Competitor Running Article: Benefits of the Single-leg Tube Squat

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One version of the 1-leg tube squat.

The Benefits of the Single-leg Tubing Squat is for runners who want to build leg and hip strength that will transfer to running. This exercise may help you overcome knee and hip pain as well whether you’re a runner or not. There are three variations on this exercise and all are discussed in the article. This is my second article for Competitor Running. (Those pretty pictures were taken by my wife with her fancy new camera.)

Posterior Tibialis Tendinitis: The Resolution

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I wrote recently about my experience with posterior tibialis tendinitis. This post continues the analysis of the problem and solutions that helped resolve the problem.

Posterior tibialis actions

The posterior tibialis (PT), and the gastrocnemius, soleus, and plantaris, (all muscles that attach to the Achilles tendon) overlap to some degree in how they function in gait. What do those muscles do you ask?

  • Concentric function (when the muscle contracts and shortens): plantar flexion (points the foot), inversion (sole of the foot turns in)
  • Eccentric function (when the muscle lengthens): decelerates dorsiflexion (bending of the ankle), decelerates eversion (sole of the foot turns out)

Gastrocnemius/soleus/plantaris actions at the ankle

  • Concentric: plantar flexion
  • Eccentric: decelerates dorsiflexion
  • The gastroc and soleus attach to the heel via the Achilles tendon.

In the case of my Achilles pain, I found relief from strengthening those calf muscles through doing a lot of slow, controlled heel lifts. I thought the same approach would resolve my PTT. I was wrong. I believe that my efforts at strengthening the PT and the PT tendon aggravated the problem and caused more foot pain. I believe my PTT was rooted in a rigid left arch and rigid plantar fascia.

Plantar fascia flexibility, pronation, and force distribution

For years I’ve noticed that my left arch doesn’t pronate (collapse) as much as the right. I believe this lack of movement is part of my problem. In my prior post, I asked the question, “Do you have the mobility to get into the position required by your activity?” As it regards my left arch and running, my answer was, “No.”

Among many runners, the word “pronation” equates to “bad.” That’s wrong. (Uncontrolled or excessive pronation is bad.) Pronation is a necessary movement that contributes to deceleration of the foot, lower leg, and the rest of the body during foot strike. As the arch collapses, the plantar fascia acts as a leaf spring, storing then returning valuable energy that helps propel the runner forward. This energy return occurs as the foot supinates with the arch lifting as the runner pushes away from the ground.

The plantar fascia isn’t the only participant in this process of energy absorption and return. All the muscles and connective tissue throughout the body contributes to the process. The tendons of the lower leg, such as the Achilles tendon and the posterior tibialis tendons, are highly active during this process. If everything is moving correctly, in control, and in a coordinated fashion then the impact forces of running are distributed efficiently among all of the muscles and tendons.

Now imagine if some link in this kinetic chain isn’t moving the correct way. If that happens then other regions and other structures of the body will be forced to handle more than their fair share of the load. Some sort of overload, injury, and pain is likely in this scenario. Specific to my case, I believe the lack of mobility of my left plantar fascia has contributed directly to my past Achilles tendon problems, plantar fasciitis, and to my recent bout with PTT. Plantar Fasciitis and the Windlass Mechanism: A Biomechanical Link to Clinical Practice is a literature review from the Journal of Athletic Training. This review provides the following pertinent comments:

“Researchers have also reported faulty biomechanics and plantar fasciitis in subjects with a higher-arched foot.1618 A higher-arched foot lacks the mobility needed to assist in absorbing ground reaction forces. Consequently, its inability to dissipate the forces from heel strike to midstance increases the load applied to the plantar fascia, much like a stretch on a bowstring.4

“A review of the literature reveals that a person displaying either a lower- or higher-arched foot can experience plantar fasciitis. Patients with lower arches have conditions resulting from too much motion, whereas patients with higher arches have conditions resulting from too little motion.4,16,19 Therefore, people with different foot types experience plantar fascia pain resulting from different biomechanical stresses.” 

(The article is thorough and informative about foot mechanics. If you’re a runner suffering from foot problems, a running coach, or a clinician who treats these issues then I think it could be valuable to you.)

Exercises that helped

  • I foam rolled the calf. You probably know how to do that. If not, look on Youtube.
  • Band eversion/dorsiflexion: It’s one of the exercises discussed here. I did and continue to do the exercise with very high reps. It looks like this:

    Plantarflexion/Inversion

    Plantarflexion/Inversion

Dorsiflexion/Eversion. Think of pulling the pinky toe to the outside of the knee.

Dorsiflexion/Eversion. Think of pulling the pinky toe up and to the outside of the knee.

  • Bent-knee heel raises: I used high reps but there is probably benefit to using heavier weight with fewer reps. There are machines for this exercise at many gyms. I don’t have access to such a machine so I did it by stacking up some sandbags under the front of my foot and putting a dumbbell on my knee. I worked to high exertion for several sets:
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  • Arch mobilizer: It takes time to make changes to tissues so I do this frequently throughout the day.

  • Gait check: This is HUGE! In my first meeting with running coach Andrew Simmons of Lifelong Endurance, he noticed several problems with my gait. These were problems seen in the past with my gait.
    (This illustrates the immense power of working with a coach. I don’t know what I don’t know and I can’t see what I can’t see—and neither can you! My technique had slipped and I didn’t know it.)

    • My ground contact time (or how long my foot was on the ground) was too long. Thus, my feet and lower legs spent a lot of time transmitting stress through my lower leg. That may have been a part of overloading the PT tendon. This long contact time was probably a result of…
    • A low-energy gait. My legs weren’t rebounding off of the ground sufficiently and the whole gait cycle was sluggish. Now, as I run, I think of a strong, quick, powerful push into the ground. I drive the leg behind me, and I push the ground behind me.When I run correctly, my foot spends less time on the ground and the tissues spend less time under stress and I’m more efficient. Read How to Run: Running With Proper Biomechanics by Steve Magness for details on running technique including the need for hip extension.

Finally

Solving the riddle of the sore left foot has been a prolonged, tricky struggle. Every time I find relief I think I’ve solved the problem only to have some other problem pop up later. That said, I now think I’ve figured it out. I could be wrong. Maybe some of this information will help other runners overcome their foot and ankle troubles too.

Got Shoulders?

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The shoulder joint is the most mobile joint in the body. That’s a good thing! When combined with good spine mobility, our shoulders allow our arms to reach, throw, pull, and push from all sorts of angles.

A consequence of being mobile is the possibility of being highly unstable. Instability, or the inability to control a limb, may lead to the common aches and pains that many of us experience in our shoulders, elbows, and possibly even the wrists. Why might instability and pain happen? (My answer will be limited to chronic pain, not acute injuries such as fractures and dislocations due to falls and other accidents.)

My belief is that shoulder problems (and most other movement problems) are rooted in a use-it-or-lose-it dynamic. Our modern lifestyle is characterized by limited movement. As adults, we rarely crawl on the ground. As modern humans, most of us don’t have to climb trees or pick up heavy things and put them overhead. We typically sit with our arms in front of us as we type on keyboards, drive cars, and operate TV remote controls. Thus our movement skills stagnate. Our brain and nervous system loses the ability to coordinate the many movements available to us. But then we might decide to swing a golf club, swim, lift weights, attempt pull-ups, pushups, throw a ball, or reach into the back seat from the front seat. Unfamiliar movements—especially if done with high force, high speed and/or done at end-range—may be too much to ask of our deconditioned shoulder complex. Then we get pain.

The following videos are designed to help restore mobility and stability to the shoulders. Pay attention to how you move as you do them. Don’t speed through them. Always be in control of the exercise, don’t let the exercise control you. If it hurts then back off or stop. None of these drills are guaranteed to fix any specific problem you may have. You may need to see a physical therapist or some other injury rehab specialist.

For the corner stretch, keep you eyes up a little bit. Don’t let your head and neck flop forward.

For the rotator cuff complex, use high reps, maybe 15-20 reps.

The halo can be varied in some ways not shown in the video. Try the halo while in a hip-hinge or deadlift-like position. Use a light weight.

Feet & Toes Should Be Strong and Able

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When was the last time you walked into the gym and said, “Okay, it’s foot day! Let’s get to work?”

Most of us aren’t too excited about building strong, healthy feet, probably not until we encounter pain. But why not? After all, it’s only every single step that we need those lower appendages to work well. Unless you don’t have feet, unless you walk on your hands, or maybe unless you live on a planet without gravity, then there’s no question you need a pair of mobile, stable, well-functioning feet.

And if we encounter foot trouble then we want to put in an orthotic, buy shoes with arch support, or do something other than make the feet stronger. Why is it that we don’t think to treat the feet like the rest of the body? Why don’t we see the need to work the feet like all the other muscles and body parts we have? I suggest that rather than resort to external aids we should work the feet in a wide variety of ways.  Here are a few ways to do just that.

I don’t promise that any of these exercises will fix a specific injury. If anything hurts then back off. See a physical therapist, chiropractor, or podiatrist for a full diagnosis and treatment strategy.

Big toe adduction/abduction

There’s no fancy name for this exercise. You can experiment with all sorts of bands. Please notice that I do this exercise under control. I’m controlling the exercise, the band isn’t controlling me. Allow the big toe to come in far enough that you feel a stretch.

Toe differentiation (aka yoga toe)

Can you do this? You should be able to. It may seem 100% impossible when you first try it. Keep working on it. Most people can figure it out in a day. Takes work and concentration. Take notice of my arch and inner ankle. Notice that the arch doesn’t drop, and my ankle doesn’t dive in as I move my big toe.

Toe grabs on a box

Sounds like one of Vincent van Gogh’s very obscure works. It’s not. I just don’t have a better name for it. It works well though. I learned it from Denver chiropractor extraordinaire Dr. Nick Studholme. You can do this on the top of a flight of steps or over a book.

Funny walks

This is a quick, easy way to engage, stimulate, and strengthen all of the muscles of the lower legs and feet. Try it and see how you feel.

Reading & Learning: “Real Movement” by Adam Wolf, PT

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I am reading with much enthusiasm the book Real Movement by physical therapist and massage therapist Adam Wolf, aka the Biomechanical Detective. In a big way, it’s like re-reading a very good book that I’ve enjoyed in the past. I am familiar with a lot of the concepts discussed by Adam and what I enjoy immensely is coming back and examining those concepts through his eyes and his experiences.

Wolf is among other things, a Fellow of Applied Functional Science (FAFS) by way of the Gray Institute. I also study and apply Gary Gray’s material. I always like to see how other practitioners apply the principles of 3D movement. I love gaining new perspectives on how to create functional exercises, or exercises that most translate to real life. You can see a lot of examples of this at the Adam Wolf, PT, Biomechanical Youtube Channel.

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If you ain’t got that sling then you ain’t got that swing.

Something I just learned is that Adam’s dad is Chuck Wolf, another functional exercise and movement professional. Many years ago I was introduced to the concept of Flexibility Highways at one of Chuck’s seminars. These highways aka muscle slings, aka myofascial lines, are networks of muscle and fascia that often  work together during real-world, whole-body movements. (“Real-life” movements are in contrast to many of the artificially isolated movements that we see in gyms, especially those performed on machines.) One example is the posterior oblique sling as used in a golf swing. Another example is the anterior oblique sling used when throwing.

The anterior X sling is a big part of throwing, batting, golfing, running, punching and all sorts of things.

The anterior X sling is a big part of throwing, batting, golfing, running, punching and all sorts of things.

The fascial sling system was an interesting concept to me at the time but it has sort of faded from my thinking in recent years. Now, reading Adam’s book and watching his videos has brought those flexibility highways or slings to the front of my mind. These sling concepts are informing both the mobility work I’m doing with clients as well as my exercise selection. In working along and within these sling systems I feel like I’m capturing just about all of the movement we humans are capable of. Check out the following videos from Adam Wolf where he discusses how you can move better by following these fascial lines.

Hip Adduction Part II: Solutions to Mobility and Stability

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In Part I of this series, I discussed what hip adduction is and why it’s crucial for good movement, balance and sports performance. In this post I’ll give some ways to self-assess your hip adduction and increase your hip adduction mobility, stability and power.

There are many ways to investigate and train hip adduction. I do not propose to cure what ails you with any of these exercises. If you’re in real pain then you need to see a physician.

(I realize now in watching the videos that I use the term “frontal plane” more than I say “hip adduction.” Please consider the terms interchangeable for the purpose of this post.)

Check your ability to move into hip adduction. Check both right and left sides. How do they compare?

Now check your stability. Can you control your hip adduction?

Try this mobility matrix to gain more hip adduction. You may need more on both sides. The great thing about this matrix is that you’re not only address the hip but you’ll also be mobilizing other joints in concert with the hip.

This movement series is a more aggressive way to challenge hip adduction while at the same time getting an upper body workout.

The next three exercises are a few ways to challenge and develop hip adduction mobility, stability and power. These can be used for athletic training purposes or simply as fun ways to tweak familiar exercises. All sorts of implements can be used:

Hiking the Maroon Bells – A Training Plan

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My wife, our friend, and I recently completed a big hike, known as the Four-Pass Loop in Colorado’s Maroon Bells Wilderness. That part of Colorado is a truly world-class mountain wilderness. Mention “Colorado,” and most people will conjure images of this place in their minds. The scenery is as dramatically breathtaking as as anywhere on this planet. We were surrounded by massive 14,000 ft. peaks, high alpine forest, natural mountain lakes, and waterfalls. It’s difficult to describe how spectacular this trip was. I highly recommend it to anyone with a taste for outdoor adventure. Just be prepared. This trek was not a casual, easy jaunt.

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Crater Lake and the Maroon Bells looming behind.

The hike covered about 28 miles (Mileage varies depending on where you enter the loop.) and crossed four high-mountains passes each one above 12,000 feet. We took 2 nights and about 2.5 days of travel to get the job done.

Snowmass Peak and exquisite Snowmass Lake.  Trail Rider Pass is way up to the left.

Snowmass Peak and exquisite Snowmass Lake. Trail Rider Pass is way up to the left.

We carried about 30 lbs. of gear and food on our backs. The pack weight plus the elevation and the frequently very technical rocky, rooty terrain made this trip especially challenging. I’m happy to say that while it was by no means an easy task, I felt good, strong and entirely up to the event. I was pleased with my conditioning for the trip. Here are some notes our my preparation.

Specific hike training: Hike!

As I’ve said before in this blog, the best way to prepare for a specific event is to do the event. In this case, we planned to hike anywhere from 6-10 miles per day, over high mountain terrain, with heavy packs. Thus our training consisted of several long hikes with loaded packs. In addition to weekend hikes, we spent several weeks wearing our packs during daily walks with our dog. The idea being that we needed all the time we could get wearing loaded packs. We might’ve looked odd walking the streets in big backpacks, but oh well. Let that be someone else’s concern.

To be clear and emphatic: The best training for hiking, is hiking.

This is me doing my best impression of a hiker on Buckskin Pass.

This is me doing my best impression of a hiker on Buckskin Pass.

 

I’ve been running and cycling for most of the year. I believe both activities have helped provide me with the type of cardiovascular ability to sustain multi-hour hiking at high altitude.

Going back to the idea of specificity, trail running is a close relative of hiking and is a clear choice of exercise for hike preparation. Trail running seems especially effective at preparing not only my heart and lungs but also my feet and ankles for the demands of extending hiking. Walking and running over uneven ground requires the feet and ankles to move through a galaxy of angles and it’s a great way to fortify those lowly and under-appreciated appendages.

The muscles of hiking and weight training

Marching uphill is especially demanding of hip extension and the requisite muscles, particularly the glutes and hamstrings. In contrast, hiking downhill requires strength and endurance of the quads and control of the pelvis by way of the hip abductors. Lost balance and a nasty fall may be the price for poor pelvic control.

With these ideas in mind, I’ve spent much of the spring and summer doing exercises such as lunges, split-squats and step-ups. Those exercises seem very effective for addressing the demands of hiking.

I particularly like what I call offset lunges, split-squats and step-ups. These are done by holding a kettlebell or dumbbell on one side of the body, thus creating an asymetrical, offsetting effect which presents different demands than a typical squat or deadlift.

If we look at real life—particularly hiking—it’s rare that we’re balanced evenly on two legs while working against a load that’s distributed in a symmetrical way on us or against us. So I believe that exercises in which one leg is doing more/different work than the other while the forces of gravity are applied in asymmetric ways are very valuable. (Not that more conventional, symmetrical exercises aren’t of value.) Here are some of those exercises:

I also started deadlifting several weeks prior to the hike.  Even with a properly fitted pack, there is a lot of weight and work going through the back and hips. I knew I’d be putting on and taking off a heavy pack and I thought a deadlift would help prepare for that task.

Upon review, I believe a back squat or a good-morning might be superior to the deadlift in that each of those exercises put weight on the back, thus resembling a loaded pack on the back. (See, symmetrical exercises are good too!)

The future

I’m contemplating running the 4 Pass Loop. Others do it (Read some accounts herehere, here, among others.) and though it’ll be a fairly massive bite to take, I think it’s in the realm of possibility for me. I was very happy with the speed with which I was able to move during the hike. I’m thinking of what it would be like with a lot less gear, lighter shoes, etc. I think it’s feasible. So I ordered my first running vest and I’m contemplating what I’ll need to pack into it. The big run might happen next year…

 

Hip Internal Rotation: You Need It.

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All human movement can be described in three dimensions. We move in the saggital plane (front/back), frontal plain (side-to-side), and the transverse plane (rotation.) Certain movements are one-plane dominant: Distance running is mostly a saggital plane movement. Swinging a baseball bat is mostly a transverse plane movement. Ice skating and rollerblading feature a lot of frontal plane movement. Still, each of these movements also contain elements of the other two planes.

(Beyond moving in these planes, we also must stabilize our limbs against forces that are trying to move us in each of these planes.)

In my observation, a lot of people lack movement skills in one or more of these planes. Many times it seems clients lack adequate transverse plane movement, especially in the hips where the femurs attach to the pelvis. (We describe transverse plane hip movement as internal and external rotation.)  If we lack good transverse plane hip movement then we may have trouble with all sorts of activities from walking to running to skiing to golfing. Poor transverse hip mobility may result in back pain, knee pain or even shoulder or neck pain. Restricted transverse plane movement may also negatively impact sports performance.

I’ve found that restrictions in the transverse plane are often hidden. , Many people may feel tight hamstrings, tight pecs, or tight neck and upper back muscles, but rarely do I hear encounter a client who’s aware of something that doesn’t move well in the transverse plane. It seems a lot of us are walking around with no clue that we lack adequate rotation in any of our joints.

Why might an individual lack internal or external rotation? It could be any number of reasons. I believe our modern, seated, immobile lifestyle is probably a major contributor. Other reasons could be an anteverted or retroverted femur. These are structural issues of the femur that can’t be changed. Some sort of past injury could also be a culprit. All three issues could be at play.

I rest my case that hip internal and external rotation is important.

Here’s a video discussing hip internal rotation, why it’s important, and how to achieve it. Live it up kids!

Got Dorsiflexion?

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The toes, feet and ankles get no respect. I’m not sure a lot of people walk into the gym and say, “Okay, today is foot and ankle day! Gonna work those parts hard and make ’em strong!”  We throw shoes on them and ignore them. Think about this though: It’s only every single step that we need those obscure parts to work correctly.

If we look at the body as a kinetic chain then we start to see that the feet and ankles don’t live in isolation. Movement or lack there of at the feet and ankles may create problems all the way up through the legs, hips, spine and shoulders. If an athlete doesn’t have sufficient motion at the ankles then he or she may not perform at his or her best.

Similarly, limited foot and ankle motion may be a contributor to pain. I’m not just talking about foot pain either. Again, if we consider the interconnectedness of all the joints and limbs of the body then it may not surprise us that faulty foot/ankle movement could contribute to back knee pain, hip pain, back pain — even shoulder or neck pain!

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Dorsiflexion: There’s no substitution for it!

In my observing both my clients and myself, I see a lot of us don’t quite have optimal  dorsiflexion. It’s easy to overlook but as I’ve argued, it’s very important. I know in my case, my various plantar fasciitis/Achilles tendon issues have improved as I’ve worked on my dorsiflexion. (Strictly speaking, I don’t know if limited dorsiflexion was a cause or effect of my foot and Achilles pain. That said, working on improving dorsiflexion
has coincided with those problems fading out.)

Dorsiflexion is more than just forward and back motion. There is always a 3D aspect to movement and we want to consider that. Also, We have a couple of different muscles (well… more than a couple but we’re considering mainly just two) that cross at the ankle. The following drills emphasize both the gastrocnemius muscle (the straight-leg drills) and the soleus muscle (the bent knee drills.)

Thoughts on Ski Conditioning

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The big running season is over and now the snow is falling. It’s almost time to put the sticks on the feet and slide down a mountain!  Fun on top of fun! It might be a good idea to prepare myself as best as I can before I get out there. Here are some thoughts on how I might do that. Maybe they’ll help inform your own ski conditioning strategy.

Exercises should look a lot like skiing.

  • Some sort of squat should probably be employed, but a conventional barbell front or back squat may not be adequate. I discuss more of my thinking on this here and here.
  • Tri-plane movement must be considered. For example:
    Look at those joint angles. That is no mere squat.

    Look at those joint angles. That is no mere squat.

    • My hips will go back and forth between flexion + internal rotation + abduction on the downhill leg then more flexion + relative externall rotation + adduction on the uphill leg. The hip, knee and ankle joints must move well and the corresponding muscles must lengthen and contract repeatedly.
    • In addition to that hip movement, my thoracic spine should stay aimed downhill so I’ll be doing a lot of rotation through the trunk. Like the leg muscles, my trunk muscles must be able to manage the repeated loading that will happen.
    • I need adequate range of motion and control of that range as I move downslope.

Energy system conditioning

Good movement is massively important to good skiing. Adequate stamina is also a major consideration. I want to be able to last for a while and be able to have fun all day. If I fatigue too soon then it’s likely my movement skills will be compromised and I could get injured.

I have a good base of general endurance but I need to make it a bit more specific to skiing. A typical ski run involves powerful turning and management of variable terrain, sometimes for several minutes. Then I rest on the chair lift for several minutes and do it again. This cycle may repeat itself for several hours. Also, alpine skiing involves a lot more knee flexion/extension compared to running. My quads typically bear the brunt of all that knee movement so I’ll need to condition them appropriately. How will I do that?

Ski circuits

My plan is to put together several exercises that will target the muscles and movement patterns that are vital to skiing and I intend to them at a pace and for a duration that affects the appropriate energy systems. Here are some examples:

My most recent workout put together some conventional strength exercises and put them together with some ski-specific exercises in a super-set. It went like this:

Super-set 1

  • barbell clean + front squat: 1+5 (did as many reps as possible on the last set); two warm-up sets
  • pull-ups: 7 reps
  • 1-leg pivots aka balance reaches x 10/10 reps to each side; An example:
  • Repeat 3-5 times as fast as possible.

Super-set 2

  • Bench Press: 5 x 3 sets (did as many as possible on the last set); two warm-up sets
  • Various 3D jumps with the ViPR x 20 reps; Here’s an example of one version of the exercise using a sandbag instead of a ViPR:
  • Repeat 3-5 times as fast as possible

Super-set 3

  • cross court sprints on the basketball court x 4
  • odd-angle medicine ball squats; something like this:
  • Repeat 3-5 times as fast as possible.

There are lots of possibilities out there!