Janda Crossed Syndromes

This is stuff I learned years ago but now looking at it in a different context. I really don't like working in the corrective exercise area but I guess it is necessary for optimal health. Not sure if it really does blur a line between PT and personal training.

From http://www.jandaapproach.com

"Over time, these imbalances will spread throughout the muscular system in a predictable manner. Janda has classified these patterns as “Upper Crossed Syndrome” (UCS), “Lower Crossed Syndrome” (LCS), and “Layer Syndrome” (LS) (Janda, 1987, 1988). [UCS is also known as “cervical crossed syndrome”; LCS is also known as “pelvic crossed syndrome; and LS is also known as “stratification syndrome.”] Crossed syndromes are characterized by alternating sides of inhibition and facilitation in the upper quarter and lower quarter. Layer syndrome, essentially a combination of UCS and LCS is characterized by alternating patterns of tightness and weakness, indicating long-standing muscle imbalance pathology. Janda’s syndromes are summarized in Figure 1.

Upper crossed syndrome is characterized by facilitation of the upper trapezius, levator, sternocleidomastoid, and pectoralis muscles, as well as inhibition of the deep cervical flexors, lower trapezius, and serratus anterior. Lower crossed syndrome is characterized by facilitation of the thoraco-lumbar extensors, rectus femoris, and iliopsoas, as well as inhibition of the abdominals (particularly transversus abdominus) and the gluteal muscles.

By using Janda’s classification, clinicians can begin to predict patterns of tightness and weakness in the sensorimotor system’s attempt to reach homeostasis. Janda noted that these changes in muscular tone create a muscle imbalance, which leads to movement dysfunction. Muscles prone to tightness generally have a “lowered irritability threshold” and are readily activated with any movement, thus creating abnormal movement patterns. These imbalances and movement dysfunctions may have direct effect on joint surfaces, thus potentially leading to joint degeneration. In some cases, joint degeneration may be a direct source of pain, but the actual cause of pain is often secondary to muscle imbalance. Therefore, clinicians should find and treat the cause of the pain rather than focus on the source of the pain."

Short Foot Posture

From Optimum Sports Performance

"With everyone talking about barefoot running and getting out of very cushy/supported shoes over the past year, I thought it would be good to review the Janda short foot posture and go over some exercise progressions that we have been using to help re-train the intrinsic muscles of the foot.

What is it?

The Janda short foot posture is a technique that Janda proposed to teach patients to shorten the longitudinal arch of the foot, thus moving the patient out of their flat foot position. The short foot posture offers a variety of benefits at the foot such as:

- Increased proprioception of the bottom of the foot

- Enhanced joint alignment up the chain at other joints

- Improved stability of the body

- Increased strength of the foot for better locomotion

As you will see in the below video, exercises with the short foot posture should follow similar progressions of any other exercise you would use:

Bilateral stance > Split Stance > Single Leg Stance

Important point

Refrain from curling the toes, excessively flexing them into the floor, or trying to grip the floor with the toes. The arch should be created with the toes flat on the ground, not overly flexed, and drawing the ball of the big toe toward the heel of the foot.

As you will see in the video, when the client moves to single leg stance, his foot stability is challenged, and his big toe starts to come up off the ground (although he works to correct it right when it happens). The goal is to perform the movement with a healthy arch and the big toe down on the ground. Trying to push all your weight to the outside of the foot in order to create an arch is not the same as the short foot posture."

Wise Words of Wisdom

The Only Goal That Matters



Whatever goals you have made, this one must come first: The goal is to keep the goal the goal.

Read that again: The goal is to keep the goal the goal.

An unecessary translation: quit bouncing around. Pick a goal then measure all your actions against it. Does what I’m doing help me reach my goal? If not, eliminate it. Do not spend your time doing things that don’t get you closer to your goal. Avoid distractions at all costs.

Programming

Been a little backed up so I'm going to shoot off a couple of quick ones.



Mike Robertson's 10 Immutable Laws of Bootcamp (programming)
*Quality over quantity
*Progressions and regressions
*Warm-up is essential
*Coaching is key
*More stable>>>Less stable
*Learn to slow down
*Glutes, hams, and hips are critical
*Pulls before presses
*Core is almost ALWAYS weak link
*Burner/finishers can be corrective

PAIN!

"Pain attenuated movements patterns may lead to protective movement and fear of movement, resulting in clinically observed impairments such as decreased ROM, muscle length changes, declines in strength, and ultimately, contribute to the resultant disability."
-Cook and Kiesel 2006

Reinforcement of some of the concepts of Z-Health principles. Pain disturbs muscular function. In the presence of pain, nueromuscularly sequence firing is off. It doesn't matter if bad movement causes the pain or pain causes bad movement. Pain should be referred out.

I also need to review some FMS movements tomorrow and reconsider using it a bit more.

Shoulder flexibility tests

Came across this on FB and thought it was pretty damn funny.

As funny as I think it is, it actually holds a bit true for me. I always want to share and help people so I end up too chatty and people probably think I think I know it all. Not the case, I have much to learn... but I do know some shit.

Today's is short because I'm sleep deprived. I'm not sure on the validity of these test but will try them out with some members/clients in the near future to see:

"Static Flexibility Test Shoulder"
Odd that they call it static when it's about how much you can move through a pass through?

"Static Flexibility Test Shoulder and Wrist"
Same comment as above.

I think that I'm going to reach out to a PT to find how they actually measure shoulder flexibility/mobility without allowing the lumbar spine to compensate.

Big Toe Mobility

After chatting with Dana and a couple of other individual clients about feet issues, I felt the need to delve into a little more about mobilization of the big toe/foot. The more I read into how much it effects mobility up the kinetic chain, the more I feel I need to both know about it, as well as test it.



Click this link to read and watch more about foot/big toe mobility.

After watching these guys chat about the static lunge, it makes me want to go back and review the tenants and the usefulness of the FMS. So much to learn about the foot, toe, and ankle.

Median Nerve

Today was my 34th Bday. Wish I could say it was a good day but it wasn't. Saving Grace is whenever I sit and look at Jackson, it's a better day.

I decided to follow up with Jim's concern from yesterday that he has similar nerve issues but feels numbness more in the center of the hand. So after some internet searching I ran into this article on the median nerve entrapments.

I think it's pretty interesting on how they trace it back all the way to the C5-T1.

"A summary of the locations for median nerve entrapment are:
Cervical nerve root level
Against a cervical rib
Between the anterior and middle scalene muscles
Between the clavicle and first rib
Underneath the pectoralis minor muscle
Underneath the ligament of Struthers
Passing by the bicipital aponeurosis (lacertus fibrosus)
Between the two heads of the pronator teres
Compression in the carpal tunnel"

I guess the reason I found it most interesting and pertinent to know is the relation of this and carpal tunnel syndrome.

I was supposed to make up yesterdays workout, but just couldn't pull the energy together. I guess eating more than 1 meal a day would help. At least water intake was good.

Ulnar Nerve

I was suffering from a re-irritation of my left ulnar nerve for about two weeks. Last time it just went away after a week or so off. This time it wasn't going away. It's almost embarrassing to say but I re-irritated it mocking/explaining a movement with my arms...no load. Anyways, I wasn't sure if it was lack of sleep, poor nutrition, stress... because it started a couple of days before Jackson was born.

The purple is where the numbness kicks in.

I decided to just work around it and continue with the WS4SB program. I had to avoid things like chins ups and supinated grip barbell curls because of pain but quite honestly I think the curls are helping the pain go away.

They had this following pic of a reason that may compress the ulnar nerve:

Many people sleep with their arms curled up like this. Sleeping with the elbow bent can aggravate symptoms of ulnar nerve compression and cause you to wake up at night with your fingers asleep.

Click here to read more up on Ulnar Nerve Entrapment.

Guilty. I thought I was the only person that slept like this but I guess not. It's almost hard to admit I sometimes sleep like this because of how funny it looks but whatever. In the past, I assumed I had odd wrist pain from sleeping in this position but I got one of those contour pillows that helped me out. It since then has been a little deflated and not supporting my sleep as much. I found myself sleeping in ways to elevate my head pillow again. It may be pillow shopping time.

Missed my workout as the Women's Only Class was huge so I had to help out.

Shoulder impingement

Originally I was going to do this 7 days a week, but I think I'm going to take Saturday and Sunday off.

"Shoulder impingement" is a garbage diagnosis for pain. It doesn't signify exactly what's going on in the shoulder but it generalizes something gets impinged. That's it. Click here to read some of Weingroff's thoughts on sciatica and shoulder impingements.

Here are some factors that may influence the diagnosis from "Human Kinetics"
"Several factors can contribute to shoulder impingement. Structural or anatomic abnormalities might result in a narrower subacromial space. For example, some people are born with a curved or hook-shaped acromion that narrows the subacromial space. With aging, development of AC joint arthritis and bony spurs underneath the acromion can also narrow the subacromial space. The less room there is for the rotator cuff and bursa to travel, the more likely it is that these structures get pinched during shoulder motion.

A second factor is inflammation. Overuse or repetitive irritation of the rotator cuff underneath the acromion can lead to inflammation and swelling of the rotator cuff tendons and overlying bursa (tendinitis and bursitis). Not only are the inflamed tendons and bursa painful, but pain is aggravated when these inflamed and swollen structures get pinched or impinged underneath the acromion during overhead motions.

A third factor is shoulder instability, especially in young athletes. If the structures of the shoulder are ineffective in stabilizing the humeral head within the socket (glenoid fossa) during overhead motions, the humeral head might migrate upward out of the socket, causing impingement. Underlying shoulder instability is likely a primary cause of impingement symptoms in young athletes."

Click here to read more.

Saturday workout
WS4SB Day 5
A. Max 16" box squat, cambered bar, 90x3, 140x3, 160x3 170x3 (wts do not include bar wt) Very interesting how with the cambered bar you realize how much upper body momentum you use to get out of the bottom of a squat.
B. Db rev lunge 40# 3x12
C. Rev Hyper 3x12 50#,70#,90#
D. Ab Circuit 3x10 dragonflags, ghd sit-ups, ab wheel (limited Rom on all because still sore from TTB and feeling like I was going to get a hernia).

Monday workout
WS4SB Day 7
A. 2 board press (actually 1/2 foam roller on chest) 235x3
B. 12" incline bench 55# 2x15 (need heavier)
C1. BB row 155# 4x8
C2. T's 12" incline 10# 4x12
D. BB shurgs 155# 4x12
E. Hammer curls 25# 4x12

Why Zinc?

"Low zinc levels can decrease sperm output, cause testicular shrinkage, reduce testosterone, slow muscle growth, decrease immune function, cause gastrointestinal problems, slow wound healing and create problems with the skin and appetite.5 If we can assume that you are even mildly zinc deficient, then it is also reasonable to assume that you may be experiencing some of those symptoms, sometimes without even knowing it. Unfortunately, I see way too many athletes work really hard but miss out on gains because they're not addressing one of the most fundamental nutritional factors."

Enough said.

Read more from www.charlespoliquin.com

I'm not a fan of taking supplements but if someone can prove to me I should be and it makes a difference in 2 weeks then I'm game.

Bryce said if you have lines in your nails, it may be a sign of zinc deficiency. Read more up about signs and symptoms, I guess that is true as well as having white spots under your nails (which I have had before but thought it was from banging my nails against odd things at the box).

The pic also has the lines in the nails.

WS4SB Day4
A Max push ups 35/25/14 (not true max but stopped once speed slowed)
B1 Pull ups (wide, attempted chins but pain in elbow) 4x10
B2 Band Pull-aparts (black dbled) 4x12
C DB Milt Press 40# 4x10
D1 DB shrugs (Passed on these on workout 1, but since I didn't get to oly lift did these. I also guess I really need these since they sucked) Full powerblocks 3x10
D2 BB Rev Curls (tried curls, but pain in elbow) 3x10
5 3" pinch grip 25# 3x3

Magnesium OD

I rarely get 8 hours of sleep so for me it is important to get quality sleep. A while back BillyQ gave me some Natural Calm to try out and I couldn't really tell if it helped me out or not. As some time passed, I came back to some reading about magnesium and the benefits it has not only on sleep quality but other physical aspects. You can read more about magnesium here. Finally picked up some at Costco and gave it a true whirl. After about 3-4 days at 400mg, I noticed improved quality of sleep.

Bryce recently went to a Poliquin Bio-Signature Course and I asked him what Charles suggest for dosage? 2g a day for guys/1mg for gals. I guess my 400mg capsule I was taking with dinner wasn't cutting it. So I tried to take 2x pills with dinner and BAM. Sleep felt great! I woke up rested then like minutes after waking I have this pain in my stomach, like food poisoning pain. Go to the bathroom and it was like http://www.youtube.com/watch?v=qnT8hICaiNM. TMI, I know. So of course, I want to try and warn everyone once they start supplementing magnesium to split the dosages throughout the day.

So Kurt of course wants to try things out for himself because he's that type of guy (I am too, so don't judge) and has the same experience. Did I really borrow this guy my motorcycle? So after we laugh really hard about his experience of shock and awe, he came across this article http://drcarolyndean.com/2010/02/four-ways-to-stop-magnesium-from-causing-diarrhea/ which was a decent read. It's actually funny to think I never reflected on popular laxatives like "Milk of Magnesia"

Lesson learned:
Magnesium that is not absorbed by your bloodstream ends up in your colon where it has a laxative effect.

Cortisol

I feel like the previous post was more a rant than anything learned so here is something new for me. This is actually something not from the Weingroff DVDs.

This is from Precision Nutrition (Dr. John Berardi's site) and not sure the validity or the source of the research but probably enough to test if you have elevated levels of cortisol. He states sources at the end of the article but none that specifically would direct me for more information on the stated findings.

"Time of day and time of eating

The degree of cortisol release during high intensity exercise depends in part on the time of day and the timing of meals. When exercise is performed during a time of already high cortisol levels (for example, in the morning), it doesn’t increase above already elevated levels.

Cortisol secretion displays 7 to 15 spontaneous or meal-associated “pulses” throughout the day.

Cortisol circadian rhythms are closely coupled to the sleep-wake cycle. Peak cortisol release occurs between 7 and 9 in the morning, the time of dark-light transition."

Click here for a link to the article.

Back Pain

Now that I have drawn a couple of people to my blog, I'm going to have to address their specific concerns. I'm not going to name any names but I possibly sent you a personal email. Lower back pain and immobile hips. So if you haven't, take the time to read the article I wrote for the CFC blog on "Mobility and Stability". This is important to understand the joint by joint approach.

If a joint doesn't have enough mobility, it is going to ask the next structure to do what is not it's responsibility. So for all you lower back pain people, if your hips have mobility issues, it's going to ask your lumbar spine (which supposed to be a stable structure) for mobility. One of the best movements to see this concept is the overhead squat.

So, looking at the diagram above there is no contention that the load must remain over the f. line or mid foot or in the frontal plane. So, in the case of immobility in the hips, the angle of A. decreases and cause shear force on the lumbar spine because of the lengthening of the spine moment arm. If we want to delve further we can look at the opening of angle 90-A (which is 90 degrees minus A) requiring more flexibility form the shoulder joint and taking it out of proper alignment of being supported by the scapula.

Like I said, I like the OHS to describe this concept but it goes much further. If you have lack of mobility in the shoulders what happens when you get weight overhead (as in a press)? You jam your head forward because the coach want to see your ears. You put this ridiculous arch in your lower back. The coach then proceeds to tell you to tighten your abs. You tighten your abs and lose the weight out front because it is no longer in the frontal plane. This is the best pic I can find so you'll have to imagine weight overhead. So what did you do? You have lack of mobility in your shoulder (gleno-humeral joint) so you are throwing your cervical spine forward to get your ears seen, not able to stabilize correctly with your scapula (shoulder blades) because the lack of mobility doesn't allow them to be secured correctly by the rotator cuff and to top it off you are asking for additional movement from your lumbar spine to make everything happen.

What is the answer and what should you do? DON'T PRESS OVER HEAD. Work on your shoulder mobility. It's f*cking up your lower back. That's it. That simple. No overhead work until you can get the required mobility. Sad thing is that because of this ego thing that everyone swears they have checked, we wait until something is broken until we fix it.

Wow! That took much longer than expected. I know there is a ton of information in here. I have just fed you water through a fire hose. Please post questions to comments so everyone can see them. I will try not to answer them at the box or via email so ask them here. Also, if you think that I'm talking about you... I probably am.

WS4SB Day2
820pm
A1 Vertical Jump 10x2 (was supposed to be 8 sets)
B1 Barbell step up 16" box 155#s 3x8 (found a little asymmetry going on, left leg initially stronger)
C2 GH Raises 1x12 2x8 (supposed to be 3x12 but hammies couldn't take it)
D1 Controlled TTB 4x8 (supposed to be 4x10 but over come by gross amounts of weak sauce)

About an hour later, I realized that I haven't eaten all day.

Ankle Sprains

Theory is that weak hips contribute to ankle sprains.

Ankle sprains could be looked at as a result of inversion and plantar flexion. So considering the hip is responsible for the proper alignment of the femur and the tibia, the weaker the hip, the shakier the structure. So the glute med provides control to the frontal plane, while glute max controls the rotational force.

So the weakness of the hip may not be the sole purpose of a sprained ankle i.e. if you landed on someone's foot, a 5th of vodka on Elston, or kicked a puppy, the severity of it may have been lessened or amplified by the control of the muscles of the hip.

"The connection between hip, knee, and ankle pain."

Because the hips are responsible for a good portion of alignment of the legs, runners (particularly females with knee pain) are frequently diagnosed with tight IT bands and weak glutes (IT band syndrome), thus contributing to an unstable structure that is repeatedly used over and over in the gait process. This causes the knee to be a mobile structure when it is supposed to be a stable joint.

Almost forgot my workout info:
Day 1 (WS4SB)
A1 Bench press 225x3 245x2 (f*cked that one up was suppose to do 3-5)
B1 12" Incline DB bench press 55#x15x2
C1 DB rows 90#x8x3 (felt a little easy up reps)
C2 Face pulls black band 12x3
D1 Shrugs (skipping because of planned oly skill work)
E1 Curls (yea I did curls, actually hoping it will help rehab my ulnar nerve irritation) 30#x8x4

Evil Anterior Weight Shift

Still on some Weingroff/Janda stuff.

Anterior weight shift always screws up movement patterns.

Hip Flexor Paradox:
The squat is a hip flexion movement, so why would hip extension be so important to the squat?

All right this one took me a couple of re-listens and some internet research.
So, as we stated all anterior shifts are bad ie why when we explain the squat it is always "hips back and down". If the hip is restricted in extension this causes an anterior shift. This anterior weight shift requires the hip flexors to stabilize the pelvis rather than making the core do the work. The core should be doing the work allowing the hip flexors to be mobile controllers of the mobile hip.

Like I said I had to listen to it a couple of times to understand it. Here's the link:
http://www.sportsrehabexpert.com/public/264.cfm
If you are already familiar with all the joint-by-joint approach stuff, the paradox stuff starts about 30min in.

I'm also sure this man has no mobility issues: Kendrick Ferris

The Windlass Mechanism

I'm going to figure the next couple of weeks is going to be of small tidbits of the Weingroff CD. He goes into this short section on the Windlass Mechanism and I wasn't too familiar so I did some research.

The Windlass (pronounced wind-less)mechanism.

From Asics Tech:
"The Windlass Mechanism is the coordinated action of the layers of muscle, tendon, ligament and bony architecture, to maintain arch height and foot rigidity . Without correct windlass function, the foot will not act as an efficient lever, and effective push off power cannot be achieved at the end of the stance phase."
It is made up on the calcaneus, the midtarsal, and the first metatarsophalangeal (which also has an additional feature of 2 sesamoid bones)

A really cool video on the Windlass Mechanism:


This may sound like pointless information but if you think of the consequences up the chain for an immobile big toe or even a temporary stubbed toe for a runner that packs in miles, it really is something to consider in training.

A True Professional

I haven't blogged in a bit. I've been a little busy with the birth of my son Jackson. I'm so truly blessed. I haven't trained in a while but it has given me the opportunity to pick up on some continuing education and business things that I have been slacking on.

The 10,000 hour rule
It is said it takes 10,000 reps/hours of deliberate practice to be come a master at a skill. As much as I'd like to, I can't commit to 3 hours a day for the next 10 years to become a master at anything. So the least I can do as a true professional is to commit to learning something new everyday in my field.

Starting off I've recently been watching Charlie Weingroff's DVD Training=Rehab Rehab=Training. First, thoughts: this is one smart dude. Haven't even got through the first DVD and there are tons of things that I like. He breaks things down in a very down to earth simplistic, understandable way.

"Stability is the control of movement in the presence of change."
So simple, yet phenomenally great in terms of training.

We as coaches often think of the rotator cuff only as something that rotates the shoulder. The rotator cuff should more so be looked at as a dynamic stabilizer. Functionally the rotator is there to "compress the joint. It pulls the humeral head in and down into the glenoid fossa to create stability."