readers don’t really know what this means and how it might apply to them. Let’s take a closer look at one common habit to demonstrate how a simple twist can expand up and down the body.

Think about how often you stand on one leg. Most of us do it regularly throughout the day, and it’s somewhat likely it’s causing a problem that starts at the hip and reverberates from there.

Get up from your chair. Seriously, stand up. You’ll have to feel this to catch the meaning.

From a standing position, shift your weight to the right leg. Go ahead and rest your weight to the side as you’d normally do. Does your left hip drop down and your right hip jut out?

Re-center yourself and put the palm of your right hand on the front of your right hip. Shift back to the right side, only this time slow it down. Do you feel how your hip actually turns?

What has just happened is your right hip rotated inward, moving the weight of your body off the muscles of your full leg and onto the weaker muscles above the back of the hip and at the outside of the leg. Over time, this common habit is causing both tightness and weaknesses that are not natural.

Next, still with your weight on the right leg, purposefully bring your hip around so it’s facing the front, which is its correct position. Do you see how hard that is to do, and to hold there? Those are the tightness and weakness issues keeping your hip from its natural placement. Interesting, isn’t it?

We’ve seen the problem at the hip and realize we’re reinforcing that bad position numerous times each day. You next question may be, “What’s the big rip?”. What’s the difference if the hip rotates inward?

Go back to the original side stance, the weight resting fully on your right side with the hip jutted to the right. Look down at your knee (you may have to drop your pants for this one; hope you’re not at the office). Is it still facing forward, the healthy way it should be? Nope, probably not – how could it be? You have knee pain? Stop and read this again, slowly; you’re onto something important.

No wait, let’s look a little further: The ankle’s messed up, too, isn’t it? The knee is turned in, so the weight on the ankle is toward the outside. And there’s pressure on your heel instead of having your weight balanced on your entire foot, am I right?

Just for kicks, check out the left side by shifting your weight over there. Is it as bad as the right?

You’ve just seen how our bad standing habits, our postures, have a ripple affect down the body. Over time, this puts strain on the joints, connective tissue and muscles causing the joints to become less mobile in an attempt to protect the body, causing arthritis due to excessive pressure in unnatural positions, causing muscle tightness and vulnerability at crucial points, all leading to a list of easily fixable pain that can last a lifetime.

And that can be prevented if you’re willing to recognize that Dave and his peers were wrong about one thing: There actually is a little more to this than just hitting the iron, and in this case, those science guys really are onto something.

This stuff is important, and I’m so thrilled it’s becoming part of the mainstream fitness discussion.

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.

One of our common complaints is the trouble we have getting a doc to order the blood tests we want. Or perhaps we’re just curious about something — Vitamin D, for a good example — yet don’t need any other doctoring at the moment. Most of us set our blood chemistry curiosity aside at this point, thinking we’ll remember the question during our next visit to the doctor’s office.

Or not.
Easy solution: Skip the anxiety, arguing or subsequent frustration and order the tests you’re interested in via Life Extension’s Blood Testing Panels.

The only downside I can see is that you don’t know in advance where the labs are. LEF is using LabCorp as their lab, so before you order, make sure there’s a LabCorp location near you. Here’s a link to the LabCorp locations.

In case you need a refresher, this is a list of recommended tests for the status of your heart. And here’s a link to a great deal of cholesterol information, three years of cholesterol posts pulled together to keep you reading for the next couple of hours.

In this link, Life Extension provides an in-depth discussion of blood testing protocols, and the value of bringing our blood chemistry to optimal levels.

Do you have time for some price shopping? Compare the Life Extension costs with those of HealthCheckUSA, where they also use Labcorp facilities for the blood draw. A couple test prices I checked were identical, but not all. It may be worth the trouble to check both places for your needs.

I’m a big fan of regular blood testing. Try the Vitamin D test, what a trip that will be if you discover your Vitamin D is low, which it very well might be. This one’s a biggie, and until recently very few of us knew it. Check out that Vitamin D link if this is a new one on you, then make a plan to get your bloodwork done.

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.