Exercise and training are wonderful things. It is great to see people moving and trying to better themselves.
There are certain claims or ideas that are out there that are still being perpetuated by either professionals and/or people who may not know otherwise. Everyone is entitled to their beliefs, but today’s post is here to discuss why certain “thought viruses” must stop in order to help move the professions of physical therapy, strength and conditioning, and performance forward.
Exercise Thought Virus #1: Don’t Let Your Knees Go Over Your Toes When You Squat
I don’t know about you, but it is pretty hard not to let your knees go over your toes when you squat. This idea has been around for a long time and was most likely perpetuated with a study about the increase in patello-femoral forces with anterior (forward) tibial translation.
If increasing tibial translation aggravates a client or athlete, find another way to load that person without increasing their symptoms. But, in order to squat effectively with proper form and depth, the knees need to migrate forward.
In the case of a box squat,
There is very little to if any anterior tibial translation. This would be the only instance I can think of where there is no forward translation. In order not to fall backwards, the knees must move forward in order to counteract the weight shift posteriorly with squatting.
There are studies stating that squatting and allowing the knees to go forward is not detrimental to knee health. As long as someone can squat pain-free and with good technique, the knees should relatively be allowed to go over the toes.
Exercise Thought Virus #2: Strength Training Makes You Lose Flexibility
I don’t remember how long this one has been around for. Coaches years ago would claim that if you lifted weights, you became big and bulky and in turn would lose flexibility. The research has shown that someone’s flexibility is not hindered by someone lifting weights.
For the first 24-48 hours that DOMS (Delayed Onset Muscle Soreness) is occurring, someone may “lose” flexibility temporarily, but it is not permanent.
Many clinicians and coaches have spoken about the benefits of strength training for improving mobility.
Performing movements that consist of slow eccentric isometrics such as:
Slow Eccentric Reverse Lunges
Slow Eccentric Goblet Squats
Slow Eccentric Single Leg Deadlifts
Slow Eccentric 1-arm DB Bench
and many more can all help to improve mobility. With any of those slow eccentric movements, a pause should be incorporated at the bottom position to include the isometric portion of the lift.
Exercise Thought Virus #3: Self-Myofascial Release(SMR)/Stretching Fixes All Mobility Problems
This is still a discussion point in the rehab and performance worlds. There is one side of the debate that thinks stretching and SMR does not work whatsoever and the other side of the debate believes that is the best thing to implement into any program.
Like with most things…
SMR and stretching has it’s place in an athlete’s program. It can be a great tool to improve soft tissue tone in problematic areas. The idea that a foam roller or stretching is physically lengthening a muscle has been debated and the research has found that there is no actual tissue length changes occurring.
What is believed to be happening is that SMR and/or stretching is neuromodulating tone at the level of the Central Nervous System (CNS). With that being said, SMR and/or stretching can be a way to decrease tone in certain areas to allow for improved mobility and improved lifting and performance.
So, a well-rounded program should not just consist of SMR and/or stretching. It should consist of SMR, mobility work, motor control drills, and strength training. Consistent strength training when coupled with the other aforementioned parts can be a great way to maintain/improve mobility.
As mentioned before, there are countless movements that can incorporate slow eccentric isometrics to help teach the CNS to be able to control any “new” mobility so that it can be maintained.
Exercise Thought Virus #4: 3 sets x 10 reps
I’m not sure where the idea of 3 sets x 10 reps came from, but I figured it was an easy way to train clients and athletes and just tell them to do 3 sets x 10 reps for each exercise. Think about it, do 3 sets x 10 reps of x weight and when that becomes too easy, go up in weight and do 3 more sets x 10 reps.
The problem is that this has continued and still continues to this day in the rehab and performance worlds.
Don’t get me wrong. Athletes and clients can make gains and improvements in strength and muscular endurance with this method. If someone is very weak or recovering from a surgery, there is nothing inherently wrong with this method. Things with eventually plateau though. You can only continue to progress linearly until changes need to be made in regards to reps, sets, weight, etc.
As professions, we need to elevate ourselves away from the 3 x 10 mindset. We need to program intelligently for our athletes and clients and incorporate variations in reps, sets, weight, rest breaks, etc. I wrote a post awhile back entitled, “An End to 3 Sets x 10 reps.” Check it out here. In that blog post, I delve into ways to program for training and ways to get away from the 3 sets x 10 reps mindset.
Exercise Thought Virus #5: Theraband/Pink Dumbbells Are All That You Need
If you plan on training and/or treating athletes or clients who wish to get back to an athletic lifestyle, you are going to need more than theraband and pink dumbbells. If you have someone that comes in and they can back squat 300-400 lbs or overhead snatch a significant amount of weight, you are going to need the equipment to help rehab and train them to get back to that.
To piggyback on my previous point, there is nothing wrong with pink dumbbells and theraband. I use theraband or similar implements with some of my clients...when indicated! Someone coming off a surgery or are flared up from a recent exacerbation, these tools may be needed.
Eventually, clients need to be loaded! Whether it be with barbells, kettlebells, dumbbells, the body is resilient and in order to improve that resiliency, it needs to be challenged and loaded to withstand the demands of life and sport.
Eighty percent of people will experience low back pain at least once in their lifetime. That’s huge! Whether you are an athlete or someone who exercises to stay in shape, low back pain has been considered an epidemic.
There are many causes to low back pain and this is probably one of the reasons why so many people experience it at some point in their life. Pain, specifically low back pain, is multi-factorial.
The purpose of this post is not to claim that there is one way to fix low back pain or to help people with low back pain. Consider it more of a way to help others to optimize their life, to decrease the chances of experiencing low back pain in their life, and/or recovering from low back pain quicker.
As a society, not enough people move. Sitting has been considered the new smoking. I’d go a step further and say that “Not Moving is the New Smoking”. Whether you sit all day at work, stand all day, lay down, whatever the case may be, the body likes to move. Therefore, we should do that throughout the day.
Now, I’m not saying that you need to be moving 24/7. That is not feasible. But, change positions frequently. Sit down for 30-minutes then switch to ½ kneeling or standing and vary the positions for your body throughout the day.
Anecdotally, I’ve found that if I move more throughout the day, my back and the rest of my body feels a whole lot better.
2. Optimize Mobility
There are people out there who are stiffer than a board and don’t have low back pain and there are those who are more flexible than Gumby and have low back pain.
photo credit: hallmark.com
Photo credit: hallmark.com
The point here is that whether you have no mobility or too much than you can handle, lack of mobility in certain areas of the body can predispose someone to an increased chance for low back pain.
Areas where limited mobility can affect the low back are the hips and the thoracic spine.
Photo credit: en.wikipedia.org
Studies have shown that lack of hip internal rotation mobility has a direct correlation on the incidence of low back pain, especially in rotational athletes. If you can’t move rotate through the thoracic spine and/or hips, the one common area between those two is the low back and this is where the body is potentially going to compensate for that lack of mobility.
Drills to optimize thoracic spine mobility are:
Bench T-Spine Mobilizations
Sidelying Rib Roll
A-Frame Thoracic Spine Mobilization
Drills to optimize hip mobility are:
½ kneeling Couch and Hip Flexor Stretches
Quadruped Hip ER Mobilization
There are a multitude of other mobility drills to help improve hip and thoracic spine mobility. Working on a few can help hip and t-spine mobility and help to decrease stress on the back.
3. Core Stability AND Strength
Through my experiences, I have found that the body needs both stability AND strength. These 2 terms sometimes get lumped together to mean the same thing, but they aren’t.
Stability is “controlled mobility” as termed by Sue Falsone. It has to do with muscle timing, coordination, and precision. It isn’t about brute strength. It is about being able to control a certain position. Stability typically only requires about 20-25% of a muscle’s maximal voluntary contraction. With that being said, it doesn’t require a lot of muscular effort.
Strength is the ability to exert a certain amount of force. Whether it be holding a certain position with maximal force or lifting something from point A to point B, strength tends to run above 25% of a muscle’s maximal voluntary contraction.
The body needs both. It needs the precision to control certain positions as well as brute strength to resist forces that life throws at it.
Different core stability drills are:
½ Kneeling Chops
Different core strengthening drills are:
Stability Ball Rollouts
Incorporating both stability and strengthening drills into your training or exercise program can be an effective way to help decrease your chances of experiencing low back pain.
4. Exercise Technique
We can sit here and debate that exercise technique doesn’t matter. There are some people who think that you can deadlift with a round back, round your back or hyperextend your back in a squat, etc. and you can repeatedly do this over time and be ok.
There is another school of thought that you must have perfect technique all day, every day, whether you are in the gym squatting or deadlifting or picking up a pencil off the floor.
The answer typically lies somewhere in the middle.
Good technique is a spectrum. It is going to vary from person to person based off body type. Maintaining good technique when you train or exercise is important. I will never tell someone that lifting with poor technique is ok.
There are some people that can deadlift with some rounding in their low back, etc. and are totally fine. This is one person. This rule should not be applied to everyone. A good overarching theme is to train with good technique. With that being said, if you have a rep or two that aren’t “pretty”, your back will not explode.
This leads to my next point. You do not have to have perfect technique 24/7. You are going to have reps when you lift that don’t look as good as others. This happens to everyone! The key is to train with good technique most of the time.
On the flip side, when you are living your life, you do not have to have a perfectly neutral spine all day every day. Not allowing your back to move through flexion, extension, rotation, and lateral flexion during everyday life is no way to live either.
If you need to lift up a heavy bag of something, use good technique and lift it off the ground. But, if you have to pick up a pencil or a piece of paper from the floor, just bend down and pick it up. Training your back to never move is just as bad, if not worse than training with poor technique.
A good way to think of this is that if you are loading your body, ie. whether it be with weights in the gym or something heavy in real life, use good technique and lift it.
If you are going to pick up something simple that you dropped on the floor, don’t think about it, just go down and pick it up.
5. Listen to Your Body
Last, but not least, is listen to your body. This is one that many people don’t do and is one of the most important.
This can come in the form of having some pain/discomfort and just completely trying to push through it OR having a slight amount of pain/discomfort and completely shutting down all activity.
Each scenario is not ideal. For the 1st scenario, blindly pushing through pain is not a good idea. It’s your body’s way of telling you to adjust or change something. Pain does not always mean there is something structurally damaged. But, it is your body’s way of trying to tell you something so you can fix the situation.
For the 2nd scenario, this can cause some people to not want to move at all if they feel a slight tweak/twinge/pain/discomfort. This can be “paralyzing” and cause people to avoid and type of movement.
In either of these cases, dial back the intensity, check your form on an exercise, try a different movement, etc. The options are endless. Listen to your body and make adjustments accordingly. Not everyone is made to lift the same way or do the same exercise as everyone else. Either make an adjustment yourself or ask a professional to find the exercise or movement that is right for you.
There you have it! This was not an all encompassing list of ways to get rid of back pain. Back pain is one of the biggest epidemics in the world today. These 5 tips were just that, tips, to help you move and feel better and try to help reduce your chances of having back pain or to help you get rid of it faster.
Here I will be writing and posting about topics ranging from physical therapy, injury prevention/reduction, and strength and conditioning.