My Experience with ART: Part I
For years I’ve been interested in restorative and rehabilitative techniques. Whether it be something in the “do it yourself” category such as foam rolling, or something a bit more invasive like dry needling (a technique used by doctors of physical therapy to release tight muscles in spasm), I'm always interested in finding out what seems to “work” and what seems to be an expensive waste of time.
One of the rehab techniques that really sparked my curiousity was ART, or Active Release Technique. Was it a fancy style of massage? Was it chiropractic manipulation? I came to find that it was a style of treatment that involved locating scar tissue in the body that is suspected of causing soft tissue restriction or dysfunction, and using a combination of manual pressure and the patient’s own movement to break up the gunk in the body and restore the tissue to proper function.
As I read more about it and talked to several patients that have had ART before, the general consensus was overwhelmingly positive. I couldn’t resist anymore and got myself an appointment with Grove Spine & Sports Care.
The Assessment/Evaluation
I came in with no urgent concerns or problems, but I knew that I had some movement dysfunction of my own. My hips are fairly tight and I will get some lower back soreness from a long day of sitting, and my left hip will bother me if I over-do it with squatting movements. I was very curious to see what kind of condition the soft tissue in my lower back and hips were in.
Just as I suspected, there was something up with my left hip. My hip flexors are both super tight, but even more so on the left side. I’ve always felt that this is pulling my spine into a less-than-optimal hyperlordodic position.
My hip external rotators on my right side were also locked up, causing me to turn my right foot out more when I stand or sit relaxed.
But the fun didn’t end there. There was junky tissue in my adductors, spinal erectors, QL, and some scarred up ligamentous tissue in my lower back.
So I proceeded to have much of this knotted up nonsense “released” by the good Doctor. The “releasing” consisted of having deep pressure applied to the restricted area, and then moving my own body in a way that would stretch the tissue against the pressure. For example, for my hip flexors, I started in a side-lying position and deep manual pressure was applied to my psoas right next to my belly button. While the pressure was maintained I had to extend my hips by throwing my top leg back and reaching up toward my head with my top hand.
I was warned that it may cause some deep burning and even a painful sensation, but I thought it just felt awesome. I was still smiling throughout the session, so I guess that puts me at a 0-1 according to this fullproof scale.
After getting my left hip flexor, right external rotator, and left adductor magnus released I got up off the table to walk around and feel out my freshly ironed out hips. I must say I was very impressed. I did a few bodyweight squats and could definitely feel the increased ease at which I dropped down to depth.
The initial evaluation and first ART session was enough to convince me that there is something magical happening here. Of course it would be naïve to assume that my experience will be the same as others, but for those of you who have some nagging soft tissue aches and pains I definitely recommend you try it out! Stay tuned for further experiences with my future ART sessions.
Mountain Climbing
A few weeks ago I was fortunate to hear Allison Levine speak. Levine has climbed the highest peak on every continent, served as team captain of the first American Women’s Everest Expedition, and skied across the Arctic Circle to the geographic North Pole. As Levine spoke I found that her approach and mentality was very similar to the messages I talk about with clients. With that in mind, below are some of the notes that I took from her speech.
Levine spoke about how it’s easier for someone to say no, then to answer questions. She spoke about the importance of asking questions to gain information and to push people for specific information. This is an important message for athletes seeking information regarding role clarity, playing time, and team motivation.
Levine talked about Junko Taibei, the first Woman to climb Mt. Everest, and how she said, “Technique and ability alone do not get you to the top—it is willpower that is the most important. The willpower you cannot buy with money or be given by others—it rises from your heart.”
In addition to willpower Levine spoke about the importance of fear by saying, “fear is ok, but complacency will kill you.” Levine talked about fear in regard to the hazardous mountain weather by saying, “storms are temporary and they don’t last forever.”
As Levine continued to talk about her experience it was clear that she valued preparation, moment-to-moment thinking, and the importance of relishing the journey over the end result. Levine’s ability to conquer some of the largest mountains in the world is a reminder that in order to conquer the most difficult challenges, we need to make sure our mind is in as good of shape as our body.
Deadlift Troubleshooting Using the Coach's Eye
Here's a clip I recently threw together using the extremely handy application, Coach's Eye. Today we are going to analyze a recent deadlift session of one of our adult clients, Conrad, and explain how we were able to use this video footage to help him take his deadlift from "good" to "better than good."
More of these "Coach's Eye Analyses" will follow on SAPTstrength in the future, should you all find them enjoyable and/or useful.
SAPT Exercise of the Week: Single-leg RDL From a Deadstop
Who wants strong glutes and hamstrings? (Everyone should be raising their hands and jumping up enthusiastically. You'll jump even higher with strong glutes....)
How else do you think Mario jumps so high?
Enter the single-leg RDL (that's Romanian deadlift. Don't ask me why the Romanian's get their own deadlift variation. Apparently they jumped on the posterior chain training first.). Now, the SL RDL is a fabulous exercise to train all those posterior muscles, and never ceases to amaze me with it's ability to produce soreness, however, sometimes balance is a bit of an issue. Many times folks aren't ready for a full SL RDL, so a progression I like is adding in the deadstop portion.
The deadstop helps a) give a definite start/end point to the movement which I've found helps people focus a bit more if they know where they're going. And b) requires the glutes to really fire to initiate the movement (no stretch-shortening cycle going on up in here!) and I like that it teaches the sometimes-lazy glutes to turn on first. A lot of people, myself included, can have lack luster glute firing abilities and tend to rely on the hamstrings and adductor magnus (poor little guy, that's why he gets strained so much, he's doing the glutes' work!) to achieve hip extension. The deadstop slows the athlete down and allows one to really think about using those wonderful cheeks instead of just blowing through the exercise any ol' way.
"Turn on," Grock says. Grunt.
Take a look:
Coaching cues:
1. Fire your glutes! How? Start squeezing your cheeks (yup, both of 'em.) before beginning to stand up. Shove the heel deep into the ground as you stand.
2. Brace your midsection. If you don't, you're going to be all over the place, wobbling and wiggling in a manner most unbecoming to a serious trainee. In addition to preventing the wobbles, a tight midsection will prevent the non-working side's hip from rising up. So this exercise doubles as a core exercise (training the anti-rotation function). Fabulous no?
I can't get enough of this song; there may or may not be spontaneous wobbling going on in SAPT. But never during the SL RDL...
3. Move from the hip. Pretend it's a two-legged deadlift. HINGE baby!
4. Drive the non-working heel to the ceiling. This will ensure the the other glute stays tight and doesn't take a coffee break.
5. Keep the shoulders down and back, think about pulling your chest up towards the ceiling, to maintain a tight arch in the lower back and prevent slumping of the shoulders. We do enough of that slumpy-slump the rest of the day. We want a strong upper back so keep them blades tight!
6. Accept that you will be sore the following day. Sorry.
Q & A: High Intensity Continuous Training
Q: Hey Steve, I came across your post on HICT with step-ups, and I was wondering if you could answer some questions I have. I am 25-year old recreational athlete trying to improve my conditioning, mainly for basketball. 1. How do you use this type of training within a program? How many times per week? Do you use it in concert with other methods of conditioning as well? And do you perform this work separate from any other training, or before/after a strength session?
2. You mentioned doing HICT via a spin bike rather than step-ups, and I have seen Joel Jamieson and Mark McLaughlin also mention this. Do you use both methods, and if so, for what purposes would you choose one over the other? What are the differences?
Thank you in advance for any answers you may have. I am new to your site and look forward to exploring it more, keep up the good work.
(Note from Steve: For those unfamiliar with HICT step-ups, it is a conditioning protocol, probably invented by Satan, in which you load up your back with an extremely heavy weight vest or backpack and do step-ups for sets of 10-20 minutes at a time. Because of the high resistance yet long duration, it develops the oxidative capacity of the fast twitch muscle fibers. Brutal yet certainly effective.)
A: Good questions! With regards to Question #1, the answer is - as typical within the sphere of strength and conditioning - "it depends." Let's break down each of your subquestions one by one:
How do you use this type of training within a program?
It depends on where the athlete currently stands with regards to his or her schedule, external stressors (ex. how many times a week is he/she practicing or competing), internal stressors (Girlfriend just break up with them? In depression because no one "Liked" their recent Facebook status?), what their physical condition looks like, and their goals. Are they currently inseason or offseason, what other "qualities" do they need to work on; for example, do they currently need to improve strength or power output? How many days a week do they have to train? Can they train 2x/day on some days but not at all on others? Answers to all the above questions will affect how to employ HICT within the program!
To simplify things a bit: If your PRIMARY goal is to improve aerobic conditioning, then you should prioritize something like HICT in your weekly training structure. Here are four different ways I recommend setting it up, depending on your schedule:
Option 1 (two-a-day workouts) - Strength or power work in the AM, and then HICT in the PM
Option 2 - HICT as a standalone training session
Option 3 - Sport practice immediately followed by HICT. The HICT would act as a pseudo "active recovery" and restorative tactic.
Option 4 - HICT and strength training in the same session. HICT would go first because your priority is aerobic conditioning. (Note: If you're someone who has a lot of strength and power to gain, you would train those qualities FIRST in the session.)
How many times per week?
One to two times per week. Begin with 1x/week, assess tolerance and recovery, and gradually increase the frequency to 2x/week.
Do you use it in concert with other methods of conditioning as well?
Yes, absolutely! While you certainly don't want to utilize everything and anything at the same time, something like HICT can certainly complement other conditioning modalities such as running or cardiac output circuits*.
To truly develop one's aerobic system, it takes more than just one or two haphazard sessions per week, or deciding to just "throw in" 10-20 minutes of aerobic training at the end of a resistance training session. I'd ensure you're undergoing some form of aerobic training 4-6 days a week, provided you remain prudent with the modalities and intensities you implement, of course.
However, don't neglect the fact that just playing basketball is aerobic training in nature! Thus, your pick-up games and competition games must be accounted for when analyzing your total volume of training in a given week.
*Note: These are actually one of my favorite methods of developing the aerobic energy system during the initial phases of training and/or during periods in which one has many competing demands outside the gym walls, as the risk of overreaching is extremely low.
And do you perform this work separate from any other training, or before/after a strength session?
While I touched on this a bit during the answer to your first question, let's expound a bit further here. The research is actually a bit mixed with regards to "mixing" aerobic training and strength training in the same session:
- This meta-analysis by Wilson et al. (2012) showed a loss in power when endurance training was trained concurrently with strength training, but no decline in VO2max when the endurance+strength group was compared to the endurance-only group.
- This paper by Want et al. (2011) concluded that endurance training immediately followed by strength training actually INCREASED mitochondrial growth compared to endurance-only training. (Mitochondrial growth will augment the muscles' oxidative capacity, thus improving one's endurance.)
- This paper by Hawley showed that conditioning before strength training blunts the anabolic effect of strength training, while conditioning after strength traning leads to greater amounts of inflammation and protein degradation.
(Note: Credit to Patrick Ward for pointing a couple of those out.)
While I obviously don't prefer to allow solely on research to dictate what I do and do not do with my athletes - after all, most research subjects are woefully untrained, along with the fact that many of the research protocols (ex. machine leg extensions for the "strength" exercise) are a far cry from what I use in the real world - it certainly still helps things to take a look at what goes on at the molecular level with human physiology.
So, what to do? Personally, I think it's ideal to separate the strength and endurance sessions completely - either by 8 hours or 24 hours - but this assumes that you have nearly every day of the week to train, and are able to fit in these sessions OUTSIDE of your practice and game schedule.
If you can't afford to split up the training sessions, then train FIRST what you want to prioritize, and then scale back the volume and intensity on the other goal. So if your goal is improved aerobic function, then do HICT first and follow it up with low volume strength training; for example, 2-3 exercises for 2-3 sets at 75-80% intensity. If your primary goal is strength, then attack your resistance training and follow that session up with HICT or a cardiac output circuit.
2. You mentioned doing HICT via a spin bike rather than step-ups.....Do you use both methods, and if so, for what purposes would you choose one over the other? What are the differences?
I primarily use step-ups with our athletes, but that is more a function of the fact that we don't have a spin bike in our facility. Not to mention, even if you do have a spin bike, it needs on the higher end of quality (ex. something you'd find in a good spin class) to be capable of cranking up the resistance so high that it's literally impossible to pedal quickly; you won't typically find these bikes sitting out in the cardio sections of gyms.
Here's a brief listing of the pros and cons of each:
Spin Bike
Pros - Less eccentric stress than a step-up, so theoretically less muscle soreness during the days following the HICT session; this also means a spin bike would probably be better suited for an active recovery and restorative tool compared to step-ups. No weight vest or heavy backpack required.
Cons - Requires access to a good spin bike. The "hunched" over position of biking forces a more flexed posture in general during the entire set: Kyphotic t-spine, shortened hip flexors, internal rotation of the shoulders, no hip extension achieved at any point (bad for glute function).
Step-Ups
Pros - No spin bike required. Achieve way more glute recruitment than on a bike, due to the glutes driving you up all the way to full hip extension at the top. Is much more of a total body workout than a spin bike as the bike will pretty much only hit the quads, but the step-ups will hammer the glutes, hamstrings, quads, not to mention the upper back+traps will be blasted during the weighted step-ups as these muscle groups have work like crazy to hold the weight vest or backpack in place.
Cons - More eccentric loading on the knees/legs when compared to a bike, so need to be more careful about where you fit them (step-ups) into the training week. Possibly worse for those with knee pain issues. Requires a heavy weight vest or large, heavy backpack.
Hope this helps! There is no doubt that HICT is certainly effective, but caution must be adhered to when planning and progressing it. Start on the low end of frequency and volume, and don't be in a rush to progress too fast too soon.
Grip, Dip, and RIP!
Obviously, we’re talking about DEADLIFTS! If you haven’t heard it before, “grip, dip and rip” typically refers to the set-up and execution of picking up heavy barbells off the ground. Grip- Grab the bar and squeeze it tight. Dip- Dip your hips down, get your back flat. RIP!- RIP that bar off the floor!
I’m a big fan of the phrase. It takes an extremely technical lift like the deadlift and boils it down to three simple words that happen to rhyme. Awesome. Of course, when teaching someone how to properly pick up heavy things, more effective cueing is going to be necessary. However, if you’ve been deadlifting for a while and your technique is in check, sometimes you need to stop obsessing over the MILLIONS of details involved in the technique and just RIP that bar off the ground and into lockout.
The Dip
Although each cue deserves a blog post of its own, what I want to talk about specifically is that crucial point between the grip and the rip. That moment immediately before you pull when you set your position can make or break your lift. So what really goes on in that short duration in your deadlift set-up?
Bracing and Setting Your Lower Back
The moment you set your hips into position is also the moment when you should be bracing as hard as you can through your abs. With your hips in place and your abs as tight as possible, you set your lower back into a neutral position to protect your spine from the high sheer and compressive forces you’re about to hit it with.
Applying Tension in the Hamstrings
Pulling your hips down into position while simultaneously flattening out your lower back will place a significant amount of tension on your hamstrings, which is a great thing to have happen right before your deadlift. By creating this pre-stretch, you will be able to take advantage of the stretch reflex that we humans so thoroughly enjoy. When the muscle spindles in your hamstrings are stimulated by the stretch they will freak out and wake up all the contractile units, who will all jump on-board the deadlifting train and say “alright boss, LET’S DO THIS!”
One thing to keep in mind regarding the pre-stretch on your hamstrings is that the longer you hold that stretched position the more the reflex potential will be diminished. Think about it in terms of another lift: what’s easier, a touch-and-go bench press or a bench press with a 3 second pause on your chest? So when you dip down into position on your deadlift and feel tight, PULL! Don’t hang out at the bottom for too long.
Setting Your Upper Back
Another key component in preparing for a nice deadlift is setting your upper back. This means shoulders down and back, sufficient t-spine extension, neck packed, and using your lats. During my “dip” on the deadlift, I also like to roll my shoulders from a shrugged position into a packed position while doing my best to extend through the t-spine. I also like to apply some external rotation torque on the bar with my hands because I feel like it helps me “turn on” my lats.
All of THAT in the Dip?!?
Yep, all of that happens in the dip. It’s a lot of detail, but as I mentioned earlier, don’t get caught up in trying to go down a HUGE technique checklist before every pull. Trust me, you’ll drive yourself crazy because you will always be able to find an aspect of the lift you didn’t do with absolute perfection. Just work on fixing a couple form issues at a time and keep on grippin’ dippin’ and rippin’!