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Shoulder

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Non Traditional Tweaks to Old Time Favorites–Bonus

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Bonus:

The last four exercises I want cover are not traditional resistance training exercises, but they can have a dramatic impact on your movement, decrease discomfort, and just help make you a more awesome and higher functioning individual.

Lateral Squat– Most standard exercises are done bilaterally (2 hands or feet moving together) and in the sagittal plane of movement.  We want to make sure to also incorporate the frontal and transverse planes when training.  The Lateral Squat gets us into the frontal plane and strengthens the often neglected adductor muscles (groin/inner thigh muscles), as well as hitting the glutes in a direction they normally don’t get worked.

Crawling– Crawling is fundamental to human development.  We learn to do it before we walk or run.  We also start to lose this ability as we age.  By continuing to crawl, we can keep important neurological pathways working, as well as strengthen our core, upper body, and legs in a relatively low stress way.

Get Ups– The best-known form of this exercise is the Turkish Get Up.  However, it doesn’t need to be that complicated or technical.  Simply lying on the floor and getting up a variety of different ways can go a long way in maintaining core strength, and whole-body mobility.

Farmers or Suitcase Carry– The Farmers and Suitcase Carry are great tools for building a stronger gait, improving grip strength, core strength, and stability.  The Suitcase Carry, because of its asymmetrical loading, adds a great anti-lateral flexion component that really challenges the obliques to lock down and hold the ribs in place.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 6

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Hinge:

Traditional- Barbell Deadlift

Alternatives- One Leg Deadlift or Kettlebell Swing

Both the One Leg Deadlift and KB Swing reduce the load being used.  Both have less shear forces going through the low back.  The One Leg Deadlift introduces a great balance component, as well as anti-rotational component to the hips.  The KB Swing introduces high velocity and power production which can’t be matched by a Barbell.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 5

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Horizontal Pull:

Traditional–Bent over Barbell Row

Alternatives–Suspension Trainer Row or Horse Stance DB Row

The Suspension Trainer Row requires only your body weight and places no external load on your lower back.  It also better activates the lats.  The Horse Stance DB Row introduces a component to the movement in a position known to reduce back pain and strengthen the core musculature.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 4

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Squats:

Traditional- Barbell Back Squat

Alternatives- ½ Racked KB Squat or Rear Foot Elevated Goblet Split Squat

Both the ½ Racked Squat and RFE Split Squat reduce load, easing the stress to the low back, hips, and knees.  The ½ Racked KB Squat introduces rotational & lateral flexion forces to the equation causing the core to work very hard to resist these forces.  The Rear Foot Elevated Goblet Split Squat leads to a more upright posture reducing shear and compressive forces on the lumbar spine.  This exercise also tends to better target the glutes and put the quad under a more stretch and larger range of motion.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 3

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Lat Pullovers:

Traditional- Flat Bench DB Pullover

Alternatives- Decline Bench KB Pullover OR Alternating DB Pullover on Table or Foam Roller

The Decline KB Pullover actually increases the range of motion of this exercise and causes the Lats and Pecs to work longer and harder.  This makes this a superior exercise and reduces load so it’s a win-win.  This version also causes your anterior core to work very hard as an anti-extension component.  The Alternating DB Pullover on Table of Foam Roller increases shoulder stability, and if using the Foam Roller, also increases stability demands of the whole body.  Both of these versions will reduce strain on the shoulder, and increase core activation.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 2

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Vertical Press:

Traditional- Barbell Military Press (Overhead Press)

Alternative- ½ Kneeling One Arm KB OH Press, One Arm One Leg KB OH Press, or Stability BB Overhead Press

Both these alternatives reduce overall system load.  This can help reduce neck, shoulder, and elbow pain. The half kneeling option adds a great core strength/stability component, while the One Leg Press adds a great balance component to the movement.  The Stability BB Overhead Press introduces instability to the bar which increases the dynamic stability demands on rotator cuff muscles.

View video of these exercises: View Video

Non Traditional Tweaks to Old Time Favorites–Part 1

In the fitness world, there are several exercises which have stood the test of time.  These movements have remained because they work, require little equipment, and give you a lot of bang for your buck. The movement patterns these exercises use are very important and you should continue to train using them throughout the duration of your life for optimal function. However, as we age, our joints lose space between them.  This makes spinal compression and shear forces more problematic in many individuals.  This decreased space in the joint also makes impingements in the hip and shoulder more likely, as well as discomfort in the knee and elbow.  When this begins to happen, many individuals just shy away from the movements all together leading to loss of strength, stability, and mobility throughout the body.  One solution we have found to this problem here at Fenton Fitness is reducing overall system load by altering range of motion, balance/stability, or load placement.  In some cases, these lower load alternatives completely replace the standards and in others, they are rotated in based on client history, goals, and adaptation.  For the next few weeks, I will be giving some alternatives to some traditional exercises.

Jeff Tirrell, CSCS, CSFC, Pn1

Horizontal Press:

Traditional- Barbell Bench Press

Alternative- Alternating DB Bench Press, One Arm DB Bench Press, Stability BB Bench

The Alternating DB Press, the One Arm DB Bench, and the Stability BB Bench reduce the load you are capable of handling.  This can reduce overall stress on the shoulder, elbow, and wrist.  The Alternating Press has the added benefit of greater stability demands on the shoulder which better strengthens the rotator cuff musculature while the One Arm Press introduces some rotational forces which force the core musculature to resist the rotation.  The Stability BB Bench introduces instability to the bar which increases the dynamic stability demands on rotator cuff muscles.

View video of these exercises: View Video

The Cumulative Effect of Activity

Many people are put off from starting an exercise routine because they are overwhelmed by the time commitment they feel is necessary.  Fitness magazines, exercise experts, and everything on youtube preaches–

–30 minutes of cardio three times a week

–45 minutes of strength training twice a week

–150 minutes of exercise per week

Most of this well-intentioned advice is wrong.  Nearly everyone can derive significant benefit from short bouts of fitness activity that are performed on a consistent basis.  Walk for five minutes twice a day.  A simple routine of two strengthening exercises will take no more than five minutes.  Climb the stairs in your home three times once a day.  Practice getting up and down of the floor.  Stay consistent with a routine of short exercise bouts and you will be healthier and stay independent for a lifetime.

More research has demonstrated the beneficial effect of short exercise sessions interspersed throughout the day.  Read the March 28, 2018, New York Times article by Gretchen Reynolds, Those 2-Minute Walk Breaks?  They Add Up.  View the article: https://www.nytimes.com/2018/03/28/well/move/walking-exercise-minutes-death-longevity.html

Mike O’Hara, PT, OCS, CSCS

The Coldest of Shoulders

Understanding and Not Understanding Adhesive Capsulitis

Marilyn first noticed the right shoulder pain when she was sleeping on her right side.  Over the next month, the pain became more frequent and more intense.  Her shoulder ached in the morning and after any repetitive activity.  Marilyn tried medications and ice, but the pain persisted.  After eight weeks, the pain decreased, but her shoulder movement had become restricted.  Her shoulder became so tight that she developed difficulty with activities of daily living such as fixing her hair, dressing, and bathing.  Marilyn had developed a “frozen shoulder” and the frustrating thing was that she had no idea why it had happened.

No one fully understands why a frozen shoulder develops.  For some reason, the envelope of tissue that surrounds the glenohumeral joint–the joint capsule, shortens and develops thickened adhesions or scar tissue.  The medical term is “Adhesive Capsulitis”.  This tissue restriction limits the ability of the humeral head (upper arm bone) to rotate and glide properly so your shoulder becomes tight and painful.

Most of the time, a frozen shoulder occurs with no associated injury or activity.  Frozen shoulder most commonly affects patients between the ages of 40 and 60 years old.  It is far more common in women than men.  Individuals with diabetes are at far greater risk.  If you have undergone a surgery or sustained a trauma to the shoulder, you can develop a frozen shoulder.  This is especially true if you have held the joint immobile for a period of time.  Several studies have linked Parkinson’s disease, thyroid problems, and heart disease to a greater incidence of frozen shoulder.  Patients that develop a frozen shoulder are more prone to getting it in the opposite shoulder.  Despite all of this knowledge, we continue to see many frozen shoulder patients that have none of these predisposing factors.

I would add another condition to the commonly mentioned predisposing risk factors for frozen shoulder.  In my career as a physical therapist, it has been a rarity to find a frozen shoulder patient who was strong.  From grip strength in the hand to the muscles that hold the shoulder blade on the rib cage, these patients are usually weaker than their same age and sex peers.  The strength in the unaffected arm is often as limited as the arm with the frozen shoulder.  My belief is that the most common risk factor for developing a frozen shoulder is upper body weakness.  The glenohumeral joint is a fairly unstable joint that relies on the integrity of the muscles to kept it free from trauma.  If the shoulder muscles are unable to properly control the joint, then excessive stress is transmitted to the joint capsule and an inflammatory response ensues that scars and tightens the capsule.

Physical therapy for a frozen shoulder consists of manual therapy to stretch out the shortened joint capsule and a program of exercise to restores shoulder range of motion, coordination, and strength.  Most of the time, we get the patient when the shoulder is at its tightest point and recovery takes six to ten weeks.  As with so many conditions, the patients that get to therapy earlier or before the shoulder is fully frozen do better with therapy.

In many ways, Marilyn is the typical frozen shoulder patient.  She is the correct, age, sex, and fitness level.  Further medical work up revealed that she was prediabetic and in need of some ongoing medical attention.  Marilyn was a model physical therapy patient and her shoulder function was restored with six weeks of physical therapy.

Michael S. O’Hara, PT, OCS, CSCS

Functional Stability

The last twenty years have brought about many changes in the fitness industry as our understanding of functional anatomy and evidence based training grows.  Some of these changes have been taken too far, misunderstood, or poorly applied such as stability training. When I was introduced to weights in 1998, exercise programs were built around machines which offer very little carry over to stability, core strength, and function.  Machine based training fails to maximally improve balance/stability, prevent injury, or maximize performance.  Enter functional fitness.  This concept has been popularized by strength coaches and physical therapists such as Eric Cressey, Dan John, Mike Boyle, Grey Cook, and Fenton Fitness owner, Mike O’Hara who saw a gap in training methods and optimal coaching.  Functional training includes better core stability/lumbopelvic control and more unilateral (single limb) exercises that closely mimic human movement. Unfortunately, as with many concepts in the fitness industry, this trend has been taken too far.

Many have latched onto “functional” fitness and incorporated unstable surfaces to challenge the small stabilizing musculature. This gives the illusion of strength and function, but as world renowned strength coach Mark RIppetoe says, these are simply “balance tricks”.  Real life doesn’t involve unstable surfaces like wobble boards, bosu balls, physioballs, etc.  This type of training highly restricts the amount of work the primary movers of the body can do, and doesn’t allow for strength adaptation to occur which should be a primary focus of any solid fitness program.

This Functional Stability series will address the best ways to improve real world function and strength while reducing injury.

Jeff Tirrell, CSCS, CSFC, Pn1

Lower Body

Split Squat

To set up for the split squat, put one foot in front of the other with the heel of the back foot off the ground. 85% of the weight should be on the front foot. An airex pad can be placed under the body for the knee to come down on when lowering to the floor. When in the bottom position of the exercise, the front knee should be in line with the toe creating a slight shin angle. Make sure to push through the front heel on the way up instead of the toe. This exercise can be made easier by holding onto a railing, or can be made harder by adding weight such as a kettlebell in a goblet hold. The split squat displays greater hamstring, external oblique, and gluteus medius muscle activity than the back squat, but less quadriceps muscle activity.

RFE Split Squat: RFE stands for “rear foot elevated”. With this variation of the split squat, set up with the back foot elevated on a bench or a padded stand created for this exercise. An airex pad can be used under the knee if necessary. Squat down, touching the knee to the floor or airex pad.  When in this bottom position, the shin angle should be angled forward just as before, not straight up and down. Common errors include sitting too far back on the rear foot, touching the glute to the heel, or the back foot can tend to roll off the padded stand on the way up and move more onto the shin. Avoid this by putting more weight into the front leg and dropping the knee straight down instead of back. This exercise can be made more difficult by adding dumbbells in each hand, a kettlebell in the goblet, racked, or double racked position, or a barbell in the front or back position. Make sure to descend slowly, creating an eccentric load instead of dropping down fast.

FOB Hip Lift: FOB stands for “feet on ball”. Lay on the floor or table on your back and place the arms out to the side. Push down into the floor with the arms to stabilize the body. Keep the feet together and brace your abdominal muscles. Use the glutes and hamstrings to lift yourself up off the floor, making sure to keep everything tight at the top of the movement. Hold 3-10 seconds at the top and lower slowly and controlled. You can remove the arms from the floor and rest them on your stomach or behind your head to create more of a challenge.

One Leg FOB Hip Lift: Same setup as before except one leg will be used. The other leg will be pointed up to the ceiling as the other presses into the ball to lift the body. This creates more of a stability challenge.

FOB Leg Curl: This variation starts out just like the FOB hip lift, except at the top of the movement when the body is raised, the knees are bent and the ball is pulled in towards the body creating more work for the hamstrings. Keep the hips extended by activating the glutes and moving the hips upward, avoiding the tendency to bend at the hips. It should look like your hips move up and then return to a straight body position.

One Leg FOB Leg Curl: The hardest variation for the FOB series is the one leg curl. Use one leg instead of two, extending the other leg up to the ceiling. Make sure to still avoid bending at the hips in this variation as well.

One Leg Deadlift: When starting out with this exercise, it is best to just use bodyweight. Stand with 95% of your weight on one leg. Extend the arms and free leg out to a “T” position, bending the standing leg slightly. The extended leg should be reaching backwards as far as it can go.  Think about sitting into that hip just as you would during deadlifts. As this exercise becomes easier and balance is not an issue, it can be progressed by holding a kettlebell. The kettlebell should be held in the same side as the leg extending back. Reach the kettlebell straight down by the big toe; the weight should not go in front of the toe but rather by the instep of the foot. If you have progressed pass the kettlebell, two kettlebells can be used or a barbell with weight. The primary muscles being used in this exercise are the posterior leg muscles including the glutes and hamstrings.

One Leg Squat: Stand in front of a 12-18” box (start higher, and work your way to a lower box).  You will want to have 5-10# of weight to use as a counter balance (dumbbell, plate, or med ball).  Standing on only one leg, slowly lower yourself to the box.  As you descend, reach forward with the weight to help with balance.  Control the descent until your butt taps the box and then stand back up.  Work for 3-12 reps before switching legs.  Over time, try to get to a lower box so that your hip is slightly below your knee at the bottom position.

Watch video of these exercises: https://youtu.be/SqFqf81UnIk

 

 

 

 

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