Lessons of the Jaw: A Few Thoughts on the Body's Intradependence
As you read this, I'm either in surgery or in the recovery room. For those who don't know, I am having lower jaw surgery to correct a severe over (also called "open bite") and cross bite. That being said, blogging might be a bit spotty (more so than usual) over the next couple weeks, but I'm going to do my best. Seeing as this surgery has been on the forefront of my mind for quite a while, I thought I'd share a bit of the physiology connections I've learned over the past year or so. It's actually pretty interesting how dependent the body is on it's collective parts. So dependent that something up in my face affects the rest of my body rather dramatically. We'll do bullet points because I really like them.
Lesson 1: Pain is sneaky. Sometimes the origin and/or cause is not where you think.
I've known I would need this corrective surgery at some point for quite a while now. About 3 years ago, I experienced severe and prolonged pain in my tempromandibular joint (TMJ), the hinge joint of your jaw that connects the lower to the upper. I didn't have the means to have surgery at the time and the pain receded a bit, so I put it on the back burner. Just over a year ago, I started having migraine/severe headaches in the front of my head that would last for days, even weeks. Medications didn't help. Then I started to have shoulder pain on my right side. This made me think something else was going on since I knew I wasn't doing anything that would aggravate my shoulder.
I popped over to this site and discovered that a tight sternocledomastoid can cause both pain in the head and shoulder. Sure enough, I had knots the size of marbles all along these muscles. Guess what? The SCM connects right up behind the ear, near the TMJ, thus a misaligned jaw (being used for thousands of reps per day) will definitely cause some tension in the poor ol' SCM.
Lesson 2: The suboccipital muscles are really, really important.
I also had pain in the base of my skull on a regular basis, thanks to irritated suboccipital muscles. I trolled around to find some information and perhaps home treatment to help manage the pain symptoms. I came across fellow strength coach, Patrick Ward's post here. Readit, seriously, it applies to everyone. It'll blow your mind how important those little muscles are to your overall health. Patrick Ward goes into the implications of tight suboccipitals and their effect down the stream, such as posture in general and neural control over postural muscles. I found it interesting that "voluntary trunk control" was one of the muscle functions affected. Guess what? I struggle with bracing my right side. I know that sounds weird, but I can not get as "tight" on the right side without really thinking about it. Might be why I have a collapsed disc to the right side?...
Lesson 3: It's seriously all connected.
Then I came across this paper (you don't have to read the whole thing unless you're super-into-science and research papers) that linked symptoms of TMJ dysfunction and jaw pain with the suboccipital muscles. Check out pages 13 (yup, I have all those symptoms, including impaired vision) I should also note that I've suffered from vertigo since I was 13, so perhaps, once my jaw/bite is corrected and those muscles are no longer strained, I might see a decrease in symptoms. Page 15 which connects hypertonic (too tight) neck muscles with TMJ muscles dysfunction and pain, and 17 describing short cervical muscles and posture and how they research has found correlations... craziness. Upper cross syndrome, a posture <--- description used by those in the health field, is either a creator of tight neck muscles or the result of tight suboccipitals. It's a bit of chicken-egg questions, but either way, they tend to coexist. So, if you have a hunched posture, try massaging the base of your skull, that might help loosen some things up!
Lesson 4: Pain eventually conquers proprioception
We recently had an in-service where we learned about the neuromuscular implications of injuries in regards to training athletes. The main point I retained was, if muscle tissue is acutely damaged, such as a sprain, or chronically irritated, such as repeated spraining of said ankle, the muscle spindles, which reside in the tendons, will no longer respond accordingly, much like Ariel responding to her father's command to stay away from land... Poorly.
Muscle spindles are proprioceptive organs that control the stretch-reflex, for example when the doctor taps your knee and your leg kicks forward a bit, the muscle spindles are rapidly stretched (when the mallet hits your patella tendon) and they respond by sending a signal to your brain to flex the quads (thus, pulling your knee into a bit of extension).
So, damaged muscle tissue, specifically the muscle spindles and especially chronically damaged tissue ("damaged" doesn't necessarily mean an acute injury, but a chronic posture, like your shoulders slumping and your neck protruding forward as you peer at the computer screen) tend to lose their ability to provide valuable feedback to the body in the form of proprioception (where your body is in space i.e. balance). Instead, pain signals are sent. This is bad on two fronts: 1) it hurts 2) lack of proprioception means loss of muscular control, be it voluntary or involuntary.
I don't know too much on how to restore muscle spindles and transfer them back to being proprioceptive and not pain oriented, but I do know that a) removing the irritaing stimulus (in my case, setting my jaw in the correct alignment) b) improving tissue quality through manual therapy (professional or at home) and c) retraining the muscles to move how they should (i.e. standing up straight instead of slouching, or going back to the ankle example, walking without a limp or favoring the ankle).
Lesson 5: Implications for training.
Another random fact, there's a correlation with a cross bite and scapular winging (the shoulder blade sticking up instead of laying flat on the rib cage). Winging impairs overhead movement, messes up the rhythm of the humerus and shoulder girdle and makes picking and lifting heavy things a bit problematic. I've done just about every exercise under the sun to fix my wing, to no avail... maybe surgery?
Anyway, as a coach, just by looking at my own situation helps me work with our athletes here at SAPT. If at first the basic, usual cues don't fix a problem, like "pulling yourself to the floor" during a push up to fix a winging scapula or "crack a walnut" to prevent knee pain during the squat, then, maybe there's an underlying issue that demands a different approach. Maybe some dedicated soft tissue work is in order to correct a nagging pain or it might be severe enough to refer out to a physical therapist or doctor. Whatever the case, if after working with an athlete diligently doesn't solve the problem, probably time to delve a bit deeper. (and check their bite! Kidding.)
When You're Feeling Beat Up
If you’ve been training for a while, you’ve surely had those days, maybe even weeks, where your joints are crankier than usual, your shoulders and back are sore, and you get out of bed to realize gravity turned it up a notch.
When you load the bar up with 70% as you work up you get confused because it’s heavier than it should be. Did you miscalculate? Is it the wrong bar? Wrong plates? Are you using 70% of your deadlift max for your single-arm bottoms-up kettlebell floor press?
When you rule out all other factors, you may come to the conclusion that you’re probably just beat up from the training you’ve accumulated. This is especially true if you’re an athlete. It’s important to train hard at practice and train hard in the weight room, but you also have to remember to take note of how your body is reacting to all of it. Here are some tips for those dark times when your body is beaten and walking up the stairs feels like max effort step-ups.
Deload
I don’t believe that everyone needs to schedule a strictly consistent deload in their programming (e.g. every 4th week) but they certainly have their place. I see more benefit in scheduling a deload with specific regards to competition. However, sometimes an unscheduled deload is necessary if you feel super banged up. Rather than stay at home drag yourself to the gym and hit a few movements with lighter weight, for a FEW sets of a FEW reps (50%-75% for 3-5 sets of 3-5). You don’t have to hit 10x10 just because you’re going light. Deload weight AND volume.
Cut Back on Assistance Work
Does your training log tell you to do 4x8 Bulgarian split squats after your back squats? Cut it to 2x8. Or 2x5. Or 0x0. Rest assured, your beloved assistance work isn’t going anywhere, so cut back on it for a session or two and hammer it hard when you come back fresh.
EAT
Eat.
Epsom Salt Bath/Contrast Shower
Try some new recovery techniques! The idea behind an Epsom salt bath (basically soaking in a tub of magnesium sulfate) is that magnesium will soak into your body through the skin, restoring a huge list of body cell functions in the muscles, nerves, and other soft tissues. Magnesium is also inhibitory to the muscle cells, which will help you relax.
Contrast showers are (in my opinion) not as relaxing. I think they are actually pretty brutal. Enjoy a few minutes of a nice warm shower, then quickly slam the dial from H to C and suffer through 30 seconds to a minute of an ice-cold blast. Repeat several times. It takes some discipline, but you will be rewarded with increased blood flow and recovery throughout your whole body.
Soft Tissue Work Whip out the foam rollers, PVC pipes, lacrosse balls, and go to town. Or pamper yourself with a visit to a reputable ART practitioner. Or do what I do and go to Brookstone to sit in one of those super massage chairs until somebody kicks you out.
With Spring sports starting up, all you athletes know what you're in for: Months of hard training, tough competition, lots of fun, and your body taking a pounding! Just keep a handful of strategies to help you dust off your shoulders and get back in the game when you get beat down. Those of you with try-outs this week, best of luck!
You're Doing It Wrong: Split Squats (lunges) and Knees Edition
I haven't done one of these posts in a while so I thought it was high time we had another "You're Doing It Wrong" post.
Diving right in, a common complaint we hear at SAPT is knee pain during split squat or lunge variations. Typically it's pain in the front of the knee, though sometimes it's on the sides as well.
*Disclaimer* Please remember that I'm not diagnosing anything and if these general fixes in this post don't help your knees feel better, I'd say there's probably an underlying issue that needs more digging either from a coach (for the easy, common problems like tight or weak glutes) or a therapist of some sort (assuming the coach refers you to someone if your pain is outside of their scope of practice).
Ok, so two of the most common errors we see during split squat/lunges are:
1. Pitching forward into the front knee with the shin angle less than 90 degrees to the floor. Typically, the front heel rises off the floor as well, thus limiting glute involvement in the movement (mostly of the front leg). Glutes don't like that; they like to be involved with exercise so don't leave them out!
2. Shifting too much of the body's weight to the back leg and crumpling into a ball of poo in the back. The front shin will often drift past 90. Again, this position takes out the glutes' involvement and puts too much emphasis in the quads. This causes more pressure to be exerted on the knee joint, which makes it cranky.
Here's a video to distinguish the two errors, followed by a correct split squat. Note that these form corrections carry over to the lunge variations as well.
So how do you do it right?
1. Keep a 70/30 weight distritbution of front to back leg.
2. Keep your front heel down and push through it (as if you were squishing a bug) as you straighten your legs.
3. Squeeze your butt and abs (hmmm.. that sounds familiar.)
4. Don't let your front knee stray over your toes. Your knees will be happier that way.
That's it! Follow those simple guidelines and split squats and your knees should work together like the Harry Potter Trio!
Friday Musings 1/18/13: Coaching the Overhead Press, Deadlift Program, Tying the Perfect Tie
No, it is indeed not Friday at the time of posting this....decided to do this round a day early.
1. Coaching the Overhead Press
There's something intrinsically satisfying about pressing a heavy weight overhead, not to mention the host of benefits it provides, provided you don't butcher it. I actually did a little Q & A on overhead pressing HERE, for those interested. Moving on...
A cue often given in the overhead press is to "push the head and body through" at the top, the goal here being to prevent the bar from drifting too far away from the body. However, I often see people woefully abuse this cue to the extreme and jut their head way too far out at the top, slipping into gross extension, especially at the cervical spine:
Those of us coaches in the crowd often experience profuse bleeding of the cornea when we see people perform a pushup with the oh-so-prolific forward head posture, so why is does it all of a sudden become a different ball game when we press vertical instead of horizontal? You can see, if I flip the above picture of Kelsey 90 degrees, where she would be in the horizontal plane:
Not a pretty "pushup" position, right?
Yes, you do want to prevent the bar drifting away from the midline of the body, but be sure to keep the head neutral - aka a packed neck - as you finish the lift at the top:
When we jut the head forward, all we essentially wind up doing is cranking on that levator scapulae - thus cementing a downward scapular rotation pattern (not ideal) - and substituting forward head posture for actual scapular upward rotation and posterior tilt, anterior core stability, shoulder flexion, and T-Spine extension.
Translation: Shoving the head forward turns you into a walking ball of fail.
Keep those glutes tight, abs engaged, ribcage down, and ideally you'll want a vertical line going through the bar, ears, and midfoot when at the top of the press.
2. High Frequency Deadlifting
Back in 2012 I wrote a post called A Little Deadlift Experiment, Part 1, in which I briefly discussed a high-frequency deadlifting plan I used to add 40 pounds to my deadlift in 4 weeks. I never ended up writing Part 2 (yes, fail on my part), but I received a number of questions, both on the blog and through email, on how it ended up.
Well, I actually only ended up doing it for another month, but I did add another ten pounds to my total during that month. Excellent. I stopped it due to the pursuit of a few other goals, but I did want to share that I've "experimented" with the program on other people and it has worked wonders.
Mark - one of my buddies, and a physical therapist - called me up last year year telling me he made a bet with his supervisor that he could eventually deadlift over 400lbs. The kicker? He only had about 4 months to do it, his deadlift 1RM was sitting right around 300lbs, and he made the dreaded Alpo Bet, a la Dan John. So he called me in hopes I could help him add 100lbs to his deadlift in a matter of a few months.
Great.
After berating him on the phone for making me responsible to help him win an absurd bet he never should have made, I gave him the very deadlift program I used.
The result? His deadlift shot up from 300lbs to 435lbs in a matter of five training cycles, leaving him the winner of the bet and relieving him from eating a can of Alpo in front of his supervisor. What?!
Keep in mind, he had over three years of solid lifting experience under his belt, so these weren't newbie gains, either.
Note: All the credit goes to Mark on this one. He worked his tail off - despite the fact that he has a very demanding schedule and was undergoing some significant "life" changes - and trusted me every step of the way with the seemingly asinine program I gave him.
I'm not going to share the program here yet though, as I may end up using it for future article or online program. Patience, patience....
3. Tying the Perfect Tie
This one's for you gents in the crowd.
Maybe I'm a bit of an anomaly here, given that I'm fortunate enough to wear t-shirts and athletic shorts to work each day, but getting ready for an event requiring a tie can be exceedingly frustrating. (Yes, you office workers in the crowd, go ahead and shake your heads in reproach, I realize I have it easy.)
Fortunately, Tim Ferriss seems to be an expert at doing any and every random task extraordinarily well, and tying ties is no exception. Here is a quick, extremely useful video on how to tie the perfect tie, every time.
It can take a couple tries, but once you get it, you're golden. Ever since employing this tactic I've been able to boast the best tie in the room at formal events. What what!
I've run out of musings for the time being, hope everyone has a great weekend.
A Tip on Coaching New Exercises
Below is a short video regarding a tip I've found extremely useful when it comes to coaching exercises, specifically when working with someone new or walking someone through an exercise that is new to them.
Let's get to it! Hopefully you find it helpful.
10 Things I'd like to Share from 2012
As I opened my computer this morning, it didn't take long to realize I had a list of non sequiturs running around my brain. As 2012 is drawing to a close, why not allow them to run around on paper, forming a random thoughts post. Here are 10 things I either remembered, learned, or simply felt like sharing from the past year: 1. Taking the time to teach an athlete to "sit into the hip" during the foundational phases of jump training in the frontal and transverse planes will do wonders for their athletic development, as they progress onward to more "advanced" stages of change-of-direction training and force transfer outside of the sagittal plane.
Notice how in the video above, I use a "soft knee" during each landing and and push my hips back to decelerate. This displays the proper utilization of the glutes and other active restraints of the hip to create "tri-planar" stability: eccentrially controlling flexion, internal rotation, and adduction of the femur upon each ground contact.
However, the video below shows how you'll typically see people perform lateral hurdle (or cone) hops. Note how I rely much more heavily on the passive supports of my body - namely, ligaments, menisci, and other joint structures - to decelerate each landing.
Many athletes will land with a "double step," or even fall over, when learning how to decelerate correctly for the first time. Investing ample time in mastering this entry-level progression will pay huge dividends later on within the realm of injury risk reduction, change-of-direction speed, and rotational power on the field.
2. I love coffee, and, as a result, one of the best parts of my day (other than a good poop) is preparing and enjoying a quality brew early in the morning. Either that, or visiting my favorite local coffee shop, Caffe Amouri, where I settle down to do computer work alongside my faithful squire, Aragorn.
The best decision I made this past year to enhance the morning experience of home-brewing coffee was to purchase a Clever Dripper to prepare my morning elixir. Some of you may recognize it as the "pour over" or "hand pour" method.
With it, you receive all the benefits of a french press - full extraction of the flavors and sugars of the bean - but without the "mud" that typically resides at the bottom of a the mug. The Clever Dripper also WAY easier to clean than a french press.
I highly recommend it for you coffee-lovers in the crowd.
3. Here's an important classification I like to use for differentiating between main lifts in and accessory lifts in program design: Any main movement can also used as an accessory movement, but not all accessory movements can necessarily be a main movement.
It may sound simple and borderline obvious, but it bears repeating for those that are unsure of how to set up their programs.
4. The wrong and right way to hip hinge during a squat. Be careful of overemphasizing the familiar "hips back" cue too much when either squatting yourself or teaching someone else how to squat, especially if an anterior-loaded squat pattern like a goblet squat or barbell front squat is being performed.
If you push your butt back too much at the start, then your body has nowhere to go but forward on the way down in order to find its center of gravity with respect to the bar position. I think it goes without saying that this is unfavorable, with regards to both safety and that whole getting stronger thing.
See the video above for a brief demonstration of what I'm referring to. The first two reps show what happens when you overdo the hip hinge at the start, and the third and fourth rep show how to properly push your hips back as you descend to the bottom.
5. I read through the Harry Potter series this year (yes, admittedly it was fantastic), and jotted down some memorable lines as I went along. Here are a few of them:
- "Indifference and neglect often do much more damage than outright dislike." ~ Dumbledore
- "If you want to know what a man's like, take a good look at how he treats his inferiors, not his equals" ~Sirius Black
- "It does not do to dwell on dreams, and forget to live." ~ Dumbledore
6. Speaking of literature, I'm currently reading A Game of Thrones, and it is spectacular, to say the least. The author, George R.R. Martin, does a phenomenal job of reeling you into the story relatively quickly, and the world he creates is a different than most fantasy stories in that he veers away from the typical character archetypes (few are totally good or wholly evil, you don't have the classic hero who overcomes impossible odds and is immune to corruption, etc.) and he breaks many of the "rules" of stereotypical fantasy.
Hint: Don't read it if you're afraid of your favorite and/or likeable characters to die.
Not to mention, Martin is an absolute master of metaphors, description, and overall wordplay. Read it, and thank me later.
And, while I've heard good things about the HBO series, it still doesn't count. Sorry. However, that still doesn't mean this picture is not awesome:
7. One of the most rewarding parts of my job, by far, is helping people to train around injuries. It's extremely humbling to have the opportunity to help countless individuals - be they just coming out of surgery or simply dealing with a "tweaked" ankle or knee - continue to get stronger despite an injury they recently received.
Below is a video of Conrad, a 64-year-old who recently underwent not his first, but SECOND, total knee replacement surgery within the past year. Instead of wallowing in misery over the fact he couldn't do lower body training for a while, he barged through the doors of SAPT, with a battering ram, asking us to prepare him for a powerlifting meet. Keep in mind this was just weeks after his total knee replacement.
We put him on a bench-specialization program, and the end result was him hitting a bench PR in an official meet.
He serves as such a great example to those - way younger than 64 years of age, mind you - who make excuses as to why they seemingly can't take time to care for their bodies.
8. The Hobbit was an excellent film. I honestly don't see how Peter Jackson, or anyone for that matter, could have possibly done a better job with it. Yeah, people are upset he's splitting it up into three parts, but to me that just shows how Jackson pays attention to detail, and wants to ensure they leave no stone unturned during the film. It also means we still have two more excellent experiences in the theater to look forward to around Christmastime.
I didn't want to read any of the reviews before I saw it, so I looked at them a couple days after seeing the movie. Upon reading just a few of them, it confirmed my notion that the opinions of movie critics are worthless and overrated.
9. When you set up for the basic plank (and its variations), choosing to go from the "bottom up" vs. the "top down" actually has significant impact on how much iliopsoas is recruited. Considering that heavy recruitment of the iliopsoas is generally unfavorable in core stability exercises, try setting up from the bottom up rather than the top down.
10. An admittedly strange and ungrounded pet peeve of mine is when people use the words "jealous" and "envy" interchangeably in conversation. They don't mean the same thing!
To clear the air: Envy generally implies a sense of covetousness or a desire for something that someone else has. Jealousy, on the other hand, relates to a sense of resentment due to rivalry or the fear of being replaced.
I readily admit I don't have grounds from which to stand upon this sense of annoyance, as I am far from a grammar expert myself, and I make grammatical errors all.the.time. but for whatever reason I can't get this one out of my head.
Note: If you enjoyed this list format, feel free to check out this post or this post that I wrote in 2011.
