1 part Strength, 1 part Rehab, 5 parts Uncertainty


I wonder if the team who built the great wall had musculoskeletal pain (MSP).  How about the teams that built the pyramids?  While I may never know the answer, I do know that office workers are the worst.  We all know the mumbo jumbo about how a seated posture leads to a caveman posture.  Whatever is going on with these guys we don’t need more excuses to give them.  Pretty soon, we will have “caveman” posture syndrome and all the medication to go with it.  I prefer to use, weakling behind a desk syndrome but that isn’t very PC.  But then again the mouse weights about 500g and doing anterior posterior and circumduction movements all day long tends to make for one strong deltoid.

In my reality, there is nothing more rewarding that getting people out of some serious spinal pain (except for having an ice cold Newcastle beer which New Zealand doesn’t seem to stock).  What’s better is when I get them out of pain after someone has been doing “core” exercises with them and the pain actually became worse.  In a state of humility, it’s because I have a secret agenda.  That secret agenda is that you can’t always fix a spine by doing the big three (bird dog, curl up, and side bridge).  Most (now a days) would probably agree that fixing the aberrant movement is the NUMBER ONE most important start.  For instance, if some one was bashing their head against a wall and they were complaining of a headache which of the following would you do?

A.  Strengthen their Neck
B.  Stop them from hitting their head on the wall
C.  Stretch their Neck
D. I would start with B then decide.

This article is pretty random (reckless?) and to be honest I have been trying to type something good for a few days but between patients, clients, running a wine-shop and me playing call of duty 6, this is the best I could do.  So don’t tell me it sucks.

Stop doing your stupid stretches

Being a doctor and a movement coach (personal trainer for the non-PC) I see some stupid stuff.  I remember reading from Prof. McGill, a rule of thumb for the gym, which is perfect:

“If it looks wrong, it probably is”

Now I am included in this and if I look back a few years ago, much of the stuff we were doing as kids (pun intended) was ridiculous.  TVA isolation, drawing in, rolling the spine during the descent of a back bridge, stretching the upper traps like some sort of rabid monkey… The list goes on and on.

Trainers are moving into a weird metaphysical realm of pseudo-physical medicine, while rehab specialists are moving into some weird metaphysical realm of pseudo-strength training.  What in the world is going on?  Even I get confused sometimes.  I look around and think, my God, did I miss something?  Maybe I need to attend some more muscles, meridians, myofascial train, trigger point, spray and stretch, neuromuscular technique, “you wish you were an orthopedic specialist” seminar(s).

Be Serious!

That’s what this brat girl used to say to me in 5th grade math when I use to laugh every time the teacher said the word “duty”.    All jokes aside, be serious with what you are doing.  Exercise is physical medicine.  You wouldn’t just pop pills here and there expecting a positive result.  Well maybe you would but then again that’s a whole other type of rehab.

Anyways, exercises are exercise.  There isn’t a magical combination that automatically makes you a body-builder or pain-free.  However, there is a magical combination called “structured intelligence”.  This involves having a game plan.

Five Ways to Organize Your Training:

  1. Know where you are at.
  2. Know where you are going
  3. Proper Progression
  4. Proper Understanding
  5. Follow Through

You’re not going to get where you are going if you don’t know where you are to begin with.

It’s important to understand where you are strength-wise at the moment for two major reasons.

  1. So you can determine what you might need to work on
  2. So you can reflect on where you came from

Don’t just jump onto the bench press one day and think you are going to start cranking away at a weight you saw Ronnie Coleman lifting on YouTube.  It’s been what, five years since you exercised last?  Yeah, well get assessed by a competent health care provider and figure out what needs to be added or removed from your routine.  It doesn’t mean you have to do boring corrective exercise all day long, it just means that what you do, you need to do right.  You can also look back with a proper starting point and realize the progress you are making or have made.

Knowing where you’re going is systematically and equally important.  Have a vision.  You always hear that for life and for business, well now have it for your training.  Don’t just expect to put on a Richard Simons DVD and “get fit”.  That is not training; in fact it may just be “anti-training”.  Anti-training not only affects you but others around you.  Simply put, don’t do it.  Your goals could be a progression as such:

  1. Improve my biomechanics
  2. Improve my  endurance
  3. Improve my strength
  4. Improve my speed and agility

Which leads me into progression in itself, make sure its proper, safe, and structured.  This could be stable to unstable, bodyweight to resistance, and/or closed chain to open chain.  The take home point is do not be stupid with your organization.  Advancing your strength properly week by week in a methodical way is idea.  There are many ways to do this.  Bill Starr’s 5×5 program is one of the most common ways for people wanting to build strength through compound lifting, to get organized.  Best of all, the program is free.  The internet is littered with it.  If you don’t want to exercise and still get fit, then watch this video (don’t forget your tap shoes and perhaps some nortriptyline to fight off the nasty migraine):

Don’t You Get It?

If you don’t have a clue about the muscles you are working or why, then really what is the point?  It reminds me of cattle being led to the slaughter-house.  Lame workout programs that end up causing more damage than good and guys saying that all they need to do is bench press.  Yeah, because bench press is a whole body workout just like beer contains all the vitamins and minerals a man needs.  I first read this quote on Tony Gentilcore’s site but it rings true, “the hardest person to train, is yourself”.

Take a moment and learn about some of the muscles your working on.  It doesn’t need to be specific movement diagnosis or musculoskeletal differentials; keep it simple.  But have an idea of what you are doing and why you are doing it.

Follow Through

This is as simple as doing it.  No one makes you change except yourself.  People (clinical psychologists) get paid lots of money to make people decide for change.  Perhaps you need one?  Seriously, get off your butt (if it can even be classified as that anymore, thanks Bret!) and get to work.  Find a great training partner or find a trainer.  What’s the cost of a trainer vs open heart or key-hole rotator cuff surgery?  Enough said.

The three things that have really helped me to re-motivate are:

  1. Knowing that I CAN do it.
  2. Knowing that I WILL do it.
  3. Knowing that I can do it NOW.

Can, will, and now is all you need to get you into gear.  Say it enough to yourself and you will realize that you are not actually believing it, but that its true.

-Dr. Anthony Close

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About doctoranthony
As a spinal rehabilitation specialist with over 7 years clinical experience in the areas of - Spinal Manipulative Therapy, Active & Passive Spinal Rehabilitation, Functional Movement and Orthopedic Assessment, Strength and Conditioning Coaching, Fitness Programming, Business Development, Cognitive Behavioral Therapy, Motivational Interviewing and Consultancy - you can feel safe knowing that I understand the worry and concern surrounding spinal pain. This is why self-efficacy lies at the heart of my practice. For more info: nz.linkedin.com/in/anthonyclose

One Response to 1 part Strength, 1 part Rehab, 5 parts Uncertainty

  1. Pingback: Good Reads for the Week « Bret's Blog

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