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Performance

Unlucky Me

In my sports and fitness life, I have some regrets.  I spent too much time in activities that turned out to be worthless or worse, unhealthy.  I missed some opportunities to learn new skills and have more fun.  Looking back, I would change several aspects of my fitness life.

Bad Coaches
Growing up, I had some great coaches—Dad, Coach Sharpe, Coach Boulus, Coach Ross–Thank you.   However, some of my coaches were horrible.  They had no idea what they were doing or how they should interact with young kids.  They usually had a child on the team and this was their true motivation for coaching.  They smoked, obviously did not practice what they preached in regards to exercise, and were poor role models.  I was taught not to quit on a team, but looking back, I should have opted out.  The drills we performed were often punitive.  They denied us water, gave us salt pills, and made us participate in ridiculous training exercises.  Unfortunately, many of my friends dropped completely out of organized sports at early ages because of these coaches.  I think this is still happening today.

Too Much Team and Not Enough Solo Sports
From grade school to high school, I played team sports–baseball, football, and basketball.  In retrospect, I should have tried more solo athletic activities.  I did not start playing golf until my mid forties and I really enjoy it.  I did not try snow skiing until I was in my twenties.  You can participate in these sports through an entire life span.  My big wish is to be able to play golf, tennis, or frisbee with my grandchildren.

Nautilus Stupidus
When Arthur Jones came out with the incredibly intricate “cam gear” driven Nautilus machines in 1977, I jumped in head first.  They were big, shiny, and complicated, so they had to be good for me.  The Nautilus sales pitch was that 30 minutes of intense training twice a week would turn you into a physical super hero.  I bought a membership at a Nautilus equipped gym, and spent two years wedging my body into all sixteen of these mammoth machines.  I got better at moving a lot more plates on each of the machines, but I saw no improvement in my vertical leap or performance on the basketball court.  During that two year period, I became more and more physically limited.  When my shoulders started to ache at night, I had to give up the pullover machine.  When I developed tendonitis in my knee, I had to give up the leg curl and “squat” machine.  I suffered an abdominal strain working on the “torso trainer”.  I ended my Nautilus Era limited to only six of the sixteen machines.  I learned the hard way that seated, strapped in, muscle isolation resistance training is a waste of time.

Synchronized Drowning
My body is not made to swim—I am too dense (no jokes please).  I don’t float–my body sinks like a stone.  In my early twenties, I spent six months trying to learn how to be a proficient swimmer.  I never became any better at moving horizontally through the water—just vertically.  I had great coaching, but the harder I tried, the more my shoulders hurt and my neck ached.  The sensory isolation of looking down at the line in the pool was more than I could psychologically bear.  In the future, I will spend less time on trying to master an activity that physically is inappropriate for my body type.

Road Running Era
I spent three years distance running.  My goal was to run a sub forty minute ten kilometer race time.  I liked being outside and enjoyed the camaraderie of my fellow runners.  In three years of running, my body composition changed from 195 pounds at 12% bodyfat to 175 pounds and 16% bodyfat—I got smaller and fatter.  I went from ten pull ups to three, sixty push ups to twenty two, and my strength in the weight room plummeted.  My vertical leap went down and I got pushed all over the basketball court.  I did get faster in the ten kilometer run, but the running left we weak, tight., and slow.  It took me two years to fully recover.

Michael S. O’Hara, P.T., OCS, CSCS

Lucky Me

Good or bad, you are the sum of the influences in your life.  When I read the latest and greatest research on motor control development in children and listen to the experts on sports performance and injury prevention, I realize I was very fortunate.  Some of my story may help you in fostering an optimal environment for your children.

My Father
My Dad was a high school teacher who also coached basketball and football.  We always had barbells, medicine balls, and jump ropes in the house.  We had a ladder nailed to the ceiling in the basement to climb on and a balance beam in the back yard that was three feet off the ground.  We had a swimming pool, swing sets, ropes to climb, and heavy bags to tackle and hit.  I was encouraged to play everything from football to badminton.  When I read the latest research on the development of motor control in children, I realize I was provided the ideal environment.

The Felician Sisters
In grade school, following recess, the sisters would line us up in the parking lot–no one was permitted to opt out.  They brought out a big box that Sister Ludmilla or Sister Euphrasia would stand on while using a bullhorn to lead us in calisthenics.  Six hundred kids did 20 minutes of jumping jacks, push ups, squat jumps, and lunges.  I always liked it because it was the one portion of the school day that you did not get into trouble for moving around.  As a third grader, I became pretty good at push ups and jump squats.  I do not know of a single guy or gal that grew up doing the Felician Sister Fitness program who tore an ACL or destroyed their shoulder playing sports in high school.  I have always wondered if that was coincidence, early training of neuromuscular control, or just divine intervention.

Minimal Equipment and Maximal Coaching
My high school weight room was small and poorly equipped.  In my basement were some dumbbells and a barbell.  My strength training options were limited.  As I look back, this was an enormous blessing in disguise.  It made me concentrate on the basics of strength training.  No wasted effort on decline bench press, lat pull downs, or preacher curls.  I did squats, lunges, overhead press (no bench for bench press), chin ups, push ups, and cleans.  What I did have was consistent coaching that kept me safe and motivated.  Despite all of the sports I played, I never had a major injury.  The last twenty years of sports performance research has reinforced the importance of basic movement patterns performed extremely well.  If an athlete is strong and moves efficiently, he or she is far less likely to be injured.

My Friend Frank
I met Frank when I was in pre physical therapy college classes.  Frank was an incredibly well read student of fitness and human performance.  He had been a physical education teacher, army fitness instructor, and former professional boxer.  He was nearly seventy years old when I met him and his advice was priceless.  He pulled me out of bodybuilding type training and taught me the essential components of being athletic and moving efficiently.  Now as a physical therapist listening to presentations on the latest research in strength and conditioning, I often laugh because Frank told me the same things more than thirty years ago.

Michael S. O’Hara, P.T., OCS, CSCS

Thanks Bob, I Think

Coach Bob Gajda’s Brutally Effective Training Advice

I like to pair up, triple up, and sometimes quadruple up exercise activities.  The exercises chosen are based on selected goals and performed in a circuit fashion.  I have found that this format makes the best use of available training time and is optimal for remodeling a specific area of function.  If you want to get stronger, lose bodyfat, improve coordination, or resolve a movement asymmetry, you will get there faster with using this type of training.

For most gym goers, their primary goal is changing body composition—less fat and more muscle.  For body composition goals, an extremely effective training method that utilizes a circuit style format is peripheral heart action training.

Peripheral Heart Action
In the 1960’s, Dr. Steinhaus coined the term peripheral heart action (PHA) to describe his systematic grouping of exercises to make athletes stronger and improve their anaerobic fitness.  Bob Gajda, a Chicago area strength coach from the 1970’s, popularized this style of training.  He found that PHA training made his athletes leaner, more muscular, and fitter in a shorter period of time than other forms of training.  In high school, I read many of Mr. Gajda’s articles and books on PHA and used these programs in my own training.  PHA training is attractive because it requires minimal equipment and time.  What it does require is a lot of effort.

The theory behind PHA is that you stimulate a strong systemic vascular response by selecting activities that emphasize effort in different parts of the body.  A lower extremity dominant activity is followed by an upper extremity dominant activity.  It is the opposite of bodybuilding style training of working one muscle with multiple sets and exercises.   Recent exercise science on the positive hormonal responses that speed up our metabolism and improve body composition have found the PHA method of training produces ideal results.

My two favorite PHA combinations are listed below.  Pick a weight you can perform for the specified repetitions or distance without reaching failure.  Move through the cycle with minimal rest between exercises.  When you have completed the cycle, rest for two minutes and repeat.  Start with three circuits and, as your fitness level improves, progress to four of five circuits.

PHA Kettlebell Series
1.  Kettlebell Goblet or Barbell Front Squat  x 10
2.  Pull ups, Chin ups, or Inverted rows x 10
3.  Kettlebell Swings x 10
4.  Push ups x 10

PHA Sled Series
1.  Sled Push x 25 yards.
2.  Dumbbell, Barbell, or Cable Rows x 10
3.  Sled Posterior Drag x 25 yards.
4.  Standing Barbell Overhead Press x 8

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

Toddler Fitness

Why Squatting Properly Makes Everything Better

A healthy squat pattern keeps your lumbar spine happy.  The ability to squat with strong, flexible hamstrings and gluteals keeps you lifting and carrying safely and efficiently.  If you are unable to squat, then every time you move toward the floor, you use your lumbar spine instead of the bigger and more powerful hips.  Just like the tread on a tire, you only have so many cycles of flexion in the lumbar spine.  Once you use those cycles up, the back problems begin.

If you enjoy water skiing, snow skiing, volleyball, or other lower extremity intensive recreational activities, you need a full, solid squat pattern.   If you are unable to efficiently decelerate force across all of the lower extremity joints, you are far more susceptible to injury.  The Functional Movement Screen Overhead Squat Test has become one of the best predictors we have for future injury.  Athletes that score poorly in this test get hurt more often and the injuries are more severe.

For those primarily interested in training for aesthetics, a set of loaded squats will do far more for your lower extremities than nearly any other exercise.  The metabolic boosting response from a set of twenty full depth squats is unbeatable.  Try three sets of twenty kettlebell goblet squats and let me know how you feel.

The squat exercise can be done anywhere and it requires no fancy equipment.  It is not overly complex and can be progressed with different types of exterior loading.   It builds better communication between the feet, legs, and torso than any seated machine based training and has far greater carry over to real life.

Unfortunately, due to deconditioning, injury, or a lifetime of sitting, many of us have lost any degree of squat capacity.  The good news is that regaining this pattern of motion is easy.  Listed below are some methods of retraining your squat.

Start At the Bottom
Babies learn to squat from the floor up.  As adults, we reverse this and try to relearn from the top down.  Lets go back to the baby method.  Try sitting on box or bench about sixteen to eighteen inches high.  Slide the hips to the edge and bring the feet back so the knees are bent.  Place the feet as wide as your shoulders.  Lean forward and push the knees apart as you stand up.  Do not push up with your arms on the bench or legs.

Push the Knees Apart
Many of us have sleepy gluteals (butt muscles) and are unable to push the knees apart effectively.  The knees collapse inward into a damaging valgus position.  Try placing a resistance band around the knees and push out on the band as you rise off the box.  This will reinforce activation of the gluteus medius muscles and improve your performance.

Keep a Long Lumbar Spine
If you slouch forward when you squat, try holding a stick overhead as you rise up off the bench.  Grip the stick like you mean it and pull the shoulder blades tight across the upper back.  This will help activate the muscles surrounding your spine and pelvis that have become disassociated from their isometric stabilization duties during a squat.

Load From the Front
When loading the squat pattern, I believe it is far more beneficial to load from the front.  Front loading will make the pattern stronger and it is far safer.  The sheer force on the lumbar spine is less in a front loaded squat than a back loaded squat.  Front loading does a better job of improving squat mobility, core strength, and functional carry over.


Michael S. O’Hara, P.T., OCS, CSCS

Year 55 Scorecard

Fitness is a motivational mind game.  Setting achievable goals provides the ongoing positive reinforcement needed to keep at the fitness habit.  I no longer set as many performance goals.  As I get older (55), it is more difficult to get stronger, run faster, or jump higher.  I try to set attainable process goals.  I want to stay injury free, metabolically healthy, fight off postural deterioration, and train consistently throughout the year.  If I happen to lose some fat, get stronger or faster, it is a happy by product.  Every birthday, I do a fitness goal review and this is my year 55 fitness scorecard.

Two Hundred Training Sessions a Year
My goal is to get in 200 training sessions in a year.  I managed to fit in 212 sessions for the past year.  Setting specific attendance goals is critical.  In fitness, all of the significant long-term benefits happen when you show up on a consistent basis.

Maintain Proper Movement
This is how the downward spiral starts.  You lose some mobility in your lunge, squat, or overhead reach.  Limited mobility means you no longer can work the muscles through a full functional range of motion.  The muscles move less, atrophy takes hold, and the metabolism slows.  You gain fat more readily, and because you are weaker and heavier, you move less.  Less total movement activity leads to even less mobility.  Less muscle mass leads to far less stored glycogen and insulin sensitivity suffers.  Insulin sensitivity problems lead to diabetes, obesity, metabolic syndrome……. You get the idea.  Mobility is a key component to remaining injury free and staying metabolically healthy.  This past year finds me better in all lunge patterns, and my sprint strides no longer look like Barry Sanders on one side and Colonel Sanders on the other.

Better Single Leg Motor Control
This has been the biggest challenge and the biggest change.  My single leg balance is better and the strength in my hips and lower back has improved.  Single leg training becomes more important as you get older or have a history of injuries.  I enjoy the variety that single leg programming brings to my training.

Power Up
In 2012, I did much more power type training.  In athletics and daily survival, power is more important than strength.  As we get older, the ability to fire muscles rapidly recedes.  The last decade of research studies have shown that this trend is reversible.  My scores in the medicine ball throw and the standing long jump both improved.  I believe the drills that helped the most were the hurdle jumps and kettlebell swings.  I became more proficient in both of these exercises.  My vertical leap did not get any better, but it did not get any worse.

No Injuries
I started with a sore shoulder, but some dedicated mobility work and rehab training set that straight.  I made it through the rest of the year with no dings or dents.

No Medications
This is a goal of mine every year.  I consider it a fitness victory if I am able to go another year and not have to take a blood pressure pill, statin drug, or an anti-inflammatory. I can think of no better fitness goal than being able to eliminate medications because your health is better.

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

Multi Directional Power Training

Surge 180

We have recently added a new training tool to our physical therapy clinics.  The Surge 180 is a simple and incredibly effective training device for rehab patients.  The patient stands on the platform, grasps the handle, and works against resistance provided by three pistons.  The physical therapist can use the Surge 180 to improve many different areas of performance.

Safe and Effective Power Training
Most physical therapy patients are severely underpowered.  Not only do they need to get stronger, they must also get better at creating force quickly.   The patient can accelerate against the handle of the Surge 180, and because the overall mass is so small, there is no damaging inertia to overcome.  The mass of a weight stack, barbell, or dumbbell creates so much inertia that when you attempt to move the load quickly it creates damaging joint stress.

Multi-Directional
In life and athletics, our bodies move in all directions.  The Surge 180 handle moves forward–backward, right–left, diagonally, and into rotational movement patterns.  The handle excursion is big enough to accommodate patients of all heights.

It Demands You Stand
Rehabilitation is all about getting better at functioning in standing positions.  Patients need to learn how to efficiently transfer forces from the ground up through their body.  On the Surge 180 platform, the patient can be positioned in-line, split, straddle, or single leg stance.  Connecting the shoulder to the opposite side hip, through an active core is the essence of rehabilitation training.

Core Coordination
The coordinated performance of the team of muscles that control the hips, pelvis, and spine is more important than simple strength.  Standing, walking, climbing stairs, and carrying all require the synchronous transfer of forces from right to left and back again.  The resistance provided by the Surge 180 creates the neural feedback to fire those reciprocal motor patterns.

Michael S. O’Hara, P.T., OCS, CSCS

Suspended Push Up Animation

Atomic Push Ups Are A Fitness Blast

Your muscles work as a team to carry you through the day.  They never function alone, so training them with isolation exercise will produce less than optimal results.  The muscles over the front of the body are linked together through interwoven layers of fascia to form what Thomas Myers, in his book Anatomy Trains calls the “superficial front line”.  The shoulder girdle is slung onto the body in a basket weave pattern of muscles.  One of the best exercise activities to activate this team of muscles is the Atomic Push Up.

The guys and gals at TRX named this exercise because of the metabolic response it produces.  Although the TRX company popularized the Atomic Push Up, you can use any type of suspension trainer that has foot straps.  This exercise helps build a better connection between your shoulders and hips.  It will strengthen the push pattern and activate the frequently neglected hip flexors.  Unlike a bench press type drill, the Atomic Push Up requires core control and the active participation of your legs.  Atomic Push Ups require a great deal of neural control as you must coordinate muscles from the hands to the feet to properly perform this drill.  The Atomic Push Up is not a bodybuilding type exercise that will “sculpt your outer pectorals” but it will help you move better.

Atomic Push Up Performance
Attach the suspension trainer overhead with the foot straps eight inches off the floor.  Sit on the floor and place the feet in the straps.  Roll over and assume a push up position with the feet suspended off the floor in the straps.  The top of the suspension trainer should be directly over your feet.  Descend toward the floor, and as you push back up, pull the knees up toward your chest.  Use a steady cadence of lower down–push up–knees in–knees out.  Beginners should aim for sets of five repetitions.  Stop before the performance of the drill deteriorates.  Common faults are sagging in the middle, lack of depth during the push up, and poor head position.  For men, twenty repetitions of Atomic Push Ups is a worthy fitness goal.  For women, eight is great.

You generally do not see Atomic Push Ups performed in commercial gyms because suspension trainers are rare and this exercise is difficult.  Beginners may wish to place a mat under the torso and head in case of a sudden face plant.  You can use a pair of parallellettes if you find weight bearing on your hands is difficult.  Moving the body forward so the suspension strap is pulling you backward makes the exercise more challenging.

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

A Step Up In The Right Direction

Anterior Step Ups

Most of the lower extremity training in the gym occurs with both legs working at the same time.  Leg press, leg extensions, squats, and deadlifts all train both lower extremities simultaneously.  In life, we almost always function in a single leg, or predominantly single leg manner.  All athletic activity requires a high degree of single leg control to be proficient and remain free of injury.  Your fitness training should include activities that improve balance, proprioception, core stability, and strength while on one leg.  One of the best single leg exercises to add to your training program is step ups.

Connecting Your Lateral Subsytem
When you stand on one leg, the team of muscles that keep you upright and tall are collectively called the lateral subsystem.  They consist of the groin muscles (muscle on the inside of the thigh), the gluteus medius (outside of the hip), and quadratus lumborum (side of the spine).  These muscles must work in a coordinated fashion to keep you straight and stable.   A step up exercise places a strong demand on the lateral subsytem.  Seated machine based exercises have no effect on this essential neuromuscular interaction.

Keeping You Safe
When I start clients on step ups, the most glaring deficit is almost always single leg stance balance.  Many of these people run, bike, and regularly attend group exercise classes, yet they have very limited control when they stand on one leg.  I do not care how much weight you use on the knee extension machine or how flexible your hamstrings have become; if your balance is poor, you are at a far greater risk for a fall and/or injury.  Anterior step ups will help improve single leg stance balance.

No Squishy
Deadlifts, squats, and leg press all create spinal compression.  The anterior step up exercise creates much less in the way of compressive force on the lumbar spine.  Fitness clients and athletes with a history of lower back pain can strengthen the legs with less spinal stress.

Real Life Carry Over
There is specificity to training.  The exercises you perform in the gym must look and feel like the activities you must perform in real life.  Your performance on a step up is far more likely to carry over to real life than your performance on a leg press or leg curl machine.

Anterior Step Ups
If you perform this at home, make sure you use a stable step up box—I would not use a padded lifting bench, milk crate, or old air conditioner.  A mirror can be very useful in monitoring your performance.  Most people can start with an eight inch household step.

Stand facing the box with one foot completely on the box–from heel to toes.  When you perform a step up, use your gluteals and hamstrings to push through the foot and drive up into single leg stance.  Do not jump up on to the step by leaning over and “popping up” with the rear leg.  Bring the rear leg up to 90 degrees hip flexion, and hold a single leg stance for two counts.  Try to abolish any wobble in your single leg stance position.  Lower back down using the stance leg to control the descent.  Perform all of the repetitions on one leg and then repeat on the other leg.  If you find one leg is significantly weaker, then start with that limb first.  Perform two or three sets of eight to ten repetitions.

Master your bodyweight on the eight inch step first and only then move to a higher box.  A good goal is to move up a box height that places the top of the thigh just below parallel when the leg is placed on the box.

You can load the anterior step up many ways.  I like using a medicine ball held at chest level as the first progression of loading and then progress to using an Iron Grip plate.  For athletes the Barbell Step Up is a great functional exercise.  It is best to perform this exercise in a power rack in case you lose control of the weight.

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

Pushing Through Fitness Barriers

How Sled Pushing Can Produce Big Results

Most of us have busy schedules and limited time to exercise at the gym.  We want the most benefit possible for our time spent working out.  Sled Pushing is a high value activity that can be utilized by almost all fitness clients.

True Core Stability
How our “muscles in the middle” truly work is in a standing position with our legs in contact with the ground.  The legs are usually in an asymmetrical stance, transferring force from the ground through our body into the arms.  Most “core stability” exercise performed in the gym put you in a supine position with no leg to arm connection.  Sled pushing more closely emulates the demands place on our spinal stabilizers during daily activities.

Training Acceleration
In sports performance, the development of acceleration—the first four or five strides– is critical.   Weight room training with box jumps, barbell squatting, and hang cleans has been shown to produce better vertical leap numbers, but not nearly the same gains in 40 yard dash times.  Sled pushing places the body in the forward lean position you need to properly accelerate out of the blocks when sprinting.  It trains the neural pathways that turn on your acceleration muscles.

The Road to Easy Recovery
Sled pushing is all concentric muscle activity and no eccentric.  Eccentric muscle activity, the muscles lengthen against a resistance, creates much of the muscle soreness brought on by exercise.  Your body needs more time to recover from eccentric muscle activity.  You can perform a greater volume of work with a sled, and not be terribly sore the next day.  For older trainees, whose bodies require more recovery time, sled work is a valuable training tool.

The Injured Athletes Rehab Training
If you have a knee, lower back, or hip injury you may not be able to perform squats, lunges, deadlifts, or kettlebell swings.  Sled pushing is an alternative rehabilitation exercise for the lower body.  I have had great success treating runners with knee pain using sled work as a recovery exercise.  The core stability demands of sled pushing are helpful in restoring lumbar function in lower back pain patients.

Scalable to Any Fitness Level
Beginners can start with an empty sled and gradually add weight.  I have been able to progress physical therapy patients from 25 pounds to 125 pounds in as little as four week’s time.  Pushing is a very primal movement pattern, so most people catch on after two or three attempts.

Michael S. O’Hara, P.T., OCS, CSCS

SUSPENSION ROWS

Our shoulders and spine must endure prolonged computer input, extended commuter drives, sustained television staring, and way too much general slumping.  The important postural muscles that keep us tall become weak and the muscles in the front of the shoulders get tight.  The spinal muscles that hold our 24 vertebrae upright and stable functionally fall asleep and forget how to work together as a team.  Prolonged sitting creates all sorts of neuromuscular problems that can be managed with restorative exercise.  One of the best exercises you can perform to mitigate the damaging effects of prolonged sitting is the suspension row.  

Better Than Seated or Bent Over Rows
Suspension rowing requires your spine to stay in a neutral position from the head to the pelvis.  Most of the bent over rowing I witness in the gym involves the same slumped sitting posture you see in every office in America.  Rows performed with a flexed thoracic spine are far from optimal and often help reinforce postural deficits.  Properly performed suspension rows improve communication between the spinal stabilizers and strengthen the muscles that retract the shoulder blades.  

Mastery Of Your Bodyweight
Being able to maneuver your body using the arms makes you functionally fit.  During suspension rows, the resistance is not a plate or weight stack, but rather the weight of your body.  You alter the resistance by moving the feet and changing the angle of the body in relation to the floor.   

Friendly Force Curve
Suspension rows produce an accommodating resistance that is easier when you are at the weakest part of the rowing motion.  The force necessary to perform a suspension row decreases as you move from the arms fully extended to the arms pulled in close to the body.  This makes it a good exercise for people with weaker than average shoulder muscles.  

Cervical Proprioception
Many people have no idea of how to correct the posture of their head and neck.  Prolonged sitting, driving, and computer work have damaged their positional awareness or proprioception.  The movement of the head and neck during suspension rows produces a neurological training of the cervical proprioceptors that can help fix this problem.

Suspension Rows
Improve the strength and endurance of the team of muscles that keep your posture tall and shoulders strong with suspension trainer rows.  At FFAC, several TRX suspension trainers are located throughout the gym.  For home use, attach the suspension trainer to the top of a doorway.  Adjust the suspension trainer length so the handles are at your waist level or lower.  Stand facing the TRX and grip the handles firmly.  The position of your feet will determine the amount of resistance.  Move the feet forward and the exercise is more challenging.  Keep the entire torso straight, one long line from ear to ankle.  Brace the abdominal muscles and gluteals and lean back.  From the arms extended position, pull the handles into your side.  As you perform the rowing motion, focus on moving the shoulder blades down and back.  Return to the starting position and repeat.  Perform two or three sets of six to ten repetitions.  As you get stronger, progress to a full inverted row with the legs on a bench.  

Caution:  Make sure you use a solid suspension trainer product when performing this exercise.  I have treated two patients with injuries that occurred when their homemade units malfunctioned and sent them flying to the floor.  Do not skimp on safety with suspension training exercise.  The emergency room visit and CT scan of your skull will be far more expensive.  The TRX and Lifeline USA suspension trainers are the most well known units on the market.    

Michael S. O’Hara, P.T., OCS, CSCS

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