There's one old adage that gets used quite a bit in the world of strength and conditioning and physical therapy. "If you only have a hammer, everything looks like a nail." But you know what? It's an adage because it's true!
A lot of people probably dislike me because I'm not a cut and dry, black-and-white issue guy. I won't just tell you to "do this" or "do that." I'm pretty sure that "it depends" is the correct answer to 90% of the questions I'm asked regarding corrective exercise and strength and conditioning.
I get irritated when I see people trying to go "one-size-fits-all" with fitness training. Obviously, this has implications in terms of performance and physique improvements, but because I'm such a functional anatomy geek, I need to explain how trying to jam a round peg in a square hole can lead to injuries.
You've got to make sure the training suits the trainee.
1) Forcing Deep Squatting on a Flexed Spine
In the training world, not squatting deep is sacrilegious. Many lifters have been relegated to the deep, dark corners of the Internet after posting videos of squatting only to parallel, or worse, above, and being berated by their keyboard warrior counterparts.
Unfortunately, that depth isn't really safe for everyone. Flexibility and stability limitations (outlined in my To Squat or Not To Squat newsletter) can lead to lumbar flexion (rounding) as one approaches the rock-bottom position. So, as heretical as it might sound, some people just aren't made for squatting deep.
Here's a perfect example: Omri Geva is a Cressey Performance athlete who's a member of the USA Skeleton Developmental Team. Relative to his overall body size, he has a freaky long spine, with some serious hypermobility.
I doubt there are many lifters out there who can do that in shoes, let alone barefoot.
Now, here's the thing... his long spine (and its pliability in flexing) is advantageous for his sport, which involves sprinting in a position of lumbar flexion. Take a look at him in action.
This is flexion without axial loading. However, loading his spine in flexion would quickly chew up his back. Like everyone, Omri has a certain "cut-off" point at which his spine slips out of neutral and into flexion.
Watch what happens when we take him from a 14" box height (appropriate, as it keeps him in neutral) to a 13" box, where he slips into flexion.
Remember that we want to squat to get better at our chosen sports, and enhance our quality of life. Is that extra inch of depth really going to make that big a difference in how you look? Even if it did, is the extra risk of injury worth it?
I'm all for deep squatting, but it's important to individualize squat depth for everyone.
2) Forcing Overhead Pressing on Overhead Throwing Athletes
I recently gave a presentation about training overhead throwing athletes. In it, I mentioned that I didn't use overhead presses with any of my baseball guys. When I returned home, I already had four emails from strength coaches and trainers asking me why not. They each read something like this:
"Why you don't do any overhead training with your throwing athletes? Isn't it important to maintain balance in the shoulder musculature and, by eliminating that plane of movement, are we not putting our athletes at a greater risk for injury?
If an athlete is structurally and mechanically sound in their movement, shouldn't they be okay when performing overhead movements?"
Now, if you think about it, that second question actually answers the first. I've never seen a pitcher who is "structurally and mechanically sound" in his movements, and the research has verified that.
Some key points I've mentioned in other articles:
• Compared to position players, pitchers have less scapular upward rotation at 60 and 90 degrees of abduction.(1) Upward rotation is extremely important for safe overhead activity. So, the more you throw, the more screwy your upward rotation potential gets.
• 86% of major league pitchers have supraspinatus partial thickness tears.(2)
• While the labrum provides approximately 50% of the stability in the glenohumeral joint, all pitchers have some degree of labral fraying.(3)..
• Considerable research suggests that congenital shoulder instability is one of the traits that make some pitchers better than others, as it allows for more external rotation during the cocking phase to generate velocity.(4)
• Most pitchers lack internal rotation range of motion (ROM) due to posterior rotator cuff, and possibly capsular, tightness and morphological changes to bone (retroversion). This increases the risk of anterior instability.(5)
Retroversion in action,
• Subscapularis strength is incredibly important to prevent anterior shoulder instability in the above scenario.(5) Ask any good manual therapist and they'll tell you that almost everyone you see has some degree of subscapularis shutdown.
Now, with all that said, telling an overhead throwing athlete to perform an overhead press is like giving him a 1984 Chevy Cavalier with no brakes, and sending him into the Daytona 500. It's a disaster waiting to happen.
3) Wearing Spandex Just Because You're "a Cyclist"
Summer is upon us, and here in New England that means plenty of folks with big fat rumps have taken to the roads with their bikes and their horribly inappropriate Spandex shorts.
Oh, so wrong.
If you're a competitive cyclist, triathlete, or volleyball player, then by all means, rock 'em. Also, if you're an attractive female and you have the inclination, regardless of the activity, you can rock 'em.
Oh, so right.
However, if you're using cycling to shed some pounds, you need to be as non-aerodynamic as possible – for your sake and ours. Having to stare at your supersized posterior chain when we drive around you is like living under power lines. We know something's wrong, but we can't put our finger on the extensive damage it's doing to us until it's too late.
4) Doing Dips on a Shoulder with Acromioclavicular Joint Problems
Traditionally, the acromioclavicular (AC) joint has been associated with traumatic shoulder separations, but one issue that has become more and more prominent over the past 25 years has been atraumatic osteolysis of the distal clavicle.
Interestingly, this increase parallels the increase in popularity of resistance training during that same time period. In 1982, Cahill noted that of 46 cases observed in a particular study, 45 of the subjects participated in weight training.(6)
We know that weight training is incredibly valuable, and that full ROM is crucial for long-term success. However, if you've got osteolysis, or are on your way – or if you have a history of traumatic AC joint problems – pressing exercises that pull you into full extension can be a problem.
We've seen people who've dealt with the issues, and most of them have a big history of dips and (obviously) benching in their pasts. When the problem is at its worst, benching with full ROM is painful, but dips are absolute murder. I've simply decided to avoid them for anyone who has ever had AC joint symptoms.
If you've got a bad history, cross dips off your list.
Interestingly, my experience has been that if you iron out the other related inefficiencies at the shoulder and just do partial ROM pressing (board presses, floor presses), in most cases, you'll be able to return to full ROM benching down the road, once the pain settles down. I suspect that it has a lot to do with the fact that the scapulae can be locked in place on a bench, whereas they're moving with dips.
Of course, some people struggle long-term with these issues and go the surgical route (distal clavicle resection). It's actually not too bad a surgery and the recovery is relatively quick.
5) Running to Get Fit Instead of Getting Fit to Run
If you're overweight and think that running is a safe (or effective) way of addressing that problem, you're sorely mistaken.
I present exhibits A and B, taken at this year's Boston Marathon. I was out to watch a Cressey Performance client and friend participate, and once I saw the mayhem taking place, I just had to bust out my digital camera. These videos were taken at approximately mile 6. That means these two guys still had another 20.2 miles of running ahead of them.
If you ever see me moving like this, please just put me out of my misery. And, if you move like this, you might consider doing the same... or at least implement some corrective exercise.
I'll be blunt: The overwhelming majority of people move like absolute crap. When you take a body that moves like crap, and move it like crap for an extended period of time with very little range of motion or rest – and add in ground reaction forces – you make a lot of physical therapists and orthopedic surgeons wealthy.
6) Using the Clean-Grip for Front Squats
I'm partially skewed by the fact that we work with a ton of baseball players for whom hand, wrist, and forearm health is really important, but we really don't teach the clean grip to anyone for our front squatting.
There are a lot of folks, athletes and weekend warriors, who lack the wrist flexibility to perform the lift with the proper clean grip. We want to front squat most of them from day one, so even if we wanted to work on the flexibility to eventually get to a clean grip, they'd be more comfortable with our other set-up by that time anyway.
That said, we generally teach our athletes the cross-face version where the thumbs are at the end of the knurling and there are fists – not open hands – pushing the bar back toward the neck. Don't attempt this in jeans unless you're Dave Draper and can front squat 315 butt-to-heels like it's air.
Of course, if someone comes to us already using the clean-grip, and they're comfortable, I'm fine with it. Mike Boyle has also introduced a great option with wrist straps.
Remember, as much as you might like getting hammered, you don't have to nail everything. No... wait... I mean just because you have a hammer, that doesn't mean that everything is a nail.
Each trainee is unique and needs to be treated accordingly. What works for your buddy or your coach might not work for you. Review these six steps and see what changes you may need to consider, so that you can custom-fit your training program to your body and needs.References
1. Laudner KG, Stanek JM, Meister K. Differences in scapular upward rotation between baseball pitchers and position players. Am J Sports Med. 2007 Dec;35(12):2091-5.
2. Reinold, M. (2008, June 6). Current concepts in treating the overhead athlete. Second Annual Distinguished Lecture Series in Sports Medicine in Boston, MA.
3. Andrews, JR, Carson, WG, McLeod, WD. Glenoid labrum tears related to the long head of the biceps. Am J Sports Med. 1985 Sep-Oct;13(5):337-41.
4. Bigliani, LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ. Shoulder motion and laxity in the professional baseball player. Am J Sports Med. 1997 Sep-Oct;25(5):609-13.
5. Borsa PA, Laudner KG, Sauers EL. Mobility and stability adaptations in the shoulder of the overhead athlete: a theoretical and evidence-based perspective. Sports Med. 2008;38(1):17-36. Review.
6. Cahill, BR. Osteolysis of the distal part of the clavicle in male athletes. J Bone Joint Surg Am. 1982 Sep;64(7):1053-8.