Articles Archives - Prevail Conditioning

Articles, Prevail

Introducing Prevail Conditioning Recovery Center!

Posted on by admin

Perhaps you’ve been told that in order to make improvements in your health, athletic performance, or just overall wellbeing, you should put more focus on your recovery. The idea of “train hard, recover harder” is something we strive to instill with the grand opening of our Prevail Conditioning Recovery Center. Studies have shown that doing only 30 minutes, 2-3 times per week utilizing a recovery modality is enough to instill recovery benefits. We are excited to offer our clients the following recovery modalities: 4 person infrared sauna, red light therapy, PEMF (pulse electromagnetic field), and compression therapy. Each modality brings with them a plethora of recovery benefits, some of which are listed below. We hope you’re as excited as we are to give our Recovery Center a try!

Infrared Sauna

The benefits of saunas go back thousands of years in many parts of the world for health, hygiene, spiritual, and social purposes. Infrared sauna use brings the benefits of traditional saunas, and then some. Studies have shown that frequent use (3 – 4x, 15-30 min sessions per week) can bring major health benefits, including lowering blood pressure, enhancing one’s immune system, improving circulation, pain relief, and reducing stress & anxiety. The infrared sauna available to our clients provides a true full spectrum infrared therapy, meaning near, mid, and far-infrared is being emitted during a session, all while doing so with ultra low EMF levels. Imagine getting the benefits from the sun without the harmful UV rays! Providing a full spectrum infrared therapy brings additional benefits also seen with red light therapy (see section below for more red light therapy benefits). In addition to the benefits listed above, studies have shown that infrared sauna use can improve cardiovascular health, decrease inflammation, provide low back pain relief, improve sleep, and lower the risk for dementia & Alzheimer’s disease.

Red Light Therapy

You may have heard about red light therapy as a way to increase skin elasticity and fight against the signs of aging and wrinkles, but did you know there’s also other benefits from an athletic and training standpoint? Red light therapy penetrates deep into joints and tissues, increasing oxidation and circulation for better cellular repair. At the cellular level, red light therapy penetrates deep into the mitochondria (the powerhouse of the cell) and allows oxygen to bind with an enzyme known as Cox (cytochrome c oxidase), which increases cellular energy levels primarily through the production of adenosine triphosphate (ATP). Our body is then able to use the ATP to fuel our cells and aid in recovery. These recovery benefits can occur in many different ways, such as:

The repairing of various skin conditions (psoriasis, stretch marks, age spots, wound healing, etc)
Reduction of pain & inflammation associated with tendonitis, arthritis, carpal tunnel, and osteoarthritis
Improved sleep quality due to an increase of melatonin secretion
Increased tissue recovery for delayed onset muscle soreness (DOMS)

PEMF (Pulsed Electromagnetic Fields)

PEMF has been used since the 1970’s in orthopedic settings to treat various orthopedic conditions. PEMF creates magnetic fields that increase or cause ions and electrolytes in bodily fluid and tissues to mobilize. This stimulates the tissues to rebalance and heal where necessary. At the cellular level, all cells need energy to function in order to eliminate waste, repair and regenerate, and to perform their predetermined function based on the cell type and location in the body. This is where ATP once again comes into play. Low levels of ATP can cause our cells to be sick and decrease their ability to heal and function properly. The increase in motion of ions and electrolytes increases this energy and the body’s ability to create ATP. The use of PEMF can lead to several recovery benefits including increased blood oxygenation, improved circulation and muscular function, decreased inflammation, and stress reduction. Some common ailments PEMF has been successfully used to treat include the following ailments: pain and inflammation, arthritis, osteoarthritis & osteoporosis, migraines, wound healing, tendinitis, and general body fatigue.

Compression Therapy

Compression therapy works to increase blood flow resulting in several benefits: improved circulation, reduced swelling, inflammation, and soreness, enhanced removal of lactic acid, increased flexibility & range of motion, and accelerated muscle recovery. Our compression therapy for the lower body aids in lymphatic drainage as well. It can be used as a pre workout warm-up to aid in blood flow to decrease leg stiffness, as well as post workout for the benefits just listed above. Putting on the compression legs and reclining back in one of our zero gravity recliners will make you feel refreshed and ready to attack the next workout!

Articles

Self Care of Lower Back Pain Part 4

Posted on by admin

The purpose of this article is to discuss some of the self-care practices that can prevent or address lower back pain. Lower back pain is not a general condition, but has many specific potential sources that cannot all be addressed in this article. This article will discuss self myofascial release (foam rolling) for maintaining tissue health and Stuart McGill’s Big 3 exercises for building a strong, well-rounded core.

Self myofascial release (SMR):
SMR is essentially the poor man’s massage. Massages are great for releasing knots and reducing creep. Creep is the low stretching of of muscle beyond their normal length that can come from slouching. Mike Boyle explains creep as slowly pressing your fist through a plastic bag. If you don’t apply too much pressure, the bag will stretch and retain that stretched length. Slouching does the same thing for the lower back. The muscles and connective tissue of the lumbar spine are slowly stretched and lengthen and become more dense. It was found that slouching as little as 20 minutes a day causes the ligaments of the lower back to lengthen (Boyle). The end result are lower quality muscles. SMR is especially important for the back side of your body because it reduces creep.

Importantly, SMR is perhaps the only area of strength and conditioning where “no pain, no gain” is actually true. For any SMR movement, roll out at a rate of about 1 inch per second and when you find a sensitive area hold that position while taking 3-5 deep breaths. The targeted muscle should be relaxed while rolling. If the muscle is flexed, transition to a softer tool.

Foam Roller Piriformis
The piriformis is an area I roll out daily. Put a foam roller, tennis ball, or lacrosse ball on the ground and sit down on it so pressure is applied against the butt cheek. You are looking for sensitive areas where back pocket of your pants would be located.

Other areas I like to focus on during SMR are my thoracic spine, levators, traps, quadriceps, and IT band.

Stuart McGill’s Big 3
Stuart McGill is one of the leading lower back pain researchers. If you would like more information on lower back pain, his articles are very highly regarded in the strength and conditioning community (Here is a great summary article on his system). McGill’s Big 3 movements are core exercises that increase core stability without risking your spinal health. They aren’t the movements you’ll see in the latest YouTube video on getting 6 six-pack abs or a slimmer waist, but they have the potential to build a healthier, more resilient torso.

Curl to Neutral (curl up)
The curl to neutral is similar to a sit up except the lower back stays on the ground. The purpose of the movement is to train the abs without straining the lower back like sit ups.

Side Bridge
The core is never really a massive generator of force. For most functional movements, it just transfers force generated by the lower body to the upper body. Thus, the core should be trained to remain rigid against extension and rotation. The side plank trains the core to remain rigid when a lateral force is applied. During the movement, everything should be flexed especially the hips, core, and lat of the bottom arm. For this movement it is important that the entire body remains straight (including the neck) and that the top shoulder stays back.

https://www.youtube.com/watch?v=dklb3Al6WCs&t=15s

Quadruped Position (Bird Dog)
The quadruped position is an anti-extension and anti-rotation movement. The user has to keep themselves from letting their back arch and stay balanced as their leg moves.

There are many progressions for each of McGill’s Big 3 movements depending on factors including goals, training history, injuries, and mobility limitations. Check out Prevail’s Torso Training playlist for a run through the different variations!

Torso Training Playlist

Alright! That sums up this series on lower back pain. If you read all 4 parts I am very thankful you stuck with it. I hope this information has been informative and useful. I’ve got your back! Get it?

Reference:
Stuart McGill’s Big 3

Articles

Causes and prevention of LBP from poor posture Part III

Posted on by admin

The purpose of this article is to discuss the causes and prevention of lower back pain that comes from poor sitting and standing posture. There are many ways LBP can develop from slouching and this article will focus on one source and attempt to provide an understanding of common motifs on how the body works. In Part II of this series, I talked a lot about the role of hip mobility restrictions in LBP and in this article I will focus on the role of the thoracic spine. Figure source

The thoracic spine

The thoracic spine are the middle 12 vertebrae that mostly run along the rib cage. When we slouch, the thoracic spine bends forward, putting more stress on the lower back and pushing the neck and head forward. This can lead to LBP and headaches (Alexander). Figure source

Only so many bends before it breaks

The spine is a collection of versatile joints that can generate mobility and stiffness while withstanding high compression forces. Unfortunately, the stress placed on the spine means that it is vulnerable to fatigue, and later, pain. A large portion of the prevention of LBP is respecting the fatigue lifespan of the spine by reducing the number of flexions that put the spine in a vulnerable position (McGill). Patients who repeat the flexion events that aggravate their pain, such as sitting, set themselves up for worsening pain. Degeneration of the spine is completely normal, but good posture can be the difference between getting LBP now or later.

Joint by joint perspective revisited

The thoracic spine is especially relevant to the lower back because it is the joint directly above the lumbar spine. In Part II, we discussed the joint by joint perspective of training where the lower back primarily needs to provide stability while the hips and thoracic spine should provide mobility (Rusin). The hunched over position during sitting tightens the thoracic spine, which compromises our ability to maintain a good posture (Alexander).

Improving thoracic spine mobility

The press up is a valuable corrective movement that moves the user in back extension. The press up keeps the user away from flexion and counteracts the poor posture most of us assume when sitting. The bend in the spine should be distributed throughout the spine (the lower back does not articulate that much in this plane). The glutes should be relaxed. If practical, doing work while in the press up position (supported by elbows) can be helpful!

Furthermore, stretching the thoracic spine through multiple planes of motion is also beneficial. A lying spinal rotation stretch can help the thoracic spine improve its mobility. For the spinal rotation it is important to remember the emphasis is on the thoracic spine. The lumbar spine only has a rotational range of motion of 13 degrees and most people have decent lumbar mobility. The shoulder should be placed on the ground before the hips are rotated and the emphasis is on the twisting in the chest.

Misconception Correction: Some stretches are bad for LBP

A pillar of the prevention of future LBP is removing the movement that causes pain. For most people this movement is flexion. Oddly, some LBP patients stretch their spine by curling up and pulling their knees into their chest. This reduces their pain because it activates stretch receptors in the lower back muscles, but sets the patient up for worse future pain. The stretch is a flexion event that will trigger the pain mechanism they suffer from. Beware of stretches that are quick fixes to pain.

Tune in next time for a discussion on the self-care of LBP! It will be a more practical article with a healthy array of foam rolling and corrective exercises.

Articles

Fundamentals of Lower Back Pain in Athletes Part II

Posted on by admin

This article is on the causes and prevention of lower back pain (LBP) in athletes. LBP can result from several different kinds of causes that cannot all be addressed in a single article. My goal for this article is to provide a foundational understanding of the motifs that can contribute to LBP.

Prevention is the most important component of keeping your back pain-free. The best predictor of a new injury is a previous injury. One of the founders of chiropractics, B.J. Palmer, said “The preservation of health is easier than the cure of the disease” (Palmer). For this reason, time invested in prevention will yield more benefit than time spent on rehabilitating an injury that could have been avoided.

Back pain may not be rooted in back issues. When looking at the primary needs of our joints beginning at the ankles and ascending to the shoulders they alternate between needing mobility and stability work (see table).

The alternating pattern comes from observations that joints like the ankle have a tendency to become stiff and need additional mobility work, while joints like the shoulder have a tendency to move sloppily and need stability work (Cook). Most people have good mobility in their lower back, but are poor at maintaining its stability.

The significance of the alternating pattern is that a deficit in the primary needs of the joints immediately above and below lumbar back forces the spine to compromise its ability to stabilize (Boyle, 2007). A lack of hip mobility is a common cause of LBP because it forces the lumbar spine to compensate by providing mobility. The lower back cannot provide maximal mobility and stability in the same moment.

When these errant patterns are repeated and become habits, it becomes more difficult to engage the hips without also losing a neutral spine position. A joint by joint view of training suggests that the early signs of LBP may reflect inactive hips and preventative work may be best focused on joints above and below the lower back.

The Cook Lift is a good test of whether an athlete activates their lower back when they engage their hips. Here is a video of the Cook Lift demonstrated by Peter Blumert!

https://www.youtube.com/watch?v=UAPXpx-yWpE

A good progression for the Cook Lift is a set of 8, then 10, then 12 reps.

The cause of back pain results from cumulative trauma rather than a singular event.

LBP originates from thousands of flexions of the lumbar spine which causes disc herniation at a microscopic level through nucleation and delamination (Tampier et al., 2007; McGill, 2010). These preceding events occur without giving athletes an indication a future injury is looming. An important idea is that the lumbar spine only has so many bends before it breaks (McGill, 2014). Use them wisely for essential everyday activities instead of sit-ups that place a large load on intervertebral disks (Reynolds, 2009). Simply substituting the curl-up for the sit-up takes a lot of the stress out of the back.

Movement quality and endurance are the keys to preventing LBP.

Between strength, endurance, mobility, and movement patterns, the quality of the movement patterns appears to be the most significant difference between patients with lower back injuries and asymptomatic controls (McGill, 2014). Patients with LBP lift more with their back causing unnecessary lumbar flexions. A common flawed movement pattern involves “gluteal amnesia” where athletes present with tight hips, hamstrings, and hip flexors and do not activate their glute complex to the necessary degree (McGill, 2007). These patients often do not improve with typical therapy methods because general back pain programs do not focus on developing the hips. Furthermore, the endurance of the lower back is more critical than its strength because technique is more likely to breakdown after several, light movements compared to a few heavier ones (McGill, 2007).

Misconception correction:

Balance is not stability. YouTube and gyms everywhere have a population of lifters that rely on the bosu ball (half ball) and fitness ball for their workouts. Their core argument (get it?) is that the instability of the ball provides more stability training than traditional lifts. Squatting, pressing, and rowing on the bosu ball improves balance, but does not improve spine stability (McGill, 2014). Instead, spinal stability is improved by practicing stiffening the core to allow force to be transferred through it more effectively. Practice abdominal bracing during your big lifts to improve your core stability.

Our next article will discuss lower back pain developed from sitting and standing.

Articles

Lower Back Pain Part I: Overview of the lower back anatomy and mechanics

Posted on by admin

One of my greatest fears in weightlifting is the development of chronic lower back pain. This recurring condition would transform my, and many others’, main source of strength training into a zero sum game. Regardless of level of ability, a vast majority of lifters unnecessarily develop lower back pain (LBP) due to a larger focus on increase in strength versus a focus on staying healthy. The purpose of this four part series of articles is to discuss the causes, prevention, and self-care of LBP.

Part I: Overview of the lower back anatomy and mechanics

Part II: Causes and prevention of LBP in athletes weight training

Part III: Causes and prevention of LBP in sedentary people

Part IV: Self-care of LBP

Significance:

LBP ranks third in most burdensome causes of mortality and poor health (behind ischemic heart disease and chronic obstructive pulmonary disease from smoking) — over 25% of people have experienced it in the last three months (NIH LBP Fact Sheet). Most LBP is acute and typically a result of a mechanical problem, resolving itself in a few days. About 20% of people who suffer from acute LBP eventually suffer from chronic LBP lasting over 12 weeks. Furthermore, almost one-third of patients with chronic pain are clinically depressed (Watson, 2011). Staying away from LBP is critical to staying disability free and aging healthily as described in my last article (Paras, 2017).

General Anatomy:

The lumbar spine represents the lowest five unfused vertebrae of the spinal cord. The lumbar vertebrae are the largest of the spinal column as they are built to carry the most weight while providing both stability and mobility (Davis, 2013). In between each vertebra there is a cushiony, spongy intervertebral disc that absorbs shocks to the spine. Notably, the spinal cord does not run through the lumbar spine. Instead, large nerves run through the lumbar spine and branch out in the sacrum. This includes the sciatic nerve, which has a larger diameter than most garden hoses (Eidelson, 2017)! (figure source)

Torque and reasons the lumbar spine is vulnerable:

The lower back is surprisingly mobile considering it is a long stack of discs. It allows for forward and backward bends, twists, and movements in multiple planes simultaneously. However, this mobility comes at the cost of the stability necessary to maintaining proper posture. Common types of injuries are strains (e.g. muscle tearing, ligament tearing) and herniation (i.e. damage to a intervertebral disc).

The torque placed on the lower back is extremely high due to its long lever arm. The amount of force needed to produce a rotational force is proportional to the distance of the weight from the joint and distance of the muscle’s attachment to the joint. The lower back is mechanically disadvantaged because a weight held at shoulder distance is very far away, while the lever formed by the muscle and joint is only a few centimeters long.

Therefore, the muscles of the lower back have to exert many times more force than the weight of any object it needs to support. For example, if a 180 pound person bends over 40 degrees to lift a 30 pound weight, the erector spinae muscles would need to generate 738 inch-pounds of force and experience a compressive force of 2214 inch-pounds just to maintain an isometric hold (Cornell University Ergonomics, n.d.). The massive torque placed on the lower back when lifting even light weights is one reason it is injury prone. (Figure source)

Conclusion:

The lower back is a common injury site that can develop into a source of disability. It provides stability and mobility in multiple planes, but its multi-functionality makes it vulnerable to injury. Furthermore, the lower back is mechanically disadvantaged because weights are typically held far from the hip and thus, require many pounds of exertion for every pound carried.

Tune in next time for a practical article on the causes and prevention of lower back injuries in athletes!

About the author:

Tyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine

Tyler was born and raised in Santa Barbara, California and began training at Prevail in 2016. He attended Westmont College and will be attending medical school this fall. While at Westmont he graduated Summa Cum Laude, led a student-run homeless outreach program, and volunteered with medical clinics in Mexico and Bolivia.

After Tyler’s mother was diagnosed with rheumatoid arthritis (RA), he became interested in the cellular mechanisms behind the disease. He conducted his Major Honors project at Westmont on the role of the microbiome in inflammatory arthritis and conducted summers of research at Harvard Medical School studying the role of macrophages in RA. Including his critical care clinical research at Cottage Hospital, his research has resulted in seven presentations, three at national medical conferences.

Articles

Ergonomics and Posture:Sleep and other stuff! Part 3

Posted on by admin

19
Mar

In the first installment we discussed what posture and ergonomics are from a general perspective and how to begin addressing them.

Our second installment discussed how posture is a product of habits, not exercise. Exercise can support or hinder postural change.

In this installment we deal with the “other stuff” that is typically overlooked and under discussed.

First: sleep! We need it.

Though it’s received a fair amount of press and research over the past 10 years, we constantly overlook its importance and relevance to our health, recovery, reduction of pain, body fat and weight levels, and the proverbial stiff neck.

So how should we sleep?

From a postural standpoint, we might be in a sleep posture for anywhere from 1-10 hours. Think about how we would feel if we were in a seated, slouched posture for 10 hours; it would likely cause some pain or discomfort. If we are in ill-advised postures for that long during sleep, they are likely to cause some similar effects. If, however, we set ourselves in good sleep postures, we can reduce spine and intradiscal pressures from 25-75%, allow discs to rehydrate more effectively, and muscles to rest and recover at appropriate length-tension relationships. See the picture inserted1 for some basic recommendations that assist in good sleep postures.

Although there is likely not a perfect sleep posture, here are a few items to consider that may alter or influence postures to try out:

Lower back issues: supine with a pillow under the knees
Upper back or neck issues: a supported cervical spine pillow or roll
Other Joint issues: avoid impingement or extreme range positions
Snoring/breathing issues (large decrease in sleep quality): you may need to seek a sleep professional
Brain health and recovery: side sleeping has shown some promise
Work toward good posture
Implement methods and plans to “block” or help your sleep posture
Trial positions out on weekends or vacation (when you can afford a not-so-great-night-of-sleep)

What about when we wake up? I have found this to be another commonly overlooked arena of musculoskeletal and spine health.

Caffeine and sugar
The “Bucks”
Loud and immediate noise with blaring alarms
Rushing, being late
Jamming in too much during our morning routines
Hyper speed, super intense morning workouts before work

…and the list goes on for our typical American schedules.

Well then, what is there to consider that might influence a change in the routine mentioned above?

Spine Hydration: your spine is HYPER hydrated (that’s a good thing)^2,Avoid:
- Aggressive bending in any direction for at least 60 minutes (that include cracking your neck and back and extreme spine extension or flexion)
- Prolonged sitting (try to move a little)
- Heavy lifting for at least 60 minutes
- Morning shock (alarm)
Spine Activation: get stuff “turned on” before asking it to work
- Chin Tucks before getting out of bed ⁴
- Glute Bridge before getting out of bed
Myofascial Health:
- Light and slow ROM: “Stretching”
- Plantar fasciitis??? (stuff gets tight and cold during the night)
- Full body motion/twists/turns
- Light massaging, foam rolling, LAX ball on foot
- Fascial rolling on tight areas

If you’d like to get a Biomechanical Analysis to assess your posture so you know how to integrate a proper corrective program that will support your Health, Golf, Tennis, Strength and Yoga practice, please get in contact with us a.s.a.p. so we can help!

http://yorback-5c4c.kxcdn.com/wp-content/uploads/2017/06/sleepingposture.jpg
http://buffalorehab.com/blog/3-ways-to-ruin-your-back-before-9am/
Wilke, Hans–Joachim, et al. “New in vivo measurements of pressures in the intervertebral disc in daily life.” Spine 24.8 (1999): 755-762.
http://www.drnick.ca/neck-mobilization-and-stability-program/

Articles

Ergonomics and Posture: Exercise is the solution…right?! Part 2

Posted on by admin

For: The Divot
By: Chris Ecklund, MA, CSCS, TPI, PES, USAW

In the first installment we discussed what posture and ergonomics are from a general perspective and how to begin addressing them.

As I review what these are and how they impact us all on daily basis with people, the common response I get is, “Chris, I’ll just fix my posture with my exercise program.”

Eh…maybe not.

The reality is that posture is a product of habits, not exercise.

Exercise can’t fix posture just like hard workouts won’t fix poor nutrition.

Exercise can either CONTRIBUTE to the problem or REINFORCE the good habits.

Think about it:

Average person exercises 2x/week
Average Workout (strength) = 45m
2 x 45m = 90 min / week
Average amount of other minutes during week with bad posture = 9,990

90 minute versus 9,990 minutes…who will win?

It’s simple math, really.

And, if you exercise as many do, these are the types of activities that are engaged in with the hope of creating good posture and core stability:

Do we see a theme (and maybe a problem)?

These activities are not intrinsically poor, but there should certainly be questions related to IF we do them, HOW should they be done.

Motor programming and learning is often said to take place over the course of 3,000 repetitions (we often refer to this as movement becoming muscle memory). Think of how many swings it takes to implement a new golf stroke, a new tennis serve. Posture is no different. It takes time and repetition…in every facet of life!

Furthermore, look at the great positions we commonly put our spine/discs in while we lift weights!

Check out the 220%, 275% and 210% areas highlighted by red. These are all typical workout positions. The percentages are telling us what research has found as intradiscal pressures. Said simply, the higher the number them more disc pressure exists (and perhaps more injury development). Hmmm. Hopefully it makes us think about what lifts we are doing and HOW we are doing those lifts…

Big deal (we often think). What could that lead to?

It could lead to this beauty. Ah the wonderful Upper and Lower Crossed postural distortions. Said simply: some things get short and hypertonic while others get weak and long (and maybe hypertonic or hypotonic). Basically, stuff starts to hurt because it’s at the wrong length and tension.

Question: “Chris, we just need to stretch, right?!”

Answer: “No. And stretching can make this worse, unless you are STRETCHING THE CORRECT STUFF!”

For some folks, stretching upper trapezius and hamstrings might help. But for most others, it will only reinforce the issues or even make them worse.

Remember: Posture isn’t a product of exercise. Exercise can’t fix bad posture. And, if not done well, it can definitely make it worse.

If you add STRENGTH to DYSFUNCTION then you will STRENGTHEN the DYSFUNCTION!

If you’d like to get a Biomechanical Analysis to assess your posture so you know how to integrate a proper corrective program that will support your Golf, Tennis, Strength and Yoga practice, please get in contact with us a.s.a.p. so we can help!

References:

Articles

Muscle Knockout: Muscles you won’t miss until they’re gone

Posted on by admin

The purpose of this series is to provide readers with an understanding of how stabilizing groups of muscles work. The more a client knows about how muscles work, the more they can learn from their trainers. This series aims to provide some of that fundamental knowledge.

During the final block of medical anatomy, my classmates and I learned the muscles of the arms and legs. It quickly became difficult to remember exactly what muscle did what and in the company of which other muscles. I found the most effective way to learn how muscles work is to learn about disorders that target specific muscle groups and see what symptoms present in patients.

This article focuses on the insanely interesting (to me) gluteus medius and gluteus minimus, which are knocked out in the Trendelenburg gait. Trendelenburg gait is a irregular walking pattern in which the hips sway excessively side to side due to lack of hip stability.

Key Terms:

Abduction: raising the leg to the side, away from the midline

Internal Rotation: twisting the thigh so the kneecap points towards the midline

Gluteus Medius and Gluteus Minimus at Prevail

Many at Prevail Conditioning train their gluteus medius and gluteus minimus whether they know it or not. They are primary stabilizers for walking and all single leg exercises. Many warm-ups include banded movements, like clamshells, that target the gluteus medius and gluteus maximus. Lateral band walks and single leg banded hip extension with external rotations also target the abduction and stabilizing roles of the gluteus medius and gluteus minimus.

VIDEO:

https://www.youtube.com/watch?v=Udkhn7_yxpM&list=PLQIblP9oJNhC2ftPcZZ2IY6g6wQa1FIC_&index=2

Anatomy

The gluteus medius and gluteus minimus lie deep to the gluteus maximus. Their function is to abduct and internally rotate the thigh. The gluteus medius is particularly important because it is the strongest abductor of the hip muscles. Both muscles begin at the outside of the hip and descend to the lateral, posterior side of the femur (see figure).

In life, the gluteus medius and gluteus minimus contract together whenever a step is taken. When one leg lifts to take a step, both muscles contract to keep the body balanced on the planted foot. Similarly, when one balances on one foot, the gluteus medius and gluteus minimus

Trendelenburg Gait

Trendelenburg gait occurs when the gluteus medius and gluteus minimus are weakened, meaning abduction at the hip will be weakened. Now when a step is taken, the weight of the raised leg causes that hip to drop. The body then loses stability and leans towards the raised leg. To keep from falling, the lumbar spine bends towards the planted leg (see figure and video).

In the video above, we can see that whenever the patient plants with her left foot, her left hip lurches outward, showing a weakness in the gluteus medius and gluteus minimus. This is a common pattern in runners where it can lead to knee and lower back injuries as the hip tilts from side to side every step (Davis et al, 2016).

Conclusion

The gluteus medius and gluteus minimus are essential to every step we take. They are the primary hip abductors and critical to athletes’ stability in all single leg exercises.

Sources:

Washington University Musculoskeletal Atlas

Stanford Medicine 25

Davis IS, Futrell E. Gait Retraining: Altering the Fingerprint of Gait. Physical medicine and rehabilitation clinics of North America. 2016;27(1):339-355. doi:10.1016/j.pmr.2015.09.002.

Souza RB. An Evidence-Based Videotaped Running Biomechanics Analysis. Physical medicine and rehabilitation clinics of North America. 2016;27(1):217-236. doi:10.1016/j.pmr.2015.08.006.

About the author:

Tyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine

Articles

Muscle KO: The Reason You’re Doing Scap Pushups

Posted on by admin

19
Mar

What you need to know

The serratus anterior are dagger shaped muscles that protract the scapula.
They are critical stabilizers for all pushing movements.
Scapula pushups are a corrective movement that targets the serratus anterior.

For Part II of the Muscle KO series we’ll be looking at the serratus anterior, the “boxer’s muscle”, which is incredibly important for stabilization during pushing movements. In the figure, Manny Pacquiao’s serratus anteriors are the dagger shaped muscles that run along his rib cage. The most important function of these muscles is to protract (shift forward) the scapula.

The reason scapular stabilizing muscles are so important is that the scapula does not have strong bony attachments like other bones. Instead, the weight of the scapula and arm is supported by attachments to the clavicle which attaches to the sternum. This arrangement allows for increased scapular mobility, but decreased stability. Muscles then take on stabilizing roles and, if weak, can lead to dysfunctional movement.

In cases where patients have a weak or dysfunctional serratus anterior, “winging” of the scapula is observed when they push against a wall (see figure). This is to say that loss of control of the serratus anterior leads to destabilization of the scapula and inability to brace when pushing.

At Prevail, the serratus anterior is most obviously worked in the scap pushup (see figure below). These pushups are done with locked elbows and build up the serratus anterior and improve scapular mobility. Corrective exercises like the scap pushup prepare your stabilizing muscle groups to assist in bigger lifts.

Work Cited

University of Pittsburgh School of Medicine Anatomy Course 2017

https://www.crossfitinvictus.com/wp-content/uploads/2009/11/Serratus-2.jpg

http://www.backoutofwhack.com/wp/wp-content/uploads/2012/04/boxer-muscles.jpg

https://upload.wikimedia.org/wikipedia/commons/f/f9/Protraction_Retraction.png

http://www.safeandhealthypeople.com.au/wp-content/uploads/2014/06/scapular-winging.jpg

About the author:

Tyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine

Articles

My First Powerlifting Meet

Posted on by admin

19
Mar

Introduction: There is no certainty; there is only adventure

My first powerlifting meet was a great challenge and learning experience. My goal was to get a 942 lbs. total to qualify for USA Powerlifting Collegiate Nationals in the 182 lbs. raw weight class. With five weeks to prepare, I was confident I would succeed, but realized there were many obstacles to overcome. These challenges included that I had never used a belt before, had no experience with sumo deadlifting, had just injured my elbow which had kept me from benching for a month, only high bar squat, and didn’t know how to max out a lift.

Peter was instrumental through this entire process. Without him I would have made completely wrong decisions in every step of my preparation. In fact, ever since I’ve been training with Peter it constantly amazes (and somewhat frustrates) me how he always turns out to be right whenever our opinions disagree. It’s incredible to think about how much I still have to learn about training and how my body functions.

Preparation: The chains of habit

Of my five weeks leading up to competition, weeks 1-2 were aimed at practicing squatting heavy with a belt, developing my deadlift technique, and getting my elbow well enough that I could bench pain-free. Weeks 3-5 were used to develop my warm up progressions, test my openers, and fully recover for the meet. The most challenging, and failed, part of my preparation was changing my squat depth. Powerlifters typically use a low bar squat and descend only until the crease of their hips drop below the top of their knees. I am a high bar squatter who squats far below what is required for powerlifting, which made my squat inefficient. I wasn’t able to correct this problem in training or in competition. As you can see in the picture, in my final squat at 330 lbs., my hips and even my 4 inch wide belt were below my knees. That was deep.

Competition: The man is nothing–the work is everything

I slept for 3 hours the night before the competition, got out of bed at 5:30am and got to the competition at 6:30am for equipment check. Everyone at the meet was friendly and helped me throughout the day. I spent most of the day with another first time competitor and his coach.

During my first squat attempt I was completely thrown off by the lights, the 50 people staring at me, and having to follow the judge’s commands. I squatted with a form I never use and was essentially falling forward when I completed the lift. But, I got 2 white lights and had 303 lbs. on the board. I spent the 10 minutes between attempts essentially mentally rehearsing the steps of a squat that are usually automatic for me. After mentioning the environment was affecting me the coach I was talking to said 1) it’s just like people watching you in the gym and 2) no one in the crowd knows anything about lifting so everything looks impressive to them. The next attempts at 320 lbs. and 330 lbs. were much easier.

For a first meet, lifters aim to be successful at all 9 attempts because every lift is a PR and there is no need to kill yourself. During the bench I lost my chance at going 9/9 by failing my 3rd attempt at 225 lbs., finishing with 215 lbs. on the board.

Deadlift was intense–more mentally than physically. Warming up felt normal and my opener at 382 lbs. felt fine. Then I set my next lift to 403 lbs. to set my total at 497 lbs. and qualify for nationals. My max deadlift is about 440 lbs., so 403 lbs. was going to be easy. However, when I took my attempt, the bar didn’t even leave the ground. While waiting for my next lift in the warm up room I had never felt such a singular need to have something. There was no way I was going to go home a failure. Fortunately, when the next attempt came I made the lift and finished the meet a success.

Conclusion: Art is long; life is short

I am thankful for the opportunity to compete and see how my training has prepared me thus far. It’s amazing how much I was able to learn about lifting during this process that I might have never had the chance to without completing.

About the author:

Tyler Paras – Prevail Intern

B.S. – Cellular Molecular Biology (Westmont)

Matriculating M.D. Candidate – University of Pittsburgh School of Medicine