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You Have A Social Media Disease

There Is No App for Thumb Pain

Your thumb is made up of an intricate system of tendons that enable very precise movement.  The joints of a thumb are fairly small and yet we are able to produce an amazing amount of force with this single digit.  In this age of all things digital, the modern American thumb has been subjected to greater workloads.  Problems with thumb pain, numbness, and limited function are becoming more common complaints in physical therapy.  I have some suggestions on how to manage pain and limit the damage and embarrassment of excessive social media thumb exposures.

Thumb Tendon Troubles

Dr. De Quervain was the first to clinically described thumb tendonopathy, and we call thumb tedonosis De Quervain Syndrome.   The test for De Quervain Syndrome was created by a clinician with an equally odd name and it is called the Finkelstein test.  Place your thumb in the palm of your hand.  Make a fist with the finger around the thumb.  Hold the wrist in neutral and then deviate the wrist toward the pinkie finger.  If you feel pain it is a positive Finkelstein test.

Resolution of thumb tendonopathy pain happens quickly when you give in to the symptoms of pain and modify your activities.  Rest the thumb tendons by using your fingers instead of your thumb on that smart phone.  Avoid fitness activities that put stress on the thumb.  Lifting in front of the body with the palms facing inward is often the lift that new mothers perform and develop painful thumb tendons.  Early on in the pain onset, icing is often helpful.  In physical therapy, we are successful with soft tissue mobilization, ultrasound, and manual therapy.  A gauntlet type thumb splint you wear at night is an unattractive but provides aviable position of rest for severely aggravated thumb tendons.

The Numb Thumb

Irritation of the median nerve in the carpal tunnel of the wrist will create thumb, second, and third finger numbness and pain.  An injury of the recurrent median nerve in the front of the palm will produce numbness in the thumb and limited strength during thumb opposition–thumb to pinkie finger.  Patients with neural irritation often develop numbness, weakness, and then pain.  The pain often wakes them from sleep and disrupts hand function.

Once again, you will resolve a numb thumb with rest.  Once neural irritation gets fired up, it takes longer to resolve than an aggravated tendon.  Giving in to the numbness and resting the hands will produce better results if you start early.  Two weeks of avoiding the aggravating hand activity produces good results.  Night splints for the wrist and thumb are often helpful.  A carpal tunnel release is a common surgical alternative that takes pressure off the median nerve.

Gumbie Thumb Beware

Every joint has a certain degree of stability and certain degree of mobility.  Our spine, knees, hips, shoulders, and elbows must move enough to produce motion but not so much that they fall apart.  The amount of movement in our joints is largely an inherited characteristic–you can blame Mom and Dad.  The person at the extreme end of the scale (“double jointed”) needs to take certain precautions with their thumbs.

The Beighton Score is a popular screening technique for joint hypermobility.  It has been around for thirty years and is used in research all around the world.  The scoring is based on eight passive range of motion assessments and one active range of motion assessment.  One point is assigned for each of the following.

A pinkie finger that can be passively bent backward more than 90 degrees.

A thumb that can be pulled down to the front of the forearm.

Elbows that passively hyperextend to 10 degrees.

Knees that passively hyperextend to 10 degrees.

The subject can place the palms on the floor during a straight leg, forward bend.

Researchers disagree on the score that should be a threshold for concern about systemic joint hypermobility.  I have found that fitness clients and physical therapy patients that score a 5/9 or higher require modification of their training programs.  It is not uncommon to encounter physical therapy patients that have a Beighton Score of 9/9.  Hypermobile individuals need to take more precautions when they perform repetitive tasks such as texting on a smart phone.

Kimberly Salt wrote an excellent article on social media induced thumb pain in the May 19, 2018 issue of the New York Times.  Take a minute and read, Me and My Numb Thumb: A Tale of Tech, Texts and Tendons.

Michael S. O’Hara, PT, OCS, CSCS

Progression Know How

Carries, Crawls, and Core

If I could kill a word it would be “workout”.  People who are into fitness love to talk about working out, but seldom do you hear people talk about training or practicing movements.  “Workout” tends to infer any form of structured exercise with the sole purpose of expending energy or making you tired.  It focuses on today and perhaps a feeling (tired, sore, or getting a pump, etc.), but has no thought of tomorrow.   Our focus at Fenton Fitness is always on training or practicing movements.  The focus is always on the future–reducing injury risk, becoming more durable, performing better at sports or life, or just feeling better.  Our focus is on skill acquisition, not feeling tired.  Just imagine if we treated education the way we treat exercise.  Think of the difficulty of  learning a new subject every day, rarely repeating something, with the sole purpose of making it difficult.  That would be crazy, yet that is more and more of what we see in the fitness industry.  In workouts, exercises tend to change just for the sake of changing.  In training, the movements are not random and serve a direct purpose, and are therefore performed for a minimum of 3-4 weeks.  We progress these movements by performing them with more control, increasing the number of sets or reps, increasing load, or reducing rest intervals.  Here are some benchmarks that we like to use with some basic exercises to do before progressing on to the next movement.

Jeff Tirrell, CSCS, CSFC, Pn1

Carries, Crawls, and Core

Push Up Position Plank: Goal of 1 minute

Plank: Goal of 30 seconds

Side Plank: Goal of 30 seconds/side

Side Plank w/ outside foot elevated: Goal of 30 seconds/side

Side Plank w/ inside leg elevated: Goal of 30 seconds/side

Anterior Baby Crawl: goal of 15 yards with stable torso

Anterior Crawl: Goal of 30 yards with stable torso

Farmers Walk: Goal of 60 yards with body weight

Turkish Get Up (¼): Goal of 8/6kg (men/women) for 10 reps/side

Turkish Get Up (½): Goal of 10/12kg (men/women) for 6 reps/side

Turkish Get Up (full): Goal of 25% body weight for 4 reps/side.

See video demonstration of these exercises here: https://youtu.be/5OkXbOWx4mw

Progression Know How

Vertical Pull Patterns

If I could kill a word it would be “workout”.  People who are into fitness love to talk about working out, but seldom do you hear people talk about training or practicing movements.  “Workout” tends to infer any form of structured exercise with the sole purpose of expending energy or making you tired.  It focuses on today and perhaps a feeling (tired, sore, or getting a pump, etc.), but has no thought of tomorrow.   Our focus at Fenton Fitness is always on training or practicing movements.  The focus is always on the future–reducing injury risk, becoming more durable, performing better at sports or life, or just feeling better.  Our focus is on skill acquisition, not feeling tired.  Just imagine if we treated education the way we treat exercise.  Think of the difficulty of  learning a new subject every day, rarely repeating something, with the sole purpose of making it difficult.  That would be crazy, yet that is more and more of what we see in the fitness industry.  In workouts, exercises tend to change just for the sake of changing.  In training, the movements are not random and serve a direct purpose, and are therefore performed for a minimum of 3-4 weeks.  We progress these movements by performing them with more control, increasing the number of sets or reps, increasing load, or reducing rest intervals.  Here are some benchmarks that we like to use with some basic exercises to do before progressing on to the next movement.

Jeff Tirrell, CSCS, CSFC, Pn1

Vertical Pull Patterns

X Pulldowns: Goal of 50% bodyweight for 10 reps

Isometric Pull/Chin up holds: Goal of holding for 1 minute at both the top and bottom position

Eccentric Pull/Chin ups: Goal of 10 eccentric reps with a 3-5 second descent

Pull/Chin ups: Goal of 10/5 reps (men/women)

See video demonstration at: https://youtu.be/Xidv7HlNtWE

 

Progression Know How

Horizontal Pull Patterns

If I could kill a word it would be “workout”.  People who are into fitness love to talk about working out, but seldom do you hear people talk about training or practicing movements.  “Workout” tends to infer any form of structured exercise with the sole purpose of expending energy or making you tired.  It focuses on today and perhaps a feeling (tired, sore, or getting a pump, etc.), but has no thought of tomorrow.   Our focus at Fenton Fitness is always on training or practicing movements.  The focus is always on the future–reducing injury risk, becoming more durable, performing better at sports or life, or just feeling better.  Our focus is on skill acquisition, not feeling tired.  Just imagine if we treated education the way we treat exercise.  Think of the difficulty of  learning a new subject every day, rarely repeating something, with the sole purpose of making it difficult.  That would be crazy, yet that is more and more of what we see in the fitness industry.  In workouts, exercises tend to change just for the sake of changing.  In training, the movements are not random and serve a direct purpose, and are therefore performed for a minimum of 3-4 weeks.  We progress these movements by performing them with more control, increasing the number of sets or reps, increasing load, or reducing rest intervals.  Here are some benchmarks that we like to use with some basic exercises to do before progressing on to the next movement.

Jeff Tirrell, CSCS, CSFC, Pn1

Horizontal Pull Patterns

TRX Row: Goal 45 degree angle for 10 reps

One Arm DB Row: Goal of 50% bodyweight for 10 reps per arm

Inverted TRX Rows: Goal of 10 reps with full range of motion

Watch Jeff demonstrate these exercises: View Video

Progression Know How

Vertical Press Patterns

If I could kill a word it would be “workout”.  People who are into fitness love to talk about working out, but seldom do you hear people talk about training or practicing movements.  “Workout” tends to infer any form of structured exercise with the sole purpose of expending energy or making you tired.  It focuses on today and perhaps a feeling (tired, sore, or getting a pump, etc.), but has no thought of tomorrow.   Our focus at Fenton Fitness is always on training or practicing movements.  The focus is always on the future–reducing injury risk, becoming more durable, performing better at sports or life, or just feeling better.  Our focus is on skill acquisition, not feeling tired.  Just imagine if we treated education the way we treat exercise.  Think of the difficulty of  learning a new subject every day, rarely repeating something, with the sole purpose of making it difficult.  That would be crazy, yet that is more and more of what we see in the fitness industry.  In workouts, exercises tend to change just for the sake of changing.  In training, the movements are not random and serve a direct purpose, and are therefore performed for a minimum of 3-4 weeks.  We progress these movements by performing them with more control, increasing the number of sets or reps, increasing load, or reducing rest intervals.  Here are some benchmarks that we like to use with some basic exercises to do before progressing on to the next movement.

Jeff Tirrell, CSCS, CSFC, Pn1

Vertical Press Patterns

Tall Kneeling Bilateral Landmine Press- Goal of 45# for 10 reps (men), 25# for 10 reps (women)

½ Kneeling 1 arm Landmine Press- Goal of 45# for 5 reps/arm (men), 25# for 5 reps/arm (women)

½ Kneeling 1 arm KB Overhead Press- Goal of 20kg for 5 reps/arm (men), 12kg for 5 reps/arm (women)

Standing 1 arm DB/KB Overhead Press- Goal of 25% bodyweight for 10 reps/arm

Barbell Overhead Press- Goal of bodyweight for 1 rep (men), or 75% bodyweight for 1 rep (women)

Watch Jeff demonstrate these exercises: View Video

Progression Know How

Horizontal Press Patterns

If I could kill a word it would be “workout”.  People who are into fitness love to talk about working out, but seldom do you hear people talk about training or practicing movements.  “Workout” tends to infer any form of structured exercise with the sole purpose of expending energy or making you tired.  It focuses on today and perhaps a feeling (tired, sore, or getting a pump, etc.), but has no thought of tomorrow.   Our focus at Fenton Fitness is always on training or practicing movements.  The focus is always on the future–reducing injury risk, becoming more durable, performing better at sports or life, or just feeling better.  Our focus is on skill acquisition, not feeling tired.  Just imagine if we treated education the way we treat exercise.  Think of the difficulty of  learning a new subject every day, rarely repeating something, with the sole purpose of making it difficult.  That would be crazy, yet that is more and more of what we see in the fitness industry.  In workouts, exercises tend to change just for the sake of changing.  In training, the movements are not random and serve a direct purpose, and are therefore performed for a minimum of 3-4 weeks.  We progress these movements by performing them with more control, increasing the number of sets or reps, increasing load, or reducing rest intervals.  Here are some benchmarks that we like to use with some basic exercises to do before progressing on to the next movement.

Jeff Tirrell, CSCS, CSFC, Pn1

Horizontal Press Patterns

Push Ups- Goal of 20/10 reps (male/female) with chest touching floor.

Alternating DB Bench Press- Goal of 50% body weight per arm for 5 reps/arm (men) or 33% body weight per arm for 5 reps/arm (women).

Bench Press- Goal of 75% bodyweight (women) or bodyweight (men) for 3-5 reps

See video demonstration of these exercises here: View Video

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

 

 

 

 

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

Vertical Pulls

Just like the vertical press exercises, vertical pulls can be hard to execute due to their mobility requirements, but are the most effective and efficient movements when trying to build a strong and healthy upper body. The broadest posterior chain muscle in the body, the latissimus dorsi, has the primary actions of humeral adduction, extension and internal rotation, but also contributes to posture due to its attachment points. Vertical pulls also work the arms (brachioradialis, biceps brachii, triceps long head), shoulders/back (trapezius, posterior deltoid, teres major, rhomboids), and pelvic floor (rectus abdominis, internal and external obliques).

Pull Up/Chin Up: Pull ups/chin ups work the majority of the muscles in the mid/upper back and flexors of the arm. The rotator cuff muscles and core musculature play a more stabilizing role.  In both variations, think about keeping the core engaged.  There should not be extension in the lower back and if there is, you will notice yourself swinging back and forth during reps. When pulling up, think about leading with your collarbone and actually touching it to the bar. Another useful cue is to think about pulling the elbows to your pockets. Avoid rounding the upper back over the bar when reaching the top of the movement.  If you are having trouble touching your chest to the bar, it is either a strength or mobility issue.

½ Kneeling One Arm Pull Down
Set up at the Cybex machine or any cable hook up. Grab just one handle and put that same side knee down on the ground with the toe dug in.  Make sure the arm is angled in such a way that you have to reach across your body when the arm is flexed overhead. Your palm should be facing forward, and as you pull down, turn the hand towards the body and keep the elbow close to your side. Concentrate on squeezing the muscles in the back and keeping the rest of the body still with the core braced. Switch legs when you switch arms.

View video of vertical pulls here: https://youtu.be/knAFry9p-LM.

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

Horizontal Pulls

A horizontal pulling exercise is any exercise that involves moving a weight in towards your torso horizontally from straight out in front of you. A good exercise routine should incorporate both pushing and pulling movements in order to keep a healthy balance, better posture, and prevention of shoulder injuries. Muscles involved in pulling exercises include biceps, latissimus dorsi, rhomboids, posterior deltoid, and middle trapezius.

Arm DB Row
There are a couple different variations that could be done with the one arm row. In the first and most common variation, set up with one dumbbell and put the opposite hand and knee on a flat bench. The back should be flat and the weighted arm should be straight with full extension in the shoulder. Keeping the core braced, bring the dumbbell straight up to the side of your chest, keeping your upper arm close to your side. Concentrate on squeezing the back muscles once you reach the full contracted position. In the second variation, we are going to get a little more athletic and functional. It is called three stance row, or straddle stance row. Stand with the legs a little wider than shoulder width apart. Bend the knees slightly and make sure the feet are equally distributed and the back is flat (think linebacker).  Put one arm on the end of the bench or a 16-20” box. The hand with the dumbbell should be directly under the shoulder and centered. Row as described previously.

PUPP DB Row
Set up with two dumbbells in a push-up position plank. Keep the feet further apart to make the exercise easier, keep feet closer together to make it harder. Pull up one dumbbell, keeping the elbow close to the body and avoiding the tendency to dip the opposite hip. The body should stay still throughout the exercise. This variation is going to challenge the core as well as the rowing muscle groups. Alternate arms.

Horse Stance DB Row
This variation of the DB row is going to be more challenging than just a regular row as it is going to test your core stability and balance. Set up with one dumbbell and a bench. Put the opposite hand and knee on the bench and extend the free leg out horizontally, with the ankle dorsiflexed. The other arm is holding the dumbbell straight down as with any other row variation. Keeping the core braced, bring up the dumbbell in the same pattern as previously stated. Avoid the tendency to dip the opposite hip down. The weight used in this variation is going to be lighter than usual.

View the video here: https://youtu.be/gSMvrJGVeN4

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

Vertical Presses

The vertical press targets the sternal and clavicular head of the pectoralis major to a small degree as well as the anterior deltoids in front of each shoulder. The triceps are the prime movers.  This is a tough movement for beginners to grasp because it requires a certain degree of mobility, but can be very beneficial to overall strength with a huge carry over to other pressing exercises. These movements can be performed kneeling or standing with one arm or two arms. Start from the ground and work your way to standing.

Tall Kneeling Bilateral DB Press: By starting in the tall kneeling position, we remove the hips, knees, and ankles from the equation.  This makes it easier to focus on what the upper body and core are doing along with eliminating common compensation patterns.  Kneel down on both knees with your toes dug into the ground.  Make sure your hips are fully extended (not sitting back on your feet).  From there simply bring the weights up to shoulder level with a neutral grip (palms facing each other).  Squeeze your grip and press upward while rotating your palms forward.  Stop when your elbows are locked and your biceps are by your ears.

Tall Kneeling Alternating DB Press: In this progression, the setup is the same as for the Tall Kneeling Bilateral Press, except you are going to alternate pressing one arm overhead at a time.

Tall Kneeling One Arm DB Press: This movement will require the same setup as the former two movements.  However, you will only use one weight and do one arm at a time.  This will require more rotational and lateral stability out of the core musculature.  Make sure to brace your core and don’t allow yourself to twist or shift your weight to one side.

½ Kneeling Bilateral DB Press: By lowering the center of mass, it is easier to practice moving through the hips and shoulders with less movement through the pelvis and lumbar spine, which is a common mistake and more difficult to fix in the standing position.  Assume a ½ kneeling position with the kneeling side toe dug in.  The front leg should be in line with your hip (not out to the side), and the ankle should be under or slightly behind the knee.  The knee that is down should be under your hip.  Bring a pair of dumbbells up to your shoulders with a neutral grip and press them overhead just as with the tall kneeling press.

½ Kneeling Alternating DB Press: Same setup as the ½ Kneeling Bilateral Press.  This version simply alternates the pressing.

½ Kneeling One Arm DB Press: Same setup as the previous two exercises.  For this version, you will only use one arm.  Grab a weight on the same side that you are kneeling on.  Start with a neutral grip and press overhead.  The asymmetrical loading will place a large stabilizing demand on the obliques and rectus abdominal musculature.

Standing Bilateral DB Press: Standing tall with the feet about shoulder width apart, bring the dumbbells up to shoulder level and press both at the same time. Make sure to keep core engaged and feet grounded. A common mistake is to arch the back and lean back just to get the weights up.  Make sure the weight being used isn’t forcing your body into extension just to lift them up.

Standing Alternating DB Press: The same setup as the previous exercise, just press one arm up at a time while the other stays at shoulder height. Try to avoid tilting in the shoulders.

Standing One Arm DB Press: The same setup as the previous exercise, just use one dumbbell and do one arm at a time.

Contralateral Standing DB Press: For this variation set up with one dumbbell, stand on the opposite leg than the dumbbell side. This movement will require core stability and balance and due to this, the weight used does not need to be heavy, which is ideal for those who suffer with shoulder pain as they can still feel challenged without lifting a heavy weight.

Video of vertical presses can be seen here: https://youtu.be/2-7T0ebGIkM

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