Monday, December 28, 2009

35 Things I learned in 2009!

1. The Sleeper stretch is over prescribed – Mike Reinold:
When looking at the ROM of the shoulder, don’t just look at internal ROM, look at total ROM.

2. Overhead Press in the Scapula Plane – Rob Panariello:
When overhead pressing, keep your arm in the scapula plane. Think of bringing your upper arm beside your ear.

3. Make sure you have adequate upward rotation to overhead press – Rob Panariello/ Eric Cressey:
To continue on from point 2, if you are going overhead press your athletes or clients make sure they have adequate upward rotation.

4. Keep a vertical shin if you have patella-femoral pathology – Charlie Weingroff:
Keeping a vertical shin can allow athletes/client with patella-femoral pathology to effectively train their lower body in a lot of cases.

5. The hip Flexors are huge in Low Back Pain – NMT course:
This is where Positional Releases Techniques can be ideally used.

6. Mobility before Stability – Charlie Weingroff/ Gray Cook:
It is very important that all joints know their full ROM of motion. You need full joint mobility to be able to have sufficient stability. This is how we came into the world as babies. First we had mobility, and then we had to earn our stability.

7. Lumbar Flexion is NOT bad – Charlie Weingroff/ Nick Tumminello:
Lumbar flexion is not bad as a MOVEMENT, but it is still bad as an EXERCISE

8. The government don’t give a shit about what is been put into our food!

9. Muscle and Fascia are inseparable – Leon Chaitow/Judith DeLany.

10. TRX’s are well worth the investment

11. Nobody cares how you know, until they know how much you care – Mike Boyle

12. Three things to look at when someone has pain – Biomechanical, Biochemical, or Psychosocial – Chaitow/DeLany

13. The body really is one piece – Don Kelley:
I know we all know this, but this point was really driven home, when Don Kelley showed a study that showed when something is struck in between your teeth this can lead to SIJ dysfunction!!

14. Conjugate Periodization (Is it the Best Method?)

15. Nutrition drives fat loss, not exercise:
You will never work off a bad diet.

16. Grip strength is crucial to shoulder stability – Gray Cook/Brett Jones

17. Intermitted Fasting is not a bad thing – Brad Pilon

18. The Bench Press is a total Body Lift – Jim ‘Smithy’ Smith

19. Tear the floor apart with your feet when deadlifting – I can’t remember?

20. Watch out for cervical hyperextension when performing certain exercises – Eric Cressey

21. Never extend your elbow on an anterior tilted scapula – Eric Cressey

22. Pec Minors are the devil – Me!!

23. Have a system in place – Nick Winkleman

24. Kettlebells are vastly different than dumbbells and are far superior for some exercises – Me

25. Hip Lifts – Bret Contreras

26. Some people are just not built to squat – Dr. Stuart McGill

27. Shirley Sahrmann is a legend – Me
Even though I still think you need to perform soft tissue work, and other therapies (ie. Muscle Energy, Positional Release, and Myofascial Release Techniques , as well as the movement therapy that Sahrmann prescribes too.

28. Drawing in might be needed for some:
For some patients with chronic back pain, drawing in may be still very important in the early stages of rehab. Then after this initial stage you can teach them to brace (or not? Depending on who’s opinion you believe).

29. McGills 5 stages - Dr. Stuart McGill:
1. Corrective perturbed motions
2. Build Endurance
3. Build total body stability
4. Build strength
5. Build Power and agility

30. The first 30m of a 100m sprint relies on max strength, and the strength of your glutes , and your vastus group of your quads. After 30m your performance relies on the elasticity of your bi-articular muscles (hamstrings, rectus femoris, and gastrocmienus) to produce and re –use elastic energy – Klomp/Bosch.

31. Grass feed beef has just as much omega 3 content as cold water fish – Dr. Loren Cordain

32. Vitamin D is important

33. Fish Oil is important

34. Breathing dysfunctions are very common and can cause a lot of problems if left unresolved (e.g depressed immune system) – Leon Chaitow

35. High Fructose Corn Syrup is poison

RB

Sunday, December 20, 2009

Would you try to fix the Kitchen Sink?

This blog post is going to be a rant, but feck it, its my blog! I love Strength and Conditioning and all other things that go with. I love all types of therapies and rehab. I love nutrition, even though this along with business are my weakest areas,but my knowledge getting better. Sometimes though it can be so frustrating. It is so hard to get the respect that we deserve as Strength and Conditioning Coaches. Take for example a meeting I had during the week with two members of a GAA club. I gave them a presentation, and we discussed about setting up and putting in place Strength and Conditioning System within the club. Now all that’s fine but what really pissed me off was the two guys who frankly have not got a clue about Strength and Conditioning or the role of a Strength Coach, or who are not Manual Therapists, and know nothing of functional anatomy, started telling me that they designed and implemented strength workouts (not a programme) for the players last year!!

OK, so you might be like so what? Will let me ask you a question. If your kitchen sink was badly leaking water, would you try to fix your sink? No. You would get a Plummer in to fix it, because 1). You are not a Plummer, and 2). It is his JOB. This is the exact same thing. The two guys that I was talking too, thought just because they had attended something shitty workshop on weight training for their players put on by the county board that they didn’t need to get someone in to work with their players. No they decided that they knew enough after that workshop (heavy sarcasm here), to design a Strength workout (they didn’t design a programme, because a programme to me means that there some sort of periodization involved)! Instead they should have got a Strength Coach in to work with their players because 1). They are not Strength Coaches, and 2). It the Strength Coaches JOB!!!!

Who the hell do they think they are? YOU ARE NOT STRENGTH COACHES!! What will you do if Johnny cant squat, and you cant figure out why he cant squat, because you don’t realise that his ankle mobility is shit! What about when Brian does a chin up and his scapula keep going into anterior tilt, but all you see is him getting his hyperextended cervical spine over the bar. Not knowing the damage he is doing to himself ever time he does a chin up. What about Joe’s push up form? What are you going to do to fix that? What cues will give him? There are so many examples that I could use! But do you want to know why you have no answers to these questions - BECAUSE YOU ARE NOT STRENGTH COACHES!!!!!!!!!!!!!!!!!!!!!!!!

You DO NOT spend EVERYDAY reading, watching, listening, e-mailing other coaches, therapists, etc, being on well respected forums, visiting other coaches, therapists, doctors, and nutritionists. As well as spending all your hard earned money on more books, dvds, seminars, courses, and internships to further better yourself to be the best you can be. Plus you have never trained yourself, and DO NOT know what it feels like to be under the BAR! So Please I am asking you, at very least give us the same respect you would give the Plummer that fixed your sink. Let us do are jobs.

One day, one day, we will get the respect we deserve. But for now we will just keep fighting the good fight! Rant over!

Stay Strong,

RB

Thursday, December 17, 2009

A Weekend with Don Kelley


Well I am officially back in cold, wet, depressing, and miserable Ireland! Ah, its good to be home! I had been really looking forward to this weekend for a while, not because I was coming home, but because I had a 2 ½ day seminar with Don Kelley on the cervical spine, and the cranium. Don is an outstanding LMT for Tennessee, who has been teaching with NMT centre in Florida for the past 19 years. Dons excellent teaching style and sense of humour made the weekend not only extremely informative, but also extremely enjoyable.


As I stated above I was really looking forward to this seminar, but at the same time, a bit cautious as I knew that I was going to be a bit out of my comfort zone with some of the work that we were going to be doing. But everyone else in the class were in the same boat. Plus if you want to be the best got gota learn from (in my opinion Don Kelley is) the best.


Don was extremely trough with all of his presentations, and demonstrations. This made the work of the cervical and cranium far less daunting.


Friday 7-10


Don give his usually (as I have had Don as a tutor before) Friday night presentation on what we could expect for the weekend, before getting into the Anatomy of the cervical spine, and cranium. Hi give a great example of how poor posture can play a role in Tempomandibular joint (TMJ) dysfunction. Try this. Sit really tall on a chair and clench your teeth together and try to remember where your top and bottom teeth are in relation to one another. Got it. Then slightly open your so your teeth aren’t touching anymore, and allow yourself to slump forward into a forward head posture, and re-clench your teeth. If you did that right you will notice that your teeth were in a different position to one another.


Saturday 9-6


We started Saturday off with treatment of the lamina groove of the cervical spine, which we did both supine and prone. Then we moved onto the subsoccipitals. Here we concentrated on rectus capitis posterior major, minor, and obliquus capitis superior, and inferior. Again we treated these muscles in supine and prone. These muscles are highly rich with proproiceptors as the give constant feedback on the position on the head in space. Rectus capitis posterior minor actually has a connection with the dural of the spinal cord. Next up was Sternocleidomastoid (SCM). You gota love that name.


Finally we ended the with some anterior work. Up until this everything had been pretty routine, but now came the ‘out of my comfort zone part’. We treated all the muscles attachments to the hyoid bone, before moving on to longus colli and capitis. Martina if you are reading this you would have love this!! For the treatment of the longus colli and capitis you have to displace the hyoid bone, thyroid cartilage, esophagus, and your trachea laterally to make room for your one of your fingers to treat the anterior surface of you cervical vertebra. We were told repeatedly be extremely careful of the carotid artery.



Sunday 9-6


We began with treatment of the scalenes. Treating all 3 heads (posterior, middle, and anterior). We were told to be cautious of strumming from anterior to posterior (which was not advised) over the tubercles of the transverse process of the cervical when treating the scalenes as you may rub the brachial plexus against the tubercles of the transverse process.


Then we finally moved onto the cranium. Here we treated the external muscles of the TMJ, as well as treating them internally. I don’t think I will get in dept about the techniques here as I could spend all day writing about them. But we treated the superficial cranium, external aspects of the temporalis, masseter, and the pteryoids (silent p). We then went on to the styloid and mastoid processes, treating the muscles attaching to those sites, before moving onto the internal work.


This was the part of the weekend that I was looking forward to the most. Getting to stick my finger into someones mouth!!!! We treated the intraoral temporalis tendon, masseter, medial, lateral pteryoids, soft palate, and finally the tongue!


So you might be asking why would you be treating any of all the muscles I have just talked about. Well you would treat these muscles if someone has the following. Chronic headaches, blurred vision, constant sore throat, thoracic outlet syndrome symptoms, chronic tooth aches, back pain (yes even back pain) and many other symptoms that I have to go back and check my notes for.


If you feel confused by any of this imagine how I was by the end of the weekend. Even though the weekend was very intense it was also very enjoyable, thanks mainly to Don’s excellent teaching skills. I learn a hell of a lot, and takes exactly what I wanted.


I would just once again like to thank Don, and Kevin (who is our course director) for all their great work the past weekend.


Until next time folks, stay strong,


RB

Thursday, December 3, 2009

The Push Up - Lets Get It Right

Lets get one thing straight, if you cannot do at least 20 strict push ups then get away from the bench! Some exceptions would be an obese client, and maybe some female clients, but other than that I am sticking to my opening line. Every single time I see someone attempt the Push Up they, as Eric Cressey would say, butcher it! In this short post I will give you the most common mistakes with the Push Up, show you proper set up, the proper way it should be preformed, regressions, progressions, and why you should perform push ups. I have no video unfortunately as the digital camera is back home in Ireland.
Common Mistakes with the Push Up:

1). Hands not under the shoulders, for some reason they out in front on the face

2). Elbows flaring out to the sides. Not very healthy for the shoulders

3). Elevation on Scapula instead of Retraction on the eccentric (downward) phase of the push up

4). Chin Poking forward instead of been tucked

5). Low back and hips sinking towards the ground due to a weak anterior core, and not squeezing glutes

The Proper way to perform a Push Up:
(Note: I like to teach a bottoms up approach)

The Set Up - Getting into Position:

1). Lie flat on the ground. Bring your thumbs to your nipple line, and from there slight,y move your hands out. Your wrist should be directly under your elbow. Your upper arm should be at a 45 degree angle to your upper body. So DO NOT have the elbows flaring out to the sides.

2). Tuck your chin. Think of making a double chin. DO NOT flex the neck.

3). Brace your core (like you were going to be punched in the stomach), and squeeze your glutes. When you do this, it will prevent your hips from going into an anterior tilt and prevent you low back from sinking, as the anterior core and the glutes perform a force couple that posteriorly tilt the pelvis.

4). Push yourself to the top position. Hold your form (Chin tucked, core braced etc)

Performing the entire Push Up:

Descent:

1). Now you are at the top position. As you begin to descend, retract your scapula forceful. Think about actively pulling yourself toward the ground, so that when you are at the bottom position your shoulder blades are together.

2). Keep your Chin tucked.

3). Keep your elbows tight. Keep that 45 degree angle throughout the entire set.

4). Keep your core braced, and glutes tight (squeeze that ass :-)

5). Your chest should touch the ground, NOT you chin, head, of face!

Ascent:

1). Push mainly with the thenar eminence (outside part of your hands)

2). Keep your Chin tucked.

3). Keep your elbows tight. Keep that 45 degree angle throughout the entire set.

4). Keep your core braced, and glutes tight (keep squeezing that ass ;-)

5). Protract your scapula at the top position. Push out of your shoulder blades, so your shoulder blades move away from one another as you ascend.

6). Keep going until you perform the desired amount of reps.

Regressions for the Push Up:

- Wall Push Up if extremely weak!

- Elevate the hands on a bench or a barbell in a rack

- Assist with a band around the hips.

Progressions for the Push Up:

- Feet Elevated

- Weighted – vest, chains, or bands

- Unstables – Stability ball, Bosu, dyna disc


Why Should You Do Push Ups:

Push Ups are a great exercise for shoulder health and core stability. You get Serratus Anterior activation, which is a very important muscle in shoulder stability, and if you think about the push up is a dynamic plank, great for your anterior core.

Thats all for now folks,

Peace,
RB

Tuesday, November 24, 2009

Nutrition and Pain

Anti-Inflammory Nutrients and Herbs

I am currently reading ‘Clinical Applications on Neuromuscular Therapy – Vol 1 Upper Extremity’, and I am extremely impressed with the information in the book. I am slowly progressing through the book. This is actually one of my main course books for my Higher Diploma course in Neuromuscular Therapy (NMT).

While I was reading through chapter 7 ‘The Internal environment I came across an interesting section on treating inflammation on a muscle when healing form an acute trauma. It was mentioned in the section that fish oil, pineapple stem, and papain from the papaya plant all reduces inflammation. Remember that inflammation is a necessary process of the healing process, so never try to eliminate inflammation, just try to reduce it. But what was interesting to me was the that the fish oil study was done back in 1986 (Moncada 1986). So it has been know for a long time that fish oil is a great supplement.

Whole body Inflammation and treatment

What also was of interest was the section on how important magnesium (Mg) and potassium are in reducing inflammation, and controlling pH levels. Low levels of Mg were linked to cardiovascular disease, atherosclerosis, hypertension and diabetes (Jing et al 1995). Barbagello et el (2003) stated:

that intracellular Mg has also been shown to be effective in modulating insulin activity ( mainly through oxidative glucose metabolism).

Barbagello et el (2003) also state:

A poor intracellular Mg concentration, as found in noninsulin-dependent diabetes mellitus (NIDDM) and in hypertension patients, may result in defective tyrosine-kinase activity at the insulin receptor level and exaggerated intracellular calcium concentrations. Both events are responsible for the impairment insulin action and worsening of insulin resistance in NIDDM and hypertension patients.

They further concluded:

We further suggest that a reduced intracellularMG concentration might be the missing link helping to explain the epidemiological association between NIDDM and hypertension.

The very next paragraph went on to talk about diet and inflammation where Seaman (2006) suggests:

We can craft a diet that is rich in foods that are know n to be anti-inflammatory .... such a diet would be free of simple carbohydrates because they drive hyperinsulinemia and the expression on syndrome X.

Seaman conclude that a hunter-gather style diet would be the diet prescription for people with chronic disease and inflammation.

Within the following paragraph it is discussed how non-steriod anti-inflammatory drugs (NSAIDs) can be harmful to the body, and the authors (Chaitow and DeLany) are strongly of the opinion that other, less harmful methods, should be employed in preference to NSAIDs whenever possible.

Amen!

RB

References:
Clinical Applications on Neuromuscular Therapy Vol 1 – The Upper Extremity 2nd Ed

Barbagello M, Dominguez L J, Galioto A et al 2003, Role of magnesium in insulin action, diabetes and cardio-metabolic syndrome X. Molecular Aspects of Medicine 24 (1-3): 39-52

Jing M, Folsom A, Melnick S et al 1995, Association of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness. Journal of Clinical Epidemiology 48 (7): 927-940

Moncada S 1986, Leucocytes and tissue injury, the use of eicosapentenoic acid (EPA) in the control of white blood cell activation. Wiener Klinische Wochenschrift 98 (4): 104-106

Seaman D 2006, National considerations for inflammation and pain. In: Liebenson G (ed) Rehabilitation of the spine 2nd Ed. Lippincott Williams and Wilkins, Baltimore

Sunday, November 22, 2009

I am Finished!!

Yesterday I officially finished my MBSC internship. Boy that was a fast ten weeks. So you are all probably wondering, what was it like? How much did you learn? How much money did you spend? Where did you live? Did you have transport? What is Mike Boyle really like? Was it worth it?

Well.......... Here you go

How much did I learn?
I touched on this in my previous post. I didn’t learn much from a scientific standpoint, but a lot from a real world, practical stand point. I have become a much better coach with logistics. I have become much better when dealing with varied types of personalities, and boy are there varied personalities at MBSC! So becoming better at dealing with large groups, and having to adjust things on the fly (injured athletes, space available)is what I think I learned the most

How much money did you spend?
Not much! Flights were cheap (Thank you Aer Lingus!). Housing is free. So, all you need money for is food. Ah Stop and Shop!!

Where did you live?
I lived (still am as I write this) in an apartment in Woburn. I am about a 10 minute cycle from the facility. It is a nice apartment, has everything you need. Even your own crazy neighbour from Russia!!!!Plus did I mention that it is rent free. Thanks guys!

Did you have transport?
Not when I came, but thanks to Steve Bunker I got a bike (bicycle that is, not the motor type). Thanks for that bike Bunkie, now will you please do something about those white socks you wear when you train :-)

What is Mike Boyle really like?
I also touched on this on my previous post. The man is not just a legend of a coach, but a legend of a person. He let me sit in on his mentorship. He got me a spot at the Cressey/Reinold seminar, and wait for it, he give me FSC 3.0 for free. What a guy. He is also always very approachable and always willing to give advice but also will always listen to your opinion on things. Thanks for everything Mike. Also I think it is worth mentioning Mike’s partner in crime Bob Hanson. If you ever get the chance to intern at MBSC, and if you are like me, an Irish F-bomb, and strength and conditioning nerd who will work hard, you will love Bob Hanson, because he will look after you. He is truly a great guy.

Was it worth it?
Yes.

I am not heading back home for another two and a half weeks. So I hope to get some more time with John Pallof. I also hope to get to BU with Mike. Got to keep learning baby! Everyday!

RB

Monday, November 16, 2009

One down, Five to go!

Today marks the first day of my last week as an MBSC intern. I can’t believe how fast the time has gone by (Ten weeks!). It has been a worthwhile experience for sure. I meet so many great people, and made some great friendships. If I was to be completely honest I didn’t learn an awful lot science wise with regards to strength and conditioning. I would have loved to have worked with another intern (as I was the only one for most of the Fall), who was a nerd like me. Someone who I could just talk strength training and rehab with all day. In fairness Sam Dadd an MBSC employee (who was hired during my internship) is my go to nerd, so at least I had Sam for some of my internship. Plus Sam love The Kings of Leon, and Artic Monkeys is well, so we got clicked straight away!

What did I learn then?

I did learn to be a much better coach logistically. I have become a much better coach at making on the spot decisions. Nearly everyday I would have to tweak some kids program as they had a sore shoulder, back, knee, or ankle. In fact I had a client tonight come in with a broken ankle!! There would also be times when there just wouldn’t be enough turf space for a group to throw some medball throws, so you would have to come up with a comprise, such as partner medball slams. Like a lot of things in life, what you get out of something, will always depend on what you put into! I like to think that I have made the most out of my internship.

I hope to spend more time with John Pallof, Karen Wood, and Chris Larson when my internship finishes. These three are all excellent therapist that I hope to learn a lot from before I go back.

At the end of the week I will give a more detailed account of my MBSC experience. And for anyone wondering – “Robbie, what’s Mike Boyle really like?”. All I will say is LEGEND!!

PS. Kyle I hope you have checked my blog out by now ;-)

RB

Cressey/Reinold Shoulder Seminar!

First of all a big shout out to Mike Boyle for getting me a spot for this seminar. The advantages of being an MBSC intern. Thanks Mike.

Going to Cressey Performance for this seminar I expected a lot of anatomy, a lot of research, and a lot of applicable exercises that I could use with athletes. It is safe to say that I got all three. The four presentations that were given by both Eric (2 presentations), and Mike (the other 2 obliviously) were extremely informative.

Mike put the sleeper stretch into a whole new perspective. The sleeper stretch for anyone who is not familiar with is a stretch that has been prescribed by a lot of coaches who deal with overhead throwing/striking athletes (i.e baseball, tennis). Mike said that as clinicians we are not doing a good job at looking at TOTAL range of motion at the shoulder. What this means is that if you have an athlete you must add BOTH his/her external, and internal rotation to get their total shoulder range of motion. So if you have a baseball player, and I know that there isn’t many back home in Ireland, but lets just use a baseball player as our example here, who has only 65 degrees of internal rotation, but has 115 degrees of external rotation, that base player already has a total range of motion of 180 degrees, which is ok.

What Mike believes is that many clinicians have only been focusing on the internal rotation number, and automatically assume that an athlete has posterior cuff tightness, or GIRD (gleno-humeral internal rotation deficit), and will prescribed sleeper stretches for this athlete. He believes that this could be detrimental to an athlete as your are adding flexibility to something that dosen’t necessary need any more range of motion.

Mike did say that when total range of motion is out of whack that this would call for some sleeper type stretches. He cautioned that the pressure should be very slight, and that there should be no sensation in the front of the shoulder.

Mike also went on to talk about perturbation type exercises for the shoulder stability. I had talked about this briefly with John Pallof at MBSC, as he too is a firm believer in this type of training. Some very cool exercises.

What about Eric you ask?

Of course Eric had some excellent points throughout his presentations. Some of the things that I took away from them was a better understanding as to why he does not overhead press is baseball players, and how important he thinks breathing patterns are in some of his guys.
Eric won’t overhead press his baseball guys because many have such poor upward rotation patterns that overhead pressing would just lead to ugly things. I have to say that I agree with him. I found the discussion on breathing patterns very interesting as this is something that I have become very interest in ever since I attained a weekend seminar with Leon Chaitow, and begin reading his outstanding text that he co-authored with Judith DeLany – Clinical Applications of Neuromuscular Techniques Vol 1, which I am slowly progressing through.

Eric said that he was getting some of his guys to lie prone on the massage table for 2-3 minutes and focus on breathing from their diaphragm. He said that some guys were instantly increasing their shoulder internal rotation range of motion by a few degrees (I can’t remember exact number), simple by doing this. This is from the deep breathing into diaphragm helping to mobilize the thoracic spine, and as any well read strength coach, or therapist will tell you, increase t-spine mobility will lead to a better moving and healthier shoulder joint.

So, all in all a great day spent at Cressey Perfomance. I would just like to Thanks Eric, and Mike for a great Seminar, and for anyone wondering this will be coming out on DVD. I make a cameo appearance on a foam roller wearing my Dublin jumper. UP THE DUBS!! Finally I have to give a huge, huge, THANK YOU to my man Connor Ryan who picked me up on Saturday night, let me stay in his apartment, and then drove to the seminar, and drove me all the way home to Woburn. Connor you are a LEGEND!!!! Thanks again buddy.

Hello World!

I suppose I should introduce myself to the Strength and Conditioning world. My name is Robbie Bourke, I’m a strength and conditioning coach, and certified Neuromuscular therapist from Dublin, Ireland, and I am glad that you have come to my blog. I hope to achieve a high quality of information for any strength coaches, and therapist’s out there, particularly the young coaches and therapists getting into fields of Strength and Conditioning, physical therapy, and rehabilitation. I hope you enjoy!!