pain

The ROOT Cause Of [Many] Aches, Pains, And Injuries*

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*[BIG FAT DISCLAIMER: I’m not a medical professional. Just a dumb trainer who’s figured out how to finally lift heavy stuff again after 10+ years of trying. If you have active or chronic pain, or an acute injury, go see your Medical Doctor. What I’m about to present is based on the research, observation, experimentation, and practice of myself and a few others. Proceed and read with caution. This may or may not help you out.]

I know A LOT about aches, pains, and injuries. Too much in fact. And it’s not because I’m married to a DPT (Doctor of Physical Therapy) either.

Nope.

I’ve been going to the doctor for knee pain since I was 13. I remember going out for the cross country team my freshman year of high school but having to quit due to excruciating knee pain.

Then when I was 16, I dislocated my right patella while wrestling. (Later verified by my orthopedic surgeon through x-rays.) My coach put it back in, and I put an icebag on it, and wrapped it in an ACE bandage. I was wrestling again the next day. From that day on I had chronic right knee pain in everything I did. EVERYTHING. Takedowns. Running, jumping, kneeling, walking, climbing stairs. Everything.

Things only got worse when I started lifting heavy. I avoided squatting for the first two years of weight training cause of the knees. Eventually, I “manned up” and got under the bar and fell in love with the beautiful brutality of a heavy squat.

In spring of 1998 I “sprained” my left SI joint squatting and that put me out about 3 to 4 months, following one of the corrective exercise guru’s cues.

And then in 2002 I injured my lower back deadlifting – so bad in fact – that my body spasmed to form a protective brace from my chest to my hips. I couldn’t bend over for a week. In fact, my diaphragm spasmed so I couldn’t even take a full/deep breath. It was all shallow breathing for a week.

Fun stuff.

By this point my knees hurt so bad to squat I couldn’t get down without 225lbs on my back. I’d put the bar on my back and literally free fall into the bottom. It reminded me of popping the clutch on your car.

Meanwhile, I’d been doing a bunch of corrective exercise (since 1998 actually with the corrective exercise guru’s home study course), including self-myofascial release on the foam roller. And I’d gotten really good at “activating” my transverse abdominus too, despite my mishap back in ’98.

In January 2005 I tore the labrum in my right hip. That was fun and a lesson in the futility of alternative medicine. Four months later I took a cortisone shot just to get some relief.

In September of 2005, I did the same thing to the left hip. No alternative medicine or cortisone this time.

Unfortunately, but the end of the year, I could no longer even sit on the toilet (sorry to be so graphic) my knees hurt SO badly. You know that sensation when you hit your thumb with a hammer? Now double that. That’s how each knee felt. I literally had to use my arms and hold on to the sink to sit on the john. How sad.

This is as low as I could squat without excruciating pain.
January 2006: This is as low as I could squat without excruciating pain.

 

At that time, I got involved in and subsequently became a very vocal advocate of a “performance” system simply because the guy running it helped me get out of pain. (And got me hooked on unwittingly paying him LOTS of money to stay out of pain.)

I took that system to it’s logical conclusion and almost blew out my back again – probably permanently.

At that point I quit using his stuff and called one of my buddy’s who teaches for another movement system and he “diagnosed” the problem.

I had no “reflexive core stability.”

Zero. Zilch. Nada.

He gave me a couple of exercises that made me sweat, huff, and puff, almost as much as a kettlebell complex. The sad part is that I was lying on my back, it involved rubber bands, and I only did 3 reps on one leg, and 2 on the other then I was done.

It was the “reflexive core stability” thing that got me.

And it’s what’s getting you too.

Well, not exactly.

Reflexive core stability is a “subset” for lack of a better word, for “reflexive stability.”

And it’s what you’re missing that causes your aches, pains, and even overuse injuries. (Not contact injuries from sports – like ACL injuries from getting hit in the knee playing football.)

What is “reflexive stability?”

It’s your body’s subconscious ability to anticipate and control movement. Specifically, to stabilize and move the right joints using the right muscles at the right times, at the right speeds to get whatever job it is you’re doing, done.

Whether it’s running or jumping or even lifting submaximum and maximum loads, your reflexive stability allows you to get it done – and here’s the KEY point – WITHOUT thinking about it.

(SIDENOTE: Heavy strength training, including advanced calisthenics, like gymnastics exercises, requires active thought – or feedforward tension. Traditional athletics should not.)

Reflexive stability, as the name suggests, is based on your reflexes.

These reflexes get “dull” like a knife blade, from lack of use (disuse, misuse) and so your body no longer functions, or operates, the way it was designed to.

How and why? We’ll save that for the next few posts.

As a result, you develop “compensations,” which are your body’s way of surviving and keeping you moving. We now call these “movement dysfunctions.” And as a results of the compensations, when you go to move, one of several things happens to cause aches, pains, or injury:

  1. Your joint moves, but the wrong muscles stabilize and move it, and so it moves incorrectly (Trendelenburg’s Gait comes to mind here).
  2. Your joint doesn’t move well, so other joints which aren’t supposed to move as much move more (thoracic spine and lumbar spine come to mind here).
  3. Your joint moves, but the muscles stabilizing and moving it are moving at the wrong speed(s) – like a muscle pull when running.

And because of that, we seek modalities and treatments that address the symptoms, but don’t fix the underlying root cause – restoring your reflexive stability (also known as “reflexive strength.”)

What have I been able to accomplish since I “discovered” this idea of restoring reflexive stability?

Well, bilateral chronic and acute knee pain is no longer an issue. (I can sit on the can and get off it with ease – just in case your wondering. There’s a mental picture for you that you can’t take back. You’re welcome. ;-] )

Reflexive core stability is back and working better than ever. I can do bodyweight Pistols all day long. Got the One Arm One Leg Push Up too. And, I’ve actually been setting some “real” strength PRs as of late – hitting numbers I haven’t hit 10 to 15 years. (I’ll show you some of those videos too.)

In the meantime, how do you know for sure that you need to regain your reflexive stability and how do you go about doing so?

More on that in upcoming posts.

Feel free to leave a comment or question below.

The Best Spinal Stability Exercise For The Kettlebell Swing

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In my last post we saw that there were two reasons for back pain when performing Kettlebell Swings, according to Dr. McGill’s study in The Journal of Strength and Conditioning Research. They were:

  1. Poor technique, which we addressed with the video in the last post, and
  2. Actual lower back instability, which we’ll address in this post

What is lower back instability?

It’s simply your body’s inability to properly stabilize your spine under load – any load.

This means your body is unable to create “stiffness” in the muscles around the spine in a coordinated manner to protect the spine from the force of loading. Sure, it’s a little more complicated than that, but I’m not really a “science guy” so if you want to know the in-depth details of the science, buy Dr. McGill’s book, Low Back Disorders for an in depth explanation.

Spinal instability often comes from daily prolonged postures, oh, like… sitting. All day. At your computer or desk or whatever. Sitting promotes a slumped posture which places the lumbar spine in flexion (the whole spine actually for most people) and in turn shuts off the deep abdominal and lower back stabilizers, effectively putting them to sleep (called sensorimotor amnesia) so your body no longer has immediate access to them. Your body then relies on prime movers – muscles designed to move, not stabilize – to stabilize the spine. That’s where bad things happen.

Anyway, there are a ton of resources on lower back pain, etc. for you to google, bing, yahoo or whatever and this post isn’t meant to be an in depth essay or primer on lower back pain, low back mechanics and the such.

What it is meant to be is a “hack” – something that strips away all the noise and gives you a high payoff action you can use immediately.

My favorite exercise for spinal stability to help fix your Kettlebell Swing

It’s really simple in theory but for many it’s very challenging to do.

It’s the Bird Dog.

With of course, my own modifications. (Because I just can’t leave well enough alone.)

Here’s a picture.

spine stability exercise extraordinaire - the Bird Dog
The Bird Dog

It’s quite simple to perform. (And yes, you’ll probably notice that this picture looks a little different from pictures of the Bird Dog you may have seen in other places – like there is no stick on my back, etc… I’ll get to that.)

Here’s how:

  • Assume a quadraped stance – on hands and knees
  • Lift your head up and look straight ahead, not down at the ground
  • Simultaneously lift one arm and the opposite leg
  • Push your heel as far away from your body as possible without rotating your hip
  • Reach as far as possible with your arm
  • Imagine there’s a string or a rope connecting your arm and your leg and you’re trying to lengthen the rope by pushing against it from both ends
  • Hold for a second or two to prove you’ve got control of the movement
  • Place the hand and the knee back back on the ground.
  • Repeat. Then switch sides.

I recommend working up to 3 sets of 20 reps per side, with about 60 seconds of rest between exercises. This builds strength endurance in the lumbar stabilizers and strength endurances has been shown to be a preventative mechanism against lower back injuries.

Now, about my exercise “tweaks.”

Depending on your education, you’ll notice that there’s no stick on my back. I don’t believe in using it. In my book, it’s an unnatural teaching cue that doesn’t necessarily produce the desired response – natural movement patterns. The body goes where the head and eyes take it – at least it’s supposed to: Eyes, then head, then body. It’s a natural reflex pattern or synchrony that many of us lose. So I train that along with the spinal stability. I find tucking the chin and pushing the back of the head into a stick while maintaining or trying to maintain the lumbar curves distracting and frustrating. You may disagree. That’s fine by me.

But some interesting things happen when you perform it the way I’m suggesting:

  1. You definitely feel your lumbar extensors working.
  2. The more you focus on lifting your head and reaching with your limbs, the more you’ll feel your deep abdominals contract reflexively. That’s the key – reflexively. Or automatically in response to the load/movement. And that’s exactly what we want.
  3. You’ll feel the glut and the hamstring contract.
  4. You’ll feel the muscles of your middle back contract to counterbalance the weight of your head and your arm – those pesky and hard-to-reach middle and lower trapezius muscles.
  5. By lifting the head and balancing on your knee, you are simultaneously creating space in your tight hips, which have been overstressing your lower back, and are creating stability as well. Stability and mobility in your hip with one exercise tied in with reflexive abdominal contraction. Sounds just like what we’re looking for. Nice.
  6. By keeping the head up, especially by focusing on lifting the crown (top) of your head to the sky, your lats reflexively contract and your shoulder are automatically packed.

So by working the Bird Dog the way I propose, you’re not just working lumbar stability. You’re working a whole lot more at the same time.

And make no mistake, this puppy is challenging for many and probably will be for you. Working up to sets of 20 strict reps, where there’s a pause of the limbs – the leg in extension and the arm in flexion, is seriously demanding. There were times in the past when both my clients and myself have been left huffing and puffing and dripping sweat. That’s because there’s way more going on with the Bird Dog than meets the eye.

Some exciting news you may not know…

By now, many are familiar with the concept of the body being “wired” as an “X”. Cool. But, by training the limbs contralaterally (opposite arm and leg – like the gait cycle), you actually do several things.

  1. You increase whole body coordination through increased synaptic connections between left and right hemispheres of the brain. You literally become smarter.
  2. You become stronger. Training / loading the body contralaterally naturally trains the core musculature (similar to the crawling/creeping pattern babies use).
  3. When you load the opposite hand and foot, you also load the core musculature and simultaneously train the vestibular system, a common and often overlooked place for movement dysfunction. (By actively pulling your foot into dorsiflexion and actively extending your fingers on the hand on the elevated arm and pressing your palm into the floor on the Bird Dog, you’re working your feet and hands.)
  4. Training the vestibular system improves your total body coordination by increasing your proprioceptive awareness, or your body’s perception of itself in time and space.

There are many other wonderful things about the body that we are only just rediscovering. And there’s a lot more information to be applied to our training as well.

Unfortunately, I just looked at the clock and I’ve run out of time so I’ll have to make this a topic of future blog posts.

In the meantime, get on that Bird Dog. Work up to 3 sets of 20 – that’s my recommendation.

And obviously, there are some caveats:

  1. If you currently have back pain while swinging a kettlebell and it’s not technique (the FOLD didn’t help you) make sure your doc says you’re good to go for the Bird Dog. (That’s my CYA – you like it?)
  2. If you’re currently under a Physical Therapist’s care, ask about doing it.
  3. Make sure the Bird Dog doesn’t cause pain while doing it.
  4. Make sure the Bird Dog relieves your pain while swinging. Check, recheck, right?

About #3 – you may have to reset using FOLD concepts, so revisit the video.

That’s it, gotta run. In the meantime, if you want to know or experience more about the whole “Body is an X” thing here’s something my buddy Tim and I are doing that will immediately improve your kettlebell lifting.

“Help! My Kettlebell Workouts Suck Cause I’m In Pain!”

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Yesterday I posted about what I’d do if I were in pain and trying to “get my kettlebell workouts on.”

Today, I thought I’d follow that up just in time for Christmas – because there’s no sense doing the same thing in 2011 that you did this year if what you did this year didn’t work for you. That’s the definition of insanity – doing the same thing you’ve always done and expecting a different result.

So, if you’re about to enter 2011 dinged up, banged up, run over, or run down, here’s some ideas to jump start your progress in the New Year (they also make for great stocking stuffers…)

The following is a guide to get you up and running (literally, if you want to…) in 2011:

“Ouch! My Shoulder Hurts!”

Yup, that ol’ familiar “can’t lift my arm over my head” rotator cuff impingement pain. Lovely. So much fun. Been there, done that. Got my first shoulder ding in ’94 on a bench press in Ukraine. Fun. That was the rigth shoulder. Got a serious ding in the left one when I learned how to clean properly. That took a long time to heal up. More fun.

Wish I had “Secrets of the Shoulder” back then.

Wish I knew the following –

  • How to grip for shoulder strength
  • How to use my breath for shoulder strength (and protection)
  • Why my posture was important and how looking like a gorilla wasn’t necessarily a good thing
  • Why I couldn’t put my left arm all the way over my head

If you’re having shoulder issues – “Secrets of the Shoulder” is a great place to start.

“Why’s My Knee Hurt When I Go Up And Down The Stairs?”

Ha! I’ve asked myself that so many times it’s laughable!

How ’bout you?

In my case, I’m missing cartilage that sits under the right patella. My ortho said it literally looks like a pothole. Darn thing bothered me from ’89 to ’09. Twenty years! Holy cow! (Batman…!)

Even after doing a TON of joint mobility work from 2006-2009 I still had some problems. I wish Brett and Gray had put “Secrets of the Hip and Knee” together about 10 years ago – I could have saved myself not only knee pain but undoubtedly both my hip injuries…

I wish I knew in 2000 –

  • What real ankle mobility is and more importantly – how to measure it (“GRRRR… Hulk Smash!” – Funny Iron Tamer story here…)
  • That there is such a thing as “stability” and it is different than “mobility” from a neurological perspective – and how to train it – and of course why it’s important
  • Why my knees were taking a beating even after doing all that JM work (HINT: Stability…)

Short story long, got knee pain? Get rid of it with “Secrets of the Hip and Knee.”

“Man My Low Back Is Stiff When I Get Out Of Bed… Stand Up… Bend Over… Swing…”

Back pain is so much fun. The best is when you hurt yourself in 2002, think you rehab yourself with the latest CNS Trickery, only to find out you’ve probably wasted 4 years of your life, if not 7. And if you had just gone straight to the source you could’ve saved yourself a lot of time, energy, and money. And probably gotten on a podium with a medal. All this is of course, is hypothetical.

I wish in 2002 after tweaking my back on rep #8 of my 405 DL, and then proceeding to 10 reps, knew what I was going to be in for and how I’d gotten there in the first place. I wish I’d had “Secrets of Core Training: The Backside.” Then I would’ve known –

  • What is the ASLR and why it’s important to me – and to my lower back health
  • How to own the “hip-hinge” – how to get there by creating real hip mobility (and stop relying on my “strong” lower back)
  • Learned how to establish static hip stability – yes there’s that differentiation again between stability and mobility
  • How to get my hips and abs to “play nicely” together
  • Why traditional ab exercises, although good for the washboard, do nothing for your low back
  • Why my freakin’ IT Bands were chronically sore
  • What I was doing wrong with my deadlift and how to fix it

If you’re tired of your lower back pain – do yourself a favor (and your loved ones who are probably as tired of hearing about your back pain as you are having it) and grab “Secrets of Core Training: The Backside.” You’ll thank yourself in 30 days or less. (And so will your loved ones.)

Yeah, so I did a ton of things wrong when I first started training. And even after I’d been an exercise professional for years, I still looked for the answers in the wrong places.

I guess the real epiphany was when I went to see my good friend Brett (Jones) last November (2009) because my left hip was STILL bothering me, even after doing an unbelievable amount of specific, focused, precise joint mobilty work. He was good enough to let me spend the night at his place and then spent about 3-4 hours with me the next day taking me through the FMS and giving me correctives.

Long story long – that little trip, as fun as it was, cost me over a grand between travel time and time off from work.

The good news is, the solutions on this page are a minute fraction of that.

What’s your health and quality of life worth to you?

I know for me, it’s priceless.

On Kettlebell Workouts And Pain…

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A buddy of mine sent me an email the other day and asked me how I coped with pain and still manage to do my  kettlebell workouts. He’s had some serious setbacks since September and was feeling discouraged.

So I thought I’d write a little bit about it today.

It’s funny – because I honestly haven’t felt too much pain anywhere in the last year – and more imporantly, I’ve felt so good I  haven’t focused on pain in any way shape or form. Occasionally when it does rear it’s head – it’s minimally prohibiting and 9.9 times out of 10 I can make it go away and do whatever I want.

It hasn’t always been so.

From 2002 to the end of 2009, I’d been focused on getting out of and avoiding pain.

What am I doing differently now?

Well, I had spent some time doing FMS correctives, and they worked pretty well. I liked them. Challenging. Fun.

Then I started making my own stuff up based on the FMS correctives I learned and some other stuff. (The reality is, I probably am just “re-inventing” something someone else has done…)

And then I started focusing on performance.

What could I do on any given day? And then I started thinking “Screw that – I should be able to do whatever I want on any given day!” And so I’ve been focused on that.

And that’s how I think we should view our kettlebell workouts – or any training for that matter.

We should get out bodies to the place where we can do anything we want to do at any given time. (I’ve been doing some tumbling and rolling lately and ran the stadium stairs on Sunday for the first time in 8 years – because I wanted to.)

How do we do that?

  1. If you’re in pain, go see a doc and get cleared medically. If things still don’t seem right, go see a specialist. Health first, then performance.
  2. Do the best you can not to train in painful movements. Don’t confuse discomfort with pain. Pain is throbbing, sharp and achey. Discomfort is not.
  3. Train in areas that you can move freely in and are fun and enjoyable.
  4. If you are restricted and have been cleared by your doc, go see someone like an FMS practitioner who will actually measure your movement capabilites and give a reference point – a starting point from which to work. Schedule follow up visits every 30 days to assess your progress.
  5. Do physical activity that is fun. (Did I mention that already?)
  6. Learn fun (that word again) and new physical skills. (I’m going to start investigating Grip Training)
  7. Keep a positive attitude – it’s not always going to be this way – it’ll get better. A positive attitude will actually help the process along.

Realize that whether you like it or not, you’ve “earned” the body you’re in right now. It may take you some time to get around your pain and movement dysfunction, but view it as a learning experience. I did. My understanding of the human body, coaching, and business have all flourished because of my “pain.” I’m thankful for having walked that path because it made me a better man.

Finally, don’t own your pain.

It’s not a part of you.

Not really.

It’s just an indicator – kinda like the “check engine” light – it’s there when you need it. Don’t look for it to always be on. Take care of the issues and it’ll most likely rarely come on again.

If you’ve still got some pain and have been cleared by your doc – a good place to start changing your movement patterns is with an Functional Movement Screen. If you don’t have access to an FMS practioner, start with Brett Jones and Gray Cook’s “Secrets of…” series – especially “Secrets of Primitive Patterns.” It’s probably the MOST UNDERATED  and highly beneficial DVD they have, in my ever-so-humble opinion.

If that doesn’t sound good to you, another great place to start is with Kettlebells From the Ground Up. It’s packed with what I call “safe movements” (another blog post) and everybody I know who’s used it, including myself, has benefited from it.

That’s all I’ve got time for right now – I’ve gotta go off and train. Fun and pain free.

Hopefully you’ve found some of these ideas helpful.